Eating disorders: "simple" solution, complex issue

Eating disorders can be hard to understand. What seems like a straight forward “skewed vision of one's body” is rarely this simple.

Providing a fridge full of good food or begging people with an eating disorder to "just eat!" very rarely works. No matter how minor the problem seems to be (and it is common to scoff it off as not serious enough for therapy) professional help is needed to recover. One problem that tends to be underestimated is binge eating disorder. Unfortunately, many people who suffer from BED have the same body image problems as people with anorexia or bulimia.

Why professional help? Because they help the sufferer deal with all the major complexities of an eating disorder. Believing yourself to be “fat” when you are thin (or a normal weight) is only one of the symptoms of an eating disorder. A major component that goes one step deeper is the fact that self-worth is based on weight. The higher the weight, the lower the self-worth. Rather than looking at all aspects of life that make up an evaluation of one’s self, like being a nice person, a good student, a kind daughter/son, punctual, reliable, etc-  weight is the most important aspect.

This is why exploring more than just body weight is needed for recovery. Specialized psychologists and dietitians can help with all behaviors of an eating disorder to help increase other aspects of life that make up self-worth.

When weight loss is the goal, no amount of weight lost is enough. Food becomes feared since it brings the person farther away from their goal of weighing less. This fear can be compared to a fear of dogs. If someone has an intense fear of dogs, they will likely do anything they can to get away from one or avoid being close to one. This intense fear can lead them to do things that puts their life in danger. Imagine running into traffic after being scared by a dog on the street or being confining to the house since there may be a dog outside. Neither of these behaviors are healthy but they are done to avoid the dog. Similarly, if someone is scared of food, they may avoid social situations where food is the main event, live with a dangerously low body weight or even sacrifice their teeth to get rid of any food eaten.

So, would offering food to someone who is scared help to decrease this fear? Well, in the short run, no. It is a process that takes time. Small exposures to the thing that is feared (whether it be dogs or food) and working up to the equivalent to petting a dog works best. Although someone who is underweight would benefit from eating high calorie foods, it takes time to work up to being able to do it. This process is best done with the help of a professional to help guide and provide support. Usually it starts by adding “safe” foods to a routine and progress to more “scary” foods.

One thing that has been proven time and time again, is that returning to a healthy weight by eating the foods your body needs is the most effective treatment for an eating disorder. 

Binge eating disorder demystified

We've all heard of "binging" or an eating disorder called "binge eating disorder", but so many people don't understand exactly what it is or how to identify it. This is especially true of the very people who suffer from it. Too often the sufferer will blame themselves and and their "lack of self control".
Take Joan, for example. She was a client of mine who had followed many diets in her lifetime and as a consequence, her weight had fluctuated by about 15 pounds up and down for the last few years. She did not understand why she just could not just keep off the weight after following low carb diets, and why she could not stop eating food even when she was full. She believed she was "addicted to food" and always wanted to lose just 5 more pounds to feel better about her body. She was convinced that she needed to have more firm rules about what to eat and that if she didn't have rules, she would go crazy eating "bad foods". Unfortunately, this way of thinking is very common despite the fact that strict food rules lead to binge eating. "Lack of self control" is in quotation marks because binging has nothing to do with self control, and has everything to do with strict diets, food rules and vilifying certain foods.

Understand the complexities of this disorder and identifying what you are struggling with is key to finding the right help. Here are the criteria for identifying binge eating episodes (binge eating disorder is when a person suffers from recurrent episodes of binge eating) : 

1. Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances and 
2. A sense of lack of control over eating during the episode (for example, a feeling that you cannot stop eating or control what or how much you are eating). 

Binge-eating episodes are also associated with 3 (or more) of the following:

1. Eating much more rapidly than normal.

2. Eating until feeling uncomfortably full.

3. Eating large amounts of food when not feeling physically hungry.

4. Eating alone because of feeling embarrassed by how much one is eating. 

5. Feeling disgusted with oneself, depressed, or very guilty after overeating.

6. Marked distress regarding binge eating is present (meaning, you or your friend is unhappy and stressed about binge eating).

7. The binge eating occurs, on average, at least 2 days a week for 6 months.

If you or someone you know is suffering from binge eating disorder, you are NOT alone. There ARE things you can do to help overcome binge eating (and beating yourself up for not having enough "self control" is certainly NOT part of the treatment). Firstly, it is invaluable to seek help from a knowledgeable dietitian or psychologist who specializes in eating disorders. Understanding why you binge eat and what is influencing you to do so is key to stopping the binge eating cycle. If you live in the Montreal area, contact me to discuss finding an expert who can help you today. 

when is YOUR vulnerable hour?

So many people get frustrated with their latest "cheat" or guilt trip. After hearing many stories from my clients, it started to become clear to me that there are times during the day in which we are more likely to make unwise food decisions.
This "vulnerable" time may be influenced by a number of different factors: low energy levels, high stress levels, the feeling of being over worked and the need for recompensing, the feeling of deprivation after a very low calorie day, etc. If you can identify your most vulnerable time during the day and understand what influences the strength of the cravings, then you are one step close to being able to handle even the toughest of temptations.

One of the best tools for helping you to ID what emotion or situation is influencing your eating and food decisions is a food journal. Tracking not only what and how much you eat, but including information about how you are feeling (emotions like stress, sadness and boredom) or whats happening around you (getting dinner together while helping the kids do their homework, or sitting at desk working on a late report) can give you valuable insight as how they influence your eating. Patterns may emerge and by understanding what to do to avoid being in a potential trouble situation can make things a lot easier.
Being aware of when you are most likely to overeat, eat when you are not hungry, or make unhealthy choices can help you better prepare a counter attack. Surrounding yourself with healthier choices or giving yourself options during this time is a good first start. For example, if you tend to eat a snack the minute you walk in the door after work (even though dinner is only 30 minutes away), perhaps planning to take a walk or do the laundry rather than heading to the kitchen would help. Another solution could be to prepare a healthy snack ahead of time so you don't have to go rummaging through the kitchen.
Sometimes ignorance it not bliss, and understanding when your vulnerable time is, can help you manage your weight.