When fat things happen to good people. On being thin, fat, and your false assumptions.

"Such crazy thoughts in that Aussie article!"

Do you think that if only you do the right thing—eat a healthy diet, exercise, get enough sleep—then you will achieve your dreamed of weight, live free of disease and live happily ever after? This, dear readers, is a fairy tale. 

If you believe that eating nutrient packed, low calorie foods is solely responsible for whether or not you get cancer, or arthritis or MS, think again. And don’t be fooled by the preaching of Dr. Fuhrman in his book, Eat for Health, that health equals nutrition divided by calories, period. Health is not such a simple equation. And no, eating whole grain, veggie packed meals won’t protect you from an eating disorder either. 

If you think that eating 'right' ensures thinness, as was recently emphatically suggested in a popular newspaper article in Australia, it is yet another fantasy.

And if you torture your overweight self with the belief that you must lose weight--at all costs, and that your inability to reach target goals based on BMI charts is your personal failure, you’re wrong again.

“What is she thinking?” you’re thinking? Let’s start from the top. 

Eating healthy equals health

Yes, diet can impact many, many health measures. And I certainly encourage a balanced, varied diet filled with a complement of vitamins, minerals, antioxidants, and an appropriate level of fiber, to name a few. Yes, there are correlations in populations that have higher intakes of alcohol and saturated fat, for instance, with increased rates of cancer and high cholesterol, respectively. And a nutrient-rich diet chock full of antioxidants and lycopenes, like those found in tomato-based products, may help stave off such conditions as Alzheimer’s, cancer, and other diseases. But eating a proscribed diet will not guarantee your health. Nor will it ensure happiness, which is not to say I don’t encourage making healthy choices—I surely do. But do not, for a moment, think that if you are fortunate enough to stay healthy (or unfortunate enough to become ill) that it is solely by your hand. Credit your parents for their genes, to start.

Fallacies about thin

And do you know what? Eating well does not ensure thinness either. I see my share of patients who choose the most wholesome foods, but eat in excess—even those nutrient rich, heart healthy foods, like avocado and almonds, lean protein and kale. By excess I mean frequently eating without regard for hunger, and eating past a point of comfortable fullness. And eating well—high quality, nutrient-rich foods—even eaten mindfully and intuitively—may not keep you slim. Yup, it’s a sad truth that many of you don’t want to hear. And in fact, the very act of pushing your body to be a weight it is not meant to be, may put you in worse shape—both physically and psychologically. Just wait until you hear about these studies!

Stay tuned. That’s my next post, based on fascinating research presented at the Renfrew Conference I attended last weekend.

And those who are thin do not necessarily eat well and are often hardly fit by any standard. Do be careful about equating weight with health because they do not always pair up as you’d expect. Individuals may be thin because they are genetically predisposed to be, or they may be thin because, in contrast to what journalist and dietitian Susie Burrell believes—that they “know what to do to control their weight”—they may fall quite short in controlling it appropriately. They may be no better than someone who binge eats for emotional reasons at knowing “how to cope when things are tough”. Don’t be fooled into assuming that thinness is simply a lifestyle choice, a moral higher ground.

And I’d caution her, and you, not to overgeneralize about thin people’s skill at “assuming responsibility for self”. Just spend a few hours in my office; even those without eating disorders may allow anxiety or depression to stand in their way of eating enough. How responsible for self is the person who denies herself nourishment when low energy or headachy—hunger gone too far—or pushes herself to exercise even when she reports constant fatigue, or pain? 

Eat when they are hungry, stop when they are full? Some thin people may. But overgeneralizing about a segment of the population isn’t too intelligent. 

No, I didn't leave the rest over, for the record.

Thin people may self-regulate just fine. Or they may deny their hunger and fluid load or rely on high volume low calorie foods. They may eat nourishing foods, or a diet of junk—just not excessive in calories. Or they may compulsively exercise, hardly resulting in mental health, potentially leading to loss in muscle mass, heart problems and a range of symptoms if accompanied by undernourishment. Really, the only thing you can generalize about thin people is… that they are THIN. You can’t assume they are healthy, or happy, or good at self-care or self-regulation.

And of course the reverse is also true. The only thing you can tell by looking at a fat person is….? Yup. It’s that they are fat. You cannot predict their lipid levels or their blood pressure. You can’t tell whether they’ve never exercised or they exercise too much. And you can’t determine the quality of their diet.

My own parents are perfect examples of this, as I’ve written about previously. 

The mere suggestion that health is 100% in our hands I take offense to, as would the rest of the population which struggles with MS, and cancer, and ALS, and type 1 diabetes and arthritis and, and and… And I can say the same thing about a target weight or size. I hate to break it to you, but even if you do all the ‘right things’, you may not achieve your desirable, fantasized-about weight. And you know what? It’s not your fault.

Stay tuned for part two, (which I hope to get out within the week), which will address obesity, weight loss, and the risks and benefits of change.

Did this post push your buttons? Did it challenge your thinking? Did it offer some relief? Do let me know what you’re thinking! 

Thanks for reading, and if you liked this post, please share!

How Not to Be a Shrinking Woman

I don't know Lily Myers, whose YouTube clip follows, but I know lots of 'Lily Myers'. She is strong and powerful as she describes her mother and herself and the culture which helped to shape her, for better and for worse. She is painfully aware of eating disorders and the grip they can have on us.

Please watch it. But don't blame your mothers, or your grandmothers, just as you can't blame them for the cancer and diabetes genes they pass on to you.

http://www.youtube.com/watch?v=zQucWXWXp3k&app=desktop#!

And make your voice heard--please don't keep silent, waiting for all the others to share their seemingly more important thoughts.

What did you think of her poetry?

Reasons to believe in recovery? Take this simple, anonymous online questionnaire.

Perhaps you CAN rise above the clouds.

I don’t know the Harvard psychologist Dr. Sheila Reindl, but I have recommended her book Sensing the Self, many, many times over the years. It’s filled with wisdom about recovery from bulimia, honed from Reindl’s extensive interviews with 13 recovered women. (Not bulimic? Please read on! There’s something here for you too!)  Maybe I was attracted to it having learned that several of the pseudonym-ed women were actually past patients of mine, shared with a therapist who contributed these cases to the book. 

Or maybe that it meshed research with patient stories, extracting the essence of the recovery process into meaningful chapter themes. Personally, I hate reading books about recovery (but I read this at the insistence of a patient). That likely has mostly to do with the fact that I discuss recovery almost 40 hours a week. Do I really want to engage with strangers’ stories on my down time? I don’t think so.

Yet I likely suggest it because I believe it may help readers with recovery. Just as I recommend Schaefer’s fabulous Life Without Edand Arnold’s blog ED-Bites—long before it became chock full of valuable research interpreted into a language we can all understand.

I don’t know if reading recovery stories truly makes a difference in the recovery process—for better or for worse. But I’d like to find out! Because I’d like to have another tool available to help support recovery.

Can recovery stories show us the way?

Enter Lisa Dawson, an Aussie PhD candidate who has the very same goal and is doing the research to find the answers—and I reallyhope you will help! You may remember her name from previous research I referenced. Here’s the description of her research:

Researchers at the University of Sydney are interested in whether reading stories of recovery are helpful for current sufferers of anorexia nervosa. People aged 18 years or over who have anorexia nervosa or an eating disorder similar to anorexia nervosa are invited to participate. This study is conducted entirely online so anyone in the world can participate. Participation involves completing questionnaires on two or three occasions and reading five short stories about recovery. We are very interested in receiving your feedback about the helpfulness of the stories.

The study has been approved by the University of Sydney Ethics Committee and all aspects of the study, including results, are strictly confidential. We are hoping to have as many people as possible take part in the study. If you are interested in participating then please contact Lisa at lisa.dawson@sydney.edu.au.

So if you have a few moments, please email Lisa to learn more. And say hello for me!

Thanks for helping. Oh, and PLEASE share this any way you can!

Half full? What perspective has to do with recovery

It took me years to grasp this not-so-deep expression.  Rather than focusing on the full vs. empty, I'd get stuck with the half part. So while viewing a cup as half empty suggests looking at what's missing, and seeing it as half full connotes a positive outlook, I simply couldn't see it. The half empty description seemed rather positive to me. I mean, at least it's only 1/2 missing! I'm not sure I ever really contemplated half full—as in "it's just not good enough".

Take a look at the image to the right. What do you see?

And when you look at your body? 

Do you focus on all that's good about it, or get fixated on those parts that disgust you?

When you reflect on your eating yesterday do you highlight where you slipped, or acknowledge what was in place?

When you consider how you've eaten over the past week, do you recognize your mindfulness or your balance? Or can’t you get past where your eating, activity or behaviors were less than stellar?

Oh, and about that image above—did you note the black dot, a blemish of sorts? Or did you notice the full screen of white, of possibility?

Gratitude

Why would you take care of a body you despise—one you view as too fat, or weak, or unattractive? Why adequately nourish it, lovingly stretch it, gently exercise it? And why would you keep pushing for change if you can not appreciate the benefits of your efforts?

What if you woke up every morning with appreciation that you were still breathing, that you had the gift of another day? And what if you noted that, beyond the aches and pains, most systems functioned quite well? I know, I know—this maynot be the case for some of you. Persistent tinnitus (that high-pitched ringing in your ears), chronic hip pain, or knee or backaches, problems digesting or sleeping—these are nothing to be thankful for.

A patient of mine just told me about a buddy of his who's an avid hiker. He climbed all 48 4,000 footers in New Hampshire—an impressive feat, I'll tell you, as someone who knows those trails well; they're steep, rugged, filled with loose rock. It's certainly motivating, though, when rewarded with the stunning panoramas when we hit the peaks.

The only thing is, that successful hiker? He's blind, and hikes with a guide dog. Somehow I suspect he doesn't wake up and dwell on his lack of vision.

I really don't know. I am quite fortunate to have a body which functions at 100%, at least for now.

Do we need to experience the threat of loss of function to appreciate that our body works? Must we starve, or fast, to appreciate food? Can't we appreciate the power we have to change our reality, to shift our perspective?

Shift your thoughts

• Perhaps you purged this week, but only once or twice—per week, that is, versus per day.
• Perhaps you exercised, a goal you set for yourself, for 10-15 minutes per session—less than you intended, but more than you had managed to do in the recent months.
• Perhaps you overate, but stopped yourself much sooner than you usually do, preventing an all out binge.
• Perhaps you ate cookies, or cupcakes, but in reasonable portions, and perhaps you allowed yourself to finally taste them and thoroughly enjoy them. Imagine that!
• Perhaps you are beginning to give yourself credit for some positive actions you are taking—just not all the time. 
• Perhaps you can begin by identifying 2-3 positives each day, while getting ready for bed or when getting dressed in the morning.

Your intake, activity, or behaviors may be far from perfect, but perhaps you’re still moving forward. The work may not be done.

Maybe things aren’t so great. But have you lost the ability to create a positive shift, to see the white space?

Perhaps, it’s only half empty.

My gratitude to Rabbi Leslie Gordon and Rabbi Barry Starr for their recent words which inspired this post.

Consider these other posts on this topic:

http://dropitandeat.blogspot.com/2011/06/30-chance-of-rain-70-chance-of-recovery.html

http://dropitandeat.blogspot.com/2011/10/setting-record-straight-shifting-your.html

http://dropitandeat.blogspot.com/2012/01/saying-goodbye-to-your-jeansa-new.html

http://dropitandeat.blogspot.com/2011/07/losing-part-of-your-body-gaining-vision.html

I’ve Gained Weight. Now What Am I Gonna Do?

Perspectives for those with bulimia, anorexia and those with no eating disorders at all.

"How much weight have I gained since we started working together?", “I want to know." That was the pressing question.

Ellie has been seeing me for several years, for periods at a time. She presented with severe bulimia, purging 3 times per day, every day, after each of the three times per day she allowed herself to eat. Back then, eating and keeping food in was simply not an option. Over time, her purge frequency decreased and she normalized her food intake, ultimately giving up her bulimia. 

Beyond her initial and modest weight increase, her weight has remained stable within a 2-3 pound range over the past many years. And that initial increase can be attributed to two things—no longer living in a dehydrated state and better nourishment.

To me, the better question for Ellie to ask would have been " how much better off am I since I’ve changed my eating?" In spite of the modest weight increase that she had no interest in, what did Ellie get in return?

When confronted with this question, she appropriately retreats from her disordered thoughts which periodically reemerge and readily acknowledges just how far she has come, how much better she feels. She remembers that there's no way she could've taken care of her newborn grandchildren in the state she was in then, or be trusted driving back and forth to their home. No, the price she paid, the few pounds gained, is nothing given what she's getting in return.

Gaining weight is rarely seen as a positive in our culture. Advertisements fail to praise us for outgrowing our jeans.

But for some, that is exactly what needs to happen. Staying at the weight you were at when you were 12  is hardly appropriate when you are 16, 20, or 40 years old. And even if your weight is objectively 'within the normal range' for the population, it may not be in range for you. It drives me crazy when doctors tell their patients that their weight—a  weight that has never been maintainable without an eating disorder because it's too low—is fine, because they are basing it on the charts for populations. Why the double standard? Because if you've always been a healthy larger size and you've lost weight through unhealthy measures, that 'normal range weight' may be anything but normal. Perhaps given your build, your genetics, your muscle mass, your history of athleticism, your body needs to be at a higher-than-average weight. And fighting it to be at a place you've never been will only contribute to unhealthy ways of eating and thinking. For your mental and physical well-being, weight gain may be just what's needed.

Gaining weight without an eating disorder?

Not long ago—a couple of months, maybe—I noticed that snugness around the middle. No, my jeans hadn't just been dried at high heat for too long. And really it was not in my head. Everything was fitting a bit too tightly. (Yes, even the bras.) Not one to weigh myself with any regularity, I suddenly jumped on the scale. I felt the need to reality check, to verify what I was feeling.

Yup. My weight was up.

Save your rush to judgement, please--it has nothing to do with the cupcakes, the chocolates and my homemade, full fat lavendar ice cream. Ok, let me clarify. No "I told you so's" necessary, because I ate all those foods before. But over the months of summer, the balance wasn't perfect, and so my weight crept up. 

Could it be that I was super active through the end of June, training for my fundraising ride, only to reduce my activity precipitously with the heat wave and awful humidity? Perhaps. Could it be that I've been socializing more, sipping on wine with dinner more nights than previously. Perhaps.  Could I have possibly joined my husband for an after dinner snack—just because it looked good and I thought I'd keep him company—more often than I really needed from a nourishment standpoint? Likely. Like you, I'm not perfect.

But the bigger question is what to do about it. If you were me, would you:

1. exercise a couple of hours each day to make up for the previous reduction in activity?
2. reduce your food intake to compensate for the extra calories consumed?
3. seek the guidance of a Registered Dietitian?

Ok. So I'm the RD so  I'd better come up with a fix.

But if you don't fall into the categories described above--those truly needing to gain weight, or those who've gained appropriately as a result of releasing yourself from disordered behaviors--and you find you've gained some unnecessary weight, here's what I'd suggest. Intuitively, it may seem appropriate to make up for any overeating in the days or weeks which follow. But don't do it! Instead, refocus. Get back to the basics, particularly if you've found yourself slipping into old patterns. Have you forgotten the basics? For starters,

Sit. No eating as you walk around the kitchen emptying the dishwasher. No eating standing at the fridge. And no, don't sit at the fridge; seat yourself at a kitchen or dining room table.

Separate. Eating and distractions,  (other than your family which you can't get rid of) should be separate activities. TV watching, texting, reading--these should be separate from eating. (Unless, I'll add, you are struggling to get food in and find that being less mindful is actually helpful--which it often is!)

Eat with your senses. Are you seeing your food and acknowledging what you're eating? Are you experiencing the textures of what you're eating? Are you tasting your food? Doing so will allow you to slow the pace and to feel more satisfied with what you're eating. You'll enjoy the food so much more!

Choose what you enjoy. Are you giving yourself permission to eat what you like, or holding on to rules about what's allowed vs forbidden, in your mind?

Tune in to  your hunger. Don't wait  until you are at the extremes of hunger--if you're starving you are more likely to struggle to eat as described above, and overeat.

Re-explore fullness. Are you eating until you are stuffed? Might a modest adjustment in portions be appropriate? That said, if you start with smaller portions, do give yourself permission to eat again later--after about an hour--regardless of what you you ate before.

Don't panic! And don't take radical steps to 'fix' the problem. Restrictive eating, denying your body's signals and needs, does nothing positive in the long run. It will only perpetuate an unhealthy cycle and make you feel like c!*P!

Breathe. It won't take long to get yourself back on track. But be realistic--if your eating was off course for some time it will certainly take some time for you to be back to your former, healthy self. Radical dietary changes can have radically negative consequences, so do be patient and appreciate the modest improvements as they happen.