My Declaration about Eating Disorder Recovery

Recovery from an eating disorder has been an extremely hot topic lately. A recent New York Times article has created a firestorm in the eating disorder community (from clinicians, people suffering from an eating disorder, as well as their families). In fact, “recovery” is a highly debated topic as there is no consensus currently as to what it actually is or how to define it. If you are interested in reading more about this topic, I highly recommend this blog post by Aimee Liu, this blog post by Randi Hutter Epstein, and this blog post by Lauren Grunebaum.

I’ve been thinking A LOT about this topic. My entire life’s work is dedicated to working with people who are suffering from an eating disorder. And you better believe that I believe in complete recovery. But I’d like to take it a step further. I believe that people who struggle with an eating disorder can actually have a healthier and happier relationship with food and their bodies than people who have never had an eating disorder.

Now, you make think that’s totally crazy but hear me out. While eating disorders may be somewhat rare (but more common than Alzheimer's and Schizophrenia combined), disordered eating, body hatred, negative self-talk, and extreme dieting are not uncommon. In fact, it has become normal in our culture to have a dysfunctional and unhappy relationship with food and your body. Here are a few examples:

*Labeling foods as good and bad (ie “I ate so much last night, I was so bad.” Or “Wow, you’re skipping the bread basket, you’re so good!”)
*Cutting out food groups- Atkins diet anyone?
*Incessant fat and body talk. If you have a lot of girlfriends or work in an office, you know what I’m talking about

My point is that some people with an eating disorder spend years in therapy and/or working with a dietitian to repair their relationship with food and their body. They do an incredible amount of work and find peace on the other side. While many people (particularly women) spend their lives griping, stressing, agonizing, restricting, dieting, and compulsively eating or exercising but never get help. They don’t have a full-blown eating disorder, so they somehow believe that this is an acceptable (even normal) way to live life. And they get stuck there.

While eating disorders just plain suck, they provide an opportunity to “take the road less travelled” and discover that there is life beyond calories, points, and the number on the scale. Yes indeed, having an eating disorder may in fact be a catalyst to living a fuller and more vibrant life than most people think possible.

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Nursery Rhymes & Emotional Eating

Emotional eating makes me think of the nursery song, "There was an old lady who swallowed a fly". Just in case you need a refresher:

There was an old lady who swallowed a fly
I don't know why she swallowed a fly - perhaps she'll die!
There was an old lady who swallowed a spider,
That wriggled and wiggled and tiggled inside her;
She swallowed the spider to catch the fly;
I don't know why she swallowed a fly - Perhaps she'll die!
There was an old lady who swallowed a bird;
How absurd to swallow a bird.
She swallowed the bird to catch the spider,
She swallowed the spider to catch the fly;
I don't know why she swallowed a fly - Perhaps she'll die!

And on and on it goes. She swallows a cat to get the bird, and even manages to swallow a goat, until we find that she swallows a horse (she's dead, of course).

Often there's something in life hurting or bothering us, and when we don't know what to do with it, we just swallow something else. But of course, it can't touch the real problem. We keep eating and eating to fix it, rather than addressing the underlying hurts and fears. Short-term, it's a familiar, non-threatening escape, but it's much harder in the long run, because nothing is solved.

When we're little, food may be the only thing we can control, and so at that point in time, the strategy makes sense. We can soothe ourselves and comfort our bodies. And yet as we get older, oftentimes the habit remains. Just like the song, as our life's challenges get bigger and bigger, often the eating issues do, too, until, well, it seems like it would take a horse to fill the hole in our hearts and to leave everything behind for a while.

It doesn't seem that this is in any way a problem limited to people with eating disorders. It seems that people (namely women, but men are catching up) have disordered eating behaviors to try to control the chaos in our lives. Sometimes the emotional eating is unmistakable and sometimes it's more subtle. And yet if we're paying attention, we know the difference between eating because something is delicious and eating for momentary stress relief.

The trick is in realizing what we're doing, and finding a new way of self-care. It takes courage, self-compassion and lots of support. Getting help and trying something new is brave work.

But it beats swallowing a goat.
At least, that's my vote.
(pardon the pun)

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This post is brought to you by Cheryl Harris, a Registered Dietitian in Alexandria, VA. She loves writing on matters near and dear to her heart, including a gluten-free diet, health, self-acceptance and of course, food. For more of Cheryl's musings, see www.harriswholehealth.com, www.gfgoodness.com or follow on Twitter @cherylharrisrd.
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International No Diet Day

I just saw this fabulous post by Ashley Solomon, PsyD. She is one of my favorite writers on topics like body image, self-acceptance, self-esteem, disordered eating, and eating disorders. I had to share it with you, as I can think of no better day to share my birthday with than "International No Diet Day." Enjoy.

Marci E. Anderson MS, RD, cPT
Not dieting today...or any other day for that matter.
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Recipe: Curry Chicken Salad with Bananas

This post was written by Jessie Erwin, dietetic intern at the University of Connecticut. You can follow her Tweets at @JessieHealth.

Back when my husband and I were studying at Amherst College in Amherst, MA, we used to eat at a restaurant called Judie’s. Although I loved to try new dishes every time I went to Judie’s, I had a favorite: Curried Chicken Sandwich with some (ahem) unusual ingredients. Kitchen experimenter that I am, I knew I wanted to try my own version of this meal. I’ve been making this curry chicken for years, and now I’m excited to share it with you!

Curry Chicken Salad with Bananas Adapted from a Judie’s original Serves 4
Ingredients:
1 pound chicken breast
1 tbsp mayo
1 tbsp yogurt
1/2 tsp curry powder
1 tsp honey
1 tsp lemon juice (fresh-squeezed if you can swing it – makes a HUGE difference)
1/2 cup red seedless grapes, halved
2 Tbsp peanuts
1 banana, sliced

Directions:
 Poach chicken breasts in water or broth until cooked through. Set aside to cool.
Shred chicken into a large bowl.
Add grapes, peanuts, and bananas.
Mix mayo, yogurt, curry, honey, and lemon juice in a small bowl.
Add to chicken mixture and toss.
Serve with salad or veggies and your favorite crusty bread.
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Product No Case: Full Bar

All too often, a product appears that causes me to shake my head in disappointment. The latest product? Fullbar, a granola-type bar that claims to help you “feel full and satisfied on smaller amounts of food”. Developed by a bariatric surgeon (Dr. Snyder), the bar’s use is simple: consume with 8 ounces of water 30 minutes before a meal and you’ll eat less at the actual meal! Exciting, right? Not so fast! Let’s look at the ingredients, shall we?

A cranberry almond fullbar has the following ingredients: brown rice syrup, puffed wheat, soy protein concentrate, honey, acacia gum, cranberries, sunflower seeds, agave syrup, glycerine, almonds, canola oil, salt, cinnamon, sugar, natural flavor, sunflower oil, soy lecithin.

Can you say “sugar”? Sugar by any other name is just as sweet: brown rice syrup, honey, and agave syrup are all sugar. This quick-digesting carbohydrate will provide a little energy and almost no nutrition. The bar’s five grams of protein will not keep you full for long. The other ingredients, such as puffed wheat, acacia gum, and glycerine, also do not provide adequate nutrients. And, what is “natural flavor”, anyway?

If the bar causes you to eat less at meals, you will be consuming less of the nutrients you need from “real” food. In general, real food is more satisfying that processed food. Unfortunately, fullbar fills your stomach with quick-digesting sugars and fillers, so that you will eat less real food. Thanks a lot, Dr. Snyder. I don’t know about you, but not only do I like to know what I’m eating (and “natural flavor” doesn’t cut it), I prefer real nutrition to fake “food”.

Also, as Marci wrote in a prior post, intuitive eating is flexible and allows you to enjoy a wide variety of foods without guilt or shame. Listening to your hunger cues is an important part of intuitive eating. Unfortunately, a fullbar is designed to suppress the hunger cues that help us decide when to eat and may increase feelings of shame and guilt around these natural cues. Eating a fullbar is like saying “my hunger cues are not natural and should be suppressed!”

This product has a definite health halo. The packaging is stamped with as many healthy looking words and images as it can hold, from the “100% Natural!” claim (“natural” is not a regulated FDA term and means nothing), to the mistakenly-used medical symbol surrounded by the words “Developed by a leading weight-loss surgeon”. fullbar even displays plump cranberries and healthy-looking almonds and puffed wheat on the front to complete the look. I had a chance to try a fullbar and was turned off by the chemical taste and Styrofoam-like texture. Why eat something that doesn’t taste good and offers little nutrition? Skip the fullbar and enjoy real food with real nutrients. Your body will thank you!

This post was written by Jessie Erwin, dietetic intern at the University of Connecticut. You can follower her on Twitter @JessieHealth.

As an aside, I tasted the Full Bar and have two words: flavored Styrofoam. Yuck!
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Why a "Summer Body?"

Or a "beach" body, or a "bikini" body?

Why not a "rake-the-leaves" body or a "shovel-the-snow-then-go-cross-country-skiing" body? While we're at it, how about a "clean-the-house-then-go-grocery-shopping-and-carry-the-case-of-water-yourself-'cause-you're-just-that-strong" body?

And just how IS a summer body supposed to look when compared to a winter body? Assuming you even have a "winter" body in the first place (whatever that means).

The assumption is - at least in this part of the country, where we spend a good 6 months buried beneath layers of heavy sweaters and bulky parkas - that a "winter" body is a mess.

It's worthless and disgusting. It doesn't deserve to appear in public sans layers of heavy sweaters, and is ill-suited for display during the summer months without starving or over-exercising it into some magazine editor or diet pill/book/drink/meal company's idea of a "summer" body.

And we know what THAT looks like. . .impossible to achieve (photoshopping, anyone?), maintain (never again eat chocolate?), or even aspire to (genetics, remember those?).

Why waste all that energy trying to have an impossibly "perfect" body for just a few, short months? Why not work toward having the healthiest, strongest, happiest body you can, 365 days of the year?

Trying to make your body be someone else's vision of perfect will never, ever, ever, no matter how badly you want it, be doable.

If you're unhappy in your own skin, even the perfect "summer" body isn't the answer. . .you'll soon find another flaw. Then another. Then another.

I challenge you to embrace your physical uniqueness and kick that "summer" body idea to the curb.

This post was brought to you by Cathy Leman MA, RD. Cathy Leman is the founder and owner of NutriFit, Inc., a nutrition counseling, consulting, and worksite nutrition services business located in Glen Ellyn, IL. She is a registered dietitian, certified personal trainer, and holds a masters degree in health psychology.

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Intuitive Eating and Eating Disorder Recovery

I was recently asked by Nina V, owner of the website www.helpforeatingdisorder.com, to write an article on Intuitive Eating and eating disorder recovery. I recently completed my training to become a certified Intuitive Eating Coach and was thrilled to share my thoughts. Enjoy.

Intuitive Eating is a phrase that is famous among many people hoping to recover from an eating disorder. It’s actually a concept developed by two dietitians, Evelyn Tribole MS, RD and Elyse Resch MS, RD. My goal with this blog post is to accomplish four things:
1. Explain the difference between Intuitive Eating and eating that is guided by an eating disorder (ED)
2. Discuss whether or not it’s possible to recover from an eating disorder by becoming an Intuitive Eater
3. Discuss the challenges of incorporating Intuitive Eating into eating disorder recovery
4. Share some tools to address those challenges.

An eating disorder is, by nature, the antithesis of Intuitive Eating (IE). This page from the IE website summarizes the basic premise of what IE is all about. But when I talk with my clients about the differences between IE and disordered eating, here’s what they tell me.

Disordered Eating is:
• Rigid
• Dictated by rules
• Ignores physical cues for eating
• Very judgmental and associated with feelings of guilt and shame
• Cues to eat or not eat are based on external factors or from the head, not the body

Intuitive Eating is:
• Flexible
• Dictated by whether or not you are hungry or full
• Allows you to enjoy a wide-variety of foods, without guilt or shame
• Cues to eat are largely based on your physical need and cravings for certain types of food

Is it possible to recovery from an ED by using IE?
This is a really great question. And this article, written by Evelyn Tribole, gives a fantastic explanation of how IE can be used in the treatment of an ED. It’s written for clinicians, but I use it as a handout with my clients and highly recommend you read it. Within the article is a table that explains how IE applies to EDs. I explain to my clients that when you are in the throes of an eating disorder, it’s too noisy to hear your health IE voice. So we use a structured eating plan (sometimes called a meal plan) as a bridge to walk you away from your ED and towards becoming an IE. However, the structured eating plan is only a tool to get you from an unhealthy eating disordered place, to a place that you can start listening, trusting, and responding to your body. It’s extremely important to note that the very nature of an eating disorder disrupts your biology. And following a structured eating plan is like using “Control-Alt-Delete” on your body, giving it time to heal and reset it’s natural rhythm of hunger and fullness.

I personally feel that it is extremely difficult to do this on your own if you are in the midst of an ED. In fact, I always recommend that anyone with an ED work very closely with a dietitian that specializes in the treatment of EDs. They can prescribe an appropriate structured eating plan, help you learn to reframe disordered thoughts about your body and food, and guide you to a place of trust between you and your body. It is very very hard to do this on your own.

What are the challenges of incorporating IE into ED recovery?
• In the beginning, your hunger/fullness cueing isn’t reliable or accurate so you cannot use that to guide your eating. While that is the goal of IE, it is not appropriate in the beginning stages of recovery.
• It’s easy to confuse your healthy IE voice with your ED voice, especially early on.
• Years of disordered eating create distrust with your body, and trust is the core of IE.

What are some tools?
• If possible, work with an experienced RD who specializes in treating eating disorders
• Read the article I shared earlier and keep the table of how IE applies to ED in mind
• Buy the book “Intuitive Eating” as well as the fabulous IE cds (which are different from the book). Hold this up as your gold standard ad goal for recovery!
• Don’t go it alone. Support is crucial for recovery and you deserve it.

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#endED Twitter Chat Re-Cap with Harriet Brown

Last week Harriet Brown was our guest expert for our monthly #endED Twitter Chat. She taught us a lot about family based treatment for anorexia and the important roles that families play in supporting their loved one through recovery from an eating disorder. (If you want to learn more about her story, this is a link to the New York Times article that started it all.)

Below are some of the gems from our chat that I wanted to pass along to you. In no particular order...

• 1. We need more research to assess the experiences and needs of families struggling with an eating disorder. You can help by completing this 15 minute survey online.

Asian Rice and Vegetable Bowl With Eggs and Chili Sauce

I love my Real Simple magazine and I love Asian cuisine. So I was delighted to try this recipe from my February issue of Real Simple. I have no idea how authentic this recipe is, but let me just say it is DELICIOUS and super simple. A big bowl of goodness...hmmmm. :)

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*Note my version only took about 30-40 min because I used microwaveable frozen brown rice from Whole Foods- LOVE it.

Serves 4| Hands-On Time: 15m | Total Time: 1hr 10m

Ingredients
2/3 cup short-grain brown rice
1/3 cup Thai sweet chili sauce (such as A Taste of Thai; I used a Trader Joe's version)
3 to 4 teaspoons Sriracha or Asian chili-garlic sauce
3/4 teaspoon toasted sesame oil
1 tablespoon rice vinegar
1 bunch broccoli, cut into florets
2 red or yellow bell peppers, thinly sliced
2 carrots, peeled and cut into thin sticks
*Marci's note: I didn't have carrots, but did have kale on hand and used that. It turned out really well.
2 tablespoons plus 1 teaspoon canola oil
4 large eggs

Directions
Cook the rice according to the package directions.
In a small bowl, combine the sweet chili sauce, Sriracha, sesame oil, and vinegar; set aside.
Meanwhile, heat oven to 450° F. After the rice has been cooking for 25 minutes, place the broccoli, bell peppers, and carrots on a large rimmed baking sheet; toss with 2 tablespoons of the canola oil. Roast, tossing once, until tender, 20 to 25 minutes.
Heat the remaining teaspoon of canola oil in a large nonstick skillet over medium heat. Crack the eggs into the skillet and cook, covered, 2 to 3 minutes for slightly runny yolks.
Serve the vegetables and eggs over the rice and drizzle with the sauce.
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#endED Twitter Chat with Harriet Brown

Our next #endED Twitter chat is Wed, April 20th with Harriet Brown. We'll discuss myths and facts about anorexia nervosa, family-based treatment, and ways in which families can positively affect eating disorder recovery. Check out the Facebook Event Page for more details, including how to participate in a twitter chat if you've never done so before. Below are the questions Harriet will be discussing. I hope you can make it!

About Harriet Brown
Harriet is a tremendously successful writer, whose work has appeared in The New York Times, O, Health, Glamour, Vogue, and more. She specializes in writing about issues that affect the lives of women and children.

In her book "Brave Girl Eating: A Family's Struggle with Anorexia" she "recounts her family’s efforts to help their oldest daughter recover from anorexia nervosa." It is one of the best books I have read on the topics of eating disorders, families, and family-based treatment. An absolute must-read for anyone affected by an eating disorder.

Questions we'll discuss during our Twitter Chat
Q1 What do you think are the biggest myths about anorexia nervosa (AN)?

Q2.1 What exactly is family-based treatment (FBT)?
Q2.2 How is it different from other types of eating disorder treatment?

Q3.1 What are the biggest myths about FBT?
Q3.1 What are the obstacles for families to use FBT?

Q4 What should I do if I think my child has an ED? (this would be a great place to share resources/stats)

Q5 How can we help our children have a balanced/healthy relationship with food and their bodies?

Q 6 What has been the most rewarding part of sharing your knowledge and experience with families struggling?

About #endED
The goal of #endED is to bring anyone and everyone together who care about ending eating disorders. My hope is to end the silence and myths about eating disorders, create a place for honest and informed discussion, while offering hope and encouragement.

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