The holidays do present unique challenges that are less frequent at other times of the year
Intuitive Eating and Eating Disorder Recovery: Is it Possible?
Kelly Boaz, CNP
When I went to eating disorder treatment for the second time, they gave us two books to read upon admission. In fact, reading these books was one of the conditions for moving through the levels of treatment. These books are still on my professional bookshelf to this day - Life Without ED, by Jenni Schaefer, and Intuitive Eating, by Evelyn Tribole and Elyse Resch. Intuitive Eating is one of the cornerstones of many eating disorder recovery programs. How do you know if it's right for you?
Well, as far as I'm concerned, learning to eat intuitively is important for just about everyone. BUT, it's not right for everyone all the time. Sometimes, following a meal plan is more beneficial. Here are some common stages of eating disorder recovery where it may not be possible to practice intuitive eating:
1. You're just starting nutritional therapy
Many people seeking treatment for an eating disorder aren't used to eating appropriate amounts of food. Whether you're eating too little, too much, or just irregularly, chances are your intuition is off. It's important to work with a dietitian or nutritionist to help figure out what the right amount of food for you is. Everyone's needs will be different, so it's important to get a meal plan that is tailored to your needs. Following this meal plan will help you understand your hunger and fullness signals, and get used to eating an appropriate amount of food for you. Over time, it will be important to let go of the plan, and start to trust your intuition.
2. You're working through fear foods
Some people don't really have fear foods. Some people have a LOT of fear foods. During this stage of recovery, you may move back and forth between a meal plan and intuitive eating. If trying fear foods puts you at risk for restricting the rest of your intake, you may need a meal plan more solidly in place.
I struggled at this stage, mainly because I was in denial about my fear foods. I was convinced I just didn't like certain foods, so I didn't have to include them. Luckily, my team recognized the restriction hidden in my preferences and challenged me to try these foods. Some foods I genuinely disliked. Some foods, however, were fear foods in disguise. Because my intuition was still clouded by my eating disorder, eating 100% intuitively at this point wasn't possible for me.
3. Finances are tight
When we talk about intuitive eating, we sometimes exclude those who can't afford to eat how their body wants to eat. They need to make food choices that fit in their finances. In fact, most people can't afford to eat out 3 meals a day, so planning is important to make sure you have food available when you need it. During these times, you may be able to be intuitive when you eat and related to how much you eat, but you'll still need to plan the "what". It is important to keep things as varied as possible, though, to keep your food choices from becoming food rules.
4. Your schedule is weird
Similar to those who can't always choose the "what", shift workers and those with set schedules don't always get to choose the "when". Some days, you may not be hungry when it's time to eat. You may have to eat anyhow. Some days, you may be hungry before you have an official break. Keeping portable snacks on hand (like granola bars) will help you honor your body's timing, even when you can't control meal times.
5. You're under a lot of stress or battling depression
When I get stressed out, my appetite goes out the window. If I was trying to listen to my body's cues during these times, I would be severely under-feeding myself. When stress hits, I need to go back to the meal plan. I know what my body normally needs, so I try to feed myself as I normally would, even when I don't feel like it.
For those with a history of eating disorders, living in a calorie deficit can put us at a high risk for relapse. When we're going through periods of stress, anxiety, or depression, we may need to ignore our bodies' signals and eat more mechanically for a time. This doesn't mean that you're going backwards - it means you're ensuring you can keep moving forwards.
Whatever stage you're at in your recovery, it's helpful to have a professional guiding you through the transition from meal plan to intuitive eating. It can be tricky to figure out whether your intuition is still influenced by your eating disorder, and an outside eye can help with that.
Wherever you're at, keep going. It's hard work, but you're worth it.
Kelly Boaz, CNP is a Toronto-based Holistic Nutritionist (CNP), specializing in eating disorder recovery and food freedom. After winning her 17-year battle with anorexia, Kelly Boaz turned her life’s focus to helping others do the same. She is also a writer and speaker (TEDx, TDSB), raising eating disorder awareness, and helping people heal their relationship with food and their bodies. You can find out more about Kelly, or get in touch via her website.
It seems we have entered an era where eating a cupcake is either as provocative as Christian Grey or as rebellious to culture norms as Lady Gaga. When did food become so powerful that it now is assigned a moral value: bad vs good, healthy vs unhealthy, clean vs unclean?
Some have described this constraint as willpower, however, willpower is defined as control exerted to do something or restrain impulses. Impulses are a sudden strong and unreflective urge or desire to act; willpower can be disrupted by emotions and depleted over time. Does this sound like energy that should be devoted to making decisions such as whether to eat a cupcake?
I bet you're thinking, I can't get the damn cupcake out of my head now. The brain has taken over and the brain always wins! So, let’s go back to the whole Christian Grey fascination. This has been labeled the "Ironic process therapy" or, as I call it in my practice, "the bad boy effect," which is the psychological process where deliberate attempts to suppress certain thoughts make them more likely to surface. So whether you're trying to avoid thinking about a cupcake because you think it is "unhealthy" or staying away from Mr. Grey since your girlfriends tell you he is nothing but trouble, you now have ignited your brain to hyper focus on both.
This process is worsened by stress and can eventually lead one to have more immoral out-of-character thoughts. Insert a clip of Miranda on Sex & the City here – the episode where she tries to avoid eating cake she has in her apartment by pitching it into the trash, only to later be at her wit's end diving back into the trash inhaling cake in a binged manner.
Although avoiding relationships with characters such as Mr. Grey are likely in your best interests, why can't there be a healthy relationship with delights such as cupcakes? This has led me to ditch diet mentality that strives off imbalance and join the Intuitive Eating movement. Intuitive Eating believes in the power of neutralizing all foods' meaning – not assigning moral value to one food over another. Yes, this means cupcakes and quinoa should be considered equal. This does not mean they necessarily have the same nutritional value, but like many struggling with perfectionism, culture has now decided that diets are the new thing to perfect.
For those of you not familiar with Intuitive Eating, following are the key principles:
- Reject the Diet Mentality
- Honor your Hunger
- Make Peace with Food
- Challenge the Food Police
- Respect your Fullness
- Discover the Satisfaction Factor
- Honor Your Feelings without Using Food
- Respect your Body
These principles incorporate choosing foods – not only by taste – but also by prioritizing how it nourishes your body. I love a great cupcake (personal favorite is Gigi cookie dough), yet if I had it daily it would not provide the same satisfaction and likely not appease my hunger.
So, the next time you really want a cupcake, put the children to bed, take a deep breath, put Fifty Shades on the screen and ENJOY!
Rebecca McConville, MS, RD, LD, CSSD is a Master’s Level Registered Dietitian & a Board Certified Sports Specialist. She specializes in the treatment of anorexia, bulimia, compulsive overeating & exercise addiction. She also treats the female athlete triad & athlete-associated disordered eating. Becca understands that the drive for peak performance may lead to disordered eating. Her goal is to help you fuel your body, so that you can fuel your life! Visit her website.
Think about the eating-related thoughts that go through your mind on any given day:
“You shouldn’t eat that, it’s too high in sugar.”
“You can’t be hungry already, it’s not time to eat for another 2 hours.”
“That has waaaaay too many calories in it. You don’t deserve to eat it.”
Notice a common theme among them?
It’s the overall distrust of your body and your appetite. The eating disorder makes you believe that your own body is working against you and that if you listened to its signals you’d be fat, unhealthy, and completely unworthy of love. Ouch, pretty harsh, huh?
As Geneen Roth, author of multiple books on compulsive overeating, dieting and body image, has said:
"Your body is the vehicle for your spirit and your soul. It is the piece of the universe you've been given to tend, to care, to cherish. Without it, you couldn't sense or taste or touch or feel."
Why do so many of us distrust our appetites? We’ve been taught to believe that if we ate what we wanted we’d eat ourselves into oblivion. We’ve been taught to fear food and to fear our appetite. The “war on obesity” has become a war on our bodies. Fear of becoming fat has made us afraid of food and afraid of our desire for food.
Sarah’s story (name and details changed for privacy)
Sarah is a client who I first encountered well into her recovery. She was no longer starving herself or abusing her body with purging or excessive exercise. Yet she was still plagued by food and her body. “I never feel full when I try to eat normally. It’s as if I could just keep eating and eating,” she told me. “The only time I feel full is when I’ve binged and am stuffed, and then I feel so ashamed and guilty and disgusting that I want to purge. Those urges still come up sometimes.”
Sarah was still disconnected from her body. Sure, she was eating at regular intervals throughout the day, but it still had very little to do with her actual appetite cues. It was more of a prescribed regimen for eating. Thus, she ate pretty much the same thing every day because she knew how it would make her feel, and she trusted that it was the “right” amount for her body to maintain its current weight. Any deviation from this made her anxious and uncomfortable, which made holidays and social gatherings hard. It was also hard when she had a food craving for something out of the norm.
The rupture of trust
How does this distrust of the body happen? Usually, it starts in childhood or adolescence. We are born with a natural trust of our appetite - babies cry when they are hungry, and stop when they’ve had enough milk. Toddlers and small children tend to do the same with food.
We can learn a lot from children when it comes to eating. They will eat when they are hungry, and will stop when they aren’t. The amount they eat will vary from day to day - some days they eat a ton, and other days hardly at all. That’s because they are tuned into their bodies and trust their body’s signals.
At some point, however, well-meaning adults interfere. They start trying to control and dictate the child’s eating by saying things like, “Eat your vegetables and then you can have dessert,” or, “You don’t need all that sugar, it’s bad for you.”
Yes, the adult is trying to help the child eat a balanced diet and to be healthy, but it’s backfiring. Because the underlying, unspoken message is that the child shouldn’t trust what their body has said. The appetite cues should be ignored and suppressed. Wanting something sweet is seen as bad, and the dessert must be “earned” through the holy grail of vegetables.
Then look at the broader culture we live in, with terms like portion control, detox, gluten-free, dairy-free, fat-free, sugar-free…we’re afraid of food and afraid of our appetites for it.
Fear-based eating is taking the joy out of food. We need to stop being so afraid of things like sugar, fat and salt. Reality is, they make food taste good. AND foods with sugar, fat and salt do still make a nutritional contribution to our diet. By definition, nutrients are something that the body must have, and sugar is just a carbohydrate, which is a macronutrient along with fat, and salt is an essential micronutrient. That’s how your body sees it when the food is digested and absorbed into your blood stream.
Rebuilding trust with our body
It’s time to love food again, and to enjoy foods that taste good. Eating is a sensory experience, from the sight to the smell to the texture to the taste of the food. We experience eating with our whole body. And the food is literally the fuel that keeps us alive. Not something to be afraid of - something to be cherished!
The wise Ellyn Satter, a fellow dietitian and eating expert, has said:
"Go to the table hungry, pay attention while eating, and stop when you are satisfied, knowing that you can come back and eat again when you are hungry later. Eating is meant to be enjoyable."
It takes time to repair and rebuild trust with ourselves. The eating disorder is invested in you distrusting your body and will continue to try and convince you of the ways in which you can’t trust yourself.
As your True Self gets stronger and you gather more and more attuned eating experiences, you’ll start to see “proof” that your appetite can be trusted. As for Sarah, the client I mentioned earlier, she was able to do this. It took time, patience and persistence. Every eating experience was an opportunity to take a leap of faith that her body knew what it was doing and would guide her appropriately. Sure, sometimes she made mistakes, and sometimes she questioned if she really could trust her body, but over time she was able to see that her appetite was truly calibrated to her body’s needs.
Some tips for rebuilding trust:
- Have regular, consistent eating times throughout the day. Your body needs to know and trust that it will get fed again in a few hours.
- Keep snacks on hand in case you get hungry sooner than anticipated. Your body also needs to trust that you will feed it during those unexpected times that it gets hungry.
- Include a wide variety of foods. Keeping food interesting and varied will help your body get all of its nutritional needs met, and it will help you feel satisfied by the variety of flavors and textures of the food.
- Eat without distractions. Pay attention to your food, like a toddler intently eating and savoring the food off her plate. Paying attention to your food will also foster paying attention to your appetite, and you’ll more readily notice when you are feeling satisfied.
- Treat your body with compassion. You will make mistakes with eating. It’s a fact of life. Even normal eaters do it. You’ll sometimes under eat, and sometimes overeat. Notice this sensation without judgment, and give yourself compassion for the discomfort you are experiencing. Let your body guide you on what and when to eat again.
Process, not perfection
There’s no such thing as perfect eating, so don’t even bother trying. Disappointing for you perfectionists out there, I know! But also potentially freeing? It allows you to experiment with your eating without judgment or fear of failure. Most importantly, it allows you to experience the joy of eating again while trusting that your body will guide you.
Katy Harvey, RD is a Certified Eating Disorder Registered Dietitian (CEDRD) from Kansas City. She has an outpatient private practice where she helps individuals heal their relationship with food, exercise and their body. She also blogs at Katy’s Blog.