Category Archives: eating disorders

Calories: Why You Need More Than They Tell You

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I’ve written about this before, but it’s so important that I decided that it is time for a refresher. It’s important because if you are following the recommended daily allowance of calories, or advice you’ve read on the internet, or used a calorie calculator to try and work out how much your body needs, then you are almost certainly not getting enough energy for your body.

So we all know that currently the RDA is 2000 calories for women, and 2500 for men, but what most people don’t know is that number is too low. Especially if you are under 25. For people in recovery from restrictive eating disorders, it’s wayyyyyy too low. Under-eating is damaging to our bodies and to our minds. People who do not diet and eat by listening to their hunger and fullness cues do not eat the RDA when it comes to calorie intake.

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So let me tell you a story.

In 2009 the calorie guidelines were reconsidered when a study found that energy requirements had been underestimated by 16% (around 400cals). What is telling is how the guidelines weren’t changed to accommodate these new findings. On the NHS website is written

“This news does not mean that everyone can, or should, now eat an extra cheeseburger or its equivalent in calories a day. The advisory committee makes it clear that the revised energy intake recommendations do not mean that people should increase the amount they eat and that, if people do eat more, they will need to do more exercise to avoid being overweight or obese.”

What we have here is science telling us that the current calorie guidelines underestimate the energy REQUIREMENTS, yet we are being told by our medical community and our government to not eat the amount that our bodies need. Regardless of the fact that studies found that we need more energy, the government put this on its website in 2017:

“The new campaign, due to launch in the spring of 2018, aims to help people be more aware of and reduce how many calories they consume from the 3 main meals of the day, in particular when eating on the go. There will be a simple rule of thumb to help them do this: 400:600:600 – people should aim for 400 calories from breakfast and 600 each from lunch and dinner.”

There the government are advising 1600 calories as a rule of thumb, and cited obesity as the reason for this. “As we are the sixth most overweight nation on the planet, we believe it is a sensible thing to do.” A sensible thing to do? To deny scientific findings, which have, by the way, repeatedly shown that the calorie guidelines are inadequate? To me that sounds like irrational fatphobia, and a complete misunderstanding about health, which is a pretty scary thought since this information comes from the government itself, not to mention our health physicians. It shows very clearly how our entire society including the medical community and our government is indoctrinated in diet culture and fatphobia, so much so that they will dismiss actual science in favour of advising that people restrict to stay thin. Even when this is unhealthy. Even when it harms us. How can we accept this?

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So what do we do about providing our bodies with enough energy? As stated above, evidence shows that adult women need around 2400 calories and adult men 2900 calories. This is extremely similar to the calorie guidelines shown on The ED Institute website run by Gwyneth Olwyn, who developed the Homeodynamic Recovery Method (formerly known as the MinneMaud Guidelines). Olwyn has always promoted 3000 calories for men over 25 and 2500 calories for women over 25. Under 25 the recommendations are 3500 and 3000 calories respectively, due to the fact that our bodies continue to grow and develop until around that age. Those who exercise or have children need more energy to cover this. On her website you can read an extremely detailed blog post on why the government approved calories guidelines are entirely inadequate, with far more scientific evidence than this simple refresher.

In remission you will have learnt how to listen and respond to hunger and fullness cues and your body will give you signals in order for you to provide it with the right amount of energy, without counting calories. Until then, it is advised that you keep track of calories in order to ensure that you are getting enough energy for your body (I wrote an entire post on this here). I urge you with all my heart to take note of the science, and take care of your body accordingly. Nourish your body. Respect it. Listen to it. Provide it with what it needs.

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On that note, it is also totally normal for someone in recovery from a restrictive eating disorder to eat far more than the calorie guidelines. This has been coined “extreme hunger” in restrictive eating disorder recovery. Extreme hunger is where you are eating above and beyond the calorie guidelines by quite a bit (e.g. over 4,000 calories). Eating between your guidelines and 4,000 calories is additional hunger but not classed as “extreme”, however the following explanation also applies. The reason you might find yourself eating an extreme amount of calories is because your body has acquired significant damages during your restriction and engagement with disordered and harmful behaviours. Your body needs energy for the day (actual daily guideline amounts – NOT the inaccurate government approved guidelines) but it also needs energy on top of that in order to heal the internal damage done to your body. Some people need more, and some people need less. Some people will find their bodies are calling for a more extreme amount for a shorter period, and some people may find that their bodies are calling for a less extreme amount but over a shorter period. This is something that will taper down in time to settle more around the guidelines, but whilst your body is damaged, it often will need more, and whilst it can be terrifying, it is normal. I always compare it to when burns victims are in hospital and put on a high-calorie diet in order to give the body enough energy to heal the damaged skin and flesh. It is a similar concept in that your body will need more energy on top of daily energy expenditure to restore itself to good health internally. You can read several of my blog posts about extreme hunger that include much more detail here and here. also I have my very own YouTube video on the subject, which you can watch here.

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It is a sad, and frankly terrifying fact that we can not always trust our own government or medical communities to ensure our good health. It is frightening how diet culture and fatphobia are so prevalent in every single area of our society, so much so that we can’t even escape it even when we turn to those whose responsibility is to provide us with accurate information in order for us to be as healthy as possible. What we must do is look for ourselves. Research for ourselves. Critical review the information that is given to us, and then take care of ourselves, and if we can, take care of others by enabling the science to be available to others. And most of all, heal the relationship between ourselves and our bodies, and then listen to them – our bodies have the most reliable information on how much we need to eat, and they share that information with us via hunger and fullness cues. Listen.

You can read my original and more detailed blog post on why we need more calories here.

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Repel the Relapse: 8 Tips for Staying on Track in Recovery from an Eating Disorder

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It happens to us all at some point in our journey from sickness to health: we hear a comment, see a magazine article, or wake up with rose-tinted glasses that throw us back into a tirade of insidious thoughts, ideas, and what if I just‘s.
What if I just exercise more?
What if I just restrict a little bit?
What if I lose just ten pounds?
What if I just cut out xyz?
What if I just…?
And of course: I’d feel so much better if I was thinner.

STOP.
The answer is you won’t. You’ll feel worse. You will always feel worse.

Engaging in eating disordered habits will mean spiralling down right back into the hellish Pit of Misery. You can convince yourself that you won’t end up there, but you will. And even if you don’t, engaging in any kind of eating disordered habits isn’t exactly taking a vacation to Disney World. It’s dark and dangerous, and it is joyless.

Here are some things to think about when you can feel the pull of a relapse:

  1. Ask yourself this: what did your eating disorder give you? How did you benefit from it? Okay, I know it made you thin, but what did you actually gain from being thin? Did it give you stable, healthy relationships with friends, family, and romantic partners? Did it find you a fulfilling job? Did it buy you a nice home? Did it contribute towards your education? Did it make you feel better about yourself? Did it bring you happiness? I imagine the answer is no. Eating disorders help us feel in control (which is only an illusion), but beyond that, they don’t give us anything real.
  2. Think about your own personal reasons for recovery. Write them down and think about them. Is it worth abandoning those goals for the sake of losing weight? Your reasons might include the things mentioned in number 1. They might also include decreased anxiety, trips out with friends, being present in your day to day experiences, keeping your body healthy in order to have children, being involved in your hobbies and passions, being able to enjoy social events, being able to enjoy food, improved sleep, having time to do the things you want to do, dedicating your energy towards enjoying life, being productive and fulfilled by doing things that matter to you and are important, physically feeling a million times better, and regaining your identity.
  3. Use your support network. Friends, family, partners, doctors, therapists, helplines, online support forums – USE THEM! They are there to help you and are often crucial in remaining strong and continuing on in your journey. You may feel ashamed or like you have failed, but that isn’t the case – we all slip backwards at one point or another. It’s all part of the journey. Don’t suffer in silence: seek support.
  4. Eliminate negative influences. Get rid of those triggering gossip/women’s magazines that spout diet culture bullshit. Unfollow those accounts on social media that make you feel like you are doing recovery wrong. Stop looking at that vegan paleo raw blogger who survives off smashed avocado and vegetable juice and works out 7 days a week because it makes her SO HAPPPPPPY (it doesn’t). Follow people who are crushing their eating disorder, eating fear foods, and resting. Follow people who are body positive and food positive. Follow people don’t set rules for what health looks like – because it is different for everyone. Cut toxic people out of your life. Assert your boundaries with your loved ones who comment on your body/food choices/lifestyle/exercise habits or who won’t stop talking about the diet that they are on. Motivate yourself to move forwards by using the positive influence of those who truly push you onward.
  5. If you find yourself missing food here and there, make yourself a schedule. Ensure you eat regularly and consistently. If you find yourself making excuses not to eat, then you may just have to put yourself on a more rigid plan until you are able to go back to eating intuitively. Three meals, three snacks. Adequate amounts, and no excuses not to eat them.
  6. Know your warning signs! If you find you are:
    – Finding reasons not to eat/avoiding situations involving food
    – Increasing your exercise
    – Weighing yourself again/more regularly
    – Worrying about food/weight/exercise
    – Changing the way you dress/hiding your body
    – Body checking/spending time scrutinising your body in the mirror
    – Cutting out certain foods or thinking about cutting out certain foods
    – Desiring control
    – Withdrawing
    – Hiding disordered behaviour from others
    – Feeling like you NEED to change how your body looks
    – Feeling guilt after eating/resting
    then any of these could mean that you are approaching a relapse or in a relapse. If you know what your own warning signs are, and are able to recognise if you find yourself doing/thinking those things, then you will be able to address and resolve the problem a lot quicker. This will enable you to bring yourself out of a relapse/prevent a relapse before it snowballs into something more ingrained. It may also be a good idea to tell your partner, friends, and family what these red flags are so that if you are unable to see them in yourself when they happen, they can point them out and support you in getting back on track.
  7. Remember that recovery isn’t linear, and every setback is an opportunity to learn and take bigger steps forwards. Some of my most important lessons learnt were during the slip ups that I made during my recovery. Pick yourself up, dust yourself off, and don’t let the tide sweep you up and carry you back. Keep wading upstream, and take the knowledge with you for next time.
  8. Keep busy and use distraction techniques. This list is not exclusive but here are some ideas of what to do when you are sitting with anxiety/guilt/relapse temptations:
    – Watch a movie
    – Read a book
    – Write
    – Paint or draw
    – Blog
    – Collage
    – Knit or sew
    – Research something you are interested in
    – Play XBOX
    – Play games on your phone
    – Do fun internet quizzes
    – Play computer games
    – Call a friend or family member
    – Meet up with someone
    – Watch a documentary
    – Play a musical instrument
    – Do homework
    – Tidy your room
    – Do some internet shopping
    – Take photographs
    – Do puzzles

Write these tips down. Save this article to your bookmarks if it helps. Make a reasons to recover/reasons not to relapse poster or screensaver. Watch my YouTube video on that topic here. Remind yourself how strong and brave and beautiful you are. You’re gonna be okay. You’re gonna make it through. Keep on trekking on, and you can and WILL beat your eating disorder.

Coping At Christmas: A Rough Guide For Those With Eating Disorders (Take 2)

I have pretty much copied and pasted my article from last year on this topic, except for some tweaks, so if you recognise this article, that’s why!

Christmas is looming (how is it tomorrow already?), and people are preparing for Christmas with food, wine, presents, decorations, and of course, advent calenders. This time of year is always filled with trepidation for those of you with eating disorders. It’s a holiday focused around alcohol, food, and family, and at least two of the former bring on that familiar rising panic for lots of people suffering with or recovering from eating disorders.

If you are someone who is living with an eating disorder, and you are approaching Christmas Day with dread, you are not alone, and you can get through it. It is probably going to be a tough day, but there are steps you can take to make the most of it, and to protect yourself from at least some of the stress and anxiety that the day might hold.

Here are my suggestions on how to get through the day:

Focus on Family

Food is a big part of Christmas for most people, but you don’t have to let that be your main focus. Prioritise your family and/or friends and/or partner and enjoy their company. Catch up on the gossip, take part in the board games, and sing along to the carols with grandma. Spend time doing what is enjoyable for you. If your family can make this easier for you, let them know how. Maybe it means trying to keep the topic of conversation away from food. Maybe it means keeping food in the dining room and having the lounge as a food-free zone. Maybe it means going out for a walk with your siblings to get a bit of fresh air and space. Whatever you do, try to keep the focus on the company of those you love, and enjoying the time spent with them.

Set Boundaries with Loved Ones

This is a day that everyone should be able to enjoy to their very best, so do take the time to talk to the people that you will be spending your time with and set your boundaries for the day. This could mean asking them to refrain from talking about New Year’s diets, making food-moralising remarks, or reminding them not to comment on any of your eating habits or your weight. Do not be afraid to voice your needs, and do not be afraid to emphasise how crucial it is that they respect your boundaries. It is important to make clear what you need from them in order for you – and everyone else – to enjoy the day.

Use A Helping Hand

Have a chat with family and identify one or two people who you could use as a “safe person” during Christmas day. It might be good to have two people so that they can share the responsibility (one in the  morning, one in the afternoon for example). These family members can look out for warning signs that you are not coping (or you could devise a signal), and are people you can take aside for reassurance and support. If you don’t have a family member that can help you get through the day, then make sure you have a helpline phone number available on your phone that you can call if any situation gets too overwhelming and you need someone to talk to in order to get through it. 

Challenge Yourself…But Not Too Much

A huge part of the anxiety of the day is that there will be a lot of delicious food around that you will want to eat but also will not want to eat, and that’s the fight between you and your eating disorder. For a lot of people, this battle is going to go on all day, and that can make the day extremely stressful and anxiety-provoking (see Focus on Family for ways to minimise this). This is also a great time to challenge yourself, but a time to not push it too far: you don’t want to make the day even more stressful by pushing yourself to the limit. One way to go about using this day as a manageable challenge is to make rough plan of what you might eat that day. This will give you a guideline that might help you feel a little more contained, but could involve trying something new or facing a fear food. Try not to restrict yourself as much a you can, but it’s okay if you need to feel safe for a day that is so difficult already. Remember that you deserve to enjoy yourself and you deserve to be able to eat the foods that you like.

Take Care of Yourself

You may be around people this Christmas that will not respect your boundaries or may be insensitive or ignorant to your recovery. They may talk about the triggering topics which I mentioned in the “Set Boundaries With Loved Ones” section above, such as complaining that they have put on weight/are going to put on weight, lamenting that they have eaten “too much”, are being “naughty” or “bad” because they are “indulging”, or moaning that they need to go on a diet because of that. Please ignore them. They are battling their own insecurities and are looking for reassurance that what they are doing is okay and that other people feel the same and that they are not alone. This is really, really sad, and something that no one should have to feel. Enjoying the Christmas food is part of the festivity, and no one should have to feel guilty for it. Know that other people’s worries are not a reflection on you, and you should keep in mind that it is not something positive that they are experiencing, but guilt, anxiety, and insecurity. So instead of letting their negativity impact on you, empathise with them, as guilt, anxiety, and insecurity are emotions that you are likely experiencing also (albeit on a much grander scale to those who do not have eating disorders). Then turn your thoughts to yourself and keep moving forwards towards your goals. Keep moving forward on your journey towards health and happiness. Keep in mind your motivations, and remember that the way you respond to others affects you primarily.

Leave the room for a bit if you need to. Take yourself off for a relaxing bath or a nap or to read a book. Go for a stroll. Have a quiet word with that relative who keeps calling the chocolate yule log “bad”. Just take care of yourself and do what you need to do, for you, to have the best day that you can. Do not be afraid to speak up. You need this. You deserve this.

If you are someone who has an un-supportive, highly triggering family, do know that it is okay to decide not to see them at all. If you want to spend Christmas with yourself, your partner, your partner’s family, your friends, or your pets, do it. Do what is best for you. Do what you need to do to continue moving forwards. Do what you need and you deserve to continue working towards health and happiness. Make positive choices, and don’t feel guilty about them. This is what you need. This is what you deserve.

Move On

Christmas is unfortunately never going to be an easy time for those with eating disorders, and it often means that those people go into it with anxiety, and leave it with guilt. It is okay to experience those feelings: you are not alone and those feelings are not your fault. However, you have to keep remembering that these negative emotions are caused by your eating disorder and the control that it has over your life. Keep fighting the war against it, and don’t respond to those negative feelings. You are going to be okay and you can get through this. Christmas will be over in a blink of an eye, and then it is time to put it behind you and move on from that day. Don’t carry the stress from it with you. Let the day go. Remember that it is absolutely, 110%, super okay to eat more than usual, go outside your meal plan, eat “normally”, or respond to extreme hunger (this applies for always, of course). It is okay to put on weight. It is okay to enjoy yourself. The guilt of going against those eating disorder rules can be overwhelming, but it is important to remember that this is part of recovery. Going against your eating disorder and doing what you deserve is part of fighting the battle inside your head. Eating whatever you want, whenever you want, is the goal, and so if you were able to do that for a day, or two, or more, or even if you were able to eat a little more than normal, you are making small steps towards achieving that outcome. That is a wonderful thing.

If the anxiety is becoming overwhelming, check out my article on anxiety management here.

Original article can be read here.

 

A Balanced Diet: What Do Those Words Really Mean?

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We hear it everywhere: in order to be healthy, you need to eat a balanced diet. But what does that really mean? I’m scrolling through Google images right now trying to find an appropriate picture to go with this article, and at least half of the images only show “healthy” foods. You know what I mean: your greens; your grains; your fish; your eggs; your cheese; your meats (the latter four tiny splodges at the top compared to the large array of fruits and breads). A large percentage of the pictures are only of fruit and veg. I mean, come on: I have my own “cheese corner” in my fridge, and no one is ever taking that away from me. Especially not a food chart.

For the most part, the food triangle often used to demonstrate balanced eating is a fairly accurate rough guide, and looks something like this:
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It is a rough guide to the way our diet will look if we listen to our bodies (when energy-balanced and healthy in themselves – not in a state of recovery or beforehand) and follow its cues – and we do not have to do any counting or checking or weighing or recording to trust that this is what our bodies will naturally lead us to do. Our bodies are extremely intelligent and I urge you to listen to them over most external influences.

I also like this pie chart, apart from the wording of “treats”, as these types of foods should just be another part of the pie chart rather than being labelled with a word that holds so many negative connotations.

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What I do like about this pie chart is that it shows that 10% of your diet in a day should include foods deemed “unhealthy” by society. Foods like cookies, sweets, chocolate, cake, biscuits etc. Now this chart shows a representation of your daily diet. If you start to think about it, that means that you can eat these foods every day – something that I have seen demonised in countless magazines and online articles. I have often seen or heard advice that you should only eat “treats” a few times a week, and no way am I giving up my daily dose of baked goods, however much you tell me it’s not good for me, Karen.

The thing is, a lot of us believe the words “balanced diet ” to exclude those yummy foods that are so often seen as the devil. The thing is, these foods are an important part of a varied, balanced diet. They are part of our mental health – because we should not deprive ourselves of anything. They are a good, quick energy source for our bodies, and they are especially helpful to our bodies in recovery because of this. Eating a balanced diet means eating bits of everything. It means not restricting any food types or specific food items, unless you have a food allergy, food intolerance, or you have an illness that requires you to cut out certain foods or monitor them. It means varying what you eat and not eating the exact same thing every day (yeah, I’m talking to you, ED). It means eating foods and consuming liquids that you enjoy. It means getting in those nutrient dense fruit and vegetables. It means providing yourself with an adequate amount of carbohydrates so that you have enough energy for the day. It means having that coffee and cake with Ann, and getting takeaway with Heather, and digging into ice cream and popcorn in front of a movie with Sam. It means changing up your routine. It means being flexible. It means trying out new things. It means going back to old favourites. It means hearty meals, light bites, snacks, and puddings. It means not overthinking it and letting your body lead the way.

So often these wonderful foods like crisps, pizza, and cake are associated with feelings of shame, greed, and overindulgence, and there can be judgement from others when eating them. However, this is only because they also have been made to feel those negative emotions when eating those foods themselves. The thing is, food is not a moral issue (and you can read my article on that here). You are free to eat what you want, when you want. You are free to be as healthy or unhealthy as you want – and that is not anyone’s business. And if you want to be healthy, follow the lead of your body (yes, I will repeat that until my death). If you want to check that you are eating a varied, balanced diet, do a quick valuation of what you eat on an average day or an average week, but don’t overthink it, as this can very quickly descend into a spiral of obsession. As long as every food group is incorporated into your diet, that’s a good sign. And when you’re uhmming and aahing in the cafe with Susan, just get the damn cake.

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To The Bone: Yes, Another Review

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To The Bone is the hot topic right now in the eating disorder community: amongst those who are suffering, those in remission, and professionals who work with people with eating disorders. There are reviews being written about it left, right, and centre, and unfortunately I am here to throw my unoriginal opinion into the mix. I know that what I am about to write has been said already, but I wanted to join the conversation. Here are my thoughts on To The Bone below.

(GIANT SPOILERS ALERT FOR THE CONTENT BELOW)

What was wrong with it:

It shows an overly represented narrative

Eli is a straight, white young woman from a wealthy family, which is totally great, because I’ve just never seen that narrative be explored before. Not. How many times have we seen this in the media? Over and over and over and over again. Quite frankly, I’m bored of seeing emaciated white women counting their ribs in the mirror as their white panties hang off their hipbones. Not that their suffering is invalid, but because the suffering of others is just as valid and I’m not seeing them represented anywhere. Where are the black girls with anorexia? Where are the average weight women? Where are the men (I know, a man was included in To The Bone, but he was not the main character – it was not his story)? Where are the girls with bulimia (the one girl with bulimia got about a minute and a half of screen time) and the men with anorexia athletica, and the elderly? Or just anyone who isn’t white having any other eating disorder than binge eating disorder? We don’t see these people in leading roles, or talked about in magazines, or depicted pretty much anywhere, and they are a huge portion of people with eating disorders. The straight white wealthy female narrative is overdone. It is cliche, it perpetuates myths and stereotypes, and it is damaging for a large portion of those with eating disorders who do not see themselves represented anywhere, and therefore, feel that their pain is invisible, and that they are not sick enough to be noticed.

The lead actress – a recovered anorexic – starved herself for the role and then gave ridiculously problematic interviews about it

Lily Collins said that it was a “scary process,” but “I knew that, this time, I would be held accountable for it. I would be [losing weight] under the supervision of a nutritionist and surrounded by all these amazing women on set. So, I knew that I would be in a safe environment to explore this.” Do you know what is not safe in any environment? BECOMING EMACIATED. Do you know what is especially not safe in any environment? BECOMING EMACIATED WHEN YOU ARE IN REMISSION FROM ANOREXIA NERVOSA. The genetic predisposition for an eating disorder is triggered by energy deficit. A recovered anorexic cannot just lose weight and be safe. You cannot say that it is alright just because you are supervised by a nutritionist. Becoming emaciated always comes with risks, and becoming emaciated as a recovered anorexic opens the gateway as wide as you possibly can for the eating disorder to stroll right on through. Immersing herself into the role is also another huge risk factor for relapse. The point of this is not that I care about her health in particular, because after all she is an adult and she has the choice over what she does with her life. The point is that she is responsible for the way in which she takes care of herself and for the messages she gives out when she knows that a movie like this is going to attract a huge number of vulnerable people, most of them young. Saying that she lost weight in a healthy way to become incredibly underweight sends out the message to people with eating disorders that they can starve themselves and this is totally okay as long as they do it in a certain way – the “healthy” way. This is not helpful. It is damaging, and she should have been way more aware of the position she is in and how what she says will be heard by others. There is no way to starve yourself in a healthy way. Ever. She also said that she didn’t think she would fall back into it because she is “more mature”, as if that makes any difference whatsoever to the development and maintenance of eating disorders, or of the relapse into them. Eating disorders don’t just leave you alone because you grew up. Honestly, for someone who has had an eating disorder, she sure is giving interviews like she is entirely ignorant of them.

The director also said to PEOPLE that Lily Collins losing weight for the role was a conversation that they had and that part of it was “how do we keep you safe, and not at a dangerous weight that’s going to be triggering for you.” In what world was the weight she was at not dangerous for anyone? In what world was it not triggering for anyone with anorexia, let alone herself? I don’t know what planet these guys are living on, but it’s not the same one as the audience of this film.

The psychiatrist is an idiot

He is meant to come off as cool and modern with all the dramatic swearing (how scandalously hip of him!), “revelations”, “wise” and “meaningful” words, and trips to rain installations, but to me he just looks like he sucks at his job. For example, the first time is meets Ellen, he tells her that he is not going to treat her if she is not interested in living. Sorry, what?! Many people with eating disorders struggle to find reasons to live for and part of treatment can be helping someone to find them. He also dismisses family therapy after one session. Therapy is difficult. Family therapy can be a nightmare. But it is through this that many things can be explored and sometimes resolved. You don’t just give up on it in one session, and to me, it looked like that session brought up a number of issues that needed to be addressed. He also tells her that he doesn’t like her name and that it doesn’t suit her and tells her to change it. Maybe this was some sort of point about making a new identity for herself, but it came off as rude and inappropriate. And since we are on the topic of inappropriate, it is highly unlikely that a professional in his position, as a male, would be in her room alone with her at night. Just saying.

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The love story overshadowed the whole thing and was incredibly unhealthy

“I need you, Eli,” Luke, the love interests, says as Ellen leaves the unit after feeling completely overwhelmed. Luke puts Ellen on a pedestal and then continuously pushes responsibility onto Ellen for his wellbeing. He spends the entire time demanding things of her: things that often she feels she cannot do, and when he gets pushy and she snaps, he gets all upset and butthurt. This is not romantic, and this is not what should be portrayed as a good relationship. As their relationship grows, he insensitively (and that is putting it lightly) brings up the topic of sexual abuse and asks if she has been sexually abused, saying that it’s a thing amongst “us rexies” (seriously, rexies?!). He then proceeds to tell her that she needs to be touched by someone who cares about her. That’s right: needs. Nothing like a bit of sexual coercion to set a really good example to an audience of predominantly vulnerable young women. And don’t get me started on the idea that women just need to fall in love with a “great guy” in order to find a reason to recover…

There was a weird, psychoanalytical scene that came out of nowhere

Near the end of the film, when Ellen is coming to the end of her tether – or her life – Ellen stays in her mother’s yurt. Her mother starts to talk to her about her experience of postnatal depression after Ellen was born, and how she did not hold her enough and how her pastor suggested feeding Ellen like a baby in order for Ellen to heal from the neglect she had experienced in the past from her mother. Ellen wants to think about the idea, but as her mother leaves says “mom, please feed me.” Her mother then sits Ellen in her lap like a baby and proceeds to feed her from a baby bottle. The scene to me was uncomfortable and totally out of context. If more was explored and developed from this angle, I don’t think it would have come off as such a strange scene, but it was totally out of the blue. It also directly proceeded Ellen’s “revelation” scene, as if being fed by her mother was so healing that it led directly onto a pathway to recovery. It was completely oversimplified, as was the next scene which leads me onto…

Ellen’s revelation moment was ridiculous

Ellen has a dream about being a healthy weight in a tree. She looks down and see herself, curled up in a foetal position, on the ground, naked and emaciated. “Is that me?!” she asks, shocked. When she wakes, she has the drive to recover, and returns to the unit in order to get better. I know that this was an interpretation of the director’s experience, but as a director you must know that you are not just sharing your version of events but also sending a message to the world. This airy-fairy scene is, to me, undermining, and made the transition from wanting to stay sick to wanting to recover look as easy as switching on a light in a dark room, when for many it is months and months of indecision and struggle before they are finally able to give themselves permission to make the arduous but invaluable journey towards freedom.

It glamorises eating disorders

They did not seem to do too well in their quest for awareness with eating disorders let’s be honest, and just like nearly all media, it has also successfully glamourised eating disorders. Beautiful Ellen, with her smoky make up, cool clothes, and sarky attitude, who doesn’t give a shit and eye rolls at every given opportunity. She just doesn’t seem to make eating disorders seem all that bad, does she? Then there are the discussions of behaviours and weight loss strategies within the eating disorder unit that she stays in. There’s the quirky boy that she falls in love with, and the handsome psychiatrist, and almost no discussion about what actually goes on inside the head of someone with an eating disorder. All we see is Ellen pushing food around her plate; Ellen doing sit ups in bed; Ellen fainting; Ellen rejecting food; Ellen getting thinner thinner thinner. All we are seeing here are the physical symptoms and behaviours of eating disorders, and when you don’t see the torture going on in someone’s minds; when there is barely a conversation about it, then how is it going to look like the hell it is to vulnerable people watching it? How does it dissuade people from carrying on into darkness; how does it help people to seek help; how does it educate those who don’t have eating disorders themselves? The truth is, it doesn’t. Not in any shape or form.

It isn’t even interesting

To The Bone is – to put it bluntly – boring. It doesn’t change anything. It doesn’t challenge any myths or stereotypes. People who are knowledgeable about eating disorders haven’t learnt anything new, and neither have those who aren’t. It is a non-film: at best, people will watch it and come away with nothing new. But at worst, as discussed above, it sends out damaging messages to those susceptible to them.

So what’s right with it?

It acknowledges the effect that eating disorders have on loved ones 

During family therapy, and at other points in the film,  the affect that this pervasive and deadly illness has on everyone around them was depicted. This was a positive aspect of this movie, as often stories about people with eating disorders are very much focused on how the main character is affected and does not show the way in which it disrupts the lives of loved ones and the immense pain it causes them.

It acknowledges the hunger

“I’m really fucking hungry. Like two years worth of hungry,” says Luke at one point. I practically whooped at this small but important acknowledgement of the intense hunger that people in recovery often experience, and how this is quite clearly obvious. It is hunger from years worth of damages, and it is there for a reason. The body wants to heal!

It shows a tragic consequence of having an eating disorder

One of the women in the house is pregnant, but she goes on to have a miscarriage. I thought that this was the most moving scene in the film, and shows what eating disorders can do to eating disorder sufferers, outside of the usual symptoms that are often shown.

It did depict one male character with anorexia

Which is great. (But he was still an asshole).

So in conclusion…

Overall, this film to me wasn’t worth making. The only real positive that I can see from the making of this film is that it has provoked conversation across all social media sites. People are naming what is wrong with this film and that sparks debate: debate that will hopefully be educating people. Unfortunately, those involved with reading these sorts of articles will nearly always be those who are already well-versed in eating disorders, whereas the film will have a widespread audience and was a chance to educate people who would not otherwise engage on eating disorder topics. Whilst for many it will be a fleeting moment in their lives, for others it could have a negative impact that could be a factor in propelling them towards unhealthy habits with devastating consequences. Let’s just hope not.

Are You Listening? How We Hear the Things that People Say About Our Bodies When We Have An Eating Disorder

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My partner and I are lying in bed. He’s got his arms around me and we are a tangle of limbs beneath the sheets. Then he speaks.
“You’re so soft,” he says.
He says this a lot. He also says things like “you’re so huggable” and “you’re so squeezable”.

I wonder what your reaction was reading those words. Imagine hearing them said to you. How would you feel? What would you hear? I know what my reaction would have been a few years ago. I know that I would have heard “you’re fat”.

The thing is, we listen to what people are saying and then we apply our own filters to the words; filters which have been created from a whole myriad of experiences. That is what our minds do, and when it is someone with an eating disorder, that filter is especially pervasive, vehement, and antagonistic in the most negative of ways when it comes to comments about our bodies. People’s words go through this filter and it gets translated, so that what we hear is not necessarily what was said.

In this instance, I did a little laugh as I realised that his words went through my “ED translator”, and then carried on through my “recovered translator”, meaning that it went through two stages: “you’re so soft” turned into “you’re fat” and then into “he means your skin is soft or maybe he does mean your body is soft and so what Sarah, a lot of it is, and that’s nice, and it is nice to hug soft things that’s fine stop acting like he told you that you look like a naked mole rat that went through a blender.”

Sometimes my partner even puts his hand on my stomach and gently squeezes the squishy bit. Yeah, you can see my face now:

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If it was me three years ago I would have had a meltdown and engaged in some drastic and incredibly harmful behaviours, and it would be something I would probably remember forever as a trigger point for self-loathing. However, I am not that person anymore and I am – thankfully – now not in that torturous place. Instead I asked (slightly incredulously):
“Are you squeezing my fat?!” to which he replied: “Yeah, sorry.” Again, three years ago I would have heard that answer as “yes you remind me of a beached whale and I am poking fun at your fatness and reminding you that you should probably do something about it because it is gross.”  But instead the translation that finally came out of my little two-staged system was “You have fat on your body and he squished it because he had his hand there and it is a part of you and it it something that squishes and that’s okay; he still finds you attractive and wants you to be naked 100% of the time.” Because I suffered from an eating disorder for ten years, and because I live in a society that highly values diet culture and thinness, my brain will always automatically put the words through a negative filter. But because I was able to fight tooth and nail for my life and succeed in claiming it back from my powerful and evil mental illness, and because I then went on to reject diet culture and embrace body positivity, I have a wonderful second filter in place that allows me to pause, rationalise, and try to really hear what people are saying when it comes to my body (and everything else).

The important thing in these situations is that the outcome is totally different depending on where your head is at and on your ability to hear what is really being said rather than putting it through your own personal filter. You want to be able to really hear what the speaker of the words means rather than ending up reflecting back your own insecurities as a response. If we hear things through a negative filter of our own, it can then lead to negative situations with that person or people, because we think that they are insulting or hurting us. It also leads to a spiral of negative thoughts and possibly subsequent harmful behaviours. It is important not to hear the words that people say as confirmation of our own insecurities. Your eating disorder is always looking out for ways in which to validate itself. Don’t let it cause distance and destruction towards others or yourself.

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If you are struggling with something someone is repeatedly saying, or even a one-off comment that affected you, then talk about it. Be calm; be open; be honest; and try not to use accusatory language. Instead use “I feel” or “my eating disorder hears it like x” as opposed to “you are doing x/you are making me feel x”. People’s defensive barriers go up when they feel that they are being attacked. Often what is being said is actually okay to say and is not intended harmfully, but it is the eating disorder that translates it into something else and then causes harm. Because of this it is more productive to talk about how the eating disorder is at fault rather than them, or you. Of course I am perfectly well aware that there are those who are disrespectful, insensitive, and malicious and do intend to cause damage or do not care enough not to, but I am for now talking about those who we assume are not saying the wrong thing per se, but are saying things that are triggers for the eating disorder, which then rears it’s ugly head and translates for us.

It is not an easy thing to change the patterns within our brains, but it is possible. It takes time, and patience, and perseverance. It takes determination. It takes persistence. It means having to challenge negative thoughts every damn minute of every damn day. It means working towards liking and respecting yourself as a person. It means taking steps towards accepting your body as it is at its individual natural and healthy weight. It means screaming “NO” to the eating disorder and fighting for your health and happiness. It means recognising that the people who love you are not out to hurt you. It means remembering that you might at this point in your life feel hatred towards your body and self-loathing towards who you are, but that that is not how other people feel about you. It means recovery, and it means going on a journey to the place you want to be; to the life you want to live; to being the person that has been suppressed by the eating disorder. It means taking the path that leads to being free.

Recovery Does Not Mean Compromise

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Recovery from an eating disorder is a fantastic thing. A long, arduous, torturous, fantastic thing. It is painful and it is terrifying and it is tedious, but it is the most rewarding thing anyone with an eating disorder will ever do, because it gives you your life back. It gives you back your freedom, and it gives you back your health. However, all too frequently I am seeing what looks like compromise in those who claim to be recovered from an eating disorder.

I want to state right now that the recovery journey in itself does often entail some compromise as we navigate our way from disordered to healthy. It does frequently mean swapping things in and out, finding that with challenging one behaviour another pops up more strongly, transferring fixations and focus from one thing to the next, and other such struggles as we learn how to overcome our sickness. That is perfectly okay. That is part of the journey. It is part of managing the initial trauma of recovery. But there comes a certain point where you have to challenge how you are recovering, and you have to move on from compromising with your eating disorder. There comes a certain point where you have to be aware of all those things listed above, and start to do something about it, because although at the start recovery may include it, recovery cannot be about compromise. Recovery has to be about getting rid of the disordered habits, not switching them up for more socially acceptable ones and calling it healthy.

I get it: it is easy to fool the world and it is easy to fool yourself that eating “clean”/detoxing/eating only “healthy” foods/being vegan/going Paleo/etc and going hard at the gym/training for marathons/attending multiple aerobics classes/etc is living a recovered life, but those sneaking eating disorder lies and manipulations only prevent you from living the life that you deserve to live: one free from the shackles of your eating disorder. We as a society can praise the woman who “recovered” from anorexia nervosa and became a bodybuilder all we like, but it doesn’t change the fact that she still has an eating disorder. We can applaud that man who went from having bulimia nervosa to being a fitness instructor whose muscles ripple and glisten in the sunlight, but that doesn’t alter the fact that he has just switched up one eating disorder for another. We can use the woman who “beat” her eating disorder and now stocks her kitchen with protein shakes, quinoa, and lentils, and exercises an hour every day as inspiration, but that doesn’t change the fact that her life is still dominated by rules and routines and fear.

Recovery means breaking free of that suffocating cage. It means tearing down the walls that keep you from dedicating your time and energy to your passions, hobbies, interests, and relationships. It means not worrying about your calorie or macro intake. It means engaging in physical activity that you actually enjoy when you want, not in a fixed, rigid routine. It means resting whenever, but especially when you are sick, tired, or having any intrusive eating disorder thoughts, however small (because being recovered does not mean being cured). It means throwing off the shackles of guilt and anxiety by challenging and overcoming every negative, controlling eating disordered thought and behaviour. You know what they are. Push away the convincing eating disorder voice, and listen to your gut. Do you feel free? Think about the life that you want to lead. Is this it?