Category Archives: Mental health

Calories: Why You Need More Than They Tell You

food illustration 4

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.

eaing 2

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?

food-illustration-3

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.

eating

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.

food illustration

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.

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

6 Replies

Image result for freedom

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:

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.
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.
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.
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.
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.
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.
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.
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.

So Now We Have to Lose Weight to Get Surgery

2 Replies

On Sunday I read the news that obese NHS patients will not get non-urgent surgery until they lose weight.

It made me want to cry. I’m a recovered anorexic who is very active and eats a varied and balanced diet and because of that I am both fit and healthy. I also happen to fall into the “obese” BMI category. In order to lose weight I would have to restrict my food and exercise to the extreme, leaving me both hungry and exhausted; pushing my body below the weight that it sits naturally at. This is unhealthy, and it would mean that my physical and mental health would be in decline. I would also end up spiralling back down into a very dark and dangerous place, with even more devastating and continual effects to my physical and mental health. If I required non-urgent surgery, I would therefore have to force my body into a place where it is not at its healthiest, experience distressing physical symptoms, and in the process would be triggered into a life-threatening mental illness that could leave my physical health in such a bad way that it could kill me – if the torture of living with an active and consuming eating disorder didn’t tempt me to end my life first. In short, I would be put in a life-threatening situation in order to get non-urgent surgery. For me, it wouldn’t be worth the risk.

Artwork by Francis Cannon

BMI is bullshit. All health professionals know this. And if they don’t, then they should: there’s been so much indisputable evidence that shows us that using a basic BMI chart to tell us whether we are healthy or not is ridiculously primitive, simplistic, and inaccurate. To think that I might not have access to the same healthcare as someone thinner than me after working so incredibly hard to get to this healthy and happy point in my life both physically and mentally makes me feel sick.

We all have individual natural and healthy weight ranges that our bodies choose and we maintain when we have a healthy lifestyle. We don’t get to choose that weight. No one else gets to choose that weight. Our bodies determine it. And those people who don’t fit into the “socially ideal” weight category (that literally wasn’t EVER intended as a way to measure health) get punished for it (whilst those who push the “obesity epidemic” and reinforce the stigma and myths around “obesity” profit from it). There is so much overwhelming evidence that it is possible to be healthy at most weights, shapes, or sizes (depending on yourself as an individual and what your own personal healthy weight is), and it is nauseating to think that people will be forced to make a choice that could cause them both physical and mental distress.

Even regardless of health, “singling out patients in this way goes against the principles of the NHS,” says Mr Ian Eardley, senior vice-president at the Royal College of Surgeons in The Independent.

The article also reports on more details:

Patients with a Body Mass Index (BMI) of over 40 will not be referred for routine surgery unless they are able to reduce it to under that number over a nine-month period.

Alternatively they will be required to shed 15 per cent of their weight, according NHS Herts Valley Clinical Commissioning Group (CCG) and NHS East and North Hertfordshire CCG.

Whichever achieves the greater weight loss will then allow them to be considered for surgery.

Patients with a BMI over 30 but under 40 will also be required to reduce that figure to under 30 or lose 10 per cent of their weight before they are considered for surgery.

This decision is yet another discriminatory act against people in larger bodies in the UK, and I’m so tired of it. I’m tired of being told everywhere I look that my body is “wrong”. I’m tired of watching my category of bodies represented by images of men and women with protruding stomachs and their heads cut out of the shots as if they are nothing but their size (for example right now I typed in “obese patients will not get non-urgent surgery until they lose weight” into Google and the majority of the images are fat people with their heads chopped off – seriously, I’m so done). I’m tired of things like having a “World Obesity day” following the National Mental Health day – which if it wasn’t so revoltingly ironic, would be laughable, without even addressing the fact that there is literally a day to tell us all how bad and unhealthy our bodies are if we are over a BMI of 30.

Artwork by Frances Cannon

Despite that, I’m someone who exists in a body that is fairly “average”. Even as an “obese” person, I have an amount of thin privilege. I can fit into clothing at regular stores. My friends laugh as if it is absurd when I say that my body fits into the “obese” category. My booty is the UK’s “average” size (although this booty is anything but average, just saying), and my top half is below the UK’s “average” size (and just so you know the average clothing size for women in the UK is a size 16, which is a US size 12, and in the U.S. the average size is between a 12-14, which is a UK size 16-18). I have only had one health professional (physiotherapist) mention my weight in a negative way (AFTER I had told him all about my previous experience with an eating disorder and described to him my active lifestyle and balanced diet. And boy, did he receive an educational six-page feedback letter on eating disorders and health at every size? Yes he most certainly did). The discrimination that I face is significantly less than those who live in bigger bodies than I do, and it can have devastating effects on mental health.

I don’t want to be fighting to be seen as equal to other people because of my BMI. I don’t want to fight for those bigger and smaller than me to be treated the same. I don’t want to fight to get rid of negative associations with certain body sizes. I just want it to BE like that. Right now. I will, of course, keep fighting this fight, but man, am I exhausted of having to argue with at least one person every time I say that to be obese is okay and that someone who is obese can be just as healthy as someone who is not. And now we have our healthcare to fight for, too.

Hopefully, one day, we will all be at peace with our own bodies, and each other’s, and regardless of our weight, shape, or size, we will be treated equally and our health considered individually. Until then, let’s keep being angry, let’s keep speaking up, let’s keep pointing out the evidence, and let’s never give up.

Artwork by Francis Cannon

A Balanced Diet: What Do Those Words Really Mean?

2 Replies

Related image

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:
Image result for balanced diet

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.

Image result for balanced diet

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.

To The Bone: Yes, Another Review

3 Replies

ToTheBonePoster

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.

tothebone

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

1 Reply

speak-listen-image-e1436187399321

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:

meme

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.

trh_the_act_of_listening

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

4 Replies

art 8

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?

5 Ways to Manage Exercise In Remission From An Eating Disorder

2 Replies

loving-yourself

So you’re in recovery from an eating disorder, or disordered eating, or compulsive exercise, and you’ve used and abused exercise as a form of punishment/weight-loss/distraction/control/etc – whatever reason you’ve used it for, it’s come from your eating disorder or disordered thoughts, and it’s well and truly messed up your relationship with exercise. To be fair, with the society that we live in, you don’t even need an eating disorder to have the idea of exercise completely screwed around with and made into something that is a torment. Thanks, society! But whatever has caused your negative relationship with exercise to develop, and whatever you are recovering from, you’re now wondering…am I ever going to be able to have a healthy relationship with exercise again? How will I keep fit and healthy once I am recovered if exercise has such negative connotations for me?

Moving your body in life is part of general well-being, both mentally and physically, but it’s a totally different experience to forcing yourself to the gym five times a week because you want to lose 10lbs or get a six pack. It’s not the same as stressing over being at peak fitness, or worrying that if you don’t do x amount of exercise, you won’t be the healthiest that you could be. It’s about exercise being an enjoyable addition to your life; something that isn’t rigid or absolute, but something to engage in as and when it fits around the rest of your life. Here are 5 things to think about when trying to establish a positive relationship with moving your body:

1. Go Cold Turkey

If you want to change your relationship with exercise so that it is a healthy one, you first have to break your addiction to it. That means stopping exercise entirely. It means totally breaking all your compulsive habits; it means managing the anxiety that goes with that, and it means overcoming that anxiety, in order to be able to develop a totally new relationship with moving your body. You can’t just flow from a disastrous and destructive relationship into a positive and beneficial one without stopping the former, unhealthy relationship, and leaving it behind you before starting to form a new relationship in a totally different way.

2. Traffic Light Your Exercise

The first thing I did when I really got to grips with the reality of my situation with exercise was to traffic light each individual type of exercise. I was in recovery and I was failing in my attempts to cold turkey exercise. I would stop and start, stop and start, and each time I started, I without fail fell back into the addiction. And so eventually I decided that if I was ever going to be able to move my body in a healthy way without the compulsive element creeping back in, I’d have to first recognise that going back to it wasn’t working and that I’d have to cease it entirely for a while, and secondly, that going back to the same type of exercise was setting me up to fail. I decided that I needed to categorise each type of exercise in an honest way in an attempt to recognise exactly when things were headed in the wrong direction. For example, badminton I green-lighted: it’s a sport that I did not play at all when sick and a sociable sport that I enjoy playing. I know that my risk of abusing this is almost nil as I play it for fun with my friends. Walking and swimming I orange-lighted: both had been abused during the time that I was ill with my eating disorder, but are also activities that I take pleasure in. These are activities to keep an eye on; to assess myself now and again to make sure that they are being used in a positive and healthy way. Aerobics I red-lighted. Aerobics is a form of activity that I do not enjoy and used purely as a way of losing weight. I know that if I find myself doing aerobics, then something is very wrong, and I need to address it ASAP. Traffic-lighting your exercise only works if you are completely and utterly honest with yourself, and then continue being honest with yourself when you have your traffic light system. There are no excuses for those red-lighted activities. Those orange-lighted ones are going to be the trickiest to keep an eye on, because it will be more difficult to distinguish when it’s being used in a positive or negative way, and again, that requires 100% honesty from you, to you.

3. Move Your Body in an Enjoyable Way

Find recreational activity that you actually like doing that involves moving your body. This could be taking your kids swimming, walking your dog, riding your horse, or playing footie with the guys. It could mean taking photographs on a country walk, taking a sunset stroll to the pub with a mate, playing rounders with a bunch of friends, or taking part in the annual cheese-rolling contest (no, seriously, we have that here). Find something that is actually about enjoying yourself, rather than about exercise. Find something that is another hobby. This is not about exercise – that is secondary. This is not about changing your body – that is no longer the aim. This is about moving your body and enjoying it whilst you do it. There are no reasons for doing this any more other than pleasure and recreation: this is not about guilt, or burning calories, or altering your appearance. This has to be just another thing in your life that you enjoy doing, that coincidentally involves moving.

4. Don’t Have Set Routines or Rules

Do not get caught in the trap of setting routines for yourself that you find yourself unable to break. You don’t have to play tennis every Thursday. You don’t have to walk to town every time you need to go to the shops. You don’t have to swim 25 lengths every single time you get in the pool. Switch it up. Fit these hobbies around the rest of your schedule rather than fitting the rest of your schedule around moving your body. Try not to make it a priority – because it’s not. There are more important things than physical activity. Do it as and when. Do it because you have a spare couple of hours and you need some fresh air, or to let off some steam. When it comes to making something a set routine, you know as well as I do that they can quickly become compulsive time slots where you feel that you have to do that certain activity, for that certain amount of time. Check in with yourself about how you feel before doing an activity and go with how you feel, not how long you feel you should be moving for. If you feel tired, skip it for today. If you’re sick, skip it for today. And if you are feeling that there is a certain amount of time that you should be exercising for, then you’re probably not ready yet to reintroduce movement back into your life, and should go back to resting, and working on your relationship with healthy movement. When it comes to rules, I’m talking about that little voice that says: “I can eat x if I do a pilates class” or “I can have a nap later if I have an hours walk” or “I can rest all day tomorrow if I do a run today”. No, no, no no no no. If that is what is going through your head, then you need to check out number 1 again and cold turkey your exercise. You need to separate everything from movement food; weight; rest; everything – nothing should be linked with exercise other than the fun of it. If you are setting rules for yourself, you need to continue working through your issues with exercise and how you use it.

5. Assess Yourself…Then Assess Yourself Again

This is so, so, so important to do, and again, requires being transparent with yourself – always. It means checking in with yourself over and over and over again to see how you are feeling about the movement that you are engaging in, and your reasons for taking part in the activity in your life. The more stable your remission, the less you may find that you need to check in with yourself, but this takes time, work and patience, and however firmly you are in remission, you still need to take the time to reflect on the movement in your life and how that is going for you. If you are feeling uncertain about any type of activity that you are doing, then you need to cease it. Challenge yourself now and again to test yourself: can you go a week or two being sedentary? Doing this is one of the easiest ways to see what anxieties arise for you when you take time out and rest up (or even think about doing it), and is one of the easiest ways to identify problem activity. It means acknowledging and working through whatever anxieties you feel if you should feel them.

body-positive

Really, this all comes down to getting to a place where you love yourself as you are and don’t see exercise as a way to change your body. It comes down to not feeling the need to compromise your health and happiness. It comes down to always being honest with yourself so that you stay within the boundaries of what is healthy for YOU. It means coming at recreational physical activity with a totally different mindset. It means finding what is right and healthy and positive for YOU, and going with that. It means being able to not exercise at all, in order to then exercise in a positive way. It means taking time out whenever you want/need to. It means not having any anxiety around moving your body. It means loving yourself, and loving your body, and it means being free.

An Open Letter to the Girl I Saw at the Pool

Hidden Behind A Healthy Weight: The Eating Disorders You Can’t See

5 Replies

invisible

Eating disorders are complex illnesses. They are a mental illness that often result in the deterioration of physical health, and there is not one recovery method that has a high success rate as of yet. They have a complicated entanglement of genetic and environmental causation that is entirely individual to each person. There are many different types of eating disorders (anorexia, bulimia, EDNOS/OSFED, ARFID, BED, purging disorder, rumination disorder, pica), and people of all ages, genders, weights, ethnicity, sexual orientation (etc, etc) can develop one. And yet we are bombarded only with images of eating disorders in the form of extreme anorexia: the emaciated, skeletal bodies of those walking the fine line between life and death. The media blasts out the headlines that often scream something like “I WAS 4ST AND ONLY ATE A LETTUCE LEAF A DAY”. They plaster photos of bones protruding across the articles and present to us an “after” photo of the recovered victim: nearly always a slim, beautiful, white young woman.

And there we have it: the damaging stereotype of what an eating disorder looks like and who develops one. This stereotype harms everyone who deviates from the narrative of pretty young white girl who starves herself to within an inch of her life. I’ve never seen an article about anyone black with an eating disorder. Ever. I’m sure that there are one or two articles out there, but the media all but erases the existence of black men and women with eating disorders. It erases the existence of older adults with eating disorders. It erases the existence of men with eating disorders. In fact, the media erases nearly all eating disorders in themselves – the minority of people with eating disorders experience anorexia nervosa, and an even smaller amount have the chronic anorexia that the magazines depict. “Before the latest change in diagnostic criteria, it was estimated that of those with eating disorders, 10% were anorexic, 40% were bulimic and the rest fall into the EDNOS category” (from here). Most of the 90% of people with eating disorders that are not diagnosed as anorexic will be fit into the “healthy”, “overweight”, or “obese” BMI categories. That’s not to mention all the undiagnosed people who are not seeking help and are invisible because of their weight, who are not getting the help and support that they need and deserve.

There are also different types of “invisible people” with eating disorders at a “healthy” weight. Those who have lost lots of weight but come from a higher weight are one set of people. These people are often congratulated for their weight loss, even though it has been lost in exactly the same way that someone going from a “healthy” BMI to an “underweight” one has – someone who would be diagnosed with anorexia rather than praised for their efforts. We offer treatment to those that lose weight and fall into the weight criteria for an anorexia diagnosis, and pat those on the back that lose the same amount of weight but come from a weight perceived as socially unacceptable (or a weight perceived as “acceptable” but not “desirable”). And what many people do not know, or forget, is that we all have our own natural healthy weights (that can be pretty much any weight, shape, or size), and if people are well below those weights, they are underweight for their own individual body. So if someone is naturally a BMI of 27 and they starve themselves to a BMI of 20, they are severely underweight for themselves, but their eating disorder are often dismissed as “healthy weight loss efforts”. Their illness can be not only hidden, but recognised as something positive, and therefore encouraged and reinforced. Included in this category are those who will never dip below a “healthy” BMI and could remain invisible for any amount of time, and those who will continue to lose weight. At this point society will go “woah, lose weight but not too much weight!” This is when their weight loss will be recognised as an issue, but as it was never noticed before, by now the person will likely be entrenched with their eating disorder.

Another group are people who have eating disorders but find that their weight doesn’t change much, or there are those that gain weight during their eating disorder. Weight is only a secondary symptom of some eating disorders, and it is important to understand that not everyone experiences a change in weight when suffering from an eating disorder. They are primarily mental illnesses.

Another group of “invisible people” at a “healthy” weight are those who are recovering from a low or lower weight and have gained weight to a weight that society deems “fine”. Peoples see them in the street and don’t suspect a thing. Friends stop worrying and family heave a sigh of relief. Those close to the person show less concern and more frustration: they think that the journey is over. You look fine therefore you must be fine. It’s important to remember that this is a mental illness, and that the physical symptoms are secondary. It is also important to remember that the person may still be at an unhealthy weight for their own personal body, and though they may be an acceptable size in terms of society’s standards, they may be underweight still regardless of BMI. Just because you can’t see their pain doesn’t mean that they are not experiencing it. The mental anguish that led them to rock bottom is still there and still needs to be addressed.

People who look fine but have expressed that they are not need to be taken seriously. They need to be supported, and they need to be encouraged to move towards being healthy and happy: whatever that looks like for them. It might not look like your idea of healthy and happy, but you have to put aside your biases, your judgements, and your prejudices in order to help that person achieve the best life that they can for them.

If you are someone who is living at what society says is a “healthy” weight, but you have engaged in disordered habits to get there, or you are regaining weight and are still unwell but people think you “look fine”, then sit those people down that are important to you and tell them. Set your boundaries, let them know what you need, and ask them to support you to get better. Be open and honest. Don’t downplay your struggles. Be assertive when telling them what is helpful and what is unhelpful. Print off information on eating disorders to support what you are saying and to give them something to read later to help them to understand how pervasive and powerful an eating disorder is mentally. Write a letter if that is easier. Whatever you do, talk. Your voice needs to be heard.