Tag Archives: diet

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.

5 Tips For Coping With January’s Diet and Weight Loss Talk

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It’s January, and we all know what that means: a total inundation of diet talk. It’s EVERYWHERE. TV advertising is filled with diet promotions, “healthy” eating, exercise equipment, gym memberships, and low fat yogurts (although hell, when do those NOT appear in the ad breaks?!). Friends, family, and colleagues are on a mission to lose weight, tone up, or get super heallllltthhyyyyyyy (god, pleeeeeease make it stop). “Lifestyle changes” are being broadcast from the rooftops (it’s still a diet, Susan, don’t kid yourself). It’s really difficult trying to deal with all this talk when you are trying to recover from an eating disorder or dieting, and/or are on a journey towards body acceptance. It can be downright triggering. So here are some tips on how to deal with the diet culture disaster that is January:

1. Set boundaries

I know that this can be really tough for a lot of people, but it is so important. If someone is talking to you about their diet/lifestyle change/new workout routine/how many pounds they’ve lost since only eating lettuce for the past two weeks, or god forbid are trying to offer you “advice”, tell them that it is making you uncomfortable. Hell, tell them that it downright harms you when you are trying so hard to explore a different path. Let them know that diet and exercise talk is not appropriate or helpful for you and that you would appreciate if you engaged in conversation about other topics instead. If they are commenting on your own body or eating habits, let them know it’s entirely not their business.

2. Use facts as a weapon against disordered thoughts

When you are feeling the insidious pull of temptation leading you towards to some sort of restriction, consider the facts:
* Diets don’t work. 95-97% of people who lose weight on diets regain the weight within 2-5 years (if not sooner). They also often end up gaining more weight due to the body trying to protect itself against “famine”.
* Chronic restriction can push people’s set points (their natural, healthy weight that is individual to each person) higher, because the body becomes damaged by getting less energy that it need, and can alter its set point in order to protect itself from harm.
* The metabolism slows as a response to not getting enough energy, and this makes it harder and harder to lose weight – which if you have an eating disorder or have ever been on a diet, you know already. Leptin levels also drop when our fat levels decrease. Leptin is a hormone produced by the fat cells in our bodies. It exists in the body in proportionate amounts to our weight. Our bodies want to compensate for this loss in leptin and respond by increasing hunger urges, which makes not eating enough super unpleasant – as you know already. Your body does not want to lose weight, and it is going to fight to keep it at its set point.
* Studies show that weight cycling (losing/gaining/losing/gaining) is much more unhealthy than just staying at a higher weight. It increases the risk of developing major illnesses such as cardiovascular disease.
* Restricting often leads to binging, and that’s a signal from your body that you are not getting enough energy on a regular basis. Binging also leads to emotions that are really not fun to experience, and can lead to even more unhealthy behaviours as compensation. Restriction also leads to obsessing over food, and that means less time for doing things that are important, productive, and enjoyable. In addition, restriction leads to increased cravings – again, not fun to feel, and again, often leads to binging.
* Any type of restriction is a slippery slope. It could easily turn into a full-blown relapse. Don’t risk it.
* Losing weight won’t make you happier. It won’t. We’ve all been there before, ladies and gentlemen. Who’s life was super awesome with an eating disorder/chronic dieting? I’m betting no one at all.
* Did I mention diets don’t work?

3. Unfollow or mute people on social media who are triggering you

This is advice for anytime of the year, but if people are going on about losing weight, cutting out certain foods, restricting their intake, or exercising then unfollow them. If anyone is making you feel bad about yourself, triggered, or is causing you to compare yourself to them, then unfollow them. If they are a friend or family member that you want to keep on your social media, you can mute their posts, or you can let the know that their posts are negatively impacting on your wellbeing (see tip number 1).

4. Fill your social media feeds with body positive and food positive people

This has helped me so much in the past few years, and is definitely one of the things that gives me ongoing support and a sense of community, hope, and positivity. Start following people who are body positive. Start following people who love food and have a healthy relationship with it. Start following people who are fat, trans, disabled, of other races than your own, etc. Fill your feed with people who are diverse. Fill your feed with people who look like YOU, and people who don’t. Just stop filling it with thin white women (or if you are a guy, muscly white men). Stop looking at people who you want to look like or be like, just because our diet culture told you that’s who you should look like or be like, and start looking at people who celebrate who they are. Start celebrating who you are.

5. Write down reminders of why you made the choice to try something other than dieting/restricting

There’s a reason that you are in recovery for an eating disorder or chronic dieting. There’s a reason you chose to try going down a new pathway; why you decided to give another option a try. I bet there are quite a few reasons. Write them down somewhere where you can always see them if you need to. If you need any help with thinking of reasons not to relapse, you can check out my blog post ‘Repel the Relapse: 8 Tips for Staying on Track in Recovery from an Eating Disorder‘ or watch my video ‘Reasons to Recover and Reasons Not To Relapse‘ on YouTube.

I know that it sucks to hear the constant chatter about diets, weightloss, exercise, and the body-shaming that comes with it, but you know it’s all for nothing. You know that diets don’t work. You know that it is extremely bad for your physical and mental health. You know it won’t improve your life, or make you happier. Remember remember remember. Grit your teeth, and do your best. You can do this.

Our Bodies and Us: The New Years Revolution

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Artwork by Marie Boiseau

It’s approaching the New Year (another one already?!), and a lot of people will be suffering with those all-too-familiar post-Christmas blues. And a lot of those negative emotions will be coming from the shame and guilt so many of us feel for eating what we wanted and eating more than we usually would. Our cupboards are filled with leftovers: chocolates; biscuits; crackers; cakes…not to mention the mountain of cheese in the fridge. We are slumped in front of the remaining Christmas TV and we are being inundated with advertisements. Diet advertisements. Like, seriously, they are really shoving it in our faces this year. Every time I turn on my TV there’s a woman with dead eyes smiling at me, talking about her calorie-controlled diet and how much weight she has lost. Her mouth says “this is great!” but her face says “help me I’m starving!”

The diet and weight loss industry raked in $66 billion in America in 2016, and in 2014 the British diet industry was worth £2 billion (and as far as I am aware that hasn’t changed). The UK has a £20 million laxative industry, and almost two thirds of Brits are on a diet “most of the time”, even though research has showed time and time and time again that diets do not work and that 95% of the time people regain the weight that they lost within 2-5 years (and frequently end up gaining more on top of that). In short, these corporate assholes are making money of our self-hatred, and they will feed into it (excuse the pun) as much as they can so they can continue bringing in the big bucks.

Their biggest secret? IT. DOESN’T. WORK. If it did, everyone who has been on a diet or restricted their intake (which if we are honest is pretty much all of us) would be thin, and we would be thin forever, because that is what a success is: reaching a goal and staying past the goal posts (obviously this is not what I view success as, but in that context that is what people on diets are aiming for). But we aren’t staying thin – if we even get there in the first place. Those who go on diets lose weight, then gain it back again, then find another diet to go on, and then regain the weight (and so on and so forth). Or they don’t lose weight at all. If we want to stay thin, we have to punish our bodies and our minds every single day; something that most people cannot sustain, and something that is extremely damaging. Those that can are nearly always the victims of torturous eating disorders – and some of us will die trying to reach an unattainable goal with ever-moving goalposts.

So this year, let’s go into the new year with a different motive. Let’s choose life. Let’s choose happiness. Let’s choose self-love, and body-acceptance. Let’s see food as just that – food. Let’s see how it brings us together. Let’s eliminate the use of labelling foods as “bad” and “good”, and let’s eradicate the words that send a shudder down my spine “I’m being good” or “I’m being naughty” (oh god I’m shuddering just typing it eaugh). Let’s choose to nourish our bodies with adequate and consistent energy. Let’s face our fear foods and overcome them. Let’s stand in front of the mirror and challenge all the negative things that we feel about our bodies. Let’s support our sisters and brothers in body positivity, and let’s make the promise to ourselves and each other not to waste time on diet and weight talk, and self-deprecating comments. It will take time, and it will be hard, but let’s make this not just a New Year’s Resolution, but a New Year’s Revolution. Let’s fight to end body hate, not be a part of it, even if that means taking it one small step at a time.

So Now We Have to Lose Weight to Get Surgery

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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?

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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.

Is Intuitive Eating a Good Idea in Eating Disorder or Dieting Recovery?

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Intuitive eating is a concept that really resonates with me. In a society entrenched with diet culture, a huge percentage of people have lost the ability to trust their bodies, and instead opt for counting calories or macros, or eliminating food groups, or trying out various juice fasts, veggie cleanses, cabbage soup diets…the list of restrictive diets and ways to self starve is endless. The fact that we do not ignore other bodily signals: emptying our bladders or bowels; sneezing; coughing; itching; removing our fingers from a burning surface; blinking; but ignore our body’s signal for hunger and then call it a good thing is absurd. We have decided to stop trusting our biological body; a body built for survival, and instead listen to the multi-billion dollar diet and weight loss industry, our unhealthy thin-obsessed culture, and the media which panders to both (again, to make money). It is nonsensical. It is ridiculous. It is madness. And yet nearly all of us are guilty of listening and responding to it.

Intuitive eating is a nutrition philosophy based on the premise that becoming more attuned to the body’s natural hunger signals is a more effective way to attain a healthy weight, rather than keeping track of the amounts of energy and fats in foods.

This is why I love the idea of intuitive eating (although do remember when reading the above that a “healthy weight” is whatever your body needs to be at naturally, and has nothing to do with BMI). Reconnecting with your body; listening to it; honouring its cues and signals; respecting it and giving it the treatment it needs and deserves…this is exactly the right attitude to have, and exactly the right action to take. However, when it comes to recovering from the effects of dieting, or even more serious, an eating disorder, intuitive eating becomes a little trickier to throw yourself into.

Months or years of damages done to the body through restriction can cause huge issues with the way the body communicates with you, especially when it comes to hunger. Your hunger cues may have become suppressed, and therefore will be unreliable during the recovery process. When this is the case, it means that both hunger for the correct amount of energy and cravings for the right types of foods that the body needs won’t be felt by the person experiencing this, and so intuitive eating would be a disaster for them. It would mean that they would not get the energy that their body needs for daily energy requirements, and would not get the types of food that the body needs and nutrients that the body is lacking in. For these people, intuitive eating would not be something that they could jump into straight away, and would have to be a goal for later on in the recovery process. Those without reliable hunger cues would need to count calories to ensure that they are eating enough (I wrote about calorie counting in recovery here), and also keep an eye on the types of foods that they are eating to make sure that they are getting enough of each food group.

Those with reliable hunger cues will find that they are able to move to intuitive eating sooner, although I would always suggest counting at first whilst you establish if you have reliable hunger cues or not (and I have a video on when to know when you are able to eat intuitively here). Those with reliable hunger cues may find themselves ravenously hungry, or may be hungry for the amount that they need day to day, and then find themselves absolutely starving most of the time. This is normal and expected and in recovery is called “extreme hunger” (I have a video on this here). This is something those in recovery often experience, but not always. Those with reliable hunger cues find that they are hungry for the amount of energy that their body needs each day.

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Some people in recovery go through periods of both reliable and unreliable hunger cues, and during this time it is best to keep counting calories and keeping an eye on what you are eating until you are receiving consistently reliable hunger cues.

For both those who have reliable and unreliable hunger cues it is important to make sure that you are eating all food groups, as they are all important for health. It is important to note for both those with reliable hunger cues and those with unreliable hunger cues that it is normal in recovery from restrictive eating disorders or dieting to crave foods that are high in energy, especially foods with a high fat, sugar, or carbohydrate content. This is because processed food can be one of the best things for recovery, especially during the initial stages. Foods high in energy help to fill the calorie deficit and repair the extensive damage done through starvation, as well as providing energy for the day. Foods high in fat help with regaining your period, aid bowel movements, and most importantly, the brain is made of at least 60% fat which requires eating fat in order to heal and maintain its health. Fat is also most easily processed by the body, which is quite essential to your damaged digestive system. Usually in recovery people crave “junk” food because this is just what their bodies need, and that is okay. If you are eating far more carbs than any other food group, that is okay. If you are eating far more sugary foods than any other food groups, that is okay. What is not okay is if you are only responding to these cravings and not having any other food group. Responding to the cravings is really important, but it is also important that you don’t go without an entire food group. Some people find that whilst their bodies are busy craving foods high in energy, it can end up not sending signals for fruit and vegetables. It is quite common for those with eating disorders or even dieting to have issues with filling up on fruit and veggies, and for these people, cutting down and thinking about it less is the goal, but for others, they can find that in recovery they can have reliable hunger cues for the energy that their body needs, but do not have the cravings for all the food types that it needs. The body, in this way, is being reliable in letting you know exactly what it needs in order to become energy-balanced (by craving foods high in energy), but has made this a priority and is not giving the right signals in order for the body to get all the nutrients that it needs. So if you realise that you are going days without fruit or veggies, make sure to incorporate some into your diet. Don’t become rigid or fixed upon a certain number, but just make sure you are having some throughout your day. The same applies to any other food group that you might find yourself not eating through lack of cravings.

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Whilst many people crave “junk” food, you may also experience cravings for dairy, cereal, and meat/fish. You can have cravings for anything! You may also find that you have cravings for odd combinations of food, and that is perfectly normal too. Just respond to what your body is asking for.

If you are experiencing extreme hunger and/or having intense cravings for only one food group or particular type on food – don’t panic. Appetite settles down when the body is healthier to include cravings for a massive variety of foods: chocolate, milk, fruit, cereal, doughnuts, pizza, pasta, vegetables, fish, steak, cake….EVERYTHING. No foods should ever be off limits, and your body will start giving you more and more reliable hunger cues as your body gets healthier and healthier, until you are able to really connect with it and trust it. Throw out your magazines. Forget the media. Forget diet culture and societies unhealthy obsession with thinness. Trust your body and work with it. There is no wrong way to have a body (and please please please check out weight set point theory, and health at every size under my resources section).

food 3

For some people, intuitive eating can be something that they start doing fairly early on in recovery from an eating disorder or dieting, but for others, it can take time for their bodies to adjust and be able to communicate correctly. Whichever is the case, intuitive eating is a fantastic goal to work towards, but it is important to recognise that it can take time, patience, and perseverance. I would always suggest it be the goal, and would never want anyone to have to return to listening to diet culture – it’s what got a lot of people into a terrible place emotionally and physically in the first place (particularly those recovering from dieting as eating disorders are nearly always a lot more complex . However, recovery is certainly not helped along by diet culture). Listening to your natural, biological, earth-given body is the best thing to do for your mental and physical health when it comes to eating. Not concepts created by society. And always know that food is not just about nurture and nourishment, but about pleasure and enjoyment too. Do what makes you happy and healthy, both physically and mentally. You deserve it.

New Year’s Resolutions vs Eating Disorder Recovery

Eating Disorders and Willpower: An Absurd Association

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Willpower. It’s something that we associate with strength. It is something that we admire in others, and it’s something we want for ourselves. And in this day and age, it is problematically associated with dieting and weight loss. The association even extends to restrictive eating disorders. I want to tell you how wrong it is to think that the two are synonymous.

I want to firstly consult the dictionary. Let’s take a look at the definition of “will”:

Will
noun
1. the faculty by which a person decides on and initiates action.
“she has an iron will”
synonyms: determination, firmness of purpose, fixity of purpose, will power, strength of character, resolution, resolve, resoluteness, purposefulness, single-mindedness, drive, commitment, dedication, doggedness, tenacity, tenaciousness, staying power, backbone, spine; More
2. control deliberately exerted to do something or to restrain one’s own impulses.
noun: willpower
“a stupendous effort of will”

A person with an eating disorder does not decide to have one. They do not have any power or control when developing or having an active eating disorder. They do not initiate action: the eating disorder does. They have no say in the matter whatsoever. So using “will” in the context of eating disorders is absurd.

Let’s also have a look at the definition of willpower itself:

noun
1. control of one’s impulses and actions; self-control.

Again, there is no control when it comes to an eating disorder. There is certainly no self-control. In actuality, it is the opposite that is true: someone with an eating disorder is completely out of control. They are not deciding to abstain from food or drink. They are not deciding to compulsively exercise. They are not deciding to vomit their meals into toilets and trash cans. They have no control over their ever dwindling intake, the inability to eat ice cream, or the ten miles they feel they must run. The severe mental illness that they are suffering from is running the show, not the person with the illness. Eating disorders are not a choice, and to insinuate that someone with an eating disorder has willpower is to insinuate that they have a choice.

You might be someone who has previously considered an eating disorder to be a choice, and are looking for an explanation of how it is not. Let me first stress: eating disorders have a genetic link. This means that if you do not have the genes to develop an eating disorder, then you will not develop one. If you have the eating disorder gene (which is being researched: the specific gene has not been identified as of yet, and it is most likely a combination of genes, not just one) then it is possible to go through life without triggering it into action. However, if environmental factors trigger the gene (and the triggers are plentiful: dieting, bullying, death of a loved one, abuse, parents divorcing, illness, fasting – you see how these can be both emotional or physical triggers), then you will develop an eating disorder. Genetics load the gun, environment pulls the trigger, the saying goes. So genetics have an important part to play in the development of an eating disorder, and you don’t get to choose your genes.

Here are some examples of how it works inside the mind: if you had to choose between eating a highly restrictive amount of calories and living with aching hunger, or feeling like tearing your own skin off, would you comply with your eating disorder or your hunger? If you had to choose between exercising until you felt like you might vomit and pass out or feeling so disgusting in your body that you would consider killing yourself, what choice would you make? If you had to choose between not eating a slice of pizza that you desperately crave or feeling like such a failure that you punished yourself by cutting you body multiple times in multiple places, what would you choose? And when you see those options, does it really look like much of a choice any more? Each option is torturous and punishing, but one always gets you closer to the goal of losing more weight, or at least attempting to. You’ll feel better when your body is perfect, the eating disorder says. You’ll feel better if you barely eat. You will be more in control, it lies, and there are so many lies it will tell to keep you from fighting against it.

The more the illness pervades the mind and the sufferer responds to the eating disorder, the more things like food and weight become a source of anxiety. Each time you respond to the voice telling you not to eat or you will feel something unbearable, the more the message in reinforced in the brain. You see, when you avoid something that makes you anxious, the more the brain is told that it is something to be anxious of because it is being avoided, and the more anxious you become of it. Another sneaky way the eating disorder survives is to completely distort the perception of the sufferer, so that their body looks to them to be completely different to what anyone else sees, and in a lot of cases, the thinner they become, the fatter they feel. This way the eating disorder continues to dictate the actions and thoughts of its host (and yes, that is what you feel like: just a host to a demon that is making you diminish in size inside and outside day by day).

I could go on, but let’s get back to willpower.

Meghan Trainor caused uproar with her incomprehensible comment about her apparent lack of willpower to “go anorexic”.

I wasn’t strong enough to have an eating disorder. I tried to go anorexic for a good three hours. I ate ice and celery, but that’s not even anorexic. And I quit. I was like, ‘Ma, can you make me a sandwich? Like, immediately.’

Her comment is one of such extreme ignorance that it makes my blood boil. For one, strength doesn’t come into eating disorders. Strength is something of value. It is a brilliantly positive trait to have; something you use in the face of hardship; to get through something or to defeat it. It is something that you use to fight and beat an eating disorder, not something you use to continue its existence. It does not take strength to have an eating disorder: it takes sickness and misery and intense self-hatred. It takes strength to recover. Secondly, you cannot “try to go anorexic for a good three hours”. Anorexia is first and foremost a mental illness (like all other eating disorders), not something that you can just “try” and then stop because you get a bit too hungry. “Trying” is not part of an eating disorder. You would never in a million years “try” to have an eating disorder if you understood what it entailed. It’s not about having the willpower to “go anorexic”. Any eating disorder is a disease that creeps up on you and slowly invades your mind bit by bit until it has wormed its way into every part of it, and then suddenly you realise that you are drowning in it and there is no conceivable way out. You don’t just “go anorexic” for three hours and then choose to stop. Need I say it again: there is no choice. And no, funnily enough eating ice and celery for three hours only does not mean you have a serious and deadly disease.

Willpower is inextricably linked to choice, and we know that eating disorders are not a choice, so the two cannot be thought of in conjunction with each other. Ever. To talk about eating disorders requiring willpower undermines the helplessness and hopelessness that someone feels whilst being under the control of such a powerful and deadly disease. To talk about eating disorders requiring willpower – a positive trait we all want – undermines the sheer anguish and torment someone suffering from one has to experience every second of every day. To say eating disorders require willpower is to inadvertently say that there is something that tortured person has that you admire. You are looking into eyes full of pain and saying, “I want what you have.”

Willpower is a positive thing. Having an eating disorder is a living hell. Willpower is strength and control. Living with an eating disorder is being crushed under a dictator that ultimately wants you dead and feeling unable to do anything but obey and walk knowingly into the jaws of death. Willpower is willpower and eating disorders are eating disorders. Let’s not mix up the two.

Vyvanse and BED: Money-making in Disguise as Treatment?

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Fairly recently, Vyvanse – a drug known for treating ADHD – was approved to treat binge eating disorder (BED). I was first made aware of this drug via a message sent to my blog from a woman living in the US who was angry about the effects this could potentially have on people who were prescribed it. I did a bit of reading up about it, but soon forgot about it. The topic came up again when a friend linked me to an article about the drug being used for treating BED, which I read, and my interest was piqued. I started thinking about the problems that would arise from it’s approval to treat BED that are both numerous and highly concerning.

In May 2013, the DSM-V was published, with BED being newly recognised as a psychiatric disorder. On the surface, this sounds great: sufferers of BED were finally being recognised and validated, but a further look into this and the subsequent approval of Vyvanse to treat it raises some serious questions.

In a society where almost two in five (37%) women and one in six (18%) men in the UK are dieting “most of the time”, and 108 million people are on diets in the US, a huge amount of us are restricting on a daily basis, and when we “fail”, we feel shame, guilt, hopeless, and anger at ourselves. And failing is inevitable, because diets do not work. Dieters often end up in a restriction/binge cycle, and mistake their dieting for normal behaviour, and so only take note of their binging and see this as a weakness rather than a normal biological response to starving the body. If the body has an energy deficit due to restriction, it will seek to restore balance by compensating later on. So with that in mind, we can now look at the criteria for BED:

DSM-5 Diagnostic Criteria

Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
- eating, in a discrete period of time (for example, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances
- a sense of lack of control over eating during the episode (for example, a feeling that one cannot stop eating or control what or how much one is eating)
The binge-eating episodes are associated with three (or more) of the following:
- eating much more rapidly than normal
- eating until feeling uncomfortably full
- eating large amounts of food when not feeling physically hungry
- eating alone because of feeling embarrassed by how much one is eating
- feeling disgusted with oneself, depressed, or very guilty afterwards
Marked distress regarding binge eating is present.
The binge eating occurs, on average, at least once a week for three months.
The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (for example, purging) and does not occur exclusively during the course Anorexia Nervosa, Bulimia Nervosa, or Avoidant/Restrictive Food Intake Disorder.

For me, this criteria is extremely problematic. This criteria is pretty vague, and in conjunction with a society that vehemently fears over-eating and weight gain, becomes a fit for a large proportion of people. Let’s take a look at it in more detail:
– “an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances” – this is particularly non-specific, and in our society, many people have a distorted view on what is larger than most people, especially when so many are restricting. It is also normal for someone who has been restricting to experience eating more than normal, because of the body trying to restore itself to being energy-balanced.
– “a sense of lack of control over eating during the episode” – many people feel out of control when it comes to food because we are made to feel that out of control if we are not eating in some strict and regimented way. That feeling is even more accentuated when the drive to survive overcomes the person’s desire to diet, and the body makes up for lost energy by “binging”.
– Eating rapidly is also part of the drive to get energy in as fast as possible when it needs it.
– Eating until uncomfortably full is easy to do when the body requires more energy than the stomach has room. The desire for food is just another way for the body to communicate hunger, and people often do not recognise this as a type of physical hunger (the brain is part of our physical being as well).
– Eating alone when eating what someone considers more than normal, or when someone is experiencing reactive eating in response to restriction, is – unfortunately – normal because of the way our society has surrounded food in a thick layer of shame.
– And if you are dieting, or misinterpreting your eating as a “binge” (because I would argue that many people have a distorted view of what a binge actually is), this is likely to happen “at least once a week for three months”.

“With these diagnostic criteria [for BED], there is huge potential for a false positive. Do a lot of people struggle with binge-eating? Absolutely. Are all of these people actually ill? That is the major question around this diagnosis and the Vyvanse treatment,” said Lisa Cosgrove, a professor and clinical Psychologist at the University of Massachusetts, Boston.

So what we have here is a list of things that those with BED suffer from, but written in a way that it could easily fit someone misinterpreting their eating habits because they have distorted ideas of what binging is, or are not aware of the effects that dieting has on the body. This means that these people could go to the doctors, tick all the boxes, and receive a diagnosis. Our fatphobic society steeped in diet culture would have no problem with that. A quote from Ray Moyniham in Motherboard talks about this:

“You have to be extremely sensitive to the fact that there are people who are really suffering severe and debilitating symptoms from a condition,” said Ray Moynihan, a senior research fellow at Bond University in Australia and the author of Selling Sickness: How the World’s Biggest Pharmaceutical Companies Are Turning Us All Into Patients. “But when we put so much energy into medicalizing normality, it takes resources and attention and care away from people who are seriously ill.”

Now on to June 2014, where Shire wins the key patent ruling for the drug Vyvanse. The Telegraph writes:

Shire hopes to increase sales of the drug by broadening its uses into other patient groups, such as very young children and sufferers of the newly-recognised psychiatric problem binge-eating disorder (BED).
The drug maker told investors on Monday that it expected to make $300m from sales of Vyvanse to BED patients by 2020, following a successful clinical trial showing the drug helped control binge eating.

This raises a red flag for me: Shire will desperately want to make as much money as possible before its patent expires, and this means expanding its treatment to those with other illnesses other than ADHD. Shire had already thought of BED as an option, and already had that idea in the pipeline. Is the fact that BED was finally recognised and put into the DSM-V just when Shire needed a new illness to treat a convenient coincidence, or something more dubious?

In January 2015, Vyvanse was approved to treat BED. The fairly vague criteria for BED could mean that BED is over-diagnosed and over treated, with a drug that is an amphetamine. Hang on, what?

Amphetamines became extremely popular in the mid 1900s as a weightloss drug, before concerns about the dangerous side effects caused the FDA to ban amphetamines from diet ads.

The most serious risks include psychiatric problems and heart complications, including sudden death in people who have heart problems or heart defects, and stroke and heart attack in adults. Central nervous system stimulants, like Vyvanse, may cause psychotic or manic symptoms, such as hallucinations, delusional thinking, or mania, even in individuals without a prior history of psychotic illness. The most common side effects reported by people taking Vyvanse in the clinical trials included dry mouth, sleeplessness (insomnia), increased heart rate, jittery feelings, constipation, and anxiety. – take from here.

Vyvanse was approved for treating BED after only two 12-week studies.

“I tried (and failed) to persuade the DSM 5 group that BED was a premature and dangerous idea precisely because I feared it would be a backdoor excuse for drug companies to promote stimulant diet pills,” Dr. Frances Allen, a psychiatrist and frequent critic of the DSM-5, told Motherboard in an email. He has had particular concerns about the new criteria for diagnosing eating disorders. “The rushed approval of Vyvanse realizes my worst fears”

People actually suffering from BED are desperate to get rid of their mental illness, but therein lies the issue: BED is a mental illness. I have severe reservations about an appetite suppressant being used to combat an eating disorder that for a lot of people has roots in trauma, and other deep-seated emotional problems. The appetite of that person isn’t the issue: the drive to eat as a coping mechanism is. And not only are we going to be dealing with actual sufferers, but those misdiagnosed because of the ill-defined criteria, and those faking the illness to get a hold of Vyvanse, either because of its street value, or because of its use as a weightloss drug. Which brings me to the dangers of those with restrictive eating disorders reeling off the list of BED symptoms, and getting a prescription of Vyvanse to continue their downward spiral that only leads closer and closer to death. Because a binge eating disorder diagnosis relies on self-reported behaviour, it means that it is not difficult to fake, and consequently, it is not difficult to get a diagnosis. Pro-ana sites are already sharing their experiences with Vyvanse, and tips on how to get hold of the drug. The consequences of this could be catastrophic.

I received a message to my blog recently when the subject of Vyvanse came up:

I was recently diagnosed with BED and prescribed Vyvanse. My psychiatrist gave it to me because he said I was gaining too much weight. He gave it to me to use as a weightless pill. I don’t think that’s okay. In the past I have suffered from anorexia and bulimia. So of course, I accepted the pill. Hoping it would be easier to not eat at all. I think this may be a problem for a lot of people very soon.

This shows that already Vyvanse is being misused by doctors themselves, who are supposed to be people that we trust with our healthcare. But with the pharmaceutical industry being all about the money-making, it’s hardly surprising.

In my opinion, the inclusion of BED in the DSM-V, the vague diagnosis criteria, the subsequent research into using Vyvanse to treat BED, and the swift approval of that usage, are linked together. The pharmaceutical company have helped themselves to make more profit off both those with BED, and so many without it, with a drug that in my opinion will not successfully treat the disorder it has been approved for. And this drug is likely to have devastating consequences.

Food is Not a Moral Issue

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“I’m being naughty today”, the woman in front of me paying for her coffee and brownie says to the cashier. I grit my teeth and bite my tongue. I want to tell her that the word “naughty” does not apply to food. I wanted to tell her that being naughty is doing something wrong, and food is not a matter of right and wrong. I wanted to tell her that food is not a moral issue.

“I’m treating myself today” is another one I hear often when in the queue at coffee shops; the women looking guiltily at the cashier, wanting to justify their hesitant decision to buy a slice of cake. The underlying message is always “I’m disciplined usually! I swear it’s just this one time! I don’t usually eat cake!” And underneath that, is the belief that cake is bad.

How can a food be bad? It doesn’t make sense when you really think about it. Food fits into the category of inanimate objects. They are not alive, and do not possess a personality or a concept of right and wrong. Food cannot be good, and it cannot be bad. Food is food. Food provides energy, and different types of nutrients dependent on the type. Eating one type of food doesn’t make you good, and eating another type of food doesn’t make you bad. It just means that you are eating a food type. Having cake does not have an impact on your morality, and therefore, neither the cake nor you are bad.

Bad, indulgent, naughty, sinful – these are all words to describe a personality or moral status, and yet we – and the advertisements that we watch – use them to describe some of the foods that we eat. Why only certain types of food? Who decided that cake, chocolate, or ice cream was indulgent or sinful? Who came up with the idea that eating a burger is bad? Who suddenly felt that consuming a bag of crisps was naughty?

But what about gluttony? you ask, gluttony is one of the sins. If you are of a certain religion, then you’re right: gluttony is, in some Christian denominations, viewed as a sin. I also want to point out that, according to the Bible, wearing two types of material together is a sin, as is divorce, eating shellfish, and your wife defending your life in a fight by grabbing your attacker’s genitals (no seriously: “If two men, a man and his countryman, are struggling together, and the wife of one comes near to deliver her husband from the hand of the one who is striking him, and puts out her hand and seizes his genitals, then you shall cut off her hand; you shall not show pity.“). We seem to over-exaggerate some “sins” and ignore others entirely to suit our society. Gluttony – derived from the Latin “gluttire” (to gulp down or swallow) – means to over-consume food, drink, or wealth items to the point of extravagance or waste. Note that it is not limited to food and is about the immoral actions of wasting food or wealth that could be given to the needy. Note again how it does not specify certain types of foods and is not related to weight or healthy but rather to greed – having so much that it goes to waste. That does not mean eating a piece of cake because you fancy one. It means buying two cakes, eating to the point of nausea, vomiting so that you can fit in more, eating again, and throwing away the rest. (In this example I want to make it very, very clear that I am not talking about vomiting as an eating disordered behaviour. Vomiting to fit more food in was something that historically was used by wealthy citizens so that they could continue to eat more when extremely full, and I would imagine is linked to how gluttony was historically viewed in its accurate portrayal rather than our ridiculous twisted version of “gluttony” in our diet culture orientated society).

Even when I’m aware of all of this and have a healthy and happy relationship with food, it is still sometimes near impossible to not become sucked into the feeling of shame for buying foods that are considered “bad” in our diet culture, even though I myself do not feel that way. Standing in the queue at a store, chocolate in hand, I have felt anxious that I might be being judged for my choice of purchase. This is heightened by the fact that I am not someone who is super slim, and people are far more likely to judge those who are not super slim for their food choices than those who are. This type of judgement becomes more prominent the bigger the body – which is utterly inappropriate and stems from the incorrect belief that food and weight are intrinsically linked and that those who are bigger should eat less or differently to those who are smaller (check out my section on set point theory under “links” for more information), so I dread to think of the way those without any kind of thin privilege might feel at the prospect of being harshly judged for buying chocolate and the like.

I was talking with a friend recently about how people feel they have to behave in a society like ours in regards to food and exercise. My friend, for your information, is the epitome of the “ideal” woman that our society says we should strive to be: a blonde beauty: very slim but with curves in all the “right” places, but she is not exempt from the multitude of insecurities that our society pushes upon us. You can be the “ideal”, and you are still not ideal enough, and that is how the diet and weight loss industry makes billions of dollars per year, because we are always striving to change our body and make it “better”. She says, “I can be dressing up to go out on a night out, and I will have the same amount of insecurities as someone else [with a completely different body type] – they are just different insecurities about different things.” In our second year of university she was miserable, and on reflection, she now puts a lot of that negativity down to the fact that she was forcing herself to go to the gym and eat salads, just because she felt that was the “right” thing to do. She was restricting her body in the name of being “healthy” and being “good”, when in actuality she was starving her body and subsequently destroying her emotional state at the same time. She has no history with an eating disorder in any shape or form, and even so, our diet culture told her that what she was doing was “right” – something she continued to do for the majority of that year, in spite of both mental and physical effects.

The message our society gives out about food is toxic and damaging. Start trying to repair your relationship with food. It’s okay to eat what you want, when you want. You do not have a moral obligation to eat in a certain way (the same applies to exercise). Don’t label foods as “healthy” and “unhealthy” (read: “good” and “bad”), as this perpetuates a negative and unhealthy relationship with food. Enjoy your food. See it as a wonderful thing that provides for your body, brings people together, and gives you pleasure.

Food is food. Food is not a moral issue.