Tag Archives: society

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.

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

Health At Every Size and Big Is Beautiful/Fat Acceptance: What These Movements Stand For and Why They Are Important

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Health at Every Size and the Fat Acceptance Movement started as small, barely recognised movements. Due to the hard work of those involved and the (very) gradual shift in views around weight, shape, and size, these movements are now beginning to get the acknowledgement and publicity that they deserve. The more exposure these movements get, the more people will start to be enlightened to the real facts, figures, and evidence around size, health, and weight set point theory. Hopefully with time weight-based myths, discrimination, and stigma will be something that we as a society look back on and cringe with shock and humiliation that we got something so wrong and treated millions of people so badly. However, we still have a really long way to go until then.

You might be new to these movements, or you might not be, but either way, you may be unsure about what they stand for and why these things are so important. So let’s have a look at each movement and discuss a little bit about them. haes-4

Health At Every Size (or HAES) was first developed by American psychotherapist and nutritionist Linda Bacon, who wrote the book Health at Every Size (first published in 2008), and the sequel, Body Respect. Health At Every Size is a movement that is promoted by those who believe that health and fitness can be achieved regardless of weight, shape, and size, and that weight-loss is not a requirement for those deemed “overweight” or “obese” by BMI in order to live a healthy and happy life. HAES encourages people to accept their weight as it is, and promotes mental and physical well-being without weight loss as a goal. HAES cites studies that have shown that weight loss often leads to worse health regardless of the starting weight, and presents evidence that suggests that obesity is not the cause of health issues or premature mortality. It provides strong arguments for the idea that correlation does not equal causation, and picks apart flaws in studies that apparently connect obesity to poor health. HAES supports self love, self care, and body positivity, as well as healthy physical lifestyle choices such as being active and eating a balanced diet. HAES promotes this in a way that is conductive to mental health: it urges people to engage in activity that is enjoyable first and foremost, and not gruelling and repetitive work-out routines, and it supports the idea that food is not just for survival but also for pleasure. It maintains that weight loss should never be a goal, and that weight loss is frequently damaging, and encourages people to follow intuitive and instinctive eating and activity. It also supports weight set point theory.

The Health At Every Size® Principles are:

Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.

Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.

Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.

Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.

Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

Health At Every Size is a movement that I strongly agree with. Its main principles on exercise, food, weight, and body positivity are ones that I advocate with every fibre of my being. It’s incredibly important because we live in a culture obsessed with dieting and weight loss; a culture preoccupied with attaining the “perfect body – a body that is not achievable for the majority of people without sacrificing their mental and/or physical health. Even if you are someone who naturally has society’s idea of the “perfect” body, the dieting and weight loss industry will find ways to make you feel inadequate and flaw-ridden in a bid for you to buy their products to “fix” yourself with. The diet and weight loss industry controls much of our research into food and weight, and sweeps any evidence that contradicts their interests under the rug and publicises in a selective and biased way research that has questionable study methods or sample sizes, contentious results, and tenuous correlations. So do I have any criticism of the HAES movement?

Firstly, I think that although HAES is absolutely correct in that we should intuitively eat and listen to hunger and fullness cues, it underestimates how difficult that can be to relearn, especially if you are someone who has suffered with an eating disorder or severe dieting. In our society, feelings of guilt, self-loathing, shame, anxiety, and, on the other hand, superiority and control, have become inextricably linked with food and weight, and so it can be incredibly difficult (and perhaps even impossible) to entirely disentangle our emotions from our biological signals. That’s not to say that it cannot be done, but we need to address the context in which we live in our bodies before we can start to challenge and relearn the way that we feed and view our bodies. Being presented with the principles of the Health At Every Size movement can feel like ordering flat-pack furniture and taking it home, only to open it up, lay out the pieces of the floor, and realise that the instructions aren’t there. You’re left with all the parts, but with no idea how to assemble it. And in reality that’s not exactly a flaw of the HAES movement itself, as HAES aims to educate and promote a mentally and physically healthy and positive way of living, but it is an area it sometimes fails to recognise and address.

Secondly, I’m not really a fan of the name. Heath At Every Size is misleading. Although I absolutely 110% agree that the what we view as “healthy” should be a much much much broader range of weights, it is undeniable that there are certain weights at which you just cannot be healthy at. You cannot be a healthy adult at 50lbs, just like you cannot be a healthy adult at 500lbs, and so the name of the movement leaves it open to criticism from the onset. Prader-Willi syndrome, hypothyroidism, cancer, depression, anxiety, or eating disorders are a few examples which can cause a person’s weight to plummet or skyrocket, and there are weights that are too low or too high for anyone to be healthy at. So for me, I believe in Health At (Pretty Much) Every Size, and whilst Health At Every Size is much more catchy, it’s technically incorrect, allowing those against the movement an easy starting point on which to discredit it.

Last but not least, HAES aims to provide people with the information to start working towards accepting their bodies whatever their weight, shape, and size in order to improve both physical and mental health. However, it also has to be addressed that we live in a society where fat people are constantly subjected to prejudice, body-shaming, weight stigma, and discrimination. Fat people who agree with HAES may still struggle to accept their body size in a culture so cruel to them, and their inability to find peace with their bodies may well become yet another source of shame. Again, this isn’t a flaw in the principles of HAES, but a topic that may need more recognition.

So what is the difference between Health At Every Size and the Fat Acceptance Movement? Let’s take a look at the latter:
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The Fat Acceptance movement (also known as the size acceptance, fat liberation, fat activism, fativism, or fat power movement) is a social movement seeking to change anti-fat bias in social attitudes. Those involved seek to change attitudes towards fat people in areas of life including the aesthetic, legal, and medical approaches to people whose bodies are fatter than the social norm. The Fat Acceptance movement focuses more on the way fat people are perceived and judged due to their weight, shape, or size, and although it does address physical health and the research to back up the same principles as the Health At Every Size movement, it is more focused around changing the way fat people are treated and discriminated against. Fat people are often dehumanised and shown far less respect than those that are at a socially “acceptable” weight. One of the main examples is medical care. Fat people’s medical issues are often inaccurately dismissed as being caused by their weight, are shown less respect, and are often shamed for their body size.

The Big Is Beautiful movement is a smaller movement that comes under the Fat Acceptance movement, and focuses more on aesthetics. Its message is that people whose bodies are bigger than what is considered socially “acceptable” are beautiful too, and that you don’t have to be a certain weight, shape, or size to be attractive. Its aim is to help people find beauty in their bodies regardless of any contributing factors that make them look a certain way: health is besides the point.

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Both movements are focused around respect, and also talk about health as irrelevant. The ideas is that even if you believe that someone IS unhealthy due to their weight, its not your business what lifestyle choices they make, and they should be treated with respect regardless of those choices. For example, we all know people who smoke or binge drink, but we do not treat them as less human on an everyday basis because those choices lead to poor health. We do not assume their personality, or directly link their personal lifestyle choices with their moral character. This is why these movements are so important: they address the way society perceives and treats people who are fat.

My only criticism of these two movements (Fat Acceptance and Big Is Beautiful) is that there are some people involved in this movement who look down on those who diet as betrayers of the movement, when they should be seen as victims of a diet and weight loss obsessed society. As I stated above with HAES, it can be forgotten how powerful and pervasive “thin ideals” are, and all of us are affected by it in some way, even if we do constantly work to disentangle ourselves from it and rise above it. We should all be working together to support one another and help to lift each other up not put anyone down. We should aim to educate, not shun; support, not vilify.

Health At Every Size, the Fat Acceptance movement, and Big Is Beautiful, are all extremely important in terms of physical health, mental health, feminism, and education around food, weight, and health, amongst other things. They are powerful and uplifting; inspiring and motivational; enlightening and passionate. They can give us the information and confidence to live in a better way; a way that makes the aspirations of health and happiness more achievable.

To find out more about weight set point theory, and to read discussions around and evidence to support Health At Every Size, you can visit the resources section on this website. There is a drop-down menu that displays many sub-sections, including one for each of these topics.

And as a last little titbit of information, check the photo out below:

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

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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.

Fat Girls Can Wear Crop Tops Too

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Yep, you heard me. Fat girls can wear crop tops too. Let me say it again for the people in the back:

Fat

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girls

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can

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wear

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crop tops

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too.

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But this article isn’t just about crop tops.

I understand that we live in a society that has brainwashed many of us into believing that fat bodies are worth less than thin bodies; that fat is synonymous with ugly; that there is nothing worse than being fat; that we cannot be fat AND happy (these are all lies by the way) but I still do not understand why anyone would feel that it is acceptable to attempt to police the clothing choices of any other human being, regardless of their weight, shape, or size.

Fat girls are told implicitly and explicitly that they should not wear leggings, or crop tops, or bikinis (or even go on the beach at all), or bear their legs in dresses, or wear mini shorts, or…the list goes on. There is even a hierarchy of privilege amongst fat bodies, depending on how fat you are or where your fat is stored or whether you have big enough boobs to even out your thick thighs and hips. And frankly, I find it all disgusting.

We are all people. We all lead different lives and have different values and passions and hobbies. And we all have different bodies. And the weight, shape, or size of our bodies does not alter our self worth or how beautiful we are. It also does not give anyone the right to dictate what we wear. Fat, slim, curvy, thin, chubby, muscular, pear-shaped, apple-shaped…you can be star-shaped for all I care and wear the same clothes as anyone else. Certain clothes are not reserved for certain body sizes or shapes, and whether you are a size 6 or a size 26, you are the only one who gets to choose what you wear. Don’t let ignorance get in the way of your clothing preference. If you want to rock a crop top, a mini skirt, and nine-inch heels, you do that. If you want to wear a cute summery dress to the beach and then whip it off to reveal an itsy, bitsy bikini, you do that. If you want to wear leggings and a bralet, you do that. And if you feel more comfortable in jeans and a t-shirt, you do that too. Because you should be able to wear whatever it is that you feel the most confident in. And if our fatphobic, asshole of a society has made you feel too uncomfortable to wear a crop-top even if you really like them, it doesn’t make you any less badass if you save the crop tops for another time, or even never.

You do not have to wear whatever society thinks is most “flattering”. I only recently took a real long hard look at this word, and saw it from a totally different angle to what I previously saw. People use it as a compliment towards each other all of the time, and it seems like a genuinely nice thing to say someone until you examine what it wearing something “flattering” really means. The word “flattering” in itself is oppressive: it implies that we should be aiming to look a certain way – and that certain way is “as thin as possible”. No one should feel that they have to disguise their hip fat or accentuate their waist or push up their breasts or flatten down their bellies. You do not have to hide any part of your body as if it is shameful. Not one part of your body is shameful, and you have the right to wear whatever you want, at all times. Everyone deserves to embrace the body that they have and everyone deserves to love it for what it does for them and for what it looks like.

It is summer time, and it is hot outside, and fat girls are entitled to dress in the clothes that make them feel coolest – both in temperature and in style. Don’t ever shame anyone for wearing what they want to wear. It is their right to do so and to feel confident in doing so. Respect everyone’s clothing choice. Respect everyone’s bodies. Respect everyone.

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(Here’s me and my crop top)

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

7 Replies

food1

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).

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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.

MinnieMaud: Is It the Only Way to Recover from a Restrictive Eating Disorder? (Take Two)

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New-YE5

It has been over a year since I wrote my first article on this topic, and I am still somewhat inextricably linked to the MinnieMaud method of recovery, however much I try to disentangle myself from it. I thought I would talk about this topic again because my views have continued to change as I grow and develop as a person, and also learn new things in the recovery community. Being in remission has given me the motivation to celebrate my own recovery and give opinions and advice based upon my own journey, but it has also given me the ability to recognise that we all take different paths to get to a full recovery. Even the concept of “full recovery” in itself is individual for each person, and the goals we wish to reach can be quite different. Some people in recovery are not able to yet reach for a full recovery. Others take different routes to reach the same destination. What people define as “remission” or “full recovery” varies, and that’s okay. We are all allowed space to determine what it is that we believe, and what we want for ourselves. We are allowed space to express what we want for others, but we have to respect what people want for themselves over our own views of what would be best for them. The only decisions we can really make are for ourselves.

As I have progressed and developed in my remission, my advice has been less “Gwyneth Olwyn” (creator of MinnieMaud) and more personalised to my own individual views and experiences. In a nutshell, my views on MinnieMaud are that it is an invaluable recovery method for many people during the early to middle stages of recovery and can help inform the rest of the recovery process whilst you learn to navigate your own path leading into remission. Eventually you will find your own version of remission and start living your recovered life in the way that works for you. MinnieMaud can still be useful then, but your recovery/remission will now be tailored to you as an individual. I think that the black and white approach to information and advice is apt for the unwell; for the people who need firm, unflinching boundaries between them and their eating disorder (and boy, did that help me when I needed it). It gives permission to do the things that society forbids – things that profoundly help so many people in their recoveries (e.g. freedom around food, encouraging the idea that all food is good food, resting and repairing, breaking unhealthy relationships with exercise by total cessation of activity, eating enough, always responding to any hunger however much that means eating, accepting your body at any weight, shape, or size etc). It outright rejects any and all unhealthy societal views in order to promote a healthy relationship with food, exercise, and the body. Is Gwyneth Olwyn the only person to encourage all these viewpoints? No, not by a long shot. There are a huge amount of people in the recovery community, body positivity community, and health at every size community (all of which overlap quite frequently) that share and promote these views and give advice accordingly. However, Gwyneth Olwyn is, as far as I know, the only person who has taken these viewpoints and created a structured, research-informed recovery method for those with restrictive eating disorders. The fundamental difference that people see is that Olwyn has created a set of guidelines, and given these views a name; made them into a method of recovery. She has solidified a huge amount of people’s views into “rules for recovery”. Now this irks some people because they don’t like the black and white; they don’t like the “you need to/must do this in order to recover”, and I entirely understand that. As I spend more time in remission and grow and develop as a person and as a member of the ED recovery community, I have become aware that this way of thinking and dishing out advice becomes problematic especially as people come out of the initial stages of recovery and start to make their own way towards remission. People start coming out of the very necessary and standardised initial parts of recovery and start to develop personal goals and targets and outcomes and values and opinions and moral standpoints and….and and and. I could go on. I think that to reach remission there are fundamental aspects of recovery that need to happen – but again, these are my own individual views on what remission is – and those are:

Regaining normalised and reliable hunger cues in order to eat intuitively and respond to the body’s request for energy, always.
Being able to eat any and all food without anxiety, fear, or guilt (seeing food as food, seeing it as nourishment, enjoyment, and just another part of life rather than immediately worrying about weight gain, compensation, exercise, or seeing certain foods as “bad” or “unhealthy” etc).
Being able to eat when not hungry (for example, in social situations) without anxiety, fear, or guilt.
Being able to eat without compensation.
Building a healthy relationship with exercise (moving the body primarily for enjoyment not for burning calories or altering the body).
Managing or resolving underlying issues that contributed to the cause of the eating disorder.
Working towards body acceptance and acknowledging that your body’s natural weight is outside of your control and to obsessively focus on controlling it is to be disordered.
Being able to manage stressful situations without lapsing, and using healthy coping mechanisms in response to stress and anxiety or being able to pull yourself out of a lapse very quickly because you are perceptive about your behavioural reactions and then use healthy coping mechanisms.

Outside of that are a wealth of details within recovery that are different for every single person. For example, whilst I feel assured in giving out the advice that someone in recovery should not make drastic decisions around their diet (such as becoming vegan or vegetarian), when that person is in remission, I am unable to say whether that person would become triggered into relapse by making that choice. I have a fully recovered friend who has become vegan. I myself am now a pescatarian. But I have also known people who have made changes to their diet and spiralled back down into illness as the elimination of certain foods opened the door for the eating disorder to slip in through. For some people it triggers those restrictive thoughts, and for others, opens up new doors to try new foods. Since I have had to become gluten free for medical reasons, I have tried and discovered a wealth of new wonderful foods (although I do mourn my loss in the bread department), and find joy in doing so. Others might find this a slippery slope into restriction without the right mindset and support. Another example might be yoga. Yoga might help one person relax and fight anxiety, whereas for someone else it might be another form of burning calories or subscribing to an obsession with “health”. There are a million examples of things that affect different people in different ways in recovery, and I do think that MinnieMaud forgets this. Its rigid blanket statements and black and white style are appropriate for most people in the initial stages of recovery, and even for some further on, but are not so relevant to those moving towards their own individual destinations, and for those in remission itself.

I reference the site so frequently because many people that I talk to are in the initial stages of recovery, and I think that everyone, whatever stage they are at in their journey, could benefit from the views expressed there in regards to body positivity, health at every size, freedom around food, and a no bullshit approach to exercise. I think MinnieMaud is fantastic, but that doesn’t mean that I don’t think that it is flawed. Because the MinnieMaud site (Your Eatopia) informed so much of my recovery and started me off on my journey towards discovering body positivity and health at every size, I wrote a lot about it, and at first when my blog turned into an advice blog, I was regurgitating everything Olwyn said. Because of that, I have struggled to separate myself from it in the eyes of my audience. I have attempted to distance myself as being seen as a “minion of MinnieMaud” and be viewed instead as a standalone person who references MinnieMaud and its recommendations, but is not solely about MinnieMaud. Like The Fuck It Diet, I want MinnieMaud to just be another site that I reference – albeit it is the site I reference the most as it is so concise and informative and is the one site aimed so specifically at restrictive eating disorders and the recovery process. Hopefully one day, the association between myself and MinnieMaud won’t be so strong, and I will be able to promote the MinnieMaud method alongside my own indvidual views and that of many other people.

I advocate freedom around food, health at every size, the rejection of diet culture, moving your body in a mentally and physically healthy way in remission, body acceptance and positivity, self love, eating what you want when you want, personal growth and development, resolutions or management of toxic situations, relationships, internal beliefs, and/or experiences with the help of professional support, and building and living a full, rich life outside of your eating disorder. Does MinnieMaud advocate this too? Yes. But it is only one website amongst many that does so. Olwyn is one person amongst millions holding these beliefs. I am advocating all of them, not just MinnieMaud. I am advocating all of the incredible women and men fighting for these views to be the norm; for diet culture to be destroyed; for people of all weights, shapes, and sizes to be accepted as equally beautiful and equally potentially healthy; for a recovery from restrictive eating disorders not informed by our unhealthy, toxic societal views on food and exercise and weight. I advocate Caroline of The Fuck It Diet, Amelielee of LetsRecover, Bodyposipanda, Nourishandeat, and Goofy_ginger of Instagram, Harriet Brown of Brave Girl Eating, Ragen Chastain of Dances With Fat, Kate of FYourED, Michelle of The Fat Nutritionist, Sandy of Junk Food Science, Tetyana and Andrea of Science of Eating Disorders, Summer Innanen of Rebelle Radio, Rachel W. Cole of her website of that name, and those who run Big Fat Science. I also advocate Gwyneth Olwyn of Your Eatopia, and I agree with the method of recovery that she promotes, as I also agree with the way of eating that Caroline and Rachel W. Cole promote. They are slightly different, as are my own views, but we all agree on some basic fundamentals.

I am not here to say that MinnieMaud in and of itself is the only way to recover, but I do think that its basic principles are needed for a full recovery: basic principles that are supported in many other places, not just Your Eatopia. Am I here to say that MinnieMaud is the only method of recovery that works? No, but it does work. It may not work for everyone, but as recovery methods go, its success rate looks pretty good when you look at the multitude of anecdotal evidence. There is no one recovery method that works for everyone. Success rates for any treatment for eating disorders are mediocre at best, so let’s not slam a recovery method that so many people (including myself) have used successfully to help them in their journey, whether that is using it fully or taking bits from it that inform their own personal path to becoming well.

This will be the last time focusing solely on MinnieMaud, because I am not a spokesperson for that method of recovery. I am someone who used MinnieMaud to help my recovery. I am someone who agrees with its main principles, and I am someone who refers to it and uses information from it in order to try and help other people.

MinnieMaud is, in my opinion, a good way to recover. It is not the only way to recover. However, I believe that its underlying principles are needed for a full recovery. Those underlying principles are not exclusive to MinnieMaud. They are not the entirety of MinnieMaud. They are basic principles that underlie the method and are shared by many other people. MinnieMaud was built on top of those principles, and the nitty gritty details of MinnieMaud are not things that I think are always necessary to recovery – I think that is individual. I think that is as clear as I can make it.

If you have any questions, don’t hesitate to contact me through the contact section above, or leave a comment on this article.

Our Bodies and Us: The Disconnect.

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listen to your body

Our bodies are wonderfully constructed, complex, ingenious natural creations. They are fantastically clever, and work to keep us in the best of health. But we have been working against them. We have stopped listening to them. We have decided that they are the enemy and we have been treating them as such.

Our bodies are natural but our culture is man-made, and our culture has decided to wage war on women’s bodies (and to a lesser extent, men’s too). We are bombarded from every direction with the message that our bodies are not enough; that we are not enough; that we must mould and warp and change our bodies into something else to be satisfactory women. We are told that our bodies are not good enough as they were born to be; that they are not good enough in their natural forms. We are told that we must alter them, no matter what pain that means putting our minds and our bodies through. Low carb diets, low fat diets, high protein diets, Paleo diets, Atkins diet, cabbage soup diet (?!), 5:2 diet, raw till 4, weight watchers, slimming world, eating “clean” (because other foods must therefore be “dirty” right?)…it makes me want to scream. Instilling fear of sugar and fats and carbohydrates until there is nothing else that is “safe” to eat creates more and more anxiety around food and makes us try to restrict further and further. Equating certain foods with morality and superiority and “making the right choices” makes us turn on one another as if eating a certain way can make us better than someone else who chooses to eat differently. Food has become about being “good” and being “bad”. Food has become about being worthless or worthwhile. Food has become our means of exerting control over our bodies and our lives.

All the while, our bodies are being ignored. They give us a pang of hunger, and we focus on something else. We pass a bakery and saliva pools in our mouths, and we swallow and walk on. Our brains direct thoughts of food to our brains over and over, and we shut them down. Our bodies keep sending us signals, and we pretend that they are not there, and instead, we listen to the magazines and other media telling us to ignore our hunger…drink a glass of water instead…eat a celery stick. We have become so far removed from our bodies that we listen to an unnatural ideal rather than the natural being of our bodies. We are so disconnected that we read information on what we should do with our bodies in regards to food and exercise, instead of actually listening to them. Our society has made us so focused on our bodies: how they look, what we do with them, and what we put into them, that we are panicked by it, and in turn, it has become an obsession. Health; fitness; food…we follow other people’s advice on what to do with our bodies and pay no heed to what our bodies are communicating to us. We are out of touch with what we really need.

Breaking away from that is hard, but freeing. Your body will thank you, and so will your mind once you learn to reject dieting culture and embrace your natural weight, shape, and size. If you develop a healthy relationship with food and your body, eating intuitively will come effortless as you follow your hunger and cravings. Healing, and repairing that relationship between you and your body will allow you to reconnect and work with your body, rather than against it. This will, in time, lead you to naturally eating a balanced diet – this includes “junk” food too. We need to start viewing food as food, rather than something that is “good” or “bad”, “healthy” or “unhealthy”. Food is fuel, and food is also part of our enjoyment in life. It has no place alongside morality. None of it should be demonised. None of it should be feared. None of it should be restricted. When you stop listening to outside noise, and start turning your focus inwards, that is when you will be able to be your healthiest. When you get back in touch with your body and start to really listen to it, that’s when you will start getting healthy again, both mentally and physically. If you fancy a fruit salad, eat a fruit salad. If you fancy a doughnut, eat a doughnut. No rules, no restriction, no foods that are off limits, and no foods that you “should” or “should not” eat. Shut out our dieting culture and embrace your body’s signals.

As a side note, it’s important to understand that if you have been dieting or restricting, that your hunger may be powerful and insistent, and your cravings may be strong for the foods that you have restricted (and therefore have fear and anxiety around). This is normal. If you don’t give your body enough energy, it will have an energy deficit, and will need more energy than usual until it is energy-balanced again. If you restrict certain things, your body will want them more, as it is often low on carbs and/or sugars and/or fats, and “forbidden” foods will also always be the ones you want most. If you respond to your body and work with it by providing it with the energy that it is asking for and the foods it is craving, it will settle down. It will become energy-balanced, and it will not be lacking in any food types, and when you stop viewing certain foods as forbidden, it will not want them as much. When all food is available to you, you don’t feel the need to eat certain foods as if it is the last time you will ever eat them (which you may have felt before when you let yourself have a “cheat” (I shudder at this word) snack/meal/day). When your body is energy and nutrient balanced, your eating will be balanced. When you are lacking in something, your body will give you signals in the form of hunger or cravings.

Listen to your body. It is cleverer than you, and it certainly cleverer than dieting culture and the media. Listen to your body, and embrace it.

Men with Eating Disorders: Suffering in Silence

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men and eating disorders

Eating disorders amongst men: we are not talking about it enough. We are not doing enough to end the stigma against eating disorders in general, let alone for the male population that suffer with them. We need to raise awareness. We need to be having conversations about it. We need to be educating the general public about it. We need men on TV, in magazines, on the internet, on every social media platform, to speak out about their struggles and help others do the same so that they can get the help and the support that they need. The thing is, many men don’t feel comfortable talking about it with their closest friends and family members, let alone the public. In fact, they aren’t just uncomfortable: they are terrified, and this is because of the incredibly detrimental stigma wrapped around eating disorders that is magnified tenfold when it comes to the male population. And when people don’t get help, there’s an increased risk of them dying from complications due to their eating disorders.

Out of those with eating disorders, it is reported around 10% of sufferers are male, although these statistics are unreliable due to the fact that so many men do not come forward for treatment and so are not recorded as part of the statistics. A recent study on a large university campus found that the female-to-male ratio of positive screens for eating disorder symptoms was 3-to-1 (you can read more statistics with references in my article Men Get Eating Disorders Too).

For this article, I talked to two men with eating disorders, a friend of mine, Leo*, who is a man in his mid-twenties from the UK, and Joshua*, an Italian-American, who got in touch with me via this website to talk about his experiences with his eating disorder and the stigma surrounding men with eating disorders.

Leo talked to me about how his eating disorder affects him in day-to-day life, and about the one and only time he sought help from a professional.

“I wake up every morning and the first thing I do is check the mirror and look at myself and think I’m fat. I will do it again after a shower and again once I’m dressed. I will do this throughout the day while at work if I go to the toilet as well. I try not to eat to much because in the back of my head is someone saying you’re fat, you’re fat, don’t do it. People at work have joked about me being fat, and I cannot get rid of them saying it over and over again in my head. I want to be perfect, I want to feel normal, and it probably started with the bullying at school and has always sat with me. I went to the doctors and explained that I didn’t feel normal and I hated eating food and I wanted to make myself sick and all I got was the doctor telling me that I need to eat to be healthy and we need food to survive, and that was pretty much it.”

Leo experienced disordered eating for three years, before developing a full blown eating disorder which he has now suffered with for seven years. He struggles with restriction, self-induced vomiting, and compulsive exercise. As you read, when he opened up about it to a doctor, he was met with dismissal. After describing his fear of weight gain, and sustained body hatred, his doctor chose not to explore this further and just told him to eat. I asked him about whether he would consider going back again to see if his experience could be different if he saw another doctor.

“I don’t go back to the doctors because it is embarrassing. I’m a guy and I have to not show weakness. I tried to cry for help and no one cared and so I shut all my emotion off towards it.”

Unfortunately, this is all too common an experience for men, and because of these negative experiences, men don’t seek help in the first place, or don’t go back again after being met with invalidation. Doctors are reportedly less likely to make a diagnosis of eating disorders in males than females (again, you can read my article “Men Get Eating Disorders Too” for references and more information). Not only is there limited training in eating disorders for medical professionals, but the stereotype of eating disorders being an illness exclusively suffered by white, young, females still lingers, and professionals are not exempt from absorbing the myths and stigma that surround eating disorders. Coupled with the damaging pressures from society telling men what they apparently should be like, people seem to have a really hard time accepting that men can suffer from such a debilitating illness as an eating disorder. These societal pressures, which include not showing emotion (or not too much, whatever that means), not crying, not needing help or support, are aspects of being a woman, and they are also supposedly aspects of being weak (because, just in case you are unaware of this entirely ludicrous concept, in our patriarchal society, being like a woman – and therefore being a woman – means that you are weak). On top of that, eating disorders are seen by some as obsessional vanity, whereas they run much deeper than that, and can stem from a variety of things (bullying, abuse of any kind, sense of worthlessness, deep insecurity, trauma, to name a tiny proportion of triggers). They are also a biological illness with genetic links. Your genetics play a part in determining whether you are someone who will develop an eating disorder or not. Those who understand eating disorders already know that developing one is not a choice, but this provides further and solid evidence for those who may not be able to fully comprehend the fact that there is no choice when it comes to mental illness. Still, so many people are still ignorant about mental health. Leo says,

“People look at it as a female disorder. I have mentioned it in conversation with friends and family, and I always get the same opinion – that it’s a woman’s disorder because they are weak or have issues because of how society sees them.”

Leo feels like he can’t talk to anyone about his eating disorder, because they won’t understand. He is terrified of the reaction that he could get.

“I can’t talk to people because they won’t understand. They won’t understand waking up every day feeling the way I do about myself and how I want to fit in and for people not to say I’m fat or chubby. I can’t talk to them or even want to talk to them because my step-dad, my brother-in-law, and I are always in competition in everything we do and I wouldn’t let them know I am weak. I don’t know how they would react. They will see it as a weakness and will think less of me. Even my mum wouldn’t understand.”

I ask if he thinks his mum would view him as weak. “I’m not sure, but I don’t want to risk it.” The concept of men (and women) with eating disorders being weak is so persuasive that Leo sees his own eating disorders as a weakness in him, but says that he doesn’t make the same judgement about anyone else.

Another issue we have to look at is the “ideal” male body that our society has created. Women face a huge amount of pressure to look a certain way thanks to our society, our diet culture, and the media continuously shaming women, telling us to lose weight, giving us diet tips, banging on about “health” 24/7, and showing us a disproportionate amount of slim, beautiful women who have been photoshopped to the nth degree, but whilst we do receive the majority of this pressure, we forget that there’s so much pressure going around that there’s plenty left over for the guys too. Men are being exposed to an increasing amount of images and messages pertaining to what a man “should” look like, and this is extremely harmful. Leo has been affected by this.

“Having 0% body fat and all the muscle in the world is the only way to fit in society for men. Women are seen as having to be skinny but men have to be both skinny and muscular.”

Whilst this is not a reality, and in general only men who are fat or very thin experience stigma around weight, the message has become so strong from the media that for some men, this is how they feel – that they and their bodies will not be accepted unless they look a certain way. The expectations that this is driving some men to have for themselves are unrealistic and unhealthy, and is having a dangerous impact on the mental and physical health of men.

Eating disorders can also be harder to spot in some men because it is more likely for women to have dramatic weight loss, whereas in men their eating disorders can expressed through “bulking up” and hitting the gym, which is not seen as particularly suspect in a society so keen on advocating exercise and showing male body “ideals” as lean and muscular. It is important to note that if an individual is taking performance-enhancing supplements in their attempt to become more muscular and then engages in weight lifting, they are at increased risk of suffering a heart attack or stroke (this paragraph has been taken from my article “Men Get Eating Disorders Too”).

Joshua also talked to me about his experience with an eating disorder.

“My situation largely stems from my cultural love affair with food and how the outside world placed such an unnecessary stigma on what are “good” or “bad” modes of eating. I am an Italian-American, and as such, our lifestyle revolves heavily on cooking and family gatherings that centre on delicious dishes. It is a tradition and rite of passage to learn how to cook for many of us. This is an overwhelmingly positive facet of our heritage, but the media’s obsession with “thin” and “perfection” have demonized any sort of fascination with food beyond what they deem “healthy or fit.” Admittedly, I was heavy as a child and into my teen years – but with changes in my daily lifestyle and just growing, I evened out to what was my normal weight (which was apparently still slightly “larger” than the projected ideal). I still enjoyed any type of food that I wanted and never did I have to restrict. Naturally, as I got older, I became interested in finding a meaningful relationship with a girl. This was when the pressure of having to achieve that outrageous image of “true masculinity” began to weigh heavily on my mind, and my interactions with women in my age group reinforced these damaging gender stereotypes.”

Joshua was also influenced by the media.

“The problem is that “having abs” and looking like an actor/model is so much more than losing weight – it is about obsession to the point of illness.”

Joshua was shamed for his appearance when he became very ill during his eating disorder.

“Ironically, I never did achieve the appearance I aspired to even when I was dangerously skinny. I merely became an emaciated mess, which ended up working against me as I was told it “feminized” my looks and made many girls lose interest.”

Although no one should ever reach any weight, shape, or size by unhealthy means, this shows again the idea of an “ideal” body shape and size for men that has pervaded our society. Whilst no one is naturally emaciated, many men are naturally slim and can feel ashamed of being so. In fact, within a couple of weeks of being with one of my partners, he asked me, “Is my body okay? Am I too skinny?” because he was naturally slim. I had never even considered that this might be an insecurity of his, but it is more common than we think. Insecurity is rife amongst both men and women, and whilst this is damaging in itself, this can also contribute towards the development of eating disorders, which are severe and life-threatening. Anorexia has the highest mortality rate of any mental illness, and other restrictive eating disorders follow close behind.

“I find it so difficult to explain to anyone I meet (especially potential dates/prospects) that I am trying to heal from this battle. It is such a strange position to be put in – knowing that double standard of men not expecting to be concerned with weight or appearance (to be outwardly cavalier/macho) but still having to hide their true feelings when exercising themselves into oblivion for muscles/being defined. Gender roles and expectations for men are just as serious [as they are for women] – yet they fly under the radar as something that doesn’t happen and are laughed at by those from older generations.”

These myths, stereotypes, and stigmas need to become a thing of the past. We need to be talking about eating disorders more in general, but we also need to start prioritising the inclusion of men in every conversation that we have about it. We need people to stand up and talk about their experiences, but this should never have to be their responsibility in the first place. We need to educate ourselves and each other about the realities of eating disorders and how they affect men as well as women. We need to dispel the untruths and we need to be more proactive in challenging hyper-masculinity in our society. We need to help our men, and we need to help them to ask for support. If we don’t, we are going to lose them. If you are someone who looks down on men with eating disorders; if you are someone who sees them as weak, put that aside now, and take the time to research eating disorders. Keeping your mind shut to their suffering is costing them their health, their happiness, and sometimes even their lives. These are your sons, your brothers, your husbands, your friends. Each minute we continue to treat our men with eating disorders as weak; each minute we continue to dismiss them, we put their lives in danger.

*Names have been changed for confidentiality

Exercise (pt 2): Exercise and Eating Disorders

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exercise addiction

This is the second part to the article I wrote last time, which talked about exercise in general and the way that an unhealthy mindset around exercise has infiltrated our society as a whole.

Today I want to talk about exercise and eating disorders.

Like I spoke about two weeks ago, nearly everyone views exercise as something that is healthy, regardless of how it is used. During my recovery from my eating disorder, I told a friend about my compulsive exercise and about how I was trying to challenge it because I was doing x amount of exercise a week because I felt that I had to, and hadn’t been able to stop myself from doing it even when I didn’t want to. She genuinely replied with “Yeah but that’s fine because exercise is good!” Because we have such a warped view about exercise, many people don’t seem to understand how detrimental it is to those with eating disorders, especially when it doesn’t appear to be severe.

Some people with eating disorders push themselves to the extreme when it comes to exercise. Some people exercise for five hours a day, and some more. Some people never let themselves sit down – ever – except when sleeping (and I’ve even known someone to sleep standing up). It is easier for people without eating disorders to understand why this might be a problem, but when you are someone with an eating disorder who exercises in a way that people might perceive as inspiring and healthy; in a way that people might see as #goals; in a way that people aspire to, you may end up with congratulations rather than concern.

For those who have exercise addiction, you can’t just stop when you want to, or give yourself a day off (unless you already have a “scheduled” day/time, and then it must be that day/time and none other). You will miss social events if it coincides with your sessions. You will feel incredibly anxious before exercising, and after the exhilaration of finishing a workout has subsided, you will feel the dread of knowing that in less than 24 hours you will be repeating the same monotonous and exhausting work out. You will continue with your exercise routine however much you don’t want to do it, however tired you feel, or however sick you are. It is not enjoyment that drives someone with exercise addiction: it is the perceived need to do so.

As well as being mentally draining, compulsive exercise (also known an obligatory exercise or in extreme cases, anorexia athletica) can have a negative effect on the body. Firstly, by working out intensely every day, the body is being put under a lot of strain, and is not being given any time to recover, which is needed. Those addicted to exercise will work out even if they are ill or injured, which could have serious consequences to their health, including damage to tendons, ligaments, bones, cartilage, and joints. When injuries happen and are not given enough rest to heal, this can result in long-term damage. If the body is not getting the nutrition that it needs, muscle can be broken down for energy instead of building muscle. Girls and women could disrupt the balance of hormones in their bodies, which can change menstrual cycles and even lead to the absence of them altogether. It can also increase the risk of premature bone loss, which is known as osteoporosis. The most serious risk is the stress that excessively exercising can place on the heart, particularly when someone is also restricting their intake, or using self-induced vomiting to control their weight. Using diet pills or supplements can also increase the risk for heart complications. In worst case scenarios, restrictive eating disorders and compulsive exercise can result in death.

The reasons behind exercise addiction can be complicated when it comes to eating disorders. For many people it is an additional means of furthering and/or quickening weight loss, or it could be the main part of someone’s eating disorder, in order to get “fit” or muscular (anorexia athletica). It could be about control. It could be, like the rest of the eating disorder, a form of distraction from feeling or thinking certain things. It could be part of orthorexia (an obsession with eating “healthy” or “pure” foods and leading “healthy” or “pure” lifestyle). Athletes, dancers, wrestlers, gymnasts, and other people who are fixated with keeping in shape and keeping their weight down for their careers are also susceptible to developing exercise addiction.

Although it is not listed in the Diagnostic and Statistical Manual of Mental Disorders, exercise addiction is a serious and potentially life-threatening obsession, and needs to be taken extremely seriously. It is not just a strain on the body but a strain on the mind. It is absolutely exhausting, and completely miserable to experience. It can take up a huge amount of your life and a huge amount of your thoughts, and is extremely unhealthy for your physical and mental health. Whether it is the main part of an eating disorder, a lesser part of an eating disorder, or a disorder on its own, compulsive exercise is serious. It is something that must be challenged and overcome as part of recovery from an eating disorder, and must be ceased until the unhealthy relationship with exercise is broken and remade into something healthy. Only in remission can someone make an informed and healthy decision about whether to restart exercise and how much/what to do in regards to moving their body. Even then, it’s a fine line.

I talk more about a healthy relationship with exercise in part 1.

If you think you may be developing/have developed an addiction to exercise, seek medical help from your GP.

Signs that you or someone you know may be suffering from compulsive exercise include (but are not limited to) the following:

Not enjoying exercise sessions, but feeling obligated to do them
Seeming (or being) anxious or guilty when missing even one workout
Not missing a single workout and possibly exercising twice as long if one is missed
Seeming (or being) constantly preoccupied with his or her (or your) weight and exercise routine
Not being able to sit still or relax because of worry that not enough calories are being burnt
A significant amount of weightloss
Increase in exercise after eating more
Not skipping a workout, even if tired, sick, or injured
Skipping seeing friends, or giving up activities/hobbies to make more time for exercise
Basing self-worth on the number of workouts completed and the effort put into training
Never being satisfied with his or her (or your) own physical achievements
Working out alone, isolated from others, or so that other people are not aware of how much exercise is being done
Following the same rigid exercise pattern.
Exercising for more than two hours daily, repeatedly

(sites used for reference and more information:

http://www.brainphysics.com/exercise-addiction.php
http://addictions.about.com/od/lesserknownaddictions/a/exerciseadd.htm
http://kidshealth.org/parent/emotions/behavior/compulsive_exercise.html
http://en.wikipedia.org/wiki/Exercise_addiction )