Tag Archives: weight loss

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

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

1 Reply

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

2 Replies

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

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

Artwork by Francis Cannon

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

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

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

The article also reports on more details:

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

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

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

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

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

Artwork by Frances Cannon

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

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

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

Artwork by Francis Cannon

New Year’s Resolutions vs Eating Disorder Recovery

Why Do We Find it So Hard to Accept that Our Weight is Not as Within Our Control as We’d Like to Think?

4 Replies

Most of us have grown up in countries preoccupied with weight. We have grown up being told that it is down to us what size we end up at, that we have control over what weight we are, and that it’s about having willpower and making the “right” choices about what we put in our mouths. We’ve been told to count calories, exercise at the gym, resist cake, fill up on fruit and veggies, and even to curb hunger with glasses of water. We’ve been told to ignore hunger, wage war on our bodies, and to trust the information given to us by the media and the weightloss and dieting industry. Even our doctors have gotten on board with the “healthy is only for the slim” message, regardless of evidence to the contrary.

But recently, health at every size and weight set point theory are finally starting to become recognised as fact. Information about our bodies having varying, individual, healthy weights that the body will attempt to stay at regardless of what you eat is at last wedging itself into the media. Information about the fact that you can be fat and be healthy is now getting noticed, rather than being swept under the rug and buried by the pharmaceutical and weight loss industries that benefit hugely from the majority of the population trying to alter the way that their bodies look.

But even though this evidence is coming to light, people still seem to be having a hard time accepting it. By people, I mean healthcare officials and others who get to make the big decisions about what information is given as guidelines for health. By people, I also mean the public. Even though the evidence showing those who are in the “overweight” BMI category are living longer than any other BMI category (yes, including the “normal” category) was so overwhelming that it was published in the Journal of the American Medical Association, people are still trying to find reasons to why this could be other than it actually just being the obvious: that it’s healthy to be “overweight”, and that “overweight” is not overweight: that we have to accept this as reality, like we would with any other comprehensive scientific study. Even the medical community keep trying to bury their heads in the sand and subtly hide or erase the information that the (many) studies have given us.

Other studies show that you can be any shape, weight, or size, and be healthy (this becomes less likely with the very morbidly obese and the underweight, but that is not to say that there are not those in both categories that are healthy), and many, many studies show that food and weight is not as correlated as we have been told it is (for more information on weight set point theory go to “Weight Set Point Theory!” under my links section). In fact, it probably doesn’t play much of a part at all, unless you are starving yourself so that your body cannot maintain its weight because of the lack of energy, or you are stuffing yourself to the point of nausea every time you eat so your body cannot cope with the excess energy. The latter is not a common occurrence, except for those with binge eating disorder (which is far less common than you think it is, but that’s a conversation for another time), whereas, unfortunately, the former is – because of the influence the dieting and weight loss industry has had on us, and the prevalence of restrictive eating disorders. The body actually has it’s own system for regulating body weight when you are listening and responding to it properly, not ignoring hunger, and following cues from the body to eat whatever it wants, whenever it wants. If you are in touch with your body and can eat an amount comfortably within your day, then you’re not eating too much, and your body can regulate the energy it is being given so that you still maintain within your healthy weight range that is individual for your body.

So why, even with all the hard facts and evidence, it is so hard for us to accept that a) you can be fat and healthy and b) if you want to be healthy, you have to let your weight be what it is supposed to be naturally?

It’s something that I’ve had to think about, because this is a topic close to my heart and one that helped my recovery from atypical anorexia, and because I’ve come across people on the internet and in my life that have point blank refused to even look at the research showing them that the misinformation that has been drilled into us from our fatphobic, thin-obsessed diet culture isn’t actually reality. It’s frustrating, and it’s sad. I am lucky that most of my friends are at ease around food, and – even though they have their own insecurities about the way that they look – accept their bodies as they are. However, I have a few friends that include those who go on and off diets, desperate to find a way to feel better about their bodies, those who flit between diets and disordered behaviour whilst loathing the skin they live in, and those who battle eating disorders (and before I end up validating the myth that diet culture is a common cause of eating disorders, it’s not, but it sure as hell makes recovering all the more difficult). It’s these people that I feel so sad for, and all the billions of others that are at war with their bodies, that don’t know about – or can’t accept – the fact that their natural, healthy weight is not under their control. And I feel sad for all those who are naturally in the overweight or obese BMI ranges, whose natural, healthy weights are where there bodies are at, but are constantly shamed and abused for those bodies that they are in. And I feel sad for those who have spent their life yo-yo dieting, only to see their weight go up and up and not understand why (side note: it’s because your metabolism slows down during the diet because your body is being starved, and then it stores energy as fat when you go off the diet and so you subsequently gain weight, so you end up back on a diet again, and the cycle continues, rather than letting your body heal and settle back at its natural, healthy weight range). And I feel angry at those who remain wilfully ignorant and keep judging and condemning those who are overweight or obese.

But back to the question: why is it that we find it so hard to accept that maybe body diversity is great, and that people can be healthy at any weight, shape, or size, and that we can’t dictate what our weight is if we want to be healthy and happy?

The first, most obvious reason to me is that we have had misinformation drilled into us for so long. We have grown up being told fat is bad and that we are responsible for saying no to so many of the foods we want to eat, responsible for exercising frequently, and responsible for maintaining a slim body. To then hear such opposing information means that our world turns upside down. Food and weight are such integral parts of our culture and society that to have what we think we know turned on its head is disturbing. It’s confusing. It’s shocking. It means we have to rethink everything about that topic. For some people, that’s just too much, so they refuse to believe it: they reject the new knowledge outright. People don’t like change. It’s scary and it makes people feel uneasy and unstable. It also means that if you accept that we are being lied to, then it makes it hard to know what information to trust, and that makes life a hell of a lot harder.

For some people, making choices about food and maintaining a certain weight through those choices are a form of control. People generally like to be in control. And even though we associate food and control being two parts of an equation that results in an eating disorder, those without eating disorders often engage in what is called “disordered eating”, and that can most definitely include feelings of control. Disordered eating is not a mental illness, but it’s an unhealthy relationship with food (and most probably involves body image issues too). It’s also really, really common because of how obsessed our society has made us with food, and because our diet culture literally encourages it. To be someone who uses food and weight maintenance as a way of feeling in control, and then finding out that you don’t need to have that control and actually to not be controlling about food and weight is the best way to be healthy, is an anxiety-provoking experience. So they reject it.

People also don’t like to have laboured under false hope. Those who feel unsatisfied with their bodies (and who doesn’t after our bodies have been attacked and shamed and ridiculed by the media and the dieting and weight loss industry in order to get us to buy their products) and who have gone on to diet, don’t want to know that their efforts are in vain and that they will not maintain any weight loss, that they will probably end up gaining more weight than the weight they originally lost, and that their dieting and subsequent weight loss and weight fluctuations can actually create health issues including higher risk of developing diseases, and a higher mortality rate. People who feel unhappy in their bodies don’t want to hear that they actually can’t make those changes to their bodies, especially if they want to be healthy. They don’t want to know that they are stuck with the body that they have, even though it has been shown over and over that changing your body doesn’t make you any happier (and again, changing your body isn’t sustainable). To actually learn to accept your body as it is can – sadly – seem like a much bigger challenge than changing it.

In addition, there’s a darker reason why people don’t want to accept the changing of the tides where food and weight is concerned: people who make what are considered “healthy” choices about diet and exercise feel morally superior.

from “How We Eat: Appetite, Culture, and the Psychology of Food” By Leon Rappoport

This makes me feel highly, highly uncomfortable, and it should make you feel the same. What people eat or don’t eat is not a reflection of who they are as a person. It doesn’t make someone a better person if they eat whole foods and abstain from any kind of “junk” food. It doesn’t make someone a worse person if they enjoy burgers and fries. Eating “healthy” doesn’t mean that they have more willpower than someone who chooses to eat “junk” foods. It doesn’t make anyone more superior than anyone else. It doesn’t mean that they are making better life choices. It doesn’t even mean that they are doing the best thing for their body and souls. It doesn’t mean anything except that they are making different choices to someone else. That’s it. That’s all it means. But somehow, it has become ingrained in us that we are morally superior if we make “healthier” choices. And yes, I chose to put that word in quotation marks because I don’t believe that you are necessarily healthier if you only eat “healthy” foods. I also believe that distinguishing “healthy” and “unhealthy” perpetuates a negative relationship with food because it then leads to “good” and “bad”, and there we are, back to morality, guilt, and shame again.

Accepting information that affects us in so many different ways is a really, really tough thing to do. Food and weight is inextricably linked with feelings of superiority and willpower, shame and guilt, with privilege, abuse, money, hatred, insecurity, laziness, greed, power, and sexuality – if not much more. To look at it all anew and recognise how much of it is wrong, and the devastating affect it has had on so many people takes time and patience. It also takes acceptance that those providing us with our health information don’t have our best interests at heart, and that can make some people feel embarrassed for having such blind faith in such a corrupt system.

So I get it. I get that it’s not something that people can just accept at a moment’s notice. But on the other hand you can’t bury your head in the sand and protest blindly against that which is proven fact, however much others try to muddy the water and cloud your judgement. Think for yourself. Educate yourself. Whatever conclusion you come to, make sure you’ve got the information and the knowledge. Don’t just blindly accept whatever you are told as the truth. That is all I ask, for your sake, and the sake of those affected by our obsession with food and thinness…for the sake of everyone. Take control by educating yourself, making the right choices for your physical and mental health, and taking steps towards making peace with your body, as it is.

Eating Disorders and Willpower: An Absurd Association

8 Replies

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?

1 Reply

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.