Building a Bridge from ED to Intuitive Eating, Part 3: ED's Accomplice... EDNOS

As I began my recovery process I became more aware of certain struggles the members of the “Through Thick & Thin” community were experiencing. Repeatedly, I saw similar threads emerge. When I came out to the community and shared the truth about my relapse it sparked a lot of discussion on the forum. The more we honestly shared with each other, the more our similarities became evident. In hearing my story, others heard echoes of their own voice. Some were ready to step up to the plate and acknowledge that they too, struggle with eating disorder. Others felt apprehensive about wearing that label as if it were the equivalent of brandishing a scarlet letter. Many who felt fearful of looking into their shadowy areas have since found the courage to strike their own matches and see what has been lurking in the dark all these years. All over the “Through Thick & Thin” forum we were opening communication and talking about eating disorder. This act of truth-telling has erased the shame and given more people the courage to own their experience along with their path to recovery.

We have always had members in our community who deal with the clinical eating disorders anorexia and bulimia but in the past, we have seemed like a minority. However, since I began to share information about EDNOS many members are recognizing that eating disorder may be at the root of their food and body image struggles.

EDNOS stands for Eating Disorder Not Otherwise Specified. It is a horribly limiting diagnosis which prevents people from getting the help and support they need. Many with EDNOS fall through the cracks and spend their lives constantly battling a feeling that something in their relationship with food and their body is amiss, but they can’t quite put their finger on it. All their efforts to find the peace they seek seem to fall to the wayside despite their dedication to heal. It can be very painful and confusing for these individuals. EDNOS is a serious issue that requires support. It should not be swept under the rug like some dirty little secret.

EDNOS today can quickly spiral into clinical eating disorder tomorrow. It can cost you the heavy price of your life. “Through Thick & Thin” wants to give all those living with EDNOS a voice in our effort to educate and empower. We know your pain. We understand your struggle. You are not alone. It’s time for your voice to be heard.

EDNOS is the gray area of eating disorder. It comes in many shades and hues. Vlogger, ‘xxstrawberrykissezxx’ on YouTube described the experience of EDNOS so clearly when she expressed in her video…

“You know you’re EDNOS…

When one day you can’t imagine eating over 1,000 calories and the next you hit 2,000 or more.

When you tell people, (including health professionals) you have an ED and they don’t believe you.

When your weight always stays the same because the starving and the binging seem to cancel each other out.

When no one sees your emotional pain because you’re not thin enough to show it.

When you want the definition of anorexia to change so you can fit into something for once.

When your weeks tend to go… purge, fast, purge, fast… binge, binge, binge.

When someone asks you what ED you have you say, ‘All of them… on different days… and not to the extreme.’

When you eat until your stomach hurts and then realize you don’t feel like purging.

When you go to the supermarket and buy all healthy stuff and then go back to buy all the junk food.

When you reward a day of restricting by binging.

When you starve all day but eat over 2,000 cals at night.

When you drink until you vomit because… well, because you want to.

When you feel like you’re anorexic but sure don’t look it!

And when you wish food didn’t exist because it would be so much easier that way.

Anyone can suffer an eating disorder. They strike regardless of age, sex, or race. And whatever the weight of a disordered eater… under, normal, or overweight… they can all suffer the same pain.”

I think this captures the essence of EDNOS better than anything I have ever come across. A person does not have to have every experience that is described here in order to have an issue that needs intervention. Displaying even one of these behaviors is cause for concern. If you or someone you know is dealing with these issues, please reach out for support. It can be a scary first step to take but it is one that will put you back on the road to reclaiming ownership of your life.

It dawned on me that the vast majority of those who come to the path of intuitive eating contend with some level of disordered eating, with many falling in the EDNOS category. Most don’t turn to the intuitive approach until they have reached complete diet burnout. Inside, they know that something has to give. They can’t keep going on like this. Having exhausted all their resources, intuitive eating becomes a last resort… the final hope. There are no absolutes and occasionally a person stumbles along the intuitive approach before dieting behaviors become deeply entrenched. However, in the vast majority of cases there is lengthy chronic dieting history or episodes of eating disorder.

Medical professionals and researchers have noted a distinct link between chronic dieting and the rise of eating disorder. Often, dieting is a gateway into eating disorder for those with genetic, societal, and emotional vulnerabilities. Even someone without this propensity can get caught up in this vicious cycle because dieting distorts our perceptions about food and our bodies. It is my belief that the large majority of individuals who turn to intuitive eating deal with some level of eating disorder, varying in degree of severity all the way from meeting clinical criteria for ED, to falling in the murky range of EDNOS. This has been played out in full view within the “Through Thick & Thin” community. 

Most individuals attempting to integrate an intuitive approach to food struggle greatly. I have witnessed a high level of confusion and subsequent relapse into disordered eating behaviors. These behaviors fall into a wide range from restricting, over-exercising and occasional purges, to chronic binging and compulsive overeating. All too often I have heard the body bashing and self-denigration so indicative of the eating disorder mentality. I have seen patterns of emotional issues, social anxieties, intimacy and relationship struggles that are the blueprint of ED.

Building a Bridge from ED to Intuitive Eating, Part 5... Consistent Self-Care

“Planning is bringing the future into the present so that you can do something about it now.” – Alan Lakein

In keeping aligned with the, “Food For Thought Pyramid” we are going to use nutritional counsel sparingly. I am going to provide you with some general guidelines. I will show you how to tailor a personal ‘plan’ that will help meet your individual needs. This 'plan' will bridge the gap between where you are now to where you hope to be... living as a natural, intuitive eater. We will discuss some basic nutrition. Before you begin rolling your eyes, have no fear, we will not discuss portions sizes, except in the most simplified sense. Our goal is to make this as uncomplicated as possible. A stripped-down approach to portions will be covered in an effort to create a foundation of understanding. What will be outlined is the minimal amount of food that needs to be eaten in order to foster a sense of health and well-being.

Those with ED often have faulty perceptions in this area. Much like Goldilocks, they are used to piling their plates to overfull or leaving them near empty in their attempt to find their 'just right'. The vast majority with ED exhibit some form of restrictive eating. This statement applies whether the individual struggles with anorexia, bulimia, binge eating disorder, compulsive overeating, or all the many shades of EDNOS in between. Those who tend toward binging/chronic overeating often have periods of restriction where meals are skipped or only small amounts of food are eaten as a compensatory measure to 'make up' for out of control eating.

Additionally, when people binge or chronically overeat, rarely is it on nourishing foods. Binge foods stereotypically lean toward those of the play food persuasion… candy, pastries, chips, fast food, ice cream, and the like. These foods, though tasty, are relatively nutritionally devoid. They are an essential part of any diet for the role they play in satisfaction. Pleasurable eating experiences are vital. However, it’s best to think of these foods as spices and seasonings. They provide variety, interest, and enjoyment to our meals. They are not a substitute for the main course. This is how someone categorized as morbidly obese can be nutritionally undernourished, despite their body size. In essence, many bingers and compulsive overeaters are restricting nourishing foods. All of these factors create a physiologic environment where the body is in a chronically underfed state. This is one element that all eating disorders have in common. Although, this is more readily apparent in cases where individuals are chronically under-eating, restricting, and in a state of starvation, this applies across the board in all ED conditions.

Until this state of internal deficiency is addressed, it will be next to impossible to rely on bodily signals to guide eating choices. It’s kind of like the telephone game you used to play as a kid where you would whisper a phrase in a friend’s ear and they would pass it along. The further down the line the phrase traveled, the more distorted the end message became. This is the distortion that takes place when someone with ED is first learning to decipher bodily signals. Much gets lost in translation. This is largely related to the contributing factors of severe blood sugar fluctuations and nutritional deficiencies, both of which lead to physical and cognitive imbalances. Until these two factors are addressed the dysfunction will remain rooted. There is no way for a balanced relationship with food to develop when it rests on that foundation. The material outlined here will help you build a new foundation that will support you fully in your recovery, improving your health physically, mentally, and emotionally.

Before I get further into this information I want to make it very clear that if you are dealing with ED/EDNOS, it is vital to have support and work with a recovery team of professionals who specialize in eating disorder. A nutritionist who has experience working with eating disorders can be a very valuable member of your team. The knowledge I am sharing here is in no way intended to replace the counsel and guidance of an eating disorder specialist. The approach I am outlining is for informational purposes only. What you choose to do with this information is your decision alone. I encourage those who are working with nutritionists to share what is presented here. Have your RD look over what is outlined to make sure it is a fit for you and your recovery program. My intention is to help those who are struggling understand that in making the transition from ED to intuitive eating, it is often necessary to build a bridge in order to get to the other side.

This ‘plan’ has an intuitive element. This is intentional. I believe it’s very important to begin the process of reconnecting with your inner guidance right off the bat, with a little structure and assistance along the way. I will not be telling you what to eat, when, or how much. I will be sharing what sound nutrition is. I will explain how to compose your meals in a way that stabilizes blood sugar and mood. I will outline the minimum amount of food needed for the body to function. This is not a limiting factor. You are free to eat more if this is what your body requires. All foods are on the menu. You are free to eat whatever you like. In fact, I encourage you to regularly include pleasure foods you love into your ‘plan’. This will up your satisfaction factor. I will be presenting a road map, but you are the one in the driver’s seat. It is up to you which route you take to get to the final destination.

If you want to implement this approach I strongly urge you to commit to it for at least three weeks. Your body needs some time to rebalance. This will be necessary if you wish to experience the beneficial effect deep nourishing can bring. Give yourself that gift. Trying this out for a day or two will not do much for you. This should be viewed as part of your process toward becoming an intuitive eater.