Is It Eating Disorder?



I wanted to post this information for those who struggle with body-image issues and feel that something is amiss in their relationship with food but are uncertain if an eating disorder is playing a role. I was further compelled to share this post with every mother, father, sister, brother, family member, or friend who suspects someone they love is suffering from an eating disorder. Maybe you have refrained from addressing the issue because you feel unclear about the source of the problem and don't want to further isolate your loved one. Hopefully, the information presented here can clear up any gray areas and give you the courage to intervene, if necessary. The following list of eating disorder signs is presented in, "The Eating Disorder Sourcebook - A Comprehensive Guide to the Causes, Treatments, and Prevention of Eating Disorders", By, Carolyn Costin M.A., M. Ed., M.F.T.

For those of you unfamiliar with Carolyn Costin's work, she has been a specialist in the field of eating disorders for over 30 years. She owns and directs several eating disorder treatment facilities including the Monte Nido Residential Treatment Facility in Malibu, California. Additionally, she is clinical advisor to the Parent Family Network of the National Eating Disorder Association. Carolyn Costin is the editor of, "Eating Disorders: The Journal of Treatment and Prevention". She is an established and respected author on the topic of eating disorders. Along with "The Eating Disorder Sourcebook", she has also published the titles, "Your Dieting Daughter" and "100 Questions About Eating Disorders". Carolyn Costin continues to educate and empower through her nationwide public speaking engagements. She was featured in the groundbreaking documentary "America the Beautiful". For a free viewing of this powerful full-length feature film that exposes the insidious way the current beauty ideal is creating a rise in eating disorders, follow the link below...

http://www.hulu.com/watch/198883/america-the-beautiful

This movie is a great resource for educators. The information covered in this film will speak to a wide range of age groups. Tweens and college students alike could derive great benefit from the material covered. A viewing could spark the initiation of meaningful dialogue on the subject of eating disorders. ED's have long been shrouded in secrecy and shame. It's time we talk about it, making it safe to ask questions and honestly discuss these topics. Both prevention and recovery depends on connection and open communication.

Below you will find the excerpt from "The Eating Disorder Sourcebook", which includes the telltale markers of eating disorder. An individual does not have to display every sign listed to be in need of help. The signs noted cover a broad range of eating disorders from clinically recognized anorexia and bulimia, to the classification of EDNOS which includes binge eating disorder, compulsive eating behaviors, yo-yo dieting, exercise addiction and other forms of self-abusive behavior. Not every individual will show all of these signs because of this distinction. Please keep this in mind when reviewing this list of symptoms. If you or someone you know is displaying any of these behaviors please find support. NEDA is a good place to start...

http://www.nationaleatingdisorders.org/

Checklist of Observable and Non-Observable Signs of an Eating Disorder:

*Use the checklist here as a guide to substantiate your concerns.

• Does anything to avoid hunger and eating and feels guilty after eating.
• Is obsessive and preoccupied with food.
• Eats large quantities of food secretly and/or eats when upset.
• Counts calories obsessively.
• Disappears into the bathroom after eating (probably to vomit food).
• To lose weight takes diuretics, diet pills, laxatives, enemas, ipecac, and so forth.
• Must earn food through exercising or exercises as punishment for overeating.
• Is preoccupied with fat in food and on the body.
• Increasingly eliminates food groups and/or eats only nonfat or "diet" foods.
• Becomes a vegetarian BUT also avoids nuts, cheese, pasta, and many other foods.
• Displays rigid control around food (e.g., type, quantity, and timing of food eaten).
• Complains of being pressured by others to eat more or less.
• Weighs obsessively, panics without a scale, is terrified of gaining weight.
• Isolates himself or herself socially.
• Substitutes sweets or alcohol for other nutritious foods.
• Constantly needs reassurance regarding appearance, self-denigrating.
• Constantly checks the fit of a belt, a bracelet, a ring, or "thin clothes".
• Checks size of thighs when sitting and space between thighs when standing.
• Uses large amounts of coffee, diet drinks, caffeine pills, or other stimulants.

Building a Bridge from ED to Intuitive Eating, Part 1: You Can't Put a Face on Eating Disorder... But You Can Face Them

“Most patients who are in the throes of anorexia nervosa, bulimia nervosa, or compulsive overeating have lost touch with their innate signals of hunger and fullness and taste preference. The physical starvation is often so grave in those who are suffering from anorexia nervosa that an attempt to listen to the signals of hunger or fullness can only lead to confusion and maintenance of the underfed state. If even the smallest amount of food is ingested, the slowed stomach emptying that occurs in anorexia pushes away signs of hunger and creates a false sense of fullness.”

“In the treatment of binging disorders, including bulimia, patients have become so accustomed to eating quantities of food that are larger than one’s normal needs that their interpretation of fullness is highly skewed. They so often have ignored hunger by eating for many other reasons, such as boredom, loneliness, anger, etc., that asking them to listen to hunger signals feels alien and frustrating. We begin, instead, by putting on our nutritionist caps and teaching them about normal body functioning, including the concept of blood sugar fluctuations and the body’s reaction to meals that are imbalanced or inadequate in terms of energy intake.”

“So, intuitive eating is best seen as the model of eating that will ultimately become one’s own. This happens after there has been a period of time for healing the body physically and shifting the cognitive distortions that rule the mind of someone who has developed an eating disorder as a coping mechanism.” – Excerpt from, “Intuitive Eating: A Revolutionary Program That Works”, By, Evelyn Tribole, M.S., R.D. and Elyse Resch, M.S., R.D., F.A.D.A.

“Hello… I’d like you to meet my frenemy, ED”

For a long time now I have felt like there was a piece of the puzzle missing in the ultimate design of intuitive eating. Something about the process felt off. Working as an intuitive eating counselor, I have seen far more people struggle to embrace the path of intuitive eating than I have seen readily take to it. I have experienced difficulty myself and this is after four years of believing I was an intuitive eater. In order to paint a clear picture, it’s necessary to share the story of my struggle. It is a struggle shared by many worldwide who have crossed my path on this journey.

In October of 2009 I experienced a relapse of my eating disorder issues. I have a long history of eating disorder with the first signs emerging when I was 10 years old. By the time I was 12, ED was running the show. I battled anorexia and purging behavior off and on over a period of 12 years. I never received any kind of professional support for my eating disorder even in my most desperate state of crisis. At that point, I was 24 years old. My weight had plummeted to a dangerously low level. At a height of 5’7”, I was a slip of a woman, registering a mere 85 lbs. I was vomiting blood on a daily basis. I was isolated, without the necessary support I needed. Many of my friends, feeling fearful and not understanding the gravity of the situation, turned their backs on me. The abandonment and rejection was almost more than I could bear. The intensity of the shame and humiliation I felt is beyond words. Somehow, in the darkness of that bleak space I was able to strike a match. That inner light, however small, illuminated the possibility of hope burning brightly in the distance. I reached for it with both hands like a moth drawn to a flame. I clawed my way out of that dark tunnel and nurtured myself back to some semblance of health. It would be many years before I would notice that ED was still hanging out in the background, lurking in the shadows of my consciousness.

I had a brief period of stabilization. Life felt good for awhile. I was out of the danger zone health-wise and things were looking up in my life. I finally found the courage to stand up for myself and leave behind the abuse. I left a dead-end job in the dust and moved on to a new career as a therapeutic massage therapist, working alongside doctors, providing physical therapy for patients. It felt deeply rewarding to be earning a right livelihood by helping others find healing. In restoring others, I felt renewal in my own soul. Call it karma yoga.

I took a leap of faith and manifested a lifelong dream, opening up my own practice. I had reached a goal many doubted I would achieve, launching my own business at the age of 27. My practice was booming. I found instant success. Within my first month of opening doors I recovered all my start-up costs plus found myself securely in the black with a handsome profit. It only continued up from there. I was working hard, but for the first time in my life I had financial security and was able to treat myself to the finer things. Within a few months, everything I had worked so hard for was reduced to nothing more than ash when a practitioner who shared space with me left a hot plate burning that set a fire, quickly consuming the building. I’ll never forget standing in the charred remains of what used to be my treatment room. How quickly life can completely change on the drop of a dime and leave you reeling senseless. I was not able to salvage a single thing except for a large statue of a fairy that I had sitting in the corner who somehow managed to survive the fire, her face glowing pearly white against a backdrop of blacken ash. I kept her as a reminder that even within darkness, there is light.

After this event, I hit the wall. Truth be told, the fire was a symbolic message... a divine intervention, if you will. I was burned out. The field of rehabilitative massage is a taxing one. I didn’t do what therapists have dubbed ‘club rubs’... the massages you get at frou-frou spas where they pet you into submission. I did deep tissue, neuromuscular retraining, Heller work, sports massage, and action release/trigger point therapy. This kind of work exacts a major toll on the body. I was in high demand and often found myself grinding through 60 hour work weeks. I was spent. My body depleted, I collapsed. I struggled for many years and saw a reactivation of my eating disorder issues, but this time it took a different form… non-purging bulimia. I used excessive exercise and tight eating as my compensatory behavior for the binges that were becoming ever more frequent. My weight escalated and I quickly became morbidly obese. I never discovered my highest point because it became too depressing to see the rising numbers after awhile. I felt completely powerless against my body which only made my anxiety rise. This was a new experience for me. I had never been a large woman. I had gone through periods of being softer, fleshier, a bit zaftig perhaps, but never to the extent that it was difficult for me to function physically. I felt ashamed and trapped like a prisoner in my body with no hope of parole.

“Off with her head!”

Physically, this was a scary place to be. I was constantly getting winded and could barely make it around the block without having to stop to catch my breath. I was scared to sleep. When I laid down for bed I could feel this crushing weight on my chest. It felt suffocating. The worst part was that my ED tricks were no longer working. No amount of compensation could unravel the cascade of biological events that were happening in my body. This is the part of eating disorder that many people don’t talk about. I think it’s time we did.

Eating disorders do serious physical damage to your body. They wreak havoc on your digestive system and once that damage has been done, it takes a long time and much effort to repair your internal terrain. When your digestion heads south, watch out! You become vulnerable to a whole slew of physical health complications. Unable to assimilate the nutrients from food, your state of well-being quickly deteriorates. It may seem like ED is helping you obtain the coveted prize of a thinner body but you can rest assured, there will come a time when you have to pay the piper and the price exacted will be your heavy head. Take it from someone who knows. It’s not worth it.

My body was in constant pain because of depleting bone mass. I had a bone density screening and the nurse practitioner was highly disturbed by my results. She informed me that I was only 3 points away from being like an 80 year old woman with osteoporosis. She had never seen a woman in her twenties with these results in all her years of practice. I found myself having to visit my dentist frequently for dental caries. My immune system was shot. I seemed to get every virus that came around the bend. It was very common during those days for me to be laid out sick for weeks on end. Every time I tried to exercise to address my escalating weight it was like throwing a match into a barrel of kerosene. My body was on fire and it was screaming at me, “Stop! Please stop! Be gentle with me. Be kind. I can’t take this abuse anymore!” My body was in the trenches of eating disorder, raising the white flag of surrender, but sadly, for many more years the battle raged on. Ultimately, my energy was completely snuffed out. I blew out my thyroid.

Many people are unaware that a major contributor to hypothyroid conditions is a history of chronic dieting. It’s no wonder that thyroid disease has reached almost epidemic proportions in the United States with our cultural diet obsession. The irony is, the longer you restrict, yo-yoing back and forth between feast and famine, the more your body will put up a fight for self-preservation. This is why many people find that despite the small amount of food they eat and the more strenuously they exercise their body only holds on to fat stores for dear life. This is because in a very real sense biologically, it is a life or death struggle. After years of abuse and self-neglect of basic needs, our bodies remain in a state of high-alert, never knowing when the next meal will come. Despite being fed, this uncertainty will linger. How long will this food be available? When will the next famine arrive?

To the average person trying to live up to society's one-note beauty ideal this pursuit may seem harmless. Intellectually, you may understand that you are choosing to forgo food in favor of thinness, but this is completely irrational to your body. The body adapts in these situations and will slow everything to a grinding halt, including metabolism. This is why it is very common for restrictive eaters, chronic dieters and those who have battled anorexia to deal with overweight/obesity conditions later in life. We can’t blame our bodies. They are responding accurately to a lack of food security. We have to stop working against our bodies and instead work with our natural biological drives if we ever hope to have lasting healing.

There’s a Light in My Attic

After 9 more years of struggle with bulimia, beaten down and spent, I finally made the decision to give up the fight. I made a commitment to never diet again. I wanted to reconnect with my body. Even though I was a very large woman, I couldn’t be concerned about my body size. I was so tired of the constant struggle... the fight that came every morning when first opening my eyes and wondering if today was going to be a good day or a bad day. Most were bad days. I couldn’t take the sheer disappointment… the numbness and apathy… of living that way a moment longer.

I decided to embrace intuitive eating. The first year was challenging. I continued to exhibit bulimic behavior, but I was seeing slow and steady improvement. My second year into intuitive eating, my binges fell away. However, an air of restrictiveness remained. I couldn’t see this at the time, but looking back now, it is very clear to me. I will share how this restrictiveness stayed in place in hopes that it may help others recognize destructive patterns within themselves.

I was very conscious about eating just to the point of satiation. This is something that is recommended in the book, “Intuitive Eating”. Unfortunately, since I never received any help for my eating disorder I had certain distorted perceptions about food, hunger and satiety embedded in my brain. Adhering to this guideline kept me in a state of perpetual underfeeding. Additionally, I continued to over-exercise. Not to the extent that I once did at the most exacerbated point in my ED history, but imbalanced nonetheless. I frequently hit periods of over-training and injury. I summed this up to being the end result of trying to exercise as a heavy woman and something I just needed to push through.

After two and a half years binge-free, I felt better than I had in a decade. A doctor’s appointment confirmed that I had released 70 lbs. effortlessly. My energy was improving. My health was on the mend. I had a new respect for my body and felt a peace around food that I never had at any point in my life. During this period of time I became certified as an intuitive eating counselor by going through the training program designed by, Evelyn Tribole and Elyse Resch, the authors of, “Intuitive Eating”. I was listed on the national directory and made the decision to pay it forward by founding, “Through Thick & Thin”. My vision was to establish a sacred space in the format of an online community where support would be free. We would uphold a 'come as you are' atmosphere where every member would feel welcome, fully accepted, and receive resources for their recovery. It was a lofty vision because that level of integrity is rarely seen on the internet, but we have somehow managed to hit the mark. Every time I hear a member express that “Through Thick & Thin” is one of the only places they feel free to be themselves, accepted and safe, it reminds me of the value of the work we are doing collectively as a community. I felt I had mastered recovery.

Building a Bridge from ED to Intuitive Eating, Part 2: The Birth of Relapse

An Itch Begging To Be Scratched

2009 was a year to remember, though not fondly. At the time, I was married and my former husband faced a major health crisis. At a dinner party, he suddenly fell unconscious. His heart had stopped. He had no respiration. I had to resuscitate him with CPR. It was a very traumatic experience for me. What followed were months of doctor visits as we tried to ascertain what led to this crisis. We never did reach a definitive diagnosis. It was a time of uncertainty and my sense of safety was rocked. This came on the tail of my father's medical emergency. He went in for a routine cardiac stress test only to be admitted to the hospital on critical status. The main artery that feeds his heart was 80% blocked. It was not a matter of if he would have a heart attack, but when. The cardiac specialist who counseled my family expressed how lucky we were to catch this. It was unlikely my father would have survived the degree of heart attack that was brewing and if he did, he would have wished he hadn't. Within 24 hours he was transported to San Francisco for an emergency bypass operation. The fragility of our mortality seemed to be a running theme. There was death in the family and many losses to grieve. One of my dearest friends was mourning the sudden death of her only son. He passed unexpectedly due to a genetic heart condition that was never caught at birth. Understandably, she needed to rely heavily on me for emotional support. Upheaval was the order of the day.

They say when it rains it pours and in my neck of the woods, it was dropping by the bucketful. I began to feel overwhelmed. Every safe space was crowded out by an ever-expansive sense of impending doom. My heart sank when the phone rang because it usually brought more bad news. My sense of anxiety grew as I realized that life promises no guarantees... that safety and security are mere illusions we pin our hopes upon. This is something I had always grasped intellectually, but mental knowledge is quite different from direct experience. This pushed play on some old tapes that habitually run through my mind during times of great stress. A sense of wondering when the other shoe was going to drop colored every waking moment. I saw the reemergence of ED.

At first, it was an isolated incident. A binge here, some ‘careful’ eating there, then progressing to periods of ignored hunger and over-exercise. At first, I chalked it up to all the crisis I had been wading through. I knew these coping mechanisms were comfort zones for me. Naturally, with my sense of overwhelm increasing my survival instincts would guide me to rely on old ways of dealing with difficult emotions and situations. This is the only way I have known to keep myself afloat since I was a little girl. I decided that if I could be more aware I would be able to reel myself back in and reconnect with intuitive eating. It wasn’t that easy.

As my eating disorder behavior increased my body was thrown into crisis. My health started to nosedive. This only fueled the fire of urgency to ‘get back on track’. Medical doctors were admonishing me left and right to lose weight or else. Though they were pleased with the progress I had made up to that point with intuitive eating, it wasn’t good enough. When they saw my weight release stall due to enforced starvation, it upped the ante. Each medical appointment became a flogging session that led to mounting frustration.

My doctors are aware of my eating disorder history. What I would like to let medical professionals know is heaping this kind of pressure on patients with eating disorder issues is irresponsible. It is like flipping the switch on those latent tendencies. We need more compassion from the medical community. Slimness does not equal sound health. I am living proof of that fact in light of my personal history.

By October 2009 my balance reached the tipping point and I saw a full-blown relapse of eating disorder. I exhibited non-purging bulimic behavior in full bloom. Days would go by where I would starve, existing off nothing more than a single fruit smoothie. Eventually, my biological drives would kick in and I would experience subsequent binging. The binges could last days on end. I stayed in this pattern for close to a month distracting myself by disassociating through the channels of over-work and over-obligation. “No” ceased to be part of my vocabulary. I was stretched paper thin. Somehow, the intuitive knowing I had nurtured the decade since initiating my healing process kicked in. I woke from my haze and realized I was in trouble. I needed help.

Breaking Up Is Hard To Do

ED has always been a shitty partner. ‘He’ expects so much and gives nothing in return. ‘He’ is a sadist… hell-bent submission. It’s ‘his’ way or the highway. Every time I've tried to use my voice in the past and stand up for myself, ED told me to ‘shut up’. ‘He’ is a gatekeeper. ED wanted to keep me under lock and key. ‘He’ would never willingly grant me freedom. ED isolated me from my friends, family, and the things that make my heart full. ‘He’ crowded out all space for my soul to breathe. ‘He’ sought to make me smaller… to strip me of my power. I was so over ED. Breaking up is hard to do, but it was time for me to move on and ditch this toxic love affair. One thing was certain. ED had to go. I'd glimpsed the other side. Although the grass may not always be greener, in this case it is. I packed ED's bags and gave 'him' a swift kick to the curb.

It may seem funny to describe eating disorder as a relationship, but that is exactly what it becomes. Anyone who has experienced the death grip of ED knows it’s like being in an abusive relationship with your self. You feel divided, as if there is a civil war going on within you complete with two dueling sides. One side wants recovery so badly it can nearly taste it and the other side doesn’t want to relinquish the control required to get free. At some point you have to dig deep and find that small still place inside… the place where the authentic you lives… and using all the strength you can muster, walk out that door toward a life that holds no space for ED in it. This is exactly what I have done.

I began my journey into recovery by attending a day long workshop at Beyond Hunger that was led by one of the therapists who co-wrote the book, “It’s Not About Food.” This is the first time I ever sought any kind of eating disorder support for myself. It was an essential first step. The workshop was a condensed version of the book so I didn’t receive any monumental benefit from the experience. I didn’t let that discourage me. Sometimes, you have to be open to exploring your options when you first reach out for help. Serendipitously, there was a therapist attending the workshop who specialized in eating disorder. When I asked if there were any other ED support resources in the area she guided me to a free ANAD (Anorexia Nervosa and Associated Disorders), support group that has weekly meetings in a neighboring city. When you reach out for help you may not get the answer you expect, but often are led to exactly what you need.

I have been faithfully attending weekly ANAD meetings and going through therapy with an eating disorder specialist since December 2009. I've also worked consistently with a registered dietitian through Kaiser's eating disorder treatment program. The experience has changed my life. There are so many things I have discovered about the way I move through this world that I was completely unaware of before. Some days are better than others. Opening up and peeling back the layers can feel scary at times, especially when you are so used to living closed off and shut down. There are moments when the intensity of my emotion takes my breath away. I am sorting through a lifetime of repressed gunk. I’m learning to hold space for the suffering. I don't wallow in it. I gently welcome it in to sit for a spell so it can speak its language to me. Through this process of self-inquiry, I have gained a better understanding of myself. Little by little the part of me that longed for full recovery grew stronger until my emancipation became reality.

Here I am, a year later after beginning this journey and I know with absolute certainty that eating disorder is part of my history, not my future. I have zero investment in self-abuse. I have come to gain too much genuine love and respect for myself. I was very fortunate that I had the awareness to get myself the eating disorder support that had always eluded me. My relapse was in the birthing stages at the time I reached out. All the healing work I had done on my own had made a difference. It nurtured an awareness that allowed me to easily spot old patterns resurfacing. A mere month of emerging behavior was all it took to wake me into action. I knew if left unattended, the eating disorder would take over and I would slide into the danger zone. I couldn't fail myself like that again.

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 4: The Missing Piece of the Puzzle



In a crystallizing moment, I discovered the missing piece to the puzzle. I finally understand why so many people are not finding complete recovery through the path of intuitive eating. Quintessentially, the intuitive eating approach puts the cart before the horse. It works on the basis of assumption that most do not deal with any degree of eating disorder, when sadly, this is far from the truth. The reality is actually the mirror opposite.

Evelyn Tribole and Elyse Resch have hit the nail on the head when they express the challenges that someone faces in integrating an intuitive eating approach when there is a pre-existing condition of eating disorder. They outline the importance of educating individuals about how to properly nourish their bodies and in many cases, employ a rehabilitative plan that will provide the safety of a certain level of structure. This allows the individual to gradually release distorted behaviors and perceptions around food as they are nurtured back to health physically and cognitively. Once this balance has been established, the individual can be guided gently into learning how to listen to their body’s internal cues to direct eating experiences. Intuitive eating is the ultimate destination, but a large majority of people coming to this path may need to take a detour, first learning how to properly care for themselves by addressing internal imbalances that result from a history of ED/EDNOS or chronic dieting.

I can hear it now… “Wait a minute! I know what’s healthy. I could probably school my doctor in nutrition. I’ve read so many books on how to eat. I’ve been on countless plans. How is this supposed to help?! Isn’t a plan just another diet?” What many neglect to acknowledge is that the vast majority of their nutritional information has come from faulty sources. Most have received their nutritional ‘education’ from fad diets and the media who is always quick to jump on the bandwagon of the latest food hype. Tell me I’m wrong. We’ve all heard the never-ending droning of the media machine extolling the virtues of acai berries and mangosteen. For every ‘It’ girl in Hollywood we have a corresponding ‘It’ food… the flavor of the moment… and it sucks people in. First coffee is ‘bad’ for us, and then it's ‘proven’ to prevent dementia. How many foods have been put into the penalty box only to be redeemed a few short months later? Remember how we demonized carbs? That screwed up many people’s perceptions of this essential fuel source. Now we are being encouraged to bring grains back to the table. What gives?

The funny thing is the core nutritional information for building a foundation of health hasn’t shifted all these years we've been trying on different fashion food trends. I can read your thoughts… “Oh great… here we go with the Food Pyramid and the dreaded countdown of servings a day. Here come back the measuring cups, food scales, the lists of ‘good’ and ‘bad’ foods. I knew it!” Wrong again. “Through Thick & Thin” would never pull the rug out from under you like that. Besides, there is much room for improvement when it comes to the Food Pyramid. Marion Nestle agrees.

Marion Nestle is Paulette Goddard Professor in the Department of Nutrition, Food Studies, and Public Health at New York University. She chaired the Department of Public Health from 1988-2003. She holds degrees in molecular biology and an M.P.H. in public health nutrition issued by UC Berkley. She has schooled physicians, residents, and medical students at the UCSF School of Medicine. She has served as a member on the FDA Food Advisory Committee and Science Board, the USDA/DHHS Dietary Guidelines Advisory Committee, and the American Cancer Society who establish nutritional protocol for cancer prevention. This is the short list of her numerous contributions to the field of nutrition. She is a highly regarded professional. You would be hard-pressed to find a member of the medical/dietetic community willing to go head to head with Marion Nestle. She knows her stuff and has poked many holes in the value of the Food Pyramid.

If you feel compelled to learn more about nutrition I encourage you to read Marion Nestle’s book, “What to Eat” where she sorts through the ‘Big Food’ hoopla to reveal the simple truth. It’s not complicated, but the food corporations have made it that way. In fact, the current Food Pyramid is more strongly influenced by commercial gain than by public interest. If you have any doubt about this I welcome you to read Marion Nestle’s telling book, “Food Politics: How the Food Industry Influences Nutrition and Health”.

What I appreciate about Marion Nestle is that she presents an informed, well-rounded view. She knows both sides of the story and is able to present the facts free from bias. I view her approach to nutrition as integrative. Unshackled by the conventional approach, she is open to applying alternative nutritional therapies where they have merit. Neither too far on the left, nor right side of the fence, she can meet the public in the middle and provide a balanced view.

If any food pyramid were to be employed in the design of our plan, “Through Thick & Thin” favors the “Food For Thought Pyramid – How to REALLY Enhance Your Health” created by, Laura McKibbin, LICSW that is founded on the HAES (Health At Every Size) approach. The “Food For Thought Pyramid” features:

• Genetics, Luck (6-11 servings)
• Socioeconomic Factors: Country of birth, race, gender, income, access to healthcare, freedom from violence (6-11 servings)
• Relationships and Social Support: People, pets (3-5 servings)
• Purpose and Meaning: Spirituality, altruism, contact with nature, forgiveness (2-4 servings)
• Humor, Optimism, Play (2-3 servings)
• Emotional Resilience: Healthy management and expression of anger and other emotions, ability to take action (2-3 servings)
• Exercise (1 serving)
• Nutritional Advice (Use Sparingly): Instead, rely on internal cues

Sources: Dean Ornish, Jon Kabat-Zinn, Bernie Siegel, The Buddha, Gloria Steinem, Viktor Frankl, Glenn Gaesser, Mother Teresa, Martin Seligman, Jesus of Nazareth, Jon Robison, Larry Dossey, Jean Baker-Miller, the World Health Organization, my Mom, your gut intuition.

As described on the website the “Food For Thought Pyramid” was, “Designed as a tongue in cheek response to and criticism of the FDA’s Food Guide Pyramid.” There are “Food For Thought Pyramid” posters available for purchase at:

http://www.food-for-thought-pyramid.com/

In a spirit of paying it forward, every poster purchased allots 20% of the proceeds to the Ecumenical Food Shelf of Alberta Lea, MN. Or if preferred, you can provide the name of a food bank in your area that you would like the funds to be distributed to and they will make a donation in your name to the facility of your choice. This poster is a great way to visually remind yourself to keep your perspective on your journey and to heed your counsel first when it comes to making decisions about your path to recovery.

Our ultimate destination is intuitive eating. Those who are currently struggling with ED/EDNOS issues may need a helping hand to rehabilitate their bodies so they can get back to a balanced state biologically where they can once again rely on internal cues. For those who have been coming up against a wall of resistance in implementing intuitive eating, this approach may also prove beneficial for you. Please be mindful that this is a temporary means. The intention is not for you to fall back on this plan indefinitely. The idea is to help you get reconnected with your personal rhythms and bodily signals. I encourage you to give yourself at least 3 weeks to work with this technique so you can experience the rebalancing benefits that come from nourishing your body deeply.

This approach is being outlined for those dealing with eating disorder. If you have found your transition into intuitive eating to be a smooth, seamless one and your formerly imbalanced behaviors around food have stabilized… congratulations. It’s empowering to reconnect with your body and inner sense of knowing. There is no need for you to make any alterations. This approach is not for you. I request respect for those in our community who may need to rely on this transitional technique. If this plan is not for you, it does not mean that it is not needed by another who feels disconnected from their body. Honor the right for each individual to chart the course that is needed for them in their recovery.

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.

Building a Bridge from ED to Intuitive Eating, Part 6: Nutrition 101

What is sound nutrition?

Sound nutritional nourishment is created when the majority of food choices come from plant sources. These include:

• Starchy Complex Carbs: Whole grains, whole grain/sprouted grain breads, whole grain cereals, pastas and crackers, brown rice, grits, polenta, potatoes, yams
• Non-Starchy Complex Carbs: Fruits (fresh and dried), 100% fruit juices, vegetables, 100% vegetable juices
• Protein: Beans, lentils, split peas, tofu, nuts, nut butters, seeds, soy/nut milks
• Fats/Oils: Olives, olive/vegetable oils

That’s right folks… carbs are the foundation of sound nourishment. They are not the ‘bad guys’ they have been made out to be. Despite what you may have heard in recent years, this one nutritional tenet has never changed. Our bodies need nourishing carbs and plenty of them in order to function properly. This includes starchy carbs, not just fruits and veggies. Without this essential nutrient, our energy plummets and our health suffers. Most Americans get plenty of fast absorbing carbs in the form of highly-processed white flour products, sugar, and sweets. This is how carbs have earned a spot in the penalty box. We have all seen the detrimental effects resulting from over-consumption of highly-processed foods and sugar. Our escalating diabetes rates clearly demonstrate the aftermath of a diet based on simple carbs. However, we largely turn to simple carbs because we are so deficient in complex carbohydrates. It’s akin to a dog chasing its own tail.

Complex carbohydrates provide a vast array of essential nutrients and one that is sorely lacking in the Standard American Diet (SAD)… fiber. Fiber is a pillar of disease prevention. One of the best things you can do for your body is up your fiber. Now, does this mean you can never enjoy simple carbs? Absolutely not! However, you will be best served by letting the majority of your choices come from complex carbohydrate sources. For our intents and purposes of nutritionally rehabilitating the body, I encourage you to make at least half of your choices from complex carbohydrate sources before you fall back on highly-processed foods. The more you favor complex carbohydrates, the more you will see your energy increase. Your moods will stabilize as brain-fog begins to clear. Binging/compulsive overeating will start to fall away. You’ll also notice a distinct reduction in cravings for sweets.

Now, you may be wondering, “Where are the meat, dairy, and eggs? Are you asking me to become a vegetarian?” Nope… try again. We are going to get into that in just a minute. Before we cover that topic, I want to assure you that you can get all the protein you need from plant sources. Plants provide all the essential amino acids. In the old days they used to believe that in order to make a complete protein out of plant sources you had to food combine. Combining rice with beans is an example of this outdated food philosophy. We now know the body will balance out amino acid intake throughout the day of its own accord. Food combining for complete protein is not necessary. This statement is in fact supported by the ADA (American Dietetic Association).

Vegetarians who are getting all of their protein from plant sources need to be mindful of keeping up their vitamin C intake. This is because there are two types of protein... heme and non-heme. Meat is the only heme protein source. This bears mentioning because heme proteins provide essential iron. Heme sourced iron is more easily absorbed by the body than it is from plant sources. In fact, meat eaters absorb on average 15-35% of the iron from heme protein, whereas vegetarians, including lacto-ovo vegetarians who continue to consume eggs and dairy products, only absorb 2-20% of the iron from non-heme sources. This is important to consider because iron deficiency can lead to anemic conditions. There is no reason for concern though because this reduction in absorbability can easily be addressed by getting plenty of vitamin C rich foods. Vitamin C facilitates more complete iron absorption from non-heme protein sources. Foods rich in vitamin C are:

Sweet red bell peppers, parsley, broccoli, cauliflower, strawberries, mustard greens, papaya, grapefruit, kiwi, oranges, cantaloupe, cabbage, tomatoes, raspberries, celery, spinach, pineapple, watermelon, tangerines, limes, cranberries, guava

Realistically, most vegetarians are getting a wide variety of these vitamin C rich foods so the great iron debate can be put to rest. A plant-based way of eating can absolutely fulfill all of your nutritional requirements, so long as you are being mindful of nourishing yourself from a variety of nutritional sources. I’m sure this now raises some questions regarding calcium. Don’t you need milk in order to get the calcium needed to strengthen bones? The short answer is no. Plenty of plant foods contain highly-absorbable calcium. Plant foods high in calcium are:

Green leafy vegetables, nuts, oranges, kidney beans, lima beans, whole grains, Swiss chard, lentils, raisins, broccoli, kale, celery, tofu, romaine lettuce

In fact, it is a myth that you need to consume dairy in order to fulfill your calcium need. You may be thinking… “What about osteoporosis? Don’t I have to get 3 servings of dairy products a day in order to stave off bone loss?” Wrong again. In examining nutritional guidelines it is important to remember the politics of food. Food industries dish out a lot of cash to take up more space on the USDA Food Pyramid. Keep that in mind before allowing yourself to be blindly led. Many people are lactose intolerant and have difficulty digesting dairy foods. In fact, in some of the healthiest societies in the world, very little, if any dairy is consumed. This is evident in rural China where the population consumes about one third the amount of dairy that most Americans do. They also have virtually no incidence of osteoporosis. In fact, the highest rates of osteoporosis correspond with countries consuming the largest amounts of meat and dairy products including the United States, New Zealand, Britain, and Sweden. The reason... excess animal protein consumption leaches calcium from bones.

Does this mean you should avoid meat, dairy, and eggs if these are foods you enjoy? Not a chance! We have to stop looking at things in such black and white terms. The key here is excess animal protein intake can create calcium deficiency. This is another way that the low-carb fad diet trend has promoted harmful misinformation. It has skewed people’s thinking about balanced nutrition. Especially in fitness communities the macro-nutrient, protein is over-emphasized and excessively valued. Remember, you can get all the protein you need from plant sources. Plant protein will not deplete your calcium stores. If healthy strong bones are important to you, and they should be, consume animal proteins more moderately. This can easily be achieved by going for the regular burger instead of the triple-decker, putting a little less meat in that chili, and enjoying a slice or two of cheese, not half the brick. Our bodies really don’t need 16-oz. steaks, giant burgers, and heaping plate-full’s of Buffalo wings. We don’t thrive on head-size hunks of cheese. The fast-food industry has greatly played into this portion distortion with their super-sizes and plates of food that can easily feed an entire family. Our whole idea about what constitutes a reasonable portion is skewed.

Those who struggle with restrictive eating disorder behaviors are probably used to seeing a plate as half empty and falsely believing this is a reasonable amount of food, while those with binging/compulsive overeating disorders have eyes much larger than their stomachs. Here is the only portion guidance I am going to give. I share this not as a limiting element, but to help those who may feel confused understand what a reasonable portion of food is. What I am about to outline is the bare minimum amount of food that needs be consumed at meals for general health. I’m not going to ask you to pull out a food scale or measuring cups. Those are the tools of the dieter and we have no need for those here. I’m also not going to break down serving sizes into their measurement equivalents by listing how many cups or ounces of food ‘should’ be consumed. I personally find that kind of information triggering. I think this is where nutrition professionals have really missed the mark. They understand the importance of sharing this information but present it in a manner that automatically breeds resistance and can be activating for ED issues. That’s not our intention here, so we are going to keep it simple. Want to know what a reasonable portion of food looks like? Put out your hand and make a fist… that’s it. A serving of protein, starchy carbs, fruits or veggies, is about the size of your fist. Use fats in small amounts to add flavor, while increasing both the enjoyment and nutritional content of your meals. A little butter can be a great thing! This is not an exact science, but it comes close enough to hit the mark.

The final nutritional area I want to cover is pleasure foods. Don’t worry… I didn’t forget about those treats we all love. What would life be without a cookie, scoop of ice cream, grab-bag of chips, or basket of fries from time to time? Boring and bland. Who wants any part of that? I think each one of us will have our hands raised high when I ask the question, “How many of you are sick and tired of being told to avoid the very foods you love?” Pleasure should be considered an essential nutrient. Like a multi-vitamin, we should take one a day… at least. Pleasure is required to feel a sense of satisfaction. Feeling satisfied is an underrated component of ending binging, compulsive overeating, and restricting behaviors. We need to learn the art of receiving pleasure. We also need to understand that pleasure comes through more sources than food. I encourage you to include a little pleasure each day from a variety of sources. In terms of sweets and treats, include reasonable amounts at the end of your meals or build them into your meals, if you so desire. This will allow you to experience the pleasure of the treats you love while also bringing your relationship with these foods into balance. Rather than viewing them as the main event, you will begin to see them realistically, as extras. Treats serve the purpose of providing dimension and interest to your meals. Biologically, this will prevent blood sugar spikes. Since the bodily need for nourishment will take precedence it will foster an internal equilibrium that will allow you to experience satisfaction with smaller amounts of these foods. When it comes to reasonable portions of treats, once again, look to your hand. If it wouldn’t fit in your hand, it is more than your body needs to feel supported. A cookie or two, a handful of chips, a scoop of ice cream… all sensible amounts. You can enjoy these foods every day! Build them into the meal ‘plan’. It’s important that you have enjoyable eating experiences. Many of you have been denied this pleasure for far too long. It’s time to welcome all foods back to the dining table.

Additionally, consider inviting other sources of pleasure into your day, as well. Make time for a relaxing bath. Allow yourself a 15 minute cat nap. Treat yourself to a warm cup of tea and a page-turning novel. Make a play-date with your best friend. Create space for you. You deserve it!

Finally, make sure you are getting plenty of water. Carry a water bottle with you and sip on it throughout the day to keep yourself well-hydrated.

How to Create Your ‘Plan’

In order to get your blood sugar levels stabilized, reduce binging/compulsive overeating, sugar cravings, and create a sense of food security that will allow your body to find physical and cognitive balance, it is going to be imperative that you feed yourself consistently and regularly with adequate nourishment. In order to achieve these aims you will be creating a ‘plan’ that will include 3 substantial meals and 2-3 snacks each day eaten no more than 4 hours apart from one another. Your snacks will be smaller than what you normally consume in a meal. It is also necessary to get a nurturing breakfast in every day within an hour of rising. Skipping breakfast invites in too many physiological responses that trigger ED behavior. This meal is going to be an essential component of your recovery process. This may seem like a task at this point, but I promise it will do amazing things for your body. You’ll be surprised how much this single step can improve your overall well-being. This is not about putting yourself on a mini-meal plan, which has been a recent popular diet trend. This is about nourishing your body with essential fuel.

When preparing your meals, think of including at least a fist-sized portion each of starchy complex carbohydrates, protein, and a fruit or veggie. Add a little essential fat to round things out. Balanced snacks will include complex carbohydrates (starchy or fruits/veggies) and protein. At first, this may seem like a lot of food to you and believe me, I understand. I was taken back when I saw the minimum amount of food I would need to eat in order to repair and replenish my body. At first, I thought there was no way that I could do this, but in a very short time I was proven wrong. It makes me all too aware how deeply grooved those patterns of restriction and under-eating are when there is an ED history.

I feel much better physically, mentally, emotionally, and energy-wise since implementing my own ‘plan’. I now get how carb-deprived I was. A rise in energy level and improvement in mood were the two benefits I noticed right off the bat upon implementing this approach. I was able to experience this within a few days. Initially, it took a little time for me to adjust to this new amount of food. I had been used to eating to the ‘just satiated’ point with intuitive eating and was not familiar with a sense of being truly full and nourished. This was an adjustment for me. If you are like me and have been eating to the ‘just satiated’ point, you have probably been under-eating. This is likely a great contributing factor in the continuation of your ED behavior.

Under-eating promotes binging and compulsive overeating. It also increases your cravings for sugar, sweets, and highly-processed foods. This is because simple carbs are quickly absorbed into your bloodstream. With a lack of adequate complex carbohydrates (this is the nutritional food source most restrict and under-consume), the body is going to scream for emergency fuel. I have always had a major sweet tooth. Upon integrating consistent nourishment from nutrient-dense foods, my desire for sugary treats all but vanished. I continue to include a little dessert each day but find a very small amount satisfies me. I now realize that my body was so pulled to those foods before due to existing in a chronically undernourished state. It was a real eye-opener for me. I continue to enjoy all of my favorite foods, including takeout, but a true balance has developed. I’m finding that the reward of feeling deeply nurtured with solid nutrition is more appealing to me than flooding my body with empty play foods.

Set Your Feeding Schedule on a Day-to-Day Basis

Every night before you go to bed, think about what the next day has in store for you. Pull out a notebook or journal to record your ‘plan’. I used a dry-erase board because I work out of the home and it was convenient for me. It served as a visual reminder to tend to my self-care. This alone was an efficient tool that ended my restriction/starvation cycle.

In creating your ‘plan’ for the next day, it is vital to consider certain elements. When will you be rising? Schedule your breakfast within an hour of your wake-up time. When will you be able to break for lunch? Note your lunch time. When will you reasonably be able to prepare yourself dinner? Pencil it in. Now that you have the basic template for your meals pinned down, it’s time to think about adding those 2-3 snacks. Is there more than 4 hours time lapsed between breakfast and when you will be having lunch? Schedule a mid-morning snack somewhere in there. Do you frequently experience an energy slump in the afternoon, or do you find your cravings for sweets tend to escalate later in the day? If so, schedule an afternoon snack. Are you a nighttime binger? Make sure to schedule an after dinner snack. Whether you choose to have 2 or 3 snacks is totally up to you. Base this on your personal needs and ED patterns.

There is no need to plan what you are going to eat. This will allow you to begin to tune into your intuitive signals. Simply keep in mind the importance of having a portion of starchy complex carbs, protein, a fruit or veggie, and a little essential fat with each meal and a complex carb/protein combo for snacks. You are merely setting reminders to feed yourself consistently in a nourishing way. Amazing things will happen for you physically, mentally, and emotionally when your body begins to get the signal that food is available in abundance. Your body will reward you as its needs are met. Your entire being will come into balance. Food is powerful medicine!

The great thing about a ‘plan’ like this is that it is all about you. It provides just enough structure to create a sense of safety for those transitioning from ED to intuitive eating. The planning also allows individuals to begin to reconnect with their own inner knowing in terms of food choices and how to best support their nutritional needs by working around their daily schedules and responsibilities. It fosters an awareness that providing your body with this essential care is equally important, if not more so, than any other obligations in your life. The schedule allows you to stop thinking about food so much and release the obsession. You will now be able to rest assured that you have a ‘plan’ in place and can begin to direct your attention toward other meaningful pursuits. Finally, it addresses common areas of concern that usually arise with newcomers to intuitive eating like how to plan around work or school schedules.

Our responsibilities shift from day to day. By setting your schedule the night before, you will be able to take these varying elements into consideration and plan accordingly. Your ‘plan’ does not have to be static. It can shift and grow with you. Shape it around your needs. Perfection is not required. Do your best to stick with your ‘plan’. If you have a meal or snack where you fall behind schedule don’t beat yourself up over it. Simply get back on track to the best of your ability. The only thing not allowed on this ‘plan’ is guilt. As you begin to feed yourself consistently, your hunger cues will start coming forward regularly and predictably. As this occurs, take this into consideration when creating your ‘plan’. For example, let’s say you note that you tend to get hungry in between breakfast and lunch consistently. There are a couple of ways you could alter your ‘plan’ to address this issue. You could opt to go for 3 snacks instead of 2 and add one in mid-morning. You could also choose to schedule your lunch a little earlier if this is something you are able to accommodate. Brilliantly, this begins to get you used to tuning into you own internal rhythms. Think of it as the first stirrings of the intuitive eater awakening.

There is a second piece to this puzzle which involves how to transition away from this ‘plan’ into becoming the natural eater you were always meant to be. Consider what has been presented here to be part one of this recovery process.

This is going to be an unfamiliar experience for many of you. Please, give yourself time to adjust to regular, nourishing feeding. It is so necessary to allow space for your bodily signals to begin to come forward consistently. There is always a result-driven aspect to human nature that makes us want to rush ahead. To do so would defeat the purpose of this approach. Be patient and give yourself some time to experience the many improvements feeding yourself soundly will bring. Three short weeks from now you will begin to reclaim your natural, instinctive eating abilities. Consider how brief a time span this is in comparison to the years you have struggled with food and body obsession. Anything worth doing is worth doing well. Give yourself time to flow with this transition. Don't push the river.

Building a Bridge from ED to Intuitive Eating, Part 7: Nature's Perfection... The way you were born to eat

As promised, we are now going to gently guide ourselves back into a natural pattern of eating according to bodily signals of hunger and fullness. Now that a solid nutritional foundation is in place and a sense of balance has been restored, the transition into natural instinctive eating can be made with ease. For those who have attempted to grasp intuitive eating in the past but found it a struggle, you will discover that you feel more supported this time around.

If you have applied the approach that has been outlined in the "Building a Bridge" series for the recommended three weeks, your body has reached a state of equilibrium. Physically, you feel nurtured. You have greater clarity. Your mood is lighter and clearer. You have likely noticed that hunger signals that once eluded you are now coming through like clockwork. As you take these first steps to trust your body and its communication, you do so from a new foundation. What once seemed complicated will now become simple. Finally out of your head and into your body, you will simply eat. It is a freeing experience.

Much like the first phase of this approach, there is a three week transitional period. Certain elements will remain in place as a life practice of self-care. In reality, the act of eating can never be a totally intuitive experience. For a state of balance to be fostered it is necessary to blend intuition with common sense. To try to divorce one from the other is to create division within yourself. It's like rejecting part of your natural makeup. This is largely why so many intuitive approaches fail. It is also the reason fad diets mire us in over-thinking that disconnects us from our bodily wisdom. There needs to be a marriage of common sense with intuition in order for balance to take root.

Obviously, you can't cut yourself off at the neck and have a totally 'heady' experience. At the same time, you can't disconnect from that beautiful brain of yours. Otherwise, chaos would reign. It would be akin to taking a long walk off a short plank. In the end, you would be left wondering how you landed in such hot water. In the book, "Health At Every Size", By, Linda Bacon, PhD, there is reference to the experience of cavemen. Somehow they managed to survive without best-selling diet books, nutritionists, and 'experts' to guide them in their eating practices. This is because the act of eating is a biological experience. It is hardwired in our genetic makeup. It doesn't require an instruction manual. However, if those same cavemen didn't also rely on common sense they never would have survived the ravages of winter. After bringing home the bounty of the hunt they may have been tempted to wolf down their lion's share, leaving little to spare for lean times. Employing reason, they understood they may not come across such bounty so readily in the future. Game was portioned and preserved to help the tribe survive during cold, unprosperous months. It is clear to see that we need to use all of our faculties when it comes to our self-care.

Another point that bears mentioning is that our current climate of convenience is a far cry from what it was even 50 years ago. There have been a lot of changes in the way we produce food, along with our current ease of access to virtually unlimited supply. We have more food availability and options now than at any point in history. As a species, we are evolving. Our bodies adapt to their environmental circumstances. However, in terms of genetic evolution, 50 years is a mere drop in the bucket. We have not adapted physiologically to the factory produced foods that grace most American tables.

Back when our parents were kids, dining out was a special event, not a regular thing. Meals were cooked at home and were balanced. Fruits and vegetables regularly found their way to the plate. Foods were closer to the source, not so highly-processed. People sat down to eat and used meal time as an opportunity for connection with their loved ones. They weren't eating on the run, shoving food in their mouths as they rushed out the door, or chowing down absentmindedly in the car on the way to work. They weren't using food as anesthesia, zoning out in front of the TV with seemingly bottomless bags of man-made snacks engineered to make their taste buds crave more. Mom made treats for movie watching in her own kitchen. She served up wholesome goodies like homemade cookies, freshly popped popcorn, or a batch of her famous brownies.

There is also another distinct difference between the way we live now and yesteryear. There were no video games back in the day. Computers had yet to take center stage. TV viewing was limited. People got out and about more. They connected with others. They found pleasure in more social activities. Kids didn't plop down in front of the tube and waste their days away. They were outside riding their bikes, building tree forts, and having outdoor adventures. Dances were a popular social pastime. People moved more. Without all the modern trappings, people had to get up and do things for themselves.

The reason why we are seeing such a decline in our health has everything to do with the way our environment has shifted, along with the damaging message of the diet industry. The spin doctors of these corporations want you to be confused. Their wallets grow fatter the more disorientation prevails. You have been programmed to believe that eating is complicated and that you need a trained 'expert' or the latest 'it' diet to guide you in one of the most intimate affairs... the nurturing of your body. The truth is, eating is simple. You were born to eat in a natural, uncomplicated way, but industry doesn't want you to know this because it would affect their profits. This is why 'Big Food', the beauty myth, and the diet industry will set you up for failure every time. It's nothing more than a numbers game for these snake oil purveyors. They care nothing about you or your well-being.

It is impossible to look at our current state of health without considering the environment we are living in. Again, our common sense has to come into play. To try to discard this aspect is to muddy the waters.

When you were an infant, you didn't pull out a measuring cup to portion yourself a serving of your mother's breast milk. You also didn't concern yourself with how that milk was going to affect your body size. You ate because you were hungry and your body demanded that fuel. Without it, you would perish. When you look at it this way, it seems completely asinine. However, in kitchens worldwide millions of people feel completely lost when it comes to feeding themselves. Make no mistake. It is not an accident. This is calculated confusion.

We were never meant to eat this way. We aren't designed to waste away. We are built to survive. Our bodies will resist us tooth and nail in our vain attempt to whittle ourselves to a size that will fit in the cookie cutter mold of the prevailing beauty ideal. Rather than blaming our bodies we need to recognize that they are responding appropriately. Our bodies are doing their job. In fact, the so-called 'obesity epidemic' is largely fueled by propaganda carefully planted by industries who stand to profit from our fear. Our expanding waistlines are our natural survival reaction to existing in the climate of semi-starvation that diets have created along with a reliance on foods that our great grandmothers wouldn't even be able to recognize. What we have here is a case of wag the dog. If we all believe that our lives are in danger because of our body size and we bear the brunt of the blame, won't there be an increase in demand for the quick fix promise of a diet? After all, according to media we are the ones who have dropped the ball. The overwhelming message is that we can't be trusted and need to rely on professionals to resolve this crisis in the state of our nation's health. Corporations are well aware of the power of fear-based marketing. Here is the truth. We need to eat to thrive and well at that. It's time to stop putting the focus on body size and instead direct our attention where it really counts... our health.

That's where the, "Building a Bridge" series comes in. In a very real sense, this has been a reeducation. We had to unlearn all the messages the diet industry has fed us via the media. Now that we understand how to nurture our bodies well we can return to the way we were born to eat.

It will be important to continue to have breakfast, lunch, and dinner every day. If you are not eating these three meals, you are under-eating and doing biological harm to your body that will prevent you from restoring health. I encourage you to continue to eat your breakfast within an hour of rising. This simply makes common sense. Why work against your body when you can get your day off to a solid start? Continue to be mindful of the composition of your meals as outlined in the preceding installments of this series. A balanced meal will include quality carbohydrates, protein, produce, and a little essential fat. If you have any questions about this, review part 6 of the, "Building a Bridge" series. This portion of the presentation boiled down balanced nutrition to its purest, most accessible form. Snacks will now be optional. If you become hungry in-between meals, it makes sense to have a snack. In fact, it's helpful to always have a small portable snack on your person such as a grab bag of nuts and dried fruit, trail mix, a granola bar, or other quick and easy fuel that won't easily spoil. This way, if you get caught in a pinch and your hunger catches you off-guard, you are prepared.

You will no longer be planning the timing of your meals with the exception of breakfast. It truly is the most important meal of the day, especially when an individual has a history of eating disorder. Skipping breakfast leaves the gateway open for ED behavior to enter. In order to prevent this backlash it is essential to start your day with some nourishment.

For three weeks you are going to utilize a technique that will help you adjust to allowing your bodily cues to guide your eating experiences. When you are done eating breakfast, note what time it is. Add five hours to this finish time and log the result in your journal. For example, let's say you finished eating breakfast at 8:30 am. Adding five hours to this time would give you a time of 1:30 pm. You would write 1:30 pm in your journal as a reminder to eat by this time if you have not felt your hunger kick in before then. The reason for this is that you should avoid going for more than five hours without food. At that point, all the food from your previous meal is long gone. You need to nourish your body with fuel so you don't become depleted or court blood sugar fluctuations. Every time you eat, note your finish time and add five hours, then logging the result in your journal. This will ensure that you continue to take care of your basic needs if your hunger signals remain a little foggy.

You will only need to employ this reminder technique for three weeks. Within that period of time, your body will fall into its own individual rhythm and pattern. There will no longer be a need to remind yourself to eat. It will be automatic. If you think about it, it's pretty exciting to consider that in only three more short weeks you will be back to eating in a completely natural body-driven way. You will simply eat. Consider this helpful tool the training wheels that will prepare you to ride free.

Another element that will come into play at this point is paying attention to your fullness. Throughout the nutritional rehabilitation period you likely experienced a reality check about the bare minimum amount of food your body needs in order to function optimally. I know this was a very awakening part of the experience for me and probably the aspect that had the greatest healing impact. Now you will be ahead of the game. Your body has recalibrated and your sense of fullness is going to be more clear to you than it was in the past. If you continue to have a little fuzziness in this area, simply try to inject more awareness into your eating experiences. Pay attention to the sensations in your body when eating. True fullness will leave you with a warmth in your belly. You will be able to feel the food in your stomach. There will be a sense of substance there. You will know you have found the groove when you feel completely satisfied and content after your meal.

If you happen to overeat a little in these beginning stages of listening to your body be patient with yourself. Try not to over-emotionalize the experience. It really is no big deal. Since you will now be eating when you are hungry, your body will balance it out. You may find your appetite is held over a little longer when you overeat. You might be used to having your hunger come forward about every three hours. A meal overeaten will likely hold you over for a bit longer than usual, edging you closer to that five hour mark. Your body will make the necessary adjustments if you allow it to lead the way. There is no need for guilt or worry.

At the end of these next three weeks take a moment to acknowledge all the progress you have made. You are now a natural eater and can get on with the rest of your life. Congratulations!