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Friday, February 5, 2016

So you think you're recovered from an eating disorder? Take this quiz to find out.

1) Recovery is about weight gain. Period.


The simple answer? 
It just might not be going the way you planned. 
False. Now don't let your eating disorder get all excited, saying "See! I told you so!"

Weight restoration is surely a must for those who have fallen from their usual weight or in the case of kids, their weight for age and BMI curves. That is, their expected pattern of gain based on their age and their weight history. For kids, falling off their usual growth curve suggests a problem. It shouldn't be praised or rewarded, but evaluated. (Pediatricians, did you read that?!) But if someone's weight was high due to unhealthy behaviors such as binging, emotional overeating, or general disregard for satiety, and weight dropped with improved eating and coping, weight gain is likely unnecessary.

Simply reaching a healthy range based on the charts also isn't enough. Perhaps your restrictive eating and suppressed weight began as a young teen, and you've lived for years with eating disordered behaviors. Did you rely on cigarette smoking or other substances? Was your appetite suppressed by ADHD meds? As you recover, weight gain may be essential regardless of what the BMI charts say. Focusing on the weight is misguided!

Your weight may be technically in the normal range, but your behaviors may indicate a problem. You know, like restricting, binging, purging, laxative abuse, compulsive exercise.

Weight is just one component of eating disorder recovery.

2) If I get a period (and I'm not a guy) then my body is healthy.

False

Surely losing your period when you're of age and sex to be getting a period is cause for concern. But getting your period is not evidence that all is well and you have recovered. You may get what seems like a period when you're on the pill, or start to get periods back without all the hormones being back to normal. Or maybe like one adult patient I used to see, in spite of her struggle with anorexia, she managed to conceive and deliver 5 children, never missing a cycle. Similarly, weight may be restored to the appropriate place, but it may take several months for menses to resume. For guys, low testosterone level is a more silent red flag that things are amiss; is resolves with adequate eating.

3) If I can take in enough calories, then I've recovered.

False

Can you eat foods you used to enjoy?
Sure, you will need enough calories to get your body bad to normal function--with a healthy heart rate and blood pressure, without major drops in pressure when you go from lying down to sitting or standing; with normal body temperature and energy level; with better sleep and mood. But full recovery means eating a range of foods and nutrients. It requires eating enough carbohydrates and fats-- not just protein. Recovery, true recovery, demands you include foods that seem scary, foods that you used to love, so that you aren't controlled by them. Like eating some pizza or an ice cream if the spirit moves you.  It means eating bread that may be whole wheat, or white, sourdough or french, without relying on ‘sandwich roundsor high fiber, low calorie flatbreads, or “Ezekiel” bread. If you’re truly recovered you can eat foods even if you can't justify them for their nutritional value, even if you don't think of them as "good for you".

4) I've stopped using laxatives, vomiting, and I'm eating better. I'm healthy now that I'm exercising every single day. So surely I'm recovered.


False. Replacing one behavior with another-- in this case, having to exercise to allow yourself to eat-- is also not healthy. Be careful that you aren't just swapping one behavior with another-- even a 'socially acceptable' behavior like exercise. If you feel you can't eat if you don't exercise you have work to do!

Ok. So I am doing fine with all that. But I need to be the one preparing the food. I'm still recovered, right?

I know. This is a scary idea. I will
settle for nourishing you
with words.
Not quite. Full recovery includes some flexibility and acceptance of what you can't control.
It means eating meals out without having to look up the calories before hand, and without having to modify the entire meal according to ED (that said, being vocal about your preferences doesn't have to be disordered. While Sally didn’t have an eating disorder in "When Harry Met Sally" this scene is worth viewing for some comic relief. Recovery is being able to eat a meal without watching the food be prepared, fearing the secret addition of ‘toxic’ ingredients.

Recovery acknowledges that people you know diet or overexercise or are losing weight, and it is what it is. (see husband triggering) And that you stay the course with eating and avoiding behaviors because it simply has to be; because you can be a great dieter-- but it didn't serve you very well being in that place before. And because you simply deserve to feel better.

Not as far along as you hoped? 


Then move your frustration to action. If you've just started on this path, hooray for improving your intake and taking steps toward recovery! Perhaps you're finding other ways to cope, so you're freeing yourself from unhealthy disordered behavior. Maybe reading this post helps you realize that more recovery pieces are in place than when you started. Progress! The point of this piece is to raise your awareness to help you keep going and reach fuller recovery. And to shake up some denial that stands in your way.
Yes, there's hope. See some of the links below.

Any changes to your thinking or eating you still need to make? Perhaps the post below will help to motivate.


Please share your thoughts!

And thanks for reading.

Friday, January 15, 2016

I'm Sorry. Blame the Bread.

You are owed an apology and an explanation. After receiving a reader's most thoughtful, concerned email I decided I needed to post. I stopped putting out blog posts and virtually disappeared (pun intended), with no warning or explanation. Admittedly, it happened gradually, from blogging 1-2 times per week to monthly to, well whenever the spirit moved me. Why, you ask? For lots of reasons.

Bread


You could say I've replaced one passion with another. Or that I've been compensating for the deprivation of the masses who have chosen a low carb or gluten free lifestyle. Defiantly making and eating bread? Maybe. I've been baking (and eating) sourdough breads and I'm thoroughly enjoying the process, the art, the texture and the taste. And no, in spite of all the carbs and gluten I've neither ballooned in size nor suffered inflammatory attacks (other than from my friends when I don't share these highly desired loaves.)




The vacuum


It's not easy to continue to write posts and get minimal feedback from readers. I know you're out there--my stats prove it--but the feedback is so minimal. And I'm no different than the rest of you; I also care what others think about what I have to say--even if you don't agree. If you've tried to respond but Blogger isn't letting you, than please let me know at info (at) LoriLiebermanAndassociates.com. 

Recirculating misinformation


Writing about nutrition fallacies falls flat. When misinformation gets out, it's most impossible to reverse. I wish we learned from our mistakes--that diets ultimately result in weight gain not loss, that deprivation ultimately will drive you nuts, and that no nutrient group is toxic. And most importantly, that you deserve to eat what you like--in public--and truly enjoy it with all your senses. I started shifting this blog to leading by example--showing real foods and meals, and practical recipes (as in www.food-2-eat.com) which I'm hoping was useful. Like you, I'm challenged every time I hear the craziness from public figures and common folk. It's simply overwhelming and perhaps counterproductive to keep spreading their lies.

The end of DropItAndEat?


I doubt it. But maybe you can offer me some guidance. What would you like to see? And how can you get more engaged, dialoging in the comments?

Again, I'm sorry if my absence worried any you. It's nice to know you missed me.

Monday, October 12, 2015

Spouses, partners, parents of loved ones with eating disorders--I need you to keep reading. Really.

You may have no idea how they're suffering. Your wife, or mother, or partner or son. It's about shame. And fear. That's why they can't tell you. That's why it's so hard for her to ask for help. I'm not placing blame, but I'm asking you to start to listen like you never have before. Because it's hard for those living with anorexia, bulimia and binge eating disorder to say what needs to be said.

Don't be fooled by his size or his weight. People with eating disorders come in all sizes. And don't be fooled by how well she had been doing. Slips happen. That's normal. But recovery requires acknowledgement that things are amiss, and that support is available. Right there. In person. Not just virtually through this blog, or a virtual support group or a friend across the world.

Yes, they need to know that you are there for them, unconditionally. Even if you really don't understand. Even though you wish they'd just 'get over it'. Struggling with an eating disorder is something they simply did not choose.

She may not discuss it with you, seeming as if all is well. And he may deny that he's restricting or over exercising. Besides. It's so much easier to see what we'd like to see.

So if you suspect that there's something not quite right, please start a discussion. And use open ended questions, ones that can't be dead-ended with a simple yes or no response.

You just might have your blinders on to
what's really going on--right before your eyes.



Do you know how trapped she's feeling?
Like there's no way out of her misery?
Sometimes we're a bit too close to the situation to
see the whole picture.

Saturday, October 3, 2015

Does this nutritionist count calories, track exercise on a Fit Bit, or limit her gluten, sugar or carb intake? You just might be surprised.


Time for lunch? Thinking about dinner?  I've gathered a bunch more pics to share from my recent meals. But first I need to respond to a couple of comments and questions you've voiced in person and on the last post.

Lean steak which I have infrequently with grilled farm-fresh
potatoes and watermelon.

Do you think about balancing your day's eating depending on what you ate earlier in the day?


Not at all.  I don't think "I shouldn't have bread again since I had some at breakfast" any more than I think "Oh, I had three fruits already so I'd better have something else for snack." I go with what I feel like, when I'm hungry. 


So you don't give any thought to your food choices?


Homemade pizza topped with artichoke and peaches.
That's not the case either. There's a balance between nutrition information and pleasure/preference that informs my decisions about what to eat. I might have lox at a meal but I wouldn't include olives, let's say, as the sodium would be quite high. And since I have high blood pressure I try to be moderate about my intake. Besides, I think it would be disgusting together. I might have pasta--white, low fiber pasta, but I don't eat a pound of it. I'll add veggies and perhaps a protein source such as chicken or tofu for some balance; the protein and fiber impact fullness which helps make the pasta meal more satisfying.  

Similarly, I'll routinely have a large salad with my pizza or I'm apt to eat a lot more pizza than I need, before recognizing that I've had enough. I happen to love fruit and vegetables so I eat them generously. But my favorite food just might be bread which I eat no less than twice a day. My latest favorite is homemade sourdough.

Do you calculate your calories? And if not, how do you know how much to eat?


I never calculate my calories. Okay. Not true. I did it once after a 2 day bike ride at my husband's request, as he was curious about how our constant eating (and cycling) measured up with our calculated need. In fact, it was strikingly right on--but calculated after the fact; I did not count my calories to limit my intake or determine my portions. When you allow your self to acknowledge hunger and not mask it with water or coffee or deny it until you 'deserve it', and respond to it with food for fuel, the system starts to work just fine.

This is a special meal I prepared from Gramercy Tavern cookbook
featuring halibut, zucchini in various forms and corn salsa.
But you also need to be eating regularly to prevent excessive hunger and impulsive eating. And it helps most of us to control the environment--removing food as a visual trigger to eat. Store food behind cabinet doors, in the fridge or freezer instead. And beware of the impact of other triggers such as alcohol, stress, and mood. Feeling a sense of hopelessness about your eating doesn't help either.

A veggie heavy pasta meal.

Do you think some people are born unable to do this and others aren't? Because I think I'm different, and this simply won't work for me.


No. I felt the same way many years ago when I struggled with a cycle of restrictive eating followed by binge eating. It feels like there's no way out. I don't buy into the addiction model for foods (http://dropitandeat.blogspot.com/2012/09/what-ive-learned-about-food-addiction.html) but I do see that behaviors can be addictive. So focusing on eating behaviors (which I address a great deal on this blog) is key. Search this blog for mindfulness, hunger and fullness to start.


Sure, you can do this because you must exercise a lot. 


Pasta with an indian flare-with some cashews and coconut.
Sometimes I exercise a lot, like when I'm training for my annual fund-raising bike ride. But I usually work out about 3-4 days/week (once is just a walk with you-know-who*), with an additional day of Pilates. In cycling season the rides may be long, but aside from then,  I don't spend more than an hour working out. 

And I don't intentionally adjust my food choices or portions on non-work-out days. I know my body burns calories at rest, even when I'm sitting at my desk for 8 hour days, 4 days a week. 

Hope this helps. Still thinking this is unhealthy? Let's discuss.
And by the way, all the meals above right were dinners, and those below were my lunches. Missing are the frequent PB and P (preserves of all kinds) sandwiches I bring for lunch but neglected to photograph.

A grilled cheese, arugula and tomato. Yes, on sourdough.

That's cheese hidden under the figs, and lox. Admittedly a weird 
mix, but I had little time to make a lunch when I was
running late.
Add caption


Bread and houmous, with yogurt and granola.
Lemony Lentil Stew with goat cheese, served on 2 corn
tortillas. From Drop the Diet www.food-2-eat.com



Yum!



*yes, you know who.





Monday, September 7, 2015

You won't believe what this nutritionist had for breakfast.


And more importantly, what you can eat for breakfast, too.


I started to do a food record of sorts two weeks ago. "Why put yourself through the misery?" you might wonder? Well I wanted to send some positive messages about food, about eating, about what constitutes a normal, healthy diet, both physically and mentally. And I wanted to do it visually. Instead of fighting the diet myths—the must-eat low sugar, low carb, low fat, high protein—with words, I figured I'd show you snippets of real meals and snacks that I eat, that a nutritionist eats, on a regular basis.

I planned to do it like a food log, including everything I ate, and I mean everything. But it got tedious. And then it started to annoy me. Do I need to include the bites of sourdough bread I grabbed before dinner? Will I be sending the wrong message by showing all that I eat, as if to say "this is fine for you too in these amounts" when really our needs are so variable?  It started to get complicated.

My compromise? A brief, photo-filled post, a conversation starter I hope, to discuss what you can eat. Each of you. All of you. But brace yourself. My eating is neither light nor low anything.  I include plenty of fats, my fair share of baked goods, and plenty of pleasure from food.

My oh-so-honest patients tell me that readers won't believe me. “Sure there are pictures of foods, but how do I know that you actually ate what's shown? Or didn’t over exercise, or purge, or restrict after eating?”

You simply can't know for sure. This relationship we have, virtual or live for those who meet with me in person, is built on trust. And trust takes time to build. Send me a question, start the conversation, and let me help allay your fears about what’s okay to eat. Lunch and dinner to follow if the interest is there.

Note: If you have a medical condition that requires adherence to particular nutrition guidelines, please follow those!  If you have celiac, do not consume gluten. And if you have diabetes, seek professional guidance on an appropriate budget of carbohydrate to control your blood sugars. But if you are looking to eat, feel and be healthy, try to release yourself from the unnecessary diet rules.


Peach pancakes, topped with real maple syrup and berries. And
yes, there's always coffee with my breakfasts!

Okay, I did have seconds. Just a couple more.


Challah bread (all white flour) with cottage cheese and farm 
fresh tomatoes.


2 eggs fried in a little butter, with my homemade sourdough
bread--my recent baking obsession.


Rolled oats, raisins, apples and Maine blueberries--with
some maple syrup and milk.



There's nothing like cold cereal for a quick breakfast, eaten
with low fat milk (not skim, not almond).

I don't get to make these crepes too often, but I do love
them, filled with vanilla yogurt and fruit.

Chocolate croissants are rich, but sometimes there's nothing
I'd rather eat. So I have it as breakfast, instead of as a snack.

Tempted to lick the plate, but I didn't.