Tag Archives: body image

Eating Disorders: Why can’t I recover?

Working in eating disorders as a dietitian is the very hardest part of my job. As a freelancer I cover a huge variety of roles. In my other world as a Pilates teacher and studio owner I have an altogether more energetic and flowing role. Yet it is working with eating disorder clients that uses the most of me, pushes me hardest, and pulls on my mind, spirit and emotions. 

 Some of my hardest work is with the “stuck” clients. Those who really want to change, really want to break free, really want help…. and yet they just can’t do it. It is so very hard for them as you can see they do want to get better. Imagine this – knowing how you are living is ultimately going to shorten your life, make your life difficult and lead to you not being able to do a lot of things and yet not being able to change it. Life with an eating disorder is a very hard life.

Often there is a specific weight that they cannot push past. 

Sometimes there are behaviours such as exercising or purging that they cannot give up.

Change can be made, but only to a point.

 

So what causes this “stuckness”?

An association with a certain weight.  

It is not uncommon for me to being working with someone who 100% agrees that they need to get their weight to xx kg. We put a plan in place, they are working towards it really well, everything seems to be on target and then the “stuckness” hits just before our weight goal. Why? It could be that when they were last at this weight they didn’t like their bodies/themselves, someone said something negative about them or that something traumatic happened at this weight. It could be they have never been that weight before, it is the highest weight they will have reached.

I like to work this through with people. 

“What will it be like being this weight”

“How will it change your relationships and how you see yourself”

“What will be better and what will be worse?”

I also remind them that you really cannot predict how it will feel and be until you get there. Using the analogy of a night in a hotel. You can guess how it will be, you can imagine how you may spend the time with your partner, you can predict the layout of the room, the hotel and the menu. However you cannot really be sure what it will be like until you get there. Even if you have stayed there before, things change, things feel different at different stages of life.

2. Not wanting to move on.

Having an eating disorder can for some be a way of escaping. Escaping growing up, escaping emotions, escaping reality. So getting better means that you have to deal with all those tricky issues. You cannot run away any longer. You have to put on those big pants and be a grown up. It isn’t necessarily going to be fun, but in the long term it will be worth it. 

I find using some motivational work can be beneficial here. Looking at the pros/cons of change. Planning out a vision board of where they want to be in 1 year, 5 years time. Talking through the real reasons they need to get better. For most people there is something driving the desire to make change. Examples are wanting to have a certain career that you can’t do at a low weight (nursing, law), wanting to have children, wanting to be able to go travelling.

3. Invested in the Eating Disorder.

This may seem like a strange one. If you have had an eating disorder for a long time it can be hard to imagine not have one. It becomes part of who you are. It becomes part of the way that other people see you, relate to you and care for you. If you no longer have an eating disorder there is an uncertainty, how will others see you, will they still care for you, will they still take time over you? If you no longer have an eating disorder who will you be? A huge part of this is all around knowing your identity. Spending time journalling can help with this. Thinking about who you used to be, who you would like to be. What are the things that make you come alive inside? Spend time doing those. What are your dreams and aspirations? What things are you good at? Asking someone close to you the question “What are my giftings or what are I good at?” can be very revealing and helpful.  Once you have an idea of who you could be outside of your eating disorder you can push yourself to move past it.

Working on your relationship can also be helpful. If these are strong then you know that people will care for you always, with an eating disorder or not. Being in a sick role means you are seen in a very different way. Being recovered and healthy can expand and move your friendships and relationships to new levels. 

Being stuck in your eating disorder recovery can be a very natural part of the recovery process. If you are in this place do seek some help. Do spend time journalling, talking, being creative and finding who YOU are. To look for a good therapist and dietitian near you in the UK the B-eat website is a good starting place. Or drop me an email as I work with people around the UK by video call.

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Detox the diet talk.

Diet and Detox.  These words can be destructive. They suggest that you need to lose weight, that you have been doing things wrong, that you are not good enough, that your body is full of toxins, that you need to change the way you look. I see a lot of broken people with broken thoughts about their bodies and eating. 

Diet:

a special course of food to which a person restricts themselves, either to lose weight or for medical reasons.
restrict oneself to small amounts or special kinds of food in order to lose weight.

Detox:

a process or period of time in which one abstains from or rids the body of toxic or unhealthy substances; detoxification.

So it’s all about restriction, abstaining and getting rid of the bad stuff.  NO! Thinking like this will lead to negative thoughts about yourself, lowered self esteem, negative body image and the feeling that you are not good.

Dietitian UK: detox-the-diet-talk

Now I’m not saying that there aren’t changes that people need to be making to their eating and their lifestyles. Some people need to gain weight for health reasons and others need to lose weight, some people need to have a healthier balance of foods in their days, others may need to be more active. What concerns me is the mindset and thought patterns around why these changes are made. Approaching it from a “I’m a bad person and need to change” mindset is not going to give long lasting positive results unless those thoughts are challenged along the way.

Use a Positive Mindset:

Have a longer term approach. What are your long term goals? Where do you want to be in 1 year and in 5 years? Think about how your health and body need to be in order to achieve those goals.

To be a nurse I need to be strong, fit and have a healthy relationship with food so I can eat around my shift patterns.

To have children I need to be a healthy weight for fertility, I need to be a healthy role model with my lifestyle and I need to be able to cook a good range of meals.

From here write yourself out a list of positive changes you can make to your eating and lifestyle. These are some of mine:

To eat an extra portion of vegetables every day.

To get outside in the fresh air for some form of exercise 5 days a week.

To cook a new recipe once a week.

To switch off technology, read more and get to bed early once a week.

To make healthy snacks ahead of time so I stay away from the biscuits.

It’s not about having a strict diet plan and then beating yourself up when you can’t stick to it.  It is about having a plan that is achievable and flexible. 

It’s not about cutting out food groups and thinking foods are bad. It is about moderation and balance.

It’s not about only making change for a few weeks. It is about the long term.

 

Be kind to you. Be achievable. Be true to you. 

 

Eating Disorder or Disordered Eating ?

 There is a difference between an eating disorder and disordered eating, but it is hard to distinguish. Just because a person has a pre-occupation with food, shape and weight, does not mean that have an eating disorder. For lots of people that can come as a relief. You can have some of the signs and symptoms of an eating disorder but not actually meet the criteria for the label of one. Let’s look into it a bit further. 

Statistics:

 NICE  1.6 million in UK affected by an ED, 11% are male.

1/4 of adults admit they feel guilty after eating and think they would be happier if they were thinner (when they are not overweight).

6/10 women cannot stand the way they look and only 1 in 25 are totally happy with their body. 

Dietitian UK: Eating Disorder or Disordered Eating?

 The difference between an eating disorder and disordered eating:

The key difference is in the degree of symptoms and behaviour. Someone with disordered eating may be engaged in the same type of behaviours as someone with an ED but at a lesser frequency or severity. For example you may feel obssessed with food, be counting calories, be checking your body in the mirror a lot and weighing your food and yourself. These behaviours can all happen to a lesser and greater extent. An eating disorder specialist will be able to use specialist questionnaires to establish if you have an eating disorder or not. 

An eating disorder is usually more secretive in nature. Often showing dramatic weight loss, hiding under clothes and a real obsession with food, weight, fat, exercise and body shape that does not go away and takes over life. There are often set rules about food and exercise.

Disordered Eating can involved restriction, purging, bingeingg, exercise, counting calories and being very aware of body shape and weight. This may be fuelled by beliefs, culture, education and learnt behaviours.

Either way it is highly likely that you need some support from a therapist and a dietitian. Although the term disordered eating may not seem as significant as an eating disorder it can mean that your nutritional intake is not providing your body with what it needs and can have an impact on your physcial, emotional and psychological health.  Sometime disordered eating can also be the start of an eating disorder and without help one may develop later.