Tag Archives: eating disorder dietitian

What makes it easier to recover from an eating disorder?

“Recovery is like riding a wild stallion. It is unpredictable, you will likely fall off many times. You will go through emotions ranging from fear to excitement, feeling out of control at times and clinging on to anything you can. Keep getting back on the horse, keep holding tight, sit up tall and go with the ride.”

There are many times in my working life that I just wish I had a magic wand to make recovery easier. The fact is, recovery is hard, damn hard and it takes a lot of guts, determination and hard work to even make a start on it. Once you start it can feel like it just gets harder at points, so you really need to plan and have support in place to help guide you and keep you going. Here are some things that can help the ride.

Have a social support structure in place

Deciding to make changes to your eating may sound simple, but once you plan it and then actually have to put it into place, it really gets harder. Having people around you who you are accountable to, people who will sit with you in the hard moments, challenge you to keep going and celebrate with you too. True friends and family who love you for you but want to see you healed up and able to live life to the full.

Have professional support

Yes you can do it on your own. However an eating disorder is an isolating illness, it can be a long and lonely path. So having a professional or a team of professionals who you trust is a good idea. People you can get the right information from and trust it, people who will challenge your thoughts, assumptions and beliefs and believe that you can do this. 

Being in the right place at the right point 

There is a cycle of change that I often use with people to talk through how you need to be in the right mindset and the right point of your life to begin recovery. This is especially key if you are in the community, recovering at home. In a eating disorders unit things are a little different and you have more support and encouragement. Take a look at the  phases below and see if you can identify where you are. Recovery can be a cyclical process where you move forward 5 spaces and then back 2 spaces, but do not give up, this is normal. 

Stages of ED recovery 

  1. I don’t think I have a problem
  2. I might have a problem but I’m ignoring it or I don’t care
  3. I don’t know how to change but I  want to
  4. I tried to change but it didn’t work
  5. I can stop some of the behaviours but not all of them
  6. I can stop the behaviours but not the thoughts
  7. I can be free from my eatind disorder some, but not all the time
  8. I am free from behaviours and thoughts = recovered

Have goals in mind

You need something to aim for. Why do you want to get better? What will life be like when you are free from your eating disorder? What do you want to do with your life that you cannot currently do. I recommend writing out or creating a vision board showing where you want to get to. Write out your dreams and dream big. Then use this as a motivational tool, put it up where you can see it. 

Surround yourself with the positive things

Part of recovery is about changing your mindset and the way you view life. It can be so easy to see the negatives about your life and yourself, then use food as a way to help with this. Or to get drawn into the negatives about weight gain. I challenge you to instead see the positives. Why is weight gain good? What does it mean for your body and your life? Grab hold of those negatives and turn them upside down. Having motivational phrases and images around you can be really helpful on those days that thinking is too tricky.

Go do it. I believe you can.

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The golden toolbox of recovery

What’s in your toolbox?! I was recently at a meeting and friend turned to me and said “I have a strange picture that I’ve seen, it’s you with a golden toolbox. It’s like you have everything you need in that toolbox to deal with life”.

This spoke volumes to me as a person and as a health care professional. Having worked in a team which was predominantly psychological I was immersed in the language of the therapists and the word toolbox often came up. I sat in on plenty of group therapy sessions and got to experience a whole range of different therapies.  Also, in our team meetings we used these skills on ourselves as part of the debrief process. It showed me how important it is to look after not just your patients, but yourself. If you have a life with some stress in it (let’s face it that is probably everyone) then you need to have some skills to hand that help you deal with that stress. Stress and anxiety can be a huge factor in an eating disorder, in mental health conditions and also to physical digestive issues such as IBS. When you have a stressful event how do you respond? What does it trigger in you? When you know how you respond you can start to work on a more effective and helpful mechanism. 

 I will never forget my interview for my eating disorder post. I was asked such an eclectic mix of questions that I had no idea how I had done on leaving the room. When I received the call to say I had the job, I asked why I was chosen. The response “we could see you are robust and able to cope with the strains of this work”.  In the eating disorder field this robustness is certainly needed. I continually need to keep on top of my own anxiety and practise what I preach. 

I want to  highlight some skills or tools that we all, health professionals, patients, people, could include in our golden toolbox. Tools you can use regularly for moments of anxiety, tools you can pull out for those emergency moments.

I remember being on a train that got stuck in a tunnel and suddenly feeling trapped and my anxiety levels rising. It was not an experience I was prepared for and suddenly I knew I needed to use one of my tools. At that point visualisation of a calm beach with lapping waves and some square breathing helped immensley. I know if I had not practised these skills  previously, I wouldn’t have been able to use them there and then. So practise really is the key. 

Here are some of my favourite toolbox tools that I use myself and recommend. 

Journaling –

I’m a seasoned journalling fan. This is something I have always done since my teenage years, I now have a lot of full notebooks with a collection of my teen angst, my working life, my spiritual life and my family life in them. Looking back it shows me how I have evolved and where my stress triggers are. I can see the patterns that I fall into and work on improving my reactions. I dig out my journal when I have a moment I need to work through, when my mind feels cluttered or when something erupts! I also love to journal the good and positive, so any life events or just when I get the urge.

If you are on a recovery journey then I recommend that you journal daily  or at least 4 times a week. It needs to become a discipline and a part of your coping mechanism. A good way to start is to write down 3 things that went no so well in your day and how you could have dealt with these better. Then always finish on a positive, so 3 things that have gone well or that you coped with well. You can also take a single scenario and write out alternative endings. Using an eating disorder example: You had an argument with a friend, this increased your stress and you responded by missing your snack. Thinking through why this was not a useful response – restriction of food does not help your emotional well being, it is a quite fix but not a long term cure. Now you have missed out on some nutrition for the day and your body is hungry. Your body needs regular food right now as you work towards recovery. So take a think through how you could have responded instead…. maybe you could have gone for a walk, taken a bath or done some mindfulness to help you reduce your anxiety after the argument instead of turning to food.

Mindfulness and Breathing –

Such a buzz word at the moment, but this is not a fad. I’ve been using mindfulness with eating disorder clients for over 10 years and I’m sure it has been used for far, far longer than this. Just 10 minutes before a meal or after a meal can make a huge difference. It is all about calming your thoughts and body. I personally love just deep breathing, there are so many variations on this so try a few out. For me, the breathing  is something that spills over from Pilates practise and so I get a double benefit from Pilates of exercise and mindfulness. There are some great free resources to help here. 

Exercise –

This is something to decide upon according to your recovery stage. Exercise can be amazing as a mood booster and a de-stresser. However if you are working on weight gain then it will also have an affect on this. If your BMI is less than 17.5 then you will want to modify your exercise so that it is physically safe. 

Distraction – 

I often suggest that people put together a list of distraction techniques that they can use. For example, after a meal,  or when a the urge to binge strikes, at times when anxiety levels are rising it can be useful to have an activity planned. Things like craft, having a friend to call, painting your nails, reading a book, cleaning out a cupboard – something that immerses your mind and changes your thoughts. Puzzles, crosswords, knitting, collage are all great things to have on your list.

Positive thoughts –

Those anxious, negative thoughts are something that we all get. It is how we deal with them that is key. I love the thought of noticing the thought, and finding the opposite reaction. So turn that negative into a positive. If you practise this regularly it can turn into a habit that you hardly notice you are doing. I’m now working on this one with my children too, teaching then that there is always a positive side to things. It is a great skill to learn at a young age but one that you can learn at any age.

I’d love to know what tools you find useful. 

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Polly’s Eating Disorder Recovery Story

When I heard Polly’s eating disorder recover story I knew I had to share it. Working in the field of eating disorders can be frankly hard work. It is a long road to recovery and a battle. It takes dedication, support from others and challenging yourself at every meal time. However it is possibly and it is worth it. I hope sharing this inspires others. 

“It took 10 years for me to finally ‘come out’ and be open about my Eating Disorder. But now I’ve come to realise that in being open I can help others, never will I keep quiet again. I hope that by sharing my story I can help you, or someone you know who is struggling, and show you that recovery is possible.

Why was I silent for so long? I didn’t think anyone would think negatively of me. At age 33 all my peers are open and mature enough not to judge in such belittling ways. Perhaps it was that people wouldn’t take me seriously as a health professional – I’m a Personal Trainer & Nutritionist who helps Mums get in shape. Ironic? Not really. Because needing to lose weight or gain weight often come from the same root psychological cause. I think a lot of it was that I just wanted to forget that horrible time in my life, sweep it under the carpet. But in doing that I’m not able to help and inspire others. The can of worms had to be opened. 

They say that to develop an eating disorder you need to have the right genetics (science shows there’s a link), the right personality (typically perfectionistic and with high personal standards – me to a T), and an immediate trigger or stress at the time of developing the disorder.

I first felt fat age 8. My Dad got remarried and family life was changing. Not in a bad way, but a lot for a young child to process. I first made myself sick age 12 at boarding school. I was bullied, not for being ‘not skinny’ (I wasn’t fat), yet somehow I figured being thin was the answer. But the problem never really took off until, at age 17 at dance school (i.e. where we spent all day in a leotard being judged on how good we’d look on TV), and my then boyfriend was sent to prison. I was also living alone in London and had struggled to fit in at the college. On a subconscious level, all would be well if I lost 3 kilos. Then I would be happy. Reading this back, how silly does that sound now?

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I only ever meant to take the laxatives (half a box of them) once, just to ‘erase’ Christmas day. Each day I would swear on ‘no more Yule log’ and it was salad from now on. I never binged, but every time I ate something ‘non-diet’, I took more pills. Or vomited. Or did an extra 4 hours exercise (it was the holidays, I had time). Or all of the above. Nobody knew. I was way too ashamed to tell anyone.

It was only when this cycle started to impact my daily life about 6 weeks later – skipping classes to make myself sick, blocking up the loo in my flat, not being able to think about anything else but my fat thighs and pathetic self-will, that I switched to a new tactic – restriction. 

It started innocently enough – cutting out fat, then bread, meat……until I was probably living off about 500 calories a day of primarily vegetables, and my condition was noticed, I was removed from dance school, and put under the care of an outpatient clinic. 

And herein began six years of treatment that I resisted as much as I could. Meal plans, counselling, CBT, supervised meals, meals in tubs to take home to eat, and three times I was hospitalised at a dangerously low weight. Nothing worked. 

Why was I so resistant? To say I was miserable doesn’t cut close. If there is a Hell, I have been there. I was also diagnosed with extreme clinical depression unresponsive to medication, borderline OCD, showing bipolar ‘tendencies’ and one therapist suspected I had Borderline Personality Disorder, which some say is what Amy Winehouse had before she died. I self-harmed, and I attempted suicide twice. 

But my eating disorder kept me safe. By this time it was a way of life, it was my identity, and in some distorted way it made me feel special. This is what it comes down to in the end – I never felt special. I felt like a worthless waste of space, yet ironically struggling with this eating disorder only reinforced how much of a waste I was. After all I was putting my family through so much stress and worry. None of it makes sense, but I guess that’s why mental illnesses are so hard to recover from.

So how is it that I can be here today, happier than I have even been in my life, married with two children, and helping other women learn how to treat their body well?

I often get asked what made me finally recover. Honestly? I don’t know. I remember being in a pub garden one summer with a couple of friends, fresh out of another hospital admission and going downhill already. One companion announced she was getting married, the other that she was pregnant. Suddenly for the first time since I developed anorexia, I felt lonely. The eating disorder had been my only friend who stuck by me, yet this ‘friend’ was turning against me. Everyone was growing up, creating careers, moving on with their life. I was stuck in this child like state, being left behind. If there’s one dream I had all my life even throughout the illness, it was to have children. A little girl I could bring up as my little princess. That was not going to happen if I carried on. I was at that time infertile and no man in their right mind would be attracted to an emaciated mess. 

It was like I woke up, or a lightbulb went off, or something switched in my brain. I didn’t want this illness in my life anymore. This time I really didn’t want it.

That’s not to say it came easy. Anorexia is like having a little devil on your shoulder, dictating what you should and should not eat, telling you how pathetic you are if you give in and eat. I’m not going to lie – those voices are still there every day, even 10 years on. But there’s a difference. Now, I shout back louder. 

It’s a fight, every day. I know people who seem to have completely recovered and they think the same way about food and their body as any ‘normal’ person. I may get to that place, I may not. But I’m happy, I’m healthy, and I will keep on winning this fight. 

I’m not a counsellor or psychologist, but I have been there, I do understand. So if anyone wanted to reach out and chat, ask advice, or hopefully to tell me they’ve been inspired to keep fighting, I’m only an email or social media contact away. If I can help just one person, that can of worms was definitely worth opening. ”

 

Pollyanna Hale helps Mums lose weight and get their body confidence back via online coaching with www.thefitmumformula.com/. A qualified Personal Trainer, Polly knows from personal experience and though helping hundreds of women that there is more to having a healthy body than just following some cookie cutter meal plan. Long term success comes from learning to love yourself and your body and treating it with the respect it deserves. It doesn’t matter if you’re overweight or underweight, or somewhere in between. The weight is just a symptom. Everyone deserves to feel special. 

 

Should we label a food as good or bad?

The label of good and bad foods annoys me. It is one of those labels that I find hard to get away from when I am talking to people as it comes up constantly. I spend a lot of time trying to break that idea down in people’s minds. Google it and there are over 71,800,000 links talking about what foods are good/bad, what bad foods are really good, the best good foods to eat and so on. But do good and bad foods really exist?

Bad foods seem to be ones that are high in sugar, fats and calories. Foods that are “not healthy” and that exert a “bad” affect on the body. They can range from fast food, processed food and high fat/high calorie snack items to carbohydrates and dried fruit.

Dietitian UK: Should we label foods as good and bad?

We have a complex relationship with food. Trying to make it fit into just one camp is tricky. Look at the major food groups – carbohydrates, protein, fat, dairy, fruit and veggies. Then look at lentils. They are put in the protein group but they contain carbs and are a portion of veggies too. 

Let’s take it to a more philosophical level. Can a person be labelled as good or bad? Take an object like a razor blade. Is it good or bad? One the one hand it can be used to shave and on the other hand it could be used as a weapon. 

So by trying to label foods as good or bad we are over-simplifying it. Foods are really neutral. Labelling them automatically places them into one category. Let’s take chocolate as an example. On the one hand this is a high calorie, high fat food that is often laden with sugar, so could be classed as a “bad food”. However dark chocolate contains iron, magnesium and fibre. It has antioxidants including polyphenols, catchins and flavanols and may help lower blood pressure plus reduce LDL cholesterol levels. Some research suggests it may help with cognitive function too making it sound like a pretty amazing food to be eating. Even fruit and vegetables can have their negatives, too many carrots can turn the skin orange due to excessive beta carotene!

No single food is to my knowledge nutritionally complete. We need a combination of foods in order to provide the body with all the nutrients it needs. This includes the full range of essential fatty acids and some sugar too.

The old phrase “All things in moderation” is actually very true. Instead of looking at a food in isolation we need to think about how often we eat a food, how much or it we eat, combined with what else we are eating and adding to a food. Limiting or not allowing yourself to eat certain foods can actually lead to you craving them more and then over-eating them. Food is something to be enjoyed rather than denied, so a small amount of the things you like really can be good. 

So instead of labelling foods as good and bad, or healthy and not healthy, how about we change the way we view it. I let my children eat all foods, including cake, sweets and chocolate. However they know that some foods are best to eat in small amounts as they can lead to their bodies getting sick. A good example of this is a weekend recently where we had multiple parties, leading to a lot of party food being consumed. Both children had tummy aches and were slightly constipated! An excellent time to highlight that they had eaten more biscuits and cakes, less fruit and veggies and their bodies were complaining. We talked about how these foods are delicious (the words of my toddler boy) but if you eat too much of them they can make you feel unwell. 

How do you label food in your mind? 

5 tips for recovery from an eating disorder.

1. Make recovery a priority:
This may mean taking a break from normal life. A year out. Recovery takes a lot more energy and effort than you may originally think. It needs to be right up your priority list. Time off work, school, certain friendships, travelling, exercise. Whatever it takes, this is important for this season.

Dietitian UK: Make recovery a priority

2. Find yourself again:
What do you like to do? It’s often hard to know what things make you, you. The busyness of life gets in the way of our identity. 
Book out some time to find you again. Try some activities you used to enjoy. Often creative projects can be a useful part of recovery. Maybe photography, baking, sewing, painting, collage, scrap booking, gardening,  I love the phrase “Find what makes you come alive, then go and do it”.

3. Mindfulness:
Sitting in silence and paying your full attention to your breath and body can help you bring an awareness of your thoughts and feelings. This practise helps you let go of the unhelpful thoughts and be more compassionate to yourself. Practising letting thoughts go in your mindfulness practice will enable you to take this into everyday life so when an unhelpful thought comes along you are in a better place to acknowledge it, but not to act on it.  

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4. Value yourself :
Take time to look after your body: nutritionally and physically. Some self care time in your week can make a real difference and can remind you that you are important and worth looking after. For some people an eating disorder can be a form of self neglect and may have some punishment aspects to it. Creating the emphasis on it being good to care for yourself and give yourself pamper occasions helps build self esteem and love for your body. 

Some ideas: A long bath, a manicure, pedicure, haircut, moisturising your body, shaving. Taking time to tidy your home, buy yourself flowers or something nice to look at each day, light candles in the evenings. 

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5. Fuel your body:
The right fuel at the right times of the day is vital. This may mean going against your feelings and thoughts, but with repetition a routine will evolve and habits will form. 
It is likely your have no idea what normal eating should be for you now. Plan out 3 meals and 3 snacks a day with general timings to stick to if you can. There will always be days things don’t fit into your plan, that is also part of normal eating! For more advice take a look at my healthy eating in Anorexia post.
Go for as much variety as you can. There is no perfect meal plan, it’s all about making small steps and challenging yourself as often as you can. 

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Anxiety Techniques for Eating Disorders

Anxiety is one of the biggies when you are working on recovery from an eating disorder. I’ve worked through this with many clients: either whilst they are eating, after a meal or whilst choosing a meal. It can feel totally overwhelming and be quite debilitating. So you need tools available to help you deal with those consuming anxious moments. One thing I alway like to remind people is that anxiety is a natural body response. It may feel like it will overtake you and spiral out of control, but it has to peak and then lessen. Give it 10-20 minutes to pass.

Dietitian UK: Anxiety Techniques For Eating Disorders

Distraction

Find something that can change your focus. If you are eating you may need someone to start a conversation, the radio may help or watching a candle burn.

If it is away from a mealtime then crafty activities, a good book, a bath or a phone call to a friend could help. Write out a list of things to try out.

Do a Body Scan

A Body Scan is a a great way to reconnect to your body. In moments of anxiety your parasympathetic nervous system can take over, dry mouth, heart beating faster, harder to swallow, feeling hot, a pounding head, tunnel vision – none of it will help when you are trying to eat or to relax after a meal. By working through your body from feet to head you cab bring your awareness back to your body and reduce the anxiety.  

Here is a free video version from Elisha Goldstein.

I particularly like progressive muscle relaxation, probably because it is a more active form or relaxation so I have something to do! It works by tensing the muscles in a body part, holding for 30 seconds and then releasing. This leads to a sense of relaxation in that area.. The whole process makes your think about your body and not that anxious event and helps you slow down your breathing too. 

Here is a useful script you can use.

Or you can just work from your toes through each muscle you can think of going up to your jaw. Or pick large muscle groups such as your fists, feet, legs, jaw and just do those for a few minutes. 

Being Barefoot

Walking barefoot can be a good exercise in thinking about movement, feelings and breathing. Slowly walk around on difference surfaces, working slowly through the foot and focusing on using as many of the small muscles in the foot as possible. Use deep breathing through the ribcage whilst you walk.

Try using a tennis ball to massage and release through your feet first to increase the amount of movement through your feet. 

Mindfulness

I often ask clients if they have tried mindfulness. Some people love it and others struggle with it. If you haven’t tried it then good apps include Headspace and Breathworks. It can take time to really get your focus and practise will improve it. Try and find a set time to practise each day, even if it is only 5 minutes. 

Breathing

I know this is something we all do, all of the time, but there are some good breathing techniques that can help reduce anxiety. Deep breathing reduces the fight/flight response that occurs when you are stressed. So simply focusing on your breath and slowing it down can help. When you are sat eating and the anxiety starts to mount up, threatening to overwhelm you, try refocusing on your breathing. 

In Pilates we use thoracic breathing, where you bring yourself into a neutral posture – stacking your ribcage over your pelvis, breath in deeply expanding through the chest and breath out letting the chest fall back. It always amazes me that just deep breathing uses the right muscles can make a difference. 

Another one I like is square breathing – think about or look at a square. Breathing in for 4, hold for 4, breath out for 4 and hold for 4. The counting can be helpful and you can do this without anyone noticing.

Orthorexia: when healthy eating is not healthy.

If you read my blog regularly you will know that healthy eating is definitely something that I promote. Sometimes, there can be point where healthy eating goes a step, or several steps too far. Can we be too healthy with our eating? 

The rise of healthy eating blogs, clean eating movements and instagram gurus has led to there being almost too much access to information, recipe and tips. As well as the not always qualified voicing their nutritional opinions. This can lead to confusion and information overload.

Dietitian UK: Orthorexia

What is Orthorexia?

Orthorexia Nervosa is a relatively new term meaning a “fixation of righteous eating”.  It was first used in 1996 by Steven Bratman, MD. It is not yet recognised as a fully fledged eating disorder in the diagnostic criteria, but is definitely something that is on the increase. 

People with orthorexia may not notice they have an issue with their eating, in face they may think the opposite. They can start out trying to eat a healthier diet but get drawn into the spiral of trying to eat a healthier and healthier meal plan. They become consumed with food, trying to eat right, being strict with their food intake and restricting the foods they are allowed to have. Purity, eating the healthiest foods they can and guilt if they stray off the plan are hallmarks. This can lead to an obsession with weight, shape and calories. Weighing food and adding in specific “health” foods can also creep in.

There are usually underlying issues that precipitate Orthorexia. This could be a need to escape, feeling out of control and needing to control an area of life, feeling a loss of identity. Suddenly finding an outlet in the form of control via eating can help fill that void. It starts out seeming like a healthy way to deal with your feelings, but then spirals out of control.

Why is it a problem?

Although on the surface a diet may sound healthy, when you dig down it is usual to find nutritional deficits in the diet. A lack of calcium for example, that can affect bone health. A lack of essential fatty acids, affecting brain function, skin and blood flow.

More noticeable is often the weight loss that ensues and the affects on socialisation. Physical side effects of weight loss can include: poor circulation, feeling cold, hair loss, poor concentration, memory and reactions times, low mood and mood swings, being unable to eat out, wanting to isolate yourself, fatigue and a general lack of lustre. People can feel consumed with the need to know what they are eating each day, needing to prepare it all themselves, planning meals and recipes far in advance and this becoming all-consuming. There can be a loss of hunger and fullness signals, with increased anxiety around meals. 

Dr. Bratman, who recovered from orthorexia, states “I pursued wellness through healthy eating for years, but gradually I began to sense that something was going wrong. The poetry of my life was disappearing. My ability to carry on normal conversations was hindered by intrusive thoughts of food. The need to obtain meals free of meat, fat, and artificial chemicals had put nearly all social forms of eating beyond my reach. I was lonely and obsessed…I found it terribly difficult to free myself. I had been seduced by righteous eating. The problem of my life’s meaning had been transferred inexorably to food, and I could not reclaim it.” (Source: www.orthorexia.com)

So a healthy diet is bad for me?

Well it can be, if it takes over your life, your thinking, your time and leaves you with feelings of anxiety, guilt and self-loathing. If you are not able to relax and eat cake now and again then that is not normal eating.

How to get help?

  1. Recognise the problem. This is a huge step.
  2. Talk to your GP and ask for advice. They may be able to refer you to a local eating disorders team.
  3. Look for an eating disorders specialist who can work through your food beliefs and give you the confidence to make changes.

Men Get Eating Disorders Too

Eating disorders are not something we generally associate with men, there is a huge stigma attached if you do have an eating disorder and it’s not an issue frequently discussed. So I was so pleased to come across the Men Have Eating Disorders Too (MGEDT) charity. I was even happier to find they had a conference running within travelling distance for me. So off to Brighton I went. Below are some of my take home points.

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The prevelance of ED in men is 40%, this is a huge statistic and I certainly don’t find this in my clinical practice which suggests there are men with ED who are not seeking help. A recurring theme throughout the day was the lack of specific treatments and treatment pathways for men. Services are aimed at treating females not males.

Gender differences mean that there needs to be a different approach to treat men. Therapy, group work and literature all needs to be adapted. One talk was looking at whether we need a specialist inpatient unit for men. Rather than fitting men into a standard ED unit, which can lead to them feeling isolated  and like they stick out, how about providing a place specficially set up to treat and help them? It’s an interesting question and I can really see the benefits of doing this.

Back to the gender differences that came out over the day. These show how our current society can lead to incorrect beliefs and values that are unhelpful and can perpetuate an eating disorder. Have a think about whether any of these are core beliefs you hold.

 Incorrect Core Beliefs/Assumptions:

  1. THE BELIEF: Eating disorders are something only women get, so I am less of a man if I have one. Sexuality: eating disorders are primarily a female issue so there can be a thought that if you are male with an eating disorder you are less of a man…… or you are homosexual as gay men are usually more concerned with their weight and shape. The statistics actually show that this is not true, most men with eating disorders are not gay and a lot of men have an eating disorder it is just not talked about often.
  2. THE BELIEF: If I have an eating disorder I am weak. Male Identity – the image of a man being strong, muscular and able to cope. Having an eating disorder makes you vulnerable, it breaks you. Asking for help can be the hardest thing to do. It can therefore be hard to seek help.
  3. THE BELIEF: Men have to look a certain way. Body Image – over the years the media stereotype has changed to one of a man being muscular with broad shoulders, a large chest and a small waist. Not a very achievable look of course. Often we see the female stereotype and not the male one. 
  4. THE BELIEF: Men eat and drink a certain way, I need to do this to fit it. Male eating habits – it is seen as ok for men to eat large portions and overeat which can make binge eating acceptable. Certain foods and drinks are seen as more “manly” – beer and red meat for example. What if you don’t actually like those foods or are not the kind of man who likes going to the pub for a pint? 
  5. THE BELIEF: Real Men don’t cry, express emotion or talk about how they feel. Men don’t always like to talk about their feelings – again this can be linked to not wanting to be seen as vulnerable as this is a sign of being a girl or being weak. So it can make it even harder for a man to step out and seek help. Whereas actually we know that talking about your feelings really works and helps.

 Men come in all kinds of shapes and sizes, like all kinds of foods, can love to express their emotions and are all INDIVIDUAL. Don’t be afraid to be the man you were made to be. Seek help if you need it, therapy is an amazing tool.

If you are a professional be aware, there are more men out there with eating disorders than you may think. 

For posters and resources see the Men Get Eating Disorders Too website.

 

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How often should I weigh myself?

In my role as an eating disorders specialist I come across a lot of people who weigh themselves daily or even several times a day. So this post is written from an eating disorders perspective. Now whilst regular weighing can seem like a sensible idea to help keep you on track here are my thoughts on why you want to step away from the scale at times. 

Dietitian UK: How often should I weigh myself?

1. You are not just measuring one change in your body. When you weigh yourself it is not just your body fat that you are looking at but also your muscle, bones, organs, body fluids, glycogen, cells, tissues and any water products that are being measured.  Plus we know that muscle weighs more than fat. If you have been working out more and building muscle then this can cause your weight to increase. So you can increasing your stores of glycogen from eating more carbohydrate. Or conversely using up your glycogen stores through exercise or not eating carbs will look like weight loss. 

2. Your weight fluctuates over the day and week. Whilst you may think this is to do with body fat, it isn’t! This is usually down to fluid, you will weigh less at the start of the day, before breakfast, after doing to the toilet. During the day you eat and drink which means you take in food and fluid, which increases your weight. By the end of the day you will weigh more than at the start but this is not necessarily true weight. Responding to daily changes in your weight will make you become fixated on your eating and weight.

3. Your hormones and your monthly cycle (for women) will affect your weight. You know how you often feel bloated and heavier around your period. Well that’s because you retain fluid and you do weigh a bit more. It’s perfectly normal and not something to worry about. Your weight will have a natural fluctuating cycle that happens over a month.

4. Constipation can have an impact on your weight too. So if you haven’t been for a few days then remember the waste in your body will weigh something. 

So you can see that weight is a complex issue. Within my clinical practise in eating disorders I don’t take a one off weight in isolation but always look for the trend. If you want to weigh yourself regularly then go for no more than weekly. Track your weights and look at the trend, you need at least 3 weights to do this. Do not freak out about a one off change in your weight but wait and see what the next reading does as it may not be a true reading. Look at the bigger picture – are you constipated, what have you been eating, are you dehydrated, where are you in your cycle? Weight needs interpretating with filters and googles. 

My last and biggest tip: Don’t use weight alone as your judge and guide. How you feel, your body shape, how your clothes fit and how happy can be better ways to focus on you. Step away from the scales once in a while.

How to prevent a binge.

When most people think about eating disorders the image of a low weight person who restricts their food intake comes to mind. Anorexia Nervosa is the most commonly talked about and known about eating disorder. However there are other kinds. I also work with people who suffer from Bulimia Nervosa, binge eating disorder and a mixture of all the above.

Whilst restricting your food intake can sometimes be understood as “dieting that has gone too far”, bingeing is less socially acceptable. In my mind both of these ways of eating are problematic and indicate underlying issues that need to be worked through. An eating disorder is a horrible illness that is hard to understand for those around the person, it can be consuming for the person and it takes a lot of willpower, guts and hard work to conquer it. I hugely admire the people I work with who make those steps towards beating this nasty mental illness.

A true binge involves eating a large amount of food in an uncontrolled manner. We are not just talking half a packet of biscuits. Some binges can range into several thousand calories. Some people describe a switch being flipped, they are unable to stop and are almost in  trance like state. After a binge you are likely to feel very uncomfortable physically due to the amount eaten and you may feel uncomfortable emotionally and psychologically. Many people have an urge to compensate – for example exercising, purging (vomiting) or restricting their food to make up for the binge.

 

The science

You cannot vomit up all the calories you have eaten. The maximum you get rid of is 60%. Absorption starts in the oesophagus so by the time food gets to your stomach you have already absorbed some.

Restricting after a binge leads you into a cycle. When you restrict you end up really hungry at some stage which then leads to another binge. 

You would need to do a lot of exercise to burn off all the calories from a binge. 

So the best answer is to try to prevent a binge from happening in the first place. Now this is easier said than done. It will take time and be a work in progress. My top tip is to not expect to just stop bingeing and to expect a relapse to happen. When it does, it is ok. Just get back on track as soon as you can.

 

Preventing a binge:

1. Identify the key times you binge. Think about the Why, Where, When and How it happens. 

Why – how do you feel before a binge? Bored, tired, upset, angry, hungry?

Where – is it linked to being on your own, in a certain place?

When – does a binge happen at a certain time of day?

How – how do you get the foods you binge on? 

2. Use the above information to think about how you could stop a binge occurring. Is there an activity/place you need to avoid? Can you limit access to the binge foods?

3. There should be a point just before a binge occurs when you are thinking about bingeing. The idea is in your head. This is the point to stop it. Jump in there and say NO. At this stage you need a distraction. So write out a list of things that could take you away from the binge, that keep your mind and hands busy. Good options can include doing something crafty, calling a friend on the phone, having a shower, journalling how you feel, having a bath.

4. Look at your meal plan – it need to be structured with regular meals and snacks to prevent you getting too hungry. It may be that building a snack in at a key time will help prevent a binge. 

If you do binge DO NOT PANIC. Get right back on track with your normal eating plan as soon as possible to stop that restriction, bingeing cycle. 

You can do it. I know it.