Tag Archives: anorexia dietitian

Feelings of Fullness

“I feel full after eating a small amount”

“When I eat more than usual my stomach feels uncomfortable and bloated”

“I feel like I have a food baby”

These are phrases I often hear from clients with eating disorders as we work on increasing their meal plan. Unfortunately there is no magic cure here and it is a stage that has to be worked through. What can help is understanding what is happening.

Dietitian UK: Feelings of Fullness

The Science:

In someone who has been under-eating for some time, the digestive track slows down. As a result food moves slower through the system. That feeling of the food remaining in the stomach for a long time can be true and is known as “delayed gastric emptying”. This can also lead to a heightened sensitivity to feelings of fullness and bloatedness. It is not necessarily that you are fuller than anyone else, but you may feel that way.

If you have an eating disorder you are likely to have been blocking out those feelings of hunger and of fullness too, there is a disconnection and a loss of sensitivity to them. Fullness is regulated by the hypothalmus in the brain. 20 minutes after you eat a signal is sent to the brain. This is an easy system to overide so it needs your sensitivity. This connection has to be rebuilt and relearnt which takes time. It may feel like you cannot trust the signals the body is sending. Actually it is your reading of these signals that is the issue, sticking to a balanced, regular intake of meals and snacks will help to realign your thinking with your feelings and food.

Thoughts are powerful. If you think you should be full or are full then this can trigger anxiety leading to feelings of fullness. Try to keep mealtimes relaxed and have a period of time afterwards where you distract yourself with something like art, craft activities, phoning a friend, reading a book. It takes 20-40 minutes for the feelings of fullness to subside. 

Boosting your nutritional intake – the healthy way to weight gain.

I work in the topsy turvy world that is eating disorders. Most of the media focus, food manufacturers, shops and nutrition business is on how to lose weight. whilst I work with people on how to gain or maintain their weight. Gaining weight may sound like it is easy to do but it often isn’t. You need to increase your dietary intake by 350-500kcals per day to start gaining weight. Now if you don’t have an eating disorder that may seem like no hard thing. A latte and slice of cake will easily hit the mark. However often the clients I work with are keen to increase the energy density of their diet in healthy ways. Now I’m all for eating plenty of veggies but you will have to eat a whopping amount if you are going to gain weight on extra veggies alone As I had to explain to one client recently – 350kcals extra in salad alone would mean you would be eating salad all day long. However there are options, if you can keep an open mind. 

Foods like nuts, seeds, avocado, dried fruit, nut butters, hummus, yoghurt, cheese, eggs, olive or rapeseed oils and fruit juices, will provide a nutrient dense way to increase the calories of your diet.

Dietitian UK: Why almonds are so good for you

 

Some of these foods may be on the scary side but they all provide nutrients that the body needs.

Dietitian UK: Gaining weight the healthy way for eating disorders

Here are some of my top suggestions of ways to boost up your intake by around 350kcals:
 
Add 1 tbsp seeds and 1 tbsp dried fruit to your normal cereal then top with your usual milk plus 2 tbsp yoghurt and add a glass of fruit juice.
Make your own snack boxes with nuts, dried fruit and small crackers (e.g: 15 almonds, 5 dried apricots, 7 rice crackers).
Homemade smoothies with yoghurt, chia seeds and fruit (e.g. 1 banana, 100g yoghurt, 100ml milk, 1 tbsp chia seeds and 1 handful blueberries).
1 serving Granola with 1 serving of Greek yoghurt.
1/2 avocado on 1 slice toast with a glass of fruit juice.
2 tbsp almond butter on 3 oatcakes with 1 banana sliced on top.
3 peanut butter cookies with a portion of fruit.
 
To read my healthy eating tips for Eating Disorders go here.

 

Mealtime Guidelines for Eating Disorder Sufferers.

 When you have an eating disorder or disordered eating it can lead to mealtimes becoming a stressful, hated time. For parents, carers, loved ones and friends it can become an anxious minefield. With everyone treading on eggshells, what should be a relaxing eating experience turns into an emotional melting pot.

I’ve spent a number of years eating more meals than I can count with people suffering from all types of eating disorders. In that time I’ve worked with hundreds of clients and listened to their stories of meal times, spent time finding ways to make eating more bearable and sat with them practising it. I’ve had food thrown at me, been shouted at and watched all kinds of odd food behaviours. I’m no stranger to tears at the table, tantrums and food mysteriously disappearing. I’d pretty much say I’ve seen it all and this means I know how hard it is for the sufferer and for the carer too. So here are my top tips for sufferers on making mealtimes easier.

Planning and Preparation.

Plan out in advance what is going to be eaten, don’t get caught out by the element of surprise. If you are preparing the food yourself then keep it simple as the act of preparing the food can put you off eating it.

Distraction is your Friend.

Find some good ways of distracting your mind from your food.

  1. Have someone sit with you and talk to you, but set boundaries such as not talking about food, diets and body image. Having a list of topics to discuss can help the person sitting with you. Good topics include holiday destinations, movies, music, topical TV shows. If you get stuck have the paper to hand to get topics or even read a quotations book aloud.
  2. Have “feel good” music on in the background or the radio, but not the TV.
  3. Read a magazine/book.

Keep Calm and Carry On Eating.

Eat in a calm, quiet and comfortable atmosphere and place. Keep it as stress free as possible. As soon as you feel anxious your “fight or flight” pathway kicks in. Think about it. Your heart beats faster, you may feel hot and sweaty, you may feel shaky and clammy, your throat constricts, your appetite gets less – so it will definitely be harder to eat!

Portion Perfect.

Only put on your plate what you need to eat. Don’t overload it as it will seem overwhelming.

Meal Motivation.

Keep in mind the reasons why you need to eat these foods. Either think it through in your head or have a list of reasons written out to refer to at the table or just before your meal. Use your long term goals, physical health reasons or any others that are positive. 

Reflect.

After a meal reflect on what went well/not so well. If you struggled, think through how you could improve this for next time, what would help/did not help. There will always be highs and lows in recovery. That is normal, the trick is to not give up.

After Activity.

Have something planned to do afterwards to distract yourself and to help you relax. Listen to relaxing music, watch TV or phone a friend are all good options. 

If you need one to one support, an individual meal plan and more guidance on this, please get in touch. An eating disorder is a very difficult illness to live with, live through and for some to let go and live without BUT it CAN be beaten,