Tag Archives: bulimia

Having an Eating Disorder over Christmas.

I love Christmas and all the build up that goes with it, I’m like a small child with the excitment of it. For me it is special celebration. However through my work in eating disorders I know what a hard time it can be for some. 

Christmas brings with it a lot of socialising, which can mean a lot of different meals. Eating in restaurants, buffet events, and more alcohol than usual. Then we have all the delicious, but high calorie festive foods: mince pies, christmas cake and pudding, stollen, pannetone, yule log, pastry items, cheese, nuts and those tubs of chocolates. All of this can cause someone with an eating disorder a lot of anxiety and that is before we get to the Christmas meal itself.

Dietitian UK: Surviving christmas with an eating disorder

I know I will freak out over buffet food but I really want to go, what can I do?

How can I eat in front of other people?

Should I cut my intake down the rest of the day if I am eating out?

How much can I drink and how does it affect my calories?

The 25th December. A special day, spent eating, drinking and being around people you may not see all the time. In our family we end up having 2-3 Christmas days as we visit my side of the family and hubby’s side to celebrate with them too. So it could end up being 3 Christmas meals. Suddenly you are in an environment where you may eat at different times, have higher calorie foods at meals that you haven’t eaten for a while and are eating with different people. 

Will everyone be looking at me and watching what I eat?

If the Christmas meal is late what do I do about sticking to my usual meal plan?

How much should I have at that meal, will it be more calories than  I am used to?

What will this do to my weight?

I don’t want to spoil the meal/day for everyone but how what do I do if I am not coping?

Should I have dessert?

This year, I have spent time with each of my clients talking through their plans for the build up to Christmas. It’s been a real challenge for some with meals out with work colleagues and planning the Christmas Day itself. However everyone has a plan in place and I hope everyone will be able to relax a little and enjoy the moment.

Dietitian UK: Surviving Christmas with an eating disorder 2

Here are my top tips:

  1. Preparation is key. Try to get as much information about what is going to be happening in advance. If you take some of that element of surprise out of the equation you will reduce  the anxiety somewhat.
  2. Ask others around you for support. Let someone know that you may find this meal/event tricky and if so this will be your signal and give them ideas of what they can do to help. Maybe they can distract you with conversation or use a few motivational phrases to boost your confidence. 
  3. If people do not know about your eating disorder then they are unlikely to be watching you. If they are watching you then it is probably out of sheer intrigue. You could try smiling at them to show things are ok (even if they are not). Remember that this is a moment for you to enjoy and you don’t want to let little things get in the way of your recovery.
  4. Plan out which days you will be eating differently over the festive time. Then also plan out a list of foods you want to allow yourself to eat. When are you going to do this? Can you swap a normal snack for a mince pie? One of my clients worked out a mini mince pie was not that different to her usual cereal bar so that was an easy way to build a mince pie into her meal plan. Try not to let yourself miss out.
  5. The meal itself can be overwhelming. It is one meal out of 21 in a week. It is 1 day out of a week. If you eat an extra 700kcals that day, it only equates to an extra 100kcals every day that week – not enough to cause any effect on your weight. You need to eat an extra 250-500kcals everyday for your weight to increase, and even that is not enough for some people.
  6. The 80/20 rule – stick to your meal plan 80% of the time and you can come off your meal plan and relax more around food 20% of the time. It is a normal and healthful way of eating – for example think how people eat in a more structured way during the week but eat differently at weekends.
  7. Keep some meals on that big day safe and normal. It may be you can have a normal breakfast and morning snack but then you have a large lunch with dessert. Listen to your body and your wise thoughts. Check out those feelings of fullness – are they related to your emotional fullness, your anxiety or your physical fullness? Use your knowledge and common sense to decide what else you need to eat for the rest of the day. 
  8. Restricting, purging or exercising after a big meal is not the answer. It may help you feel better initially but it won’t help your recovery in the long term. Find ways to distract yourself – crafty things can be good, get a mindfulness colouring book (all the rage right now it seems!), phone a friend, hang out with that family member you haven’t seen in ages, suggest a gentle post-meal walk with people. 

Relax a little.

Enjoy the moment so you can look back and be proud of you.

Keep recovery in mind and keep going one meal at a time.

If you need any support get in touch and we can set up a face to face or Skype consultation.

Dietitian UK: Surviving Christmas with an eating disorder 3

What is Binge Eating?

This post was written for Slimsticks.

One of the words that commonly comes up when talking about diets and weight loss is Binge. For many this means a one off slip/lapse or an over-indulgence. For others it’s a recurring cycle that they hate but are stuck in….

A binge is defined by the American Psychiatric Assoication (1) as:

  1. Eating in a discrete period of time (e.g. 2 hours) an amount of food that is definitely large than most people would eat during a similar period of time and circumstances.
  2. A sense of lack of control during the epsiode of eating.

People describe being out of control and in another zone when bingeing, some people can’t actually remember a binge at all. Whereas other people plan a binge, buying the foods and working out when and where they can eat it. The majority of binges happen in secret and are not talked about. Binge foods are usually high sugar high calorie foods, high fat foods or carbohydrate rich foods, for example chocolate, biscuits, cakes, bread, cereal. However it can just be whatever is available.

The first moments of a binge bring pleasure and a sense of euphoria, but these feelings don’t last. People tend to eat rapidly during a binge, researchers have found women with bulimia are food twice as fast as women with no eating disorder (2).

The typical binge is 1,000-2,000kcal, but they can range up to 10-15,000. (3) To put this in context the average women should be looking to eat no more than 2,000kcals per day.

Binges where more normal amounts of food are eaten but the person still has all the feelings of being out of control are called Subjective Binges and binges where large amount of foods are consumed are known as Objective Binges.

What can trigger a Binge:

One of the keys to stopping binges is to work out what triggers them, here’s some of the common triggers:

  1. Feeling fat
  2. Gaining Weight “I’ve failed so may as well give up”
  3. Hunger and Dieting – The thought of food can become overwhelming.
  4. Breaking a Dietary Rule
  5. Having free time or a lack of routine.
  6. Boredom
  7. Premenstrual Tension
  8. Alcohol

I’ll be dealing with tips on how to break the binge cycle in the next blog post.

References:

  1. American Psychiatric Association. Diagnositc and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV).
  2. Effect of eating rate on binge size in Bulimia Nervosa. Kissileff H.R et al (2008). Physiology and Behavior 93 (3): 481-485.
  3. Overcoming Binge Eating. Dr Christopher G. Fairburn (1995). The Guildford Press