Tag Archives: dietitian southampton

Cooking with Kids, Dairy Free, Family Meals, Gluten Free, Special Diets, Wheat Free

Easy Peasy Paella

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With parents who reside in Spain, paella is something my whole family loves, my mum has been taught how to cook it by the locals. This weekend with my mum in the UK at my home I decided to cook her my version. It’s probably not a true paella but hey, it’s tasty family food and a one pot meal that you can put in the middle of the table so everyone helps themselves. 

Of course you could totally add chicken, fish or your own favourite vegetables to this, I used what I had in my kitchen. Make your own version and let me know how it goes.

Easy Peasy Paella
Serves 6
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Prep Time
10 min
Cook Time
40 min
Prep Time
10 min
Cook Time
40 min
490 calories
70 g
105 g
13 g
23 g
4 g
335 g
736 g
5 g
0 g
8 g
Nutrition Facts
Serving Size
335g
Servings
6
Amount Per Serving
Calories 490
Calories from Fat 114
% Daily Value *
Total Fat 13g
20%
Saturated Fat 4g
18%
Trans Fat 0g
Polyunsaturated Fat 2g
Monounsaturated Fat 6g
Cholesterol 105mg
35%
Sodium 736mg
31%
Total Carbohydrates 70g
23%
Dietary Fiber 5g
21%
Sugars 5g
Protein 23g
Vitamin A
88%
Vitamin C
27%
Calcium
9%
Iron
14%
* Percent Daily Values are based on a 2,000 calorie diet. Your Daily Values may be higher or lower depending on your calorie needs.
Does this look wrong?
Ingredients
  1. 1 tsp tumeric
  2. 1/2 tsp paprika
  3. 1/2 tsp cumin
  4. 1 tsp mustard seeds
  5. pinch of saffron (optional)
  6. 1 tbsp olive oil
  7. 100g chorizo, chopped
  8. 3 cloves garlic
  9. 450g basmati rice (you could use paella rice)
  10. 1 tsp Italian mixed herb mixture
  11. 2 dried lime leafs (optional)
  12. 450ml chicken stock (mine was homemade or use a stock cube and water)
  13. 2 large carrots grated
  14. 2 medium courgetes grated
  15. 100g mushrooms
  16. 100g peas
  17. 450-600ml water approx, judge it on the rice as it cooks
  18. dash of lemon juice
  19. 250g frozen prawns
  20. large handful of fresh herbs, chopped
Instructions
  1. Place the spices in a large wide based pan on a medium heat, add the boil and cook for a couple of minutes.
  2. Add the chorizo and allow it to release its oils.
  3. Next add the garlic and rice, cook for 2 minutes. Then add the stock, dried herbs and lime leaf.
  4. Allow this to simmer whilst you prep the veggies, you could use any veggies you like!
  5. Add in the vegetables one at a time and stir in.
  6. Add the water and place the lid on the pan. Allow it to simmer until the rice is cooked.
  7. Finish with the lemon juice and prawns, allowing the prawns to cook in the pan with the rice for a few minutes.
  8. Finally add the herbs, taste and season.
beta
calories
490
fat
13g
protein
23g
carbs
70g
more
Dietitian UK https://www.dietitianuk.co.uk/
Check out a little video of us cooking it here. My 7 year old girl was on “sous chef” duty tonight and she totally enjoyed helping out. Her tasks were to measure the rice using the Carb Spoon, to cut the chorizo up, grate some vegetables, add them and stir the pan. She added the stock, picked the herbs and chopped them too. Plus she got the prawns out of the freezer and added those for me.

I’m trying to get my children to each cook with me once a week, making it a scheduled activity and time with mummy all at once. It slows me down and means more planning is needed but it is also teaching them valuable skills.

 

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Dietitian Advice, Nutrition Education

Breastfeeding and the Microbiome

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Breastfeeding is something I am quite passionate about, partially because I’ve breastfed 3 children, for a total of 4.5 years. That’s a lot of feeds and little sleep 😉 however totally worth it in terms of the impact on their long term health. 

Now this is totally not meant to be a dig at anyone who cannot breastfed or who chooses not to breastfeed. Breastfeeding is blimming hard work. I’ve been through mastitis, blocked ducts, nursing strikes, bleeding nipples, tongue ties x 3, nursing strikes, expressing (such a faff!) and babies who just want to feed forever. So I totally get that how you feed your baby is your choice and for many combination feeding or formula feeding is the way forward. I planned to only breastfeed my first for 6 weeks, then 3 months, then till weaning. Small goals and steps helped me. However I also have ladies in my postnatal pilates classes who just cannot get on with breastfeeding and for them using formula saves their sanity. 

Ultimately we all know breastmilk is amazing stuff, so if you can breastfeed I heartily recommend you do it. Here I’m sharing an article I wrote for Network Health Digest on how breastmilk affects the microbiome of the infant. Fascinating stuff. 

Issue 135 breastfeeding and the microbiome

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Eating Out Gluten/Wheat Free, Family Meals, Intuitive Eating, Kids Nutrition

Colour up kids restaurant menus

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Let’s talk childrens menus when eating out. This can be a topic of division in my mind and in general amongst parents. I doubt many people choose where they eat out based soley on the kids menu but when you are eating out with small ones it is hugely important. 

Often childrens menus are high on beige foods and low on colours. I’m talking fishfingers, nuggets, burgers,  chips, potato waffles with maybe beans or peas but not much else. I totally get why, as a restaurant you want children to enjoy their meal and hey, it’s only one meal. So does it really matter?

 I think it does. Children are little adults, as an adult I want choice, flavour, foods that I don’t usually eat at home, foods that make me think and that my tastebuds explore. Beige food menus are devoid of a variety of  tastes, textures, fibre and colours. All things we want kids to be eating.

Now for my kids eating out is a complete treat. We don’t do it that often. I also don’t tend to offer “beige meals” often at home, unless they are requested. Not that I am against those foods, they have a place. However, I  prefer to go for plenty of veggies and variety, aiming for homemade foods when I can. So we may have fishfingers from the freezer but I’d serve them with a mixture of veggies, potato wedges, with the skin on and thus provide a range of nutrients, fibre and tastes.  Nuggets and fishcakes can totally be offered as part of a balanced diet but do they need to make up the majority of children’s menus when eating out? I think not. Let’s get some balance on the menu please. 

Miss K totally loving her ramen bowl.

If we start to offer variety and treat children as little foodies maybe they will start eating in this way? Having had a boy who was anti-vegetables I’ve had first hand experience of how consistency, being non-judgemental and continual exposure works. So if we only offer beige foods they will only eat beige foods! This is part of the basis behind raising intuitive eaters, as parents we offer a range of foods and let them choose how much and what to have.

My crazy kids actually get a bit excited about a kids menu but at times I get “why is my food not as nice as yours”.  Which has led to us ordering an adults meal for the kids to share or of course sharing our own meals. I do remember at a wedding the sausage and chips being shunned in favour of the delicious buffet. When travelling I encourage the children to try cultural foods and things they have not had before – with varying results but it’s all about continuing to promote these values and ideas.

 Eating out is about pleasure and enjoying meals different to those at home. My 7 yr old especially loves eating “adult meals”. So I love places who make small versions of the adult menu. In my mind this is how it should be. Yesterday we ate out at a restaurant that did an amazing menu with kid friendly versions of their dishes – no chilli, smaller portions and some meals where all the foods were separate for those, like my boy, who would have wanted to pick bits out. They were also happy to make changes to the kids meals. My children were VERY happy. 

This boy, so happy with his meal and he demolished it.

It’s all about enjoyment, choice, variety and #empoweringkids to do this. I see it as part of intuitive eating, letting them choose what to have and how much to eat. My kids are very different in their eating and how they eat but all loved their lunch out today. 

 

 

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Dietitian Advice, Family Meals, Intuitive Eating, Media, Nutrition Education

How do we know when we are hungry/full?

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In a completely perfect world we would eat when hungry, stop when full and eat the foods our body tells us to eat. However few of us are that tuned into our bodies signals. We are bombarded with outside signals for example the media, advertising, other people, shops, restaurants – food is all around us.

You walk down the road and pass someone eating a burger, “hmmm I fancy one of those now”. Then you pass a billboard advertising ice-cream, “oh I could eat an ice-cream later”. Then someone in the office has a birthday so you have a slice of cake. Later on the radio is advertising a meal deal which makes you think of buying one for your lunch. In the shop you are standing waiting to pay and see a cereal bar so pick it up to nibble on. All those extra signals that are overriding your actual body signals. It’s all so easy to be overwhelmed by the external and takes a lot of quietening ourselves to hear the internal cues. 

Many people I work with cannot actually initially  pinpoint what hunger feels like. I ask how hungry they are and am met with a confused look. Hunger on the one hand is quite a simple idea, your body is hungry, it tells you, you eat. Other the other hand it is complex, so complex. There is head hunger, body hunger, stomach hunger, emotional hunger.

Here is my 7 year olds take on how she knows she is hungry. I think this is such an important conversation to have with children AND adults. So have a think this week, how do you feel hunger and how hungry are you before you eat? 

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Dietitian Advice, Nutrition Education

The non-diet approach for children.

8 Comments

In a time when there is a focus on reducing sugar, countering obesity and improving the long term health of the nation, it can be hard to know how to approach these topics with your family. On the one hand we want children to be aware of what is in food but we don’t want them to be obsessing over it or feeling they need to go on a diet.

Personally I think that teaching children about nutrition, food preparation, healthy behaviours and their bodies early on is really important and can be part of the solution that our society needs. So as a mum I do my best to educate my children on a daily basis.  Simple messages that we use are “There are no good of bad foods but some foods we eat less of as too much of them are helpful for our bodies”. We also talk about what is in a food and why it is good for us – often using “Funky Facts” such as the fibre in bread or the vitamin C in a kiwi. Top facts like this are things I find they store up and remember.  

We may talk about dental health or how out tummy feels if you eat too much of certain foods.  Both my older children (age 4 and 7 yrs) can associate with a time they have eaten sweet foods and felt unwell from it! I love talking to them about how their tummy feels and what do they feel it needs as well as what does it want!

I prefer to focus on these messages rather than focusing on weight/size/shape.  Being a dietitian who works in the eating disorder field I am well aware of the issues that can occur when there is too much of a focus on weight, shape, size and how your body looks.  Instead I like to focus on the enjoyment of food and on healthy behaviours such as being active, getting fresh sunlight, being outside and taking care of our teeth, hair, nails. 

Here is a little video of my 7 year old explaining her thoughts on food:

I’d love to hear your thoughts! 

 

Dietitian Advice, Vegetarian

The least sexy but vitally important nutrient

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Facebook likes too ask “what’s on my mind” well actually right now it is fibre. An overlooked and neglected nutrient, maybe because bowel health just isn’t sexy. However to my mind, neither is constipation or piles. 
 
When the recommendations for fibre increased to 30g per day there were lots of posts out there about how hard it would be to achieve it and how to meet your fibre needs. At the time I remember thinking how hard this would be for many people to achieve. It’s all about making small changes one at a time and then building on these. In my clinic I see the extremes. Sometimes underweight people who are eating too much of the fibre rich foods (and I have to ask them to decrease these) but then also plenty of people who are just not having enough fibre which is causing some of their symptoms. 
 
(Disclaimer: this advice is not for those who are weight restoring from an eating disorder, too much fibre can be very filling and stop you from eating enough energy).
 
So why is fibre important? 
 
  • Bowels, bowels, bowels. As a student dietitian on the wards I remember having to swallow my embarrassment and loudly say to people “how are your bowels today”. These days I’m older, a lot harder to embarrass, mum to small kids and used to talking about bowels a lot… whether it be a clients, a child’s or a worms. Yes this week my girl wanted to chat about worms poo. Having enough insoluble fibre is important for bulking your stool. 

 

  • Soluble fibre forms a gel that slows digestion. This also means it helps stabilise blood sugars, lowers cholesterol and aids satiety, keeping you fuller for longer. Soluble fibre is found in oats, barley, psyllium, nuts, seeds, beans, lentils, peas, and some fruits/vegetables. 

 

  • The microbiome is a fascinating area. Research has shown that the largest influence on the gut microbiome comes from diet. Fibre feeds the gut bacteria so by eating your fibre you are helping ensure your gut stays happy and healthy.

So how much fibre is in your foods? Although I wouldn’t promote you analyse labels all the time it can be interesting to compare the fibre content of some of the foods you eat.

Some fibre rich foods that can help boost your intake are:

Lentils, Spilt peas, beans,  garden peas, nuts, seeds, wholegrain versions of pasta, rice, bread products, wholegrain cereals, grains such as oats, quinoa, cous cous, popcorn, fruit and veggies, potato skins.

Top tips to increase the fibre content of your meals: 

  • Add lentils, beans and pulses to your meals. A couple of handfuls of lentils goes well in casseroles, soups, salads, even stir fries. 
  • When possible opt for wholegrain versions of foods.
  • Add nuts and seeds into meals. I love them sprinkled on breakfast or my yoghurt, you could add to a salad or on top of a stirfry. Sprinkle some in your sandwich or add to baking.
  • Increase your portions of fruit and vegetables if you are not meeting the 5 a day target. 
  • Eating more plant based meals in your week. We aim to eat plant based meals 4-5 times a week in our house. 

Here are some meals where I’ve pimped the fibre:

Oats with fruit, seeds and nuts – 15g fibre. Plus the oats here are soluble fibre. 

  

2 x Rye bread with 1/2 avocado – 10-15g fibre, this particular bread is very high fibre, 10g for 2 slices.

If you used a different rye bread it would be lower, using my normal rye bread plus the avocado it would be 10g fibre.

Risotto made with pearl barley and broccoli – 12-15g fibre per portion. Pearl barley has a high fibre content and is a great grain to cook with. It takes slightly longer to cook than rice but can be used instead of rice, or added to soups and stews. 

Vegetable fajitas with chickpeas, peppers and sesame seeds, smashed avocado and seeded wraps – 10g fibre.

I totally encourage you to try increasing your fibre intake and help your gut bacteria, blood sugars and bowel health. Remember to also drink plenty of fluids to help that fibre move through your system.

 

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Family Meals, Intuitive Eating, Nutrition Education

Let the children lead the way

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Ever get the feeling that the children in the house are in charge? Oh my days, I know I sometimes feel like I just run from child to child doing things for them! 

Letting them be in charge of some things can be empowering and really positive. When you think about it there isn’t that much that they are actually in charge of. That can be hard as these little people want a chance to grow their independence and show their preferences. Eating is one of the ways that they can do this. So from a very early age they can show which foods they like/dislike and how much they want to eat. As parents it is whether we take note of these signs or think we now better! I’m trying to raise my children as intuitive eaters but it is hard as often I think I know their tummies better than they do. I then have to sit back, breathe and let them lead. When you are in a rush or have other children to also look after it can be frustrating to do this but we are setting our children up for life. I want mine to know how to pause, think about how their bodies feel and then respond accordingly and not be rushed because I have a schedule.

I find toddlers fascinating as they are so in tune with their bodies. My 22 month old will literally refuse to eat when she doesn’t want to, there is no way I can force her. She now chooses what she wants to eat from a selection of foods and she tell me when she is hungry with “Eaaaaaa” or “Snaaaaa”.  A funny example this week was when I made a cake for Mothers Day and then we had some for pudding. However the toddler shunned it and ate a bowl of peas instead! 

As we grow up eating becomes more complicated. Foods plays more of a social role, there is an enjoyment factor and just seeing things that you fancy. Advertising, being around food, media and other peoples food choices also influence us. This is why I think it is SO important to encourage our children to build great relationships with food whilst they are young and to continually reinforce these principles:

 

  1. Listen to Hunger – eat when you are hungry, stop when you are full. Think about your hunger at the start, middle and end of mealtimes. I sometimes talk about hunger being a butterfly in your tummy that grows to a dinosaur. Where are you on that scale?
  2. Listen to Fullness – this can be fun with kids. My 4 yr old boy pokes his tummy and that can help him connect with how full he is. My 7 yr old girl just knows and will leave her food for later.
  3. Eat a balance –  I teach my kids that all foods are great but that our bodies need balance for energy, protein for building, fat to keep us warm and protect our organs and all the vitamins/minerals to keep it working properly. 
  4. There are no good/bad foods. I love this conversation with my children. We’ve used plastic foods to group them into food groups and then talked about what all the foods contain that is great for our bodies. Instead of foods being good/bad for us I talk about how we need to moderate foods that are higher in sugar due to our teeth and balance our snacks as biscuits don’t keep us full for long. 

I’d totally encourage you to let your children lead a bit more with food. If you want more tips on how we do this at home then do let me know. 

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Dairy Free, Family Meals, Gluten Free, Recipes, Special Diets, Vegetarian, Weaning, Wheat Free

Lentil Lasagne and Lasagne made easy

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Lasagne is one of those meals that is loved the whole family. Let’s face it, if you don’t love lasagne then you are very usual! Often seen as hard to make, time consuming and more comfort food than “healthy” I want to share my top tips for making it a standard weeknight family meal.

  1. Pack in the veggies. Lasagne does not have to include meat! I rarely use mince to make lasagne these days. Instead I use lasagne as a way to pack in the veg. You can use lentils, beans or tofu or quorn to get protein in. There is nothing wrong with using the normal beef mince but  if you are looking for more variety with meals or like us, are wanting to eat a greater range of plant based protein sources then it’s time to expand your lasagne repertoire.
  2. Making your own sauce doesn’t have to be complicated. As much as I love a white sauce, if I’m in a rush it always goes lumpy or I burn the bottom of the pan. One of my hacks is to use cottage cheese. Add a little natural yoghurt to thin it down and pour it on the top of the lasagne, top with grated cheese and the jobs done. I wasn’t convinced this sauce would pass the lasagne police in my house  but it did. Phew. The other easy alternative is to use a half fat creme fraiche, simple. 
  3. Embrace your freezer. I totally love my freezer, it saves me on a regular basis. Oh, and it needs defrosting, in case anyone fancies helping me with that. You can either make a double batch of the main filling and freeze it for another meal, or I like to make a whole lasagne and freeze it, makes me feel like a proper domestic goddess. Minus the tidy kitchen, mine is never tidy.
  4. Make ahead. I often make lasagne in stages. so I will either get the main filling out of the freezer and leave to defrost, or make the filling up and leave it. Then later I get a child to help me put it together, layering the filling, pasta and sauce. 
  5. Use pre-bought lasagne sheets. I know most people don’t make their own fresh lasagne sheets, but I sometimes do, it makes the lasagne SO good, literally the best lasagne. But it takes more time that I just don’t have that often. 
So why not transform your lasagne into sometime more inventive. It’s a forgiving dish. Here is a recipe for a wheat free, dairy free version I made this week:
 
 
 
Lentil Lasagne
Serves 4
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Cook Time
45 min
Cook Time
45 min
585 calories
89 g
13 g
11 g
35 g
3 g
533 g
221 g
14 g
0 g
7 g
Nutrition Facts
Serving Size
533g
Servings
4
Amount Per Serving
Calories 585
Calories from Fat 94
% Daily Value *
Total Fat 11g
16%
Saturated Fat 3g
16%
Trans Fat 0g
Polyunsaturated Fat 2g
Monounsaturated Fat 5g
Cholesterol 13mg
4%
Sodium 221mg
9%
Total Carbohydrates 89g
30%
Dietary Fiber 34g
136%
Sugars 14g
Protein 35g
Vitamin A
203%
Vitamin C
165%
Calcium
24%
Iron
49%
* Percent Daily Values are based on a 2,000 calorie diet. Your Daily Values may be higher or lower depending on your calorie needs.
Does this look wrong?
Ingredients
  1. 1 onion
  2. 2 garlic cloves
  3. 3 carrots
  4. 2 peppers
  5. 1 medium courgette
  6. 1 tsp olive oil
  7. 2 cups of dried lentils
  8. 1 tin chopped tomatoes
  9. 1 tbsp tomato puree
  10. 250ml stock (I used homemade chicken stock but you could use a stock cube and water)
  11. 1 bay leaf
  12. Dried mixed herbs
  13. 1 small glug of balsamic vinegar
  14. Lasagne sheets (wheat free if required)
White sauce
  1. 1 tbsp rapeseed oil
  2. 2 tbsp wheat free flour
  3. Soya milk as needed, approx 250ml
  4. 250ml water (you may not need it)
  5. Soya cheese or normal cheese
Instructions
  1. Chop all the vegetables in a food processor (this saves time!) or chop finely by hand.
  2. Saute in the oil for a few minutes, then add the lentils, chopped tomatoes, tomato puree, bay leaf, dried herbs, balsamic, stock and simmer for 20 minutes. This is your basic lasagne filling, You can now freeze this, keep it in the fridge for making up later, or use straight away.
  3. Make up the lasagne with 1 layer of lentil mix, lasagne sheets, lentil mix and lasagne sheets.
White sauce
  1. Pour the oil into a sauce pan and mix in the flour with a wooden spoon, it will make a thick paste. Mix in a little milk and stir to make a batter, now add in the rest of the milk place on a gentle heat and keep stirring to incorporate it all. The sauce will thicken, if it is too thick add some water. Keep stirring! Let it gently bubble but not too much. I like to let it cool a little and then pour on top of the lasagne.
  2. Top with cheese and bake at gas mark 5 for 45 minutes.
beta
calories
585
fat
11g
protein
35g
carbs
89g
more
Dietitian UK https://www.dietitianuk.co.uk/
 
Dietitian Advice, Eating Disorders

The golden toolbox of recovery

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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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Dietitian Advice, Eating Disorders

Eating Disorders: Why can’t I recover?

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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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