Tag Archives: eating disorder dietitian

Book a Consultation

Priya provides one to one consultations from her home consultation rooms in Southampton or online using video calls or phone consultations. See below for the types of issues Priya can help with. Skype/Zoom video calls provide a more flexible way to see Priya face to face but from the comfort of your own home. The software for this is free to use. The majority of Priya’s work is done this way as she works with clients all over the country and internationally too. She also offers dietary analysis via email where a thorough analysis is conducted on your food diary and a report emailed back to you.

As everyone is different and needs differing levels of support Priya does not have a set way of working. However she does work from a non-diet and intuitive eating background. This is based on the concepts that diets do not lead to long term change and that it is better to focus on changing health behaviours rather than just diet and a weight focus.  Retuning your body to listen to its hunger and fullness cues, learning to respect your body and listen to its needs can be a longer route but leads to lasting changes for life.

A initial consultation lasts up to 1 hour and includes an in-depth review of your current and previous diet and food related problems plus your weight and medical history. From this information Priya will give education, advice and help you set goals that are realistic and achievable. All advice is individualised and tailor-made for you. You will receive an email summarising the agreed goals set  along with any agreed information. This may include a meal plan, worksheets or educational literature.

Follow-up sessions can be booked and last for up to 30 minutes. The number of sessions you will need will totally depend on your needs. 

Prices: £95 for an initial consultation and £65 for follow ups.

Package: £260 for 1 x initial consultation and 3 x follow up sessions.

Email dietary analysis with report £65

Eating Disorders:

Priya is renown for her expertise in this subject and the majority of her clients will have an eating disorder. She takes a holistic approach, not just looking at nutrition in isolation but helps clients to look at the wider issues too. Many of Priya’s clients have worked with the NHS and need further support or have not met the criteria for NHS input. If you do not think you have an eating disorder but know your approach to food is not as it should be, then get in touch. Working as part of a team of specialists Priya can recommend a therapist for you to work with or can liase and work with your current therapy team as well as your GP. She works with the Wings Eating Disorders Unit in Romsey and also as part of the Marchwood Priory team. If you need help getting your eating back on track Priya is here to help with education, meal planning, practical help, support and an understanding ear.

Weaning Consultations

One of Priya’s specialist and much loved areas – book a weaning consultation for advice, recipes, top tips and support to help you get your baby off to a wonderful start with food. Having weaned 3 children herself Priya has first hand experience as well as the evidence case and the research to support her advice. If you are struggling with fussy eating Priya can also help with this. Family meal planning and suppoprt can also be supported.

IBS:

Priya can help with advice and support for those with IBS, this includes the low FODMAP diet which is a specialist diet that should be followed under dietetic supervision.

Other consultations topics Priya can help with include:  Chronic Fatigue, Learning Disabilities, Family Meals,  Anaemia, Osteoporosis, brain injury and achieving a healthy balanced diet. If you have another dietary issues please do contact Priya to discuss. If Priya is not able to help she can help point you to someone who can.

Some private medical insurance companies cover dietetic consultations, please check with your insurer. Priya is registered with AXA, AVIVA, WPA, BUPA, Exeter Family, Allianz and Pru Health.

Testimonial:

“The support Priya provided to help me gain weight and overcome an eating disorder was above and beyond what I would expect from a dietician. We met regularly and she never failed to surprise me with creative and interesting ideas to introduce variety into my diet and ensure that the weight gain process was as exciting and smooth as it could be. She encouraged me to face my eating disorder head on and used her incredibly extensive and detailed knowledge on nutrition to challenge disordered thinking. Her holistic approach has been so integral to my recovery that I cannot thank her more! I’d recommend working with Priya to anyone, as her caring, enthusiastic and creative approach is something you don’t find easily.” 

Constant thoughts of food? It could be linked to your diet.

One statement I hear regularly in my eating disorder clinics is “I feel like I’m going mad, all I think about is food”. Now whilst an eating disorder is a mental health illness it is not a sign of madness. However you can feel so consumed by your thoughts of food that it feel that way. Why? Well let’s have a look at some of the symptoms of being underweight….

Back in 1941 there was a landmark study conducted by Ancel Keys called the Minnesota experiment. The aim of this study was to get information on how to refeed those starving from famine conditions. 32 men completed the study, 12 of these were studied for 8 weeks to assess their baseline intake before the trial began. Then they were all starved for 24 weeks, with their intake reduced from 3,200kcals to just 1,600kcals/day served in 2 meals. which led to a 25% loss of body weight.  Now take a note of the number of calories, yes these men would have been more active and lived a different lifestyle but 1,600kcals led to them being starved. Many of the diets that are advertised today are much lower in calories that this, so are they really healthy for our bodies? 

Fascinatingly the men showed a lot of the symptoms we see in people suffered from an eating disorder. They become obsessed with food. Some read cookery book and stared at pictures of food. Cheating become a huge issue with them trying to find extra snacks. One man became psychotic, having vivid dreams of eating flesh and threatened to kill Keys, he was dismissed and after a few days these dreams and thoughts went away. This to me highlights the affect being a low weight can have on your thoughts and mental health. If you have an eating disorder and are a low weight that pre-occupation you have with food can totally be related to your body being undernourished. It is not you going loopy, it is the impact of being malnourished.

These men displayed a biological drive to eat, their hunger was increased and felt out of control. Keys ended up having to have each men chaperoned to stop them eating other snacks when not in the hospital. Our bodies are built to live and to live we need food. So they will do all they can to get us to eat. When you restrict your intake it makes perfect sense you will hungrier than before, stronger signals are being sent out and the body is going into amber alert. So that pre-occupation with food is actually a normal, biological sign that your body is working and doing it’s job.

The good news is, upon being re-fed, for most men, these symptoms disappeared. They were refer back to their usual weight and felt a lot better. Their thoughts, mood and emotional state improved alongside their physical healthy. Some of these men were interviewed in 2003 and they reported being glad they took part in the study, but there being some lingering after-effects. Some were worried about food deprivation for years afterwards. This can also be seen sometimes in recovery from an eating disorder, which is why  it is important to focus on recovery happening in stages and being a continual work in progress. 

If any of this has hit home to you and you feel like you need some support, do get in contact with me, see your GP for advice  or check out the B-eat website who have a helping and a list of eating disorder specialists. Taking that first step can be the hardest but with good support around you, recovery really is possible.

 

 

The goal of recovery is not about weight.  

I’m constantly on a journey with my clinical practice and dietetic thinking. One of the keys to a good health professional (or any professional) in my mind is one who constantly evaluates their practice, the evidence, the new trends and uses this to shape how they work and think.  

I started work as an eating disorder dietitian in 2007. On my first day I was handed a box file that contained a few black and white print outs of out of date dietary information and told those were all the resources. There had been no dietitian for 5 years. I built up the resources, my knowledge and educates the team as well as myself. As a lone dietitian on a psychology based team it was at times very tough but it was the making of me and I loved it. When I left that job I had experience of helping run a day care programme, groupwork, meal support, out patients, inpatients and I had gained a whole new language. I am so thankful for those years. 

Now as someone who works in the private eating disorder field I am constantly working to better the support I offer. Not so that I am better, but because I want to do myself out of a job. I want to see my patients recover, I want them to have a good relationship with food, I want them to no longer need my support. 

We live in a weight focused culture. I personally struggle with this. I would love to not weigh anyone who comes to clinic, yet most of the time I have to. Working with people who are very low weight it would be negligent of me to not know what their weight is doing. It has to be a focus, but I don’t want it to be the primary and only focus.  So we get it out of the way, debrief and then move onto other areas. Weight is never an easy topic and is certainly not foolproof. The simple idea of eating so much leading to so much weight gain every week just isn’t that simple  in the community. There are so many factors than can complicate the picture. Activity levels, mental energy used in work/study, looking after children, anxiety etc… So focusing on the weight alone can make it slow, hard and distressing. 

Instead of a weight focus only, I like to work with people looking at their relationship with food. We may look at the their food beliefs, busting any incorrect ones. Ideas such as carbohydrates are fattening or I shouldn’t eat fat are common ones. It doesn’t always work but I try to stay away from calories and strict meal plans and instead focus on eating regularly and including a good balance of foods at meals.  No food is off limits, no food is good or bad. Switching the focus from weight to health has always been one of my aims. Instead of what foods you need to gain weight I look at why food groups are good for your health and how restriction is unhealthy and can cause physical harm. Finding out what foods people have been avoiding and why, is always a good place to start.

 As people make progress it can be so liberating to weigh less often and incorporate more freedom into the meal plan. Learning to listen to those signals of hunger and fullness can be very scary and overwhelming at first but it opens up a whole new future and a way of eating that will see you through life, with no need to restrict, binge or diet every again. Let’s make that the goal. 

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.