Tag Archives: eating disorders dietician

How to prevent a binge.

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

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

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

 

The science

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

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

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

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

 

Preventing a binge:

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

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

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

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

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

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

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

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

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

You can do it. I know it.

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.

 

Visualisation leads to better dietary change

An interesting piece of research caught my eye this week. A team of psychology researchers in Montreal looked into how using mental imagery techniques may increase the likelihood of people eating more fruit and vegetables. They asked 177 students to aim to eat more fruit over the next 7 days. Those who planned, wrote it down and visualised how they were going to do it (e.g. where and when they would buy, prepare and eat the fruit) were twice as likely to increase their consumption.

 Plant-Based-Foods

This was based on sports psychology. “Athletes do lots of work mentally rehearsing their performances before competing and it’s often very successful. So we thought having people mentally rehearse how they were going to buy and eat their fruit should make it more likely that they would actually do it. And this is exactly what happened,” says Bärbel Knäuper.

 

As a dietitian part of my job is helping people plan how they will manage to alter their eating habits so this research is further evidence that planning really is key. Talking through with someone what your long term goals are, how you can put them into place and having a short term goal to achieve are vital components of achieving dietary change.

 

 

Reference:

http://www.ncbi.nlm.nih.gov/pubmed/21337259