We live in toxic environment for eating disorder recovery. We are constantly bombarded with media messages that thinness equals perfection, success and beauty. Add that to our own relentless negative self talk that we are not good enough, not thin enough, not smart enough, and just not enough can take a toll on fragile tools of recovery. Here are the top 5 ways to prevent relapse.
1. Avoid the scale. Weighing, for most people, is a surefire way to slide the slippery slope to relapse. Most people struggling with eating disorders, distortions and low body esteem are likely to misinterpret their weight, regardless if their weight is higher or lower than expected. If their weight is higher than expected, feelings of being out of control, self loathing and body hatred are common. This can lead to more food restriction and excessive exercise. Sometimes weighing can trigger overeating. The person struggling with the eating disorder may feel so frustrated and defeated, they end up over or binge eating. This may go on for days or months until the next cycle of restricting.
If weight is lower than expected, the reward center of the brain does a happy dance. Fireworks explode and the Hallelujah chorus breaks out….until the person with the eating disorder looks down. “Hmmmm, one more pound and my stomach will be flat.” And thus begins the never ending quest for perfection.
2. Avoid “Recovery” Instagram, Tumblr, and similar sites. These so-called recovery accounts are another quick route to a rocky recovery. These sites typically advertise a person’s lowest weight, goal weight, current weight and pictures of stomachs, thighs and food. Is it really helpful to know all of this information? Those struggling with eating disorders tend to be a competitive group and these pictures are an invitation to relapse. Some of my clients also find talking about recovery or reading recovery books or blogs can be triggering. The authors often tell stories about the worst of times in the midst of their eating disorder which can lead my clients to minimize their own issues with food and body image. Perhaps even worse, my clients feel they are “failing recovery.”
3. Follow your meal plan. If you are in recovery from an eating disorder it is probably safe to assume that your hunger and fullness cues are faulty. Continued under eating causes hunger cues to disappear. Additionally depression and anxiety can lower hunger and appetite. Continued overeating creates an increased hunger. Most people in recovery need to use a meal plan as their guide for at least a year before embarking intuitive eating. Meal plans teach normal eating habits and skills that need to be relearned before doing it on your own. Meal plans normalize eating and even after hunger cues return, they provide a foundation for eating intuitively, the ultimate goal.
4. Not practicing daily gratitude. Need an attitude change? Try listing the things you are grateful for. Even negatives can turn into positives with perspective. For example, are you hating your body? Be thankful that you have a body and that you can walk, run and laugh. Gratitude can help shift values and broaden ideas.
1. Myth: “Pasta, rice, potatoes, and bread are fattening.”
Carbohydrates, specifically grains are still singled out as the culprit for weight gain ever since the wave of low carbohydrate diets in the 90’s. The truth is that grains are no more likely to lead to weight gain than any other food. The simple, but boring truth is: excessive calories from any source causes weight gain.
Hint: Choose 100% whole grain pasta, brown rice or whole wheat bread as these products have added fiber and are associated with decreased inflammation, a lower risk for heart disease and a decrease in all-cause mortality. Additionally be careful with calorie dense sauces and condiments such as butter, gravies and alfredo sauces. Instead go for marinara for pasta and try savoring the nutty nuances of brown rice and whole grain breads without rich toppings.
2. Myth: “Gluten free products will help with weight loss.”
In the past couple of years gluten free products have exploded and currently about 30 percent of Americans report reducing their intake of gluten. Gluten free products were originally developed for people with celiac disease-which affects 1% of the population-and those with gluten sensitivity-about 5 to 10% of people according to the NIH. For those who do not have celiac disease or gluten insensitivity, save your money. Gluten free products often have the same or even more calories than regular products. After all, gluten-free chocolate chip cookies are still chocolate chip cookies. The absence of gluten does not affect whether a food will lead to weight gain.
Hint: The key factor to weight loss is taking in less calories than you expend. Work on increasing fruits and veggies rather than eliminating gluten.
3. Myth: “Eating at night causes weight gain.”
Do you buy into the adage, “breakfast like a king, lunch like a prince, and dinner like a pauper?” If so the media wins again. Many people believe that eating in the evening makes the body store fat because it is not burned off with activity. In reality the time of day has nothing to do whether weight is lost or gained. Many people tend to overeat at night which leads to packing on the pounds but eating within your calorie requirements, even at 11:00 pm, will not cause weight gain.
Hint: Eating every 3 to 5 hours can help stabilize blood sugar and prevent overeating.
4. Myth: “You can weigh whatever you want to weigh.”
Do you get to choose your height? Choosing your weight is similar to choosing your height. Weight, like height, is influenced by your genetic makeup. Certainly eating within your caloric requirements and being physically active can help you lose weight; however if your family tends to be rounder than your chances of having a similar body type is high.
Hint: Accept that a natural normal weight for your body is based on an adequate, healthy diet and regular physical activity. If you radically reduce your intake in order to maintain a certain weight you’ll likely end up feeling feeling deprived, hungry and have low energy.
5. Myth: “If you can pinch an inch, you need to lose weight.”
Pinching an inch is NOT an accurate indicator of body composition. Not everyone carries weight in the same place therefore pinching in any one particular area is not indicative of excessive weight. Additionally without calipers and specific training, it’s impossible to know how much of what you’re grabbing is skin and how much is actually fat. Other factors such as age and skin elasticity also need to be considered. The bottom line is pinching your body may lead to feeling unnecessarily overweight.
Hint: You probably know if you are sporting extra pounds. Choose reasonable, measurable goals such as increasing water intake or eating less restaurant foods rather than losing inches.
Pam Chin-Lai, MS, RD, LD, CEDRD specializes in the nutritional rehabilitation of eating disorders in children, adolescents and adults.