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.

Article submitted by R.S.
When my friend texted me upset after trying on clothes, my first reaction was to giggle. Obvious I felt sad she was going through a rough time, no that is NOT why I laughed! Basically, I had that urge to just laugh because who among us has not been brought to tears in a dressing room.
There’s some nice ones, granted, but most are pretty darn bad, and the ones that are bad, tend to be really really bad.

Why? Um, hello–crappy lighting, tilted mirrors that make you look wider and distorted, everything on display, you’re trying on a bunch of different sizes (in a world with vanity sizing, no less). You would think retailers would have figured this out by now and have nice dressing ones, but even the big names don’t always nail it. And if it sucks at some high-end boutique or department store, it only gets worse when you are in some cheap, trashy store like Forever 21 (don’t get me wrong–I love it, but face it, that dress will last you about half a wear)–everything ends up being cramped and hot and sweaty. GROSS.

A suggestion I’ve heard is simply avoid them at all costs. With online shopping and places that have and easy return policy, sure, this might be a great idea. But that isn’t always the most affordable, feasible, or sometimes even possible option. Soooo, when you absolutely most face the dreaded dressing room, here’s some tips:

1. Ask the salesperson for a pair of heels to try on (WITHOUT AN ANKLE STRAP). It’ll help you feel more confident elongate everything. Ankle straps will just cut you off at your leg.
   
2. Try on the largest sizes first. That way, if something is tiny and doesn’t fit, you don’t have to be dissapointed when you ask for the next size up. Sizes are stupid anyways because they aren’t standardized and today’s size 8 was yesterday’s size 2 and tomorrow’s size 00. So don’t hold you’re stock in them. Actually, when I shop, sometimes I don’t even look for sizes–I’ll just hold up a pair of jeans or a shirt and see if it looks to be my size. (Try this–you’ll be surprised how much better and accurately this works than by going by a size–and then you only have to try it on once!)
   
3. Look in the mirror as little as possible–and only when clothed. Rather, try using other people’s opinions like a trusted friend (I wouldn’t trust most salespeople to be that honest…) and use the big mirror that stores sometimes have outside of a dressing room (even target has this!)

Dressing rooms can be really hard for a lot of people–they’re are one of my. biggest. triggers. My suggestion isn’t to use these tips as a crutch and avoid every mirror and always wear stillettos, etc, but especially when you’re struggling big time, these can be super helpful!

“I don’t eat all day but I still can’t lose weight!”  If this describes you, then you may benefit by having your metabolic rate measured.  Metabolism is a complex system of hormones and enzymes that converts food into fuel and determines how efficiently that fuel is burned. The process of metabolism determines the rate at which we burn our calories which, ultimately, affects how quickly we gain weight or how easily we lose weight.
Metabolism is influenced by many factors.  Some of the factors that we cannot control include genetics, gender (males burn calories faster than females), and age (metabolism slows down about 5% per decade after age 40).  The factors that we can control include the way we eat and exercise.  Here are the facts to increase your metabolic rate:

1. Eat adequately.  If your intake is about 1200 calories or less your body goes into starvation mode and begins to conserve the calories that you do eat by burning them very efficiently. When intake is increased, metabolism continues to run on slow, which can cause weight gain.
2. Eat breakfast, regardless of hunger.  Breakfast revs up metabolic rate. Studies show that breakfast eaters weigh less than non breakfast eaters.
3. Eat small frequent meals & snacks.  Research shows that eating every 3-4 hours speeds up metabolic rate.  Additionally snacking helps control hunger and snackers have better portion control at meals.
4. Exercise.  Aerobic exercise increases metabolic rate during exercise and immediately afterwards. Strength bearing exercise helps to build muscle and muscle mass is proportionate to metabolic rate. Which to do? The best advice is to engage in exercise that you enjoy so that you will become a lifelong active person.
5. Hydrate. Water is necessary for processing calories and even mild dehydration can slow metabolism down. 

One way to measure your own unique metabolic rate is by indirect calorimetry. This is performed by breathing into a calorimeter which measures your oxygen consumption and provides a precise measurement of resting metabolic rate. The Body Gem device is quick and accurate and is used by contestants on The Biggest Loser. For more information about measuring your metabolic rate see Services page.

One of the most frequent questions I am asked is “how much should I weigh?”   There is no one formula, graph or chart to answer this question.  Instead a number of factors are used to determine a healthy weight range for every individual.  Listed below are some of these factors:

• No symptoms of malnutrition or being underweight.  Some of the main symptoms of being underweight include fatigue, inability to concentrate, insomnia, constipation, cold intolerance and irritability.  Consequences that should be addressed by a physician include cessation of menstruation, anemia, osteopenia or osteoporosis, low pulse, low blood pressure and heart problems.
• Normal body composition.  Bodies require a minimum of body fat in order to maintain life and reproduction.  Research shows that a minimum of 16% body fat is necessary for menarche.  Most authorities agree that lean women have body fat percentages of 18 to 24% and average weight women have 25 to 31% body fat.  Lean men have body fat percentages of 6 to 17% and average weight men have 18 to 24% body fat. Body composition is a vital measurement for determining healthy weight.  This is because a person can weigh what is considered a healthy weight but have too little body fat to begin menstruation and  protect bone health. 
• Body Mass Index (BMI).  BMI is a measurement of weight in relation to height. A BMI of less than 18.5 is underweight and indicative of under nutrition. A BMI between 19 to 24 is considered healthy.   BMI, however, does not take into account muscle mass and since muscles are heavier than fat, BMI is not an accurate indicator of healthfulness for athletes and fit individuals.   
• Maintained with “normal” eating.  A healthy weight is a weight that a person can maintain with normal eating. In brief normal eating is having regular meals and snacks, eating adequate amounts of food and having a wide variety of foods.  A normal eater trusts their internal hunger and fullness signals and is able to be flexible with variety and scheduling. A normal eater has a peaceful relationship with food. 
• Consideration of weight history and ethnicity. Just as skin color, hair color and height vary among ethnicity weight also varies. For example American Indians tend to have bigger frames than Asians. Thus a lean American Indian would probably weigh more than a lean Asian person. Additionally if a person has struggled with obesity in the past, she is more likely to have a higher healthy weight range than someone who has never gained excessive weight.
• Maintained without excessive or compulsive exercise. Sedentary people tend to maintain higher than recommended body weights and people who engage in excessive or compulsive exercise typically maintain artificially low body weights.    
• Increases with age. As height increases so does weight. Each inch in height is equivalent to 3-6 pounds of increased bone mass, blood volume, and organs. Even after peak height is reached bodies continue to physically mature thus a person may continue to gain and /or redistribute weight. Ideally, from at least the mid 20’s to mid 40’s weight is maintained within 5 to10 pounds. Perimenopause and menopause is also a time where weight gain and redistribution may occur due to lower estrogen levels. The average weight gain during menopause is 5 to 10 pounds.
• Weight range rather than a single number. Weight fluctuates within the day and from day to day due to fluid fluctuation, hormones, elimination, sodium intake and a number of other factors.  At least 3 pounds during the day and even more from day to day can be attributed to normal fluctuation which is why a range instead of a single number, is imperative. 

In summary just as no two dogs, even within the same breed, are likely to weigh and look the same, no two people are likely to weigh and look alike. We each have our own unique features which are mostly determined by factors that we cannot control. People become dissatisfied and unhappy trying to achieve and maintain a weight that is unnatural for them.