Find peace with food and overcome disordered eating.
Overcome disordered eating and find peace with food
by Harriet Frew on January 22nd, 2020

You’ve meticulously read the anti-diet books from cover to cover. They stand proudly piled on your bedside cabinet, key phrases annotated in pink highlighter and noteworthy pages book-marked and available for instant inspiration, as needed. These books are a crystal-clear reminder of your life changing declaration to yourself and others. No more diets for you.
And what a contrast: - you reflect over the last few Januarys, noting how they have each been deeply associated with a specific regime.  Cleanses, Keto, paleo, shakes and sugar-free; you’ve always had something on the go.  But not this year!

And surprisingly, you’ve even survived the incessant diet chatter of the past month, drawing on your new determination and resolve. It has in fact, been quite a relief to be disengaged from the old water cooler diet chat. You’re pleasingly an anti-diet newbie; fresh faced and determined to reject the old ways for good.

A few weeks in though, you’re struggling to maintain your anti-diet stance. You’ve even had a few sneaky Google searches ‘how to lose belly fat really fast’. You’ve found yourself feeling conflicted and disappointed that you’re not sticking to your guns. You can’t quite fathom why this anti-diet business is harder than you thought.

Some thoughts on this:
  • 1. You purpose and identity. For as long as you can remember, you’ve either been on or off a diet, or plotting and planning your next one. Although this has been an uncomfortable mood rollercoaster of sorts, giving catastrophic lows, with intermittent fleeting highs; this way of living has defined you. It’s offered a structure and purpose to the fabric of daily life and has become a way of bonding with others. You might be known as the ‘one that’s weird with food’; ‘the one that doesn’t eat cake in the office’ or ‘the one that’s the fit gym bunny’. Although a part of you loathes these pigeon holing labels, they have also become a part of you and your identity. Who am I without scale hopping or calorie counting or food obsessing you wonder? Being anti-diet feels wishy-washy and less defined.
  •  2. The mindset hangover. When food has been associated with sky rocketing levels of guilt, better matched to someone committing murder, it’s pretty darn hard to shake this off quickly. The black and white diet thinking: ‘I’m a greedy person for eating this’ or ‘I’m a saint for drinking my green juice’. Or ‘I’m so good at keeping to this diet’ or ‘I’ve completely fallen off the wagon and failed, as a human being’.  These thought patterns will be wired strongly in your brain, having built up with years of repetition. Not surprisingly, dichotomous thinking patterns will take significant time to blur towards helpful shades of grey. And you will likely need to proactively practice the mindset work to find this grey in the first place.
  • 3. Time. It probably took you several months (likely years) to immerse yourself in the grimy depths of diet culture. You were unconsciously and consistently reinforcing the beliefs, behaviours and thinking that saw dieting as ‘good’. Alas, this cannot be reversed immediately.  Instead, expect it to be a plodding marathon rather than a dashing sprint. If you can lower your expectations and engage with the long game, this will massively help.
It takes time to move away from diet culture and establish a healthy relationship with food. Don’t give up on it though, as the long-term benefits are absolutely worth the investment. Remember to be kind and compassionate with yourself in this process; as one step forward and two steps backwards is the norm. Seek out support through other people on the same journey and work to put the blinkers on, to the old seductive diet triggers.

You will get there with consistency and a commitment, but it will likely be a gradual dilution of symptoms, rather than an overnight transformation.

by Harriet Frew on January 21st, 2020

Eating disorder therapy - what does it look like?

Do you need to unearth your past?

Can you focus on symptoms alone?

What therapies can help?

There are a number of eating disorder therapies available. Therapy can help you understand why disordered eating has become a coping strategy.

You can look to your past, and you can also work on your present symptoms and learn new ways of coping. I think that both have their place.

A focus on symptoms is an imperative part of treatment. It’s all very well to understand your relationship with your parents to the nth degree; process the past trauma and grieve loss, but if you’re continuing to starve your body, over exercise, purge or binge eat, you will need help in breaking these cycles. They have become destructive habits that need interrupting.

What about the deeper work? I think that this is also essential. A symptoms only approach might never result in longstanding change, if you’ve feeling undeserving of recovery or if the disordered eating symptoms are effectively numbing deeper pain. Focusing only on the symptoms might temporarily plaster over the wound. You could be vulnerable to redirecting your symptoms in another destructive direction.

Therapies that can help: -
  • Motivational Enhancement Therapy – if you have disordered eating, you are likely ambivalent about change. This therapy helps work with your ambivalence and makes sense of it. It’s about helping you move to a place of taking responsibility and feeling more ready for change.
  • Cognitive Behaviour Therapy – a more symptom focused approach and is very helpful in treating bulimia and binge eating particularly. You will learn to identify links between your thoughts, feelings and behaviours. The therapist is directive and guides the therapy and you are an active participant in the process. You will likely use a range of diary keeping tools and thought records.
  • Cognitive Analytic Therapy – this combines developing an understanding of your past, with practical tools for new ways of thinking and behaving. You will develop a visual map with your therapist, outlining patterns in your relationships, with others and yourself. You gain awareness about cycles you have become caught in and then look for exit strategies to manage things differently.
  • Dialectical Behaviour Therapy – a therapy working in the present (similar to CBT) but with a greater focus on emotional and social aspects. It can be particularly helpful if your emotions are extreme or if you are engaging in particularly self-punishing behaviours.
  • The New Maudsley Method Family Therapy – this therapy supports carers of people with eating disorders. This is valuable work, as carers can often be drawn (without awareness) into unhelpful ways of helping. You learn skills to help support your loved one and this approach is largely motivational.
  • If you have experienced trauma, EMDR treatment Eye Movement Desensitization and Reprocessing can be valuable, as can longer term psychotherapy.

This is by no means an extensive list but gives some pointers on helpful therapies. Many therapists also work integratively and can combine helpful approaches.

What type of therapy has worked for you? Do you have an experience to share?

by Harriet Frew on January 7th, 2020

If you have been ignoring your hunger through persistent dieting or engaging in disordered eating behaviours, understandably, your body will be confused!

  • You won’t know when you’re hungry.
  • You won’t know when you’re craving.
  • You won’t trust your appetite.
  • You won’t know when you’re full.

How we learn to under-eat or starve

1.Being exposed to chronic stress impacts appetite.
2.Not having enough food available means that hunger becomes a norm.
3.Exercising as an alternative distraction from eating, hence why compulsive exercising can become dominant in anorexia nervosa.

How we learn to overeat or binge eat

1. If you are undernourished, your body will crave the nutrients it’s missing.
2. When stomach contents are drained after eating (often through purging).
3. Eating at unpredictable and irregular times; some routine and structure is helpful.
4. Eating food that is highly palatable and easy to overeat on.

If you are exposed to these triggers for overeating/bingeing, you may likely still repeat these behaviours (at least initially), even when normal eating patterns are restored.

This is a normal part of recovery. It can be tricky to hang-in there, when you are negotiating this difficult phase. You have probably lived in fear of losing control of your eating; it might feel that these worst fears are being manifested. This is in the short term. You will come through the other side. The only way out is through!

How to re-set a disturbed appetite control system

1.Eat regularly; this means no long periods without eating. This allows your blood sugar to stabilise.

2.Try to eat slowly and mindfully, so you register the food you are eating. It gives a chance for your body to respond appropriately and acknowledge your eating.

3.Work (with support if possible) on reducing vomiting or chewing and spitting; this will allow body satiation mechanisms to be restored.

4.Aim to get your weight within a healthy range.  When you are underweight, the biological drive to eat will be really strong. You will be extremely sensitive to the sight, smell and flavour of food. This will leave you vulnerable to out of control eating.

5. Develop other non-food self-care and pleasurable activities, as part of daily life.

 Choose activities that activate the left side of the brain that has the soothing system.

Eg: Touch – massage, aromatherapy, reflexology.
Smell – have a warm bath with your favourite fragrance.
Sound – listen to music that you enjoy.
Vision – make your room a pleasant environment with colours, pictures and soft fabrics.

It takes patience, time and commitment to re-set your hunger signals. Be kind and compassionate with yourself in this process.  Your body will begin to respond, as you treat it with love and respect.

by Harriet Frew on January 5th, 2020

When you don’t fit neatly into an eating disorder diagnosis

It is very common that you might not fit neatly into an eating disorder diagnostic category.
In this case, you might believe that your symptoms are not valid or that you aren’t ill enough to warrant help. THIS IS NOT TRUE.

In this case, you might be diagnosed with Other Specified Feeding or Eating Disorder (OSFED).

In the past (1987 – 2013), if you were in this category, you might have been diagnosed with EDNOS (eating disorder not otherwise specified). You may well have heard of this? Before 2013, around 50% of people diagnosed with an eating disorder were diagnosed with EDNOS (Beat website).

If you have a diagnosis of OSFED, this is every bit as valid as the other eating disorders. In fact, most people will fall into this diagnostic category.

Your symptoms are serious. They signal a coping strategy for underlying distress and difficult thoughts and feelings.

You are absolutely worthy of treatment. Your symptoms count as much as anyone with a ‘neater’ diagnosis.

Some common OSFED presentations that we see in therapy: -
  • When someone has all the symptoms of anorexia nervosa, but their weight remains in the normal range.
  • When someone has all the symptoms of bulimia nervosa but their frequency of bingeing and purging is less than official criteria.
  • When someone has all the symptoms of binge eating disorder but the frequency of bingeing is less than official criteria.
  • When someone purges regularly without binge eating.
  • When someone massively over exercises but appears to eat ‘normally’.
  • Binge eating to the point of being uncomfortably full, but not full-blown binges.
  • The list could go on........
If you recognise yourself here, do reach out and get help.

You are worthy of treatment.

OSFED is an eating disorder. Don’t hesitate to reach out.

by Harriet Frew on January 2nd, 2020

I used to dive headfirst into the deep-end of January resolutions, with enthusiastic zeal!

Following the indulgence, of one too many mince pies and not moving from the comfy sofa, the resolutions held the supreme promise and hope of transformation.

Sugar would be completely banned; a shiny, new gym membership would carve out the dream body, whilst I followed a strict regime detailing calories, steps, measurements and goodness knows what else.

Of course, it always started tremendously well.

On day one, my motivation was sky high and plans were followed to the letter. I was sure that this time, I had finally nailed it. This plan was THE ONE! I had unlocked the magical, secret to change; I’d just never had the right willpower or regime in place before.

Unsurprisingly, the zeal and optimism of day one, or even day seven in January, quickly dissipated, as the month moved on.

January is not a month for extreme, low carb diets or cold chicken salads or early morning gym visits. The dreary, dark days and the persistent cold can quickly sap motivation. Three weeks in, I was feeling ravenously hungry and irritable, like an angry bear deprived of food. I was dreading the early morning alarm clock, signalling my supposed gym visits and the body transformation was no way near fast enough.

By Valentine’s Day, the expectations and aspirations of January 1st had been recklessly abandoned by the wayside; with the need for hot dinners and sustaining comfort food sensibly winning the battle.

This was not accepted on my part, with an understanding self-compassion or wisdom of the non-sustainability of such a punishing regime. Instead, the feeling of doom and failure would set in.

‘I don’t have enough willpower; I never follow through; I’m just not good enough’.

My ‘all or nothing’ thinking would lead me into destructive and negative behaviours.

‘I might as well eat everything in sight; there’s no point doing exercise, if I can’t follow through; I might as well self-sabotage to prove how much of a failure I am’.

Thankfully, with the passage of time, I no longer take the same strategy with resolutions.

But what’s changed?

ONE: – Resolutions are no longer fixed in stone, with their achievement marked out, as the holy grail of self-worth. Instead, there are flexible goals in place and part of my longer term development. They are not unique to January alone, but part of the ongoing practice of gently chipping away at enhancing mental wellbeing, relationships; health and happiness. There is no longer a drastic, overhaul that descends on December 31st.

TWO: – I have learned that effective change comes from consistency and baby steps. And isn’t that so boring and underwhelming to hear? How we long for the magical, overnight fix to make it all better! The lose ten pounds in ten day days or transform your relationship in an hour. So rather than the exhausting workout at 5.30am, it’s about adding in that extra walk, but consistently; and instead of transforming my limited social life to friendship-queen status, it’s about making that call to my friend on a Sunday regularly and nurturing those connections.

THREE: -When you’re making change, it helps to have support around you, to stay motivated and inspired.

If you want to dance, enroll in a class with some buddies. Want to stop overeating? Join an online forum, follow some inspiring accounts on Instagram or get some counselling. Other people can be your cheerleaders and spur you on. It can be incredibly hard in isolation.
As we move into 2020, do take from this post, the tips that work for you.

Choose sustainable, achievable mini goals and work on them consistently. Don’t set yourself up with unrealistic resolutions that will be abandoned, well before January comes to a close.
Remember to be kind and compassionate with yourself in this process, as self-chastisement is not in the least bit effective for motivation.

This post is currently live at SELFISH MOTHER

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Find peace with food and overcome disordered eating.