Sandy Naiman: How I got an eating disorder at 62

If you haven't had the chance, please read this healthzone.ca article, "How I got an eating disorder at 62" by Psych Central's blogger Sandy Naiman. I found many interesting points and provided answers to my EDNOS diagnosis.

Here are my thoughts from the article:

I’m 62 and 5-ft. even. I’ve been an extreme yo-yo dieter my whole life, but it’s growing harder and more oppressive every day.

Harder and more oppressive every day is how I see my own dieting journey. Losing weight and dieting became increasingly impossible, my motivation and "willpower" to succeed was slowly replaced by anxiety and disdain of deprivation.

Disordered eating is defined as any sort of irregular eating behaviour that, while not exactly healthy, doesn’t fit the characteristics required for an eating disorder diagnosis. Chances are good that you’ve observed disordered eating at some point while listening to a group of women agonize over restaurant menus.

Recently, NEDA (National Eating Disorder Association) successfully pulled a Yoplait yogurt ad from the air due to the portrayal of diet negotiating language as healthy and normal. It's very common (I too, thought this was normal and healthy) but it's not healthy or normal. I blogged about the Yoplait ad here. 

"Anorexia, bulimia and what are known as “eating disorders not otherwise specified (EDNOS)” – including binge-eating disorder – are serious, potentially fatal mental illnesses, according to a 2011 report by the Academy for Eating Disorders (AED).

Once I stopped purging twenty years ago, I was no longer bulimic, but I knew that nothing changed psychologically. But if I didn't have bulimia, what was wrong with me? It wasn't until I entered into therapy that I learned about EDNOS, and now I can at least put a name and get treatment to get out of this hell hole.

“It’s well accepted by leading researchers that eating disorders are genetically pre-disposed, tend to run in families and have nothing to do with metabolism,” Tartakovsky says.

"Your metabolism is just slow," is a common catchphrase many well-intended people would tell me. I'm glad to know that the genetic aspect of my condition has nothing to do with my metabolism.

“Furthermore, genes turn on and off all the time,” Woodside explains. “Some genetic loading may be activated by dieting – this may be the most common environmental trigger – and other loading may be activated by other factors, such as the biological changes that occur in puberty.”

Holy cow, this is me. I discovered in cognitive therapy that all of my overeating, bingeing and obsession with junk food is directly related to decades of dieting. I can recall the feelings of dred and deprivation when my synchronized swimming coach told me to lose weight at the age of 13.

In her clinical practice, Bulik has seen adults with three manifestations of eating disorders. The illnesses can: start in adolescence and persist through mid-life, start in mid-life, occur in adolescence, with a recovery period, then recur in mid-life.

I'm the first manifestation, starts in adolescence and persists through mid-life. After 23 years, I'm tired of food and weight ruling my life.

15 MAJOR TRANSITIONS THAT CAN TRIGGER A LATENT OR FIRST-TIME EATING DISORDER

Wow, I may be on the way to becoming a normal, healthy eater who is not ruled by cravings, anxiety and five wardrobes spanning various sizes, but that can come undone by a major life-event. Good to know. 

“I didn’t want to preach against obesity,” Gura said. “I wanted to move to a better place in my life, to stop struggling, to accept myself.”

Yes, I want the struggle to end.

THERE IS HOPE

When I began cognitive therapy, I had no hope that I could change but my therapist told me that there is hope. Now, I know she was right.

These disorders are obsessions. They are not choices. They’re an irresistible urge to behave in a certain way, against your conscious wishes.

Obsession is how I often describe myself. Obsessed with the food I eat, obsessed with food I shouldn't eat, obsessed with my weight.

The addiction is to the behaviour of dieting, not the food, explains Woodside.

I didn't understand this statement until a friend said, "I know what makes me overeat, it's all about the carbs." That's when I understood it's not about the food (sweets, bread, french fries) it's about the behaviour that comes from dieting. If a diet tells me to limit carbs, I think about carbs, I crave carbs, I develop anxiety stemming from a fear of eating carbs, anxiety increases feelings of hunger, and I eat carbs to relieve the anxiety. It's not the carbs, it's rebelling from restricting yourself from eating carbs.

Both Bulik and Woodside say they are upset by the shortage of clinics and psychiatrists and psychologists treating eating disorders because they are misperceived as illnesses only affecting adolescent girls and young women.

In addition, do doctors recognize the more subtle signs of EDNOS in their patients? My family doctor completely dismissed me when I tried to get help a few years back telling me that, "dieting is hard for a lot of people."

The average waiting time for an assessment is now four months at Toronto General Hospital.

Wait times at clinics far from my house always deflated my resolve to get help. I went to a private cognitive behaviour therapy clinic. I called and had an appointment shortly thereafter. Expensive, but I was worth the investment.


What do you think? Does this article speak to you?

Previous post: French fries vs. the chef's salad

How do I lose weight & eat what ever I want?

Eat whatever you want. Eat whatever I want. Eat whatever I want?

How on earth will I ever take off this weight? I’ll always want to eat three bowls of granola for breakfast.

Then something happened in November. Instead of choosing granola for breakfast, I decided to have a bowl of Wheetabix. Wow - didn’t see that coming. Once I let go of what I could eat and couldn’t eat, the cravings for unhealthy foods declined.

“I’m ready to choose healthier foods,” I said to my therapist in January after two months of feeling liberated from the cravings, the confusion, and the struggle. “Great!” she answered enthusiastically. She must have known that I would eventually come to this conclusion.

I was surprised by her reply. I thought that in order to keep cravings and food obsession to a minimum that I would need to eat all the junk food in binge quantities that I desired. This, of course, would mean that I would always be overweight.

When I asked her how I actually lose weight, she said that many of her clients lose weight naturally since they eat smaller quantities and choose better foods. So from January until May, I started making healthier choices. But, from my clothes (and later confirmed when I actually weighed myself in March) I could tell that my weight was fluctuating, but not really go down (or up).

It took me eight months of thinking to figure it out.

Before therapy, I believed that in order to lose weight, I must be on a structured diet with strict rules and guidelines. I must count every calorie or point, meticulously plan every spoonful of food that went into my mouth and write everything down in order to control my eating. But I knew that this approach didn’t work (weight loss was never permanent) and is a big reason why food and weight is such an issue for me now.

I need to diet without a diet.

However, it’s not a diet. It’s a concept, a philosophy: eat healthy and if possible in smaller quantities. Vague, I know. Like something a doctor or a well-intended friend would say. It may not be a quick way to lose weight, but I think this is the only way to stay sane. And with 110 pounds to lose, I have to be in it for the long run.

MB, a like-minded blogger posted on her blog this morning her reasons for joining an online Slimmer this Summer challenge. One of the coordinating bloggers was curious as to why MB (as a no rule dieter) would choose to join a weight loss challenge with a set of rules. Her response sums up how I’m feeling right now about a structured diet.

After a few weeks of actively attempting to lose weight and reading MB’s posting, I realize that there are some rules that I’m following:

- No food journaling

- Flexible meal planning is helpful; meticulous meal planning is not

- Drink water as much as possible

- No food is considered off-limits, no quantity is too much

- Eat three balanced meals a day with reasonable portion sizes

- Eat three healthy snacks in between meals

- Eat every three hours

- Indulge in the occasional unhealthier food choice

- Choose the healthier food option as much as possible

- Choose smaller portions when possible

- Tackle cravings using the distract and delay technique

- Sign up for, train and complete 5K run

- Blog as much as possible

In any case, with or without Weight Watchers or Jenny Craig, you have to do what works for you.

The problem with bad foods

Eat normally, snack horribly.

For years I’ve known that I eat proper meals (balanced meal of protein, bread and vegetables), but I snack horribly. After reviewing a weeks’ worth of my eating patterns, my therapist agreed that I ate well balanced, normal meals, three times a day (thanks Mom for implanting this into my DNA). However, I also experienced both objective and subjective eating.

In basic terms, objective eating is eating a large quantity of food (example: eating a box of granola) and subjective eating is when you perceive yourself as eating a large quantity of food (example: eating two bowls of granola). Both types of eating are accompanied by feelings of loss of control.

I know I’m not the only one with a list of good and bad foods. The problem with labelling food as "bad" is that is human nature to want the something you can’t have. So a perfectly natural reaction to a bad food is to want it even more, developing wicked cravings. Over the years, cravings for bad food increased and my ability to resist those temptations decreased.

I couldn’t win: resist bad foods and I’d crave it more. Giving in to bad foods and I’d have feelings of guilt and shame: guilt for eating a bad food and shame that I was not strong enough, or in control enough to resist. No matter what I was doing, resisting or giving in to a bad food, my anxiety level increased. Anxiety makes you hungry; making it even more difficult to resist and perpetuating an endless cycle.

Limiting myself to a small portion perpetuates the same problem (say no to more, you want more even more). Wanting more but denying more increased cravings resulting in more anxiety and hunger.

I now tell myself:

• I can eat it if I really want to.
• I can have/buy/make more if I really need it.

Over time, knowing this and practicing this helped to decrease my obsession and cravings. Looking back, I estimate that this process took approximately three months, six therapy sessions and countless assurances from my therapist that eating bad foods or any foods in certain quantities of food was not as bad as I thought (such as a eating a whole box of Kraft Dinner)for my cravings to decrease.

In practice, if I decided that I really needed more (let’s say another bowl of granola), I would try to delay or distract myself with some other type of activity before consuming another bowl of granola.

 

Eat whatever you want?

“Eat whatever you want. No foods are restricted and you can have as much as you want.”

My heart sank when my therapist said this to me. I assumed that at some point after therapy that I would be able to go back to Weight Watchers or Jenny Craig and lose my weight. After all, chapter 5 of the Beck Diet Solution is called, “Pick Two Reasonable Diets.” I figured face-to-face therapy would work the same way.

Immediately I considered amending my original plan (step 1: reprogram thinking; step 2: lose weight) to (step 1: lose weight; step 2: reprogram thinking). The only problem is that dieting had become an impossible task. Every minute of a dieting day is difficult and angst-ridden. I had been down this road before with intuitive eating and frankly the idea of no structure scared the hell out of me.

And then she added: “But, you must write down what you want to eat first.” Well, I thought. At least there is some sort of structure.

Here were my guidelines:

• Prepare a meal plan for the day.

• Include details such as portion size and number of helpings.

• No foods are off-limits as long as I write it down in the meal plan first.

• If I want to eat something that is not in the meal plan, I had to plan that food or additional helping into a future meal.

• Plan my meals the day before, or any time during the day.

I already found meal planning and journaling difficult, so my first week was challenging. Even though I could plan to eat whatever I wanted, I remained paralysed from making food choices. So, with the help of my therapist, we planned a few days of meals together. I allowed for reasonable portion sizes and planned for a good mix of healthy and not-as-healthy snacks and balanced meals.

As for following my own meal plan, it went fairly well. Sometimes I found that I wanted an additional helping of something (let’s say granola) that was not planned for. The need for more granola would grow, and become focused; the only way to satisfy this need was to give in and eat the additional helping of granola. That is when I learned that the need, the feeling I was experiencing was anxiety. Anxiety from 20 years of dieting telling me that granola is bad for me. That I shouldn’t be eating one bowl of granola, let alone two or three bowls.

I asked my therapist: “What do I do to handle the anxiety? How do I make it go away?”
 
She replied: “You have to learn to sit with it. It will pass.”

Anxiety: the weight loss saboteur

Souvlaki on Monday. Roast Chicken on Tuesday. Baked Fish on Wednesday. Frittata on Thursday. Chicken Pizza on Friday.

Hubbie and I sit at the dining room table planning out the menu for the work week. For most families, this is a one person job. I, however, am unable to plan meals without assistance. My thoughts are paralysed when it comes to food. I have such a hard time making a decision about what to eat. It’s even worse if I have to make a spur of the moment decision.

This food is unhealthy. This food is too healthy. I can only have a little bit of this food. This food doesn’t satisfy me emotionally. This food is only for special occasions. I don’t like how this food tastes. This food tastes too good and I may eat all of it.

With all the diet speak and rebel against the diet speak floating around in my head; you can see why I have a tough time with meal planning.

Through therapy, I discovered that I have a lot of anxiety when it comes to food. This comes from 20 years of flipping between diet mode and planning to diet mode. You may be familiar with planning to diet mode: eating big helpings of all those off-limit foods because you will no longer be able to eat said foods once you go into portion-controlled, restricting-your-food diet mode again.

The problem with anxiety is that it makes you hungry. I suspect that many people like me do not like feeling anxiety and eat to make it go away. To tackle anxiety, I had to learn (and believe) the following:

• I can eat it if I really want it. (But, I will try to delay or distract myself before having another helping.)
• I can have more/buy more/make more if I need it.
• I'm feeling the anxiety because I think I must limit myself.
• I must learn to sit with the anxiety. It will pass.