What EDNOS means to me

NOTE: This is my comment in response to Nicole's of nicoleandgwendolyn.com's blog post: I have homosexuality. Her well-researched and thought out blog post outlines why she does not believe in EDNOS. I've been wanting to write about what EDNOS means to me for a while, so I copied my comment into a post. 

Sometime in the early 90s, I was reading a book on a train ride home from Ottawa. I honestly don’t remember the name of the book or its author, but it was about compulsive eating. Something about making promises to oneself. With that I made my own promise: I will stop purging and just allow myself to put on weight. And with that promise, I stopped purging. (I thought that I can always diet to lose the weight later.)

But, nothing else changed. I still had the bulimic thoughts and mentality. I still binged, but I allowed myself to gain weight. When I became “too big” I went on a diet to compensate.

What was wrong with me? I knew that when I stopped purging that I had not fixed anything. I knew I was still f***ed up. Am I a recovered bulimic who is doomed to struggle every day for the rest of my life to not eat everything in sight?  Just because I stopped purging I was now normal?

I can tell you that in a blink of an eye, I was not fixed/recovered just because I stopped purging.  

Because it’s not about fixing the compensatory behavior, it’s about fixing the mentality. Some of us purge, some of us exercise, some of us stop restrict, some of us chew/spit and some of us gain weight and diet thereafter.

In my case, I replaced purging with dieting as a compensatory behavior. Sure, dieting isn’t as dramatic, but it is still a behavior compensating for the eating disorder mentality. (Unfortunately, dieting is common and viewed as a safe and effective way to control eating, when it is an eating trigger.)

I’ve been struggling with eating, weight and food for more than twenty years. I’ve been searching for answers and seeking help.  In 2010, I decided to see a cognitive behavior therapist and she provided me with an explanation for my constant struggle: an EDNOS diagnosis. More importantly, she helped me to change my negative eating behaviour.

I don’t use it as an excuse; EDNOS verified what I had suspected for years: that there was something wrong with my thinking and that what I was thinking was not normal. 

Upcoming posts (not necessarily in this order):

• I'm fat: is there something unresolved in my life?
• More on a food neutral household
• With respect to food, I've been a four year old preschooler for most of my life
• Blog anniversary - including my first giveaway!
• Lunchtime logistics
• Start a new healthy habit - seriously, it's coming

Weight watching in gain mode

Karen @ Waisting Time wrote how the numbers on the scale affects how she feels depending on the direction the number is going (going down feel great, going up feels fat). I was reading the comments from her post (Karen's warped theory of relativity) and could completely relate to Muchberry's comment, "I travel to the land without scales when I gain weight" because I too avoid the scale when I'm in gain mode.

But then I remembered that is not entirely true. I'm at the heaviest weight in my life and I witnessed the pounds piling on and the numbers on the scale going up; weigh in after weigh in.

Of course, I would have happily avoided the scale, but unfortunately when one is pregnant, one's doctor weighs you. I was nervous for my first appointment, I had not weighed myself in a year so I knew the number was going to be a shock. Shock it was, I gained 30 pounds in a year (after a year of restricting, I followed up with a year of overeating).

Considering how the hunger hit like a cement truck in the first trimester, I was pleasantly surprised that the weight gain in the second appointment a couple of months later was only two pounds. But after that, the scale indicator didn't stop moving to the right. I even managed a five pound gain in one week. The nurse was positive it was an error (that can't be right) and weighed me again (wow, that is not a mistake).

Not all the weight was a true gain. I was trying to finish some stuff before the baby arrived; complete another class in the magazine publishing certificate program, finish upholstering a pair of club chairs in a re-upholstery workshop plus we were implementing a new online application at work which meant 12 to 14 hour workdays and overtime on weekends. Apparently it is important to put your feet up as much as possible, I retained a boatload of fluids: the swelling in my legs came to my my knees, I was unable to sleep properly during the third trimester and the water in my arms induced carpal tunnel syndrome so I wore wrist guards all day and all night.

The weird thing was that with all that weight gain, my senses dulled to the perpetually increasing number. I was thankful when the gain was limited to one or two pounds and downright delighted on the single occasion that there was no weight gain. But it was impossible to comprehend what I was seeing on the scale, I dismissed it by telling myself that I'd lose it after I was finished having children.

Now here I am, two little boys later and 75 pounds heavier than what I weighed on my wedding day five years ago. In stark contrast to the time that I put on this weight, I'm acutely aware of every pound that I lose and have yet to lose.

I'm kicking myself for not getting help for this eating disorder before I got pregnant - well, sort of - the important point is that I did get help.

Did you gain your weight slowly over many years or did you gain your weight quickly?

Previous post: Dietary Assessment

A post about "Maggie goes on a Diet"

“Hey Tania, there is a new children’s book coming out this fall. It’s called, ‘Maggie goes on a Diet.’ Izzy left a link to the CTV news piece on my facebook page.”

Tania’s eyes widen in disgust. Tania doesn’t have a weight problem, but we often talk about weight issues, eating disorders, walkable communities and the North American eating culture.

“It’s about a 14 year-old girl named Maggie who decides to go on a diet after being bullied and teased. She exercises and eats well and loses weight. In the end she is popular and becomes the star of the soccer team. It’s aimed at girls as young as five.”

“Five?” she says in shock.

“Disgusting eh? Sure, there are good messages in the book such as eating well and exercising. But why does the author need to focus on stereotypes? There is the bullied, ostracized fat girl; the thin, popular athletic star; girl bingeing in front of the refrigerator. Why does the book need to be so obvious? The book can focus on the eating and exercise but you don’t have to call it a diet.”

 “Why couldn’t the story be about Maggie getting on the soccer team?” Tania says.

“Exactly! That’s a great suggestion.”

“But it’s a business. It’s easier to market and make money with a straight-forward message.”

“It’s not even published yet and look at all the free publicity! Apparently the author is shocked by the controversy about his book,” I reply.

“Well, many people including the author don’t understand the negative implications of dieting, especially at such an early age.”

“Agreed. Dieting is one of the most common environmental triggers for eating disorders. I’ve battled two types of eating disorders since I was 15, set off from the pressures of dieting. Sure, not everyone who reads this book will develop and eating disorder, but I suspect that many at risk children will be drawn to this book like a moth to a flame.”

“Like the little girl in the CTV news piece. She wants to read the book because she ‘feels fat about herself.’ She’s not remotely overweight. She looks younger than 12.”

“If that’s not a wake-up call, I don’t know what else is,” I reply sadly.

If "Maggie goes on a Diet" disturbes you, sign the petition here.

Previous Post: Sandy Naiman: How I got an eating disorder at 62

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

What's the big deal with the Yoplait yogurt TV ad?

A thin woman looks longingly at a large raspberry cheesecake in the refrigerator. The woman attempts to decide whether or not to eat a slice of the cheesecake:

“Oh cheesecake! What if I had just a small slice, I was good today. I deserve it!

Or I could have a medium slice and some celery sticks and they will cancel each other out. Right?

Or… Ok I could have one large slice and jog in place as I eat it.

Or…Ok. How about one large slice while jogging in place followed by eight celery slices?”

The thin woman is joined by a thinner woman who says she’s been thinking about raspberry cheesecake all day and grabs a cheesecake-flavored Yoplait yogurt. The first thin woman comments to the other thin woman that she has lost weight and also grabs a Yoplait yogurt.

Recently, NEDA (National Eating Disorder Association) in the United States managed to get this ad for Yoplait yogurt pulled from the air. From some of the comments regarding this article, many people do not understand the problem with the Yoplait’s television ad.

So what is the big deal? What is wrong with this ad?

There are two issues that I have with this commercial:

1) What message does it send when Yoplait picked these thin actresses to represent their target market? Both women are thin and both these thin women were hired to play the role of women still wanting/needing to lose weight. When is thin thin enough? The media continually reinforce the idea that you can never be thin enough.

2) The first woman is trying to figure out how she can somehow eat less, eat differently and/or exercise so she can have a slice of cheesecake. Although this behavior is common, it is not normal. I frequently negotiated with myself to eat desserts (including cheesecake), movie popcorn and even an extra serving of arrowroot cookies. And showcasing this language, this behavior in a television ad only reinforces the belief that this is normal.

The second point is the reason why NEDA asked for this ad to be pulled. From NEDA’s press release: “The language in this advertising campaign was seriously problematic for those affected by eating disorders and anyone who may have a predisposition towards developing one.”

You may do this food bartering now. I think it’s safe to say that this is common practice in the dieting world (common enough for an advertising agency to develop a 30-second TV spot). Until cognitive therapy, I thought this rationalization was a normal dieting strategy. But it is not healthy or helpful in weight loss. It is just another symptom of the psychological damage of serial dieting.

A raspberry cheesecake would not cause such an obsession and turmoil in a normal eater. A normal eater would decide to have a slice or not and quickly forget about it. For others who are not normal eaters this internal debate shows the stress, anxiety and obsession that restricting oneself to eating only “good” foods, no eating an "bad" foods and eating in limited portions. And as I’ve said previously, anxiety makes you hungry, eating relieves the anxiety but perpetuates the gain/loss, anxiety/hunger cycle.

This is not to say that every person following a diet will end up with an eating disorder or has an eating disorder. Many people can forgo a slice of cheesecake and not give it another thought. Obviously, to lose weight, one will need consume fewer calories than the body burns. Eating the raspberry cheesecake flavored yogurt instead of the real thing may be a suitable compromise.

Before therapy, if I said no to the cheesecake, I would obsess about the deprivation for days. This obsession would trigger a binge; eating everything available to make up for the cheesecake. Now, I make a decision to either eat a slice or not. If I eat a slice, I’ll ensure that enjoy and savor the flavor and creamy texture. If I decide to skip the cheesecake since I'm trying to lose weight, I say no thanks and forget about it.

Sarah, thank you for bringing my attention to this story and for commenting on my SYTYCD/Gatorade post; I sent an email to NEDA and I will post when I get a response.

So what was the damage from my french fry and baked goods filled Newfoundland vacation? Shockingly I lost a quarter pound.

Next post, I will continue my review of intuitive eating...

Annoyed by Gatorade's Infomercial on SYTYCD

Excuse the interruption, but was anyone else completely annoyed by Gatorade’s infomercial on last night’s episode of So You Think You Can Dance?

If you don’t watch SYTYCD, or you missed last night’s episode, Heidi Skolnik, a nutritionist from Gatorade stopped by the dancers’ apartments and swept through their kitchens like a tornado, passing judgment on their food choices with a patronizing attitude.

To the boys: “one sleeve of snack crackers has about 570 calories,” and to the girls: “did you know when you eat a sleeve of these snack crackers you can could have actually had two ice cream sundaes?” “Who is claiming this?” she says holding a box of ice cream and all the girls point towards the offending owner (can’t really tell if that is Melanie or Sasha). “Pizza with meatballs?” she questions the boys.

Heidi is representing Gatorade, so she presents the line of Gatorade G-series fit thirst quencher drinks, protein shakes and energy bite bars for before, during and after training or performing. The dancers rush to claim the Gatorade swag. The cameras capturing their approval after sampling the thirst quencher and energy bite bars.

The package ends with the contestants throwing away the condemned food. The girls gathered around the garbage bin and Ashley sadly remarking, “I need a hug.”

I wasn’t annoyed by the product placement (although hopefully it won’t escalate to the point where the choreographers incorporate Gatorade-drinking and energy-bite eating into the routines) or the G Series Fit lecture (hydration, electrolyte replacement and carb loading; all very important for athletes) and gift bag (hey – they are sponsors of the show).

I was annoyed by Heidi’s disapproving no-bad-foods-for-you, all-or-nothing attitude; planting the seeds of diet mentality paranoia to the dancers surely training (burning off the 570 calorie snack crackers and a meatball pizza in no time) and / or performing most of the day.

What happens when you are told you can’t eat something? You want the forbidden food even more. I felt as if I was watching the girls taking their first steps towards an eating disorder.

This hit close to home for me, since I have anxiety associated with “bad” food and dieting and the roots of an eating disorder began when I was an elite athlete in competitive synchronized swimming.

I can only hope that the finger-wagging from Cat, the junk food inquisition along with a teary farewell around the garbage bin was put on for dramatic effect. That, in reality, Heidi emphasized the importance of choosing healthy foods as much as possible, offer healthy options for those with a taste for junk and remind them that they can have a bowl of ice cream if they really want it.

And for good measure, perhaps next year Gatorade can throw in a sports psychologist too.

Not a normal eater

“You just have to stop eating so much.”

My friend’s words irritated me. Of course I know that. I’ve been dieting on and off for years. It was the final trimester of pregnancy, and I was starting to think about the daunting task of losing all the baby weight.

I responded: “I’m telling you, there is something different between you and me. You don’t think about food the same way I do. You don’t obsess and think about food every minute of the day. There is something wrong in my head and I don’t think there is any point in attempting to diet unless I address that first.”

My friend is one of these people who can have a box of cookies sitting on her desk for weeks at a time. She has never struggled to lose or maintain weight. She is a thin person and thinks like a thin person. I have no doubt that if her brain and thin thinking could somehow be inserted into my head that she would have an easier time losing the baby weight (and more) that I’m currently lugging around.

I was going to do things differently this time. This time, I had a new plan: step 1: go to therapy and reprogram my thinking. Step 2: start diet and lose weight. In September 2010, I was ready to implement the plan.

In the first appointment we talked about my eating/weight issues history, including bulimia, perpetual cycles of weight loss and gain, countless Weight Watchers' memberships, and previous attempts at therapy to address these issues.

I developed bulimia shortly after retiring from seven years as a competitive synchronized swimmer. Even though I stopped purging twenty years ago, I continued to binge-eat (or perceive myself as binge-eating) and never resolved the underlying issues of the eating disorder. I learned that my suspicions were correct and that I am not normal eater, and I have an eating disorder. It's called Eating Disorder Not Otherwise Specified (EDNOS).

We discussed what I wanted to get out of therapy and setting goals; having a normal relationship with food. I want to be a person who can have ice cream in the freezer, chips in the pantry and a bag of cookies on my desk. I don't want to be ruled by cravings and feelings of guilt and dissatisfaction. I told my her that I wasn't hopeful that I could change. Without skipping a beat, she told me that I should be hopeful.