Eating Disorders and Relationship Patterns

I've heard it said that "how you do one thing is how you do everything." Patterns we build permeate our lives. In my work with people with eating disorders, I have seen that people's relationships with food are often similar to their relationships with people. If "how you do one thing is how you do everything", then it follows that it would be helpful to notice relational patterns, put them in line with values, and capitalize on the potential for that change to influence other aspects in your life. Sometimes when you move social relationships towards values your relationship with food shifts as a byproduct.

Anorexia Nervosa

Relationship with food characterized as: avoidant, fearful, rigid, insufficient, shame around size and hunger.

How do those patterns show up in relationships? Maybe you isolate or avoid people or avoid situations (likely ones involving food, but probably others as well). Maybe you have social anxiety. Maybe you are rigid with socializing and keep a tight schedule or get nervous as plans change or interactions aren’t neat and tidy. Maybe your social interactions happen infrequently or are surface level and don’t sustain the human need for true connection. Maybe you are scared that being in relationships will feel suffocating or heavy or cause discomfort so you avoid them. Maybe you have a fear that you will be too much or need too much and end up people pleasing or keeping a distance in an attempt to stay small.

Bulimia Nervosa

Relationship with food characterized as: conflicted, chaotic, secretive, shame based.

How do those patterns show up in relationships? Maybe you seem to have a lot of conflict in relationships. Maybe you struggle with boundaries and when to say "yes" or "no" or "I've had enough". Maybe you experience extremes in relationships of being very close then very distant. Maybe you have guilt and shame over what you want or need or have done in relationships. Relationships may scare you and you struggle with keeping them in balance and tolerating the discomfort they can sometimes bring.

Binge Eating

Relationship with food characterized as: lacking boundaries, lacking sense of control, soothing or escapist.

How do those patterns show up in relationships? Maybe you struggle with knowing how much to give in relationships and end up people pleasing or going past your limits with relationships. Maybe in relationships you feel like you don’t have a voice or that voice isn’t respected when you set boundaries or express needs. Maybe you have a difficult time being alone and find people to fill your time, even when you know those people aren’t "good" for you. Maybe you have codependency traits and regulate your mood through focusing on others.

These lists aren’t exhaustive by any means and don’t account for individual differences. My intention is simply too spark curiosity. It’s not helpful to judge or justify patterns. Better to simply observe and then do what you can to align food and relationship patterns with long term goals and values.

If you notice that you resonate with any of these food or relational patterns, we are here to help. Please reach out by phone or online and we will be happy to talk with you.

Healing From an Eating Disorder

While all eating disorders are different in terms of primary symptoms, anorexia nervosa, bulimia nervosa, and binge eating disorder all center around a dysfunctional relationship with food, weight, and appearance. But compulsive behaviors and obsessive thinking around food, weight, and appearance are only the tip of the iceberg of an eating disorder. 

Below the surface, we see that those behaviors could be a result of mental health issues, trauma, grief and loss, identity and societal pressure, gender and sexuality, or attachment wounds…. and not uncommonly, all of the above. A person with an eating disorder isn’t being vain or picky or selfish or sneaky or whatever by focusing on food, weight, and appearance, they’re just trying the best they can in the way they know how to cope and keep it together. 

Using an Eating Disorder to Cope 

People use eating disorder behaviors because (unfortunately) they work. Food and exercise impact our body chemicals and physiology. They can help ground and soothe anxiety and trauma by helping distract by focusing on food instead of pain or mindlessly eating or exhausting your body through exercise or being too hungry to feel emotions fully. They are also a way to have control. Maybe you can’t control your mind or your family, but you can always control your food and appearance. Everyone has their own specific ways and reasons why their eating disorder works…until it doesn’t.

Healing More Than Just an Eating Disorder 

Healing an eating disorder is complex in that there are usually hidden aspects of the person's life that lead to using food as a form of control. It does take  healing the relationship with food but, more often than not, that comes through healing the relationship with self and others that either were broken before the eating disorder or got broken as the eating disorder took over. 

Just focusing on food and weight in treatment would be a bandaid on a broken bone (at best).  Healing looks like attending to all those underlying issues and not just focusing on the eating disorder. The eating disorder was there to do a job (manage a complex, painful, and challenging life) and our mission in therapy is to heal old wounds and add new tools and skills so that the eating disorder is no longer needed. 

Because eating disorders can be quite damaging and even lethal, they often aren’t just treated by a therapist. Depending on the severity of symptoms and health issues, treatment often also involves a medical doctor, registered dietician, or psychiatrist. If they’re caught early or in less severe cases, these may not be as necessary as often, but like all eating disorder treatment, those decisions come on an individualized basis. 

Eating disorder treatment is slow, complex, and challenging but also rewarding, transformative, and, most importantly, possible.

Thanksgiving Day Tips for People with Eating Disorders

Thanksgiving can be hard for everyone.

It's a lot of people, a lot of preparation and clean up, and of course there's all manner good old f-ed up family dynamics. But this food focused day can be exceptionally hard for people with eating disorders to navigate. Here's a few quick tips to help you deal with an eating disorder during the holidays.  

1. Keep your routine as normal as possible. Don't restrict or skip meals before dinner. Doing that may make it feel more safe, but it actually sets you up to be more anxious, less present, and more likely to struggle with diner if you go into the meal super hungry.

2. Don't spend extra time around the food. Limit time in prep and clean-up of food. Being around the food more than necessary may keep you focused on food and more likely to be anxious, calorie counting, or triggered to binge. Instead, see if you can spend time with friends and family outside the kitchen. When possible, before and after the meal, distract, distract, distract.

3. Don't drink much, if at all. That will make staying centered and grounded and connected more difficult.

4. Remember that it's just one meal. Regardless of culture and family messages, thanksgiving doesn't have to be a gluttonous free for all. It's just a meal. No need to eat past fullness. That being said, it's just one meal. Even if you eat more than you usually do, you may feel uncomfortable and at the same time you're safe. Your anxiety and fullness will pass. One meal doesn't make or break your life or your body. Usually bodies are far more flexible and forgiving with food than your eating disorder mind is.

5. Try to redirect your focus from food to gratitude and family. Food doesn't have to be the centerpiece of your day. The day originated as a way to celebrate friends and family and give thanks. Don't let your anxiety and eating disorder rob you of that. The meal can be challenging AND you can still feel and focus on gratitude. Be grateful that you have a meal to attend, that you are brave for showing up, that you have values you are moving towards (connection, family, love, humor, integrity, etc.) that are more important than your eating disorder.

If you or a loved one are struggling with an eating disorder, we are here to help. Contact us to schedule a consult.

That's Not Paleo

The paleo diet is about getting back to doing things how our ancestors did them. Great concept, but, thanks to marketing and bro-science, it may have led some people astray.

Just like with the Paleo diet, I believe we should be mindful of eating processed, packaged foods. I think we should be thoughtful about eating nutrient dense foods and not just eat whatever hyper-palatable shit pops up in front of our face. But at the same time, I don’t think we need to be food phobic and weigh and measure food, including every grain of quinoa, count every calorie we consume, and eat exactly the same meals day after day. That’s not what the cavemen did. They didn’t prove worth or exert control by being restrictive or disciplined with food and they probably didn’t freak out about how a night of consuming bear, berries, and beer around the campfire would fit into their prescribed macros. Cavemen  ate to survive and have energy to do tasks. They ate communally and were grateful for food.

I also believe in a healthy exercise regimen. I think we should move around, run, and lift heavy things to stay healthy and fit. Cavemen did those things to provide food and shelter and to play, not to punish themselves,  to compensate for the food they ate, or to compete to the point of injury. They probably didn’t say "well, my garmin says I ran five miles at 10mph yesterday to catch that deer, so today I have to run at least that far and I need to run it faster."

Several of the clients that see me for eating disorder therapy reported their eating disorder started innocently, in the name of going paleo. It then blossomed and was concealed in the context of restrictive diets and excessive crossfit workouts. Without a solid sense of self we can find identity in diet and lifestyle trends. Without mindfulness and ability to trust our intuition we can fall prey to relying on rigid rules, restrictions and regulations. The Paleo diet goes bad when we focus on  "WHAT cavemen did" and forget  "WHY caveman did it". They did it probably for two reasons: 1. Survival and 2. Community. If your diet and exercise are not helping you live your best life and connect with your family and community, it might be worth looking at it and asking yourself "what would a caveman do?"

If you are struggling with an eating disorder, or think you might be on the brink of an eating disorder, call us and we can help you work through it.

Clean Eating or Orthorexia?

Food can be complicated these days.

We are bombarded by messages about what's healthy and that can change on the daily. First, fat's bad...no wait, carbs are bad, fat is great, don't eat carbs just bacon and butter...all day...oh, but not coconut oil, it's the devil! Ok...maybe they don't say all that, but they might as well, at least then we'd know how whack those headlines are! So what are you supposed to eat to be healthy these days?

In the midst of all the noise, a lot of people have adopted "clean eating." Great. Reduce chemicals and highly processed food. That makes sense. And it does, but with all good things, balance is still needed and people can take it too far.  And that's where orthorexia can sneak in.

The National Eating Disorder Association states that someone who has "an “unhealthy obsession” with otherwise healthy eating may be suffering from “orthorexia nervosa,” a term which literally means “fixation on righteous eating.” Orthorexia starts out as an innocent attempt to eat more healthfully, but orthorexics become fixated on food quality and purity." (https://www.nationaleatingdisorders.org/orthorexia-nervosa)

So how do you know you're dealing with orthorexia?

1. Your gut nags at you sometimes when you're quiet and dialed in and whispers that something is off. Maybe even now you're fighting that voice or wanting to click to the next blog.

2. Clean eating has taken priority over other values and goals and commitments. Maybe you don't go out with friends as much. Maybe you lie or make excuses to avoid situations where it's not organic or clean food. Maybe you're more focused on the food than the fun or connection in life.

3. You're dealing with anxiety. Managing food or making sure you only take in clean foods makes you anxious. Or you have extreme anxiety or guilt over eating something non organic.

4. Food takes on value and dictates your value. Food gets judged as "good" or "bad". And since you are what you eat, you label yourself "good" or "bad" based on what you eat. Maybe you've become judgy of others who don't eat like you. Maybe you punish yourself by being mean or super restrictive if you stray from your rigid rules.

Being healthy means being mentally healthy too. If the way you're managing your physical health is impacting your mental health, we can help. Contact me today. You're worth it!

Holiday Survival Strategies for People Struggling with Food

Holidays are wonderful time to celebrate with family and friends. They also tend to be food centric. Everything from Thanksgiving dinner, to Halloween candy, to cookie decorating, leaves us with a lot of food and sweets around. Not to mention all the emotions that come up around the holidays and family gatherings. While there is nothing inherently wrong with this, it can be especially challenging for someone with an eating disorder.

If you are struggling with being triggered to binge, here are some strategies to manage urges:

1. Notice the urge to binge as a thought or craving and not an imperative (just because you think about eating that plate of cookies doesn't mean you HAVE to have it)

2. Drink a glass of water. Sometimes we confuse hunger and thirst so this may help you assess if you are feeling actual hunger. It also buys you some time to evaluate your options and ride out an urge.

3. Take 20 min. Food will still be there when you're done but your emotions and urges may have settled a bit. During that time, do a mindfulness activity to switch focus. It’s not helpful to just obsess about food or binging for 20 min.

4. Consider HALT (hungry, angry, lonely, tired). Maybe the urge is a result of one of these in which the solution isn't necessarily "eat all the chocolate".

5. While food rules can be tricky, a decent food rule for someone dealing with binging behaviors can be "I need to eat it around people". If you want chocolate, enjoy it, don't hide it, eat it in a social context to avoid overdoing it.

6. Make sure you're fueling consistently. Don't restrict calories or exercise a ton or purge meals to compensate for potential calories over the holidays. It may sound counter intuitive to eat consistently, but not doing that just keeps you in the cycle of binging because you have actual hunger and low blood sugar which can make you confuse hunger cues and binge urges, make you more impulsive, and make you more vulnerable to overwhelming emotions, all of those make challenging binge urges harder. It’s hard enough.

7. Set an intention. Instead of going to an event or going through the season being at war with food, try to shift the focus. While food is still there, it’s often helpful to go to a party with your focus on your friends, gratitude, being present, feeling proud of yourself, laughing, etc. Think of how you want to feel about yourself during the party. Or how do you want to feel physically or emotionally in the moment. Find something that is more important than food and stayed zeroed in on that as much as possible. It won't make urges go away, but having an intention can add much needed ammunition to the fight to overcome urges.

If you or a loved one are struggling with an eating disorder, try to be gentle and show grace in this tough season, and don't hesitate to reach out for help. We're here for you.