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6 things I wish I knew when I started recovery

I first developed an eating disorder when I was 13, but it wasn’t until I was half way into my undergraduate degree that I faced the harsh reality of my eating disorder. When I was in my third year of university, I started to cope with stress using very problematic eating disorder behaviours. Things escalated quickly and I had to leave school for treatment. Beginning then, I became aware of how destructive my eating disorder was, and wanted desperately for things to change. However, in the beginning I struggled greatly with having a clear perspective of what was conducive towards my recovery. Today, things have improved immensely and I now wish I could go back to my younger self and tell her what I now know about recovery. Here are the 6 things I wish I knew when I started treatment.

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How Does Perfectionism Perpetuate Eating Disorders?

When perfectionism was assessed across different stages of eating disorder recovery, it was found individuals who were fully recovered had slightly lower level of perfectionism than those with active or partially recovered eating disorders (Bardone-Cone et al., 2010). Therefore, levels of perfectionism may depend on the stage of recovery the individual is in. Luckily, recovery from both symptoms of perfectionism and eating disorders is possible.

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What I Learned During My First Holiday Season In Recovery (Part 2)

*This blog was written by an individual with lived experience with an eating disorder. Content may by triggering for some people and the advice provided is based on the author's experience and should not be taken as professional or medical advice.

By: Sarah Braun

 

4. My Ability To Accept Love (and Gifts)

The month of December is a very busy, exciting and celebratory time in my life. Aside from Christmas, I also have the joy of celebrating my birthday and sober anniversary. My first year in recovery being mere days after my birthday, I decided to celebrate turning another year older and my success by paying tribute to all my hard work surrounded by my loved ones. Up until my 28th birthday, I was convinced I would be part of the “27 club”. In the past I had never wanted to make my birthday a big deal. Partially because I felt I didn’t deserve to be celebrated and partially because I was scared of the shame I would feel, if and when, nobody showed up; I felt as though someone like me, who felt was such a burden with my eating disorder and addiction didn’t deserve to feel loved or be celebrated. Over the course of my recovery, that mindset has changed. I deserved to be loved then, just as I much deserve it now. I only wish I knew that back then. 

As friends and family flooded in and gathered around the table I was overwhelmed with a sense of love and pride. I was swarmed with tight hugs, warm comments, thoughtful cards and precious gifts. A part of me still felt undeserving of these acts and the love being shown, however I’ve learned to combat those negative thoughts and accept reality for what it is. Therefore, I allowed myself to embrace it all. The love I felt in the room that day was something I had never experienced before and it’s all because I was open to accepting it. Had that love been there all along? Maybe, I’ll never truly know. All I do know, is that in the moment, everything I had ever wanted was surrounding me.

 

5. Anxiety & Triggers Are Still (Very) Real

The holidays can be a stressful time of year for anyone, not just those who live with mental illness, although that does (in my opinion) make it that much harder. This year I went into the holidays determined to make it my best one yet, as it would be my first Christmas in recovery and I wanted to prove that all my hard work has paid off. Turns out, the expectations I had for myself were set too high, and they were ultimately unrealistic. In my mind, I had convinced myself that I was far enough along in my recovery that fear foods and calorie counting wouldn’t get the best of me and that I could handle whatever came way. I believed that I could cope with being around those who were using my drug of choice. I thought that the drunken behaviour and words of others wouldn’t effect me or trigger flashbacks to my previous self. Turns out, I was wrong.

I have just over one year clean and sober under my belt, and have been committed to recovery from my eating disorder for the same length of time. I learned very quickly that the addiction and eating disorder do not care. There is no time limit, or finish line - they are relentless. To be honest, I already knew this, and perhaps was in a bit of denial. Or maybe I just hadn’t been exposed to the situations and triggers that I encountered during my time home. Either way, anxiety is still real, regardless of how far along you may be in your journey. It can still effect how you react and handle events in your life, expected or unexpected. I am not as invincible to reality as I once thought. Some meals were extremely overwhelming and I caught myself counting the calories or justifying and minimizing my portions. Some days I hated not being able to calm my nerves with a drink. However, I got through each day.

My holidays weren’t perfect - from from it actually. Looking back, I’m happy that they weren’t. I’m grateful I was put in uncomfortable, unfamiliar and triggering situations. I’m glad my emotions were all over the place and my anxiety sky-high at times. Rather than sailing through on smooth seas, I learned how to navigate my recovery over rough waters I hadn’t yet been through. 

 

6. I Can Survive

With the holidays now over, I have been able to take some time to step back and reflect. And guess what? I survived, I’m here to write about it. My body didn’t spontaneously combust because I indulged in some holiday treats. My heart didn’t explode from what felt like paralyzing anxiety. I didn’t miss out on, or not have fun at gatherings because I’m sober, quite the opposite actually. 

I had my reservations about what the holidays in recovery would look like and what they would entail. This was a whole new territory for me, my recovery and my life. Despite some moments being terribly difficult and challenging my recovery, others were incredibly powerful and I learned more about myself, my strength and my ability each time. The skills I have learned and have been practicing over the past year helped me stay afloat as I used them more than ever during this high pressure, high stress time. I continued to label my anxiety, and all my emotions for what they were, why they were there and what they were telling me. I acknowledged my triggers and rerouted my automatic thoughts. I took time to incorporate some much needed self-care into each day.  Overall I survived, and most importantly I learned that I can bounce back from a tidal wave of emotions and slippery behaviours that I once  was convinced would be the death of me.

The holidays no longer need to be a time of year to avoid or fear anymore. With recovery, they can be enjoyed, experienced and appreciated. It is by no means easy, but it is possible - just like recovery.

 

What I Learned During My First Holiday Season In Recovery (Part 1)

By: Sarah Braun

*This blog was written by an individual with lived experience with an eating disorder. Content may by triggering for some people and the advice provided is based on the author's experience and should not be taken as professional or medical advice.

1. It’s Not Bone-Chilling Cold  

Living with an eating disorder brings with it an unbearable cold. For many years my body was unable to keep itself warm and regulated in the summer months, let alone the colder ones. I had always dreaded the dark and chilly days of winter. I would drape layer upon layer of clothing each time I left the house and nothing would suffice. Being inside wasn’t any easier. The thermostat would constantly be set at what others would call ‘sweltering temperatures’ and even then, my hands were ice and my body shivering. I would try my best to erase the continuous chill in hopes that alcohol could warm me up, but it was never successful. Nothing was able to comfort me from that bone-chilling cold. 

This year is vastly different. My body is now in a place that is able to sustain warmth. My blood circulates properly and I have a healthy amount of fat cushioning my bones to protect me from the elements. I have found myself numerous times venturing outside in nothing but a light jacket or sweater in what are supposed to be winter months. My wardrobe has greatly expanded and activities now seem unlimited. Sometimes it feels as though I’m experiencing a whole new season. As any winter, there are still cold days and I have to remind myself that it’s not just me experiencing them - that’s a true reflection on the weather and I am grateful that I am alive to feel it. I sometimes find myself waiting for that relentless and unbearable cold to return, but it hasn’t and I don’t plan on letting it. 

2. Having People To Shop For Is A Blessing

I have always enjoyed shopping for others, and as I spiralled more and more into my eating disorder and addictions, that enjoyment faded. Perhaps it was because I felt as though I no longer had anyone left in my life I could shop for. Who would want to spend the holidays with an alcoholic? They’d likely just toss it to the side or into the trash because it would remind them of the girl with the eating disorder. It wouldn’t bring joy to anyone because it came from the sick, lost and dying girl. Perhaps my gift-giving passion began to falter because all I cared to spend my money on was drugs, alcohol and food that would later end up in the toilet. I was self-centred in my thinking and would rather forget about the holidays altogether with my unhealthy coping strategies. Either way, in the past, this time of year always loomed over me. I would spend hours questioning my existence, my sense of belonging and the burden I believed I brought to the lives of those I loved.

Being in recovery for the first time since I was 10 during this holiday season has been so much fun. I spent the weeks between Halloween and Christmas carefully planning, shopping and making gifts for the incredible people I have in my life. I’ve heard it said that giving is the best feeling in the world, and now I can confidently agree. I had never truly experienced the joy that came with it until this year. As I was out in the hustle and bustle of the holiday season it dawned on me what a blessing it is to have people in your life to shop for during this time. I was overwhelmed with happiness thinking of all the special relationships I have in my life today that I would not have if I did not choose recovery. Even more exciting than the planning and effort that went into each gift, was the expression on their faces as they opened them. The time and thought dedicated to each one had truly shined through. As I no longer spend my time and money centred around my addiction and eating disorder, I was able to show my loved ones just how much they mean to me. Something I was unable to do during my struggle, as I constantly pushed people away trying to isolate myself completely. Now, I know Christmas is not about the presents under the tree, but instead about the people around the tree, and this year I’m beyond grateful that I have people around the tree to give to.

3. I Enjoy Eggnog 

The holiday season is very much known for indulging in both food and alcohol. In previous years, I refused to enjoy the snack trays and appetizers set out at parties or even sit down for Christmas dinner with family. Instead I filled my stomach with alcohol and spent my time at whatever establishment was open when I needed to escape.

A well-known holiday favourite of course is egg-nog. Throughout the course of my illness this drink terrified me to my core, and I steered clear of any offerings. Even if it was an alcoholic version of the drink, I would not allow myself to taste a sip, paralyzed by fear of extra calories. I spent the majority of my life telling myself and others that I simply did not enjoy the taste. Being in recovery for the holidays this year, I wanted to re-test that disordered assumption. Therefore one of the goals I made over the holidays was to try eggnog. To my surprise, I enjoyed it. I will admit thoughts of calories still swirled in my mind as I enjoyed the thick and creamy beverage, but I liked it nonetheless. I did not let it impact or dictate the rest of my evening, and more importantly, my meal plan. It is normal to indulge a little over the holidays and I refused to let my eating disorder take control and ruin yet another Christmas. This year I was able to sit down with my family for dinner without a tense and strained conversation. The humour and love in our home had returned.

I wish I could say that I made it through the holidays without an eating disordered thought, or craving for alcohol, but I did not. Even though I am in recovery, I still struggle with thoughts and urges from time to time. The only difference this year is that I did not act on them. Some days were harder than others, but through it all I learned that the holidays can be fun without alcohol and that enjoying the specialty treats, like eggnog, is okay (and delicious!)

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In light of the retraction of Brian Wansink’s work, should we still be working on mindful eating?

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You may have heard Brian Wansink’s name before, or at least might be familiar with his work. For more than two decades, Wansink researched what he coined ‘mindless’ eating. Some of his many ideas around food include the idea that we eat larger portion sizes when eating off larger plates, and that we eat larger portion sizes when distracted. Throughout his work, he makes suggestions around how we can modify our environment to manage our portion sizes and eat amounts that are right for our bodies. In 2016, however, evidence began to mount that there were problems with Wansink’s work. By fall 2018, fifteen of Wansink’s studies had been retracted (that’s a lot!) prompting his resignation from Cornell University.

Throughout the process of eating disorder recovery, it’s common for individuals to learn about different types of eating, such as mechanical eating and mindful eating. It’s common to be encouraged by health professionals, myself included, to begin to notice and relearn how to listen to the physical signs of hunger. If Wansink’s work is discredited, does that mean that all of that advice was wrong and that all of the work you’ve done on mindful eating was in vain? I don’t believe so.

While the size of your plate, your company at the dinner table, or the size of your food packaging may not make as much of a difference as Wansink thought, I still believe that there is value in the idea of mindful eating. I think this situation is a good reminder that eating is a tricky thing. We eat for a lot of different reasons, which means it’s important to approach eating with a variety of strategies.

Many individuals with an eating disorder have spent a long time ignoring physical hunger cues or may have a very erratic food routine that makes it challenging to interpret physical hunger cues. I believe that there is a lot of value in working to notice and reconnect with what physical hunger looks and feels like for you. Practicing (yes, it takes a lot of practice) mindful eating can teach you many things. To name a few, it can help you learn about your body’s needs, how certain foods make you feel physically and mentally, and what foods you actually like or dislike. Once you have a solid food plan in place that is making sure you’re meeting your nutrient and energy needs, mindful eating can bring flexibility to your food routine.

Mindful eating, however, cannot stand on it’s own. There are many situations where it is important to eat even if your body is not giving you physical hunger cues. This is a common situation in the early stages of recovery when you are working to establish a regular routine with food. These situations can continue to occur even in the later stages of recovery if you are stressed, anxious, have just exercised, or have a cold of flu. Challenging yourself to eat mechanically in the absence of hunger cues is a very important skill that helps prevent situations where you feel over hungry (or hangry), experience low energy, or may feel out of control around food when you do eat.

Both the ideas that Brian Wansink brought forward about mindful eating as well as his recent discreditation are important for many reasons. They remind us that mindful eating (and eating in general!) is tricky to study and that many factors influence why we eat or don’t eat. Practicing mindful eating is still valuable, as long as other skills around eating are maintained and still utilized. Mindful eating cannot stand alone and cannot be used as the only strategy or explanation for why we eat.

Blog post written by Lindzie O’Reilly, MAN, Registered Dietitian, Student Health Services, University of Guelph.

 

 

Are food sensitivity tests helpful or harmful?

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Symptoms of Irritable Bowel Syndrome (IBS) and a stressed stomach include abdominal pain, bloating, constipation and diarrhea. These symptoms can be irritating, embarrassing, anxiety provoking, and can have a significant impact on quality of life. Aside from the common cold, symptoms of IBS are the second most common reason to miss work or school. In individuals with an eating disorder, symptoms of IBS or digestive upset are even more common than for those in the general population.

A diagnosis of IBS in and of itself is a frustrating diagnosis. It’s a diagnosis of exclusion, meaning you have worked with a doctor to rule out conditions such as crohn’s disease, celiac disease, or a stomach ulcer, yet you still have symptoms. A diagnosis of IBS often brings relief in that many serious conditions have been ruled out, but frustration in that usually very few recommendations are given in terms of how to improve or manage your symptoms. It’s common for individuals with digestive upset to feel so desperate for an answer that they are willing to try anything.

An option that is gaining popularity online and among alternative health care practitioners is IgG food intolerance testing. Before considering this test, it’s important to educate yourself on the science behind it. The current consensus among allergy professionals is that IgG testing is not validated and has risks associated with it.

What is a food intolerance?

Food intolerances are a real thing that can have a significant impact on one’s quality of life. They can cause symptoms of IBS, along with skin rashes and joint pain. Food intolerances, however, are very different from food allergies. A food allergy is an immune-system response that can cause anaphylaxis and an increase in IgE antibodies in the blood. A food intolerance causes symptoms and discomfort but usually does not cause harm or damage to your body and does not trigger an immune-system response.

How can we test for a food intolerance?

Unfortunately, an accurate and validated test for food intolerances does not currently exist. The only way to truly determine if you have a food intolerance is to complete an elimination diet under the supervision of a registered dietitian who can help you pinpoint foods that may be triggering your symptoms. In an elimination diet, it is important to remove certain foods to see if symptoms improve, and equally important to reintroduce foods to see if symptoms return and to ensure you are not needlessly restricting your food routine. Embarking on an elimination diet to determine if you have a food intolerance is a long process that requires patience and guidance.

Then what is IgG testing?

Immunoglobin G (IgG) is thought to be a marker of exposure to foods, and a measure of our tolerance to them. This means that individuals typically have the highest IgG levels for foods that they eat regularly. It is completely normal and healthy for all individuals to have positive IgG test results. Somehow this test has come to be marketed as a way to detect food intolerances, when it actually detects our tolerance to foods.

But if there isn’t a good test out there, can’t I at least try the IgG test?

The IgG test is very expensive ($300-700) and, according to the Canadian Society for Allergy and Clinical Immunology, not a valid way to detect for food intolerances. Instead, this testing often results in individuals following needlessly restrictive diets. For someone with an eating disorder, it is very likely that an IgG test will be triggering. The test results can cause significant fear and anxiety around specific foods when there truly is no benefit to excluding these foods from your food routine.

If you experience symptoms of IBS or a stressed stomach, it’s important to create a support team that includes a doctor, a dietitian, and a counsellor to help you determine your individual triggers while still including a wide range of foods and preserving a healthy relationship with food.

Blog post written by Lindzie O’Reilly, MAN, Registered Dietitian, Student Health Services, University of Guelph.

 

Navigating New Year’s

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As 2018 comes to a close, I am bracing myself for the unavoidable onslaught of New Year’s resolutions. Unfortunately, many (if not most) of these resolutions will focus on trying to change one’s weight or shape and this can be triggering for the millions of individuals who have experienced or are experiencing an eating disorder. Beyond this, making resolutions to try to change your body simply reinforces the message that weight equals worth. So how can we navigate the messiness of appearance-based resolutions as we enter 2019?

 

1.      Acknowledge the appearance ideal. The appearance ideal is the image that the media sells us about how we should look. This ideal tells us that if we look a certain way then we will be happier, healthier, and more successful. Every time we try to change our body to fit with these standards, we reinforce the appearance ideal and give the beauty industry more power. This year, I challenge you to ask yourself why you are making a weight or fitness-based resolution. I imagine that you will find that it is influenced, at least in part, by the appearance ideal and the belief that thinner or fitter equals better. I also challenge you to think about whether this is in line with your values and/or what you want to achieve in life. For example, I value being connected to others, so focusing my time and energy on losing weight or going to the gym, rather than spending time with my family, actually interferes with my ability to be the person I want to be. If an appearance-based resolution is interfering with your goals or values, maybe it is not the best resolution to make.

 

2.      Make resolutions that align with your values. Core values are fundamental beliefs that lead us toward our goals. They reflect ways we want to act (e.g., generous), ways we want to be (e.g., authentic), and things we find important (e.g., connection). Everyday we are presented with choices that bring us closer to or farther away from our values, and New Year’s resolutions are no exception. I challenge you then to make a resolution that aligns with your values and brings you closer to the person you want to be. For example, if you (like me) value connection, a resolution might be to catch-up with a friend once every week. If you value courage, you might resolve to share a vulnerable experience with a friend or family member. These types of value-based resolutions will likely bring you genuine happiness and connection to your true self and others.

 

3.      Take care of yourself. If you are triggered or upset by people talking about their weight- or appearance-based resolutions, give yourself permission to take a break. Take some space and try to find your center. Remind yourself of your values and ask yourself whether picking an appearance-based resolution is right for you. It is okay to walk away from conversations that are unhelpful, especially if they may compromise your well-being. Weight-based resolutions have been engrained in our society for years and it is unlikely that this will change overnight. Instead, you may have to make choices to protect yourself, like asking a family member to stop talking about their resolution to lose X pounds, sending them this blog, or walking away. Whatever you need, it is okay for you to distance yourself from harmful resolutions.

 

At the end of the day (or year), January 1st is just another day. When the clock strikes midnight you will still be the same person that you are today; changing your weight or shape will not alter who you are at your core. So why not come up with some resolutions that lead you to the person you want to be? Why not make resolutions with the aim of finding genuine happiness and contentment? Why not resolve to be more connected with your values on December 31st, 2019? What do you have to lose?

 

 

 

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Ho-Ho-Hold the Holiday Guilt and Shame

The holidays are loaded with triggers, uncomfortable situations, anxiety, diet talk, weight talk and fear foods.  Here are some keys to making it through the holiday season without relying on your eating disorder for support. 

 

·         Permission is key.  Before having a holiday meal or snack stop and think about giving yourself permission.  Give yourself permission to have the food you want and the amount you desire.  There are no good foods or bad foods.  Some foods may have more nutrient value, but other foods have benefits too.  Having fun foods will prevent you from binge eating, will help you work towards recovery and may simply nourish your soul.

·         Toss the black-and-white thinking!  The holidays can be full of trigger foods that lead to unhelpful thought patterns or urges to be symptomatic.  Many people who struggle with eating disorders or disordered eating think of holiday meals as the only time to have forbidden foods.  This often leads to over-eating or binge eating and robs you of the joy the food has to offer.   Choose to think “I can have some now and I can have some tomorrow.”  Challenge black-and-white thinking and see food as in the “grey.”  This allows for a more normal relationship with trigger foods and takes away the food’s power over you.  If you think of it as just food you will be less inclined to binge eat.

·         Step away from diet culture.  Walk away from colleagues who are talking about the latest diet trend.  Ask family members to avoid talking about good foods or bad foods or making comments about bodies.  Think about taking a step back from social media that you know may fuel your desires to restrict or change your body.

·         Listen to your cues.  If you are working on intuitive eating the holiday season is a great time to practice.  Check in with yourself and use mindfulness to check into the present.  Pay attention to what your body is telling you and listen to your food cravings. Pay attention to whether or not you are hungry for food, when you start to feel satisfied and then when you are feeling full.  There is nothing wrong with being over-full.  This is common for “normal eaters” over the holidays. 

·         If you are working on mechanical eating it is a good idea to have a plan.  Most people have an idea of the foods that will be present at holiday meals.  Think about balancing your meals with all the food groups.  Think about filling your plate as you would if you were feeding a friend.  This can provide insight into what a “normal” portion might look like.

·         Don’t deprive yourself leading up to the big event.  If you skip breakfast and lunch you will be ravenous by dinner.  This increases your chances of being symptomatic.  Instead, eat intuitively or mechanically throughout the day, just like it is any other day.

·         Practice self-compassion.  Be kind to yourself as you would to your friend.  The holidays are tough!  Offer yourself compassion and kind words when you make a mistake.  Whether making a mistake means slipping with a symptom after a meal or missing out on a holiday celebratory meal because it is just too much - IT’S OKAY!  You do not have to be perfect to be moving towards recovery. 

·         Have a plan for coping after holiday meals.  This may mean filling your evening after dinner with family time, playing a board game, having a bubble bath or calling a good friend.  Distracting after holiday meals will allow any post-meal anxiety to pass.

·         Unfortunately the holidays are often filled with stressful environments and being around people who trigger you. It may seem natural and easy to turn to restriction, binge eating or purging to cope with discomfort.  Have a list of alternate coping methods ready for when you are feeling the urge.

Holiday food is not your enemy.  Food provides nourishment, it heals both your body and your soul. The act of eating food mends your relationship with food.  Food is about spending time with people you love.  Food is about culture and tradition.  Food is about joy, you just have to feel it.

Michelle Johnson, RD

Why the stigma around binge eating disorder?

I was recently at a conference presenting research on binge eating disorder (BED).  A handful of people stopped by to discuss my findings, but very few had an actual interest in BED. This lack of interest in, and understanding of, BED is evidenced not only within the research community but also within society at large. BED is the most frequent eating disorder, 2-3 times more common than anorexia and bulimia (Hudson et al., 2007). Yet I have never met someone outside of the eating disorder field who actually knew that BED is a formal eating disorder. So I have been asking myself lately, why the stigma around binge eating disorder?

 

I think that understanding the shame around BED starts by understanding its key diagnostic feature: binge eating. Binge eating is defined as objective overeating, accompanied by a sense of loss of control (APA, 2013). This is not overeating at Thanksgiving where it is socially accepted, and indeed expected, to do so. For these individuals, overeating happens at times where it seems (and feels) inappropriate or unnecessary. Individuals with BED often say that they cannot control the amount or type of food that they are eating despite not feeling hungry or feeling uncomfortably full.

 

The stigma around BED is rooted in our fear of challenging long-held beliefs regarding overeating. As a society, we have developed the idea that worth is defined by self-control, and even self-deprivation. Weight loss is seen as some great accomplishment, while weight gain is considered to be a failure. When someone has a “smaller” or “healthier” lunch, we praise their control. When someone brings fast food, a little part of us judges the composition of that meal. To continue this narrative, and preserve our own sense of control, we adopt the position that overeating indicates a lack of willpower. Doing so, allows us to refrain from challenging our own belief that we are worthy because of our ability to “control” our food intake and/or weight.

 

The reality, however, is that individuals with BED are not lacking in willpower. Binge eating often serves a multitude of purposes including emotion regulation and coping. For some, binge eating provides an escape from unbearably intense emotions. For others, there are biological reasons why they are more sensitive to the taste and smell of food. These individuals have developed skills to manage intense sensations in the face of extreme adversity, emotions, and compulsions. When we think of it this way, binge eating actually makes sense. It is a way to survive. So just like with other eating disorders, treatment for BED requires unlearning of these old behaviours, and the development of new coping skills. And since individuals with BED often seek treatment at an older age than those with anorexia and bulimia, there are many more years of unlearning to do.

 

In order to overcome the stigma and shame associated with BED, we need to challenge our own beliefs about weight and eating. Overcoming stigma involves all of us, to some degree, embracing that worth cannot be determined by the number on a scale or what we put in our body. Only once we have started to challenge predominant societal messages around weight and worth, can we start to undo the shame and stigma around BED.

 

For more information about binge eating disorder you can visit https://bedaonline.com/.

By: Therese Kenny, MSc, MA Candidate Clinical Psychology: Applied Developmental Emphasis

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Orthorexia: a dangerous and underrepresented disorder

Blog written by Lindzie O’Reilly, MAN, Registered Dietitian, University of Guelph

Orthorexia is a term that was first coined in 1998, but seemed to hit wide stream social media in the past few years.  Orthorexia essentially refers to an obsession with healthy eating. It’s a tricky disorder to diagnose for a couple of reasons. Firstly, it is not included in the current DSM-V and, therefore, does not have specific diagnostic criteria. Secondly, it’s hard to determine what an ‘obsession’ with healthy eating looks like when we, as a society, can’t seem to agree on a definition for ‘healthy eating’. We all have to eat, so we all have different ideas about food and nutrition. Ideas about food and nutrition abound on the internet, and nutrition is a common topic of conversation between friends and family members.

Orthorexia is a scary disorder. As a society, we are generally overwhelmed and confused by the amount of nutrition information available to us (rightfully so!). Much of the information we are bombarded with stems from personal stories of individuals taking extreme approaches to nutrition or fitness. As a society, we’ve come to normalize behaviours like counting calories or macros, weighing ourselves, and cutting out foods or whole food groups. Essentially, as a society, we are orthorexic. For this reason, individuals struggling with orthorexia often fly under the radar. Their habits and ideas about food and nutrition may not seem all that different than what you hear about in the media. In fact, an individual with orthorexia may even be touted in their family or social circle as an ‘expert’ in fitness or nutrition that others go to for advice. To me, this is scary for two reasons. Firstly, it means that the individual struggling may not get the help that they so desperately need and deserve. Orthorexia can have a variety of health consequences, including nutrient deficiencies and anxiety. Secondly, orthorexia is an extremely contagious form of disordered eating because the ideas shared by the individual struggling are often adopted by those around them.

It’s difficult to agree on a definition of ‘healthy eating’ because there really truly is not one food routine that is best for all individuals. We all have different likes and dislikes, different lifestyles, and different health conditions to manage. Additionally, we eat for many different reasons. It is impossible to plug your food intake into a nutrition app on your phone, and have it spit out a black and white answer that tells you if you’re doing a good job or not. Simply looking at food and nutrient intake does not honour the fact that we eat for enjoyment and for social reasons, that we must consider factors like food availability and financial constraints, that your food intake must fit within the time constraints of your day, or that your intake depends a great deal on your level of cooking skills.

Really food, like many other aspects of our life, is about balance. We can understand, for example, that it’s possible to sleep too much or too little, and that different people need different amounts of sleep. We can understand that some people in our lives are introverts and some are extroverts, meaning that they do best with different amounts of social time or alone time. In the very same way, it’s okay, and actually quite important, to think about your food intake for the day and to take an interest in the foods you are putting into your body. It’s also very possible, however, for that interest to become unhealthy, and to overshadow other aspects of your life. Here are some signs that someone may be struggling with orthorexia:

·         They cut out entire foods or food groups in the absence of a food allergy or medical condition like celiac disease

·         They experience fear and guilt when they eat foods other than those deemed ‘healthy’ or ‘pure’

·         They spend hours per day thinking about foods that will be served at an upcoming event

·         They spend hours per day following food or lifestyle blogs

·         They are overly concerned or critical of the food choices made by others

·         They struggle to share meals with family members or friends as those individual’s food habits differ from your own

·         They feel a sense of pleasure from eating ‘correctly’ rather than from enjoying the tastes and textures of a wide range of foods

·         They spend more money than they can realistically afford on specialized foods and supplements

Eating a wide range of foods that you enjoy and that support your physical and mental well-being is important. Looking up new recipes, planning some meals in advance, and trying new ingredients can be a fun hobby. If those activities take up more time or money than any other hobby in your life, or if they require you to make sacrifices that prevent you from sharing a meal with family and friends, it signifies an unbalanced approach to food and nutrition. For more information, or to find support for you or a loved one, please refer to the support materials and list of services on this website.

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Recovery Blog: I did it my way

*This blog was written by an individual with lived experience with an eating disorder. Content may by triggering for some people and the advice provided is based on the author's experience and should not be taken as professional or medical advice.

I always felt that I couldn’t fight back against my eating disorder unless I had a something specific to fight for. It took me ten years to decide something needed to change and that I couldn’t keep doing what I was doing. I didn’t know why I suddenly wanted to get better, but I DID know that if recovery was going to stick this time, I needed to do it my way. In the two years since I started my recovery, these were some key things that really stood out for me:

1.    I had to use my past failures as lessons. I had gone through every type of program and had made many attempts at getting better, so I knew what worked and what did not. If I had gone to a dietitian and we decided to change everything at once, I knew it wasn’t going to end well. I needed to ease myself into normal eating habits. Recovery isn’t a race. Slowly changing my diet let me adjust and come to terms with what I was eating. If I had not had that time I would have eventually panicked and gone back to my old ways. It worked the same way with gaining weight. I remember crying to my mom in the hospital years ago wishing I could wake up the next day and be at the weight I needed to be. I had always tried the “gain weight as fast as possible to get it over with” method and it never worked in the long-term for me. Weight restoration is a slow process and allowing myself that time helped my mind catch up to my body. Once it became obvious I had gained weight, I had the mental capacity to realize I felt a lot better even though my size changed. I wasn’t jumping for joy about going up in weight, but I also knew I wasn’t as tired, I wasn’t as grumpy and I was having a lot more fun not thinking about food 24/7. It wasn’t about avoiding the inevitable, it was about giving myself time to adjust in order to prevent a complete riot against recovery. I knew too much too soon would result in me seeking out my eating disorder to provide me the comfort and protection I thought it could provide.

2.    I let it out. One night my mom had made this chocolate pie. Initially I declined a piece, then went back after everyone left and quickly ate it. My sister happened to walk into the kitchen at that moment. I looked at her and told her how I ate the pie and felt like shit. I ate it and I was pretty much out of control. She looked at me, grabbed a fork, ate the last few bites and said I ate it because it was delicious. It is so easy to get caught up with the voices in my head. At the beginning of recovery, I had no idea what was considered normal eating. For so long I thought my disordered eating WAS normal. In that situation, my sister normalized eating pie. People eat pies, cakes, cookies, fries, and bread all the time and no one judges them. I had to let someone else hear the voices in my head in order to realize they weren’t rational. Just saying them out loud helped me realize that maybe what I was thinking wasn’t always accurate and was usually pretty ridiculous. Every time I was freaking out about my clothes not fitting or something I ate, the best thing I could do was tell someone. It was as if I could pass those feelings onto someone else and move on from the situation. By keeping them inside, I gave them power and strength. Those voices still haven’t gone away but it is much easier to hear, acknowledge and ignore them.

3.    Food became more of a friend. This I was not expecting. I had such a terrible relationship with food for so long that I assumed I would have to force myself to keep up with my meal plan until I eventually got used to it. Well, I was wrong. All of the food I had banned for so long I started to crave and it completely freaked me out. There was a period of time I would secretly eat these formerly forbidden foods because I didn’t understand why I was eating it and didn’t want anyone else to see me eat it. I thought I went from one disorder to another. Looking back now, my body was adjusting. It had no idea if I was ever going to let myself eat that cake again so it needed to get its fill in the moment. It was tough in those times not to hate myself or compensate for it by skipping my next meal. The amount of guilt and shame just because I ate something was staggering. The best thing I could do in those times (and still do) was tell someone about it or look around and realize other people were eating it too. Eating dessert or doing something the internet tells you is unhealthy isn’t a crime. You don’t have to feel guilt when eating. Over time, the cravings went away as my body realized I wasn’t going to deprive it anymore. I began to trust myself and my food choices. I absolutely love peanut butter - probably more than the average person and now I realize that’s okay. Just because other people don’t love it as much as I do doesn’t make me unhealthy or a terrible person.

4.    Other people need to adjust too. Once my eating habits improved and my energy was back, for the first time in years, I was ready to be social again. The problem was that I wasn’t being invited to events anymore because people were used to me turning them down. It was a tough realization. I had somewhat assumed that eating and gaining weight were the hardest parts about recovery but it was harder to realize that life had gone on without me. People hadn’t stopped having parties – they were just inviting other people. I had to acknowledge that I had pushed people away for so long that there was no way it could be fixed overnight. I had accept that I had missed out on a lot of moments, but I could start making an effort to be part of them again. As an introvert, this was not an easy task. It may have been luck, or perfect timing but I was able to find a group of people that I enjoyed spending time with and who didn’t dwell on the past. Socializing also helped me see how people who didn’t obsess over food could live these very exciting lives and do so many things. It opened my eyes as to how I could live and how I wanted to live as a 26 year old. Plus – life is more fun when you have people to spend it with.    

Sometimes when I am stressed I still count calories to calm me down and sometimes I still have to mentally prepare before eating something challenging. However, I go downtown to eat nachos and I can on the whim make dinner plans. I can live by myself, look after myself and live my own life. In my recovery, I found my independence and that is what turned out to be my biggest motivation. It isn’t always easy, but instead of all the bad things I thought would happen without my eating disorder to protect me, I am thriving.

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Be Brave: The importance of courage in eating disorder recovery

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One of my personal ‘anthems’ is Brave by Sara Bareilles. In the song, she addresses the impact of shame, negative self-talk, and the importance of communicating to others what you feel or think. Similarly Dr. Brene Brown, a research professor, who has studied courage, shame, vulnerability and empathy has expressed the importance of “speaking your truth” and “owning your story” as key elements for courage. However, it can be difficult to tell others how you’re struggling and how many thoughts about food and your body dominate your mind. You might worry that others will judge, or simply not understand. However, when we keep our negative feelings and thoughts to ourselves they tend to fester and grow.

Brene Brown (2015) also states that bravery is found in “asking for what you need”, “setting boundaries”, and “reaching out for support”. Telling others what you need carries the risk of rejection, but it also carries the potential benefit of being better understood and supported in the way that benefits you the most. Maybe you need someone to sit with you at mealtimes, or perhaps you need someone to distract you and push you to get out of the house and to a movie. We all need different things, which makes it hard for others to guess what helps you without you telling them directly.  Saying no or setting boundaries helps protect and empower you, but it carries the risk of losing (albeit likely unhealthy) relationships. It can be helpful to view your ED as a relationship in your life with which you need to set boundaries, and if you're ready,  to end. You’ll feel some feelings of anxiety and resistance when you challenge the way your ED controls your life, but you will also grow stronger. 

All the elements of bravery and courage include an element of risk and facing fears, yet all these will help you in your recovery from your eating disorder.  Share your story with someone you trust and who will be compassionate, tell others what you need to help you in your recovery, set boundaries with your ED, seek support and “Be Brave”.

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- This website lists several supportive resources in the Waterloo-Wellington area under the ‘Services’ section.

Learn more about the research and work of Brene Brown in the book Daring Greatly (2015) and at https://brenebrown.com/

Carrie Pollard, MSW RSW

 

The Pursuit of Self-Compassion Versus Self-Esteem

Written by: Samantha Durfy, MA, MSW, RSW - Counsellor at the University of Guelph and Social Worker in private practice in Downtown Guelph

 

While training to become a social worker I was taught that low self-esteem was a defining feature of an eating disorder.  Naturally, as I pursued my clinical career, I frequently targeted self-esteem in therapy; albeit with mixed results.  Although low self-esteem is a part of many individuals’ eating disorders, the difficulty in targeting self-esteem in treatment is that self-esteem is often defined as seeing oneself positively, sometimes even defining oneself as special (Neff, 2011). For many folks with an eating disorder, they struggle to define themselves as unique or special outside of their eating disorder.  Self-esteem is known to be related to positive psychological well-being; however, for individuals with eating disorders, the concept of defining oneself as “the best” directly contrasts how they view themselves.  And for many of my clients, their strong feelings of shame impacts their ability to improve their self-definition as anything positive.

Due to the mixed results in therapy when attempting to target self-esteem, I began to encourage clients to pursue self-compassion instead of self-esteem.  In contrast to self-esteem, “self‐compassion entails treating oneself with kindness, recognizing one's shared humanity, and being mindful when considering negative aspects of oneself” (Neff and Vonk, 2008; Neff 2011).  Self‐compassion does not entail self‐evaluation or comparisons with others, as the development of self-esteem often does. “Rather, self-compassion is a kind, connected, and clear‐sighted way of relating to ourselves even in instances of failure, perceived inadequacy, and imperfection” (Neff 2011).  Self-compassion acknowledges the human factor in all of us – that we make mistakes and that we are not perfect.

As outlined by Kristin Neff, an expert in the field, self-compassion entails three main components: “(a) self-kindness—being kind and understanding toward oneself in instances of pain or failure rather than being harshly self-critical, (b) common humanity—perceiving one's experiences as part of the larger human experience rather than seeing them as separating and isolating, and (c) mindfulness—holding painful thoughts and feelings in balanced awareness rather than over-identifying with them” (2010).  Neff’s research demonstrates that self-compassion is an emotionally positive self-attitude that is known to protect against the negative consequences of self-judgment, isolation, and rumination; all common struggles in the world of eating disorders.  Research informs us that demonstrating acts of self-compassion is effective in improving self-worth. Self-compassion is known to be non-evaluative and interconnected in nature and therefore avoids tendencies towards narcissism, self-centeredness, and downward social comparison that have been associated with attempts to improving or maintaining self-esteem (Neff, 2010).  “Self‐compassion provides greater emotional resilience and stability than self‐esteem, but involves less self‐evaluation, ego‐defensiveness, and self‐enhancement than self‐esteem” (Neff, 2011). 

As a therapist, one of my favourite self-compassion tools is to use the “best-friend technique”.  This tool asks clients to offer compassion or kindness to a close friend or family member who may be going through something similar as them.  I ask my clients to imagine themselves offering compassionate statements to their loved-ones.  The next challenge is to transfer this compassion to themselves.  Clients often find it easier to offer compassion to loved-ones, even strangers, versus to themselves.  When a client struggles to transfer the compassionate statements they offered to their best-friend, we brainstorm the barriers or the blocks that prevent them from being compassionate to themselves.  Often clients apply a different set of rules for themselves than for others, a higher set of standards, or they have developed such strong core-beliefs about themselves that the very act of being kind and compassionate feels wrong or uncomfortable.  Together we process these blocks and help move the client to a closer space where they can be more kind.  I frequently remind my clients that they are in fact human, which means that they will falter at times.  Self-compassion helps us remember that to make mistakes does not condemn us to a life of less kindness or less love.

For anyone interested in learning more about self-compassion, I highly recommend the work of Kristin Neff.   http://self-compassion.org/

 

References:

Neff, Kristin D.  September 2010.  Self-Compassion: An Alternative Conceptualization of a Health Attitude Toward Oneself.  Journal of Self and Identityhttps://doi.org/10.1080/15298860309032

Neff, Kristin D.  January 2011.  Self-Compassion, Self-Esteem, and Well-being.  Social and Personality Psychology Campushttps://doi.org/10.1111/j.1751-9004.2010.00330.x

Neff, Kristin D. & Roos Vonk.  December 2008.  Self-Compassion Versus Global Self-Esteem: Two Different Ways of Relating to Oneself.  Journal of Personalityhttps://doi.org/10.1111/j.1467-6494.2008.00537.x

How to get a bikini ready body

Step one, buy a bikini, step two wear it unabashedly to the beach and enjoy the best of what summer has to offer.

Simple I know. And contrary to the swarms of advertisements to ‘fix this’, ‘adjust that’ and ‘in five simple workouts you’ll have a body deserving of the beach’. Truth is any messaging promoting ways of getting your body ready for the beach is really promoting body dissatisfaction. These messages have the devious intention of preying on your insecurities to make a profit off the latest miracle product, diet or workout routine. Most of which will shake your thoughts and emotions to the point that you’ll be wanting to curl up under the covers until the leaves change colour, and wearing a bikini is no longer an option.

Here’s what I know about getting a bikini body: Feeling comfortable on the beach has nothing to do with your shape and size. As appealing as it might be to drop a couple pounds it won’t ever be enough to tip the scales of comfort in your favour while wearing a swim suit.

To lessen the feeling of terror at the thought of a bikini, you have to work on changing how you see your body, not changing your body.

First off, stop telling yourself that a couple pounds will make a difference. There really is nothing but you and your negative self-talk getting in the way of accepting your body and allowing yourself to fully participate in the joys of the beach.

When you imagine your body as an object for everyone to gawk at as they stroll along the shoreline, of course you’re going to be self-conscious! Change your focus instead to the ways your body serves you at the beach. Without those funny looking toes you wouldn’t be able to walk along the shoreline. Without that arm that has a little jiggle you wouldn’t be able to play a round of volleyball or pick rocks along the shoreline. Without those legs that you painstakingly scrutinize over, swimming or walking wouldn’t be an option.

So next time you are standing in front of a mirror picking apart your “unready” beach body, show a little self-compassion for the flaws that you judge so harshly. Accepting yourself and owning every bit of your perceived imperfections and flaws will not only liberate you, but is sure to promise you a body that is ready to be seen in any bikini and take on beaches anywhere.

Happy summer everyone!

Stacey Reinsma, MSW RSW

 

Food for Life

By Kelly Forster, RD

The beginning….

In 2014, my four-year-old daughter went off to junior kindergarten to enjoy meeting new friends, learning about the world, and of course, to enjoy nutrition breaks which are often the best part of the day for young students!

Halloween eventually rolled around and the family bundled up into a combination of ill-fitting costumes and snow pants for the purpose of collecting all the candy that our neighbours had to offer. It certainly is a strange and wonderful holiday!

When we arrived at the first house to trick or treat, my daughter politely said “No, thank you” when offered the candy. I was taken back but continued on the journey. At the next house, when offered candy again, she stated “I’m not supposed to have that; it is bad for me”. And that is when my heart sank. She was being taught in school about which foods she should eat and which foods she should avoid. This was confirmed the next day when I received a newsletter home from the classroom instructing me to begin talking to my daughter about which foods are healthy and which foods are unhealthy.

I had raised my daughter with an understanding that there are no good and bad foods, just foods that we have more of and foods that we have less of. That message was taught through role modelling alone, which is developmentally appropriate at that age. It is important for adults to remember that children are hard-wired to love energy-dense and sugary foods, and that is what has helped humankind survive and thrive through years of hardship, drought and war. There can be very negative results when children are taught that certain foods are unacceptable, even when they still love those foods. This negative sanction about what they enjoy can make them feel like they are the ones with the problem and that there must be something wrong with them. Sneaking, hoarding, and bingeing behaviours can result from such messages and feelings.

Halloween is meant to be guiltlessly enjoyed for one evening out of 365 evenings. It is most likely that celebrating Halloween - and all the candy that goes with it - will not impact a child’s health or weight, but may actually begin to foster a positive relationship with food.  Food is meant to be about so much more than physical health. For centuries, food has been an integral part of celebrations, culture, connectedness and sheer enjoyment. It is important to discuss all of these issues when talking about nutrition with our youth.

So, on that night, with my daughter struggling to make the “right” decision, which she thought was to fight her natural and social drive to enjoy candy, I resolved to do my part in helping teach young students what healthy eating really looks like. I have also endeavored to support teachers in teaching nutrition by incorporating both physiological health and psychological health. It has been evident to me time and again that teachers have their students’ well-being at heart. So, when it comes to nutrition, I want to help provide teachers with a vocabulary about food and nutrition that is positive and celebratory versus negative and reproachful. It is also important to me to connect with parents and caregivers, whenever possible, to support them in also carrying on the positive nutrition messages learned at school.

Adults are increasingly putting the pressure on children to make “good” choices about foods, at a time when the adults themselves don’t have the whole picture of what our children need in order to thrive physically and psychologically.

Food for Life Program

I am a Registered Dietitian, employed by CMHA WW and working in the field of Eating Disorder Treatment.

I developed the Food for Life Program, which has now been running in elementary schools in the regions of Waterloo, and Wellington for four years. It has reached over 1000 students, over 50 teachers and over 2000 caregivers. There are currently more than five trained Food for Life facilitators in our community.

What is it?

  1. It is a nutrition program with several units geared to different grade levels from JK to grade 4.

  2. It is designed to educate children about a variety of nutrition-related topics including how certain foods contribute to our physical functioning, where food comes from, how we can celebrate food and the value of trying new foods.

  3. It is designed to provide parents, guardians and caregivers with nutritious recipes and ingredients, along with information about what foods their own children have tried throughout the program, plus guidance about how to positively discuss nutritious foods and “sometimes” foods with their children.

  4. It is based on the recommendations that Health Canada has provided in Canada’s Food Guide and meets The Ministry of Education’s curriculum guidelines.

  5. There are typically four 1-hour sessions during which several foods from the Food Guide are offered.

Why is it Important?

The frequency of eating disorders is rising amongst Canadian youth.  Parents, teachers and children are sometimes bombarded with contradicting and confusing messages regarding healthy eating.

Giving children positive messages about food counteracts this and promotes healthy living, both physically and psychologically.

This program uniquely addresses not only nutrition but also how to live in a world with an abundance of wonderful foods.

Who is Funding it?  

It has been through volunteer work that the program was founded. However, it is with the generous support of CMHA WW, the Grand River Agricultural Society, and the Healthy Kids Community Challenge that the program has been able to grow and reach many of our local communities.

Is it Safe?

  • Yes, all food is prepared by an individual with Food Handler Certification in her/ his own home.

  • Public Health has approved the program’s food handling and delivering methods.

  • NO individual information is collected about any of the children.

  • Children are NOT required to sample food, but are encouraged to try new or previously disliked foods.

  • Facilitators respect and plan for all food allergies.

Maintaining Eating Disorder Recovery during Pregnancy

Author:  Alison Elliott, MSW, RSW. Social Worker in Private Practice, Cambridge Ontario

Pregnancy can be a time filled with excitement, nervous anticipation and wonder. For those in recovery from an eating disorder, it can also be a time of uncertainty, fear and adjustment.

I have worked with many women who have concerns and questions about how to maintain their recovery, while facing so many changes to their body, emotions, appetite and life. I often hear questions like “what do I do when I’m so nauseated, and can’t stick to my meal plan?” Or, “I was okay with my body changing, but now so many people keep commenting on it, and it’s triggering my eating disorder voice.”

We know that for women who have recovered or are in a stage of recovery from their eating disorder, that pregnancy and post-pregnancy can be a high-risk situation for relapse. For some, times of change can trigger old eating disorder urges, and desire for control.  Combined with unpredictable body changes, social pressure to have a ‘perfect pregnancy’, and the unrealistic expectation that a post baby body should somehow return to its former state quickly, it’s no wonder that maintaining recovery is challenging. Some research shows that women with bulimia find improvements in their recovery during and post-pregnancy, while those with anorexia show higher risk for relapse, especially post-partum (Ward, V. 2008). However, some women may feel a higher satisfaction with their body during pregnancy, and less body conscious than prior to pregnancy. Each woman, and pregnancy, is different. However, there are some key strategies to help maintain a healthy mom and healthy baby.

Here are a few tips for supporting a happy, healthy pregnancy:

1-Build Your Team: make sure that you have health practitioners who are informed, educated and trustworthy. This will likely include an OBGYN or midwife, dietitian, therapist, and perhaps a Psychiatrist. Be honest and open with your team about your eating disorder history, current urges or behaviours, fears, and areas you’re struggling with. They won’t be able to help you if they don’t know what is happening. Ideally, discuss your pregnancy concerns before conceiving or early on in your pregnancy, to ensure you have time to prepare for the upcoming changes.

2- Review Your Skills: now is the time to review those old strategies, self-help books and worksheets! Remind yourself what tools work to keep on track with your meal planning, activity levels, handling your emotions, and reducing your overall stress. Try journalling as a way of coping with changing emotions and experiences. Not only will it be a way of improving self care and awareness, it will be a special keepsake to remember what the pregnancy was like.

3- Practice Self-Compassion: positive self-talk, gentleness and forgiveness will be a way of treating yourself with kindness. Remind yourself that this is a new experience (even if it’s not your first baby), and that you’re doing the best you can in the moment. This is a great time to ensure you have time to yourself-- to spend alone and/or with friends. Setting limits with others while prioritizing your needs is a way of acting lovingly towards yourself.

4- Express Your Feelings: hormones can throw a curve ball to your emotions. Embrace the mood swings and intensified emotions, allowing yourself to feel whatever you feel. If you’re concerned about new feelings of anxiety or depression, make sure you talk with your therapist or doctor about them. Keep your close friends, family or partner in the loop about how you’re feeling, and what you need from them. If you notice new urges, or start to engage in old eating disorder behaviours, act quickly to get back on track. Slips can happen and are valuable to shine a light on areas that you’re struggling with. Be honest with yourself and others, to get the support that you need.

5- Become Educated: the more you can learn about the changes to expect, the more prepared you will feel. Find one or two good books that explain monthly changes and ask the embarrassing questions to someone you trust. You may get inundated with people giving your advice about how to handle your pregnancy, labour, and baby care. Make decisions that are right for you.

6-Meal Planning: whether you are still following a treatment meal plan or have begun to follow some intuitive eating, now is the time to put structure into your meal planning. It can be very hard to eat when nauseated or physically uncomfortable, however, both you and the baby need nutrients and fluids to maintain health. A dietitian that specializes in eating disorders can have great tips for adjusting to food cravings and aversions. Missing meals and eliminating food groups easily trigger ED thoughts again, so plan ahead and have foods readily available. Find time outside of meals/snacks to get rest if you’re tired, as naps can interfere with meal plans.

7- Move your Body:   gentle stretching, activity and movement can help prevent injury, increase strength, and build endurance for the upcoming labour. Adapt your movements to lower impact as the baby grows and pay attention to when you need to rest. Move your body to nurture it, rather than to change it’s size, shape or weight.

8- Listen to your body: mindfulness can be a great skill to use during pregnancy, to tune into what your body is telling you. Skills like rating your fatigue on a scale from one to ten, or mentally scanning your body for aches, pains, or new baby movements will help increase self-awareness. While your doctor will want to monitor your weight gain during pregnancy, you may wish to ask for ‘blind weigh-ins’, so that your doctor can monitor you for concerns, while you can stay away from knowing the numbers.

9- Get Support: make a plan for how to manage the first few weeks and months with your new baby. Look into groups for new parents, connect with friends who also have little ones, or arrange for some helping hands from family or a babysitter. Fatigue and loneliness can sabotage your recovery, reducing your ability to cope with difficult thoughts and feelings. Try taking a minimum of one hour per week to have to your self to get out of the house, meet a friend, or have leisure time for hobbies.

10- Concentrate on Gratitude: each day take intentional time to practice gratitude. This can be actions like writing down a few things in your journal that you’re thankful for, praying, or noting what positives you can say out loud in the moment.

For more information and where to find support during your pregnancy, visit www.nedic.ca or speak with your doctor.

 

Sourced from Ward, V. B. (2008). Eating disorders in pregnancy. BMJ : British Medical Journal336(7635), 93–96. http://doi.org/10.1136/bmj.39393.689595.BE

Athletes, let your food choices fuel you

Written by Lindzie O’Reilly, MAN, RD, On-campus dietitian at the University of Guelph and private practice dietitian at The Wellness Collaborative

The 2018 Olympics in Pyeong Chang provided countless examples of exceptional athletes who demonstrated incredible feats of physical and mental strength. Athletes, whether Olympic caliber or recreational, are competitive by nature. They train hard, and they want to take advantage of every possible opportunity to improve their game.

We need many factors to perform our best - intense physical and mental training, a positive support network, a love for the sport, adequate sleep, and adequate nutrition, just to name a few. If we want our bodies to perform their best, we need to treat them well, fuel them, and allow them to recover.

Unfortunately, when pressure is high, it’s easy for us to become short sighted. We wish so badly to succeed, that we grasp at opportunities that may seem helpful, but that may actually harm our long-term chances of success in our sport.

Each time the Olympics come around, a few brave athletes find the courage to speak up about the pressures and influences they face. This year, Adam Rippon, a figure skater, spoke honestly about his struggles with body image and dietary restriction . For Adam, it was an injury that caused him to rethink his approach to food. For other athletes, extreme training and nutrition practices lead to burnout and a loss of love for their sport.

Adam’s story served as a reminder for me of the importance of specialized support. It’s commonplace for athletes to work with specialized coaches and trainers that are highly qualified to give advice around training schedules. It’s equally important for coaches, trainers, and athletes to recognize facets, like nutrition, that are outside of a coach’s scope of practice. It’s important for athletes to seek specialized nutrition advice from a qualified professional. Treating your body well, rather than punishing it, is truly the best recipe for success. If you’re unsure where to start, take a look at the booklet created by the Waterloo Wellington Eating Disorders Coalition with information and resources for coaches and trainers.

When you’re immersed in a sport, it can be easy to lose perspective and to fail to recognize when you may be jeopardizing your physical and mental well-being. Coaches, trainers, family members, and friends spend a lot of time with athletes. They are typically the people that know an athlete best. They are often the first to notice warning signs such as changes in mood, behaviour or athletic performance that may indicate a cause for concern. While this is certainly not an exhaustive list, here are a few warning signs that an athlete’s approach to their sport may not be honouring their health and well-being:

1.       Equating weight or body fat percentage with performance. There are so many factors that determine athletic performance. Physical fitness, technique, experience, and the ability to deal with the mental demands of a sport are just a few. Weight and body fat percentage alone have very little influence on sport performance. In fact, if an athlete is fighting to achieve a weight or size that is unnatural for them, their performance is likely to decline and their risk of injury is likely to increase.

2.       Avoiding eating in front of friends, family members, or team mates. Athletes needs to eat a wide range of foods often during the day. If they are going long periods of time without eating, or feel uncomfortable eating in social situations, this is a cause for concern.

3.       Labelling foods as ‘good’ or ‘bad’, or making blanket statements that tie certain foods to a certain level of performance. We eat for many reasons, and there are no foods that we need to avoid completely. While eating cookies for every meal of every day or eating meals comprised solely of carbohydrates is not balanced, never letting yourself eat cookies, or removing carbohydrates from your meals is not balanced either. Completely cutting out certain foods or food groups in an effort to increase performance gives those foods more power than they deserve, is damaging to one’s relationship with food, and can increase cravings or feelings of being out of control around food.

4.       Trading off food and activity by eating less on rest days or low volume training days. Our bodies need a similar amount of fuel on training days as they do on rest days. Rest days provide the body with an opportunity to recover and repair from training, and to prepare for upcoming training.

5.       Guilt surrounding training volume. It’s important to listen to your body and allow this to determine the length and intensity of training sessions. It’s normal to have more energy on some days than on others. Striving to complete a certain amount of reps, sets, or a certain distance regardless of how you feel increases risk of injury and is counterproductive to training.

As an athlete, the drive to succeed and the pressure to perform are high. It’s important to surround yourself with a positive and educated support team that can help you perform your best, while also prioritizing your physical and mental well-being. If you feel like you need more support on your team, please take a look under the “Services” tab on this website for a list of great resources in our community.

Eating Disorder Awareness Week 2018

Eating Disorder Awareness Week (EDAW) is upon us.  Join the Waterloo Wellington Eating Disorder Coalition’s effort to de-stigmatize eating disorders this February 1-7, 2018.

Almost 1 million Canadians are living with a diagnosed eating disorder.  Unfortunately this means there is an even higher number of people struggling with undiagnosed eating disorders or disordered eating.  The purpose of EDAW is to decrease stigma around eating disorders and encourage individuals who are struggling to reach out to local support systems. 

During EDAW, we are reminded that eating disorders impact people of varying race, gender, sexuality, ability and age.  We are reminded that despite the unrealistic images depicted in the media, bodies are not born as “one size fits all.”  EDAW is a reminder that our bodies deserve gratitude and nourishment instead of body hate and deprivation.  Finally, we are reminded that despite the efforts of countless programs and advocacy groups around the globe, system issues remain and more needs to be done.  More support, more advocacy, more programing and more funding. 

Food for thought:

The population of people struggling with an eating disorder or disordered eating is diverse, nutrition during recovery should accommodate for this and also be diverse.  Just as there is no “one size fits all” body or one perfect recovery journey there is no one perfect nutrition plan to meet the needs of all people. 

When I assess an individual’s nutrition intake and discuss a nutrition plan with them I cannot definitively determine their nutrition needs for recovery.  Defining “normal eating” is a challenge amongst professionals in the eating disorder community.  But, if there is no conclusive definition of “normal eating” then what are you striving for with nutrition in recovery?  The answer is that it looks different for each individual. 

What I do know is this: “normal eating” in recovery involves regular nutrition intake, a balance of nutrients and challenging food avoidances.  For some this may include rice and lentil dosas with chutney for breakfast while for others it may be a pastry with butter and jam and a glass of juice or even a typical American breakfast of eggs, bacon and toast.  It may require exposing yourself to eating alone, eating out at a restaurant or with your family at a holiday meal.  Reflect on a time in the past when you may have had a better relationship with food.  What were the things you enjoyed eating then? You may benefit from talking to family and friends about what you ate together in the past.  Developing a nutrition plan involves collaboration between your team, your friends, family and yourself. It will require some deep soul searching to understand which foods are a challenge for you and why.  Just as eating disorders are diverse in nature, nutrition needs in recovery are also diverse. 

Just some food for thought - Michelle Johnson, RD

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We are proud to be partnering with @theNEDIC and @NIEDCanada for Eating Disorders Awareness Week.  Join us in raising awareness about Eating Disorders and breaking down stigmas.

 

#EDAW2018 (#SemTA2018 in French) #7billionsizes #PurpleforEDAW #lightitpurple #CMHA100

Here is what is happening in the Waterloo Wellington region:

Guelph City Hall & Cambridge City Hall will be lit up in purple to raise awareness.  Watch for social media posts to also raise awareness. 

University of Guelph’s Wellness Centre is hosting various organizations at the annual Eating Disorder & Body Image awareness Exposé displaying boards, media and cookie decorating on February 6th from 10am to 3pm

Join the University of Guelph’s Wellness Education Centre for a screening of Sisterhood of the Travelling Pants Wednesday February 7th. For more information, please email wellness@uoguelph.ca

Join on-campus registered dietitian Lindzie O’Reilly and counsellor Samantha Durfy for an All Food Fits cooking class Thursday February 8th from 5:30-7:30pm. Class will be held in MINS 214 at the University of Guelph. The cost of the class is $3. Please register in advance by emailing cooking@uoguelph.ca

Wilfrid Laurier University is hosting a Food and Your Mood Workshop on February 13th and 14th with Caroline Valeriote, RD and Carrie Pollard-Jarrell, MSW RSW.  This workshop will discuss emotional eating and outline eating disorder resources in the community.  Also look for Laurier social media posts to raise awareness.

NEDIC is again hosting a Twitter chat

NEDIC is hosting this webinar about fat stigma: https://events.r20.constantcontact.com/register/eventReg?oeidk=a07ef0ysiyud6ddc24a&oseq=&c=&ch=

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A Gift for the Holidays: Self-Compassion

The holidays are a time for connecting and celebrating, but they can also bring pressure and stress.  Normal routines can be disrupted with social and family gatherings which are often oriented toward gift giving and eating. There can be pressure to get the ‘perfect gift’ or stress related to being around larger groups of people or having to navigate family “issues” (we all have them!). This is also the time of year when people often feel the loneliest, whether it be to losses of significant people in their lives, or feeling alone in a world full of people who don’t understand them.

For people who struggle with disordered eating and/or body image issues, the holidays can be challenging for all of the above reasons and more. Many celebrations are oriented towards food which can trigger a multitude of fears, and family functions can feel like they expose (or risk exposure) of eating disorder (ED) related struggles or behaviours. 

The challenges associated with the holidays can trigger our inner critics, and cause us to overextend or even isolate ourselves. However, to help manage (and possibly prevent some of) the stress, we could give ourselves a special gift this holiday: self-compassion. Self-compassion means being kind to ourselves and understanding that we, like all people, are imperfect and that sometimes our life situations are not how we want or need them to be (Neff, 2011).  We can practice self-compassion by changing the way we talk to ourselves. Instead of judging ourselves for what or how much we ate, or how much we spent on a gift, we can remind ourselves that it’s okay to enjoy treats, say “no”, and give what we can afford. If you struggle with compassionate self-talk, think of how you might talk to your best friend who is hurting or struggling in that same type of situation.  We can also practice self-compassion in how we care for ourselves. It is easy to get caught up in pleasing others and doing what is expected. During the holidays it’s important to pause, and mindfully ask yourself what you need. If you need time to yourself to relax and turn off your phone—then give it to yourself. Self-care is not selfish, instead it will allow you to recharge. With self-care, you will have the energy to show caring, compassion and patience with others.

Comment below on your favourite ways to care for yourself during the holidays!  

 

Carrie Pollard-Jarrell, MSW RSW

Reference: Neff, K (2011). Self-Compassion. New York, NY: HarperCollins.