Eating Disorder

I trust your body but I don't trust your eating disorder

I trust your body but I don't trust your eating disorder

Recently, I was talking to a client in eating disorder recovery (of note, all of this is being shared with her permission) who reported feeling really frustrated that so many non-diet dietitians are sharing messages on Instagram about trusting your body and having bodily autonomy while also being recommended by her treatment team (myself included) to eat more consistently. “Y’all need to make up your minds” she said (half) jokingly.

And to be fair, I get where she’s coming from. I am one of the many dietitians talking about body trust, body autonomy, and body liberation on social media. So many of us are practically shouting it from the rooftops - because we steadfastly believe in it for everyone, full stop. We believe that everyone gets to make choices about their body, their health care, their food, their movement.

3 reasons to throw away your scale

3 reasons to throw away your scale

A conversation I’ve been having with clients a lot lately (and frankly, have quite a bit) is about the scale. It’s actually become one of the first questions I ask people during their initial assessments - “do you own a scale? What do you do with that information?” Because I find that oftentimes, the scale plays a pretty significant role in a person’s eating disorder or as a trigger for disordered behaviors. And it turns out (as a surprise to probably no one), I am not a huge advocate of having a scale in the house or regularly using a scale in any way. Before we get into it, I want to acknowledge that it is possible to view weight as neutral and if you’re a person who can step on the scale, not judge the outcome, and move on with your day, that’s great (although I might ask what value this brings to your life). But in my experience, the scale brings up a lot for people and doesn’t provide them with much in return. Which is why I decided to craft this piece for all those people who might be feeling like they’re in an unhealthy relationship with their scale. Consider this your permission slip to throw it out. Toss it. Smash it with a hammer.

Navigating Menu Calorie Counts in ED Recovery

A couple weeks ago, my partner was going through the mail and found my journal from the Academy of Nutrition & Dietetics (that usually goes straight into the recycle bin because hi, it's 2018 and if I want to find a research article, I'll just look online). He started flipping through and was reading bits and pieces and started reading one particular study about calorie counts being listed on menu items (spoiler alert: calorie labels didn't change health outcomes in any significant way).

Sigh. 

With the new calorie labeling law going into effect earlier this month, I've had a lot conversations about this with my clients recently. If you're in the US, you've probably noticed that all restaurants (with 20+ locations) are now required to list calorie counts on their food items. As both a clinician and a consumer, I have a lot of issues with this. In fact, the original draft of this post was almost double the length because I wrote about these issues in great detail. But because I don't want to make you read a short novel, they've been scrapped (for now) and will re-emerge in a likely part two soon. What I want to address here is how challenging it can be to see calorie labels when you're recovery from an eating disorder. Because when your treatment team is emphasizing calories don't matter and then you walk into a restaurant where every item has a calorie count, it is confusing to say the least.

I totally understand how difficult it can be to be in recovery from an eating disorder and be faced with this information every time you go out for a meal. And the advice I would give to you in a perfect world would be "just order what sounds good!" But I also know that is a lot easier said than done. So here are some tips to remember when you're faced with calorie labels on menus:

1. Take a deep breath. Reminding yourself of some positive affirmations may be helpful  (I am worthy of recovery, I am allowed to listen to my body, I am safe no matter what I order, I am capable of managing this situation, etc). Try to create some space for yourself in that moment.

2. Recognize that these numbers do not have any bearing in your value as a person. They don't have the power to make you good or bad. They can't make you a failure. 

3. Think about what sounds appealing to you. Do you want something hot or cold? Crunchy or soft? Salty or sweet? Are you having any cravings? Use these answers to guide you towards the things that sound good to you in that moment. 

4. Give yourself a time limit. It can be easy to get sucked into a world of complex food math (maybe I should get that salad because it's X calories or I could get 1/2 of that sandwich and a small order of fries and that would be Y calories but if I do that, I can only have Z calories at dinner which throws off my whole day because I had ABC for breakfast and then what about my nighttime snack and on and on and on). To avoid- or at least shorten- that moment of uncertainty and panic, give yourself a time limit to decide what you're going to order. For example, if you're in line at a coffee shop, give yourself 30-60 seconds to decide on a drink and then stick with it when you go to order. If you're out to lunch with a friend, let yourself look at the menu for 3-5 minutes before making a decision and closing your menu. Set an actual timer on your phone if you think it will help. This isn't designed to be stressful, just a way for you to avoid getting sucked into that food math vortex. Give yourself enough time to look at your options and then make a decision without ruminating on it.

5. Order without overthinking. Think about what sounds good, look at the menu for a couple minutes, and then order what sounds appealing and manageable. Remember that not every meal needs to be *perfect*. Remember that you're allowed to eat all foods. And remember that every time you make choices that go against ED rules, you're taking one more step into recovery.

6. Try to stay grounded when your food comes. If you're with out with someone, try to focus on your conversation with them which is likely far more meaningful than nutrition labels. And if you're alone, consider bringing a journal and writing your way through the experience (or if that feels too intense, write about something different altogether). 

Seeing calorie counts can seem unmanageable but remember it is merely external information and that most of recovery is about re-connecting with your body's internal wisdom. In a perfect world, we would be able to clear our internal hard drives of all calorie counts, Weight Watchers point, macros, and all the other things we've memorized because there's no real need to know exactly how many calories are in 24 almonds or how many points are in a banana. This is all just  information that has no meaningful effect on your body; none of these numbers can determine what is most nourishing for you. Reconnecting with your body's needs and listening to your intuition is infinitely healthier than making frantic decisions based on what are essentially arbitrary numbers.

The goal I have for my clients (and anyone in ED recovery) is to be able to see calorie labels as neutral information.  The nutrition information that you once had memorized as well as the lyrics to your favorite song doesn't just fade away- although take comfort in the fact that as the distance between you and calorie counting grows, these numbers will start to blur and eventually pieces fade away altogether. What you are able to do is start working towards a place where this information doesn't have so much power over you. You're able to move to a place where knowing calorie information is like knowing exactly how many gigahertz the wifi is or the exact temperature of your refrigerator- both fine to know but probably not going to impact your life in any significant way. When we start placing less importance on external information and create more body trust, we're able to make decisions that nourish our minds and our bodies without guilt- and that is the ultimate goal in recovery.

Cover photo by Benjamin Zanatta 

Fat is Okay! And Other Messages I Wish I Got From Straight/Curve

Last week, I went to a screening of the film Straight/Curve that Project HEAL put on as part of eating disorder awareness week. I knew the premise and I was excited for an uplifting film about body image and diversity, but I walked away confused and angry (like, really angry). This isn’t meant to be a review of the film- I am far from a film critic-but as a Health at Every Size provider and as someone who has gone through her own recovery, I found a few things really problematic that I want to touch on here for anyone who has seen the film (or who hasn’t).

For anyone who hasn’t heard of the film, this is the description you get from a quick Google:
“A majority of women say they do not feel represented in fashion or in the media. Filmmaker Jenny McQuaile examines the industries and obstacles responsible for this body image crisis and showcases leaders who are fighting for diversity in the media.”

Hooray!! I naively thought as I walked in. Finally blowing the lid off the bullshit diet culture nonsense that media forces upon us daily. That is…not what I found. The movie starts with the director and her team discussing about a dozen women who are all outside the modeling “norm” and how diverse they are. Then they pan to the models getting out of the car….and I’m not kidding when I say I thought those where the examples of what we were moving away from. It took me a few minutes to realize those were the diverse models.  

Before I keep going, I want to say: I have respect for all these women. They are, indeed, outside the norm for modeling (they are all above a size 0/2 that we are used to seeing in models, some of them were WOC, some of them were older than the average model). A few of them shared their histories with food and without a doubt, I have compassion for all of them and their journeys. I’m excited that the modeling industry is recognizing some variety. But as far as everyday, non-model bodies go, they weren’t particularly diverse. And there was no other discussion to acknowledge that; no mention of how bodies come in a lot more shapes/sizes/colors/abilities/genders/sexualities than what those 12 or so women represented. So while I appreciate them talking about their experience in the modeling industry, I wish the conversation zoomed out to discuss the bigger picture (no pun intended).

As far as diversity goes, I was happy to see that they included women of all ages including older and middle-aged women who are so often left out of the conversation. They also represented some people of color and some size diversity. Something I would have liked to see more of was representation of folks with different abilities, who are also frequently left out of the conversation. Also, there was no representation of non-binary folks or femmes who aren’t classically feminine. The film did include one model who was part of the LGBT+ community but again, I would have loved to see more (and more diverse) stories. I had the privilege of being on the panel discussion afterwards with the creators of ThirdWheelED who both identify as queer and who were gracious enough to make that part of the discussion afterward (and I highly recommend checking out their site if you haven't already which has a lot of great resources listed). It's hard to feel good about your body when you don't see your body represented anywhere else in mainstream media (especially a movie that's about representation). 


And then there was the scene when one of the models was talking to her daughter about body image. Her daughter, who was maybe 6 or so, was saying that a girl at school had called her fat and with no hesitation, the model answered, “you’re not fat”. And I sat there wishing with everything in me that her response instead had been “it’s okay to be fat” or “who cares if you are?!”  or even just "no, you're not fat but some people are and that's okay and normal" because that’s the message that the audience (kids/adolescents/young women and their parents) need to hear. And again, I want to point out how much compassion I have for the woman who said that. I get that a mother's instinct is to protect her kid and “fat” historically has been used as an insult. And I also get that she is trying to raise her daughter to love her body in a world that teaches women to hate themselves. But there was such a perfect opportunity for a discussion about size diversity and using “fat” as a descriptor (rather than an insult) and I felt sad to watch that moment pass by.

And finally, I want to touch on one scene that has stuck with me since Thursday night, that makes me rage a little bit every time I think about it. There was a scene in which one of the models, a thin woman who I believe has recovered from an eating disorder, went to get her body composition measured (first question: why?!) and the subsequent reports showed the distribution of fat on her body (second question: why?!). The doctor detailed the different types of fat a person has on her body and then declared her particular fat as being okay. And I swear you could probably see the heat rising into my cheeks as I sat watching thinking ALL FAT IS OKAY”. Listen. I took anatomy & physiology. I know there are different kinds of fat and I understand their functions. But for a movie whose purpose was to broaden the idea of beauty and promote body diversity, “fat is only okay sometimes” feels like really questionable messaging (and also, totally against everything I stand for but that’s beside the point). The truth is that you are not wrong no matter where the fat lays on your body and more than that, you don’t have to get anyone’s permission to feel okay in your body.

I appreciate what Straight/Curve was trying to do and it was a step in the right direction. As someone who is hoping for our culture to move towards body diversity and fat acceptance with leaps and bounds, that step felt a little frustrating but I understand that’s not the way the world works (but I can dream about a world where it does, right?) There were some problematic pieces but overall, I was left wanting moreThis movie is opening some doors and it’s not enough. This movie planted seeds and we have so much work to do. I dream of the day when we can see a movie about body diversity that involves women of all sizes and shapes and abilities and genders and sexualities and ages and ALL THE THINGS. Marginalized women, we need your voices! We need your movies! And dear reader, if you have suggestions for movies like this, please leave it in the comments because I would looove to watch.

Until next time xo
Meghan

Photo by Annie Spratt