Pretzels and Cheese

By Francis Iacobucci

The Sunday after Thanksgiving I received a text from a trainer at my gym: don’t forget to sign up for a session this week to burn off all those calories! As someone who has struggled with body acceptance for essentially my entire existence, I was filled with emotions and racing thoughts.

In the immediate aftermath of the text, old eating disordered thoughts emerged: It’s not like I ate that much. Or did I? I’m pathetic. I should have purged. I wonder how much weight I gained. I’m so ashamed. 

And then justifications: Well, I had this much protein and this many carbs – that seems about right. I’m a man, so I’m supposed to be big and strong; and it helps me lift weights, of course. I need to eat a lot! Stop being a wimp – be a man! Just make sure it’s the right amount of calories and macro nutrients.

And then, as a bit of reason and years of therapy began to set it, I became frustrated: What gives this person the right to dictate to me what foods are good and what foods are bad? I’m never going back to that gym!

And finally, after my emotions regulated a bit (it’s amazing how one text can get someone so fired up!) I asked myself some questions, and I answered them: did I enjoy the food I ate? Yes. Did I eat to the point of feeling full? A little. Is that okay? Yes. Why is that okay? Because I’m allowed to eat food that tastes good.

 I’m so thankful – after years of therapy and support from so many – that I’m able to process thought and emotion to ensure my safety and health. For so many, the constant barrage of diet and wellness culture rules and regulations lead to constant uncertainty and shame about their bodies. For those with eating disorders, it can be exponentially more damaging.

I was once asked to write down a list of all the “rules and regulations” that wellness culture had influenced me over my lifespan – the list was five pages single-spaced. Eat this to look like that. Stretch that to feel like this. Don’t eat this to date a girl like that. At one point I had written down all the rules that stated why it was bad to eat certain foods, and it got to the point that the only foods that was “safe” from wellness rules and regulations were basically fruits and veggies – organically and locally grown, of course – that had fallen off the tree. Everything else was off limits if you wanted to be happy and healthy.

The list was tangible evidence that the way I thought about food and body dissatisfaction were intertwined and tangled to a point that seemed impossible to unravel. Going from saying no food is bad to engaging in that practice while eating took years, and is still very much a work and progress. I’ll always remember, though, eating pretzels and cheese (two things I would have never eaten in the past because they were on the list) and feeling satisfied and satiated, rather than guilty and ashamed. I had successfully snacked. I had put down the notions of food morality so ingrained within me briefly enough to feel what eating can be: a fulfilling and pleasurable experience. It was a blissful moment in my recovery process. I smirked as I crunched the pretzel and chewed the cheese, scoffing at the notion that what I was eating was going to change my ability to be a “good” person.

While I’m sure that trainer has good intentions, no one has the right to dictate to anyone the morality of food. Save biological reasons and personal preferences, restricting or eliminating foods from diet because they have been labeled “bad” by a multi-billion dollar industry is not healthy. I have – and at times – remain a victim of the wellness culture’s campaign to profit off of individual’s fear of imperfection; and I thank all the therapists, family members, friends, pets, colleagues, and humans that have helped me develop coping strategies for when I’m told to be ashamed of the food I eat, and the food I enjoy.

Every person’s eating disorder and body image story is unique, and I hope those who are struggling have the support they need and deserve. You are beautiful and worthy – not just of food – but of life.

Powerless Over Food

By Tommy Barnett

Which is worse, the fear of eating food or the shame you experience after you eat something? The pain of hunger and the necessity to live always led me to eat. I can remember being so afraid of taking a single bite because I feared that I would gain weight. When I would eat, the shame would penetrate my core and force me to engage in eating disorder behaviors.

I can remember a time when I was in a treatment center. During snack time, I was called upon to go and see my primary counselor. Before I could leave the group, I was told I had to eat the yogurt that was given to me. I tried to sneak out of group because I didn’t want to eat the yogurt but the therapist caught me. As I stood in the middle of a group, I ate every bite of yogurt. The fear I was facing didn’t come from eating the yogurt but more from the shame I felt that everyone was watching me.  I felt naked and embarrassed being in my own skin.

Someone once stated that the difference between guilt and shame is that guilt is when you do something wrong and shame is when you feel you are wrong. Having an eating disorder is fighting a double battle. It takes so much effort to face the fear of eating and an even greater effort to be okay with ourselves after we eat. Every time I would eat food, I can remember using self-hatred as a motivator to engage in eating disorder behaviors. I felt like I couldn’t live with myself after I would eat something. The trick is, that in order to live you must eat. This was the cycle I lived in for too many years.

As we approach the holidays, being around food of any sort is almost inevitable. Today, I am neither afraid nor am I ashamed. I value my mind, body and soul and to do that is by practicing both a kind relationship with myself and with food. My hope is for you to find freedom from your pain and realize the true nature of yourself. A kind and loving soul, no matter how far down in the darkness you have gone. Beneath your fear, guilt, hurt and shame is a light waiting to shine through. Be strong my friends for you are never alone.

 

Considering Gut Health in Treating Eating Disorders

by Jason Arnold, PhD, ND

Currently there are approximately around 30 million people in the United States struggling with some form of eating disorder whether it be Anorexia Nervosa, Bulimia Nervosa, or Bing Eating Disorder (National Eating Disorder Association, 2018). According to the American Psychiatric Association, eating disorders have the highest mortality rate of any mental illness described in the Diagnostic and Statistical Manual (DSM; 2013). Clinicians and providers are still searching for new and innovative ways to treat these serious illnesses. We have seen the use of psychopharmacology, therapy, group therapy, family-based treatment, and functional approaches to clinical nutrition – all of which have been met with measured success. One of the areas that has been recently explored is your own body system and how this can influence not only your physical health, but your mental health as well.

There has been a huge amount of attention on the gut microbiome, or the community of microorganisms living in our digestive tracts. It appears that, in the past couple years, many physicians and providers have been looking at gut health as being a link to physical and mental health. For a Cliffs Notes idea of what this means is that your gut has trillions of microbes – “gut bugs”, so to speak – that are used in digestion and other physical processes that enable a person to live.

There is evidence that the health of your gut can impact your mental health. Based on research from the Journal of Psychosomatic Medicine (Kleiman, Watson, & Bulik-Sullivan, 2015) there appears to be a direct link between your gut and your brain. A majority of Serotonin – the neurotransmitter that regulates mood and anxiety states – is actually made in your digestive tract. The link between gut health and eating disorders is even more so. According to Dr. Loren Cordain, a scientist who specializes in nutrition and exercise physiology,  people who are struggling with eating disorders have different types of microbes, or gut bugs, than those who do not have ED. Each individual has close to a trillion bacteria in their gut that aids in digestion and processing of nutrients.  In addition, those who have eating disorders also typically have fewer microbes than those without eating disorders, which may be a result of altered digestive processes or eating disorder behaviors (Kleiman et al., 2015). Research suggests that a change in your gut microbiome can also help a change in your mood and aid in your recovery as well (Thaler, 2015; Deans, 2015).

So here are a couple of helpful hints that could  build back up your gut microbes, which in turn, may potentially help improve your mood, decrease your anxiety, and also help regulate how your body digests food and stores nutrients as you progress through the recovery of an eating disorder:

  1. First things first. The best rubric: Lack of nutrition and a lack of a balanced diet lead to poorer health, symptoms of depression, anxiety, and ultimately can influence the microbiome in your gut. A balanced diet according to Dr. SC Kleiman, a researcher on gut health and eating disorders, leads to more positive outcomes. Meet with your dietician regularly and make sure you ask questions and address any concerns you have about what you are eating and how that may influence your recovery.
  2. Consider the types of foods that you do eat. To strengthen your internal body system and your gut microbes, eating a variety of foods in textures, colors, etc. Research (Heiman & Greenway, 2016) suggests that variety helps to challenge gut microbes, encourages reproduction and diversity in your gut microbes, and strengthens the microbiome. The road to good gut health and an improvement in mood and anxiety, and ultimately a reduction in symptoms of an eating disorder is to allow for variation in your diet. This is a great way to also work on challenge foods as well!
  3. If you have been struggling with an eating disorder for quite some time consider probiotics. As a society, we’ve been using probiotics for years to support good gut health and digestion. These are foods, such as yogurt, that contain good, friendly bacteria that can help restore gut health. According to Dr. Karen Ross, MD, MPH, a physician and columnist from Psychology today, probiotics are associated with positive physical and mental outcomes. Probiotics also come as supplements including products like Culturelle. These can be taken under the direction of a physician.

If this is something you feel is worth exploring, speak to your doctor, dietician, or treatment team. During your recovery, it is important to have the maximum amount of support you can during a time that may be intimidating and sometimes very scary. Your providers can best help direct your treatment in a way that is right for you that will not only keep you healthy, but keep you safe. Everyone has the right to recovery regardless as to where they are in that process. If you need help, please do not hesitate and reach out.

Be well.

 

Bibliography

Deans, E. (2015). Junk food, gut, and brain. Evolutionary Psychiatry. Retrieved from https://www.psychologytoday.com/us/blog/evolutionary-psychiatry/201505/junk-food-gut-and-brain on September 15, 2018.

Heiman, ML & Greenway, FL (2016). A healthy gastrointestinal microbiome is dependent on dietary diversity. Molecular Metabolism, 5(5) 317-320.

Kleiman SC, Watson HJ, Bulik-Sullivan EC (2015). The intestinal microbiota in acute Anorexia Nervosa and during renourishment: Relationship to depression, anxiety, and eating disorder psychopathology. Psychosomatic Medicine. 2015.

Thaler, C. (2015). Eating disorders, mental health, and the gut microbiome. The Paleo Diet. Retrieved from https://thepaleodiet.com/eating-disorders-mental-health-and-the-gut-microbiome on September 12, 2018.