Witnessing a loved one struggling with an Eating Disorder is devastating enough, but when combined with substance use like alcohol or drugs, it becomes catastrophic.
Many individuals affected by an Eating Disorder are also dealing with some form of substance use1. This can occur before, during or after the Eating Disorder. When the substance abuse happens concurrently with an Eating Disorder, it can be a method to further lose weight or numb the psychological torture of the disease. Starting after can be a way to replace the feelings of comfort that the disease gave.
The commonality of both disorders is that they originate in similar areas of the brain, as well as more likely to affect those with decreased self-esteem, depression, anxiety or compulsive behaviour. Concurrent substance abuse can lead to a more severe Eating Disorder and potentially, a more severe impairment1.
Treatment for an Eating Disorder becomes more difficult than it already is when you add substance abuse. In my experience, not only is there a lack of integrated treatment, there are also few, if any, centres that will take in a client who presents with both disorders.
I have witnessed this with my adult daughter who for years (some unknown to me) abused alcohol as a method of dealing with her severe bulimia, anxiety, and obsessive compulsion. She was refused by numerous treatment venues due to their not treating alcohol dependence concurrently with her Eating Disorder.
It was a very difficult combination to witness as a mother and caregiver. You find yourself asking: Which condition is the more urgent to treat? And…Is what I am witnessing driven by the Eating Disorder or the alcohol?
Both conditions are secretive and caused her to lie, hide effects and generally become more depressed, obstinate, and unreasonable when it came to treatment options. The concurrent substance disorder, by nature, made her more unwilling to seek treatment. She was at a high risk for falls and injury to a body already weak and abused from her Eating Disorder.
She was a shell of herself.
With firm boundaries she has since stopped drinking but still suffers from bulimia. She attends outpatient counselling and is making slow progress. She is a different person. Yes, her Eating Disorder symptoms have increased to compensate, but she can deal with them better.
This has been a long journey for her (and us), but one that is easier to plod through without the ugly head of alcohol abuse. We love her and are proud of her and support all her efforts BUT without the influence of alcohol.
1 Woodside, D.B., Garfinkel, P.E., Lin, E., Goering, P., Kaplan, A.S., Goldbloom, D.S., et al. (2001). Comparisons of men with full or partial eating disorders, men without eating disorders, and women with eating disorders in the community. American Journal of Psychiatry, 158(4), 570-4.
The large Ontario Mental Health Survey (Garfinkel et al., 1996; Woodside et al., 2001) referred to in the reference above provided information on co-morbidity in eating disorders where 34% of women and 15% of men with an eating disorder had a lifetime diagnosis of major depression; 37% of men and 51% of women had a lifetime diagnosis of anxiety disorders and 45% of men and 21% of women had a lifetime diagnosis of alcohol dependence.
Eating Disorders and Substance AbuseK.M.2021-07-27T15:05:39-04:00
There are many factors that go into someone developing an Eating Disorder. For some a disability might be one of the triggers that influence the development of an Eating Disorder and it may even perpetuate the illness.
Mouna Yassine was born with albinism and a visual impairment. She is very nearsighted and with an underdeveloped iris, glasses don’t help. Mouna says she didn’t really notice she was different until she went to school and kids started bullying her because of her pale skin and hair and inability to see properly. “I started to feel kind of that I was just not right. Something was wrong with me,” she remembers. “I felt a lot of lack of control in my life and my surroundings because of being hurt by others so ultimately I went to food. Food was the only thing I felt that I had control over.”
For 13-year-old Mouna the Eating Disorder felt like an escape. No matter what happened at school, like the bullying or feeling like she was an outsider, she could always go back to Eating Disorder behaviours for comfort. “In a way it just took me to a different world other than my reality,” she says.
Mouna started her recovery when she was 16 but says it was really hard to let go of the Eating Disorder because it had been her comfort zone for so long. Her visual impairment also continued to make her feel like an outcast…even in treatment, where everyone was supportive and welcoming. Because of all the bullying she had endured she felt like she had to keep people at a distance to protect herself. “I think that was a huge factor for me while I continued to go in and out of treatment,” she says. “I kept getting sick again and again because I couldn’t connect with everyone.”
It took Mouna 10 years and 12 rounds of treatment to finally open up about her disability, which she believes was a key component to her recovery. “I think a lot of us with disabilities kind of try to push it away in hoping that’s not the reason why I’m sick,” she says. “It’s not the whole reason for me, of course, but it definitely played a huge role.”
Mouna has been in remission from her Eating Disorder for four years now, and is starting her Masters in counselling psychology in the fall. Sometimes those feelings of inadequacy due to her disability come back, but with the skills she has learned in treatment she is able to move past them and protect her recovery. “I keep pushing through and I keep reminding myself, looking at my life now, every time I feel that way, I am able to go on,” she says. “I have accomplished a lot of things despite my visual impairment so checking those facts was really important for me to keep going.”
Mouna would encourage anyone with a disability who is entering treatment to be open to talking about how their disability has affected their life and Eating Disorder. In her experience there may be a lot of fear and shame involved in opening up, but it is an important part of the healing process. “It really opened my eyes up,” she says. “It made me realize that not everyone is going to judge me because of it. There are really good people in the world.”
In recovery it is also very important to have a support system to validate accomplishments and serve as motivation to keep going. “Let everyone kind of support you and be there for you because that’s the whole point of treatment,” Mouna says. “Tell everyone that that’s how you feel in the moment and work from there.”
Mouna says that for her, it was important to go through a grieving process in terms of her physical limitations; but in the end she came to a point of acceptance with her visual impairment. She is now very focused on living her life to the fullest and not letting her disability or Eating Disorder get in her way. “Eventually you will get to an acceptance point of accepting yourself for who you are and then once that happens, magical things can happen” she says. “You realize that you are so capable of a lot of things.”
An Eating Disorder with a disability – A story of recoveryHilary Thomson2021-06-08T19:03:25-04:00
Pregnancy and parenting require a great deal of strength, physically, mentally and emotionally. For women with a history of Eating Disorders, these challenges can be amplified as they watch their bodies change and grow.
Katherine McPhee Foster, runner up on season 5 of American Idol, recently became a new mom to a baby boy. She is one example of a woman who came close to experiencing an Eating Disorder relapse during pregnancy.
Katherine McPhee began her struggle with bulimia when she was in middle school. However, after a treatment program and therapy, she became stable for 4-5 years before her pregnancy.
This is why when Katherine began struggling with her body image during her first trimester, it came as a bit of a shock to her. To cope with these feelings, she decided to seek help from her therapist.
Ilene Fishman, board member of the National Eating Disorders Association in the USA and an Eating Disorders clinician, said that it is completely normal for thoughts of disordered eating to resurface during pregnancy as the body changes and one may feel out of control. For someone who has recovered from a past Eating Disorder, this can be especially scary.
For Katherine, her Eating Disorder stemmed from an unhealthy relationship with herself. Psychotherapy helped her develop a healthier relationship with herself which, in turn, helped her manage her Eating Disorder throughout her pregnancy.
Here are some tips for dealing with disordered eating thoughts during pregnancy:
Seek professional help ASAP. This can be a professional you have had a good experience with in the past or someone entirely new. It is important that you feel you can be completely open and honest with them. If you find they aren’t being sensitive to your concerns, you may want to consider switching providers.
Look at it as an opportunity for growth. We live in a society that constantly challenges us. Moreover, when we age, our bodies naturally change. Overcoming these thoughts of disordered eating that may occur during pregnancy can build resilience.
Remember that there is nothing to be ashamed of when asking for help. It is the best, most courageous thing you can do for yourself and your baby in the long run. Rather than seeing yourself as a failure, look at your challenges as an opportunity for growth that will help you reach your full potential as an individual and a mother.
We have the power to raise the future generation to place their focus on good health rather than weight and physical appearance. Before we can teach our children, we need to be able to embrace these positive attitudes in ourselves.
Last year NIED launched our ‘Share your Story’ guidelines, meant to teach people with lived experience how to share their recovery journey responsibly.
Since then a few people have reached out to NIED wanting to share their story, including B.C. resident and mom of two, Parisa Zaini. Parisa is originally from Iran and battled her Eating Disorder without much support for many years before she came to Canada and was able to receive specialized help.
Parisa says her fear around food probably started in high school. She remembers her classmates bringing in treats for their weekly social hour and never allowing herself to have any. However, her Eating Disorder didn’t get extremely serious until 1997, after the birth of her second child. “I had a very bad delivery,” she says. “It was a life and death situation and I had PTSD after that.”
Parisa says nobody knew what an Eating Disorder was in Iran. Everyone just thought she was weak and not eating because she wasn’t hungry. In 2002 Parisa came to Canada to stay with her uncle to see what the country was like, because it was likely that they were going to immigrate here. Her brother was living in the U.S. and came to visit for a few days during her trip. Having lived in the U.S. for 15 years, he recognized the signs of an Eating Disorder immediately. When Parisa went back to Iran, her brother phoned her parents and husband to tell them what as going on and how dangerous her situation was. “I didn’t even know what an Eating Disorder was,” Parisa remembers. “I went to the dictionary and looked up what is an Eating Disorder and I looked at it and saw the description and thought – yes- that resembles me.”
Parisa’s family found her a psychiatrist who was originally from Germany who knew about Eating Disorders. But things got so bad that she had to be admitted to a psychiatric ward in Iran for 45 days. She says her time in the hospital was horrible with little to no treatment. “It was very bad,” she says. “I was locking my door all the time because there were people that weren’t in a good situation at night.”
Six months after she was discharged from hospital Parisa moved to Vancouver, B.C. with her family. Thankfully, after she arrived in Canada she was able to get proper treatment for her Eating Disorder. She spent two weeks in an inpatient program at St Paul’s Hospital and continued to get treatment on an outpatient basis for many years after that. She had a counsellor whom she saw weekly and she used workbooks and a meditation practice to bolster her recovery. She says awareness was key in her recovery and realizing the damage that her Eating Disorder was causing in her body motivated her to make changes. “Gradually I became better,” she says. “I think those were the tools that helped me.”
Parisa now considers herself to be about 75 per cent recovered. While she is grateful for her recovery she is cognisant of what her Eating Disorder stole from her while she was sick. She is an academic at heart and her Eating Disorder caused her to drop out of a PhD program at UBC because she was too ill to study. By sharing her story Parisa hopes to keep others from suffering for as long as she did. “I have to talk about it,” she says. “It shouldn’t happen for anybody else.”
To read more about Parisa’s story check out the Share your Story section on our website. If you would like to share your own story check out our Share your Story guidelines. We would love to hear from you!
Share your Story – Parisa opens up about her Eating Disorder and recoveryHilary Thomson2021-03-05T13:07:51-05:00
Did you know that the entire month of March is Nutrition Month? Every year, Nutrition Month promotes a different theme, and the theme for 2021 is: “Good for you! Dietitians help you find your healthy.” This theme emphasizes that Dietitians consider many different factors when working with clients and providing nutrition support, such as culture, traditions, preferences, and nutritional needs.
Whether or not you have been diagnosed with an Eating Disorder, you might be wondering: how do I choose a Registered Dietitian (RD) who will provide the best support for me (or my loved one)? Kudos to you for having the courage to reach out for help!
As an RD myself who specializes in Disordered Eating/Eating Disorders, I strive to provide client-centered care and nutrition counselling that is most appropriate based on the needs of the client. I continue to expand my knowledge in the field of nutrition and different client needs every day.
That being said, here are a few things to consider when choosing an RD:
What level of support do you need, and how far along are you in your recovery journey? This will ultimately influence whether you would benefit from working with an RD alone, or in combination with an interdisciplinary team comprising different healthcare practitioners (e.g. doctor, psychologist, social worker, etc.). Working with a team provides additional layers of support whereby an RD plays an integral role.
Does the RD use a weight-inclusive, anti-diet approach, and are they confident and well-informed to provide nutrition counselling services in the area of Eating Disorders? Are they compassionate towards you? Do you feel comfortable with them? While these points may seem obvious, the type of approach that they use, and your comfort level will ultimately play a big role in recovery.
Do you have other health conditions or nutritional concerns that need to be addressed (i.e. IBS, diabetes, sports nutrition for athletes)? RDs specialize in many different areas, which is why they typically have a select few niches in which they are very well-versed.
Are there financial constraints to consider? RDs working in private practice require insurance or paying directly out of pocket. If financially feasible, the benefits of choosing private practice are that clients receive individual counselling, can self-refer, and wait times are typically shorter compared to publicly funded treatment programs. Public programs are offered in hospitals and community health centers and can include individual and group counselling, whether it be through day programs or residential programs, depending on the type of treatment. While public programs are free, they typically require referral from a healthcare professional and may include longer wait times.
Last – but certainly not least – is the RD culturally competent? A one-size-fits-all approach to treatment is like trying to use the same size collar on all types of dogs and expecting the fit to be the same. It simply does not work, as everyone comes from different ethnic backgrounds and cultural experiences, which influence our beliefs and behaviours. It is important that this be considered as part of the treatment plan.
It was philosopher Ralph Waldo Emerson who stated that, “The first wealth is health.” Are you ready to take the next step and find your healthy?
Eating Disorders have historically been pegged as a mental illness that affects affluent, white women and girls. One of the first high profile cases of Anorexia Nervosa was Karen Carpenter, a white American singer who died of the illness in 1983. Since then, there have been many other famous white females who have admitted to Eating Disorder behaviours publicly (think Lady Gaga, Taylor Swift and Portia de Rossi).
While these women have definitely raised the profile of Eating Disorders across the globe, their stories promote that same age-old myth – that Eating Disorders affect white females and no one else.
Julissa Minaya is a 16-year-old mixed race girl from Dallas, Texas who is currently in recovery from an Eating Disorder that started when she was just a child. She was heavily involved in dancing, acting and figure-skating when she was younger, all of which put an immense focus on her body. “My acting coach told me that I would probably be more successful in the career if I was smaller,” she remembers. “So I went on my first diet when I was like 10 or 11 and then it just spiraled from there.”
Julissa says that going to private school in Texas also contributed to the onset and continuation of her illness. “The schools that I’ve gone to have been predominately white, so I was with a bunch of girls that didn’t look like me,” she says. “They were all really thin and tall and I wasn’t.”
When Julissa started her recovery about a year ago, she relied heavily on social media for inspiration. Unfortunately, she couldn’t find anyone in the online Eating Disorder recovery community who looked like her. “I definitely didn’t see a lot of representation, especially being mixed because I’m Dominican, Puerto Rican, Black and German,” she says. “A lot of the time with my identities I feel kind of lost, especially growing up being surrounded by so many white people and so that kind of followed me through the Instagram community. I didn’t see anyone who looked like me or anyone who was a person of colour.”
Instead of giving up Julissa made the brave decision to start her own Instagram account to share her journey through recovery as a member of the BIPOC community. “I think that my voice matters, especially bringing in the perspective of a person of colour dealing with an Eating Disorder and having one so young,” she says. “So, I definitely wanted to share a perspective that is not like everyone else’s.”
Julissa hopes that her account will help other people of colour feel more seen and heard in the Eating Disorder recovery space. She says that if she had seen more representation it would have definitely helped push her towards recovery. “My recovery probably would have started a little sooner or made me feel less alone because when I was following Instagram accounts and watching YouTube videos it was all people that just looked the same,” she says. “I just kind of felt left out because I was like, oh, I don’t identify with these people past the fact that we all have Eating Disorders.”
Julissa believes that the fact that there aren’t as many people of colour talking about mental illness online is a societal issue. As a society we are more receptive to straight sized white females talking about Eating Disorders than fat people, men or people from the BIPOC or LGBTQ+ community. She says that within BIPOC community mental illness is something that isn’t often talked about, even though statistics show that they are disproportionately affected the most. “It’s definitely an issue within our communities and within society,” she says.
Julissa’s experience putting herself out there online has been mainly positive and she is happy that she is able to be a voice in the Eating Disorder recovery space for the BIPOC community. “I love being able to know that my story could be helping at least one person,” she says.
You can find Julissa and learn more about her story on Instagram under julissas.recovery.
Are you a member of the BIPOC community? How do you feel that the Eating Disorder recovery space can better support you in your own recovery?
More representation needed in Eating Disorder recovery spacesHilary Thomson2021-02-16T21:28:40-05:00
This article was written by a volunteer, KC, that addresses the theme – Eating Disorders Can’t Afford to Wait – What Happened While we Waited. KC is a young adult who has lived under/in/against/with anorexia for nearly a decade. I live in BC amongst big trees, wild ocean, my very special dogs, and my wonderful family and friends. I have a BA in anthropology and am active in paid, volunteer, and community roles related to health research, social justice, and community activism.
When you read the sentence “What happened while we waited,” you may imagine a group of people sitting in a waiting room, signing their names on a wait list, or standing in a line to board a ferry. Waiting is often associated with stillness, patience, and expectation. But when you enter the world of an Eating Disorder, you do not step into anything like an orderly terminal. Instead, you are thrown out to sea.
What happens when you get thrown into an unfamiliar, threatening sea with no land in sight? For the first half a decade of my Eating Disorder, my mom would often tell practitioners that we were just managing to hold our heads above water. For her, keeping afloat was a constant struggle: A struggle to keep me alive and safe, to bear with the litany of challenges and pain, and to find understanding and help.
For me, I had forsaken any expectations of reaching something better. I was not in a place of active waiting for return or arrival. In this metaphorical sea, I was swimming just “to get out,” all while other people screamed at me that I was going into deeper, rougher waters. I no longer wanted to get to the land I had left or to any new land people tried to promise me, I just wanted out of the sea I was in.
People do many things when they are thrown out to sea – metaphorical or real. They may cry out, search, fight, try, give up, try again…But they don’t wait.
We are being told to wait: Wait for assessments, appointments, beds, funding, better research, better treatments. Many of us are forced to wait even when it may seem that adequate supports exist: wait for your weight to change so you can meet eligibility criteria, wait for available providers to take you seriously, wait some length of time until those providers realize the current approach is not working at all, wait in the ER while one practitioner tells you you’re close to dying and the next tells you you’re overreacting, wait until the caring nurse relieves the punitive one, wait a requisite time and duration of weight gain to be discharged from a harmful system, wait in worsening psychological and physical decline until something might change and work.
Eating Disorders don’t wait. You can’t put an Eating Disorder on hold like we have in this pandemic with social contacts, working in the office, going to the gym, or travelling. An unmanaged eating disorder rages and infiltrates a person’s brain, body, life, family, and community.
So, as we are told to wait and as policymakers, health authorities, and practitioners look at case files and available beds, people with Eating Disorders and their loved ones are grappling, flailing, striving, suffering, and trying to survive.
There is immense suffering in life with an unmanaged Eating Disorder that cannot be captured in needs reports or wait lists. Eating Disorders tear at relationships, commitments, bodies, and even a person’s own sense of self. While people focus on weight loss, there is an underappreciation for the loss of one’s passions, physical abilities, competencies, ease in the world, caring mutual relationships, and vitality. A person with an Eating Disorder may experience utterly foreign sensations, urges, and feelings, which can be terrifying and distressing. There can be rage, fear, and despair at a level the person did not know was possible. Loved ones often feel the wrath of this rage, the harmful consequences of this fear, and the heavy blanket of numbness from the despair. As we continue to wait for meaningful understanding and support, those with Eating Disorders and their loved ones continue suffering.
The vast complexity and value of the lives that we all continue living with Eating Disorders is likewise not captured by reports and statistics.
The deep pain and fleeting times of relief, moments of pure joy and dark despair, meaningful victories and devastating defeats, daily habits and absurd coincidences, moving new connections and tragic losses continue to exist. As individuals, with diverse and rich attributes beyond “anorexic” or “bulimic,” we continue to be and interact with the world (albeit often more restrictedly) as our unique selves. In the depths of an unmanaged Eating Disorder, I have seen people kiss a newborn niece, graduate from university, tenderly care for seniors as a volunteer in long-term care, and speak articulately at an event for a cause that mattered to them. We are not BMIs to increase, beds to empty, diagnoses to resolve, and checkboxes to tick off.
As we continue to wait, people with Eating Disorders often resort to what has been done for decades, even centuries: lacking an available, accurate, and usable understanding of the disorder or any treatments, we and our loved ones guess, try, fail, try again, and hope to reach a point of sustainable life. There is such a lack of recognition of the important ways people with eating disorders and our loved ones create our own ways to cope and live meaningfully with this illness. This is one of the most important things we are doing right now while we wait: We stop waiting on the system.
But endurance, trial and error, and sacrifice as the status quo is unreasonable and dangerous. It took 8 years of my life, significant costs and damage, and incalculable suffering to get afloat. It was only because of immense support and privilege that I reached a place of stability. And, stability in the Eating Disorder sea can still be precarious.
In the absence of accessible, suitable, compassionate, effective services, people with Eating Disorders will continue to be thrown out to sea. Without acknowledgement of these gaps and inadequacies in the current understanding, treatment, and support of eating disorders, people will continue to suffer and to die in that sea. We can’t afford the pain, all the losses and sacrifices, all the damage, and all the life being lost that is incurred as we are told to wait. So, as EDAW underlines, we simply can’t afford to wait.https://nied.ca/the-history-of-eating-disorders-awareness-week-edaw/
EDAW 2021: Eating Disorders Can’t Afford to Wait – What Happened While We WaitedHilary Thomson2021-03-03T20:19:04-05:00
Sarah Thomson was diagnosed with Anorexia Nervosa when she was 16 years old. Her Eating Disorder developed quite quickly, and she soon found herself lost in a world of weight loss and restriction that seemed impossible to escape. “At first I was protective and got some thrill out of ED,” she remembers. “I knew using it wasn’t an effective coping strategy, but I didn’t know how else to cope.”
Despite numerous treatment attempts, Sarah couldn’t seem to kick the Eating Disorder mindset. It seemed unlikely to her that she would ever be able to live her life in a way that didn’t revolve around calories, food and her body. “It was like an abusive relationship that I couldn’t seem to cut ties with,” she says.
In March 2010 she was admitted to Homewood Health Centre for the last time. This was her second time at Homewood, and she was desperate to make it work. “My heart was like if this doesn’t work this is the end,” she says.
Sarah made it through the program at Homewood and was discharged in the summer of 2010. She says she did well in the artificial setting of treatment; but once she was back in the real world she started to struggle. “I went back to university and I didn’t relapse per se in my head, but I lost a lot of weight again,” she says. “But I think what kept me going is I still really wanted recovery.”
Sarah remembers trying to be as engaged in life as much as she could, while still in a place of quasi-recovery. She kept herself afloat by using all her supports, like seeing a doctor, dietitian and counsellor regularly, to remind herself of what she wanted.
In the summer of 2011, she decided to take a huge leap out of her comfort zone and take a job teaching English at a camp in Spain. At first Sarah says it was terrible. Her Eating Disorder was raging, and her other mental illnesses rose to the surface. “I was not in a good place at all,” she remembers.
She saw a doctor, talked to her boss and her father was even ready to get on a plane and take her home. But Sarah knew that wasn’t what she wanted. “It was sink or swim,” she says. “I knew I could continue down this path or I could choose something different because I knew if I came back to Canada it would be just terrible. I knew I would be so disappointed my myself and it would further reinforce the Eating Disorder place in my head that I’m not worthy and I can’t do things and I’m going to be sick my whole life.”
So Sarah swam. She leaned into the structure of the camp and ate the food that was placed in front of her at every meal. “I had a hard time but then I got into a stride of just not even focusing on the food kind of thing, focusing on the other stuff and that just kind of flew by,” she says.
The momentum that she picked up in Spain didn’t waiver when she got back to Canada. She had a renewed sense of confidence and the feeling that she could rely on herself to make the right decisions when things got tough. “That was really important for me. Even though it was so uncomfortable to rely on myself and my own choices I realized I can get through things without anybody,” she says. “It gave me a good sense of myself.”
Sarah continued on with recovery while finishing a degree in microbiology at Guelph University. She also started speaking publicly about her experience with an Eating Disorder which helped her make peace with her past while also giving her motivation to continue on with recovery.
Sarah says she attributes her recovery to the small choices she made every day that pushed her towards the freedom she now has around food. Meeting her husband was another turning point for her as she was able to make the decision to prioritize her relationship with him over the Eating Disorder. “I was taking ownership of my recovery but asking for support when I needed it,” she says. “Life had already really opened up and so life essentially become more important than the restriction and the rules and the body image.”
Sarah now lives in Guelph with her husband and two children. While she sometimes still hears the Eating Disorder voice in the background, it is largely drowned out by the “Sarah” voice that she has worked extremely hard to strengthen. “I’ve learned to listen to my body about what my body wants,” she says. “That’s such a better relationship than following all the rules and everything.”
If she could give advice to someone who is in quasi-recovery, it’s not to stop half-way. “[Full recovery] is possible, but you have to take steps,” she says. “When you’re given opportunities to step outside your comfort zone, take them and try and take steps every day to make your life worth living because if you do that then eventually your life might be just more important than your Eating Disorder.”
Intuitive eating has become a bit of a buzz word in health and wellness community over the past few years. Many people believe that it is as simple as eating when you are hungry and stopping when you are full, but this is only one piece of more complex puzzle that makes up the practice of intuitive eating.
Coined by Evelyn Tribole and Elyse Resch, intuitive eating is a ten-principle mind-body self-care eating framework. It takes into consideration nutrition as well as the emotional and social aspects of eating to help people make peace with food and live a healthier, happier life. These principles include:
Reject the diet mentality
Honour your hunger
Make peace with food
challenge the food police,
Discover the satisfaction factor
Feel your fullness
Cope with your emotions with kindness
Respect your body
Movement – feel the difference
Honour your health with gentle nutrition
As a dietitian who specializes in Eating Disorders, Dina Skaff believes that many of the principles of intuitive eating can be very helpful for those in recovery. She sees it as an important framework for making peace with food and body. “It’s that framework that really allows us to become in tune with our body signals and cues in order to fill our biological and psychological needs,” she says. “It also helps us identify external obstacles from being able to nourish ourselves intuitively.”
For people in recovery these obstacles can be the Eating Disorder itself but also diet culture which is everywhere in our society. Dina says sometimes diet culture can event coopt intuitive eating into a new diet that solely focuses on hunger and fullness cues and doesn’t take into account all of the other aspects of the process. “True intuitive eating is a weight inclusive health at every size approach,” she says. “It’s really about giving yourself unconditional permission to eat all foods in you’re here and now body. Not with the intention to change your body or your weight.”
One of the key principles of intuitive eating is not seeing any food as “good” or “bad.” Dina says that some people in recovery from an Eating Disorder they may find that they are craving the foods that they previously deemed off limits. This is a completely normal part of the process and it doesn’t need to be judged or scrutinized. Mental health plays a huge role in physical health and for many people eating a chocolate bar may be much healthier in the log run than another apple or handful of carrots. Following the rules of an Eating Disorder takes up a lot of mental energy which can in turn heighten anxiety and stress levels. “When we start to remove these [rules] and recognize that these obstacles are there, then we can start to remove the walls and the kind of rigidity that can happen with either following a diet or the rules of an Eating Disorder and allow that unconditional permission to eat,” she says. “Foods don’t hold a moral value. It may temporarily increase anxiety; but it actually opens up that mental space for more peace around food.”
Dina says it is important to note that for many people in recovery the “feeling your fullness” aspect of intuitive eating can be quite difficult, and it can be important to rely on a more structured way of eating at the beginning to get hunger and fullness cues on track. “It is self care to be incorporating that type of a structure when you need it,” she says. That doesn’t mean however, that you can’t implement other aspects of intuitive eating into your life like “rejecting the diet mentality” or “challenging the food police”. “There may be bits and pieces throughout the journey where you would be incorporating bits of intuitive eating without even really noticing it,” she says.
Dina is adamant that if someone with an Eating Disorder is thinking about experimenting with intuitive eating, they should always consult with a professional to make sure they are medically stable and getting the nutrition their body needs. Intuitive eating is an extremely personal journey and really diving into it requires a lot of self awareness in terms of bodily cues and the Eating Disorder voice. She stresses that some people with Eating Disorders may always need some sort of structured plan to safeguard their recovery. “Some people may be able to eventually move completely away from a meal plan and tap into their internal cues, but if there are others who can’t that’s OK,” she says. “I think there might be a lot of pressure in the Eating Disorder community in hearing about intuitive eating that it is the end goal of recovery and it is important to note that it is really individual.”
If you want to learn more about intuitive eating there is more information at www.intuitiveeating.org about each of the ten principles. Remember that everyone is on their own journey and it is important to take what will serve you and leave the rest. Intuitive eating can be a great way to make peace with food and your body; but nothing can replace the advice of a professional who knows your unique case. Check out the NEDIC website to find a service provider in your area.
What is intuitive eating – how to know when you are readyHilary Thomson2020-10-13T21:35:05-04:00
Recovery from an Eating Disorder is hard. It takes a lot of dedication, perseverance and, often, a team of professionals. This can typically include psychiatrists, psychologists, dietitians, nurses, social workers and even occupational therapists who all have a unique role to play in guiding a person on the road to recovery.
Many of these professionals work within the confines of scheduled appointments. While these appointments are integral, the vast majority of the recovery process happens in everyday life, beyond the four walls of a therapists of dietitian’s office. In fact, this is when many people in recovery need the most support. It is one thing to agree to a plan in a one hour scheduled appointment, but completely another to actual follow through with the stressors and pressures of everyday life.
In recent years a new field of Eating Disorder support professionals has opened up to fill that gap. Mia Findlay is an accredited Eating Disorder Recovery Coach based out of Sydney, Australia. She suffered with an Eating Disorder for six years before starting her recovery in 2013 and has now been fully recovered for six years. Findlay started off as an advocate, using her very successful YouTube channel called, What Mia Did Next, to raise awareness for Eating Disorders, speak out against diet culture and promote body neutrality and acceptance. Through her channel she also became an ambassador for Australia’s leading Eating Disorder charity, The Butterfly Foundation.
Findlay says that it was through her work with the Butterfly Foundation that she found her way into the recovery coaching field. After speaking on a panel, a couple of mental health professionals asked her if she worked in the recovery space for a living. At the time Findlay was working and finance and was finding her passion and drive in her advocacy work, never thinking that she would be able to make it a career. “They made me aware that coaching had opened up as a field, much like in sobriety and addiction treatment,” she says. “That’s been a really important part of that model for so long, and it’s only recently been adopted in Eating Disorder treatment.”
Findlay did some research, and, after doing some general coaching courses found the Carolyn Costin Institute coaching certification, which focused completely on training Eating Disorder coaches. “It was incredible, and I would highly recommend it to anyone wanting to go into the coaching field,” she says. “I just loved the concept of it because it was using my lived experience for something really constructive.”
Findlay has now been running her business as a recovery coach, called Beyond Body (https://www.beyondbodycoach.com/), for 2.5 years. She says she often works within a treatment team, usually with a psychologist and/or dietitian. “I’m kind of like the last step in the chain,” she says. “[My clients] are given all this great direction and information and understanding of their eating disorder and we actually turn that into actionable goals.”
Findlay sees clients on a weekly basis where they make very specific and flexible goals to help them move forward on their path to recovery. For example, if a client is consistently pushing off eating breakfast in the morning, she will help them set a goal to have breakfast 40-60 minutes after they wake up in the morning and implement it 3-5 days in the week. “It’s really flexible. We want to get away from that black or white thinking and that perfectionistic type of goal setting,” she says. “It’s more about trying to learn and get data out of how their eating disorder responds when we set these goals and we’re working on them.”
Findlay also encourages her clients to reach out to her via email of WhatsApp if they are having a hard time between sessions. “We’re strategizing in real time when difficulties pop up,” she says. For clients she sees in person, she also helps with things like grocery shopping, clothes shopping, going out to meals and cooking at home. “We’re trying to help them recover in the real world,” she says. “It’s really working on their resilience and helping them see that they can survive things that feel impossible to do.”
Findlay’s approach is very specific to each of her clients, who often have very different needs. Some may need to work on things like calorie counting and getting off the scales, while others may be struggling more with their relationship with exercise and movement. “There’s not like a formula or a set program or anything,” she says, noting that she does use the 8 Keys to Recovery from an Eating Disorder by Carolyn Costin with all her clients.
As beneficial as recovery coaching can be Findlay admits that they whole coaching field can be a little bit of the “Wild West” because it is not a protected title like other healthcare professionals. Firstly, she would recommend people make sure that any coach they hire is actually fully recovered. “I even had one yesterday sent to me who is actively recovering and also coaching, which I just don’t think is a responsible avenue to take,” she says. “It’s really important that you are able to demonstrate what [your clients] are aiming for.”
From Findlay’s perspective another important thing to look for in a recovery coach is proper accreditation. She says there is a huge difference between having a general coaching certification and one that is specific to Eating Disorders. “The difference in your preparedness, quality of your coaching and yourself as a professional is just worlds apart,” she says.
Findlay says being able to use her lived experience to help others with Eating Disorders is one of the most rewarding things about being a recovery coach. “The fact that I am able to help other people out of the same trap feels almost like a big middle finger to my Eating Disorder,” she says. “To have connection and purpose come out of that is incredible.”
Like many recovery coaches Findlay works with people all over the world. Sarah Rzemieniak (https://sarahrzemieniak.com/) is another Carolyn Costin Institute-certified Eating Disorder recovery coach, based out of Vancouver, Canada who also works with clients worldwide. Meg McCabe (http://www.meg-mccabe.com) is another a Carolyn Costin-trained Eating Disorder recovery coach, based out of Denver, Colorado.
Recovery coaching is still an up and coming field but if you are looking for a coach be sure to check out Findlay, Rzemieniak or McCabe’s websites for more information about what they offer.
What is an Eating Disorder Recovery Coach?Hilary Thomson2020-10-05T20:51:59-04:00