There are several papers in Eating Disorders and Obesity which deal with the psychological problems of obese and other eating-disordered people. With the obese, it's a chicken and egg thing--are fat people depressed and do they have low self-esteem because they're obese, or do they eat to get rid of pain, set off those happy endorphins and serotonin, and thus get fat? Probably a little of both, but certainly being obese or overweight is depressing in this culture. Moreover, being blamed for your illness doesn't make you feel good about yourself. Sure, there are things an eating-disordered person did/does which made her fat, but insults such as "disgusting," "ugly," "slob," "lazy," and so on aren't helpful by a long shot. If anyone's body is berated with those words, they'll soon come to loathe themselves.
People who don't have an eating disorder won't turn to food to assuage pain. They'll go for a walk, buy new shoes, see a movie, call a friend, or do any of a bunch of things to cheer up, not stuff themselves with junk food or binge on 10,000+ calories. The latter shows self-loathing. Anorexics, on the other hand, must control something in their lives. They hate their home life, work life, their bodies, their ugliness, their lack of talent--all sorts of things--and feel they can't control that. But one thing they can control is their appetite, one of the basic needs and desires any animal can have. They hate themselves so much they'll starve themselves to death. Pretty grim.
I learned today that I've never had a true binge. That was a surprise, and a comfort. I think the most I've ever eaten in one sitting is 2000-3000 calories, and I call 3,000 in one day a binge. That's not a binge in psychiatric terms. A binger will eat up to 9 times in one sitting what she'd eat in a typical day, or up to 18,000 calories a day! The bottom is 10,000. It's hard for me to believe anyone could consume 18,000 calories in one night, but I suppose that's interspersed with vomiting sessions. That's incredible, and my heart goes out to them. It must hurt very much, or at least be tremendously uncomfortable. Vomiting then serves two purposes: it gets rid of calories to keep weight down, and relieves pain in the abdomen from distention. While dangerous, it's actually helpful given the purger's mindset.
One study showed that binge eaters have a greater risk of other psychopathologies (depression, low self esteem), at 60%, than non-binge overeaters, at 28%. (Here, depression means a clinically severe depression, not just blue or "down.") This illustrates the potential danger of binge eating for a fat person. The heavier, the worse the psychological problems are, which makes sense. Age of onset is important, too. Many obese people were obese since early childhood, or certainly by adolescence. The overweight generally don't become obese in childhood. They might gain a lot of weight around menarche, but usually not before. All these things are relative, however. No one person has everything, nor is anyone a statistic.
There's a lot more to this than what I've written tonight, but you get the idea. I'll address it more later. I just wanted make it clear that you aren't the only one binging; you aren't the only one who hates herself; you aren't the only one who cries about your weight. All of us in this boat do one or another, or all of these things. In a study of small children and attitudes toward obesity, they were asked a series of questions, such as would you rather be thin than fat? They all said yes. Would you rather have a cold than be fat? Yes. Finally, they got to--would you rather lose a leg or be fat? Over 80% said they'd rather lose a limb than be fat! How on earth did we teach them this? Where have our children learned this from? How has being fat terrified children so much that they'd rather not have a leg than be obese? This is more than sad: it's nuts.
Take care this evening and until I see you again. I know that most of you are on the way to good health. It's difficult. Okay, it's harder than difficult--it stinks. But with the right attitude, it's quite doable, and certainly worth it. You'll love the normal, slim, you. Promise.
Thursday, February 10, 2011
Wednesday, February 9, 2011
Another book on tap.
I thought I'd try to read a book on low-carb dieting called Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health, by Gary Taubes. He's a journalist, not a researcher, and the book wasn't recommended by a scientist, but I thought I'd give it a shot. I'm not big on this idea; then again, I haven't read too much about it.
It's not that I don't think there are bad calories. I believe that if you're on a weight loss diet, you can't eat a sundae and that's your 1200 calories for a day. Why not? Put nutrition aside, and think only of insulin. A jolt of sugar like that causes an immediate flow of insulin to be released in your body. There will be more insulin produced than is needed to process the sugar, which leaves some "left over," so to speak. Since insulin increases appetite, you'll be hungry for a long, long, time after eating that sundae.
Moreover, people like us, who tend to binge, are eating the worst thing we can eat to keep stable. Sundaes have gotten us fat, not skin-free chicken breasts with a side of broccoli. Sweets are a huge trigger for most of us, especially sweets which are high fat. Not only does it set the body off on a hunger rampage, it sets our minds off on an "I can eat anything" spree.
I'll see what he has to say.
It's not that I don't think there are bad calories. I believe that if you're on a weight loss diet, you can't eat a sundae and that's your 1200 calories for a day. Why not? Put nutrition aside, and think only of insulin. A jolt of sugar like that causes an immediate flow of insulin to be released in your body. There will be more insulin produced than is needed to process the sugar, which leaves some "left over," so to speak. Since insulin increases appetite, you'll be hungry for a long, long, time after eating that sundae.
Moreover, people like us, who tend to binge, are eating the worst thing we can eat to keep stable. Sundaes have gotten us fat, not skin-free chicken breasts with a side of broccoli. Sweets are a huge trigger for most of us, especially sweets which are high fat. Not only does it set the body off on a hunger rampage, it sets our minds off on an "I can eat anything" spree.
I'll see what he has to say.
Monday, February 7, 2011
Book recommendation
I'm reading a book by Frank Bruni, titled Born Round. Bruni is an award-winning journalist who's covered the White House, foreign capitols, and much more hard news, but has been the New York Times' food critic for several years now. The title is a reference to something his grandmother said to him, "If you're born round, you will never be square." Bruni was born round, as many of us were.
He catalogues his appetite and the foods he ate, always in massive amounts. He just loved food, and turned it into his friend as he got older. By the time he was in college, however, he'd turned a minor problem into a full-blown, serious eating disorder, using purging to get rid of meals right after he'd eaten. He certainly was a compulsive overeater, with bulimia, by the time he was a young man, but he had an unhealthy attitude toward food practically from the time he was born.
The chronicle of his eating might be triggering for those who are fighting obesity or bulimia. The meals were eaten with abandon, and he goes into their details. He is also fairly graphic about the vomiting, and that could add a weapon to those of you who might already tend toward purging. If you think this stuff could be a problem for you, please don't read it. But for others, I do think you can identify, and he'll show you the way out of the hell of a severe ED to health. He's now able to eat the finest foods in New York as well as Europe without weight gain.
I did some restaurant reviewing when I was a journalist. It's not as easy as it sounds, and since most of the food is bad, I wasn't tempted to eat any more than I had to in order to do a fair assessment. You go to a place three or four times to get a good feel for it and to try to get several entrees, apps, salads, etc., then write the review. With bad food, trust me--it's no pleasure. Because you eat out every night, the calorie intake is high, so serious workouts, both muscle-building and aerobic, are on the menu, too. The thought that Bruni (or I) review restaurants is quite ironic, don't you think?
Anyway, Bruni does get his ED under control, brings his weight into a normal range, and mostly stops the binging. It's a story with a happy ending.
I hope all of us who are struggling with weight loss have happy endings, too. If you read the blogs I have under my favorites, you'll see some happy endings. Almost Gastric Bypass is run by Allan Klein, a New Yorker who was a major league eater. He headed a restaurant and catering business that had some of the best food you'll ever see. (Another irony, yes?) He's running a group effort toward health for obese people that is based on sound science, as well as healthy emotional and physical attitudes. Check it out--it has hundreds or thousands? of readers from all over the world.
Fat Like Me is run by a blogger who's in the middle of a life-changing weight loss. She is part of the fifth, most difficult Challenge that AGB is running. Follow her success as she battles her ED on the way to health and--dare I say it?--beauty. She's a beautiful woman. Her's was the first weight loss blog I ever read, and it was the first to set me on this road to loving your body and treating yourself as though you love it. Check her blog out, too.
Since I'm not running any sort of challenge, and don't have a formal group going, those of you who are at loose ends, in addition to those who already have a supportive team of dieters, are begged to come aboard. Since this blog is for all EDs, welcome everyone.
I'm thinking of offering raffles. Nothing huge, just something nice for fun. Let me know what you think.
He catalogues his appetite and the foods he ate, always in massive amounts. He just loved food, and turned it into his friend as he got older. By the time he was in college, however, he'd turned a minor problem into a full-blown, serious eating disorder, using purging to get rid of meals right after he'd eaten. He certainly was a compulsive overeater, with bulimia, by the time he was a young man, but he had an unhealthy attitude toward food practically from the time he was born.
The chronicle of his eating might be triggering for those who are fighting obesity or bulimia. The meals were eaten with abandon, and he goes into their details. He is also fairly graphic about the vomiting, and that could add a weapon to those of you who might already tend toward purging. If you think this stuff could be a problem for you, please don't read it. But for others, I do think you can identify, and he'll show you the way out of the hell of a severe ED to health. He's now able to eat the finest foods in New York as well as Europe without weight gain.
I did some restaurant reviewing when I was a journalist. It's not as easy as it sounds, and since most of the food is bad, I wasn't tempted to eat any more than I had to in order to do a fair assessment. You go to a place three or four times to get a good feel for it and to try to get several entrees, apps, salads, etc., then write the review. With bad food, trust me--it's no pleasure. Because you eat out every night, the calorie intake is high, so serious workouts, both muscle-building and aerobic, are on the menu, too. The thought that Bruni (or I) review restaurants is quite ironic, don't you think?
Anyway, Bruni does get his ED under control, brings his weight into a normal range, and mostly stops the binging. It's a story with a happy ending.
I hope all of us who are struggling with weight loss have happy endings, too. If you read the blogs I have under my favorites, you'll see some happy endings. Almost Gastric Bypass is run by Allan Klein, a New Yorker who was a major league eater. He headed a restaurant and catering business that had some of the best food you'll ever see. (Another irony, yes?) He's running a group effort toward health for obese people that is based on sound science, as well as healthy emotional and physical attitudes. Check it out--it has hundreds or thousands? of readers from all over the world.
Fat Like Me is run by a blogger who's in the middle of a life-changing weight loss. She is part of the fifth, most difficult Challenge that AGB is running. Follow her success as she battles her ED on the way to health and--dare I say it?--beauty. She's a beautiful woman. Her's was the first weight loss blog I ever read, and it was the first to set me on this road to loving your body and treating yourself as though you love it. Check her blog out, too.
Since I'm not running any sort of challenge, and don't have a formal group going, those of you who are at loose ends, in addition to those who already have a supportive team of dieters, are begged to come aboard. Since this blog is for all EDs, welcome everyone.
I'm thinking of offering raffles. Nothing huge, just something nice for fun. Let me know what you think.
Repeat dieting, extra BMI classes, bariatric surgery, mixed bag
I've been looking around for evidence that repeat dieting--so-called yo-yo weight loss--makes it more difficult to lose weight with each subsequent try. I've found a few research papers which say no. As soon as I can find the sources again, I'll cite them for you. I had a gut feeling that I was no different from anyone else, so if it didn't become more difficult for me, why would it be different for anyone else? The best paper spelled it out, that both the overweight and obese dieter need not fear that a weight loss diet won't work. The diet works, if we do.
I get annoyed when people say that diets don't work. They may be very difficult, require supreme dedication, and need total commitment on the part of the dieter, but several types of weight loss diets work. A low-carb diet does cause weight loss, but not because fat's high calories make you thin. It's because fat has a lot of power to cause a loss of appetite. We're satiated more easily on it. Between fat, meat, and 5% carb vegetables, such as broccoli, greens, cauliflower, string beans, and so on, eaten with wild abandon, you're full. Add lots of water to that, and essentially you're on a low-cal diet. A lap-band procedure is also a low-cal diet, albeit a drastic one.
It always amazes me that people believe low-cal diets don't work, but bariatric surgery does. They're the same thing! Surgery doesn't perform some sort of miracle and change the laws of physics. It only forces the patient into not eating as much, which by definition is lowering calorie intake. Some people do that with diet and exercise, and some with surgery.
I mentioned before that I wasn't pleased with the trend now to perform surgery on people who aren't as obese as they had to be before to get it. The minimum used to be 100 lbs. over the maximum healthy weight, which in my case, would be 145 + 100, or 245. And the patient couldn't be sure that anyone would perform the surgery then. Now, a person doesn't need to be that fat.
The lap band procedure is the reason for most of the changes in bariatric medicine. In addition to its being done on lower weight patients, it's being done on much younger ones, such as adolescents. There hasn't been much study done of the long-term results of bariatric surgery on adults, let alone children.
To add to the BMI charts from before, in Eating Disorders and Obesity, there's an add-on for the top weights on the BMI scale. This source is the National Heart, Lung, and Blood Institute, part of the National Institutes of Health.
Underweight, BMI <18.5
Normal weight, 18.5 - 24.9
Overweight, 25 - 29.9
Obesity (Class I) 30 - 34.9
Obesity (Class II) 35 - 39.9
Extreme Obesity 40 - >40
You'll note the difference in these BMI classes from the regular ones in that usually, >30 indicates obesity and there it stops. With this chart, someone can get a better sense of where s/he stands.
Having a waist circumference over 35" for women, and over 40" for men, increases the risk of significant physical problems at any weight, but particularly at obese ones. There is a direct correlation of these markers with type 2 diabetes, hypertension, and cardiovascular disease.
What's up tomorrow? I don't know yet, but this was just another info post. I hope these are working out for you. If not, please leave comments. I might go to more anecdotal and personal stuff again soon.
I get annoyed when people say that diets don't work. They may be very difficult, require supreme dedication, and need total commitment on the part of the dieter, but several types of weight loss diets work. A low-carb diet does cause weight loss, but not because fat's high calories make you thin. It's because fat has a lot of power to cause a loss of appetite. We're satiated more easily on it. Between fat, meat, and 5% carb vegetables, such as broccoli, greens, cauliflower, string beans, and so on, eaten with wild abandon, you're full. Add lots of water to that, and essentially you're on a low-cal diet. A lap-band procedure is also a low-cal diet, albeit a drastic one.
It always amazes me that people believe low-cal diets don't work, but bariatric surgery does. They're the same thing! Surgery doesn't perform some sort of miracle and change the laws of physics. It only forces the patient into not eating as much, which by definition is lowering calorie intake. Some people do that with diet and exercise, and some with surgery.
I mentioned before that I wasn't pleased with the trend now to perform surgery on people who aren't as obese as they had to be before to get it. The minimum used to be 100 lbs. over the maximum healthy weight, which in my case, would be 145 + 100, or 245. And the patient couldn't be sure that anyone would perform the surgery then. Now, a person doesn't need to be that fat.
The lap band procedure is the reason for most of the changes in bariatric medicine. In addition to its being done on lower weight patients, it's being done on much younger ones, such as adolescents. There hasn't been much study done of the long-term results of bariatric surgery on adults, let alone children.
To add to the BMI charts from before, in Eating Disorders and Obesity, there's an add-on for the top weights on the BMI scale. This source is the National Heart, Lung, and Blood Institute, part of the National Institutes of Health.
Underweight, BMI <18.5
Normal weight, 18.5 - 24.9
Overweight, 25 - 29.9
Obesity (Class I) 30 - 34.9
Obesity (Class II) 35 - 39.9
Extreme Obesity 40 - >40
You'll note the difference in these BMI classes from the regular ones in that usually, >30 indicates obesity and there it stops. With this chart, someone can get a better sense of where s/he stands.
Having a waist circumference over 35" for women, and over 40" for men, increases the risk of significant physical problems at any weight, but particularly at obese ones. There is a direct correlation of these markers with type 2 diabetes, hypertension, and cardiovascular disease.
What's up tomorrow? I don't know yet, but this was just another info post. I hope these are working out for you. If not, please leave comments. I might go to more anecdotal and personal stuff again soon.
Sunday, February 6, 2011
What weight do you dream of?
There are five weights in an obese person's life: highest weight, dream weight, happy weight, acceptable weight, and disappointing weight. Except for the highest weight, the others come from a paper in the Journal of Consulting and Clinical Psychology. They're good names for what most of us think about.
An obese person will never forget the highest weight s/he's ever been. Say 268--that number will be branded somewhere in her brain as the most she's ever weighed or will weigh in her life. That might have happened before in her life, for instance, at 247. Now, here she is at 21 pounds more. The shame of it all, the disappointment in herself. The questioning, "How could I have let myself go like that?" It's a horrible feeling. But top weight is what it is--a magic number that will never be exceeded if the person can help it.
What does she do even before commencing a weight loss diet? Dream. Dream of 110 or 115, and what the world would be like if only she could lose 150+ pounds. So starts the diet. I don't know how long it takes, but at some point, she realizes that she'll be happy with 135 pounds, not 110. Since 145 is the highest she can weigh within the BMI's normal weight limit, she'll still be normal weight and have ten pounds to spare for bloating days of the month. Perfect. It becomes as good as the dream weight, and rightly so.
Slowly but surely, she gets down to 168--100 pounds less than when she started. That is amazing, but she still wishes she could lose another 35. Still, at this point, the loss is so radical, so life-changing, that she can accept it. Losing at a rate of .5 pounds/week, with an occasional gain of seven pounds due to bloat, isn't inspiring enough to lose any more. She's done. If she can remain at 168 or so for the rest of her life, her health won't be jeopardized much (the risk of diabetes II remains); she can buy a reasonable range of clothes, and she'll accept that. She won't jump for joy, but it's acceptable.
The worst happens about a third of the time--disappointing weight loss. This would be about 50 pounds, down to 218. She still has most of the health risks she had before; she's still obese; she's still treated worse than average weight people, clothes are still hard to find . . . all that work, for "nothing" (or so she thinks). Disappointment most often leads to regaining the lost weight, causing depression. She's ashamed of herself. If she's lucky, the depression will be treatable; however, most anti-depressants cause weight gain via the serotonin system. There's nothing she can do about it except try various meds. If she's unlucky, she'll be obese and have an untreatable depression.
See what I wrote in the first line of that last paragraph: this happens one-third of the time. What is the likelihood that she will gain those 50 pounds back? Pretty high, I'd say. And as she gets older, and even less active, she'll probably gain more. Since she won't like herself, or think she's worth good things, she'll probably gain that weight with junk food and sweets. It tastes good, is cheap, it's satisfying, etc. The cycle begins anew.
There's some evidence to suggest that repeated cycles of dieting make it harder to lose weight. I'm not sure about that. It didn't happen to me, and I've been dieting since I was nine. (I had to measure foods and count calories as a little girl. There's something obscene about that.) But it could be true. Maybe one's body knows from repeated starvation that it's time to batten down the hatches because it's going to happen again.
What weight do you dream of? Do you remember your highest weight? Have you ever thought of your highest weight as something fear-inspiring? Something to dread, as though it were a monster? What about your dream weight? Can you picture yourself at that weight? Fantasize about what you'd wear, what you'd move like, what your face would look like with angular bones?
Let's do some visualization and fantasy exercises sometime. It's fun, and it works.
An obese person will never forget the highest weight s/he's ever been. Say 268--that number will be branded somewhere in her brain as the most she's ever weighed or will weigh in her life. That might have happened before in her life, for instance, at 247. Now, here she is at 21 pounds more. The shame of it all, the disappointment in herself. The questioning, "How could I have let myself go like that?" It's a horrible feeling. But top weight is what it is--a magic number that will never be exceeded if the person can help it.
What does she do even before commencing a weight loss diet? Dream. Dream of 110 or 115, and what the world would be like if only she could lose 150+ pounds. So starts the diet. I don't know how long it takes, but at some point, she realizes that she'll be happy with 135 pounds, not 110. Since 145 is the highest she can weigh within the BMI's normal weight limit, she'll still be normal weight and have ten pounds to spare for bloating days of the month. Perfect. It becomes as good as the dream weight, and rightly so.
Slowly but surely, she gets down to 168--100 pounds less than when she started. That is amazing, but she still wishes she could lose another 35. Still, at this point, the loss is so radical, so life-changing, that she can accept it. Losing at a rate of .5 pounds/week, with an occasional gain of seven pounds due to bloat, isn't inspiring enough to lose any more. She's done. If she can remain at 168 or so for the rest of her life, her health won't be jeopardized much (the risk of diabetes II remains); she can buy a reasonable range of clothes, and she'll accept that. She won't jump for joy, but it's acceptable.
The worst happens about a third of the time--disappointing weight loss. This would be about 50 pounds, down to 218. She still has most of the health risks she had before; she's still obese; she's still treated worse than average weight people, clothes are still hard to find . . . all that work, for "nothing" (or so she thinks). Disappointment most often leads to regaining the lost weight, causing depression. She's ashamed of herself. If she's lucky, the depression will be treatable; however, most anti-depressants cause weight gain via the serotonin system. There's nothing she can do about it except try various meds. If she's unlucky, she'll be obese and have an untreatable depression.
See what I wrote in the first line of that last paragraph: this happens one-third of the time. What is the likelihood that she will gain those 50 pounds back? Pretty high, I'd say. And as she gets older, and even less active, she'll probably gain more. Since she won't like herself, or think she's worth good things, she'll probably gain that weight with junk food and sweets. It tastes good, is cheap, it's satisfying, etc. The cycle begins anew.
There's some evidence to suggest that repeated cycles of dieting make it harder to lose weight. I'm not sure about that. It didn't happen to me, and I've been dieting since I was nine. (I had to measure foods and count calories as a little girl. There's something obscene about that.) But it could be true. Maybe one's body knows from repeated starvation that it's time to batten down the hatches because it's going to happen again.
What weight do you dream of? Do you remember your highest weight? Have you ever thought of your highest weight as something fear-inspiring? Something to dread, as though it were a monster? What about your dream weight? Can you picture yourself at that weight? Fantasize about what you'd wear, what you'd move like, what your face would look like with angular bones?
Let's do some visualization and fantasy exercises sometime. It's fun, and it works.
Thursday, February 3, 2011
EDs are never cured. Personal ramblings.
What the hell does that mean? It means just what it says--if you're an anorexic, you will always have a sick relationship with food, just as if you're obese. What that doesn't mean is that you won't be a normal weight for the rest of your life. You can be, and you will be. But it's work, and hard work at that.
I was a chain smoker for nearly 40 years, I'm embarrassed to say. I'm a nicotine addict. I will always be one, and can never have even one cigarette until the day I die. One will lead to another one, and that will lead to two. In a week or two, I'll be chain-smoking again. I've made a pledge that I won't smoke today, nor any day, for the rest of my life.
An anorexic must make a pledge not to starve herself, and an obese person has to do without buffalo wings with a creamy dressing for the rest of his/her life. Food is a drug to a binger. A greasy bacon cheeseburger can lead to a 10,000 calorie binge, followed by intense vomiting to get rid of the pain and calories. Each leads to self-loathing. I knew a compulsive binge eater who was so low on money from buying her binge food that she had to borrow rent money from me. I lent some to her; couldn't afford any more. But I understood why she needed it. I knew I'd never get it back, and I didn't, but she had enough money left over the following months to prevent eviction.
She suffered all day, going to school, then work, all the while thinking of what she'd eat that night. She tried a different grocery store each shopping trip so that no one would notice. She bought enough food for a normal person's week, so her behavior looked normal to outsiders. A binge was usually around 12,000 calories. She got so good at vomiting that she no longer had to use outside help, such as sticking her fingers or a tool down her throat. She merely had to bend over and vomit, perfectly, with ease. Sometimes she'd break a blood vessel with the violence of it, and the toilet would look as though it were full of blood. She'd break blood vessels on her face (I do that) and have to hide them with foundation the next morning.
She wasn't too overweight, either. BEDs who vomit can be normal or somewhat overweight. They're rarely obese. COEs are the ones who end up in the obese category. Anorexics who binge occasionally often vomit, but of course they remain seriously underweight. They make up for a binge with vomiting, excessive exercise, laxatives (they don't work, btw), and fasting. About half of all anorexics are called the purging type, with these symptoms of bulimia in addition to the starvation. The rest of us are restricting types, solely restricting eating. I have had a few binges of late, to about 3,000 calories in one sitting, but didn't vomit. I wanted to, but held back. I detest vomiting. An AN's binge is never as big as a BED's.
What separates a binge from the simple overeating a normal person does on a feast day such as Thanksgiving? The loss of control. A COE feels powerless to quit eating. He feels forced into continuing to eat, long past the feeling of satiation, and even past the point of pain. Yet s/he can't stop until control returns. That could take an hour or an entire night. It could happen in stages, with 3,000 calories, a vomiting session; another 4,000 calories, more vomiting, and so on. This all could be followed by a laxative.
You can see the overlap with bulimia here. What's the difference? The BED isn't as terrified of gaining weight as the BN is. The BEDs vomit just as much to stop the pain as they do to prevent weight gain. The BN doesn't fantasize all day about binging that night. They rarely run out of money. Yes, the differences are subtle, and there are other psychological differences, but those stand out.
While obesity is a slow walk to suicide, AN is a sprint. AN has the highest death rate of all mental illnesses, including depression. It's usually from heart failure, and is more rapid in ANs who purge than ANs who solely restrict. The death rate for ANs is anywhere from a low of 6% to a high of 10%, depending on how severe the disease is.
The obese die of diabetes, heart failure and coronary artery disease, strokes, breast cancer, and liver failure, among other things. All of these are chronic, not acute, killers. That's why the suicide is slow. Which would you rather have--another piece of cake, or blindness from Type II diabetes? The choice is clear for normal people, but not so for the obese.
Still, with a willingness to be well, all of these people can return to health, or have good health for the first time in their lives, and feel good about themselves. They can free up the tenacious webs that tie them to sick food feelings and behaviors. However, they won't be normal in the way people without an ED can be. I did feel that way once, for a period of about three years. I never weighed myself--didn't have to, because my weight was stable. I could look at myself in the mirror and not be disgusted. I could shop for clothes without fear. I didn't count the calories of everything that went into my mouth. It was such a peaceful time.
But the old, faithful enemy had never really let go. I began to gain weight, which I knew from the way my clothes fit. I bought bigger clothes. This happened because of a medication I was prescribed and my doctor said it was more important that I take it than worry about a "little" weight gain. Little? I gained over 50 lbs. I could have refused to take the medicine anymore, but I didn't.
I'd like to say that the weight fell off me when I finally had a breakdown in his office over my weight and insisted I go off. But it didn't. I struggled to lose it, but it was so hard, so very hard. I stayed that weight for four years or so. Finally, I was able to take it off. I didn't do it by eating healthful foods or living a good lifestyle. I didn't like myself well enough to be gentle. Instead I ripped through the weight, and more, to get where I wanted to be. I done that before, but didn't think about that. I got down to 92 pounds. My doctor at the time said that two more pounds and she'd have me forcibly put into an ED treatment program. I didn't know at the time that she couldn't have done that--it would have been nearly impossible. So, in tears, I got up to 97, 98 pounds.
That was my second episode of being called eating-disordered. The first was when I was a kid. My family doctor told me he was disgusted with me because I was so fat and ugly. Yup, those were his words, to a child. That office visit is clear in my mind. I can still see his face, feel his loathing, remember what I was wearing, and smell the antiseptic in the air. But my mother had said the same thing, so I don't know why I was surprised and hurt. Maybe because it came from a doctor, a man I trusted.
So I've been fat and I've been skinny. Believe me, skinny is better. Strangers treat you better. When I worked for a gynecologist, he told me that when an obese woman walked into the office, he wanted to puke. This man was allowed to work with women--be responsible for their lives and deaths. He should have had his license yanked.
*Sigh* I've gone on today, with little information for you, just bad memories of my own. I'm feeling fat today. I'm convinced that if I lose about seven pounds I'll feel better. You know what? Once I weight 91, I'll be convinced that if I lose three or four or five more pounds, I'll feel better. Yes, that's what an ED is. It keeps you prisoner, or as the psychiatrist Hilda Bruch would say, a woman in a "gilded cage."
I apologize for this entry today, but warn you that things like this will happen again in the future. Skim them or skip over them if you want the informative stuff. I just had to talk about this.
I was a chain smoker for nearly 40 years, I'm embarrassed to say. I'm a nicotine addict. I will always be one, and can never have even one cigarette until the day I die. One will lead to another one, and that will lead to two. In a week or two, I'll be chain-smoking again. I've made a pledge that I won't smoke today, nor any day, for the rest of my life.
An anorexic must make a pledge not to starve herself, and an obese person has to do without buffalo wings with a creamy dressing for the rest of his/her life. Food is a drug to a binger. A greasy bacon cheeseburger can lead to a 10,000 calorie binge, followed by intense vomiting to get rid of the pain and calories. Each leads to self-loathing. I knew a compulsive binge eater who was so low on money from buying her binge food that she had to borrow rent money from me. I lent some to her; couldn't afford any more. But I understood why she needed it. I knew I'd never get it back, and I didn't, but she had enough money left over the following months to prevent eviction.
She suffered all day, going to school, then work, all the while thinking of what she'd eat that night. She tried a different grocery store each shopping trip so that no one would notice. She bought enough food for a normal person's week, so her behavior looked normal to outsiders. A binge was usually around 12,000 calories. She got so good at vomiting that she no longer had to use outside help, such as sticking her fingers or a tool down her throat. She merely had to bend over and vomit, perfectly, with ease. Sometimes she'd break a blood vessel with the violence of it, and the toilet would look as though it were full of blood. She'd break blood vessels on her face (I do that) and have to hide them with foundation the next morning.
She wasn't too overweight, either. BEDs who vomit can be normal or somewhat overweight. They're rarely obese. COEs are the ones who end up in the obese category. Anorexics who binge occasionally often vomit, but of course they remain seriously underweight. They make up for a binge with vomiting, excessive exercise, laxatives (they don't work, btw), and fasting. About half of all anorexics are called the purging type, with these symptoms of bulimia in addition to the starvation. The rest of us are restricting types, solely restricting eating. I have had a few binges of late, to about 3,000 calories in one sitting, but didn't vomit. I wanted to, but held back. I detest vomiting. An AN's binge is never as big as a BED's.
What separates a binge from the simple overeating a normal person does on a feast day such as Thanksgiving? The loss of control. A COE feels powerless to quit eating. He feels forced into continuing to eat, long past the feeling of satiation, and even past the point of pain. Yet s/he can't stop until control returns. That could take an hour or an entire night. It could happen in stages, with 3,000 calories, a vomiting session; another 4,000 calories, more vomiting, and so on. This all could be followed by a laxative.
You can see the overlap with bulimia here. What's the difference? The BED isn't as terrified of gaining weight as the BN is. The BEDs vomit just as much to stop the pain as they do to prevent weight gain. The BN doesn't fantasize all day about binging that night. They rarely run out of money. Yes, the differences are subtle, and there are other psychological differences, but those stand out.
While obesity is a slow walk to suicide, AN is a sprint. AN has the highest death rate of all mental illnesses, including depression. It's usually from heart failure, and is more rapid in ANs who purge than ANs who solely restrict. The death rate for ANs is anywhere from a low of 6% to a high of 10%, depending on how severe the disease is.
The obese die of diabetes, heart failure and coronary artery disease, strokes, breast cancer, and liver failure, among other things. All of these are chronic, not acute, killers. That's why the suicide is slow. Which would you rather have--another piece of cake, or blindness from Type II diabetes? The choice is clear for normal people, but not so for the obese.
Still, with a willingness to be well, all of these people can return to health, or have good health for the first time in their lives, and feel good about themselves. They can free up the tenacious webs that tie them to sick food feelings and behaviors. However, they won't be normal in the way people without an ED can be. I did feel that way once, for a period of about three years. I never weighed myself--didn't have to, because my weight was stable. I could look at myself in the mirror and not be disgusted. I could shop for clothes without fear. I didn't count the calories of everything that went into my mouth. It was such a peaceful time.
But the old, faithful enemy had never really let go. I began to gain weight, which I knew from the way my clothes fit. I bought bigger clothes. This happened because of a medication I was prescribed and my doctor said it was more important that I take it than worry about a "little" weight gain. Little? I gained over 50 lbs. I could have refused to take the medicine anymore, but I didn't.
I'd like to say that the weight fell off me when I finally had a breakdown in his office over my weight and insisted I go off. But it didn't. I struggled to lose it, but it was so hard, so very hard. I stayed that weight for four years or so. Finally, I was able to take it off. I didn't do it by eating healthful foods or living a good lifestyle. I didn't like myself well enough to be gentle. Instead I ripped through the weight, and more, to get where I wanted to be. I done that before, but didn't think about that. I got down to 92 pounds. My doctor at the time said that two more pounds and she'd have me forcibly put into an ED treatment program. I didn't know at the time that she couldn't have done that--it would have been nearly impossible. So, in tears, I got up to 97, 98 pounds.
That was my second episode of being called eating-disordered. The first was when I was a kid. My family doctor told me he was disgusted with me because I was so fat and ugly. Yup, those were his words, to a child. That office visit is clear in my mind. I can still see his face, feel his loathing, remember what I was wearing, and smell the antiseptic in the air. But my mother had said the same thing, so I don't know why I was surprised and hurt. Maybe because it came from a doctor, a man I trusted.
So I've been fat and I've been skinny. Believe me, skinny is better. Strangers treat you better. When I worked for a gynecologist, he told me that when an obese woman walked into the office, he wanted to puke. This man was allowed to work with women--be responsible for their lives and deaths. He should have had his license yanked.
*Sigh* I've gone on today, with little information for you, just bad memories of my own. I'm feeling fat today. I'm convinced that if I lose about seven pounds I'll feel better. You know what? Once I weight 91, I'll be convinced that if I lose three or four or five more pounds, I'll feel better. Yes, that's what an ED is. It keeps you prisoner, or as the psychiatrist Hilda Bruch would say, a woman in a "gilded cage."
I apologize for this entry today, but warn you that things like this will happen again in the future. Skim them or skip over them if you want the informative stuff. I just had to talk about this.
Wednesday, February 2, 2011
Wednesday night, February 2, 2011
Damn, I'm sorry I missed yesterday. I had a migraine, took some drugs, and fell sound asleep in my chair. I'll do my best to prevent that again.
Finally, my favorite scientific book on EDs arrived from Amazon. It's called Eating Disorders and Obesity, ed. by Christopher G. Fairburn and Kelly D. Brownell. I had it before, but lent it to someone and never got it back--the story of my life. It's the only book out there which supports my theory that obesity is an ED just like anorexia or bulimia. In it, the doctors and researchers make the case for that, which is still considered to be controversial. I think it's so obvious, I don't know why everyone doesn't believe it. No one gets to be 400 lbs. by having a normal relationship with food, and most obese people have a lot of emotional work to do, as well as emotional garbage to get rid of along their way to their goal weight. I'm not saying they have to have recovered to get to a normal weight, just that they have to in order to maintain a normal weight for a lifetime.
I hate when people accuse the obese of not having any willpower. Who could have more willpower than someone who's felt serious hunger for weeks at a time, several times over the course of a lifetime? That takes real will, in my opinion. But they don't have the stamina and drive to stay slender. When it comes to life and death, somewhere along the line they'll choose death and fried chicken over life and broiled chicken breast. That's emotions talking, not logic. And those emotions are saying, "You're not worth it to stay alive." That has to change.
I'll be posting excerpts from the book from time to time as we go along. I hope you find it as intriguing a theory as I do.
This will be TMI--I ate like I was a garbage can today, and got cramps and intestinal upset. Ugh. For breakfast there was half a bologna sandwich on whole wheat bread. That's schizo to begin with--junk food with healthful food. I didn't eat the rest of the day until 4 p.m., when I microwaved a large bag of popcorn and ate the whole thing. It was low-cal, but still . . . . Maybe that's what gave me diarrhea. There, that was my nutrition for the day. Oh, a Coke and half a can of ginger ale. There's hardly a gram of decent food for the whole day, even though I didn't top my calorie max. I have to stop eating as though I'm a garbage can. If you are what you eat, I'm garbage. See what I mean about garbage in your head?
I'm going to look around some anorexia sites for tips on how to avoid eating when you're hungry. No one is better at that than anorexics. They do it every day, all day, for months at a time. I'd just put up links to pages, but the information and tips are a mixed bag. Some are just silly and stupid. Some would interfere with Allan's (Almost Gastric Bypass blog) Challenge. Others are flat-out wrong, with no basis in science whatsoever. Many are downright dangerous. But there is, between the lines, some good advice. I'll get back to you on that.
That's it for today. Make sure to drink enough water all day, every day, to keep hydrated and stay full. Go for a walk and relax. Pet your animal companions. And remember--you aren't garbage, you deserve to live, and you're the only one in the world, in all of history, who was, is, or ever will be like you. Take care of your precious self.
Finally, my favorite scientific book on EDs arrived from Amazon. It's called Eating Disorders and Obesity, ed. by Christopher G. Fairburn and Kelly D. Brownell. I had it before, but lent it to someone and never got it back--the story of my life. It's the only book out there which supports my theory that obesity is an ED just like anorexia or bulimia. In it, the doctors and researchers make the case for that, which is still considered to be controversial. I think it's so obvious, I don't know why everyone doesn't believe it. No one gets to be 400 lbs. by having a normal relationship with food, and most obese people have a lot of emotional work to do, as well as emotional garbage to get rid of along their way to their goal weight. I'm not saying they have to have recovered to get to a normal weight, just that they have to in order to maintain a normal weight for a lifetime.
I hate when people accuse the obese of not having any willpower. Who could have more willpower than someone who's felt serious hunger for weeks at a time, several times over the course of a lifetime? That takes real will, in my opinion. But they don't have the stamina and drive to stay slender. When it comes to life and death, somewhere along the line they'll choose death and fried chicken over life and broiled chicken breast. That's emotions talking, not logic. And those emotions are saying, "You're not worth it to stay alive." That has to change.
I'll be posting excerpts from the book from time to time as we go along. I hope you find it as intriguing a theory as I do.
This will be TMI--I ate like I was a garbage can today, and got cramps and intestinal upset. Ugh. For breakfast there was half a bologna sandwich on whole wheat bread. That's schizo to begin with--junk food with healthful food. I didn't eat the rest of the day until 4 p.m., when I microwaved a large bag of popcorn and ate the whole thing. It was low-cal, but still . . . . Maybe that's what gave me diarrhea. There, that was my nutrition for the day. Oh, a Coke and half a can of ginger ale. There's hardly a gram of decent food for the whole day, even though I didn't top my calorie max. I have to stop eating as though I'm a garbage can. If you are what you eat, I'm garbage. See what I mean about garbage in your head?
I'm going to look around some anorexia sites for tips on how to avoid eating when you're hungry. No one is better at that than anorexics. They do it every day, all day, for months at a time. I'd just put up links to pages, but the information and tips are a mixed bag. Some are just silly and stupid. Some would interfere with Allan's (Almost Gastric Bypass blog) Challenge. Others are flat-out wrong, with no basis in science whatsoever. Many are downright dangerous. But there is, between the lines, some good advice. I'll get back to you on that.
That's it for today. Make sure to drink enough water all day, every day, to keep hydrated and stay full. Go for a walk and relax. Pet your animal companions. And remember--you aren't garbage, you deserve to live, and you're the only one in the world, in all of history, who was, is, or ever will be like you. Take care of your precious self.
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