Eating Disorders

ANOREXIA NERVOSA:

Person refuses to maintain normal body weight for age and height

Weighs 85% or less than what is expected for age and height

In women, menstrual periods stop.

Young girls do not begin to menstruate as the appropriate age

Person denies the dangers of low weight

Is terrified of becoming fat

Is terrified of gaining weight even though s/he is makedly underweight

Reports feeling fat even when very thin

Anorexia often includes depression, irritability, withdraw and peculiar behaviours such as compulsive rituals, strange eating habits, a division of foods into "good/safe" and "bad/dangerous" categories. Anorexics may have low tolerance for change and new situations; may fear growing up and assuming adult responsibilities and an adult lifestyle.

BULIMIA NERVOSA

Person binge eats

Feels out of control while eating

Vomits, misuses laxatives, exercises, or fasts to get rid of the calories

Diets when not bingeing. Becomes hungry and binges again

Believes self-worth requires being thin (It doesn't)

May shoplift, be promiscuous, and abuse alcohol, drugs, and credit cards

Weight may be normal or near normal unless anorexia is also present

Like anorexia, bulimia can kill. Even though bulimics put up a brave front, they are often depressed, lonely, ashamed, and empty inside. Friends may describe them as competent and fun to be with, but underneath, where they hide their guilty secrets, they are hurting. Feeling unworthy, they have great difficulty talking about their feelings, which almost always include anxiety, depression, self-doubt, and deeply buried anger. Impulse control may be a problem; eg. shoplifting, sexual adventurousness, alcohol and drug abuse, and other kinds of risk-taking behaviour. Person acts with little consideration of consequences.

RELAPSE PREVENTION: ANOREXIA NERVOSA

Instead of dieting, design a meal plan that gives your body all the nutrition it needs for normal growth and health. If you want to work towards a healthy weight, then limit (but don't eliminate) your intake of fatty and sugary foods and refined carbohydrates. Eat lots of whole grains, fruits, vegetables, and enough dariy and protein foods to maintain strong bones and healthy muslces and organs. Also get 30 to 60 min. or exercise or physical activity 3 to 5 days a week. Anything more rigorous is excessive. (I personally don't recommend starting to exercise right away-especially for anorexics)

When you start to get overwhelmed by "feeling fat," instead of dwelling on your appearance, ask yourself how your life would be better if you were thinner. What would you have then that you don't have now? Friends? Self-confidence? Love? Control? The admiration of others? Their acceptance? Success and status?

Then, realize that being unhealthily thin will bring you none of these things. All of the above items are legitimate goals of healthy people, but working to achieve them directly is much more effective than losing weight. (My personal thoughts are just be yourself, don't strive to be something you're not, you'll ultimately be unhappy.)

Accept that your body shape is determined in part by genetics, and you may never have a totally flat stomach. Even if you are very thin, your internal organs will give a certain roundedness the, especially after you eat and if people in your family tend to store fat in the midsection.

If you feel yourself slipping back into unhealthy habits, call your therapist and schedule an appointment. Returning to counseling in no way means you have failed. It means only that it's time to reevaluate and fine tune your recovery plan. (I think aftercare is critical before you even fall back into old patterns. Without proper support you are more likely to slip back into unhealthy behaviours. Set up appointments for your therapist, general practitioner, support group, and special aftercare groups before you even leave the hospital.)

RELAPSE PREVENTION: BULIMIA NERVOSA

Never let yourself get so hungry that the urge to binge is overwhelming. People who recover from bulimia say that they eat regularly. Hunger is the most powerful binge trigger there is. It is recognized fact that the longer one has dieted, and the more severely calories have been restricted, the higher the risk of binge eating.

Never ever deprive yourself of good-tasting food, even if it has more fat and calories than "safe" diet foods. If you refuse to eat appealing foods that you really want, you will feel deprived and crave them. Then you are vunerable to bingeing.

Don't deprive yourself of other satisfying experiences either. Make sure that every day you spend time with friends. In person is best, but phone calls and emails are better than nothing.

Also every day spend time doing things you are good at, things you can take pride in, things that demonstrate your competency and abilities. Allow yourself to enjoy your accomplishments and refuse to listen to that nagging inner voice that i you could do better if only you tried harder.

Last, but no means least, every day do something that's fun and pleasurable. Watch comedy videos and laugh outloud at outrageous jokes. Play something, a board game, a computer game, tapes or CD's. Go outside and enjoy the birds, trees, flowers, and fresh air. (Some of my own suggestions would be reading, writing short stories or poetry, paint, play cards, dance, etc.)

Keep tabs on your feelings. Several times during the dy, especially in the first stages of recovery, take time out and ask yourself how you feel. If you notice rising stress, anger, fear, sadness-and even strong joy-be alert to the possibility that you may try to dull these feelings by turning to food. Find a better way of dealing with your feelings such as talking them o with a trusted friend.

Until you have achieved balance and perspective, stay away from temptation. Don't go to all-you-can-eat salad bars. If ice cream is a binge trigger, don't keep it in your freezer. When you want these kinds of foods, go to a sit down restaurant and order a single portion, ideally as part of a balanced meal. By doing so, you accomplish 3 things. You avoid depriving yourself. You avoid the urges to binge created by deprivation, and you also learn how to integrate normal food into a reasonable and healthy meal plan.

When you do feel powerful urges to binge, postpone the act for 30 min. Surely you can wait half an hour. During that time think about what is going on in your life. What stresses are you facing? What is missing right now from your life that you need in order to be happy and avoid the looming binge? Make a list of all the things you can do instead of binge eating to deal with you situation.

If you feel yourself slipping back into unhealthy habits, call your therapist and schedule an appointment. Again, I feel this is necessary before you reach that stage. Have these appointments arranged before you even leave the hospital: general practioner, therapist, support group, and special aftercare groups.

SOME SUGGESTIONS OF MY OWN:

call friends, family,

take a bubble bath

read a book

listen to music

sit in room lit only by candles and relax (concentrate on breathing-5,5,5- inhale for 5 sec. hold for 5 sec. and exhale for 5 sec.)

write friends a letter

watch TV

affirmations "I am beautiful" "I am a worthy person" - even if at first you do not believe these, post these messages somewhere you would see them everyday and spend a few min. repeating the messages to yourself. Use phrases such as "I am" Some suggestions: "I am a strong person", "accept my body", "I am beautiful inside and out", "Feeling full is normal", "I look better with curves", "I am sexier because I am healthier", "I am me and I am okay".