Sugar Addiction and Food Obsession

This is what a healthy relationship with food looks like:

You enjoy a wide variety of foods. You fill your diet with lots of different foods from every food group, so that you meet your nutrient needs through variety. You do not force yourself to eat foods you don’t enjoy (or that you have a medical reason to avoid).

Sometimes you eat purely for pleasure (like that cupcake, or glass of wine) but most of the time the choices you make fulfill both your nutrient and pleasure needs. You eat a salad because you WANT it, not because it’s what you think you SHOULD eat. And if you don’t want salad, you have something else. When you eat purely for pleasure, you savor the experience and then move on. You don’t assign shame or guilt to your food choices.

You eat when you are hungry, and you eat foods that nourish you, make you feel awesome, and help you meet your goals. You also realize that there is no such thing as perfection, and that your habits over time are far more important than any specific food you do or don’t eat. You understand that one meal doesn’t cancel out all the other meals you eat over the course of a week. You understand that there is a lot of room for flexibility within the context of a balanced, varied diet.

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Now, I frequently get comments like:

“Eating whatever you want whenever you want isn’t going to result in healthy lifestyle or longevity. Eating Doritos every day would land you in the hospital!”

Or:

“Sugar lights up the reward centers of the brain, which makes you want more sugar. Copious amounts of sugar is really bad for you!”

The people making these comments have a disordered idea of eating. They may not have an eating disorder, but they are making these comments from a place of fear. They are projecting their own fears and beliefs, about how they think they would behave if they allowed themselves to eat what they want, onto other people.

Do you see how the belief underlying both of these comments is that if a person eats what they want to eat, they will only eat ‘junk’, and eat excessive amounts of it? In the first comment, there is an assumption that if they ate what they wanted, they would eat Doritos every day. And in the second, there is the assumption that if they allowed themselves free rein, they would overeat sugar.

Both of these assumption belie a disordered relationship with food. Because you see, if these people had a healthy relationship with food, they would understand that they would be able to eat Doritos and sugar in moderation, enjoy them, and move on.

The answer here isn’t to ‘force’ oneself to eat a certain way. The answer is to address the disordered relationship with food. Because when their relationship with food is healthy, they won’t be compelled to eat Doritos and sugar in excess. They will be able to eat them in moderation, freely, and without forcing or feeling deprived.

Because that is what a healthy relationship with food is like.

I believe that the entire diet industry is deeply disordered, so these disordered ways of thinking about food are normalized and even promoted as healthy. Far too many people believe that the way they think about and approach food and eating is normal and healthy, when in fact it is disordered and destructive. The diet industry is dragging us all down into a spiral of disorder, shame and obsession. And telling us all the while that it is normal and healthy.

Need some help healing your relationship with food? Check out these free resources, and consider seeking out treatment from a qualified Eating Disorder professional:

NEDA
Helpguide
ED Referral
Youreatopia

How Much Exercise is Enough? How Much is Too Much?

Everyone’s exercise tolerance and fundamental needs are going to be unique, but there are a few things we can generalize. I think there is a minimum that almost everyone will need to meet in order to be metabolically healthy, and also a point at which exercise stops being helpful and becomes harmful. Between those two points is the potential for individualization and experimentation.

How Much Do You Need?

There’s actually been quite a bit of research into the health benefits of exercise and how much exercise is necessary to experience those benefits, and currently it appears that the amount necessary to support metabolic and cardiovascular health is fairly modest. This is good news for people who have a hard time getting motivated or who don’t enjoy it, or who simply don’t have a lot of time. The current, evidence based recommendations that virtually every reputable public health agency have adopted are as follows:

  • 150 minutes a week of moderate intensity exercise (such as hiking or brisk walking)

OR

  • 75 minutes a week of vigorous exercise (such as running or spinning)

AND

  • full body resistance exercises twice a week (such as weight lifting or even yoga. These activities can be included in the 150 or 75 minutes above if they elevate your heart rate adequately).

You can meet these minimums in five 15-30 minute sessions, depending on the intensity you work at. The higher the intensity of your workout, the shorter it can (and really should) be.

For more information on how to determine the intensity of your exercise, check out my ‘Walking for Health and Fitness’ post.

How Much is Too Much?

Determining what is ‘too much’ is much less cut and dry. Clearly there are people (like Ironman Triathletes and Ultra endurance runners) who thrive on large volumes of exercise. But it is possible to exercise too hard, or too much. Overtraining is a real condition, with a pretty well defined set of symptoms, although it can be difficult to diagnose it properly.

The objective symptoms of overtraining include: changes in heart rate response, elevated cortisol after exercise, reduced reaction time and performance, and immune suppression. The subjective symptoms include: changes in mood, sleep disturbances, perception of stress and changes in self perception.

Researches have reached somewhat of a consensus regarding the classification and stages of ‘overtraining’, as follows:

Overtraining‘ is a catch-all term to describe the process of intensified training leading to decreases in performance. The first stage of overtraining is ‘Functional Overreaching‘ in which performance suffers but resolves after adequate rest. ‘Non-functional Overreaching‘ is a decrease in performance and psychological and neuro-endocrinological symptoms that resolve after adequate rest. And ‘Overtraining Syndrome‘ is a longer term decrease in performance (more than 2 months) accompanied by more severe objective and subjective symptoms of overtraining.

Diagnosing

It is important when attempting to diagnose overtraining to rule out other psychological or physiological illnesses that could be producing these symptoms. There are MANY conditions that could be present, from endocrine disorders to nutritional deficiencies to infectious disease to eating disorders. Like other troublesome self-diagnoses (Sugar Addiction, and Adrenal Fatigue for instance) the danger in self-diagnosing and treating is that there may be a real illness present for which inaccurate self-diagnosis hinders appropriate treatment. In my opinion and experience, when a non-athlete is experiencing these symptoms it’s far more likely they’re dealing with a nutritional deficiency or an eating disorder than true overtraining. Getting proper diagnosis and treatment is vital or the problem will only get worse.

Some signs to watch for that could indicate that there could be a physiological, psychological or overtraining problem developing:

  • insomnia
  • anxiety and/or depression
  • changes in self perception
  • fatigue
  • increasing anxiety about and/or attention to your weight or body shape
  • decreases in exercise performance
  • more frequent colds and infections
  • slower recovery after exercise
  • loss of interest in workouts, decrease in enjoyment and sense of accomplishment

Treatment

For the vast majority of people, allowing adequate time between workouts for recovery is all that is necessary to prevent overtraining. Your individual recovery requirements are unique, the best thing you can do is monitor your energy levels and sense of enjoyment during workouts. If you are dreading exercise you used to enjoy and counting the minutes until it is over, or feeling a lack of accomplishment after workouts that used to make you feel awesome, take a few days off, and dial back the intensity of your workouts until your enthusiasm returns.

Who Needs to Stop Exercising

In some cases, complete rest is indicated, but in my opinion these cases are pretty rare. Exercise is so fundamentally important to healthy metabolic function that I think complete rest should be reserved for those who have the clinical symptoms of overtraining,and/or those who are dealing with metabolic adaptations to starvation. People who need to completely stop exercising are sick enough that they need to be under medical supervision anyway. Most people can prevent overtraining from progressing to Overtraining Syndrome by resting adequately between workouts and reducing the intensity of their activity.

If you feel like you’re dealing with something more than a temporary bout of fatigue, or resting doesn’t improve your symptoms, see a doctor. Get a referral to an endocrinologist and/or a therapist, and get tested for the psychological and physiological effects of overtraining. And keep an open mind to the potential that it might not be overtraining, that it might be a psychological issue. Getting an accurate diagnosis and appropriate treatment will ensure you won’t waste time and money treating an illness you don’t have. Follow the advice of your medical professional if you find yourself dealing with these issues. As I said above, self diagnosing, or relying on an internet personality for diagnosis, puts you in danger of not getting appropriate treatment. This is a fairly big problem, as overtraining is a trendy diagnosis these days. These symptoms should not be taken lightly.

Most people will do just fine with regular, moderate activity in the form of walking, cycling, or casual social sports activities and some basic resistance exercises a few times a week. People who enjoy more vigorous forms of exercises will likewise do fine as long as they make sure to give their body proper recovery time and eat enough to support the added demands of their training.

Read More On the Topic:

American Heart Association Activity Recommendations
World Health Organization Activity Recommendations
CDC Activity Recommendations

Diagnostic Tools for Overtraining
Scientific Methods for Diagnosing Overtraining
Early Warnings of Overtraining

What to Expect when you Stop Dieting Part 3: What the Heck is Happening to Me?

This blog series is an exerpt from my book ‘Taking Up Space: a Guide to Escaping the Diet Maze’.

 

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We discussed identifying disordered eating in Part 1, and the path out of the maze in Part 2. Now we’re going to get into the nitty gritty of what happens to the body when it’s finally getting adequate calories and nutrition after a long period of either undereating, or inconsistent eating. Each person’s experience is unique, and largely dependent on their history of restriction and their current state of health. If you are dealing with symptoms of malnutrition or disordered eating, do NOT attempt to undertake the process of refeeding on your own. It can be dangerous, and you need to be monitored by a medical professional.

Your Eatopia really has the most in depth description of the stages of recovery from restrictive eating. Most of what I’ll share here is an overview of the info presented there. I’ll also add my own observations of the experiences of clients and readers. Some people won’t have any of these symptoms, some will have only mild symptoms, and some will have them all. I can’t give any guarantees, or tell you how long it will take your body to heal, or tell you how extreme your symptoms will be. I can only tell you what is normal, and that you WILL get through it. In general, the longer and ‘harder’ you’ve restricted, the more extreme your recovery symptoms will be, and I’ll reiterate again the importance of working with a medical professional if you are dealing with disordered eating and/or starvation symptoms. Some common symptoms of refeeding:

Weight Gain

Almost everyone sees an initial 5-10 pound bump in scale weight. This is fluid retention, and completely normal. It is not fat. Your body holds on to extra water as it begins the process of tissue repair, think DOMS, but on a more systemic level. If you’ve been restricting carbs, or calories drastically, your muscles will also reglycogenate, and this can bring a 5+ pound bump in scale weight from the water that is bound to glycogen. It is normal and healthy! This edema seems to resolve at the 6-8 week mark for the majority of people.

Some people continue to gain weight because their body needs it. They may have been maintaining a weight or body fat percentage that was too low for their body to function optimally at. What I’m saying is, some people need to gain weight, even if they don’t think they do. A person may wish to look like a runway model or maintain a very low BMI or body fat percentage, but their body may need to weigh more to be healthy. Health is the priority here.

A few people continue to gain weight because they’ve overestimated their activity level, or are underestimating their calorie intake. If you don’t have a history of extreme restriction, and your weight continues to climb beyond the 6-8 week mark, and you’re at the upper end of your healthy weight range, take a long and honest look at your activity and your calorie intake. You may simply be eating more than your activity level demands. It’s an easy fix. Either increase your activity or decrease your calories modestly.

Go Maleo wrote a good post on calorie underestimating and metabolic derangement. There are two things worth noting here. In the study that looked at 10 women who all believed that their metabolisms were ‘slow’, in reality all but one of them were burning 2500 calories or more per day (the one study participant who truly did have a depressed metabolic rate had hypothyroid issues). Most of them were also drastically underestimating their calorie intake, hence their inability to lose weight. If you’re gaining weight at what you believe is an appropriate intake, it may be a good idea to spend a few days really weighing and measuring everything you’re eating, to make sure you’re really eating what you think you’re eating. If you are, then a visit to an endocrinologist is in order, there may be an underlying illness that needs to be addressed.

Edema

I discussed edema a bit already. This really throws a lot of people for a loop. You feel squishy and swollen. Your rings don’t fit, your clothes feel snug, your ankles swell and disappear. This is all normal. Your body is retaining water to aid in the cellular repair process. Most people see a 5-10 pound bump in weight but 15 or even 20 pounds isn’t unheard of. It’s uncomfortable, I won’t lie. It’s temporary though. Many people see it start to subside within a couple weeks, most see it resolve by the 6-8 week mark. You can read more about the edema of recovery here.

Digestive Distress

If you’ve been undereating for any length of time, your body has slowed your digestive processes. When you increase the volume of food you’re consuming, your GI system can’t quite keep up, so you’ll experience bloating, gas and other lovely discomforts. If you’ve restricted macronutrients or food groups, your gut flora may have been seriously altered, and will take time to repopulate. People can mistake this for an intolerance, so giving your system time to repair and adjust is important. Again, this can cause bloating, gas, distension and poor digestion. Like edema, this is a normal stage of recovery. You will get through it. You may look 6 months pregnant for a few weeks, but you will get through it. Eating smaller meals more frequently, and taking probiotics, can help ease some of these symptoms.

Fatigue and Joint Pain

For the most part, the fatigue and joint pain are a normal physiological response to the process of cellular repair. Gwyneth Olwyn says that this pain is your body’s way of forcing you to rest, and I like that way of looking at it.

Belly Fat Accumulation

In the early stages of recovery, as your weight begins to restore, the body preferentially stores fat around the internal organs. In combination with the edema and bloating from digestive distress, this can be very distressing and even trigger relapse. In time, this fat redistributes to a more normal distribution pattern. Be patient and allow your body to do what it needs to do to recover fully.

Increased Libido

Not all of the body’s responses to refeeding are negative! Many people experience a dramatic increase in libido and sexual response. During starvation, the body shuts down reproductive function. When you are getting adequate nutrition again, reproductive hormones rev back up. Enjoy!

Increased Energy

Lots of people experience dramatic improvements in energy levels. Workouts become more enjoyable, strength and stamina increase, and the body begins building new muscle mass. Even though they may see an increase in scale weight, measurements and pictures show that it is lean mass that is increasing.

Hair, Skin and Nail Improvements

Better nutrition means your hair skin and nails get the nutrients they need to thrive.

Improved Thyroid Function

We’ve had several people experience reversal of hypothyroid in our Eating the Food group. Again, if you have a medical condition like hypothyroid, work with a qualified medical professional (an endocrinologist for example) in addition to any dietary changes you make. Do not rely on bloggers, alternative health practitioners or diet books for treatment of medical conditions.

Changes in Self Perception

Disordered eating can mess with your mind. Most people with eating disorders have distorted body images, and lack of adequate energy intake can trigger and magnify these disordered thoughts. Many people, when finally getting adequate calories, begin to have a more realistic self image, realizing that their body really isn’t as abnormal as their disorder led them to believe. This is my favorite change to observe, the moment when a person realizes that there is, in reality, nothing wrong with their body. It is life changing.

Recovery is a mixed bag. Parts of it are wonderful, and parts of it can be so unpleasant that a person relapses to restrictive behaviors. Fortunately there are communities of people who’ve powered through and come out the other said (I linked to them in Part 2). Please seek out community support, it is so important to know you are not alone and there is a light at the end of the tunnel! A supportive community and a qualified treatment team can set you on a path to a healthy relationship with food and a healthy body image. You deserve to be healthy and thrive, free of the burden of obsession and disorder.

 

 

 

 

 

What to Expect When You Stop Dieting Part 2: How Do I Do This

This blog series is an exerpt from my eBook ‘Taking Up Space: a Guide to Escaping the Diet Maze’.
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I really like Ellyn Satter‘s definition of ‘Normal Eating’:

 

Normal eating is going to the table hungry and eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it -not just stop eating because you think you should. Normal eating is being able to give some thought to your food selection so you get nutritious food, but not being so wary and restrictive that you miss out on enjoyable food. Normal eating is giving yourself permission to eat sometimes because you are happy, sad or bored, or just because it feels good. Normal eating is mostly three meals a day, or four or five, or it can be choosing to munch along the way. It is leaving some cookies on the plate because you know you can have some again tomorrow, or it is eating more now because they taste so wonderful. Normal eating is overeating at times, feeling stuffed and uncomfortable. And it can be undereating at times and wishing you had more. Normal eating is trusting your body to make up for your mistakes in eating. Normal eating takes up some of your time and attention, but keeps its place as only one important area of your life.

In short, normal eating is flexible. It varies in response to your hunger, your schedule, your proximity to food and your feelings.

Some of the things I interpret from Satter’s description:

  • normal eating is being aware of hunger and satiety signals
  • eating foods you enjoy without guilt and shame
  • eating mostly nutritious food but having flexibility to include foods purely for pleasure
  • being aware of the emotional drives to eat, and allowing for them without guilt or shame
  • there is no one ‘right’ meal pattern – eat when works for YOU and your needs
  • being able to indulge without the compulsion to binge
  • eating to support your energy needs over time – with flexibility to eat more some days and less other days as your appetite and activity dictate
  • not obsessing over ‘slip-ups, cheats and mistakes’
  • not fixating on food and eating to the degree that it impacts your quality of life

Getting from here to there can seem like an insurmountable task though, especially when your ‘normal’ is following arbitrary, restrictive rules that someone else made up. Many very wise people have written about working toward Intuitive Eating (I linked to Ellyn Satter above, there is also Geneen Roth, Gwyneth Olwyn (who’s website I link to fairly regularly), the good people at Eat More to Weigh Less and others, all of whom bring very valuable insight to the table. The recommendations I make here echo many of the recommendations of these other people, and I encourage you to explore their websites and publications.

I’d like to begin by referring you BACK to the first installment of this series, and reiterate the importance of seeking medical treatment if you have symptoms of disordered eating or malnutrition. Refeeding can be dangerous, even life-threatening, if your body is in a state of starvation. Medical supervision is necessary.

Many people, however, are not starving, they simply have a history of unnecessary restriction and unstable eating patterns. The goal here is to get out of the restriction mindset and stabilize your eating habits. I’m going to give you some guildelines to do that. The first order of business is stabilization. You may or may not lose weight here, you may even gain a little. I’ll discuss some of the normal stages of recovery in the next installment of this series. Weight change is not our initial focus, stabilization is. Once your eating and weight are stable, we can begin making small changes, if you want to change your weight. Again, our first task is stabilization. Some people stabilize in a few weeks, others take months, much is dependent on your history and health. The more extreme your dieting history, and the more unstable your health, the more likely it is that you need to be working with a treatment team.

So, here are some guidelines:

  • Acknowledge that there is an appropriate number of calories that your body needs to support your activity and a healthy weight. I talked about the fatal flaw in the ‘calories don’t matter’ paradigm so common in the fad diet world, and the very serious consequences of eating too few calories in my Adrenal Fatigue post here. Your body needs calories, and probably more than you realize, to support a healthy weight. Many fad diets short change you in the calorie department. A calculator that factors in your activity will give you a more realistic idea of your calorie needs than many of the calculators on dieting websites. Some of the best I’ve found are this one at Fat Secret, the Health-Calc here, and Scooby’s calculator here. If you’ve been dieting all your life, the numbers you see here will probably surprise you. Determine your calorie requirements, and eat to support them. It doesn’t have to be exact every day, but aim for a window near the figure the calculators give you. That way you will be supplying your body the energy it needs to meet the demands of day to day life. While eating intuitively is a goal, many people have lost touch with their hunger and satiety signals. Being aware of calorie intake can be a stepping stone toward reconnecting with those signals, by guiding proper portion sizes and ensuring adequate nutrient intake.
  • If you’ve been restricting for a long time, ease your calories up. Many ED professionals recommend adding 200-300 calories every 3 days or so until you reach your required intake. I’ve known people who’ve added calories as slowly as 25 calories per day per week, which I think is unnecessarily slow. I think it’s important to get to an adequate intake as soon as possible. 100 calories per day per week seems to be a good half-way point. So for example, you’d eat 1600 per day for a week, then 1700 per day for a week, then 1800 for a week, etc, until you get to your target. If you’re in treatment, follow your treatment team’s advice. Some people begin eating to their requirements right away, and I think this is probably best if you haven’t been highly restrictive.
  • Eat foods you want to eat*. Yes, seriously. Lift arbitrary restrictions. Some people believe that if they allow themselves to eat what they want, they will eat nothing but junk food. Some people DO eat nothing but junk food for a little while. The vast majority of people very quickly realize that eating nothing but junk food gets tedious, and their energy flails, and they begin to crave more nutritious foods. Every now and then a person comes along who really can eat nothing but junk food indefinitely – I believe that these people are dealing with disordered eating issues that require professional treatment. Most people enjoy a wide variety of foods including many that are very nutritious. Eat what you enjoy! Nutritious and indulgent, there is a place in a healthy diet for both. *If you are allergic to a food, that would qualify as a medical reason not to eat it. Avoiding foods that make you sick is obviously a reasonable ‘restriction’.Likewise, if you have a medical condition (such as Diabetes) that necessitates a specific dietary approach, work with your doctor and a Registered Dietician to implement that diet. Do NOT rely on ‘nutritionists’, diet books or bloggers for medical treatments.
  • Pay attention to how your body responds to the food you eat. This is really the only way to evolve into a way of eating that supports your unique goals and needs. Does it fill you up? Does it give you energy? Does it make you feel good? Bad? Do you LIKE it? Diet Culture has created many food villains, but there are very few foods that are inherently bad regardless of context. Even refined sugar and processed foods can be beneficial under some circumstances, such as recovery from starvation and malabsorption issues stemming from GI conditions, and as fuel for intense physical activity.
  • Get enough protein. This is really the only ‘food rule’ I follow, as it seems to be generally true across the board. If you are physically active, if you are recovering from restrictive dieting, if you are trying to lose weight…any of these conditions and more will increase your protein needs. The current DRI recommendation is quite modest, only .66 – .8 grams of protein per kg of bodyweight per day, but there is some indication that this is inadequate, and sports physiologists have long made higher recommendations. 1.3 – 1.8 grams per kg of bodyweight per day is probably a more realistic goal, and if you are engaging in strenuous activity or losing weight, increasing to 1.8+ grams per kilogram of bodyweight per day will probably be beneficial. I simplify this for my American clients by giving them a target of 1 gram per pound of bodyweight per day; this is more than they absolutely need, but few people actually meet that target, and aiming that high tends to ensure that they do meet their minimum requirements. Get your protein from protein rich foods you enjoy. If you eat mostly plant protein, you will need to eat a little more to ensure your body is able to get what it needs as plant protein is slightly less bioavailable. This doesn’t make it inferior, it just raises your intake requirements. There is nothing wrong with using a protein supplement if you’re having trouble getting enough from food alone. I give some tips for choosing a good protein supplement here.
  • Be patient. Changing your habits takes time, and there will be starts and stops and plateaus and mistakes along the way. These are all part of the process. It can take months, even a year, to see major changes, especially if you’ve been very restrictive in the past. Work toward consistency, balance and stability. That is the goal in the beginning: consistency, balance and stability. Weight change will come later, and it will be easier when you’re consistent, balanced and stable.
  • Move away from guilt and shame. They have not served you in the past. They serve no purpose now. Allow for mistakes and setbacks, not as things to avoid, but as things to learn from.
  • Find a supportive community. Knowing that you are not alone, and that what you are going through is normal, is one of the most profoundly empowering gifts you can give yourself. And later, down the road, you can be there for others beginning their journey.

Escaping dieting is not easy, and it’s not always pleasant. It’s probably one of the hardest things you will ever do. In my next installment, I’ll discuss some of the normal physiological responses to refeeding. Some are wonderful, others can be downright awful. You don’t have to go through it alone. Many of us have been through it and can offer perspective and support.

Up Next: Part 3

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Related Posts:

What to Expect When You Stop Dieting Part 1: Who is This Post For?

This blog series is an exerpt from my eBook ‘Taking Up Space: a Guide to Escaping the Diet Maze’.

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You’ve been dieting since you were 12 years old. The thought of leaving it behind is terrifying. You don’t really know anything else, dieting has become your normal, it is just The Way Things Are. Surely without the rules and restriction your weight will spiral out of control?

Let me preface this post by saying that if what you are doing is working for you, keep doing it. If you are on a diet and it makes you healthy and happy, that’s fantastic! Go on with your bad self. This post isn’t for you. This post is for those for whom dieting isn’t working.

Now that that’s out of the way, who IS this series of posts for? Anyone who is tired of the eternal struggle with eating and weight. Anyone who has bounced from diet to diet, hoping that this one will be the Magic Diet, the one that solves all your weight and health problems once and for all. Anyone who feels great on a new diet for a few weeks or even months, but then starts to see their weight creeping up again, their health problems getting worse again. Anyone who is hungry all the time. Anyone who fantasizes about the foods their diet forbids, and who feels ashamed for having those fantasies, and who may even secretly eat them, hiding the evidence and heaping shame and guilt upon themselves for their ‘weakness’. Anyone who has a history of restricting and bingeing in an endless cycle. Anyone who has grown terrified of food. Who feels anxiety in the face of a simple meal. Who has ended friendships over food choices. Who’s life has come to revolve around food and eating…or not eating.

First Things First

The first and most important question to ask yourself is: do you have an eating disorder? Eating disorders often go unrecognized, even by the people suffering from them, because the symptoms can come on so insidiously and be so different from the stereotypes we’ve come to believe about them. Diet Culture has normalized behaviors that are pathological, so that we don’t recognize them as such. Many people believe eating disorders are confined to the young female demographic, and that if a person isn’t underweight or making themselves throw up they don’t have a ‘real’ eating disorder. Disordered eating is becoming more and more prevalent among men and older adults, and the symptoms are far more varied than pop culture makes them out to be. A person doesn’t even need to be underweight to have an eating disorder, in fact MANY people with disordered eating are overweight or obese. So I’m going to begin this post by having you give some honest thought to the symptoms I’m going to list. Do you see yourself here?

Signs of disordered eating, from the Mayo Clinic:

' Skipping meals
' Making excuses for not eating
' Eating only a few certain “safe” foods
' Adopting rigid meal or eating rituals
' Cooking elaborate meals for others, but refusing to eat them yourself
' Collecting recipes
' Withdrawing from normal social activities
' Persistent worry about being fat or gaining weight
' A distorted body image, such as feeling fat despite being normal- or underweight
' Not wanting to eat in public
' Frequent checking in the mirror for perceived flaws
' Repeatedly eating large amounts of sweet or high fat foods
' Use of syrup of ipecac, laxatives, the over the counter weight loss drug orlistat (Alli), or over the counter drugs that can cause fluid loss, such as menstrual symptom relief medications, or excessive exercising or fasting after eating
' Use of dietary supplements or herbal products for weight loss
' Food hoarding
' Eating in secret
These are signs of Binge Eating Disorder, which is frequently brushed off as ‘sugar addiction’:
  • eating to excess, even when already full
  • a feeling of loss of control over food intake, inability to stop eating
  • a sense of guilt and shame over your eating
  • never feeling satiated
  • stockpiling high reward food and eating it in secret
  • feelings of stress and anxiety that are relieved by eating
Here are some other, even more insidious, signs I often see hand-in-hand with those listed above:
  • You make fun of, or hang out with people who make fun of, people who make different dietary choices than you do.
  • You use your valuable free time to visit other people's blogs and argue with them about their dietary choices.
  • You've completely eliminated foods from your diet that you enjoy eating, and that you have no intolerance to, because your guru has told you they aren't 'optimal'.
  • You experience stress, shame or guilt when you eat (or WANT to eat) something forbidden by your diet.
  • You've alienated your real life friends and family by constantly criticizing their dietary choices, and you are ok with that because your 'real' family is your group of online friends who share your dietary philosophy.
  • You believe that your diet is the one true 'optimal' human diet, and that anyone who makes different dietary choices than you simply hasn't heard the 'truth' yet.
  • You focus on diet to the exclusion of other healthy lifestyle choices like regular exercise, proper sleep, stress management and sunlight, and believe that eating the 'right' diet can make up for not practicing those other lifestyle choices.
  • You believe that if you just eat 'right' all your health problems will go away, and that if someone is still experiencing health problems on your diet they just aren't 'doing it right'.
  • You believe that the entire medical establishment is out to get you.
  • When your diet is not producing results you keep on doing it because you've convinced yourself that you can't eat any other way.

If you’re dealing with any of these symptoms, seek professional treatment. I’ll list some internet resources below. An eating disorder professional can help guide you through refeeding (which I will discuss further in the next installment in this series), and have the resources to help you tackle these issues properly. While the things I discuss here can help you know what to expect, they are NOT an adequate substitute for proper medical treatment. Please don’t take this subject lightly, eating disorders can be fatal.

Eating Disorder Resources:

http://www.nationaleatingdisorders.org/find-help-support

http://www.youreatopia.com/support

http://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml

http://www.helpguide.org/mental/eating_disorder_treatment.htm

http://www.something-fishy.org/treatmentfinder/

Next Up in Part 2: How?

Sugar Addiction

Picture 115Do these symptoms describe you?

-eating sugar to excess, even when already full
-a feeling of loss of control over sugar intake, inability to stop eating
-a sense of guilt and shame over your eating
-never feeling satiated
-stockpiling sugary food and eating it in secret
-feelings of stress and anxiety that are relieved by eating

Do you experience any of the above symptoms and also have any of these conditions?

-Cardiovascular disease
-Type 2 Diabetes
-Insomnia or sleep apnea
-Hypertension
-Gallbladder disease
-Muscle and/or joint pain
-Gastrointestinal difficulties
-Depression and/or anxiety

If you find yourself nodding your head and recognizing some of your own symptoms, there’s a good chance you may have a very serious illness.

These are the symptoms and health consequences of Binge Eating Disorder. BED can manifest with any kind of food, but sugar is a common one because it has been so vilified by the diet industry.

Binge Eating Disorder is a very real illness with serious long term consequences. Like other eating disorders, it can even be fatal.

Fortunately there are very effective treatments for Binge Eating Disorder. Simply avoiding trigger foods is not an effective or adequate treatment for BED. Dieting, or any eating ‘protocol’ that places restrictions on food and eating, has been shown to be a primary cause of Binge Eating Disorder, and dieting has the potential to make the disorder much worse once it is already established. Any weight loss efforts should be implemented under the supervision of a team of medical professionals who have experience treating BED.

Proper treatment for Binge Eating Disorder includes cognitive-behavioral therapy, interpersonal therapy, dialectical therapy and even medication. I can not stress the importance of seeking proper, evidence-based treatment from experts with experience treating this condition. It CAN be effectively treated.

Why did I title this post ‘Sugar Addiction’? Because I am trained to recognize the signs of eating disorders, and with stunning regularity I hear from people who have self-diagnosed themselves (or been ‘diagnosed’ by an internet guru) as having a sugar addiction. More often than not, though, an objective evaluation of their symptoms points toward BED, not true addiction. Which is actually a very GOOD thing, because there is effective treatment for BED.

Addiction is also a very serious illness that, like BED, requires a multi-faceted treatment approach. Simply avoiding the addictive substance is rarely an effective long term approach to dealing with addiction. So whether a person has BED or a true addiction, it is important that they seek appropriate treatment.

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If you believe you may be dealing with either BED or addiction, please seek qualified help. Here are some resources to get you started:

http://bedaonline.com/
http://www.helpguide.org/mental/binge_eating_disorder.htm
http://www.eatingdisorderhope.com/information/binge-eating-disorder
http://www.something-fishy.org/binge_eating/resources.php

http://www.addictionresourceguide.com/
http://www.drugabuse.gov/publications/principles-drug-addiction-treatment/resources
http://www.psychology.org/links/Environment_Behavior_Relationships/Addiction/

 

Fad Diets: Normalizing Disordered Behavior

Popular fad diets are getting more and more extreme. It’s no mystery, the less extreme ones don’t work, so as people get disillusioned with each successive (and unsuccessful) diet, the diet marketers must come up with increasingly novel hooks. Low carb gets lower carb, low fat gets lower fat, more and more foods and food groups are declared the enemy, crazier and crazier food rules are invented.

scalehelp

The problem with this is that behaviors and thought processes that are legitimately disordered are becoming more and more normalized. Behaviors that, objectively, would qualify as a serious eating disorder are now considered perfectly appropriate, and reinforced by a culture that is becoming obsessively fixated on food, eating and weight. I’m going to list a few symptoms and warning signs of disordered eating, taken from the Diagnostic and Statistical Manual of Mental Disorders. These are not normal behaviors. These are symptoms of serious, potentially fatal diseases, with long term health consequences.


-Preoccupation with weight, food, and dieting.
-Refusal to eat certain foods, progressing to restrictions against whole categories of food (e.g. no carbohydrates, etc.).
-Anxiety about gaining weight or being 'fat.'
-Denial of hunger, or use of ‘tricks’ to avoid eating, such as drinking large quantities of water.
-Development of food rituals and rules (e.g. eating foods in certain orders, at certain times, in certain combinations, etc)
-Withdrawal from usual friends and activities, perhaps in favor of a new social group that shares the same food rituals and rules.
-In general, behaviors and attitudes indicating that weight loss, dieting, and control of food are becoming primary concerns.
-Rigid exercise routine, compulsive need to ‘burn off’ calories.
-Regular intake of large amounts of food in excess of the body’s caloric needs.
-Regular use of inappropriate compensatory behaviors such as fasting and/or obsessive or compulsive exercise.
-Extreme concern with body weight and shape.
-Creation of lifestyle schedules or rituals to make time for binge-and-purge sessions (purging includes fasting and exercise to ‘atone’ for food intake).

I think if you read this list objectively, you will notice that many of these behaviors are promoted and reinforced in various fad diet communities.

You may be thinking I’m being dramatic. I’m not. These behaviors are not normal. We are being conditioned to perceive them as normal and harmless though, by celebrities and diet book authors and a media that portrays each new diet as a ‘healthy lifestyle alternative’. More moderate approaches, like walking and portion control, are ridiculed as ineffective and old fashioned by those same celebrities and diet book authors, while they portray public health scientists as evil corporate pawns.

‘Oh come on, Amber! Just because a person cares about their weight or follows a diet doesn’t mean they have an eating disorder!’ This is true. Simply engaging in these behaviors doesn’t automatically mean a person has an eating disorder. The problem, though, is that engaging in restrictive eating and rigid food rules can serve as a direct mediator between perfectionistic tendencies and eating disorders. Another study found that college students engaging in ‘normal’ dieting behaviors were already exhibiting many of the symptoms associated with anorexia and starvation. Dieting has also been identified as a direct contributor to the development of eating disorders. In essence, dieting can trigger eating disorders. So be careful. Many people start down the rabbit hole without realizing it, and before they know it they’re deep, deep in the dysfunction. ED has a tremendously negative impact on quality of life.

Moderate approaches like portion control, increased physical activity and modest calorie reduction DO work. They work slowly, which can be frustrating when compared to the rapid (but unsustainable) results extreme fad diets produce. Those rapid results are appealing, and reinforce the perception that more moderate approaches don’t work. But extreme diets normalize and reinforce behaviors and thought processes that aren’t healthy and can have very serious long-term physical and mental health consequences, not to mention the monetary costs of treatment and recovery.

If you are experiencing any of the symptoms listed above, or if your diet has begun to take over your life, there is help. Start at the National Eating Disorder Association’s website, or one of the other sites I’ve linked below, to find treatment professionals in your area, or talk to your doctor about a referral to a psychologist or psychiatrist with eating disorder experience. Your diet does NOT need to consume your life in order for you to reach and maintain a healthy weight. It is possible to eat ‘normally’ and healthfully without your days revolving around food and eating. You deserve a life beyond your diet.

More Resources:

http://www.nationaleatingdisorders.org/find-help-support
http://www.youreatopia.com/support
http://www.nimh.nih.gov/health/publications/eating-disorders/index.shtml
http://www.helpguide.org/mental/eating_disorder_treatment.htm
http://www.something-fishy.org/treatmentfinder/

Check out my ‘Stop Dieting’ blog series here and my ebook ‘Taking Up Space: A Guide to Escaping the Diet Maze’.

 

Ketosis and Menstrual Function: a Canary in the Mine?

In the 1920’s, researchers at the Mayo Clinic used a ketogenic diet to treat adults with ideopathic epilepsy. In 1930, Dr. Clifford Barborka published a paper detailing their findings with their first 100 patients. Among other findings, Barborka notes that 20% of the women involved in the study experienced complete cessation of menstruation during treatment, which didn’t return until a normal diet was resumed. He only reported on menstrual cessation, but given more contemporary research on the subject we can reasonably speculate that many more women experienced menstrual irregularities that stopped short of complete cessation. Subjects were eating appropriate calories to maintain their weight, so weight loss was not a confounder here. He speculates that it may have been related to a vitamin B or E deficiency, but has no clear explanation. (Note that this was many decades before the discovery of Leptin and it’s role in hormonal regulation.)

In 2003, researchers published their retrospective study of 45 adolescents aged 12-19 treated for epilpsy with a ketogenic diet over 8 years. They noted that 45% of the girls involved in the study reported menstrual irregularities, most (2/3) of whom experienced complete cessation of menstruation (the other 1/3 were reported as experiencing delayed puberty or menstrual irregularity). Most resumed menstruation after ending the diet. 2 were treated with hormone therapy to induce and regulate menstruation. A majority of the girls did not lose weight on the diet, so again, weight loss was not a confounder in most cases. Researchers speculated that:

“The diet may mimic the menstrual side effects seen in starvation and certain female athletes.”

In 1999, a group of researchers published a review of a small group (9 women, 2 men) of otherwise healthy adults treated for epilepsy with a ketogenic diet. Of the 9 women involved in the study, 100% experienced menstrual irregularities. Although five of the 11 study subjects initially reported weight loss on the diet, calories were increased to manage it, so again, weight loss was not a confounder in most of the cases. From the researchers:

“All female patients reported menstrual irregularities. This is not uncommon, considering that menstrual irregularities are reported in other high-ketone states such as starvation.”

My friend Batty's menstrual chart before (left) and after (right) experimenting with dietary restriction. Click on image to read her story.

My friend Batty’s menstrual chart before (left) and after (right) experimenting with dietary restriction. Click on image to read her story.

As researchers noted, there’s some reason to speculate that the human body responds to carbohydrate restriction similarly to the way it responds to starvation. Certainly science has shown that leptin levels are sensitive to both calorie restriction (1) and carbohydrate restriction (2, 3, 4) and that women experience a greater leptin decline than men in response to dietary restriction and weight loss (5, 6). More and more research is indicating that leptin is an important endocrine mediator, acting on pituitary, adrenal, thyroid and gonadal axes, as well as playing a role in bone formation (7, 8). Another well-documented side effect of both ketogenic diets and starvation is bone demineralization (9, 10, 11, 12). Starvation and carbohydrate restriction can also both produce thyroid downregulation (13, and read Anthony Colpo’s exploration of carbohydrate restriction’s influence on thyroid function here).

I’ve worked with many women dealing with thyroid and reproductive dysfunction who also have a history of dietary restriction in the pursuit of an aesthetic ideal. My experience, coupled with the science I’ve seen, leads me to take a very cautious approach to dietary restriction in all it’s forms, with emphasis on promoting consumption of as rich a variety of calories and macronutrients as possible while allowing for the maintenance of a healthy weight. I think our culture has taken a myopic view of health, fixating on weight and fat loss, while tending to overlook other important markers of health. Most of the contemporary studies on extreme calorie and macronutrient restriction are short term, focused on only a few metabolic parameters (insulin and glucose dynamics and weight loss, most often) and/or focused on men, and I’ve found very little attention paid to leptin dynamics, thyroid health and menstrual function in the literature. The best use for highly restrictive diets are in the treatment of the illnesses they were developed to treat, and under the supervision of a qualified medical professional. For generally healthy people, a more modest, if slower, approach is probably the most prudent.

What do you do, though, if you’re already experiencing symptoms of endocrine adaptation to starvation? First of all, you may have an eating disorder, and even if you don’t you will still likely deal with issues associated with eating disorder recovery as you work your way through this stuff. Finding a medical professional with ED experience would probably be very beneficial, if for no other reason than that they can give you an idea of what to expect as your body recovers. Ask your doctor for a referral to an endocrinologist if possible. Eat! You should be eating at least as many calories as your body burns each day. If you have a history of undereating, you may need to keep track of your calorie intake to ensure it is adequate to support your energy needs. Carbs are helpful in raising leptin levels, so don’t restrict them unless you have a medical reason to and are being monitored by a medical professional. Prioritize sleep. Ask for help. You are not alone.

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Check out these other bloggers’ thoughts on this subject:

Krista Scott Dixon wrote an awesome post on hormones, homeostasis and carbohydrate restriction specifically in women. She touches on fasting as well.

Stafani Ruper’s discussion of carbs for health and fertility.

Danny Roddy gives a Peat‘s Eye View of female hormone regulation and provides some dietary recommendations for optimization. Of note, carbohydrates are on the menu.

Lyle McDonald’s series on leptin.

Gweneth Olwyn’s discussion of restrictive eating, leptin dynamics and infertility.

Related Posts:
Moderation is Evidence Based
Adrenal Fatigue as a Cover for Starvation
HCG, Intermittent Fasting and Ketosis
The Thing About Science

I Am Overweight.

Just over a year ago I published my most shared blog post to date: I’m Calling for a New Paradigm. My experience during what I now refer to as my ‘Fitness Model Diet’ fundamentally changed my approach to weight loss and fitness. I’d like to share some of the internal shifts I’ve made in the last year, and relate them to the trends I observe in the Fitness Industry.

First a brief review of my Fitness Model Diet. Over the course of 12 weeks, I dropped from a weight of 160 to 148 (at my lowest) and a body fat percentage of 12%. I hovered between 148 and 152 for about 2 months, and began to experience some symptoms of underweight and undereating, in spite of being at a scale weight that qualified as healthy and consuming 2200-2400 calories a day, which most people would consider not only adequate but probably quite indulgent. Perhaps more concerning, I also began to develop symptoms of body dysmorphia, a sign of disordered eating. I recognized what was happening to me and ended my experiment. To read a more in depth account of my experiences, click on the post I linked above, as well as this one, the follow up I wrote a couple months later.

In the months following, I increased my calories to where they’d been before my experiment and regained weight to 160 pounds. My symptoms resolved very quickly and my health and weight have been stable ever since. (More recently I’ve decided to purposely gain more weight in order to add some lean mass and hopefully see strength gains in the gym, I’ll discuss this further down).

My biggest takeaway from this whole experience was a new understanding of body fat; not only it’s role in maintaining metabolic health, but the disordered view our culture has of it. While it’s clear that in great excess body fat can impact health negatively, what is less commonly understood is that a certain amount of body fat is essential for health, particularly in women. Body fat is not an inert substance. In addition to insulating internal organs and storing energy, it plays a role in the production of hormones (including leptin, estrogen and resistin), and regulation of endocrine function. Just as too much body fat can throw hormonal regulation out of balance, so also can too little.

In the last year, I’ve taken a step back from the pursuit of fat loss that had been my primary focus for several years. I’ve begun to evaluate the messages the Fitness Industry sends with a more critical eye. What I see really disturbs me.

Fat Loss at All Costs

A simple Google search of the terms ‘diet’ and ‘fitness’ reveals that fat loss is THE defining goal of virtually every fitness and diet program. Try to find a ‘success story’ that doesn’t hinge on the visible reduction of body fat. Fat loss is, quite simply, THE barometer of success in this world. When fat loss is achieved, the program is deemed successful. Most programs are marketed specifically as fat loss plans. We are, as a culture, myopically obsessed with fat loss.

The human body requires a certain degree of ‘fatness’ for proper endocrine function. Women need more fat than men, and some women need more fat than others. As the body approaches that lower limit of adequate fat reserves, it initiates endocrine adaptations that inhibit further loss (downregulation of metabolism, loss of reproductive function, catabolism of lean mass, etc), such that the leaner a person is, the more extreme the measures they will need to engage in in order to see continued fat loss. The fitness and diet industry are ready with products to sell! Programs that place extreme restrictions on calories and macronutrients, and exercise routines that require extreme degrees of intensity or duration, usually combined. And it works! These extreme diets force the body to drop even more fat, with spectacular aesthetic results that are illustrated in dramatic before and after photos.

A clear message emerges from these dramatic images: Fat loss is good! Weight loss is success! Fat is bad! Weight gain is failure!

The end result is that healthy people at healthy weights internalize the message that they need to lose weight, because they don’t look like the bodies in the after pictures, so clearly they aren’t successfully managing their weight! They engage in increasingly extreme dietary restriction. Enough is never enough. There is always more fat to lose, another diet that promises fat loss success. Smaller and smaller we get.

I’ve experienced this mentality over and over during the last year as my weight has steadily increased. Every time I post on my facebook page about my weight gain, I get advice about how to turn it around. Even when I say specifically that I am gaining weight on purpose, I still get advice about how to lose weight. It’s like my words don’t even register beyond the weight gain. If I’ve gained weight it must be bad, and I must want to change it. The concept of a person, especially a woman, intentionally gaining weight is completely foreign. Even when I say ‘I am gaining weight on purpose’, a few people always seem to hear ‘help me figure out how to lose weight’. It is surreal. One person posted elsewhere that my diet ‘clearly isn’t working for her, since she’s gained 10-15 pounds recently’. See that? Weight gain = failure. End of story.

Obviously there are many people for whom fat loss is a healthy goal. When weight and body fat become a threat to a person’s health, weight and fat loss is important. But there comes a point at which the hyperfocus on fat loss becomes unhealthy. When a person is at a healthy weight, pursuing fat loss is no longer a health-promoting goal, it is at best an aesthetic pursuit, and at worst a risk to long-term health. The body will resist losing those last pounds of essential fat, and forcing the issue can set up a metabolic state that leads to adverse health outcomes and potentially even trigger eating disorders. Fat loss isn’t always good.

So, over the last year I’ve shifted my own goals, and I’ve also reevaluated the approach to weight loss I use with clients. I’ve been eating at a small calorie surplus and am now hovering right around 170 pounds. I have, essentially, gained 20 pounds in the last year. My current weight puts me just over the ‘healthy weight’ cut off on the BMI scale, I am officially overweight. In the last year, the primary focus of my training and diet has been strength and mass gains. I have gained some lean mass, and I’ve also gained some fat. This is not a failure. I am not planning to ‘cut’ after some arbitrarily approved ‘bulking’ period. In fact, as of right now, I have no plans to lose weight or fat, ever again. I do not wish that all my gains had been muscle. There is nothing wrong with gaining some fat. It does not make me inadequate or undesirable or unhealthy. Even having a BMI that qualifies as overweight doesn’t make me any of those things. My weight is just a number. A data point. It is not a value judgement. Do you want to see the body that a year of eating lots of food and focus on GAINS has produced?

Screen Shot 2013-10-16 at 8.47.47 AM

By the numbers, this body is overweight. I am part of that ‘70% of Americans are overweight or obese’ statistic. Maybe we need to re-evaluate the numbers and statistics.

For reference, here is the body that restriction and focus on fat loss produced:

148 pounds, 12% body fat.

148 pounds, 12% body fat.

Neither body is ‘better’. Some people will find my current body more attractive, others will find my leaner body more attractive, others still will find both hideously unattractive. It’s ok. I’m not here to tell you one body type is better than another, or fish for compliments, or try to garner anyone’s approval for the choices I make for my own body.

What I AM here to tell you is that there is another way. That fat loss doesn’t HAVE to be your goal. That all different body types can be healthy and beautiful. That you can be more if you want to. That less isn’t the only acceptable option. That if the endless pursuit of fat loss isn’t making you happy, isn’t improving the quality of your life, isn’t working…you can choose another approach. Choosing another approach isn’t failure. It is simply different, and there is a place in this world for different. We are not all shaped the same.

These days when clients approach me for weight management coaching, the first thing I have them do is really evaluate where they are. Many, many people who believe they need to lose weight are actually, objectively, already at a healthy weight. Trying to force their body to shed more weight, more fat, may not be the most health- and quality of life- affirming option. Taking an approach of building a stronger foundation may be a more sustainable, and ultimately more enjoyable, choice. Choosing to end the relentless pursuit of fat loss is not an admission of defeat, it is not a failure. It can be a very healthy, very positive statement of self-respect.

I can’t tell you which body you should like better, but I CAN tell you which one eats ice cream, kills workouts and has more sex. The ‘overweight’ one.

To lean more about my approach to eating to support a healthy weight, check out my ebook Taking Up Space: A Guide to Escaping the Diet Maze, and check out my other blog posts on the subject:

Adrenal Fatigue as a Cover for Starvation
Healthy Diet or Disordered Thinking?
Body Composition: That 'Last Five Pounds', and How to Deal With 'Problem Areas'

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Join the conversation on my Facebook page!
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For more information on some of the topics discussed here:

Body Fat
Minnesota Starvation Experiment
Endocrine Response to Anorexia
Endocrine Response to Typical Dieting

 

Guest Post: Kaleolani’s Story

I ‘met’ Kaleolani about a year ago via my facebook page. She continues to inspire me every day with her positive, life-affirming approach to her life and her health. When confronted with serious medical issues, she took a thoughtful and long-term approach to healing, by paying attention to how her own unique body responded to different treatments. Formerly diagnosed with Type 2 Diabetes, Kaleolani has made long-term lifestyle changes that support her metabolic health. She’s now off her diabetes medication and has normal metabolic function. Like my last Guest Blogger Jennifer, I find Kaleolani’s story inspiring and hopeful.

Kaleolani’s Story

kaleolanithumbWhen I was asked by Amber to write a piece, I was giddy, and honored and scared to death. '? Where would I start? What was I going to talk about? So I decided, very simply, to start at the beginning. I was born and raised in Hawai’i (hence my first name). I could say I was a surfing beach bunny, sitting around eating fish and poi, and laying in the sun getting my tan. The fact is, I don’t surf, deep ocean water scares me, I love poi but not so much the fish and I find laying out boring. Somewhere along the way between childhood and today, I also developed an eating disorder. I have compulsive eating disorder or binge eating. When most people think of an eating disorder they think of someone who is starving themselves or binging and purging. An eating disorder doesn’t always fit that mold. For me it was the coping skill I used for my feelings, for my emotional protection, and to make it through my daily life.

I met a wonderful man, we got married and due to his job, I moved away from home. Through other ups and downs of life, I know I suffered a few times from depression, including depression brought on by the C-section I had with my first daughter. It wasn’t what you’d call an ideal pregnancy and her birth was far from the fairy dust sprinkled, birth miracle of your favorite movies or TV show. We moved again. I had a second baby; got sick and things took a down hill turn. We moved again, and I didn’t realize that the bottom was so very far down or that I’d end up sinking down there and hitting rock bottom.

One day I went to the doctor’s for a check up, something I avoided because I was told all of my ills were due to my weight. At this particular visit, my new to me doctor, informed me I was pre-diabetic. No! Only one person in my family had been diabetic. This does not run in my family. We had other diseases, cancer, high blood pressure, high cholesterol, but not diabetes. What was I supposed to do with this? Well the very same thing I did with everything else. I ran the other way and ate to push it down.

My doctor did talk to me about my weight. I am 5’2″ and I had gotten up to about 360 lbs. '? That’s pretty short and round like. When she approached it, it was not in the same way that others had done before, but she really listened. She heard me when I said I’d tried every single diet, when I said I always came out of it feeling like I was the biggest failure in the world, when I said I had been listening to a couple of friends talk about compulsive eating and it seemed to fit every thing I was feeling and doing. She listened to me when I said I’d bought a book and cried as I read because it felt like I had written it myself. She then put me in touch with a totally awesome therapist. I was only able to spend 6 months with my therapist until we had to move again.

When we moved I decided it was time to live my best life right now. No more waiting for that magic miracle diet to help me shed all the pounds and make me a perfect size 2. By now I’d have been happy with the perfect size 20. I got a seat belt extender for my car, donated all of my clothes that didn’t fit and threw away the last scale in the house. I also found a new doctor in our new home. I needed help because I was tired all the time and couldn’t drive without falling asleep. I couldn’t stay up for more then 2 hours. I also had my first ambulance ride to the ER one morning, scared to death I was having a heart attack because I couldn’t breath and the pain in my chest was unbearable.

My totally new, totally awesome doctor sent me for blood tests, did a physical and sent me to a pulmonologist for a sleep study. Turns out, I have severe sleep apnea. The blood tests came back and, oh, by the way, I’ve now got full-blown diabetes. No time to panic as I was already panicking thinking I would die while sleeping with my daughters would be the ones to find me dead in the morning. I didn’t know what to do so I dumped all the things that could possibly cause me an issue with my blood sugar. I dumped all grains, all starchy vegetables, all fruits, and nearly all sugar. I got set up with my CPAP machine, took my Metformin and then I set about figuring out what to do with this disease I knew nothing about.

Insurance wouldn’t pay for a visit to a nutritionist. I did a better thing. I asked a diabetic friend, well, more like I cried all over my computer and begged my diabetic friend for any help. I can’t begin to tell you what my angel of a friend did for my peace of mind. She gave me wonderful advice and tips. I took them to heart. I wasn’t prescribed a glucometer, but I went out and got one from CVS. The great staff there was so helpful, showed me how to use it, and told me I didn’t need the latest and greatest one with bells and whistles. I needed the simplest one, with the cheapest test strips and off I went. I found myself a chiropractor and an acupuncturist. I wanted all of my bases covered. They were going to help me with all other physical and emotional aspects and most importantly, try to help my body heal my pancreatic function.

I tested everything I ate. I ran through testing strips like they were water. I began to exercise, which was not easy. After 2 C-sections and my illness my back was out of whack. I was in pain all the time and dealing with a second round of plantar fasciitis. My right knee would not bear any weight by itself. I walked, or tried to. I could make it maybe 1 1/2 minutes before I hurt so much I had to stop. I walked a small path behind our condo. It would take me about 20 minutes to walk something that should have taken 3. I saw a video for DDP Yoga and I got the tapes. I did the things my friend told me to do. Her most wonderful advice ever was to walk. She said if I ate something that spiked my blood sugar, which happened a lot at the beginning, to walk. If you move the big muscles in your body, it would move the sugar floating around in there, instead of sitting there making me feel high.

I had been getting horrible headaches before and the Metformin helped with that. I could visually see and physically feel when my blood sugar was going up too high and too fast. My walking was getting better. Finally, after a couple of months, I got rid of the last bit of sugar in my diet. I gave up chocolate. I knew it wouldn’t be a lifetime move, but I had to give it up for the time being to let my body heal.

Two weeks before my 3-month appointment with my doctor, I started to get headaches again when I took the Metformin. I decided to stop taking it. I got another blood test. My blood sugar numbers were dropping. My doctor was looking for my A1C numbers. According to diabetes.org A1C is: “A test that gives you a picture of your average blood glucose control for the past 2-3 months. The results give you a good idea of how well your diabetes plan is working.” She agreed when I told her I didn’t want to take the Metformin and try to control things with diet and exercise. Did I say yet how awesome she is?

I slowly started to add back in some whole starches like potatoes and some black and brown rice. I was sleeping so much better with my CPAP and life was amazingly different already. I found new recipes to help with my cravings as I still was dealing with my eating disorder. There’s a fine line to balance with making sure I’m doing what’s needed for health and balancing it out emotionally. I do not restrict my eating because for me, that is a sure way of creating a need for a binge. Paleo and primal web sites helped me tremendously. I still ate dairy and still had starches but I needed to learn a different way of baking to avoid wheat. I had a NEED for cookies.

I saw my doctor every three months. I got a blood test each time to check my A1C levels and various other things. I kept seeing my chiropractor and acupuncturist. My levels kept going to down closer to the normal range. I kept doing what I was doing.

My physical changes were phenomenal. I thought I wasn’t an outdoors person. I really was. I love walking in nature. I just don’t want to sit in nature or eat in nature (:-) I am not an al fresco diner), but moving through nature, I could do. My daughters and I found some trails to walk and we did as often as we could. I walked a bigger loop near our condo. I noticed, as I was doing my DDP, and standing in a lunge position, my right knee was able to go lower then it had before. I was taking pictures to track progress, and there was a visible difference in how I looked, how my clothes fit. I still didn’t use a scale and had to stop taking measurements. It wasn’t working for me emotionally to do this. I got derailed a bit by a weight loss challenge that I shouldn’t have joined, but it did teach me that restricting or surrounding myself with people who do, does not work for my peace of mind.

I then decided I wanted to try running. After getting the ok from all my medical people, I followed my intuition and got myself a pair of Vibram 5 Finger shoes and started to try to jog. I had read somewhere something about John Bingham and how he said he waddled when he jogged. That so fit. My friend told me she called it wogging. I loved it. I got some new wogging pants, sewed some skirts to wear over the pants and tried to see what I could do. I started very slowly and I’m still slow, but low and behold, the person who thought she hated running, LOVES it. Turns out, I just hated running for PE.

Today, I had my 1-year check up. My A1C numbers have me in the normal range. Not diabetic, not pre-diabetic but the normal range. I eat sprouted wheat bread when I want, I have some maple syrup on sprouted wheat pancakes, I have some sugar, and I still have my rice, my potatoes and everything else, including my chocolate. I have lost about 60 lbs. In the process I finally was able to lose my fear of what the food would do to my body. I still deal with my eating disorder one day at a time. I am living every day, and eating the chocolate, and wogging because I love it. I can walk a flight of stairs, I can run a few sprints, I can do actual squats without holding onto anything. I still have a ways to go physically, emotionally and mentally, but it’s no longer a race against a disease but a way to a better life. It’s always been about putting one foot in front of the other and finding a solution to the problem at hand. Now though, I look forward to seeing what new thing I’ll be able to do tomorrow, living my best life now.

Aloha,
Kaleolani Garcia
Homeschooling, stay at home mom of 2 and Coast Guard spouse.