I’m going to try to do more video blogs this year. Here’s the first one!
I’m going to try to do more video blogs this year. Here’s the first one!
One of the questions I get pretty regularly is “How can I determine the nutrition information of recipes I make at home?” When you’re trying to lose weight or build muscle, or working to ensure you’re giving your body the protein and vitamins and minerals it needs to thrive, knowing the protein, nutrient and calorie content of your meals can be super helpful. But cooking at home using whole foods can make it trickier, as whole foods don’t come with a nutrition label! There is a way to figure out all these values, and with the right tools and tricks it’s not too complicated.
The first few times you do this will be a learning process – expect imperfection. But you’ll get the hang of it quickly. Hang in there!
You’ll need two tools to get an accurate idea of the nutrient profile of your recipes. First, you’ll need to find a recipe analyzer you feel comfortable with. There are dozens available online. I would say they’re all pretty comparable, so check out a few and get a feel for which one seems most user friendly to you. I use this one at Calorie Count. Many of my clients use this one at MyFitnessPal. Spark People has a good one, as does Self Magazine. Here’s one from Fit Watch. Dieticians of Canada also has a good one. Some of these analyzers require you to create an account, but the accounts are free. The benefit of creating an account, though, is that you can save your recipes for future reference and only need to analyze them once.
And now that we’ve got the tools, here’s how you do it:
1. Enter all the ingredients of your recipe into the recipe analyzer of your choice, and tell the analyzer how many servings the finished product will produce. The analyzer will give you the nutrient profile for a serving of your recipe.
2. Prepare the recipe.
3. Weigh the entire finished recipe. Make sure to subtract the weight of the container you’re using to weigh the recipe. You can do this by weighing the empty container before weighing the recipe, or if your scale has a tare function, simply place the container on the scale and press the tare button to zero out the weight reading, then add the finished recipe to the container and the scale will read only the weight of the food.
4. Divide the finished product into servings by weight.
Here’s an example:
Our imaginary example dish is going to be beans and rice. Enter all the ingredients into the analyzer, in this case we’ll enter 2 cups uncooked rice, 1 cup dry beans, 3 carrots, 3 stalks of celery, 2 large tomatoes, a tablespoon of olive oil and a teaspoon of salt (we’re going for simple here). Then we tell the analyzer this recipe makes 4 servings. The analyzer will make it’s calculations and spit out the nutrient profile for one serving. Then, we prepare the recipe. When the recipe is finished, we place the entire dish on the food scale. After figuring out and subtracting the weight of the container the food is in, we determine the finished recipe weighs 36 ounces. We then divide the recipe into 4 equal 9 ounce servings, and either serve and eat, or package up for later. Viola! Home made meal, accurately profiled and divided. You now know your home made meal’s macronutrient, micronutrient and calorie profile.
One benefit of determining the nutrient profile of your recipes is that you can see if they are balanced to meet your goals, and if not, you can alter them. For instance, this beans and rice recipe may be too low in protein for someone on a fat loss diet, so seeing where the protein is coming from can give them ideas for improving the protein balance (perhaps by increasing the bean to rice ratio, or adding another protein dense ingredient). You can also determine if your recipe is calorie dense enough to meet your energy needs, or if it lacks micronutrients you may need to increase your consumption of. Remember, being aware of the nutrient profile of your diet IS NOT and SHOULD NOT be about restriction, it should be about ensuring you are meeting your nutrient and energy (calorie) needs adequately. Spending some time learning about the way your diet balances out over time can help you create new eating habits. Once those habits are in place, you can leave the tracking behind.
Related blog posts:
Most diet programs involve dramatic lifestyle overhauls, massive shifts in behavior, and rigid dietary prescriptions that require a great deal of effort and attention on the part of the user to implement and maintain. Willpower, they say. Stay focused on your goal (a lean physique, a specific weight or body fat percentage, etc) and WORK HARD, they say. You can do it! You can win the war with your body! It’s just a matter of focus, willpower, self control.
We all know how well most diet programs work out in the end, though.
My Own Habits
Five years ago I had an epiphany of sorts. I realized that my body was the result of my lifestyle habits. The way I ate, the way I moved, the way I slept, the way I dealt with stress…all these things worked together to produce the body I had at the time. My body, and my health, were a product of thousands of small, seemingly inconsequential behaviors (both conscious and unconscious) I engaged in on a day to day level. Trying to undertake massive behavioral changes all at once, as I had done so often as I tried fad diet after fad diet, rarely worked in the long term, as those massive behavioral changes gradually gave way to the ingrained habits that had established themselves over the course of decades.
I shifted my focus. Instead of focusing on an aesthetic goal and trying to force my body to that goal, I decided to focus on those small, seemingly inconsequential habits that formed the vast majority of my day to day activity. I identified the habits, the nearly subconscious behaviors that I fell back on automatically, that shaped the body and health I had at the time. And once those habits were identified, I identified new habits that could replace them, and I focused on shaping those new habits, slowly and methodically. The end goal wasn’t ‘weight loss’. The end goal was a new habit, a nearly subconscious behavior that I would fall back on automatically in my day to day life. I believed that with new habits and new behaviors, my body and health would change. I was right.
Research has established that what we term ‘self control’, or willpower, is a finite resource (1). As a person exerts conscious control over their behavior, they use up and eventually exhaust their reserves of self-control, at which point they revert to habits, which don’t require the use of self-control, as they are largely automated responses to stimulus (2). The more self-control a person exerts, the faster they deplete their self-control reserves, and the more they fall back on habits as they fatigue. So the more dramatic and extreme a diet plan is, the more likely the dieter is to exhaust their self-control reserves and relapse back into established, ingrained habits.
Researchers from the University of Southern California examined the role of habit in goal achievement through a series of studies (3). Their results confirmed that people fall back on habits, both good and bad (or ‘goal-congruent’ and ‘goal-incongruent’) when their reserves of self control are depleted:
In general, the present results suggest that habits are a regulatory mechanism that can enable people to engage in goal adherent action. Across all of the five studies we report, habits worked to compensate for low levels of self-control. Participants were especially likely to fall back on their habits when willpower was low, either because it had been reduced through prior self-control efforts or because it was chronically limited. This reliance on habits promoted goals when the habitual behaviors were goal-congruent, but was detrimental to goal pursuit when habits were goal-incongruent.
The last sentence is the money. ‘Good’ habits promote goal achievement, ‘bad’ habits inhibit it. The goal itself is almost incidental. For the best results, focus on those habits, because at the end of the day, those habits are gonna be largely what determines your progress.
What Does it Look Like in Real Life?
This concept is great in the abstract. Applying it to real life is trickier. My big ah-ha moment came when I shifted my thinking from ‘I want to have a lean healthy body’ to ‘I want to be exercising regularly, eating a nutritious, calorie appropriate diet, and getting adequate sleep consistently, because those are the things that will produce a lean healthy body.” How to get there from where I was was the big question mark. Ultimately, I ended up applying a lot of the behavior modification techniques I’d learned from my years of pit bull training to my own behavior.
I applied shaping techniques to my own behavior. Shaping involves breaking a desired behavior down into small, successive steps. In animal training, any behavior that is similar to the desired behavior is reinforced, and continued reinforcement can ‘lead’ the animal closer and closer to the desired behavior. With practice, the behavior becomes more and more automatic – it becomes a habit that requires no conscious effort.
I had a lot of behaviors I wanted to change. But I had tried making dramatic lifestyle changes before, and it required so much effort, so much ‘willpower’, that I reverted to old habits quickly. This time I decided to focus on much smaller changes, to ‘shape’ new lifestyle habits one at a time, to practice each new behavior until it was automatic, so that when I was tired or stressed out and reverted to habit, it would be GOOD habits I reverted to.
I started with exercise. I knew that reputable public health organizations recommend 30-60 minutes of exercise a day, 5-6 times a week, for best health outcomes, and up to 90 minutes a day for weight loss. But I also knew there was no way I was going to be able to jump straight into that kind of exercise volume when my HABIT was to be sedentary. As soon as I ran against a road block, I would fall back on my habits. So I broke it down. My initial goal was to 15-20 minutes at the gym, 3 days a week. At first, my goal was to swim for those 15-20 minutes, but in the beginning, even that was difficult. So I made it even simpler. All I expected of myself was to get there. There were many days that I got there, and sat in the jacuzzi, or chatted with the front desk staff, or even surfed the internet. But I got there. I was establishing a habit of getting there. Most of the time, once I was there I did something active, but in the beginning, getting there was my expectation, and having a manageable expectation made it more likely for me to follow through, and the more I followed through, the more automatic the behavior became. After a few months, I realized that I was scheduling my trips to the gym into my week without thinking about it. It had become a normal part of my life. It had become a habit. In the months and years since, I have increased the volume and intensity and frequency of my workouts so that now I easily meet the minimum public health recommendations. But had I not established that habit of making time, that habit of fitting it in, I wouldn’t have gotten past the initial stage. I would very likely still be sedentary.
My eating habits were another behavior I wanted to change. After decades of fad diets, I was worn out with kitchen overhauls. This time around I made a simple change – more vegetables – and practiced it until it was easy. And when I was including more vegetables in my day to day without stressing out about it, I added in some calorie tracking. And when that was easy, I started tracking protein too. And over time, my eating habits shifted, so that now I am able to put together a balanced, calorie appropriate, protein sufficient meal without needing to really think about it. I just know what to eat and how much, because I slowly, methodically changed my habits and practiced them until they were automatic. I no longer need to track my calories or protein, because I used tracking to create new habits that I can now rely on.
Sleep and stress management are other behaviors I’ve changed. I focused on one small change at a time, and practiced it until it was habit. I started turning off electronics a little earlier in the evening. I started making sure I was done drinking coffee by late morning. I stopped listening to the news in my car, because I realized it was making me anxious. And lots of other small changes.
Now when I’m tired or stressed out, I don’t need to think about these things, they are habits. I can fall back on these healthy behaviors and focus my mental energy on more pressing things, because I took the time to slowly, methodically change the habitual behaviors that form the bulk of my day to day life. And the result has been an improvement in my health, weight loss that I’ve been able to maintain with minimal effort, and a whole lot more mental energy to devote to things like my family and my career and my blog. Because the behaviors that I engage in automatically are, by and large, healthy behaviors. I’m not perfect. I’m still working on some things. But I’ve learned that humans are creatures of habit, and we have the power to change those habits. And those habits are what really make us who we are.
Just starting out? My First 100 Days Beginner’s Program is specifically designed to promote the habit of making time for exercise. Check it out!
Today’s post is by my friend Bree, a personal trainer based in Sydney, Australia. You can find her on facebook, and she’s a fixture in the Eating the Food facebook group. Thanks for your wise words, Bree!
First things first- thanks Amber for even considering that this post was worthy of being featured on the Go Kaleo blog. I tried blogging, but I’m not very good at it. To be honest, I’m an absolute wuss when it comes to revealing too much about myself. Which is why I’m way too pathetic to post this somewhere like my own blog where only my family, friends and colleagues might see, because this is about something that is very personal to me and is a topic that I will do anything to avoid discussing ‘in real life’: my weight. And how my weight is perceived by the industry I work in, which forms the basis of the love/hate relationship I have with that industry.
I’m a personal trainer. I wanted to be a trainer for many years, but kept putting it off. I’d lost a lot of weight and had been on a personal journey (like most people who change their life habits) but never thought I had ‘the look’. For seven years I waited until I had abs. I was so worried about how I would be judged, and thought surely my training business would fail if I didn’t look like the model on the cover of a fitness magazine. The abs never came, despite my best efforts, but as I reached my 30s, I realized that if I kept putting certain limitations on myself, I might never get to have a career that I was passionate about.
This week I had a conversation with a fellow personal trainer that triggered every one of those insecurities that stopped me becoming a trainer for so long. It highlighted the judgement that can silence the voices of those in the industry who genuinely love fitness, health and exercise and want to share that passion. We were talking about the new Zumba instructor at our gym, and how much the class numbers had dropped. Zumba has never been popular here, but the old instructor had worked the floor and recruited as many participants as possible. The trainer I was talking to saw the cause of the drop in participation as something very different. She blamed the new instructor’s appearance. “She is disgusting… Who would be inspired by someone who looks like THAT?”.
Despite the temptation to reach out and punch my colleague, I went silent. Why? Because this hit home.
The new zumba instructor is probably an Australian size 12-14 (US 8-10). She’s Latino, with a body that is built for shimmies and serious booty shaking. Damn it, even her hair whip has attitude. Every moment of her class is filled with a joy and energy that embodies the enthusiasm of Zumba (and having spent three days at a convention across from a Zumba stage, I know a lot about the enthusiasm of Zumba). I’ve watched this instructor dance and thought ‘that chick can move!’ Sadly, to some in the fitness industry, her skill is irrelevant. Skill alone is not enough to make her a good example for those she teaches. This hurts me. Because just like that Zumba instructor, I do not have the ‘right’ look. I am overweight, my thighs touch, I have cellulite.
This whole scenario has spun around in my head for a few days and has made me angry. I am angry at myself. My own paranoia, that not fitting the widely held stereotype of how a personal trainer should look, damages my business. It stops me from approaching people in the gym, because I often think ‘who would want to look like me?’ I am incredibly fit, healthy, and can lift like a demon. All inspirational things. And I am a damn good trainer who really cares about my clients and has helped them reach their goals. But I have gained seven kilos since December 2012. The judgmental element of the fitness industry expressed by my colleague this week makes it tough for me, every single day, to show that I have more to offer those I train, or could potentially train, than my weight gain.
It also upsets me because I know how hard it is to walk through the doors of a gym for the first time. You think everyone is looking at you. You think about how different you look from everyone else in the gym. You already think you are being judged because you don’t ‘look fit’. I’ve walked through the same turnstile for eight years as a gym member, and now as a fitness professional, and I still feel it. The last thing you need is some trainer staring you up and down, making you feel like you don’t belong. That is not what personal training is about. It is not why I joined the industry. And I don’t believe that most fitness professionals enter the industry to just train the so called ‘body beautiful’. We join it because we want all people to learn how much exercise can make you feel awesome, and help you lead a long, productive, quality life. I want those of us in the majority to stand up and outshine those who make you feel that you are not good enough, because you don’t have body fat under twenty percent, or your boobs jiggle when you run.
I want every reader to understand, there are people in the fitness industry just like you. We don’t always look perfect, and we have factors in our lives that mean exercise and diet aren’t always our top priority. This year, my mother has been diagnosed with cancer, my father died, I suffered a major injury to my wrist that is going to involve a six month recovery period and I started a new business. The last time I gained a lot of weight it was during a time of major upheaval, just like this time. There are, quite simply, times when food prep and training aren’t especially important. Sometimes it is just about getting through the day. I’m sure many of you understand what that is like.
Please don’t think we look at you and think ‘lazy/not good enough/slacker’. Please do not think that all of us believe in the ‘no excuses’, train-until-you-spew model of fitness. Most of us believe in healthy balance, and that is what we want most for you to have in your life. Fitness is about something much more important than your appearance. Don’t be like me and allow the real and imagined judgement of others to limit you. There are many more fun, loving professionals like the Zumba instructor, than the narrow minded. Judge us on our passion, our experience, our empathy, our knowledge…just remember that our bodies, like yours, are shaped by our lives, and are not the sum total of our value as a trainer.
This blog series is an exerpt from my book ‘Taking Up Space: a Guide to Escaping the Diet Maze’.
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:
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.
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.
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.
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!
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.
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:
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, Matt Stone 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:
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.
This blog series is an exerpt from my eBook ‘Taking Up Space: a Guide to Escaping the Diet Maze’.
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:
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:
Next Up in Part 2: How?
-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?
-Type 2 Diabetes
-Insomnia or sleep apnea
-Muscle and/or joint pain
-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.
If you believe you may be dealing with either BED or addiction, please seek qualified help. Here are some resources to get you started:
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.”
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.
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.
Today, for a change, I’m not going to hit you with a bunch of studies. I’m just going to tell you what I’ve learned through experience with my clients and readers. Then I give you a couple links to check out if you want to read some more sciency stuff.
My client base is made up largely of women who’ve already run the diet gauntlet. By the time they get to me, most of these women have essentially been on one diet or another for years, or even decades. They’ve done it all. They’re experts at losing weight. Trouble is, the weight always comes back. With each successive diet, they ultimately find themselves fatter and sicker. I don’t put my clients on diets: they’ve already been, to a one, on all the diets. I get my clients off diets. Get them eating a humane, sustainable amount of food, with a focus on supporting their activity and honoring their personal tastes and cultural traditions. The vast majority of my clients stabilize fairly quickly and begin making forward progress, once they wrap their minds around eating to support their metabolic health.
There are a few clients, though, who have a much harder time stabilizing. Their weight won’t budge, or it fluctuates wildly. They don’t seem to be able to build muscle mass as effectively. They begin to store more fat around their belly than they have in the past. They experience edema. They deal with anxiety and insomnia and other symptoms of starvation, even when their calorie intake is adequate. It is as if their bodies refuse to emerge from the starvation response (see my Adrenal Fatigue post for more info on the starvation response). This goes on for months, even when calories and macronutrients are all adequate and consistent. I’ve had several clients who’ve experienced this, and every single one of them had a history of one or more of the three diet philosophies that I’ve taken to calling the ‘Metabolic Downregulators’. Those three diet philosophies are: HCG, Intermittent Fasting, and Ketosis.
All three of the Metabolic Downregulators appear to provoke the starvation response by design. The first symptom of the starvation response is rapid weight loss. Subsequent symptoms are endocrine adaptations that slow the body’s metabolic processes and insure against famine by shoring up fat reserves, stopping reproductive function and reducing metabolically expensive lean mass. IF and ketosis seem to be able to do this even in the absence of a caloric deficit. HCG, of course, simply relies on extreme calorie deprivation. That initial rapid weight loss is what the dieter fixates on, and when the weight loss stalls out they wonder what they are ‘doing wrong’, and double down on the diet in an effort to get the weight dropping again. This only compounds the metabolic downregulation, and the dieter ends up exhibiting all the symptoms of starvation AND excess fat stores.
Like I said, I’m not going to throw studies at you today (I’ll let Alan Aragon, Anthony Colpo, Stephanie Ruper and others do that). I’m simply sharing the observations I’ve made amongst my clients and readers.
My clients who’ve succeeded in downregulating their metabolic function need much more time to repair and stabilize than others who’ve followed less extreme diet philosophies. 6 months is not uncommon. Some women need a year or more. The longer a person’s body has been in the starvation response, the longer it’s going to take to recover. This is a frustrating reality. The temptation to return to extreme dieting can be great. I encourage those of you who are experiencing this to remember that the diets ultimately failed, and it is exactly those diets that brought you to where you are today. There is a better way. Consistently and dependably giving your body the nutrition and energy it needs to be healthy and active will allow it to emerge from the starvation response and heal from the damage the diets have done. But it takes time. Be patient! The long-term benefits are worth it.
If you’ve gone through this, please share your experiences in the comments so that people just beginning the healing process know they are not alone. There is a vast support network out there for those ready to start on the path out of the restriction maze. Please reach out, from wherever you are, to support each other and to find the help you need.
I will add to this list as I find additional resources.