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Eating Disorder 101: A Mental Health Therapist Answers Your Most-Asked Questions Part II

Part II – Effects & Finding a Dietitian

Note: There are two parts to this article. For “Part I – Stress and Society,” click here.

I’m Limor Weinstein, founder of LW Wellness Network, and I am going to answer some of your most-asked questions about eating disorders. My background, experience, and education as a licensed mental health therapist are centered on personal and family well-being. As a mother, wife, and psychotherapist, my goal has always been to provide emotional support and knowledge that may be absent due to a variety of variables. I myself am an ED survivor. I am also an Eating Disorder Specialist who works with clients to help them find their way to better health.

What health risks are related to ED?

There are many health risks related to eating disorders. Each eating disorder has its own health consequences due to the nature of the disorders. As anorexia nervosa is characterized by self-starvation, the body is forced to live without the essential nutrients it needs for normal functioning. Anorexia can lead to abnormally slow heart rate and low blood pressure, which increases the risk for heart failure, reduction of bone density, muscle loss and weakness, severe dehydration, which can result in kidney failure, fainting, fatigue, overall weakness, dry hair and skin (hair loss is common). It is also possible that there is a growth of a “downy layer of hair called lanugo” all over the body to keep the body warm (NEDA).

With the binge-and-purge cycle of bulimia, the entire digestive system becomes affected, which leads to electrolyte and chemical imbalances of the body. These electrolyte imbalances “can lead to irregular heartbeats and possibly heart failure and death” (NEDA). This is because electrolyte imbalance is caused by “dehydration and loss of potassium, sodium and chloride” from the body each time the individual purges (NEDA). Gastric rupture can occur during binging. Frequent vomiting can lead to inflammation and possible rupture of the esophagus, tooth decay, and staining from stomach acids. Abuse of laxatives can lead to “chronic irregular bowel movements and constipation” (NEDA).

The consequences of binge eating disorder are similar to the health risks associated with clinical obesity. These include high blood pressure, high cholesterol levels, heart disease due to elevated triglyceride levels, type II diabetes mellitus, and gallbladder disease (NEDA).

Are there any ED withdrawal symptoms? What are they?

Withdrawal from an eating disorder is similar to withdrawal from other addictions. According to a study done by Indiana University, symptoms of withdrawal typically include irritability, cravings, and general restlessness.

Why do people fear overcoming ED?

Fear comes with this decision to recover from an eating disorder because until this point, the eating disorder has helped the individual to feel safe and secure. The eating disorder has given this individual a sense of control and identity. This is why it becomes difficult to stop an eating disorder. But, it is possible. The person affected by the eating disorder must overcome their feelings of helplessness, guilt, shame, and self-disgust to seek help. Once they do this, they will still fear letting go of their eating disorder and going through a change. These fears should be acknowledged and discussed to help in the road to recovery.

There is, of course, always the fear of relapse. The final stage of recovery, maintenance, is about new experiences and adjusting to new developments. With this there is the chance of relapse. But this cannot be the focus of recovery. This is why recovery is an ongoing process, involving asking for help and communicating through thoughts and feelings.

You’ve said that, “While it might not be easy to stop ED, it can be enjoyable.” Can you elaborate?

Although it is not easy to stop an eating disorder, it can be enjoyable. Depending on the type of treatment that one goes through, he or she will likely be surrounded by other people in treatment (which can be both good and bad as discussed earlier). By being surrounded by like-minded individuals, one can see that they are not alone, that there are people out there going through the same thing as them who are also looking to get help.

As August McLaughlin discusses in “The Silver Lining: 5 Happy Truths About Eating Disorder Recovery,” there are positive aspects in the road to recovery. Recovery leaves people “feeling lovelier, inside and out.” Individuals with eating disorders have distorted views of themselves both physically and mentally. They want to lose weight to fix their physical appearance, and they take these drastic measures to make them feel better internally. Treatment, however, teaches people how to appreciate themselves for who they are and to love each and every part of themselves. Treatment leads to greater energy. Eating disorders take an extreme amount of physical and emotional energy to sustain. By letting go of an eating disorder people will gain back this energy to do things they love physically and to think about something other than the eating disorder.

Treatment also brings enjoyment back to food. Food is no longer as scary as it once may have seemed. By mending one’s relationship with food, he or she can enjoy their favorite foods without feeling the extreme guilt before, during, and after. Treatment leads to freedom. Eating disorders have such control over people’s lives. By not letting the eating disorder dictate every life decision, individuals are surprised to see how much they can freely live their life, by their own rules. Lastly, treatment leads to gratitude. Living with an eating disorder can be extremely challenging and detrimental. People in recovery, living without an eating disorder, will learn to be thankful for their bodies and minds. It may be scary to think about what one’s life would be like giving up this eating disorder that has had so much control, but there is nothing to lose by giving up an eating disorder, just a beautiful life to gain.

I’m sick of people focusing on why I shouldn’t maintain my ED (health risks, etc.)! Can you tell me why people do continue their ED?

It is easy to list all of the reasons why clients should try and get rid of their eating disorders. There are health risks involved, the eating disorders take over the individual’s life, there’s dramatic weight loss as well as damage to the digestive system and potential organ damage. Sometimes it is not enough to express to the client the negative effects that an eating disorder can have. Rather, we should focus on why people maintain their eating disorders. People with eating disorders become comfortable with their eating disorders. They begin living a lie and don’t know how to get out of it, or if they even want to. As stated earlier, the eating disorder that has such control over their life becomes a sense of security and control. The eating disorder begins making life decisions that the individual does not have to make. Further, the eating disorder becomes his or her release. The willpower not to eat, the binging, purging, or excessive exercise gives the individual a way to relieve stress.

By teaching clients alternative ways to have control in their daily lives or new ways to cope and calm themselves, clients can hopefully give up the detrimental ways in which they achieve this through their eating disorders. If a client can begin to enjoy these alternatives they may be more likely to give up the harmful techniques they were using and transition into recovery.

Is it a myth that the ED person “sacrifices” something or deprives themself when they stop their ED?

Many people believe that when they quit something they are addicted to they will be sacrificing something. In the case of eating disorders a client may feel that they are missing out on something by giving up their eating disorder. To help with recovery we must show how positive it can be to live a life without an eating disorder. There should be “nothing to fear, nothing to ‘give up’ and absolutely everything to gain” (Carr, 2011).

Why do eating disorders provide people with a feeling of safety and security?

Life with an eating disorder provides people with a feeling of safety and security. This is because eating disorders are started out of instability, with the hope that the eating disorder will create stability or some kind of control. Eating disorders hold great control over individuals lives that they grow accustomed to over time. It can be scary to let go of this sense of control and comfort that they have been living with.

Is there a link between boredom and ED?

Yes, many people eat out of sheer boredom. It is important to differentiate between biological hunger and boredom. When we develop negative eating habits, we become unaware of why we are eating. An individual may try to fill themselves up with food when they do not feel like their lives are full. Eating becomes a mindless activity, similar to when one emotionally eats.

What is going on the brain of an eating disorder client?

In addition to the other emotional, physical, and social effects that eating disorders have on an individual, eating disorders can lead to neurological damage (Emilyprogram.com). A client’s nervous system is negatively impacted when they engage in restrictive behavior. This leads to disruptions in neurotransmitter behavior, structural changes, and abnormal activity during anorexic states, a weakened response in the reward regions of the brain, and potential shrinking of the brain. Nerve related conditions such as seizures, disordered thinking, and numbness or odd nerve sensations in the hands or feet are also possible effects. Eating disorder clients may become depressed, irritable, or isolated due to the adverse effects on the emotional centers of the brain. An individual also could have difficulty thinking, switching tasks, and setting priorities due to the disruption in the brain’s normal functioning.

Is it an illusion that I can overcome my eating disorder?

In some cases body dissatisfaction does not change once an individual has “recovered” from an eating disorder. Even when the physiological and behavioral aspects return to status quo, mentally a client may still feel negatively about their body. This is why recovery from an eating disorder is an ongoing process that involves overcoming daily triggers that an individual may encounter. However, it is not an illusion. There can be a light at the end of the tunnel.

How do I stop?

Unfortunately, this is not as simple as reading a response. However, I’ve put a list of things I have my clients ask themselves:

  1. What does the ED really do for me?
  2. What purpose does it serve?
  3. Do I really enjoy it?
  4. Do I really need to go through life playing with my health just to maintain my eating disorder?
  5. What am I getting out of maintaining this eating disorder?
  6. Would my life be incomplete without it?
  7. How could I make my life more complete so I can get rid of my eating disorder? How can I use the resources and people around me to help?

Where can I find a dietitian?

If you are trying to figure out where to find a dietitian, chances are, there is someone not far from you. There are fabulous nutritionists, dietitians, and eating disorder therapists all around the country who are qualified and ready to help you. Your doctor may have some good recommendations if you want to find a local dietitian. Do you want someone who is uniquely matched with you? Give us a call. We will learn about you — from your personality, your history, your health past, your struggles, and your goals — and we will find someone in your area who fits you best. We have many fantastic providers whom we trust and adore to help guide our clients on their path to recovery.

If you or someone you know is struggling with an ED, it’s time to take the necessary steps to change life for the better. You can grow into the best version of yourself, starting right now.

If you would like me to connect you with one of our expert therapists or dietitians, contact me or book an appointment with me. I look forward to hearing from you!

Eating Disorder 101: A Mental Health Therapist Answers Your Most-Asked Questions Part I

Part I – Getting Familiar With Eating Disorders

Note: There are two parts to this article. For “Part II – Effects and Finding a Dietitian,” click here.

OK. To get you into the right frame of mind, I want you to really listen up. If you or someone you know is struggling with an eating disorder, you probably have a lot of negative thoughts on the subject. You may be plagued by feelings of gloom, misery, and even depression. Put those thoughts on hold for a moment and picture yourself in a state of elation. Imagine being cured from a terrible, life-threatening disease. Because the truth is, eating disorders are terrible, life-threatening diseases, but you don’t have to fight them alone. We’re here for you!

I’m Limor Weinstein, founder of LW Wellness Network, and I am going to answer some of your most-asked questions about eating disorders. My background, experience, and education as a mental health therapist are centered on personal and family well-being. As a mother, wife, and psychotherapist, my goal has always been to provide emotional support and knowledge that may be absent due to a variety of variables. I myself am an ED survivor. I am also an Eating Disorder Specialist who works with clients to help them find their way to better health.

The following questions are questions that people have been asking me for the past 15 years over and over again, so I have decided to compile a list of answers and include some evidence as support. Since I had too many questions, I have decided to break this blog into part A and B, but if you have any other questions related to eating disorders that you want answered please feel free to email me and I will answer them for you! (limor.w@limorweinstein.com).

What is an ED?

An eating disorder is an illness that includes extreme emotions, attitudes, and behaviors surrounding weight and food issues. Eating disorders can have serious emotional and physical consequences on an individual’s life. Although the majority of people with eating disorders are female, this illness does affect males as well. In the United States, 20 million women and 10 million men suffer from an eating disorder at some time in their life (Wade, Keski- Rahkonen, & Hudson, 2011).  

There are eight types of eating disorders including Anorexia Nervosa, Binge Eating Disorder, Bulimia Nervosa, PICA, Rumination Disorder, Avoidant/Restrictive Feeding Disorder, Unspecified Feeding or Eating Disorder (UFED) and Other Specified Feeding or Eating Disorder (OSFED). I am not going to go over all the eating disorders, but I will focus on the main three (Anorexia, Bulimia & Binge Eating Disorder). This is not to say that the other eating disorders are not important, but I promise to write about the other disorders as well in later blogs!  

Anorexia is characterized as inadequate food intake leading to a weight that is too low for that individual, intense fear of weight gain, self-esteem overly related to body image, and an inability to appreciate the severity of the situation. Within this categorization, there are two types of anorexia: binge-eating/purging type that involves binge eating and/or purging behaviors during the last three months; and restricting type, which does not involve these behaviors.

Binge Eating Disorder is characterized by frequent episodes of consuming very large amounts of food but without behaviors to prevent weight gain, such as self-induced vomiting, a feeling of being out of control during the binge eating episodes, strong shame or guilt regarding the binge eating, and indications that the binge eating is out of control, such as eating when not hungry, eating to the point of discomfort, or eating alone because of shame of this behavior.

Bulimia Nervosa involves frequent episodes of consuming very large amount of food followed by behaviors to prevent weight gain, such as self-induced vomiting, feelings of being out of control during the binge-eating episodes, and self-esteem overly related to body image.

Is ED an addiction?

In short, the answer is yes. Growing research suggests that there are several similarities between eating disorders and addictive conditions. The American Society of Addiction Medicine now has a more comprehensive definition of addiction, which includes “process” addictions, such as food, in addition to drugs and alcohol. This is because the effect that these substances and behaviors have on our brain is similar across “substances.” The reward centers of our brains can be activated by food in a similar manner as by drugs and alcohol. Once this reward center is activated, an addictive cycle is created. Therefore the stimuli, such as drugs, alcohol, or food, become a desperately desired substance. This is when addiction and dependency occur. Abuse of any substance creates a false sense of temporary happiness or relief, but of course, has its long-lasting consequences. (Eating Disorder Hope, 2016))

In fact, research indicates it is the restriction that becomes addicting, rather than the excessive food. Restrictive behaviors like starving and even exercising increase endorphin levels in a similar way as opiates — which is both fascinating and scary! However, this helps explain why people can’t simply STOP having an eating disorder. It also reinforces why you shouldn’t try to go it alone.

Is there a brainwashing component to ED?

Yes! Individuals who develop an eating disorder frequently tell themselves that eating less is better, eating more is bad, eating will make them gain weight, and gaining weight is bad. They repeat these ideas over and over throughout their daily life. These individuals can be compared to those who have been brainwashed. As explained in “Recovery from Eating Disorders: A Guide for Clinicians and Their Clients,” “they brainwash themselves to prevent weight gain: their feelings of hunger are felt as positive and safe and they are proud of being able to resist hunger, which gives them a feeling of control and self- esteem.” Feeling hungry is not the “norm,” but these individuals strive for that feeling. They also are brainwashed to believe that the image they see when they look in the mirror is not an attractive image, that even at a below normal weight they are still fat.

What do stress and society have to do with my ED?

Eating disorders are a prevalent issue in today’s society, related to the constant pressures to be thin. Whether this is in the media or from our friends and family, the pressures placed on people lead them to develop eating disorders. Those who suffer from eating disorders not only have issues with their eating behaviors, but these issues spread to other aspects of their life. There is no single cause for developing an eating disorder and it can be a combination of factors related to an individual’s social, psychological, interpersonal, cultural and/or biological influences.

Yes, we need to change the way that beauty is portrayed; being thin should not be equivalent to being healthy and beautiful. Society over-emphasizes appearance and sets unrealistic goals when it comes to weight loss. It also associates a thin body with success and love, therefore convincing members of society that if they want to be successful or find love they must first meet this body type. Society also puts labels on food, labeling them as inherently “good” or “bad,” which perpetuates feelings of guilt for eating a “bad” food.

The diet industry spends billions of dollars each year to promote diet pills and magic tricks that will make people lose weight instantly. If these “tricks” really worked then why are there so many of them? The reason that there are so many options out there is because diets don’t work.  

With the increased access to celebrities’ lives it is easier than ever to know what our favorite celebrities are doing to keep their “perfect bodies.” Between this and fad diets we are susceptible to developing body issues and disordered eating.

Is it a myth that people use ED to relax and calm/soothe themselves?

No! It’s not a myth. Eating disorders aren’t always just about wanting to be thin. In addition to striving for some body image ideal, individuals may use unhealthy behaviors such as dieting, starving, binging, and purging to cope with unpleasant and overwhelming emotions and stressful situations. For someone who doesn’t suffer with an eating disorder, this can seem like an unusual concept, but for many people these restrictive and controlling behaviors in regards to food actually bring some sense of peace. While these behaviors may relieve anxiety and stress in the short term, however, in the long term they actually increase anxiety and stress — in addition to creating other serious complications (ULifeline.org, 2016). It is important to note, though, that binging and purging can feel like the only way the individual knows how to receive pleasure.

Do you have an example of an extreme ED case that made news?

Today many people are showing symptoms of orthorexia nervosa. While this disorder is not currently recognized in the DSM-5, due to the “clean eating” phenomenon it is becoming popular. These individuals have an “unhealthy obsession with otherwise healthy eating,” meaning they have a “fixation on righteous eating” (NEDA). While orthorexia may start out as an individual looking to eat better, it can turn into an unhealthy obsession. Individuals look to eat perfectly each day, sometimes taking drastic measures to overcompensate if they “mess up,” which could lead to bulimia. This obsession can also take over their lives, taking joy out of everyday activity and making it difficult to have a social life. Rather than anorexia or bulimia, which focuses on calories and weight, orthorexics focus on healthy eating.

Why do people with ED feel intimidated?

People with eating disorders may feel intimidated by everyone around them. They could feel intimidated by the really “skinny” woman on the street because of the way she looks. They could feel intimidated by the “heavier” woman who is smiling, wondering how she could be so content living like that.

Individuals with eating disorders may feel intimidated to let their secret out. For so long it has been kept a secret between that person and their eating disorder. Letting someone into that secret can be overwhelming and scary.

Another aspect of intimidation can be within the eating disorder community itself. A person may feel intimidation from those who have “worse” cases then them, those who eat less calories, or those who have seemingly more self-control. On the other hand, they could also feel intimidated by those in recovery.

It seems like the ED person has already “programmed themself to fail.” Does our society encourage that?

Recovery from an eating disorder is hard, but it is definitely possible. One of the most important aspects of recovery is willingness to recover. If a person goes into treatment and recovery with the attitude that they do not want to recover, they do not want to gain, and that they are happy with how they are currently it is very difficult for treatment to be successful.

Those who have recovered are always in recovery, which is because there will always be those little triggers and thoughts that could have potential effects on an individual. Similar to how our society can influence the start of an eating disorder, society can also help someone to fail in his or her recovery. The messages about being thin and getting the best body are still out there. Granted there are now stories about feeling good at any weight and plus size models are being featured, but those do not stand out as much as the “5 easy tricks to drop 10 pounds in a week” articles.

Society reinforces eating disorder related behavior. Unknowingly, others who are unaware that an individual has an eating disorder may give positive reinforcement. They could tell their friend how skinny they look and they admire how they can control themselves in front of food or go to the gym for so long. For people who have friends who do know about the disorder, they probably offer care and support. The client may feel that without the eating disorder they would not get the same care and attention from those around them. Whether it’s negative or positive attention that an eating disorder brings to an individual, they likely appreciate this attention and it becomes an additional “plus” to the eating disorder.

What population of the USA has ED? How about the world? Is there any country where ED is not prevalent? Why?

In the United States, 20 million women and 10 million men suffer from a clinically significant eating disorder at some time in their life (Wade, Keski-Rahkonen, & Hudson, 2011). Eating Disorders affect 70 million individuals worldwide (The Renfrew Center). A study done by Medscape’s General Medicine (2004) shows that prevalence rates in Western countries for anorexia nervosa ranged from 0.1% to 5.7% in females. Prevalence rates for bulimia nervosa in females ranges from 0.3% to 7.3% and from 0% to 2.1% in males. In non-Western countries, prevalence rates for bulimia nervosa ranges from 0.46% to 3.2% in females. Disordered eating in non-Western countries, though lower than in Western countries, have increased, likely due to the influence of Western culture (Makino, Tsuboi & Denerstein, 2004).

Is an eating disorder an oral satisfaction? Is there any evidence relating it to our early child development?

Oral satisfaction is a strong biological urge in every human being. It is common for an infant to suck on his or her thumb for self-soothing. As people get older they may smoke cigarettes or chew gum to get this satisfaction. Overeating and chewing nails has also become common practice when an individual is nervous. We know that “eating disorders are centered on fixations on food, which go beyond mere satisfaction of hunger” (Urdang, 2002). An eating disorder is not just about food or an unhealthy relationship with food, but about something deeper within the individual. There must be something else that is “unsatisfied” within the individual that the client tries to fix with the disordered eating behaviors.

What else should I know? And where can I find a mental health therapist near me?

This topic is so broad and we have so much to write about that we made it two blog posts! To read more about the effects of eating disorders, as well as how to find a mental health therapist or a dietitian, read Part II of this article here.

If you would like me to connect you with one of our expert therapists or dietitians, contact me or book an appointment with me. I look forward to hearing from you!

Treatment For Eating Disorders

 

Treatment For Eating Disorders: Notes From A Survivor & Mental Help Therapist

 

While it may not be easy to stop your ED, it can be done (and may even be enjoyable!). Before I get into the five questions to ask yourself that can help you get rid of your eating disorder, I am going to get you excited and inspired to become eating disorder free.

But before I even do that, a little bit about my recovery… My anorexia arrived when I was 14 years old and stuck with me for about a year and a half. I then, secretly, became bulimic for the next 8.5 years.  Without getting into too much of the horrifying details, I can tell you that it was a terrible disease that affected all parts of my life, and thankfully, I was finally able to overcome it at the age of 24. Now at age 41 and as a mother of three girls ages 6, 9 and 12, I have a new understanding of my mental illness at that age and why I was particularly vulnerable. I know now that it is possible to live a happy, healthy life without an ED, and that the steps to get there can be positive and full!

As August McLaughlin discusses in “The Silver Lining: 5 Happy Truths About Eating Disorder Recovery,” there are positive aspects in the road to recovery. Recovery leaves people “feeling lovelier, inside and out.” Individuals with eating disorders have distorted views on themselves both physically and mentally. They want to lose weight to fix their physical appearance, and they take these drastic measures to make them feel better internally. Treatment, however, teaches people how to appreciate themselves for who they are and to love each and every part of themselves.

 

Treatment leads to greater energy. Eating disorders take an extreme amount of physical and emotional energy to sustain. By letting go of an eating disorder, people will gain back their energy to do things they love and to think about something other than the eating disorder.

Treatment brings enjoyment back to food. Food is no longer as scary as it once may have seemed. By mending one’s relationship with food, a person can enjoy their favorite foods without feeling the extreme guilt before, during, and after.

Treatment leads to freedom. Eating disorders have such control over people’s lives that are living with them. By not letting the eating disorder dictate every life decision, individuals are surprised to see how much they can freely live their life, by their own rules.

Treatment comes with support. Depending on the type of treatment that one goes through, they will likely be surrounded by other people in treatment. By being surrounded by like-minded individuals, one can see that they are not alone, and that there are people out there going through the same thing as them that are also looking to get help.

Treatment leads to gratitude. Living with an eating disorder can be extremely challenging and detrimental. People in recovery living without an eating disorder can be thankful for their bodies and their minds without the eating disorder. It may be scary to think about what one’s life would be like giving up this eating disorder that has had so much control, but there is nothing to lose by giving up an eating disorder, just a beautiful life to gain.

Many people believe that when they quit something they are addicted to, they will be sacrificing something. In the case of eating disorders, a client may feel that they are missing out on something by giving up their eating disorder. To help with recovery, we must show how positive it can be to live a life without an eating disorder. There should be “nothing to fear, nothing to ‘give up’ and absolutely everything to gain.”

In order to stop ED, ask yourself the questions below. While I cannot answer these questions for you, I can answer for myself with the hopes that it will help inspire you to search for answers deep within yourself. I would even encourage you to get a piece of paper and write down your answers. Take some time with this, dig deep, and don’t be afraid to be vulnerable with yourself. Tell the truth, and give yourself some kind love for taking this first step.

Question #1: What does the ED really do for me?

To ask this question in a slightly different way, you can also ask yourself, “What function/purpose does my eating disorder serve in my life?”

My anorexia helped me get attention from people, especially from family members and friends. I was 12 when I was sent to live with a foster family, and by 13, my anorexia helped me stay in control over a life that felt miserable and very much not in control. Of course at the time, I wasn’t aware of that, but I am now.

I was a very developed 13 year-old. Before I became anorexic, I was a bra size D, and had no clue which bra, if any, I was supposed to wear. No one ever spoke with me about bras or anything related to sexuality. I started developing, and, after the first sign of my period — which, by the way, I thought I had gotten hurt because I had no clue what had happened to me — the fears, anxieties, and uncertainty nudged me to become best friends with anorexia and to keep me as the sad little girl that I was. Becoming a grown woman was scary, and I wasn’t ready to enter that stage. My ED also helped me to stay isolated so I could focus on my education, which I knew would help save me from a life of poverty.

As I matured and gained weight, I was sexually assaulted by several people who took advantage of the fact that I was insecure, neglected, and vulnerable. The various other traumatic incidents that happened to most of the eating disorder people I knew as well helped perpetuate my eating disorder. This kept me in a bubble, because I was under the illusion that life with an eating disorder provided people with a feeling of safety and security. My eating disorder started out of instability, with the hope that the eating disorder would create stability. My eating disorder held great control over my life, which I grew accustomed to over time. Letting go of my eating disorder was scary, and I was under the (false) impression that it gave me a sense of control and comfort.

Question #2: Do I really enjoy it?

Once again, ask yourself this question and try to be as objective as you can be. How much joy does your eating disorder bring to your life? Do you enjoy restricting? Binging and purging? When I reflect back and ask my old anorexic or bulimic self this question, the answer is that I did enjoy being skinny or maintaining weight when I binged and purged. Of course, I didn’t know back then that when I purged, I only purged about 50% of what I binged on. I wonder if knowing that would have helped me stop binging and purging. I am not sure about the answer, but regardless, I am sure that I “enjoyed” looking the way I did, even though clearly I was not happy.   

Some people believe that eating disorders calm and soothe people. In addition to striving for thinness, individuals may use unhealthy behaviors such as dieting, starving, binging, and purging to cope with unpleasant and overwhelming emotions and stressful situations. While these behaviors may relieve anxiety and stress over a short time, in the long term they actually increase anxiety and stress, in addition to creating other complications.

Question #3: Do I really need to go through life playing with my health just to maintain my eating disorder?

Of course, at the time the answer would have been, “Of course, yes!” But if you ask yourself that question and truly think about the answer and the kind of life that you wish for yourself, you might come up with a (slightly) different answer.

I remember my first visit to my doctor when I weighed 78 pounds. I had stopped getting my period, and my doctor told me that if I kept up my anorexia, I would never be able to have children. His words stayed with me and helped me kick my anorexia (by welcoming bulimia into my life). If you are wondering about the health risks that are associated with eating disorders, I can assure you that they are real.

There are many health risks related to eating disorders. Each eating disorder has its own health consequences due to the nature of the disorders. As anorexia nervosa is characterized by self-starvation, the body is forced to live without the essential nutrients it needs for normal functioning. Anorexia can lead to abnormally slow heart rate and low blood pressure, which increases the risk for heart failure, reduction of bone density, muscle loss and weakness, severe dehydration which can result in kidney failure, fainting fatigue, overall weakness, dry hair and skin (hair loss is common). It is also possible that there is a growth of a downy layer of hair all over the body to keep the body warm.

With the binge-and-purge cycle of bulimia, the entire digestive system becomes affected, which leads to electrolyte and chemical imbalances of the body. These electrolyte imbalances can lead to irregular heartbeats and possibly heart failure and death. This is because electrolyte imbalance is caused by dehydration and loss of potassium, sodium and chloride from the body each time the individual purges. Gastric rupture can occur during binging. Frequent vomiting can lead to inflammation and possible rupture of the esophagus, tooth decay and staining from stomach acids. Abuse of laxatives can lead to chronic irregular bowel movements and constipation.

The consequences of binge eating disorder are similar to the health risks associated with clinical obesity. These include, high blood pressure, high cholesterol levels, heart disease due to elevated triglyceride levels, type II diabetes mellitus, and gallbladder disease.

Two other ways to ask this question are below:

  1. What am I getting out of maintaining this eating disorder?
  2. Would my life be incomplete without it?

Question #4: How can I make my life more complete so I can get rid of my eating disorder?

Can you imagine a life where you are eating disorder free? How is your life different? What are you doing? How do you feel doing what you really want to do?

Visualize this. Really think about it. Write it down. Maybe sleep on it. It doesn’t have to be only positive answers — jot down anything that comes to mind.

Question #5: How can I use the resources and people around me to help?

I am sure that for many of you, this might not even be a possibility or an option. Asking for help? That would mean that you have to let go of what is helping you “maintain your weight” and be “happy,” right? But let’s think about it more in depth and start by stating that there ARE many resources and people who CAN and WANT to help you overcome your eating disorder.

There are probably people around you who want to support you, whether you realize it or not. These people can be friends and family members who may or may not know about your disorder already who can be a good support system on your journey to recovery.

Another resource is an eating disorder specialist and/or mental help therapist. Someone who has trained in this field will be supportive, non-judgmental, experienced, kind, and knowledgeable. They can give you specific tools unique to you to help you towards a happier and healthier life! You may be asking yourself “Can I even find a good eating disorder or mental therapist near me?” The answer is almost definitely yes. If you need help in your search, LWWellness is always happy to help by matching you with someone in your area who can help you on this path.

 

The Other Side Of Rock Bottom: Recovering From An Eating Disorder

I will never forget the day that I stopped binging and purging. In my last blog, I talked about hitting my “rock bottom” moment. That was when I realized I had a problem, but although I wanted to stop, I couldn’t completely quit. Three years later (I was 24 years old and had moved to New York), I decided to attend a seminar about eating disorders at Hunter College, where I completed my undergraduate degree in psychology. The lecturer, Sondra Kronberg, talked about eating disorders and the gap between how people with eating disorders feel and what they actually do/how they act in reality. She also talked a lot about how important it is for people suffering with an eating disorder to learn how to express their needs and how, along with therapy, it is possible for someone to overcome their problem.

 

For whatever reason, the things she said and the timing all added up in my head and from that day forward, I never binged and purged again. The day I stopped binging and purging I thought was the day my eating disorder evaporated from my life. Little did I know back then that while I had stopped abusing myself in this way, the road to my recovery was still very long. It included many more days and nights of suffering and self hatred. That day, and that lecture, were huge for me, but understanding that there was a gap between what I thought and what I actually did was only the beginning. It took months and years of practicing expressing myself and learning to say “no” for me to become the woman I strived to be — a woman with her own strong voice.

 

Soon after I stopped binging and purging, I moved in with my boyfriend (now husband) and I had to find new coping mechanisms to deal with my anxiety and insecurities. I missed my family back in Israel terribly and I thought I couldn’t share this with my boyfriend because he thought that I wanted to live in the US with him. And while I did want that and I loved him and his family, I also wanted to return to my country and my family. This inability to express those feelings and thoughts and gain control over that sadness and anxiety definitely stood in the way of my full recovery.

 

So once my bulimia stopped, I dealt with those feelings in a different, but still destructive, way. I lived in fear of overeating and gaining weight. I shifted my thoughts from obsessing over buying food and eating and purging to obsessing about what exactly I was eating and making sure it was 100% healthy. I became fixated on only eating organic, non-GMO, low-calorie foods. While my battle with bulimia had stopped, my struggle with eating disorders was far from being behind me.

 

During this time, I worked hard in school and found comfort in my books and in psychology. Understanding the human mind and what stood behind the various disorders gave me great insight into my history and allowed me to have more compassion toward myself and my family.

 

I was finally able to complete the missing pieces and the question marks of the vicious cycle I was stuck in for so many years through mindfulness and affirmations. What I realized I had to do was to step back and give myself the space I needed to feel and observe my feelings. To be attentive to what I felt and understand that I can have control over these feelings,  I had to learn not to allow the feelings to control me and make me do things that were disruptive to me. I gradually understood that the only way to break the vicious cycle was to accept certain things about my life and myself as a person.

 

Now, at age 42, food no longer plays such an important role in my life. I find so much joy in working with people and helping them overcome their challenges that abusing myself and my body is no longer something I want to do. I want to be healthy for myself and for my family.

 

A few month ago, I told this story to Doctor Judith Brisman who is my dear friend and one of the top eating disorder specialist in the world. She asked me if I ever called to thank Sondra Krongberg. It occurred to me that I had never reached out, and I didn’t know why. I knew her at this point, as we’ve shared mutual clients over the years, but for some reason I didn’t think of reaching out to her to thank her for that day. After all, it was 17 years ago. I ended up calling her the next day to tell her that I never binged or purged again after hearing her speak. She was touched that I had told her my story and seemed grateful to hear that affirmation, which just reiterated for me how important it is to continue to talk about my recovery process.

 

I’ve always been fascinated by people who knew me at the time and later found out I was anorexic and bulimic because they say things like, “I always thought that you were Mrs. Perfect. You seemed to have it all together always.” No one is perfect. There is no such thing as always having everything all together, and getting rid of that notion is one of the best ways to help your mental health.

 

That box that we put people in when we label them “perfect” is constricting. The second we don’t take the time to learn more about the person behind the smile or the pretty face or the fantastic apartment with the seemingly ideal family, we are doing them a disservice. I learned through Sondra’s lecture that I was living a life that might have seemed perfect to some, but I was not yet able to express what I was really feeling on the inside.

 

For anyone struggling with an eating disorder, I encourage you to keep searching for answers, keep talking to others, keep seeking professional help. It’s not something that gets cured over night, but it is something that can be overcome.

If you would like me to connect you with one of our eating disorder specialist or dietitians, contact us or book an appointment with me. I look forward to hearing from you!