Eating Disorders in Layman’s Terms

What's the Main Cause?

Most people probably know someone or have suspected they know someone with an eating disorder.  However, most people don’t get why anyone has an eating disorder.  People I talk to about my job often ask me what the main cause of eating disorders is.  It’s not that straightforward.  There are many contributing factors which could lead to an eating disorder.  One could have some or all of these:  

1. Genetics
2. Parents’ or friends’ beliefs about and behaviors with food
3. Comments from others about their body size or food intake
4. Depression or other mental illness
5. Emotions which trigger lack of or increase in appetite
6. Wanting a sense of control
7. History of trauma or abuse
8. Dieting gone horribly awry
9. Focus on the media’s ideals of body image
10. Distorted body image (body dysmorphia)
11. Desire to avoid or numb out using eating disorder behaviors

Why Can’t They Just Eat?

Even though I don’t know perfectly how the people I work with feel and believe, let me try to explain as best I can how the eating disordered mind works.  These are common obsessive thoughts consuming their time:

1. I don’t deserve food.
2. Too much food (which could mean normal portions of food) will make me fat.
3. That type of food (which could mean anything with calories) will make me fat.
4. I can’t enjoy the taste of food.
5. I need to feel empty.
6. If I eat, I’m weak.
7. I am bad if I eat “bad” food.
8. I am disgusting if I eat “bad” food.
9. It is better to not eat than to put “unhealthy” food in my body.
10. If I eat this type of food, I need to get rid of it by purging (through vomiting, exercising, or using laxatives).
11. I am in control when I restrict and am out of control if I eat (or eat more than what I have in my head is okay to eat).
12. If I give in to eating bad food, I’ve blown it and may as well eat a lot of it.  Then afterward, I will never eat it again.
13. I need to weigh ___.
14. I’m fat.
15. I am never thin enough.
16. If I eat foods high in fat or sugar, I will instantly gain a lot of weight.

The list could go on.  In addition, some develop an eating disorder of a different kind where there is less fear about food and more emotions causing decreased desire to eat.  I've counseled some so depressed that they don't eat even though they love food.  Some are so anxious that they feel nauseated and may involuntarily vomit when they eat a normal amount of food because the anxiety is so high.  This is one reason why treatment for the eating disorder requires not only therapy and dietary counseling but also medications. 

Behaviors Indicating an Eating Disorder

1. Unhealthy obsession about food, calories, and weight
2. Frequent talk about weight and food
3. Tendency to cook or bake a lot but not eat the food they prepare
4. Going to the bathroom right after eating
5. Eating very slowly and picking at food
6. Eating in secret
7. Telling people they have already eaten so they don't have to eat in social settings
8. Telling people they have allergies to certain foods or are vegan or gluten-intolerant or have some other dietary restriction so as to make it more socially acceptable to avoid eating
9. Excessively exercising

Physical Results

1. loss of hair or poorer growth and condition of hair
2. slower growth of nails or brittle nails
3. inability to regulate temperature
4. lanugo
5. decreased immune function
6. poorer wound healing
7. bruising easily 
8. impairment in ability to create hormones and neurotransmitters
9. decreased libido
10. bone loss
11. muscle loss
12. tingling
13. dizziness
14. headaches
15. shakiness
16. decreased heart function
17. electrolyte imbalance
18. a number of digestive issues ranging from diarrhea, constipation, gas, cramping, bloating, and acid reflux
19. possibility of ulcers or esophageal tears if inducing vomiting
20. decreased energy, concentration, and memory
21. swollen glands from purging
22. dryer skin and lips
23. increase in sensitivity in teeth or increase in cavities due to loss of enamel from lack of protein in the diet or from purging
24. muscles spasms, weakness, and cramps
25. loss of menstrual cycle for women
26. permanent brain damage

Can't I Tell Just By Looking?

You cannot tell just by looking whether someone has an eating disorder or not.  The women I work with can be any size or shape.  It can be easy to identify that someone has an eating disorder who is severely underweight or morbidly obese.  (I wish that we would call it "morbidly underweight" as well.)  Any of the symptoms listed above are experienced by all weight ranges if the eating disorder behaviors are severe enough.  The worst thing someone with an eating disorder could hear from a doctor is, "You don't look like you have an eating disorder."  And some of them are brilliant enough to say that.

What I've Loved This Christmas

I love being around Christlike people, especially old people.  I love gaining wisdom from them.  They have so many experiences to share.

I love helping others in need, but I always feel that I am more blessed than the one I help because it makes me feel so happy to help them.

I love how unselfish people can be at Christmastime and wish the season would last all year!  I have so much to work on to become more unselfish.

I love studying the life of Christ in the New Testament and learning by His example.

I love songs about Christ, listening to them and singing them.  I heard a verse to “The First Noel” that I had never heard before.

Then let us all with one accord
Sing praises to our heavenly Lord
That hath made heav’n and earth of nought
And with his blood mankind has bought.

I love the last verse of “In the Bleak Midwinter.”

What can I give Him, Poor as I am?
If I were a shepherd, I would bring a lamb.
If I were a wise man, I would do my part.
Yet what I can I give him, Give my heart.

Most of all, I was touched listening to Jane Seymour tell the story of King Wenceslas at the Mormon Tabernacle Christmas concert while the choir sang intermittently. 

Good King Wenceslas looked out, on the Feast of Stephen,
When the snow lay round about, deep and crisp and even;
Brightly shone the moon that night, tho' the frost was cruel,
When a poor man came in sight, gath'ring winter fuel. 

"Hither, page, and stand by me, if thou know'st it, telling,
Yonder peasant, who is he? Where and what his dwelling?"
"Sire, he lives a good league hence, underneath the mountain;
Right against the forest fence, by Saint Agnes' fountain."

"Bring me flesh, and bring me wine, bring me pine logs hither:
Thou and I will see him dine, when we bear them thither."
Page and monarch, forth they went, forth they went together;
Through the rude wind's wild lament and the bitter weather.

"Sire, the night is darker now, and the wind blows stronger;
Fails my heart, I know not how; I can go no longer."
"Mark my footsteps, good my page. Tread thou in them boldly
Thou shalt find the winter's rage freeze thy blood less coldly." 

In his master's steps he trod, where the snow lay dinted;
Heat was in the very sod which the saint had printed.
Therefore, Christian men, be sure, wealth or rank possessing,
Ye who now will bless the poor, shall yourselves find blessing.

Can I Get A Witness?

I was subpoenaed to testify before a judge yesterday.  I never thought I'd have to do that.  I was SO NERVOUS about it.  Since it was a 90 minute drive, I had a lot of time to think about it and try to calm myself.  The only reassuring thought was, "At least I'm not on trial."

Before walking in the building

As soon as I got there, the first question I was asked was, "Are you the judge?"  After taking that as a compliment on my attire, I told them I was just the dietitian.

They led me into a room, but before I got into that room, I saw that the person I was testifying against was in fact present.  My anxiety escalated dramatically at that moment.

I had a lot of time to wait.  I sat in a waiting room for an hour and forty-five minutes before they called me in to testify.  I freaked out about how this day could affect my client's life.  I came to a realization that really helped calm me down: I was hear to testify for a client; I wasn't there to testify against anyone.

My time finally came to testify, and I felt calm and nervous at the same time.  I was able to answer questions without feeling intimidated.  When I was done, the lawyer walked me out and told me that my client will appreciate me testifying for her.  He thanked me for being candid and told me I was very professional.  I thanked him and then booked it out of there as soon as I could.

I'm done!

I drove to a nearby temple to feel peace again before making the journey home.  It was a gorgeous day and perfect for a nice stroll.

On the drive home, this gospel song kept popping up in my head.  Click to listen to "Testify" I listened to songs and belted them at the top of my lungs the whole drive home. Very therapeutic.

I'm still nervous about the outcome.  It was what I thought about before I went to bed and as soon as I woke up.  But I will try to keep my mind off of it.

Through this experience, I learned some things and came to some conclusions.

1. When put under oath, you don't swear on the Bible anymore and it doesn't end in "so help you God."  That was disheartening.
2. I can be intimidated by people who are in the wrong.
3. I don't like people attacking my credibility as a witness.
4. I don't like feeling hatred emanate from someone's presence.
5. I can defend my credibility.
6. I like defending truth.
7. Defending truth can lead to extreme and unrealistic fears that your life will be threatened or taken.
8. I like wearing a suit.
9. Being called an expert is empowering and fun.
10. Everything spoken would be more powerful with a gospel choir in the background!

Nonessential Gratitude

"So much has been given to me; I have no time to ponder over that which has been denied." Helen Keller

There are so many things I am grateful for.  But this is a list of the top ten external things that make me happy that are absolutely nonessential for life.  I noticed that many of these are related to nature, and all of them have to do with relaxation for me.

Catnaps. There’s no way to describe the warmth of the sun touching skin and hair.  That warmth becomes part of you and sends you into sweet repose.

Good smells.  Rain, lilies, really good perfume or cologne, new car, almond extract, chocolate chip cookies in the oven, Bounce sheets.

Ballroom dancing. The act of or just watching it.  It’s so graceful and elegant.  My favorite form of physical activity.

Music.  So many kinds I don't want to list them.  Truly a universal language.

Blankets. Warm and snuggly.

Lightning storms.  Breathtaking, heavenly, exciting, peaceful, mesmerizing.

The beach. The sound of the ocean, the sun, the breeze, seashells, looking for dolphins on the horizon, sunsets, seashells.  So many happy things!

Mountaintops.  Breathtaking views, heavenly smells.

Starry night skies. Not only beautiful but also a reminder of how God’s creations are infinite.

Snowfall.  Watching it inside at night with the house lights off. So cozy!

Avoidance

During the summer, I saw the most fun flower ever while grocery shopping.  I fell in love with it and wanted to take it home because 1. it was my favorite color 2. it was from Africa, and 3. it was unique and I had never seen anything like it!  I have never owned a plant, and I feared I would kill it in less than a week.  But I took it home.  It made me so happy.  I kept it alive for at least a month, which may not be an accomplishment to some, but it was for me.  Buying that flower taught me a lesson.

In so many circumstances, we avoid.  We avoid talking about our feelings, we avoid trying things we think we may fail at, and we even avoid giving someone our honest opinion when that is what they desire most.  Sometimes we avoid saying no.  More surprisingly, we even avoid saying yes.

Avoidance creates dishonesty with self and with others.  It masks our true opinions and feelings.  It is a defense mechanism used to protect self and others.  But what does it protect us from?  Potential for failure, rejection, or change?  Yes.  But coincidentally, we also prevent our ability to learn, grow, and succeed.  Some people continue working at a dissatisfying job because they’re afraid they won’t be good at anything else.  Instead of talking to a spouse about their relationship, some choose divorce because they fear that talking won’t make a difference anyway.  They may assume their feelings may get hurt even more by talking.

Avoidance includes lack of effective communication.  It still sends a message.  But it’s a message that many may misinterpret.  Take the classic example of a girl getting a phone call from a guy asking her out.  She doesn’t want to go on the date.  She may choose to avoid answering and then never return his phone call, or to answer and make up an excuse that she is busy.  Both actions are meant to send the message that she is not interested.  But the guy may not “get the hint.”  It would be far more effective for her to answer the phone, thank him for the invite, and simply say she is not interested.

We either avoid because we don’t want to hurt someone else’s feelings or we don’t want our own feelings to get hurt.  What we do and what we say needs to be congruent with what we truly feel.  Honesty is something I value so much.  I’ve had to be honest with others who had the potential to become upset or frustrated.  Sometimes when I’ve been honest, they have gotten upset.  But what I’ve learned is that it is far more difficult to face the consequences of being dishonest.  When I stop avoiding, I develop an increase in self-confidence in my ability to communicate effectively and to succeed in life.

Antonyms for avoid are to face, meet, seek, and want.  What happens once we face, meet, and seek those things which we want? Others might improve themselves or their work with honest feedback. Relationships can be strengthened, and communication is more effective.  Not avoiding is how people learn, grow, and reach their potential.  What are you avoiding in life?  Stop asking "what if?" and go find out.

Don't pay attention to the video, but listen to this song.

No Sugar Diets? Stop the Hate.

Recently, a few men have told me they are on no-sugar diets.  I am used to hearing this from women, but for some reason I have been even more disturbed when hearing it from men. They all tell me it’s a competition with other guys and they stay with it out of pride, not necessarily because they think sugar is bad.  However, some of them do think it’s bad. 

I submit sugar is not bad!

Here’s the low-down on what sugar actually does in the body:   Sugar starts breaking down in your mouth, then is broken down further in your stomach and small intestine and then is absorbed into the bloodstream in the form of glucose.  Glucose fuels your body’s cells, including your brain, heart, and red blood cells.  What happens if you cut table sugar out of your diet completely?  Your body still converts other carbohydrates to glucose.  It just may be a longer process.

Some people might argue that sugar causes diabetes or that sugar spikes your blood sugar faster than other forms of carbohydrates.   First, sugar does not cause diabetes.  Overeating in general, being overweight, and genetics all play a role in contributing to the onset of diabetes.  Second, sugar spikes your blood sugar faster, yes, but it doesn’t stay that way.  For those with diabetes, this can be a problem, but it’s a problem that can be remedied by moderate amounts of sugar at a time and by supplementing a source of sugar with a source of protein in order to stabilize their blood sugar.  For the rest of us, if we eat too much, we may just feel crappy but then our insulin takes care of it.

So I get that men have that drive to win a competition.  But why not have a competition to eat everything in moderation and not become crazy about sugar contained in cookies, or spaghetti sauce or yogurt for that matter?  Seriously, it’s a carbohydrate and your body will use it as long as you don’t overeat. 

Or, instead of cutting sugar out of your diet, why not have a competition to eat 5 fruits and vegetables every day?  It’s not sugar that causes bad diets; it’s lack of certain nutrients or overeating.

What I Know About Food—Eat What You Want. Love What You Eat.

I’m not a health freak.  I eat what I want when I want it.

When I was in junior high, I WAS a health freak.  I went for at least a whole year with no ice cream or candy bars.  I would dab the grease off my pizza.  Then my dad told me that that doesn’t decrease the fat content very much, so I picked the cheese off instead.  Had I been genetically pre-disposed or environmentally pre-disposed, I may have developed an eating disorder.  Luckily, I just didn’t enjoy food as much as I should have during those years, and eventually, I got over that phase.  Now, ice cream and pizza are absolutely two of my favorite foods!  They make me so happy!

Food makes life enjoyable.  One of my sisters tells me she doesn’t know what it is about me, but she gets so hungry and tends to enjoy food more when she is around me.  Best. Compliment. EVER.

Here’s a fact to help you understand how much we are to enjoy food:  Of all the senses in the body (sight, hearing, touch, taste, and smell), those who have lost their sense of taste have the highest incidence of suicide.

Too often, food is thought of as good and bad.  Perhaps you deprive yourself of the bad food and choose another food as a substitute when everyone else is eating what you have forbidden yourself to eat.  You don’t feel satisfied and may end up going for another food which still doesn’t satisfy you because you don’t eat what you crave.  Because of this, you could end up eating more calories than if you had just eaten the food you were craving in the beginning.

I was at a party where a guy was choosing to drink milk instead of soda even though he wanted soda, and as I was explaining this very principle to him, he drank the milk, ate some “healthy” food, and he still wasn’t satisfied.  He ended up drinking the soda in the end.  If he had just drunk the soda to begin with, he would have consumed less calories.

You feel guilty for eating the food that tastes the best because generally, those foods are higher in fat and sugar.  The all-or-nothing thinking may set in and you tell yourself, “I may as well overeat and enjoy as much as I can now because I won’t ever eat it again.”  You think you have to deprive yourself of that food because you feel like you lose control when you eat it. 

You may figure giving high fat/high sugar foods up completely is the only way to gain self-control.  Not true.  The best way to be able to eat anything without overdoing it is to change your relationship with food, or rather, how you feel about food.  You can go from feeling guilt and deprivation to feeling enjoyment and neutrality. 

Also, consider the reasons you eat and determine how to cope with emotions instead of eating to cope.  Are you eating because you are tired? stressed? bored? lonely? sad? angry? or anxious?

Feeling out of control with food is real.  So giving yourself permission to eat certain foods may need to start small.  For example, instead of buying an entire half gallon of ice cream, go out to buy a small ice cream cone.  Enjoy it.  Savor it.  Don’t feel guilty.

The more you give yourself permission to eat "bad" foods, the more those foods lose their “sinful” appeal.  You can make the transition from depriving yourself and feeling guilty to giving yourself permission to eat and enjoying it.  

Food is meant to be enjoyed.  Eat what you want.  Love what you eat.