I was honored when Emily asked me to write for her blog for National Eating Disorders Awareness week. To introduce myself, I am Emily's sister-in-law, Anita Conley. I am also a Registered Dietitian, licensed in the state of Florida. In my path to become a dietitian, I had experiences counseling students at Iowa State who have suffered from eating disorders. I also have had my own issues with food, eating, and my body image.
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| Anita Conley |
There is much that I could say on the subject of eating disorders. Anorexia Nervosa and Bulimia Nervosa are the most well-known, but they only comprise of about half of all eating disorders. Anorexia Nervosa is characterized by refusal to maintain a minimally normal body weight, intense fear of gaining weight, body image distortion and amenorrhea (absence of 3 or more consecutive periods). This can be accomplished by restricting or binge eating and purging.
Bulimia Nervosa is characterized by repeated episodes of binge eating followed by inappropriate compensatory methods such as purging (self-induced vomiting or misuse of laxatives, diuretics, or enemas) or nonpurging (fasting or engaging in excessive exercise).
Some others are Orthorexia Nervosa, Pregorexia, Diabulimia, Nocturnal Sleep-Related Eating Disorder, Drunkorexia, Binge Eating Disorder, and Eating Disorder Not Otherwise Specified.
- Orthorexia Nervosa is essentially an unhealthy obsession with correct eating with the belief they are following a perfected diet and proud of it.
- Pregorexia is when pregnant women who exercise to excess and reduce calories in an effort to control pregnancy weight gain.
- Diabulimia refers to when people with type 1 diabetes deliberately decrease or withhold their insulin injection in order to lose weight.
- Nocturnal Sleep-Related Eating Disorder occurs when a person goes on eating binges at night and awakens the next morning with little or no memory of it.
- Drunkorexia is when a person restricts food intake to increase alcohol intake without gaining weight. This is most common on college campuses.
- Binge Eating Disorder is characterized by eating much more quickly than usual, eating until uncomfortably full, eating large amounts of food - even if not hungry, eating alone and secretively due to embarrassment over the amount of food eaten, and feeling disgusted, guilty, embarrassed or depressed after eating.
- Eating Disorder Not Otherwise Specified is kind of a catch-all diagnosis for people with disordered eating and thinking to make sure those who do not fall under the diagnoses for anorexia and bulimia. Most of the previously discussed eating disorders fall into this category.
(Information from Krause's Food, Nutrition, & Diet Therapy 11th ed., and How To Recognize Less-Familiar Eating Disorders from November 2010 edition of Today's Dietitian)
I think overall there is a lot we know about eating disorders. They are considered a major mental illness and they often have numerous underlying causes. Eating disorders are nothing to mess around with because they can and do cause early death.
The more I have been reading about eating disorders recently, the more it makes me convinced that we need to spend a LOT more time talking about what is NORMAL eating. One of the assignments in my nutrition counseling class was to develop our own philosophy of normal eating. What I came up with follows.
My Philosophy of Normal Eating
My definition of normal eating is very complex. Normal eating is eating when you are hungry and stopping before you are stuffed. Normal eating is eating two, three, or more meals a day with or without snacks in between. Normal eating is eating until you are overfull some days, and then eating very little on other days. Normal eating is when you plan out your meals so they are balanced most days, but some days you grab whatever is most convenient regardless of the nutritional value. Normal eating is enjoying what you are eating whether it is a “fattening” piece of pie or a “healthy” vegetable or anything else in between. Normal eating is being conscious of what you are eating but not being obsessed with it.
Normal eating is tasting the food you put in your mouth and savoring it. Normal eating is sometimes eating emotionally. Normal eating is also aware of when you are eating emotionally and does not let it last for an extended time. Normal eating is eating what you are hungry for when you are hungry for it. Normal eating does not deny or limit “goodies” because they do not have the nutritional value that “healthy” food does. Normal eating is trying new foods, but not finishing them if you truly do not like them. Normal eating also incorporates a healthy amount of physical activity most days of the week. Overall, normal eating adapts to your needs without controlling your life.
As I read this over four years after writing it, I am somewhat convicted. In my own life, I have embraced some disordered eating patterns. As a dietitian, this is surprisingly easy – I know as much about calories as anyone (just ask my boyfriend about my mental calorie counting) and how to “trick” the body into feeling full with less calories. This is something I have even taught my patients when consulted for weight loss education.
Disordered eating includes restricting foods, eating compulsively, and in a way which is externally regulated. In contrast, normal eating is enjoyable, deliberate and internally regulated. Internal regulation of food intake means that a person eats when they are hungry and stops when they are full or satisfied. External regulation is when we ignore the signals our body gives about hunger and fullness – this especially happens when we put ourselves on diets. The deliberate portion of normal eating cannot be ignored. This means that time and thought is put into making healthy choices and/or choices that will satisfy your hunger. Normal eating can help you reach the weight that you are meant to be at – but this may be different from your ideal.
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| Normal eating is enjoying what you eat! Image source. |
The lure of disordered eating is hard to resist and it is everywhere we look in our society. Due to my health and the body type I was born with, I have been fighting with my weight for as long as I can remember. I have a headache all day every day, and have for close to 8 years now. I have to make sure I eat when I am hungry because if I ignore my hunger, it makes the headache worse. To top that off, one of my daily medications causes increased appetite. I have gained at least 10 pounds since I started taking the medication almost a year ago. I have tried ignoring my hunger, which just caused the headaches to get worse, and I have tried always filling up on low calorie snacks like popcorn and carrots to help satisfy myself. And just to make matters more fun, I get exercise-induced headaches so I have been struggling to exercise for about a year and a half now. I find myself looking in the mirror and not liking what I see. But when I start thinking this, I am convicted by the verse in Psalms that declares
“I praise you for I am fearfully and wonderfully made; your works are wonderful, I know that full well.” (139:14)
God created us with bodies of different shapes and sizes. Our society has a ridiculous obsession with thinness. We have idolized it to the point that even in the health community it is believed that thinness is equated with health. There have been several studies conducted revealing that even among health professionals (doctors, nurses, dietitians) people who are obese are thought to be fat and lazy and have no willpower.
I have talked to many of these patients, and I would not classify any of them as such. Most have tried everything they can think of to lose weight. About 50% of people who fall in the overweight or obese category have none of the much talked about complications of their weight (high blood pressure, high blood sugars, high blood cholesterol levels), yet we constantly have news headlines about the cost of the obesity epidemic. In my personal and professional opinion, I think we would do well to be much more accepting of people of all shapes and sizes and not focus on the numbers on the scale, but on overall health.
A book that I highly recommend if you are interested in learning more about normal eating and getting away from disordered eating patterns is “Intuitive Eating” by Evelyn Tribole & Elyse Resch. This book changed the way that I viewed eating and nutrition, and in writing this entry it reminded me I need to pick up this book and read it again for myself.
Labels: Family, Guest post, health, Healthy body image, My body God's temple, National Eating Disorder Awareness Week
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