Intermittent Fasting….

FauxLiz

Sponsor
My PCP referred me to a dietitian and we met today and she wants me to try intermittent fasting. For me eating is an issue, Food was heavily controlled when I was growing up as my brother/abuser had issues with control and was a type 1 diabetic from the age of 8. Since he would not control his intake food for the rest of the family was restricted. No snacks, no desserts, nothing sugary was permitted in the house. Once I moved out to college and I didn’t have the constant restrictions I started eating out of control binging when possible but didn’t see the impact as within a year I was diagnosed with Graves Disease that had apparently been active for years but through high school I was constantly on the run participant in 3 varsity sports a year and tons of activities. In addition to all of this I was sexually assaulted my senior year of high school and forced to sodomize a guy when I was able to avoid penetrative assault.

I struggle with a love hate relationship with eating as a result. Food is my comfort but at the same time I hate putting anything in my mouth which has caused its own share of issues because I generally refuse to see a dentist until something hurts really bad. I had a tooth pulled in November of 2020 and after the horrid experience I still have not gotten the replacement crown.

So with intermittent fasting she wants me to concentrate on only eating during a specific 8 hour period each day. Which in a way feels like the heavy restrictions on eating that I grew up with but with the amount less restricted and if I feel the need I can do all liquids which seems to make me feel better about trying,I just don’t know how effective this will be for me. I need to lose weight and without an active thyroid my chances are significantly reduced, I am post menopausal which hurts my chances, I have arthritis, fibro, and spinal issues at the C3-C4, C7-L-1 and now L3-L5. I try to workout/exercise but often times the pain is too much and I am lucky to complete 20-30min at a time.

Does anyone have experience with intermittent fasting being successful when diagnosed with non-specific eating disorder in addition to c-ptsd?
 
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LittleBigFoot

MyPTSD Pro
I’m curious and going to follow this post. From my understanding those with eating disorders are supposed to avoid things like intermittent fasting, but I am absolutely not the authority on what’s right or wrong around food so take that with a grain of salt.
 
My PCP referred me to a dietitian and we met today and she wants me to try intermittent fasting. For me eating is an issue, Food was heavily controlled when I was growing up as my brother/abuser had issues with control and was a type 1 diabetic from the age of 8. Since he would not control his intake food for the rest of the family was restricted. No snacks, no desserts, nothing sugary was permitted in the house. Once I moved out to college and I didn’t have the constant restrictions I started Eaton’s of control binging when possible but didn’t see the impact as within a year I was diagnosed with Graves Disease that had apparently been active for years but through high school I was constantly on the run participant in 3 varsity sports a year and tons of activities. In addition to all of this I was sexually assaulted my senior year of high school and forced to sodomize a guy when I was able to avoid penetrative assault.

I struggle with a love hate relationship with eating as a result. Food is my comfort but at the same time I hate putting anything in my mouth which has caused its own share of issues because I generally refuse to see a dentist until something hurts really bad. I had a tooth pulled in November of 2020 and after the horrid experience I still have not gotten the replacement crown.

So with intermittent fasting she wants me to concentrate on only eating during a specific 8 hour period each day. Which in a way feels like the heavy restrictions on eating that I grew up with but with the amount less restricted and if I feel the need I can do all liquids which seems to make me feel better about trying,I just don’t know how effective this will be for me. I need to lose weight and without an active thyroid my chances are significantly reduced, I am post menopausal which hurts my chances, I have arthritis, fibro, and spinal issues at the C3-C4, C7-L-1 and now L3-L5. I try to workout/exercise but often times the pain is too. U h and I am lucky to complete 20-30min at a time.

Does anyone have experience with intermittent fasting being successful when diagnosed with non-specific eating disorder in addition to c-ptsd?
It can help, longer fasting can help also, it depends on your lifestyle and what you are eating. It is another tool, nothing magical about it.
 

Freddyt

MyPTSD Pro
You might want to get your dietitian in touch with your T. They may be able to work something out to help your food supply anxiety.

As for intermittent fasting, I don't know if cutting to two meals a day counts. I was starting to blimp last fall and went back to two meals a day. It took a couple weeks to not be hungry around lunch but planning sensible snacking it decreased until I'm fine with it now and my GP is happy because my weight is down. In addition changing simple things like boiled eggs vs fried, english muffins instead of toast, and sensible snacking have probably helped because I pretty much eat the same. I used a free app that helps track eating too. Its called MyFitnessPal. There are very few foods that aren't in it and it covers popular restaurants and it scans bar codes to find products too. You can build meals like your usuall breakfast and enter it as one thing. It tracks hydration as well. I don't use it all the time now, just once in a while to check up and remind me not to make bad snack choices.

One silly question though, how is your managed thyroid? Mine always seemed to be a little high or a little low because I needed something between two standard doses. I finally worked out with my GP it was rine a little on the high side as it helps with brain fog and weight managment to be on the higher side as well.
 

FauxLiz

Sponsor
I’m curious and going to follow this post. From my understanding those with eating disorders are supposed to avoid things like intermittent fasting, but I am absolutely not the authority on what’s right or wrong around food so take that with a grain of salt.
@LittleBigFoot the dietitian is not aware of my eating disorder neither is my PCP. Long story I was diagnosed while hospitalized in 2018 but pretty much a stickler for not allowing my care providers to communicate because I have been burnt in the past by a care providers personal "medical" opinion that the issue was "all in my head"
You might want to get your dietitian in touch with your T. They may be able to work something out to help your food supply anxiety.
@Freddyt this is tough, the dietitian works with with the med group my PCP is part of so they share my medical records within, if I explain my food supply and actually eating disorder diagnosis and information my PCP will see it and well then they both have information that while it would make sense to others for them to have I am afraid of the long term consequences of that information being a part of my physical health records as opposed to my mental health records which I don't allow to be shared with anyone.

I know that sounds odd but to put things in perspective, I have dealt with "migraine" headaches since my early teens. Bad enough that I would have some level of a migraine 20-25 days a month and many times so debilitating that I would end up hospitalized as the only relief possible was to sedate me (as in not an induced coma but dark room, heavy pain meds and anesthetics to where I basically slept 20+ hours for several days). It impacted my work as I was never able to take a true vacation as the entirety of my PTO both vacation and sick each year went to dealing with the headaches. I was sent to specialist, tried every medication on and off label possible for migraines, went through infusion treatments, TMS, nerve blocks, Botox the works. I finally had a specialist that decided I was just faking it, a form of Munchausen's in order to gain sympathy, put that in my records and no one would treat me in anyway for the headaches any longer. It was awful, at one point an ER doc told me he could fix my problem permanently and I was so desperate I asked how - his reply "we can amputate your head".

Finally I moved to a different state, had been struggling with the headache for 10 days and since my new doc didn't have the records he sent me for an MRI. The headache continued and on day 14 I gave up and went to the ER, I hadn't been able to keep food or water down for 48 hours and was hopelessly dehydrated, the ER treated me like they always do headache patients and gave me an anti-nausea med, Benadryl and attempted to put an IV in for fluids (which took 8 tries). Fortunately, my MRI had be done at that hospital and one of the ER docs read the report which I hadn't even seen and all of a sudden things changed. The MRI diagnosed a genetic birth defect that caused issues with the flow of spinal fluid between the head and spine and since my headache had been going on for so long and the information from the MRI was so acute suddenly I was being prepped for emergency brain surgery. If my doctors had been able to access the previous medical opinion that I was faking I don't think I would have ever gotten the MRI and who knows what the consequences would have been.
 

LittleBigFoot

MyPTSD Pro
I can understand why you’d feel so gun shy about it. But I feel like this:


dietitian is not aware of my eating disorder

is dangerous. Especially when she’s recommending a diet that I feel like would be potentially harmful. I know I only have one dietitian appointment under my belt, but her advice couldn’t be more opposite then IF. I’m to eat every 4 hours at least if not slightly more frequently. But if you feel confident about it then go for it.
 

Freddyt

MyPTSD Pro
I know that sounds odd but to put things in perspective, I have dealt with "migraine" headaches since my early teens. Bad enough that I would have some level of a migraine 20-25 days a month and many times so debilitating that I would end up hospitalized as the only relief possible was to sedate me
My story is sort of a sad parallel @Freida, minus the brain surgery part.

I have realized since I found out what a non specific eating disorder was that I probably have one as well. I have used a zen technique to help with snacking and eating urges.

By observing our thoughts, and the feelings that precede and follow them, we can begin to experience a gap in the sequence of impulse-to-thought-to-action, we can choose how to respond rather than automatically reacting.

Somewhere in my head I hear my T asking "Why are you doing this?" and "How does that make you feel?" and "Is that what you really want to do?"
 

barefoot

Sponsor
My GP suggested IF when I asked her for any suggestions about approaches to weight loss.

I did it for quite a few months (16/8) and had my eating window as midday-8pm. In terms of what it was like, I found it pretty easy, but it depends on your lifestyle and preferences really. I’ve never been a big fan of early breakfasts so, for me, waiting until midday to eat anything wasn’t a big deal. And I don’t go to bed hugely late, so wouldn’t generally eat after 8pm anyway. So, I found it very do-able and, in fact, mostly ended up doing 18/6 eating from 2pm-8pm.

I did lose some weight, but not huge amounts - I was a bit disappointed on that front to be honest! Then I fell off the wagon when COVID hit but I’m sort of getting back on it lately.

In terms of eating disorders though: if you have disordered eating and a traumatic history involving restricted eating, I would wonder whether this is the right approach for you. I’m afraid I don’t have any wisdom to offer on that aspect, sorry!
 

FauxLiz

Sponsor
I know I only have one dietitian appointment under my belt, but her advice couldn’t be more opposite then IF. I’m to eat every 4 hours at least if not slightly more frequently.
@LittleBigFoot The original suggestion was to eat every 3-4 hours and have 5-6 meals a day, the challenge with this is that I don't recognize hunger cues until I am at a point of getting a headache or severe nausea. Also most days especially now that I am working from home I work through what should be the lunch hour I think that she is hoping that the shortened window for eating will make me focus more on what and how much I am eating will be a start toward recognizing those cues.
In terms of eating disorders though: if you have disordered eating and a traumatic history involving restricted eating, I would wonder whether this is the right approach for you.
@barefoot I understand questioning if this is the right approach for me, honestly I have looked into IF before without a dietitian suggesting it and questioned how it could be a medically recommended weight loss program because I have always been taught that your metabolism shuts down if starved and I can't imagine the idea of not feeding the body for 2/3 of the day and restricting the amount of food consumed would be a smart idea. But, this was someone that is supposed to know what they are talking about and my distrust of medical practitioners of any sort tells me that less information is more in many cases. I never know who I can trust early on, too many care providers have hurt me or worse took advantage of their position in my past.
 

Sideways

Moderator
The original suggestion was to eat every 3-4 hours and have 5-6 meals a day, the challenge with this is that I don't recognize hunger cues until I am at a point of getting a headache or severe nausea.
One of the single most basic, and critical, things they do when you get admitted to a psychiatric facility is:
a) feed you
b) nutritional meals and snacks
c) at set times every day.

There's 2 reasons for this. The first, is that it's up there with sleep as mental health essentials: nutrition and a structured day.

The second reason they're soooo fussy about it, is because overwhelmingly, when people become mentally unwell, their diet suffers. Either eating too much, or too little. Very few people with severe mental illness manage a nutritional diet at regular intervals. Losing or gaining appetite features as diagnostic criteria in a whole host of mental illnesss.

Seeing a dietician who is unaware of your mental health situation? Is a bit like asking someone to treat your back pain without telling them that you've got scoliosis.

It is incredibly normal to have trouble getting your regular meals in, as a matter of routine, with a mental illness. Never mind then accounting for nutrient quality on top of that. The good news is that addressing those issues can make a massive improvement in mental health in a very short time.

But to do an even halfway reasonable job of that? Your dietician is going to have to know a bare minimum at least (diagnosis, for example) to provide you with sound, safe advice that is actually going to be workable with your mental illness.

I'm usually too dissociated from my body to know I'm hungry. I eat by the clock - when it says "Meal O'Clock", I find a way to get some nutrients in (and I had a dietician in the past give me strategies to do that which worked with my depressive issues and anxiety around grocery shopping). I do that like it's essential medication...because it basically is.

Consider making it easy on yourself (and safer) by giving your dietician your diagnosis. They don't need to know details, but their capacity to provide you with safe advice that you can actually use in a practical sense is hamstrung without it.
 

barefoot

Sponsor
questioned how it could be a medically recommended weight loss program because I have always been taught that your metabolism shuts down if starved and I can't imagine the idea of not feeding the body for 2/3 of the day and restricting the amount of food consumed would be a smart idea. But, this was someone that is supposed to know what they are talking about

Yes, I have to admit I was very surprised when my GP suggested it too – I thought IF was a bit of a faddy 'diet' and didn't expect a 'proper' doctor to support it. She sent me this link to have a look at:

I notice that on that page it does say that people who should not try fasting include those with eating disorders.

I get your mistrust of medical people and that it can make deciding who/what information to trust very difficult.

I do agree with the others – I understand that you might not want to get into detail about everything with everyone, but I think your history of disordered eating is a significant piece of the jigsaw to leave out of the equation when discussing best approaches for you with your dietician. I don't think you would need to go into detail about it all, but if she knew that you had trauma/triggers around restricted eating, I suspect she may not have suggested a fasting approach.

the challenge with this is that I don't recognize hunger cues until I am at a point of getting a headache or severe nausea

Also most days especially now that I am working from home I work through what should be the lunch hour

I wonder whether it could be helpful to do something really practical like set timers at certain times of the day, so you are 'reminded' of times to have something to eat? If you don't feel really hungry at that point, you could just have something small/a snack and hopefully, that way, because you've taken in food at various points, you won't ever get to the point of feeling unwell because you haven't eaten. And this might help you get into a bit more of a routine.

A few years ago, I read Susie Orbach On Eating. She's a well known psychotherapist in the UK who has written a lot about women's bodies, weight, their relationships to food/eating etc. It's a really short book and very accessible and simple (though simple doesn't necessarily mean easy, right?!) And the first time I read it, I was so struck by the revelation that I was never consciously aware of feeling hungry and eating because I was hungry, or of feeling full. It had quite a profound impact on me to realise that I was so not tuned into my body and particularly around cues around being hungry or having eaten enough. Also made me realise how, so often, eating wasn't about eating to meet my hunger need. Often, it was eating habitually (eg it's 1pm, sp I should have lunch!) Or eating because I was feeling bored or worried or because I was procrastinating about something else. Not sure if any of that resonates or whether it would be helpful for you, but I found it very useful. It isn't a diet book. It's more, I suppose, about taking a mindful approach to food and eating.
 

FauxLiz

Sponsor
Seeing a dietician who is unaware of your mental health situation? Is a bit like asking someone to treat your back pain without telling them that you've got scoliosis.
Put this way, yeah it makes a lot of sense. Haven't really thought about it this way before and will definitely need to think about this.
But to do an even halfway reasonable job of that? Your dietician is going to have to know a bare minimum at least (diagnosis, for example) to provide you with sound, safe advice that is actually going to be workable with your mental illness.
I get this as well. Unfortunately, I struggle with accepting/admitting my mental illness even with myself many times, goes back to the idea of suck it up, others have it worse than me, don't be so overly dramatic none of it was that bad. My family mocks me for seeing a therapist and I am so ashamed that I have been hospitalized for it that even my PCP doesn't know about the hospitalizations
A few years ago, I read Susie Orbach On Eating. She's a well known psychotherapist in the UK who has written a lot about women's bodies, weight, their relationships to food/eating etc
I will look into this, sounds like a good read. I wish I didn't feel the need to keep everything segregated I wish that I could trust my care providers more, definitely something to address in therapy at some point.
 
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