ED Outsmarting anorexia

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I have noticed that many PTSD survivors have had difficulties with food. I include myself in this group as I was anorexic in high school and to a lesser degree in college. Of course doctors like to treat this with pills that make you gain weight (and yes it can work) because that is what they have been trained to do. The problem with anorexia though is not a lack of hunger, its the emotions and guilt associated with food and the control you are trying to regain over your life and body (in addition to the distorted self images that most professionals already recognize). I am happy to say that currently I am at the correct weight for my height and it seems that my symptoms have gone into remission. I would like to share a short list of psychological tricks I have learned to outsmart this terrible illness.

1. Prescription Ice Cream: It is chemically no different from regular ice cream, the difference is the way it is viewed. My grandfather noticed this when he was practicing medicine and used it frequently. What he would do is take out his prescription pad and actually write out a prescription for a serving of ice cream every day and tell the patient to keep it in his or her wallet. He said it was very successful when he was practicing, and I have found it to be helpful myself. For some reason looking at that little note from the doctor tricked my anorexia into thinking the ice cream was not food, it was just a new form of medicine to take on a regular basis. This removed the guilt.
2. Food Checklist: I found that, like with many tasks, if I included eating and what to eat and how much into my daily checklist it would help change my sense of accountability. It became just another chore, right up there with washing my clothes and making my bed. If I skipped a meal the space that I would have checked off remained blank, and I could see that not all my chores had been completed.
3. Oversize Portions: I remember reading a study on this and play testing it on myself with great success. I ordered or prepared WAY more then I could eat and filled my plate until it was overflowing. When I could not finish the food I would take the rest home or put the meal in the fridge for later. Because the mind is programed on a sub-conscious level to finish what is in front of you, or at least make a reasonable dent in it, I would slowly and without knowing increase my food intake a bite or two per meal. Over time this allowed my shrunken stomach to stretch back out to a normal size.
4. Jolly Rancher Water: Sometimes, even with all this, I still had trouble getting food into my system. To keep my calorie count up until I could eat again I tried putting a hard candy (I used Jolly Ranchers or sometime Chewable Vitamins) into a generic bottle of water. Because the calories and/or vitamins were in a bottle labeled WATER, my sub-conscious thought process was "I'm just drinking water, this does not count".

I would love to hear any from anybody who can add to this list as it is far from complete. I sincerely hope this helps at least one person who is trying to overcome anorexia. I will keep all of you in my thoughts and prayers, and wish you all a safe journey towards recovery.

Liz H.

 

[NomadHeart]

Similar to the ice cream , food is medicine, we need food to be healthy.

the token method. each meal you have that is substantial and has enough caloric intake for you, you get a token, add em up at the end of the week and treat yourself to a self nurturing prize.

That one works for me, where as my two ed's stem from the punishment system of my abusers and unable to take care of my needs. along with many many other twisted reasons my head has to depend on ED.

Thanks for you post.

 

[trapped]

It does help to view food as medicine. It can also help to distract yourself while eating, by watching tv or a movie, or playing a board game with friends, or even talking to someone... if anyone on here ever needs someone to talk to while they're eating, feel free to PM me and let me know... we could exchange IM info, or meet in the chat room here, or exchange phone #'s, I'd be more than happy to be there to support anyone... sometimes just having someone to talk to and help you get through it really helps. Another really helpful thing that we came up with when I was in the residential program recently was we used "drinking games" but instead of drinking, it was an "eating game"... so, for example... you can take a normal drinking game like quarters, or you can even play any game- war, blackjack, etc.... and with something like the card games, whenever you lose a hand, you have to take a bite. Then it's not about the food, it's just a game. I still use my computer to help me eat sometimes by playing card games on the computer. It's a bit more difficult, because I don't have another person physically there to hold me accountable, but it's better than staring at my food for hours and hours.

Also, it helps to be sneaky about getting calories in... in that, I mean learning to eat and make calorie-dense food. Before I went to the residential program, I'd NEVER do that. I don't like processed foods. I don't like to mix foods or even have different foods touching. I got over it a little bit in the program, still have a lot to work on though, but there are certain foods that are okay to allow to touch or mix now... the first couple days in the program I got so sick... they let me pick whatever I wanted to eat, I just had to have a certain number of calories. I got ALL my calories for the first few days through blueberries, broccoli, and carrots. That's a hell of a lot of broccoli and carrots. I finally agreed to try some other things. Oat bran is terrific- it's good for you, and you can make it in an easy way that allows you to "hide" calories. You can make it with apple juice or milk instead of water... applejuice will add more calories, but milk (especially soy milk) adds some fat and protein. Adding a bit of cinnamon adds some calories. Adding protein powder can add a lot more calories too... and then you can mix in fruit, granola, etc... with a bit of creativity, you can easily get a 600+ calorie bowl of oat bran. It's hard to outsmart the eating disorder and allow yourself to add in all those things sometimes, because the eating disorder will tell you that it'd only be a couple hundred calories if you had that same amount of oatbran just plain and made with water... but you need the calories, and it's the same volume... some people, like myself, would rather take volume over high calorie processed foods (like chocolate cake for instance) while others struggle with having too much volume and do better eating foods that are more calorie-dense. The oatbran thing though really worked for me because I was making it on my own, and it's really healthy and good for you.

 

[trapped]

Oh, I also wanted to add... a lot of residential programs discourage you from weighing yourself, measuring your food exactly, etc. but the program I went to didn't do that... instead, they set it up differently, and now my routine every morning is I wake up, go to the bathroom, and weigh myself. I write down that weight, and mark it on a chart. I have a 5 pound weight range I'm supposed to stay in (which I already fell out of, but luckily they set the weight range high enough that I'm not in physical danger falling out of it just yet)... if my weight drops out of the bottom of that range, I'm supposed to increase my calories and decrease my activity til it's back in the middle of the range. The plotting my weight every morning really helps, because I can see that a piece of chocolate didn't make me gain 50 pounds overnight. Also, I know how many calories I'm supposed to have, and I plan it all out at least a day ahead (I actually prefer to plan out a whole week at a time)... and I measure everything EXACTLY. I have a digital scale that I use to weigh everything out, and I monitor my calories as well as fat and protein ratios... Some people might disagree with this and say it's just eating disordered behavior... which in some ways, it is... but, if I'm eating enough calories and am at a healthy weight, who cares if I have to measure everything exactly? The theory is that eventually I'll become more comfortable with food and won't need to rely on the digital scale to measure everything out, but even if I do always rely on it, it's not interfering much at all with my life, and it makes me more comfortable with the food... so many people are always telling those with eating disorders that it isn't okay to weigh and measure things out, and saying it's a bad behavior... but with eating disorders that are so much about control, being able to plan things out and weigh out your food exactly is often something that can help give you control... so you can eat, but still be in control of it, if that makes any sense.

 

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Nomad and Trapped,

Thank you for the wonderful suggestions! I especially like the idea of turning old drinking games into eating games. It is an elegant solution that I had not even considered before.

I would like to ask the forum if any men out there have had problems with anorexia. I ask because my boyfriend has always been very thin. He used to smoke pot with me and he was gaining some weight which was awesome. Now that that option is no longer on the table and we are under considerable more stress, I have noticed him loosing weight again. He swears that he does not have and ED, just a high metabolism... but I see exactly how much he eats (maybe half an order of fried rice or a 12 inch sub for the whole day). I have also lived with his mother and know first hand that food was part of the abuse he suffered growing up. He is my height and weighs at least 20 pounds less then me. His rib cage is clearly visible, his stomach is somewhat sunken in, his hip bones are clearly visible, and he needs a belt to keep up the 28 to 30 inch waist line pants he currently owns. He HATES all sweets and all forms of junk food. He will sometimes drink a soda, but usually prefers to stick with water or black coffee. The biggest problems is that he INSISTS that there is no problem, and that straight men do not get anorexia. I know for a FACT this is untrue, it may be rare, but it does happen. I have been thinking ways to add healthy calories to his diet, like adding coconut milk to fried rice and selecting higher calorie cream based soups.

My first question is have any men out there had or overcome this? If so, I would love some feedback on how this works in the psychology of men.

My second question is what else can I do to add calories to his diet or encourage him to eat more? Protein powder maybe? He already eats while distracted with games or work or movies. I have already tried ordering something larger and asking him to help me finish it, that works sometimes. I am very open to suggestions on this one as I seem to be somewhat stuck.

 

[trapped]

You're right that eating disorders can occur in males as well as females... it's not as uncommon as the general public believes either- it's just not given as much attention in the media, therefore the public thinks it's a lot less common or non-existant.

I'm not sure I'd try to "sneak" more calories into his diet, first I'd try to talk with him and just encourage him to eat more... because you wouldn't want him to discover that you were sneaking in the calories and have that be something that breaks his trust with you at all... but if you're looking for just ways to add calories while keeping the volume the same, selecting higher calorie soups and such is goo... also cook with juice or milk, etc instead of water. Adding things like nuts, raisins, other fruit, etc. to whatever you can will help... a bit of EVOO drizzled over fried rice, salad, pasta, etc also adds calories... protein powder works well too, honey an almond butter (or peanut butter, whatever you prefer) can be added to a lot of things too.

 

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Trapped,

Thanks, you made some excellent points. I think the trouble with discussing it with him so far (trust me I have tried and failed many times) is his denial. I do think that framing it in a different light while providing the same information might work, he is a mental athlete and should be on a nutritious diet anyway. That is something that I have observed in poker tracker stats and therefore it cannot be disputed. Your timing on this was quite a coincidence since I had just (during his last break) discussed a more nutritious diet for him that will help his brain and memory function more effectively... such as adding omega 3 fatty acids and micro nutrients. I do not think I can change the volume without making him feel uncomfortable or manipulated, so my goal here is to add calories, protein, and vitamins to his existing diet in a way that he will accept. I think that flax seed oil would be most effective and easiest for him to accept because it contains omega 3 fatty acids which help cognitive function. Olive oil and peanut oil are also viable alternatives.

I love your idea of cooking with more fruit juices and whole milk instead of water... I used to use cooking wine, but we no longer keep any form of alcohol in the house so I had switched back to water without even realizing it.

Honey is a great idea too, it boosts your immune system and when served in hot tea helps with your voice. Since he sometimes accepts students and has to give long lectures to teach them, this may be acceptable to him.

Thanks for all the suggestions! I will try them out next time I go grocery shopping and let you know how it works out.

Liz H.

 

[trapped]

Hey Liz- I'm glad some of my suggestions helped! You're right, framing it in a different way should work. Denial is a huge part of eating disorders (if that is what he has) even when they get severe... a lot of people have a hard time understanding that one- a common response I would often get is "but you're doing it on PURPOSE, so you MUST know how bad off you are..." Even when it got to where my therapist and doctor said it was "severe" again, I was in denial- I wasn't the 80 pounds of bones that I was in high school, therefore in my mind it wasn't severe.

Protein is important, especially if he hasn't been eating very much anyway... when you're increasing the calories in his diet, be very careful about adding *too* much too quickly (around 300 a day increase is safe... any more than that, really be careful with how many carbs you add). Fat is REALLY important for brain function and general digestion/bowel/body functions too... anything below 30% fat in the diet is a low fat diet. Anything below 10% and people actually start to go crazy. Your brain is mostly fat, and the first thing your body does with fats is use it for brain function. Not enough fat in your diet and your brain will actually shrink a bit.

Fish like Salmon has a lot of healthy fat and a nice amount of protein too. Will he eat energy bars at all? Most energy bars have more protein than fat, but there are bars that are called "trio" bars, that have a HUGE amount of fat (230 cals, 16 g fat, 6 g protein), but they're very good and healthy for you. Almonds (and most other nuts) are a good source of healthy fat- and again, are so easy to add to dishes (think: on top of oatmeal, mixed in to a side of quinoa, on top of salad, etc). Nutritional drinks (like Ensure) will add more calories, though they may be harder to get him to drink... but what most people don't think about, is you can get the plain or vanilla flavored Ensure or Boost drinks, and cook with that just like you would the milk... and the nutritional drink supplements will have more calories than milk. Also, if you do get milk and use that more, you can get powdered milk, and pour a bit of powdered milk right into the milk container and shake it up... it'll add more calories to the milk. Cheese is another easy source of more fats (and hence calories), that can be added to a lot of things- salad, sandwiches, pasta, meats... get creative, and whatever you can add the cheese too may help- even if you just end up making cheesy breadsticks or something to go as a side with dinner one night. Cooking with coconut milk is good too- 80 grams of coconut milk will have 150 calories, 14 g fat and 2 g protein. If you make any recipes that use eggs, go ahead and add an extra egg IF you guys eat the egg yolks... adding extra if you don't do the yolks doesn't help much, since all the fat is in the yolk. Add mayonaise to anything that you can as well, that will help with increasing fat and calories. And start eating dessert at least a few times a week maybe? This may be a bit more difficult if he doesn't like sweet stuff, but if he will eat ice cream, or even a smoothie for dessert, that could help... if you can get him to eat dark chocolate, that would help a lot too! Studies show that dark chocolate is actually really good for you, and it's healthy to eat 1 to 3 oz of dark chocolate EVERY DAY. 73% dark chocolate will have about 180 calories, 12 grams of fat, and 2 grams of protein per ounce. Some people don't like much higher than 73%, I still find that amount fairly sweet, and so you can always go with an even darker (higher percentage) dark chocolate, which would be a bit less sweet.

And without changing what you eat or the volume, you can increase calories just by reading labels carefully when you shop... go for the breads, soups, etc. that have higher calories or more fat in them. Even things like veggies, if there's labels, read them... for instance, baby carrots... usually 3 oz of baby carrots have 35 calories and 1 gram of protein. But some will have more calories (just mainly due to how they are processed) for the same volume, so look at that. Keep basic things like granola, nuts, etc in the house, as these can be used on salads, eaten plain, cooked up in bread if you cook your own bread, etc. Watch how much he drinks too, liquids fill you up (as does a lot of protein, so when you use the protein powder just be careful of how much of it you use, since some will be helpful, but a lot may cause him to not feel as hungry and result in him eating less). Keep snacks around and available... maaybe he will be more likely to eat more if there are lots of different items for him to have the chance to snack on.

 

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Trapped,

Thank you so much for the information and suggestions! One thing I realized last night was that when he was successfully gaining weight we always had a jar of roasted almonds or other nuts next to the computer where he works. He would just sit there and snack on them between poker hands without even thinking about it. I am going to walk to the store to buy those TODAY! I also like the idea of protein bars, but I think the ones made from scratch are much better then the store bought ones. I asked my old roommate to e-mail the recipe to me since I have lost the piece of paper I had it written on. I will post it on here as soon as I get the recipe again. It was very simple and easy to make. First you line a baking pan with non stick sheets. You mix oats, peanut butter, honey, and chocolate protein powder until you get a nice consistancy. Then you fill the pan with the mixture and let it sit in the fridge overnight and cut them into bars the next morning. They went over very well before, and they do not have all that processed garbage found in most protein bars. Again, thank you so much for your advice and suggestions. I have also gotten some peanut butter and jelly for sandwiches, and that is going over well so far.

Thanks Again!

Liz H.

 

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A quick update:

I walked to Publix yesterday and purchased some nice healthy high calorie foods. We discussed what he liked and what he did not like and I tried to stay as close to that as possible. I stocked up on nuts (buy one get one free is awesome), mayo based side dishes from the deli (potato salad, egg salad, pasta salad, etc.), Gatorade for calorie friendly drinks, and vitamins (including one that contains omega 3,6, and 9 fatty acids). The food seems to have gone over well so far. I looked in the almond jar and found that half the jar had already been eaten in one day! :-)

Thanks so much for all your suggestions and advice trapped, you have been extremely helpful.

Liz H.

 

[Grainne]

Thanks Trapped and TEN...this was helpful to me too. I have strange eating cycles and have always been very thin. I started gaining weight for the first time in my life when I went on medication for depression and freaked out...stopped eating all together. I still go in cycles like that, but have it more under control now. I've never been a 'big' eater - only ate small amounts at any meal time, and I have a strong preference for fruits and veggies (which I will eat in place of sweets or processed foods in a heartbeat) so when I stopped, I dropped weight too quickly and ended up far to thin. Putting weight on was difficult, because I had never really done that before.

Now, on the flip side of things, I'm having a hard time at my current weight. I feel rather overweight, but I know I'm not. I think I'll switch a few of my foods out and try some salmon to see if I can't build some muscle instead of fat.

Grainne

 

[naturalfirebrand]

I had a doctor I worked with for 10 years. Our agreement was as long as my weight did not drop under 150 he would leave me alone. I am 5'10".

I put almond or cashew butter on ice cream.
Oatmeal made with butter, sugar, real cream.

It is much harder to make yourself eat when you do not want to than not eating when you do.