QUESTION: What is the definition of an eating disorder?
ANSWER: Eating disorders are characterized by relatively severe disturbances in eating behaviors. They can include anorexia nervosa and bulimia nervosa as well as other individuals who are distressed over their weight and/or eating habits. It's important to note that it's the subjective feeling of dissatisfaction over our size that's important. Obesity by itself is not an eating disorder. Obese individuals can be, and often are, as emotionally stable and healthy as their thinner counterparts.
QUESTION: I've tried every diet under the sun and still can't lose weight and keep it off. Any suggestions?
ANSWER: Yes. Stop dieting. People who have a history of yo-yo dieting are in a vicious cycle that needs to be broken. Each subsequent gain following a weight loss takes a toll on us, both emotionally and physically. A better approach is to take one particular habit you'd like to change and focus on that. For example, if a problem area for you is late night eating, work on changing that. If you eat too much junk food, try finding healthier foods that you enjoy. Refocusing your goals to specific habits can help break the unhealthy cycle. If you tackle one habit at a time and change it to a positive one, you may eventually lose at least some weight naturally without having to diet.
QUESTION: I binge but don't purge; I just exercise more between binges and control my weight that way. Is that anything to worry about?
ANSWER: It depends on the severity and frequency of the binge/exercise cycles. An occasional binge is normal -- we all do it. And exercise, unless it's obsessive, is good for us. However, if your binges are frequent and severe and if you feel considerable guilt about them so that the exercise is done out of anxiety or self-hatred, or if the exercise is compulsive or overdone, you may have an eating disorder.
QUESTION: I was more than 100 pounds overweight. I've lost about 30 pounds, but I've run out of steam. What can I do to get back on track?
ANSWER: First, congratulations on the 30 pounds. That's a lot of weight to lose. Running out of steam just means that you need a breather from dieting. Our bodies as well as our psyches generally need this kind of breather during long weight loss programs so what you're experiencing is normal and healthy. Continuing to push yourself to lose weight during this time will probably make things worse instead of better. Instead, use this time to hone your weight maintenance skills and work to keep most of your weight off. In addition, focus on other areas in your life that may need attention so you'll have an even better foundation for the next round of dieting.
QUESTION: I try dieting but I always end up feeling so deprived that I cave in. Once that happens, I feel totally miserable, like I've failed and have to start all over again. It's a vicious cycle. How can I break it?
ANSWER: The feeling of deprivation sabotages many attempts to lose weight. Most people get disgusted with themselves for feeling deprived, thinking deprivation is a sign of weakness or gluttony or some other negative trait. One thing you can do is to change your attitude about feeling deprived. See it as a friendly warning sign that it's time to do something different. It's like a flashing yellow light we give ourselves before our diet totally crashes and burns. Ironically, the best thing you can do as soon as you start feeling deprived is to eat some of whatever it is you're craving. If you're feeling deprived because you've told yourself you can't have ice cream, go have some ice cream. If you're feeling deprived because of the whole idea of dieting, give yourself a day off. One day of eating whatever you want won't destroy a diet. Staying on the diet yo-yo will.
QUESTION: I'm a recovering anorexic/bulimic. How do you get over looking in the mirror and seeing nothing but fat?
ANSWER: The distorted body image aspect of an eating disorder is typically the last thing to change. I often think that eating disorders can be symbolized by two warring parts inside of us. One part tells us we're fat and disgusting and the other -- our staunch supporter -- will go to whatever lengths it takes to convince us we're not. When we finally begin to feel better about ourself and eat more normally, it's as if our inner supporter needs to put us to the test for awhile. I can picture her crossing her arms, tapping her foot and saying, "Here. Look in the mirror and see only fat and we'll see if you're going to cave in and feel bad about yourself again or if you're REALLY cured." The reality is that no one has a perfect body. Learning to appreciate and respect who we are -- including our physical appearances -- is an extremely important part of the healing process.
QUESTION: I've been bingeing and vomiting for several years and it makes me feel like a disgusting heap. It seems like the more I try to stop, the more I eat, and once I eat, I have this irresistible urge to throw up. Any suggestions?
ANSWER: There are two main things that will help with the pattern you describe. First you need to shift your focus away from the eating/feeling fat part of the battle and instead, work on eliminating the purging. Knowing that we can purge is an indirect way of saying, "Yes" to the bingeing. It's important to say that "yes" consciously, without requiring the purging component to take away our guilt. Guilt and shame are what keep an eating disorder in place, and we can't work through those issues as long as we're allowing ourselves an escape route. While you're working on eliminating the purging, it's important to allow yourself to eat whatever you want and in whatever amounts you want. Trying to control your eating while you're also tackling the purging will keep you stuck in the food battle and further prolong dealing with the actual issues.
The second thing is that you need to find ways to take your emotional energy out of the eating disorder and put it on other things. You may want to explore new job, hobby or relationship -- you may just want to veg out and relax for awhile. It doesn't much matter what else you focus on -- the important thing is to put your energies into something other than food, eating and weight.
