Atypically Recovering: On My Own No Matter How This Goes

Tag: dietician

  • Dislike vs. Fear

    Photo; Pexels image, cropped

    TW: talk of calories and restriction


    No matter how long I’ve been at this, I know that some of the things I say I don’t like are really food fears. I do have some legit “hate” foods {baked beans, sweet potatoes, peas, winter squashes (acorn, butternut, etc), cooked carrots, kidney beans, lemongrass/ rosemary/ginger if they’re the main flavors, raw tomatoes, ‘al fredo’ anything, and others}, but there are also things that I’m just plain terrified of, and haven’t been able to get near for a long time, or if I did, my ‘head’ made the idea of repeating the exercise too miserable to consider- casseroles, restaurant food that has no nutritional information, pecan pie, etc.

    While I still restrict calories and some categories of foods, I am better about trying things with 1-3 bites, depending on what it is. Much of the time, it’s just about getting the macros in to protect my kidneys, minimize muscle gain, and aim for weight loss. I have re-tried a few of the ‘hate’ foods, and I truly can’t stand them. Some go back to young childhood when I’d eaten them (cooked carrots, baked beans, cold french fries) and I threw them up immediately. My body pushed the ‘eject’ button- it wasn’t intentional. But the disgust, and frankly the ‘reject flavor’, has stuck with me for over 5 decades. I think it’s pretty clear that those are food ‘hates’, and not simple avoidance of calories.

    Except for very rare instances when biological hunger overrides my restricting, I’m about 500-700 calories short of my daily caloric intake ‘goal’ set by the dietician I saw for several years (and who gave good advice; solid, logical, and understood the fear). I could have a serving of something decadent, and still be under my calorie goal ‘limit’. And yet, I can’t just eat something for the sake of enjoyment or convenience. There has to be a reason for the food to be bothered with- carbs to avoid acute renal failure again, fats to burn fat, protein for cell structure, etc. But I still want my muscle mass to shrink, and to lose as much weight as possible, even though I end up mentally trashed. Even the ‘bingeing’ is within %150 of my goal calorie intake, so it’s a minor binge as far as ‘real’ binges go- but if it’s unplanned, it’s ‘bad’ and I’m terrible for ‘giving in’ to my body’s reaction to biological hunger.

    If someone comments about a food being ‘bad’ (to them), I wonder if I’m ‘bad’ for it not being on my ‘bad’ list. If someone says something is good, I find all kinds of reasons why I medically shouldn’t (or sometimes can’t) have something, or that my body isn’t small enough to deserve to eat a food just because it sounds good. There is no ‘neutral’ food to speak of. There are those that I don’t panic about, but would prefer to avoid. If I enjoy something, it’s an automatic feeling of having done something sketchy, and therefore ‘bad’. There is no escape.

    Because of how long this has gone on (45+ years on my own, and another 10 prior to that when my mom bribed me to lose weight when I wasn’t fat, paying $1/pound for each pound I lost or buying ANY food I needed for the diet du jour) I don’t know how to eat normally. The entire family restricted at some point, and my mom was a serial restrictor. One 15-oz can of ravioli was split between the three of us for dinner. Dad would have a blob of iceberg lettuce and bottled dressing, and there might be bread on the table. If I didn’t like something (tomato soup, bean & bacon soup- both canned, BLT sandwiches, etc) I was welcome not to eat at all. It was neither parents’ concern. And there were no options for having something else. Eat what’s served, or don’t eat.

    I think that’s where ‘tasting’ comes in. My head doesn’t get too worked up over 1-3 bites of something that I’m not ‘allowed’ a full portion (whether the ED voice, or medical food restrictions for gout, diabetes, and kidney disease). Even if I really like the taste of something, I can’t have more than a couple of bites. Those are the ‘rules’.

    Things I’d like to have without analyzing the crap out of via nutritional information: a sandwich that I don’t know all of the ingredients, a side dish that has many components, a dessert that isn’t plain fruit or a couple of military biscuits, and several things that I haven’t had for many years. I know that to work through this, I’ll have to eat foods that scare me, and that means a full portion, not just tasting. And I’m not there yet. I see what is in the mirror, and immediately, I’m terrible for even considering putting X into my mouth.

  • Grieving Hope of Recovery With Ex-Therapist

    Grieving Hope of Recovery With Ex-Therapist

    Photo- mine

    It might sound weird to grieve for something that never happened. But I’d dreamed of getting well with someone who seemed to have figured out how to get the eating disorder voice to go quiet for good. She has helped a lot of people, but it seems that she loses interest quickly when the money runs out- even though she said she’d still keep me (after paying $32,700K USD- the agreed monthly amount before she accepted me). The calls petered out, and there was always an excuse. But what hurt the most is basically being blown off while I was still paying. I know that sounds stupid. I’m skeptical of a LOT normally. I’m not one to believe most people after so many violations of trust in my life, or taking advantage/targeting me because I want to be helpful or ‘good’ to others. But I felt I could trust her. I was very, very wrong.

    The ongoing and lengthy absences with no warning, constant excuses (I don’t even know what things to believe are true or not), telling me other patients’ private information, and calls that never came just reinforced the feeling of worthlessness, with no acknowledgment of that whatsoever from her. When other patients did something she didn’t like, I was told by her that they were difficult or were somehow worth more of her time, when I did what I could not to cause problems. And that was a huge mistake. I needed squeaky wheels to be acknowledged- like she needed the patients to swarm to her for contact. I don’t do that 4th grade crap. This whole thing has been traumatic and painful. It’s hard when hope gets blown off by a person who is supposed to be a ‘last resort’. Her promises meant nothing.

    I wanted the freedom to not think about food and losing weight that has haunted me since I was 6 years old. I wanted to be able to have something just because I like it- not because it’s specifically to fit into the macro numbers. I wanted my head to be ‘rewired’ so that I had a healthier relationship with food, so I could be more social with friends, and get my body repaired. It’s been through a lot.

    But those dreams aren’t dead (they are with that therapist), and I still hope to get well via YouTube eating disorder recovery videos that all promote basically the same thing. Don’t restrict food. Period. Weight will even out when the body knows it’s going to get consistent food, and doesn’t have to hang on to calories for fear of not getting enough. I still have trouble with that because I’m not thin- but I have to try something, and with the numbers of people who have recovered with this method (intuitive eating and feast v famine mentality and body response), there has to be something to it. And aside from buying the books that Tabitha Farrar and Elisa Oras have written, it’s free. I also have my IRL dietician, who is very helpful, and knows I’m struggling. She also always responds to questions via email. If she’s out of the office, I get a notification that she’ll contact me when she’s back.

    I am hoping I have the nerve to have a piece of birthday cake this year- kind of a celebration of being free from the psychological manipulation and control by someone who isn’t worthy of such power, as well as not doing what my head says about being too ‘bad’ to deserve a bit of cake. Little goals.

  • Doing The Opposite Of What My ‘Head’ Says

    Doing The Opposite Of What My ‘Head’ Says

    Photo: Mine, lychees

    This is so hard. I’ve never known “normal” eating, and now have the Ex-T’s “food rules” to undo as well. The entire idea of restrictive eating disorder therapy to undo the restrictive eating disorder is NOT to have food rules (other than those I have to deal with for medical issues- diabetes, kidney disease, and gout). I just want my head to settle down, and not dictate what I eat, how much, when, etc. I’ve had periods of time when it was all less intense, but for the last 4 1/2 years, it’s been pretty constant- the longest continuous time in my life when I’ve been so controlled by ‘my head’ to this degree. I’ve been in acute renal failure/acute kidney injury twice because of not eating enough in those 4 1/2 years. I have to get this sorted out. I do have a dietician, and I’m thankful for her.

    Every time I make a day’s food plan, it’s all about ‘the numbers’. I don’t eat things I like UNLESS they also fit into the days ‘numbers’. Macros (protein, carbs, fats), as well as sodium (can’t go too low or my BP drops which puts my kidneys at risk, and muscle cramping is horrific). If I spontaneously eat something different during the day that messes with those numbers, I have to redo the rest of the day so the ‘numbers’ are OK again. I’m trying to figure out how to just eat stuff without focusing on the stupid numbers as much, but it’s all I’ve known for 5+ decades.

    My hunger cues have been messed up for a long time. For many years, I didn’t feel physical hunger, even though I thought about food constantly and still do. I am starting to feel physical hunger again, and it’s terrifying. I have images of me eating what I want until I feel full and ending up gaining even more unneeded weight. In reality, it doesn’t take much for me to feel full. But the fear is very real. I view myself as already grotesquely overweight, even though when I see TV shows about extremely obese peoples’ weight loss journeys I don’t judge them. I just wonder what hurt them so badly that they are hurting themselves so much. I know that sounds hypocritical. I KNOW all of this is bonkers. And, I can’t just flip a switch.

    I want to set up a day when my blood sugars are more stable (parathyroid hormone is wonky right now, so insulin resistance is increased), and then just try and – for one day only (to minimize panic in my head)- eat what sounds good when I’m hungry, and not worry so much about anything that isn’t focused on getting me stronger. If I make it for only one day, I don’t have the pressure to do it for longer while giving myself the chance to see that it is possible. Then, I can do 2 days, etc. In the meantime, I’m trying to have one thing every day- even if it’s just 15 grams more of something, that is against what my head wants, which is eating close to nothing, although I’m eating ‘enough’ to keep kidney function stable at this point. I do get some reprieve because of the kidney situation, but it’s not all-encompassing. I HOPE that if I can get my eating more ‘normally’ that my kidneys will do better. I am not someone who would do dialysis if it came to that.

    I have found that I do better if I can avoid sweet foods in the morning. I just don’t like them, so the past 3 1/2 years of being strongly encouraged to eat yogurt and berries, kefir, or oatmeal/porridge, and the horrible sweetness of those, have been miserable. I couldn’t find a savory oatmeal recipe that sounded edible. Scrambled eggs were/are allowed, but when my blood pressure isn’t stable, or I’m in a lot of pain, it’s hard to do a lot of stuff that requires prep and/or cooking. I much prefer something like cheese and crackers, and maybe some fruit that has a bit of tang, or even leftovers from another savory meal. Many countries have soups as ‘normal’ breakfasts, and that might also be a good thing to try.

    Single serving items are also helpful, though I have to be careful with prices. For frozen entrees, I have several that are budget friendly and taste good, and only require being popped into the oven or microwave. Lean Cuisine has a lot of flavor options, and for a substantial treat, I’ll get Amy’s Kitchen or MichaelAngelo’s frozen single serve entrees. With some products, I can count out the portion size-and that’s doable. I do like the flavor of a lot of different ethnic foods, so that helps as well. I do have very specific dislikes, but those are easy enough to avoid.

    It’s been good to be having more fresh fruits and vegetables, though with the prices in the US, most are a luxury. It helps to incorporate them into chickpea salads, or other food ‘stretching’ meals, and keep the frozen and some canned items for more ‘bulky’ vegetable servings. Lettuce is too expensive for what it provides, so most of my salads are what I’d put on a bed of greens. It cuts down on the volume without cutting down on the nutrition that comes from the chickpeas, peppers, onion, olives, cheese, and croutons. Doing seasonal grocery lists has been useful, as have some frozen options. I could have fruit and veg with Ex-T, but with the other stuff she wanted me to get in, volume tolerance was a problem. Now, I prefer to prioritize fruit and veggies more, and ‘fill in’ with protein, starches, and fats with an emphasis on nuts, olives, and the occasional avocado or premade single serving of guacamole. It’s still a challenge not to feel too full, but I’m making little steps.

    Mostly, I need to quit freaking out about the numbers at the end of the day. I don’t let myself get to a calorie level that is too scary, and that’s still a problem. Calories should only be an issue in that I get enough to fuel my body for continued healing. Not that are restricted because it’s what the eating disorder wants.

  • My First Hospitalization for Bulimarexia & Depression

    My First Hospitalization for Bulimarexia & Depression

    Photo: mine

    When I returned to the University of Illinois after the winter break, I limped through emotionally, and things quickly became critical. I was still freaked out about being on academic probation (not in my perfectionistic vocabulary), and very depressed. I thought I was falling everything. I wasn’t thin enough, I was evidently very stupid, and I didn’t see any way out that would end well. And the idea of ‘ending things’ was what finally broke me down. The therapist I’d seen the semester before finally heard me say something besides “I don’t know”. What she got was “I want to die.” and followed up with my plan that would have been lethal, and cause trauma to other students on my dorm floor.

    She called the university fire department to take me to the university health center for ‘holding’ until a bed could be secured at a psychiatric hospital near Chicago. The health center was for fairly minor problems or routine surgeries like appendectomies, and I guess for students who were being sent elsewhere. I was at the university health center longer than anticipated because of a severe February blizzard that made traveling to get me not possible. I wouldn’t go with my parents, so a family friend and her daughter came to collect me as soon as the roads were passable. During those days, I didn’t eat and had my jeans and shoes highjacked to prevent any ideas of ‘escape’. At that point, I was too tired to put up much of a fuss, so I sat there while dorm friends came to say their goodbyes. It was horrible. The staff were all very pleasant, but those goodbyes were SO hard. I didn’t want to leave, but knew I couldn’t stay.

    When I got to Forest Hospital in Des Plaines, IL, my worst scenario played out. I hadn’t figured on my parents needing to sign me in since I was on my dad’s insurance. I felt I’d failed them, and was so ashamed. We did the obligatory hugs through their absolute denial and disbelief, and I went onto the locked adult unit, scared shitless that I was entering “One Flew Over The Cuckoo’s s Nest” territory. Instead, I found some very 70s floral wallpaper, a TON of cigarette smoke (like clouds), and people with all kinds of diagnoses from depression to raging schizophrenia and hyper manic bipolar disorders. I was the youngest on the adult unit, and terrified. Fortunately, my roommate was in the ‘mundane’ depression category and not scary, so that helped. There was one patient there for the rest of her life after falling out of a 2nd story window some years before, and ending up with a severe brain injury. She was a ‘constant’, which in itself was very sad. She wasn’t that old.

    The first thing my psychiatrist did was ban contact with my parents for a month, to figure out why I was so opposed to seeing them. He also started me on the first of many medications, when I just needed food. I’ve never been depressed or suicidal without being very malnourished, but that realization wouldn’t come for several years. So, I settled in to the hospital routine. My folks came to family group sessions with other families and patients, but never really understood the purpose. Dad’s comment was “the sandwiches were nice”. Great, Pops, that was the goal, said no-one ever.

    The dietician was easy to deal with- too easy. I talked my way into an 800 calorie/day meal plan. The chef (yup- a chef) at that place was incredible, and being a private hospital before insurance companies decided to play doctor without licenses, the food budget was first class. Prime rib, duck (yuck), shrimp, salad bar, and desserts with honey (no refined sugar). For someone who was afraid to eat, it was a minefield. But, it was also good food, and for someone who grew up being restricted by my folks before I took over that behavior, it was great when I finally allowed myself to eat something.

    I was not so well-behaved when I was being monitored for food intake. When I had to eat on the unit vs the dining room, I’d switch out the meal cards so that I got some huge salad for a patient on a weight loss plan, and gave him my double portions. That was figured out fairly quickly… the diet guy wasn’t complaining about my donations, but the staff were not amused. Then they started me on Sustacal (now called Boost), and I poured most of it into the potted plants. That didn’t smell so great after a few days. One day, I tried to go AWOL, and hurdled the gardener’s wheelbarrow, with the gardner still attached at the handles, and got about 50 yards away before passing out on the sidewalk. I was half carried, half dragged back to the adult unit, in a haze of iffy blood pressure. Early on, I spent a fair amount of time in the quiet room (dumb name when one of the patients was in there screaming at all hours), and even in leather restraints, which was a common practice back then. I had small enough hands to get out of the straps, so then they just medicated me with heavy duty meds before leaving me in there, and peeking in the little window every few minutes. It was definitely a different kind of education. My psychiatrist never discouraged the acting out, because he sensed that I was a bit too tightly wound for “normal”.

    I went without eating anything for 2 weeks, and ended up in severe ketosis that was bad enough that one of the nurses smelled me from just walking past me in the hall. That bought me a seat by the nurses’ station desk while they pumped me full of orange juice and toast. My mouth was so dry that the toast literally stuck to my mouth.

    Bulimarexia was a term used back then for what would now be either anorexia, bulimic sub-type or EDNOS (atypical anorexia). Because of my laxative abuse, and the thinking at the time (early 80s), any purging was put into some kind of bulimic category. I didn’t binge like a lot of binges were described at that point, and if I hadn’t purged, the food I did consume would not likely have caused much weight fluctuation. But in my head, any unplanned ‘diet friendly’ foods were binges, so had to be ‘gotten rid of’. I didn’t vomit (tried, but I wasn’t any good at it), so laxatives were my purging preference. For some reason, I thought that was more ‘dignified’ than vomiting. Both are pretty disgusting. I also did a lot of running in place in my room, and when that was discovered, I spent about a week in the day room being supervised around the clock. I had to sleep out there in slightly dimmed lighting and the fog of 24-hour smokers. I ended up starting to smoke there.

    The staff were kind to me, and my psychiatrist was also a decent sort. I can’t say much was resolved with the eating issues, but they kept me alive, and with food, the depression lifted. I was still on meds, but I think that the food did more good than the meds ever did. I was released after 3 months.

    I planned to return to the camp I’d worked at the previous 2 summers, though only for half of the upcoming summer season to avoid too much pressure. My former camp supervisor had visited me while I was at the hospital, I’m guessing to be sure I wasn’t drooling in a corner somewhere, and he was satisfied that I was still the same person who was harmless, but had crumbled the year before when I became anorexic at the same camp. It was hard being there that summer since I wasn’t in the nature center, but because I was going to be there for only 1/2 of the summer, I was assigned to be a cabin counselor. I guess that was a compliment since they were turning me loose on actual kids and not the snakes and goofy ferret. It was still good to be doing something I loved, it got me away from home, and people didn’t treat me like defective goods for having been hospitalized.

    But all was not well….