- Relapse prevention: anorexia nervosa
- It sounds simplistic, but it is true:
if no one ever dieted there would be no anorexia nervosa. Instead
of dieting, design a meal plan that gives your body all the nutrition
it needs for normal growth and health. If you want to work towards
a healthy weight, then limit (but don't eliminate) your intake
of fatty and sugary foods and refined carbohydrates. Eat lots
of whole grains, fruits, vegetables, and enough dairy and protein
foods to maintain strong bones and healthy muscles and organs.
Also get 30 to 60 minutes of exercise or physical activity three
to five days a week. Unless you are working under the supervision
of a coach or trainer, anything more rigorous is excessive.
|
- When you start to get overwhelmed by "feeling
fat," instead of dwelling on your appearance, ask yourself
how your life would be better if you were thinner. What would
you have then that you don't have now? Friends? Self-confidence?
Love? Control? The admiration of others? Their acceptance? Success
and status?
Then realize that being unhealthily thin will bring you none
of these things, only a fragile illusion of success that has
to be constantly reinforced with even more weight loss. All of
the above items are legitimate goals of healthy people, but working
to achieve them directly is much more effective than losing weight.
If weight loss brought happiness, then starving Third World children
would be ecstatic with joy. They are not. They are miserable
and depressed, just like people who have anorexia nervosa.
|
- Accept that your body shape is determined
in part by genetics, and you may never have a totally flat stomach.
Even if you are very thin, your internal organs will give a certain
roundedness there, especially after you eat and if people in
your family tend to store fat in the midsection.
|
- If you feel yourself slipping back
into unhealthy habits, call your therapist and schedule an appointment.
Returning to counseling in no way means you have failed. It means
only that it's time to reevaluate and fine tune your recovery
plan.
|
|
- Relapse prevention: bulimia nervosa
- Never ever let yourself get so hungry
that the urge to binge is overwhelming. People who recover from
bulimia say that they eat regularly. Because they are never ravenous,
they have no physical reason to binge eat.
Hunger is the most powerful binge trigger there is. It is a recognized
fact that the longer one has dieted, and the more severely calories
have been restricted, the higher the risk of binge eating.
|
- Never ever deprive yourself of good-tasting
food, even if it has more fat and calories than "safe"
diet foods. If you refuse to eat appealing foods that you really
want, you will feel deprived and crave them. Then you are vulnerable
to bingeing.
Remember Adam and Eve in the Garden of Eden? The one food they
were not supposed to eat was the one they could not stay away
from.
|
- Don't deprive yourself of other satisfying
experiences either. If you make yourself feel needy, you will
be tempted to look for comfort in the refrigerator. Make sure
that every day you spend time with friends. In person is best,
but phone calls and e-mail are better than nothing.
|
- Also every day spend time doing things
you are good at, things you can take pride in, things that demonstrate
your competency and abilities. Allow yourself to enjoy your accomplishments
and refuse to listen to the nagging inner voice that insists
you could do better if only you tried harder.
|
- Last, but by no means least, every day
do something that's fun and pleasurable. Watch comedy videos
and laugh out loud at outrageous jokes. Play something -- a board
game, a computer game, tapes or CDs. Go outside and enjoy the
birds, trees, flowers, and fresh air. If you live in the middle
of a big city, go to a park. Figure out how to give yourself
a fun break from the daily routine, and then do it.
|
- Keep tabs on your feelings. Several times
during the day, especially in the first stages of recovery, take
time out and ask yourself how you feel. If you notice rising
stress, anger, fear, sadness -- and even strong joy -- be alert
to the possibility that you may try to dull these strong emotions
by turning to food. Find a better way of dealing with your feelings
such as talking them over with a trusted friend.
The 12-step folks have a useful formula. When they feel on the
verge of falling into old behaviors, they say HALT! Then they
ask, "Am I too Hungry, too Angry, too Lonely, or too Tired?"
All of those states are strong binge triggers. Additional triggers
for people with eating disorders seem to be Boredom and Unstructured
time. If you find yourself in any of these states, figure out
a healthier and more effective way of dealing with the situation
than binge eating.
|
- Until you have achieved some balance and
perspective, stay away from temptation. Don't go to all-you-can-eat
salad bars. If ice cream is a binge trigger, don't keep it in
your freezer.
When you want potato salad, for example, or rocky road ice cream,
go to a sit-down restaurant and order a single portion, ideally
as part of a balanced meal. By doing so, you accomplish three
things. You avoid depriving yourself. You avoid the urges to
binge created by deprivation, and you also learn how to integrate
normal food into a reasonable and healthy meal plan.
|
- When you do feel powerful urges to binge,
postpone the act for thirty minutes. Surely you can wait half
an hour. During that time think about what is going on in your
life. What stresses are you facing? What is missing right now
from your life that you need in order to be happy and avoid the
looming binge? Make a list of things you could you do instead
of binge eating to deal with your situation. If you are truly
committed to recovery, at least some of the time you will choose
one of these healthier behaviors instead of binge food.
|
- Take charge of your life. Stop using words
like, "I wish," "I want," "I hope,"
and "I can't." They are weak victim words. Say instead
things like, "I choose," even if you are choosing to
binge. Say, "I will," even if the thing you will do
is vomit. These are words that express responsibility, power,
and control. If you can choose to binge, then by implication
at some future time you can choose NOT to binge. If you will
vomit, then next week or next month or next year you can choose
to say, "I WON'T vomit."
|
- If you feel yourself slipping back into
unhealthy habits, call your therapist and schedule an appointment.
Returning to counseling in no way means you have failed. It means
only that it's time to reevaluate and fine tune your recovery
plan.
|
- Relapse prevention: binge eating disorder
- Same as for bulimia, above
|
- If you feel yourself slipping back into
unhealthy habits, call your therapist and schedule an appointment.
Returning to counseling in no way means you have failed. It means
only that it's time to reevaluate and fine tune your recovery
plan.
|
- Research on healthy weight management
- Most diets that provide about 1500 calories
per day will result in weight loss, but after about two months
that loss slows, then plateaus, and then reverses. The person
usually ends up weighing as much as, or even more, than before
the diet.
|
- Don't diet. Ever. Diets don't work. In fact, they work against you by making you hungry and leaving you feeling deprived. People who feel deprived, and who are hungry, are vulnerable to overeating -- and overeating, of course, leads to weight gain.
Research clearly shows that dieting in an attempt to control weight is associated with weight gain. It's even worse. People who diet gain more weight than those who never restrict. Healthy weight management means following a healthy meal plan, not a restrictive one. (Pediatrics 2003. 112:900)
|
- Programs such as the ones recommended
by the American Heart Association and Weight Watchers have been
shown to be more effective in maintaining weight loss than exotic,
unorthodox approaches. (Journal of Obesity Research. March/April
2001) Effective plans recommend
- No more than 30% of calories as fat
|
- No more than 20% of calories as protein
|
- Remaining calories to be complex carbohydrates:
whole grains, fruits, vegetables
|
- Limited amounts of salt, sugar, refined
flour, processed foods, and fast foods
|
- 30 - 60 minutes of exercise or physical
activity five to seven days a week
|
- Social support: non-food fun times with
friends and family. Also at least one close, mutually satisfying
friendship or romantic relationship
|
|
|
|
|
