Dieting With An Eating Disorder History

When I started Nutrisystem 80 days ago, I had some nagging concerns about how to lose the weight I’d gained on chemo without going nuts and ending up in a bonafide eating disorder relapse.  I’m not sure that concern ever goes away.  I haven’t done any purposeful eating disorder behaviors since 1996-1997 (it was a process), and no purging since March 1996.  Yet, there were so many years of my life, starting at a young age, when disordered eating was the only way I knew how to eat at all.  It was what I was taught.

I’ve lost 43 pounds in 80 days. That’s faster than the advertised 1-2 pounds/week on the Nutrisystem literature (and any healthy weight loss plan). I’m not purposely eating less than I’m supposed to- and when I tally the calories, fat, carbs, fiber, and protein (which is more for diabetic/insulin reasons),  I’m not compelled to cut back to crazy low numbers.  There have been days when I don’t eat all I’m supposed to, but it’s because of headaches and the accompanying queasiness.  I think some of that is because of the sucralose/Splenda in some of the Nutrisystem products (they don’t use aspartame/Equal)- so this week I called Customer Service, and was able to arrange to send back all of  the Cinnamon Buns and some of the Honey Wheat Bagels (had to do with the 30-day exchange policy).  They are sending me some Granola Cereal- no artificial sweeteners, low fat, and good protein (for granola).  I really liked those Cinnamon Buns. 😦  But, I’ve had a headache every day since I started eating those with the last order. It has been a constant 6 day headache.  I’m still not sure why bagels need an artificial sweetener.  Sure, the yeast needs honey or sugar, but adding sweetness just to make them sweeter?  Yuck.  They did still work with the salmon spread I came up with, but I’ll just have to find a store bagel that has good fiber and protein.  But I digress.

I still have the body image issues. When I look in the mirror, I don’t see 43 missing pounds. I know my clothing fits differently (or in the case of 3 pairs of shorts, just falls off).  I know the ‘numbers’ say I’m losing weight, but I don’t ‘feel’ it.  My ‘old’ pajama bottoms fit again. My t-shirts fit better. My bra doesn’t make me look like the Michelin Man.  But, I’m still waiting for my rings to fit again.  And I’m waiting to see the change in my appearance.  I took ‘before’ photos, so I will have something to compare myself to.  I hope I can see it.

I’m not sure how to see myself normally.  That part of the recovery puzzle never did work itself out.  My dad asked me how much I plan to lose, and I don’t know. I told him I’d know when I got there (which can be a scary thing to think about- those with eating disorders are never happy when they reach one goal). I have a BMI number I want to get under, but it’s not anywhere near unhealthy thinness.  When I was in the worst part of any given eating disorder period, I thought that the low 70s was a perfectly reasonable weight to aim for, at 5 feet 6 inches tall.  I do know that anything below a BMI of 18 isn’t good- and for my body type, I don’t want to go below a BMI that is much higher than that. I know I have to be careful not to keep looking for some ‘magic’ number- and that I have to be vigilant about not getting into numbers games in my head.

To look at me now, ‘eating disorders’ (the ‘thin’ ones)  are not what someone on the outside would even consider being a issue of mine , but I’ve been nearly 100 pounds heavier than I am now, and 70 pounds lighter during my adult life (18 or older). Between the relapses with anorexia, I’ve also been a compulsive undereater- people don’t talk about that. It’s not quite as bad as the internal demands of anorexia,  but the focus on food and weight is still abnormal enough to affect functioning around food and eating; social events with food are very difficult, even though the diagnostic criteria for anorexia aren’t all there.

I ate a lot when I first moved away from home in 1985, and no longer had the imposed restriction of my mom, or the original ‘diagnosed’ anorexia onset in 1981.  I’d been through inpatient psych hospitalization, and was ‘allowed’ to eat.  That led to unhealthy eating, and what I don’t really call bingeing, but more like finally being set free from a noose of thinness obsession.  My metabolism had to be messed up from so many years of dieting and starvation, which just made the weight pile on faster. “Normal” intake equaled weight gain.  I got morbidly obese- which is like a death nell for someone who has been anorexic/bulimic.  I relapsed a couple of times before the last one in 1995. Each time got worse faster.  The last one was really bad. But only those who saw what I was doing knew that I was in trouble.  To most people, I was too overweight to even consider that I was starving.  I lost 50 pounds in 3 months, and a total of 120 in about a year.  Some of that was from diabetes before it was diagnosed (weight loss is a symptom of undiagnosed high blood sugars), and then after the diagnosis I became very obsessed.

Now, I’ve lost 43 pounds in 80 days.  I  let my doctor know (that’s definitely not something I would have done during the ED years).  I know that the huge reduction in insulin is probably also a factor in how ‘easy’ this has been (when nothing I did before Nutrisystem helped budge the chemotherapy weight).  I am eating more protein than before NS.  The glycemic index of the food is much better.  Even the ‘junk food’ on NS is formulated to be healthy.  The Cheese Puffs, cookies, pretzels, and candy bars are tasty enough to order after I reach my goal weight.  It’s hard to find 8 gms of protein and 6 gms of fiber in 1 ounce of regular pretzels.

I still have a problem with feeling full. I loathe that feeling.  There is a lot to eat on NS.  Most days, I don’t get it all in, but it’s not about the numbers game- it’s about feeling really uncomfortable.  Gas-X has become its own food group.  On ‘headache days’ (whether from sucralose or not- I have chronic headaches), it’s hard to pack in every meal.  But on days when I don’t have the headaches or other pain, I like the NS food.  NS food is quite good for ‘diet food’.  I go off plan now and then and have restaurant food (and it hasn’t affected my weight loss). Some people on NS (per the discussion boards) must stay very rigid so they don’t end up in long binge cycles- kind of like alcoholics can’t have a drop of booze.  I understand that from my years of working drug/alcohol rehab, but I have to be less obsessive, and go ‘off grid’ now and then to keep some sort of balance with the real world.

One of my other reasons for wanting to lose weight (besides the chemo weight) is that I’ll be 50 years old later this year.  I didn’t want to hit that milestone at such an unhealthy weight.  I want to stack the odds in my favor for the ‘senior years’ (geez, I’ll get my AARP card soon- when did THAT happen?) 😮 . I plan to eat restaurant food on my 50th birthday in November, and I can pretty well guarantee there won’t be a carrot on the plate 😀  And I will have cake.  I don’t normally enjoy restaurants (mostly from the heat intolerance and dysautonomia), but I’ve been told the sky is the limit by my dad, since a 50th birthday doesn’t come around but once.  I don’t feel like I’m almost 50… no husband, kids, etc- I guess I bypassed some of the other milestones in life, and have a different frame of reference for a lot of things.  But, I don’t want to be fat when I turn 50.

So, I’m doing well on Nutrisystem, but I don’t think I’ll ever feel like a ‘normal’ eater.  I think that the risk of anorexia is always there once it’s ever taken hold.  It takes over very subtly at first, and then everything crashes and burns.  Being aware of this has been helpful.  The ultimate goal of being healthy has surpassed the desire to be ‘skinny’.  That part of my brain has finally grown up.  But the part of my brain that remembers the horrible years of torment from anorexia, bulimia, and other variations of those doesn’t want to get ‘close enough’ to the edge.  Ever. It has scarred me in many respects.  I guess that’s probably good.  Now to get rid of the rest of this unhealthy weight, and then maintain it like a ‘normal’ person.  I’m more than half-way to my random goal, set when I started NS  (I had to put something down) but people adjust them once they reach their original goals all the time.  I’ll just have to see what feels right.

Professional Pain Patients….When They Are ‘Family’

I just read some posts from a cousin I have no contact with because of her toxic and totally egocentric ‘interaction’ with people.  The posts were on a support and encouragement page for another (mutual) cousin who has recently been diagnosed with colon cancer.  She has had several months of pain and increasing symptoms that she had surgery for last week, and is getting ready for radiation and chemo.  The pain she has had has been to the point of not being able to eat, walk, or interact with anybody other than doctors, nurses, hospital staff, and close family and very close friends.  Everything else has been pretty much via this support page (which has been great!).  This last week I have been e-mailing her, as she’s had questions about chemo that she knows I’ve been through personally, though for a different type of cancer.

The toxic cousin has been telling the cousin who is  in immobilizing pain to do some distraction exercises and activities, or  other things that are fine for chronic pain.  There is no place for comparing what the sick cousin has to the chronic pain from the other one.   ‘Toxic’ has no clue what someone else is going through – it’s all through her eyes.  Sometimes, that is good- but there is never a ‘conversation’ that doesn’t completely revolve around her medical issues (unless she’s calling someone – me – names based on no knowledge of me as an adult).  I think people, in general, relate things to their frame of reference- but they still know how to focus on the one with the serious current issues, and not always make it about them.   But if ‘victim’ could focus on a marathon of TV shows, it’s not taking much to help her pain.  Everybody has different experiences with pain- that’s a given.  I just know that if I’m having that bad of a day, I’m not able to follow the story lines in consecutive TV shows.

I have to walk a fine line, because I have some similar diagnoses that ‘toxic’ cousin has. I am also in chronic pain. I ‘get it’.   I try to use what I know about those things to help folks (as well as my nursing background).  It’s not a competition !  But I have taken care of too many people as an RN, and read enough continuing education materials about the types of pain to know that ‘toxic’ is completely out of her league when it comes to cancer pain- but since HER pain is all she knows, she seems to think that her little distraction tactics should do the trick. Try a hedgehog with lava hot quills in her butt, and then maybe she’d get a little clue.  The cousin dealing with cancer has been going through hell.

I think what makes me the most angry is that ‘toxic’ can’t get through a post without it being in some way about HER !  😮  The site where this is all going on is supposed to help and encourage the one going through SO much.  SHE is the one who needs the support.  I try to use personal experience to help answer questions, and give some sort of emotional relief -that it’s possible to get through what’s going on.  If what I say about myself has no purpose in helping the other person when offering support, I don’t think it’s appropriate.  JMHO.

‘Toxic’ has been through some lousy stuff- there is no question about that.  I don’t doubt that she has significant pain. We have at least one disorder in common, and it is very painful- but it’s chronic pain.  It’s what we live with every day- it’s not causing abrupt and intense changes in our current level of functioning.  Chronic pain is our ‘normal’.   That’s way different than what someone with a growing tumor is feeling, in a very sensitive area- who can’t move without it being aggravated.  The pain management people are doing much more now for the cousin with cancer, so it looks like the one actually going through all of this will get some relief- at least enough to be able to get through the next phases of treatment.

I just needed to vent.  I understand when people don’t acknowledge pain, because ‘you look fine’.  But comparing what is a daily part of life of someone with chronic pain  to the sudden bombardment of life-altering changes  for someone who was just diagnosed with a very tricky cancer angered me.  Chronic pain is hard.  It never goes away, at least long enough to matter- but it’s not going to cause physical damage to me.  My cousin who is going through this really, REALLY hard time needs support- not someone who is taking things and making it about her, and somewhat trivializing the cancer hell. Maybe it’s how she tries to relate to people, I don’t know.  It just annoys the snot out of me.  She has a knack for that.  But I do wish her well. And I wish she’d find a new way to interact with people.  It takes a deliberate action to look for the good.  Being a ‘victim’ is quite unimpressive. Survivors are the heroes I respect.  It’s all a matter of perspective. And choice.

In the last 10 years, I’ve never heard of anything positive in ‘toxic”s life. Not once.  I had reached out to her 10 years ago (several times via e-mail), knowing that she had some of the same issues I deal with, in hopes of offering some support.  I never heard from her until she sent me some snarky political information YEARS later, though she hadn’t had any contact with me  for more than 20 years… like she knew anything about me.  And she was completely ‘talking down’ to me and resorted to nasty name calling… she’s 2-3 years older than I am- certainly no ‘wise elder’.  It was like an 8 year old schoolyard brat.  She’s sick in more ways than she admits, I fear.

And again, I do wish her the best.   If I become like her, someone just shoot me. 😮