NEDA Week 2/22-2/28/2015 "I Had No Idea"

My blog is about healthy balance, and I'm trying to create this blog not as a person recovered from an eating disorder, but as a person living and helping  others to live a healthy life. However, I know that the balance in my own life was created through recovering from my eating disorder and being inspired by many people and concepts along the way. So, talking about eating disorders here is very relevant to me.

This year's theme for the National Eating Disorder Association's Awareness Week is "I Had No Idea."

That theme can be taken in so many different directions. Eating disorders have a stereotype, for sure. Whether an eating disorder sufferer or someone on the outside, there are lots of false beliefs that run through our minds when we think of eating disorders. So, it can be surprising, or even shocking, to some people when those myths are disspelled. I thought I would explore a few of those right here.

I had no idea that eating disorder sufferers don't have to be underweight.

This is not just a myth that many people without eating disorders believe, but many people with eating disorders are shocked to find this out as well. Anorexia Nervosa is the only eating disorder that has a weight criteria -- and even that, with the newest diagnostic changes reflected in the DSM 5, is not a hard-and-fast rule. When I began to open up to people about my eating disorder, many people told me that they had no idea. Of course, my eating disordered brain told me that that was because I was not thin, and which may have affected people's shock, but it probably was not the only thing.  Many people with eating disorders hide it well.

I had no idea that behaviors like calorie restriction and self-induced vomiting were dangerous when the person does not fit the diagnostic criteria for anorexia or bulimia.

I have a tumblr blog, where I'm "out" about being a therapist and being recovered from an eating  disorder,  and so I often get anonymous questions about whether or not someone has "a problem." While I definitely don't give clinical advice on there and give general encouragement to seek help from a professional in person, I do notice patterns in the kinds of questions I get! I frequently get questions from people asking if it's okay to fast only a few days a week, if it's okay to purge just a couple of times a month, or if it's okay to actively work to maintain an unhealthily low weight as long as they are eating. NO, IT'S NOT OKAY! You don't need to be sitting in the "anorexia" or "bulimia" box to have an eating disorder -  you just need to be in the same general area as the box. And, that being said, if you're really sure that you don't have an eating disorder, behaviors that mirror eating disorder behaviors are still unhealthy.

I had no idea that following hunger and fullness cues will typically keep you at a healthy weight. 

I fell victim to this one. I believed that my body would lead me wrong, that listening to my body would lure me to eat tons of food and never exercise. I believed that if I listened to my hunger and fullness cues, I would be out of control. The truth is, though, that the reason why I felt that my hunger and fullness cueswould lead me wrong, was because I didn't really know what they were. I don't mean the awareness of being absolutely starving or Thanksgiving-dinner full. Those aren't cues, those are screaming directions for action. I'm talking about the inbetween. The, "I had a snack so I'm not ready for dinner yet" or the "this is the most delicious thing ever but I actually feel like I'm content now. Maybe I'll take home the leftovers." We disconnect from our bodies when struggling with eating disorders, but even many of those without eating disorders struggle to really experience their hunger and fullness. Why? Mindfulness. We are so busy multitasking, focusing on anything but the experience of food filling our stomachs, that we don't notice when we're full, and sometimes eat too much. Or maybe we eat the same daily sandwich out of habit, and ignore the fact that we had an intense workout earlier today and could probably use some additional nutrition. And then, when diet culture is considered, there are so many appetite suppressants and other products out there that confuse our bodies, and "rules" that even "non-eating disordered" people often follow that interfere with noticing and honoring our hunger and fullness cues. I told my dietitian that she was crazy when she suggested intuitive eating. But over time, I began to become more mindful of my body's needs (possibly through my yoga practice, but I'm not entirely sure how) and intuitive eating kind of took hold of itself. I know that the times I have gained weight, I have not been eating mindfully or intuitively. Intuitive does not mean "impulsive." It involves your appetite, your mind, your body. The whole deal. When you slow down and listen to those cues, they won't lead you wrong. It takes time to get in tune with them, but the only way you'll get there is time and effort. 

I had no idea that full recovery from an eating disorder was possible.

I support those individuals with eating disorders who see recovery as a journey and not as a destination, who believe that they will always be inrecovery and not fully recovered. That's not how I feel about it myself but I can support that ideology for others. What I cannot support, though, is future professionals, and current professionals, who deem eating disorder sufferers automatically as chronic, personality disordered, hopeless cases. I was in a class in social work school once, with a couple of other young women who I had met in various stages of eating disorder treatment, and we were discussing policy surrounding insurance coverage for eating disorder treatment. My classmate, who wanted to be a therapist treating eating disroders and did several internships in the field, raised her hand to "explain" to the class why insurance does not cover treatment. "Even research validates that people don't really recover from eating disorders. It's pretty much useless for them to cover treatment. Something like 10% of people make a full recovery." I don't know the source of this statistic, but I don't deny that it might be true. However, like many statistics, it can be colored to make a point when other facts are left out. For example, yes, the number of people, out of the total number of eating disorder sufferers in this world, who fully recover may be very small. However, the total percentage of individuals with eating disorders who receive treatment of any kind may be  equally as small. It's hard to find such a number but it's estimated that a similar 10% receive treatment. So maybe most of those 10% recover - and some don't. And some of those individuals who never received treatment may be able to recover on their own. It's about more than just one basic statistic. I'm proud to say that many of the people I was in treatment with have recovered and are living full lives. 

I had no idea eating disorders were so lethal.

On the opposite side of the coin, though a full recovery is possible, death is sadly also possible. In preparation for a speech I made at my former treatment center, I wrote about the possibility of recovery and how awesome it was to see so many of my peers from treatment living awesome lives. Less than two weeks later, one of my dearest "treatment friends," who I met eight years ago, passed away as a result of gastroparesis complications - a direct consequence of her eating disorder. While her parents expressed to me that, emotionally, she was in a much better place for the past several months, unfortunately, the body cannot always follow suit and emotional progress cannot always correct the damage done. Putting off treatment or recovery till tomorrow, and choosing to focus on school or work, or "just lose a little more weight first" might seem fine right now, but the longer you struggle, the more likely you are to have lifelong, and life-threatening, complications. Not to say that a longtime struggle  is necessary for an eating disorder to be deadly - even a short-term struggle can kill or cause longterm serious medical problems. I knew early on that eating disorders "kill." I had seen enough lifetime movies and even met people on message boads who passed away. I witnessed news of heart attacks and suicides in my acquaintences, peers, and friends-of-friends, but it never hit home like it did when I lost my friend. Unfortunately, I worry that this message will fall on deaf ears. It may never hit home for you reading this until it strikes much closer, but I hope that the knowledge of the lethality of eating disorders informs your own eating behaviors, steps toward recovery, and/or decisions to be sensitive about commenting on others' bodies, food, and struggles.

Other things that people sometimes have no idea about: The power of their words. The impact of their disorder on others. The impact of their diet on others. The importance of treatment in recovery from eating disorders. The incredibly high cost of treatment. The even higher cost of foregoing treatment. The uniqueness of every eating disorder sufferer, and unique needs for recovery. The growing epidemic (or possibly just growing awareness) of eating disorders. The number of eating disorder related deaths ("cause of death" is always listed as the type of organ failure, "eating disorder" is not listed). The fact that eating disorders are not usually caused by the media, but the fact that the media certainly plays a role in triggering and/or sustaining eating disorders. The repercussions of the diet culture in which we live. The effects of malnutrition in a person who is a "healthy weight." The prevalence of therapists who are recovered from eating disorders (including me, and including MINE!). That traditional treatment doesn't work for everyone. The power of education and advocacy. The need for fundraising for treatment. The need for the work of incredible organizations like Project HEAL. The number of individuals recovered from eating disorders who are now doing incredible work as advocates, and  the sadly low portion of advocates who have not suffered themselves. The way your mind really can change through recovery - it's not just about accepting a body you don't want. The gravity of the disease, the cost of help, the hope for recovery, and the possibilities that exist after.

Setting Balanced Goals

I mentioned in my introductory post that the New Year's Resolutions of diet plans drive me crazy. That doesn't mean that I didn't start my year off with a set of goals.

I'm big on "refreshing" your goals once the initial ones have been achieved, and not waiting for the new year or a birthday or even Sunday to get started. But it just so happened that I was doing a lot of  thinking towards the start of the new year, about the changes I want to make in my life.

After being diagnosed with ADHD just weeks after my 28th birthday (and thinking, WOW this explains so much of my struggles earlier in life!) and starting medication, I began better able to organize my thoughts and complete more tasks. Changed meds a couple of times until I got it right, but now that I think it's all in place, I have been able to create - and stick to - a calendar of household chores that I need to do: laundry (frequently - because our washer and dryer are SO SMALL), going through mail, paying bills, and keeping things organized. Oh, and keeping up on top of my progress notes and parent communication for work. This started to fall into place in early December and now it's time to look at the other pieces of my life that have fallen by the wayside.

We always hear "create measurable goals," but I actually find that creating measurable goals, when you have an unpredictable schedule, leads to mentally beating yourself up, on those days when you just can't acheive that goal. Or at least, beating MYself up.

The goals I'm currently working toward for myself are:

Eat more fruits and veggies: I kind of let fruits and vegetables fall to the wayside over the past year. And the truth is, most of my favorite foods are vegetables (except pancakes). My goal is not to stick to a certain number of veggies and fruits, but rather to make sure that my kitchen is fully stocked with fruits and vegetables, that are easy to access (bananas and apples in a bowl on the table thrown into my work bag with a packet of peanut butter, frozen veggies to microwave with my late dinner, baby carrots to throw in a baggie with an individual package of hummus, and reminding myself that I don't ALWAYS need to choose the high protein fish/tofu option when I'm out and can get the portabello dish that is more appealing - should never feel guilty for choosing vegetables...or ANY food but especially vegetables, come on!) I also got into this funk where I was avoiding fruits because of "all the carbs - I would rather have a bagel" but apparently fruit (and vegetables) offer more than just carbohydrates, they offer all these vitamins where, if I eat them consistently enough, maybe I won't need to load up my body with caffeine to feel awake and energized.

NYC Marathon 2015: Last year, I was so excited - I got into the NYC Marathon through the lottery. Only a couple of months later, I injured my ankle/foot and was not able to run for a long time. I had to defer my entry to the next year, but you're only allowed to do that once. So I have this marathon to train for now. If you know me, you know that one of the greatest experiences of my life was running the NYC marathon in 2011, but that I had just started running then and really over-trained to the point of injury and while I finished the race, I couldn't run for a while after. Looking back, I feel lucky that I can run now. So my goal is to train appropriately and adequately for this. I don't need to "go hard" now - but I need to get into a groove and schedule runs into my day-to-day plans, or else I'll forget them. I need to download awesome music  and make sure that I have weather appropriate running clothes. My goal is to work  my way slowly up to race day (early November) so that my body is  strong and healthy when it comes time to do the 26.2.

Cook more: I'm actually an awesome cook. I love to try new things, and have some classic dishes that I love to make too. Cooking actually really relaxes me, helps me to de-stress, and I feel good about the end result almost every time. Finding the time to cook, however, seems to be the trouble. I'm going to try to cook a few times a week - maign things that involve leftovers and things that can turn leftovers into second meals from time to time as well. I'm trying to save money, hopefully to move into an apartment with the GF this spring, and trying to not eat a thousand veggie sticks and a couple of string cheese for on-the-go meals on a regular basis, just for the sake of nutrition. Planning, cooking, and preparing leftover meals for work are on the agenda for this year. 

Me Time: In order to earn/save money, I work a million hours a week. Usually, Sunday is my only day off. I also love to sleep. And spend time with my other half. But sometimes, self-reflection is necessary. Sometimes, a little solitude is good for the mind. Running is also an excellent form of self-care and meditation for myself, so that goes nicely with the me-time goal but I need to integrate other ways of self-care and reflection time. GF does not like to watch the dark crime shows that I enjoy - so instead of sleeping till 12 on my late start days, I'm going to try to get up earlier and enjoy my episode of SVU, or write in my blog. I'm also going to start up Hebrew lessons again, and I always forget how much benefit I get from art. These are my little notes to myself that I will keep on a notecard or in my phone for when I'm bored and don't know what to do so I stare at Facebook (which doesn't really do much for the "me time" benefit, honestly). Maybe it's the ADHD, or maybe it's the fact that I have a crazy busy life, but I tend to forget what to do with myself when I actually have downtime. Keeping a little log of the things I enjoy and want to be doing for myself when I'm able to will help me to take care of me.

With all of these goals, I could certainly say "Jessica, you are not cooking enough. You're slacking on your running. When did you actually do anything productive in your free time? You didn't even eat any vegetables yesterday." However,  could also ask myself if I am doing my best given the circumstances - and if not, taking it as an opportunity to give it an extra push tomorrow, instead of beating myself up for it today. 

Self-improvement, balance, happiness, and inner peace are all JOURNEYS, not DESTINATIONS.

(Do you have any "grey weigh goals" that you're working on  to balance your life better? What do you think of the idea of NOT using measurable goals on this journey to a healthy balance? Try to think of the things you want MORE of in your life, and how to get them. There is no exact recipe for happiness, just listening to yourself - your body and your mind - to tap into what you need to be more balanced. I would love to hear what "grey weigh goals" you are putting into place to achieve balance in your own life!)

One of my latest and greatest discoveries

I was really hoping to start this blog off with some insight and inspiraton, but the kids I babysit were running high fevers all week, so here I am on Friday afternoon with some body aches brewing. Not so full of inspirational words this evening, but I did want to get into the habit of maintaining an active blog here and talk about one of my favorite recent food discoveries...

Quiche.

Quiche is a classic. Apparently, my mom used to make it when I was a very little kid, but when I got older and pickier, I refused to eat it, so it pretty much fell off of our rotation. My first exposure to quiche as a young adult was at a wedding, when they served mini quiches as hors dourves during cocktail hour. A couple of years later, I encountered quiche again, this time on a diner menu. Sick of omelets and veggie burgers (I only eat Kosher meat, for religious reasons, so most restaurant outings mean vegetarian or fish entrees), the quiche caught my eye. Broccoli and cheese - always a favorite combination for me. So I ordered it, and was quite honestly more impressed than I was at cocktail hour. For starters, this diner made their quiche from scratch, fresh daily -I'm pretty certain the hors dourves, though delicious, were popped out from the freezer. It was light and fluffy, but also filling, and SO flavorful. There was a sweetness to it, too. Definitely became my diner favorite (and they offered a few different varieties daily). I never thought to make it, though.

I'm the only one in my family who follows the Kosher restriction, so my holiday meal options are limited. The meat is rarely Kosher, and when it is, I have to opt out of the dairy sides. Truthfully, while I could ask my aunt to buy a Kosher turkey for Thanksgiving, I'd rather eat vegetarian. It's just what my taste buds prefer. But I also like to try to incorporate protein (in addition to carbohydrates and fats) into most meals. Certainly I don't always succeed, and some meals are more balanced than others (that is the grey "weigh" of life, after all), but I wanted to contribute to the meal with a vegetarian-friendly protein option. Last year, I made an awesome edamame salad, but I have an aunt who recovered from breast cancer and has to stay away from soy because of the estrogen, and I have cousins who don't touch such "health foods" as edamame, so I figured I'd try something different, to appeal to the masses. Quiche!

Quiche was on my mind, and a couple of weeks before Thanksgiving, I had a delicious lunch at the Yankee Candle Factory with my girlfriend and her parents, and she ordered a harvest vegetable quiche that had squash, onions, spinach, and grueyere cheese. I was a little sad that I didn't order it for myself, after tasting it (though my black bean quinoa burger was delicious as well), but I left there saying, "I know what I will be contributing to Thanksgiving dinner!"

Having never made a quiche before, I had to google to find a basic quiche recipe, and wanted to get some practice in before making the final product for Thanksgiving. After all, I wasn't sure how hard it would be to mess up quiche, so it was essential to have a practice round. I settled on a recipe that included butternut squash, caramelized onions, and gorgonzola cheese.

I really love the combination of butternut squash and kale, and thought about integrating some kale into the final product (girlfriend does not like dark green leafy veggies so I opted to leave it out of the practice quiche), but the practice quiche came out SO GOOD, that my decision for Thanksgiving was to leave it alone. I didn't make the crust from scratch, and ended up using a gluten-free pie crust, as my sister was recently diagnosed with Celiac and anticipated limited options for Thankgiving as well (okay - it was also all we had in the house). 

Quiche is awesome because it can be modified to meet a variety of dietary needs. I chose to use whole eggs, but if you have someone who is watching their cholesterol, there are lots of quiche (including my diner favorite) that are made with egg whites only. The veggies and cheese, of course, can be modified to your taste. Gluten-free pre-made or homemade crust is just as easy as the traditional wheat flour options, and there are also grain-free crusts with almond flour, and even crustless quiches. My personal recommendation is that you don't skip the crust, though. Helps make sure it's satisfying, not just filling in the moment. 

ALSO: This recipe taught me how to caramelize onions. A very valuable life skill I cannot believe I've gone 28 years without.

Here is the recipe I used - my modifications are in italics.

1/4 cup + 1 Tbsp extra-virgin olive oil, divided
2 medium onions, sliced
water, as needed
2 cups butternut squash, peeled and diced into bite-sized pieces (I used frozen butternut squash, and it watered itself down a little. If you can, I bet it would be better with fresh squash, but butternut does the trick. I found that with the frozen squash, it helped to add a little bit of extra, maybe an extra quarter cup or so.
salt and black pepper, to taste
8 sheets phyllo dough, thawed according to package directions (I chose to use Pillsbury gluten free pie crust - but basically any pie crust will do just as well if you don't feel like doing phyllo...but I bet it's delicious)
4 eggs, lightly beaten
1 cup 1% milk
2 oz gorgonzola, crumbled (I found  that the first quiche was a little bland and I added a little extra gorgonzola the second time, maybe closer to 3 oz or so)
1 Tbsp sage, thinly sliced (I actually didn't use any sage - and maybe that's why I needed extra squash and cheese, but if you don't have it lying around and don't feel like heading to the store, it works just fine without!)

Directions:

Heat 1 tbsp oil over medium heat. Add the onions and saute until the onions are tender, about 10-15 minutes. Reduce the heat to just a bit below medium. Add 1/4 cup water, cover and cook until the onions turn a deep golden brown, about 50 minutes, stirring every 5-10 minutes. (*** if you've never caramelized onions before, this was my experience: every time I stirred them, I needed to add a little water, otherwise the sugar from the onions would caramelize, stick to the pan, and burn. Just a tablespoon or so, every 5-10 minutes, to keep it from burning)

Preheat oven to 400 F. Place butternut squash on a baking sheet lined with foil. Season with salt and pepper and roast until tender, about 30-40 minutes. Set aside. (You can skip this step if you use frozen - just defrost in the microwave)

Lower oven to 375 F.

Brush a sheet of phyllo pastry with the remaining olive oil and fit it into the bottom of a greased 9-inch springform pan with the ends hanging over the side of the pan and repeat with the remaining sheets, placing them on top. (or just put your regular crust into your pan however that needs to be prepared, before you pour in the mixture)

Mix the onions, squash, eggs, milk, gorgonzola and sage. Pour into the crust.

Bake until golden brown and set in the center, 25-45 minutes. Yield: 6 slices. (It took me WAYYYYYY longer than 45 minutes, closer to an hour or hour and a half...just watch and test. Sticking a fork or toothpick in the center to test for doneness...should be soft but not liquid)

I actually did not take a picture of mine - though it looked and tasted amazing - but here's the one from the website I modified  the recipe off of: PreventionRD.com

Does anyone have a favorite quiche combination? I really want to try this again with some kale, and maybe subbing goat cheese for gorgonzola. If you try this, let me know how it goes!

Welcome to The Grey Weigh

It's January. You know what that means. New Year's resolutions are rolling into action. I'm not sure that there's a confirmed statistic on this, but it appears to me that the vast majority of New Year's resolutions are health oriented, and overwhelmingly, the goal is to lose weight. It's almost as if those of us whose goals are NOT about weight loss are forgotten. And if you want to be healthy, do good  things for your body and your mind, you're not very likely to find many blogs, articles, or other Internet sources that help you figure out things to do for your health from a moderate, mindful approach. An approach that doesn't tell you which foods are good and bad, or that there's a certain thing you absolutely must do in order to be healthy. I feel very passionately about intuitive eating, a non-diet approach to life (not just eating), and living life in the shades of grey (not black nor white). I believe that the number on the scale is virtually meaningless (which doesn't mean that it doesn't trigger my emotions sometimes - but that intellectually I know there is little meaning behind that number) in most situations, and don't even get me started on BMI (Body Mass Index).

I wanted to create a blog that's a collection of lessons I've learned through the thousands of dollars I've spent on fabulous dietitians (sprinkled in with some guest posts from these wonderful women, perhaps) and years I've spent moving away from harsh self-judgment about food and body. Thankfully, I've spiced up my network with tons of health professionals, so I hope to bring you guest posts that are about more than just my own personal opinion and experiences.

I also want to share recipes, not that are "low calorie" or "guilt-free" (though I would like to inform you that NONE of my recipes contain guilt, as that is not a nutrient), but recipes that I've found are particularly delicious - ones that let you experience a season or a culture, or recipes that contain several food groups all put into one dish that you can throw into a Tupperware and microwave at the office (hello, quiche!). And even share some suggestions for (I know, I know, this is not mindful eating but sometimes we have to trade the mindfulness for the physical issue of no TIME to consume necessary NUTRIENTS) what you can eat on your commute to stay energized and avoid spending a solid portion of your weekly income at the highway rest stop.

I want like-minded people to have a place to read and learn, and I want those diet-minded people to come here too, and at least play around with the idea that there might be another way.