Discomfort as a Skill

I've become more comfortable with being uncomfortable.  

 

I stumbled upon that realization the other week when thinking about why this time took, of all my attempts at real recovery, and not the other times. 

 

Last autumn I started working on assertiveness.  I bought a workbook, like a middle schooler.  This was initially more for my professional persona than anything else, but I noticed the benefits in other areas of my life, too.  

 

When I was being more assertive, it was easier for me to identify feelings instead of just reacting to them.  It's not surprising, then, that I found myself able to be less and less in my eating disorder as it stopped having reactions to immediately protect me against. 

 

This was all incredibly uncomfortable.  That discomfort has started to pass after many moons, though I'm not sure it'll ever be gone entirely.  

 

It's been supplanted by a different kind of discomfort as I've slowly gained weight since the longtime birth control fully worked itself out of my system in the spring.

 

In PCOS, birth control essentially protects the ovaries and balance the amounts of estrogen and androgens they produce.  When the body has less free testosterone, insulin levels stay steadier, and insulin resistance doesn't develop (at least with me).

 

Off birth control, that protection disappears and the ovaries (and pituitary and hypothalamus) go into overdrive producing androgens. The more androgens in your system, the more insulin your body wants to produce.  The more insulin in your system, the more androgens, etc., etc.  

 

Some of the super awesome signposts of high androgen levels include male pattern hair thinning (such as at the corners of the forehead), oily skin and acne, and the growth of dark, bristly hairs in places you'd prefer they not appear.  (I want electrolysis if I'm not knocked up by Christmas.  NYC medi-spa recommendations welcome.)

 

Those symptoms aren't fun, but they're not so, so terrible.  (Okay, if I'm being honest, the acne is really depressing.)

 

What's making me so entirely uncomfortable is the belly fat that has very gradually grown since about April.  That's an insulin thing, and it means I should really get my butt to a doctor to have a fasting glucose test to see if I need to be on the insulin regulation drug Metformin.  

 

In the meantime, though, talk about the major fear of most eating disordered people coming to fruition:  weight gain, not due to out of control diet, right on your abdomen.   It is so exquisitely uncomfortable*.  

 

But being that I have finally learned how to be uncomfortable, I finally have the ability to just sit with that feeling of I hate this so much when it crops up (which is still several times a day).   

 

About a month ago, I surprised myself by realizing that going into eating disordered behaviors (whether restricting or purging or whatever) doesn't really occur to me anymore.  At some point I took it off the table. 

 

Which leaves me here, with a belly growing for upsetting reasons (if the belly fat weren't upsetting enough all on its own), and the ability to sit with how much I hate it.   That may sound incredibly depressing, but I can assure you, it's liberating.  (If uncomfortable.)

 

Next on the docket: finding a PCP's office who actually understand whether or not they're in my HMO network, because apparently no doctor's office anywhere has fully figured out how to work with the PPACA plans offered on the state exchanges.  But that is a whoooole other post. 

 

 

*"But CN, when you get pregnant your belly's going to grow anyway."  Yes, obviously.  But, you know, that'll be a fetus, not just adipose tissue.

Welcome Back

It's been almost 2 years since I regularly posted.  What's the deal?  What have I been up to?

I decided to step away because I found myself identifying too much as "someone with an eating disorder" even as I tried to recover fully.  At some point I realized that blogging as "someone with an eating disorder" was a self-perpetuating cycle.  Identity is a huge part of many people's eating disorder maintenance, and that was certainly true for me.  "I'm anorexic," or "I'm bulimic," or "I'm a binge eater" becomes as sure an identifier as "I'm from the U.S." or "I'm an Aquarius."

I knew I wanted to get healthier, finally, for good, largely because 2012 was a crap year, and I couldn't take another one like it. 

The bigger reason, though, is that the husband and I realized we both would genuinely like to be parents.   We'd both been in denial about that for a few years, for a variety of reasons.  But in 2013 we started having serious thoughts in that direction, and it proved a fantastic springboard for a real, true recovery for me. 

Maintaining recover hasn't always been easy.  In fact, sometimes it's been really, really hard.  But it's going very well.  Better than I'd ever have thought.

Which brings us to today, or, to begin at the beginning, to January 2014.  At the ripe old age of 19, I went on the Pill largely for its on-label purpose, but also because my periods had never fully regularized, and I thought it couldn't hurt to have something to help my acne.  (Ortho Tri Cyclen had just become the first official BCP for that.)  I stayed on BCP for 12.5 years.  When hypothetical family planning came up at annual exams, I'd ask my gynecologist about my irregular periods before, and she'd wave off any worries with, "That's normal; once you're an adult, and exercising regularly, and eating right, they tend to even out."

I went off the Pill in January 2014 and I waited... and waited.  By April there was nothin' doin'.  I had to find a new gynecologist due to new insurance, and my first meeting with her revolved mostly around my eating disorder history.  She sent me packing with instructions to call in 4 weeks if my period didn't arrive.  By May she prescribed Provera to jump-start my period (and to see if a period would happen at all; she figured my ED had screwed up my estrogen regulation).  Got my period, got told "come back in 6 weeks if nothing else happens." 

I was back there 6 weeks later.  Since about March my skin had been getting worse and worse; I'd started putting some weight on my belly despite no diet changes (that was particularly fun); and I felt like I was constantly pulling more and more bristly, dark hairs out of my face. 

Finally, in late June, I strong-armed my gynecologist into ordering an ultrasound for me. I suspected, after some basic Googling, that I had polycistic ovarian syndrome (PCOS), thought to be one of the most common endocrine disorders in women. 

If you're not familiar with it (I wasn't): PCOS is essentailly a hormone imbalance: your body makes excess androgens such as testosterone.  This in turns leads to ovulatory dysfunction and other reproductive disruption, as well as to fun inflammation-related things like cystic acne and (later) higher heart disease risk.  Jackpot!

"I don't think you have PCOS," my new gynecologist had said at our first appointment in April, solely based on my weight. 

She called me the evening after my June ultrasound, clearly surprised, to tell me that I did, in fact, have polycystic ovaries. 

Isn't being right just the best?

She put me on Clomid (unmonitored -- something I learned is a reeeeeeally bad idea) in July.  By early August we started seeing a reproductive endocrinologist, and are still. 

So NOW that brings us to today. PCOS is diet-sensitive, in that it's directly related to insulin levels in the blood and insulin resistance.  Having to rewire diet and operate from the mindset of not eating certain foods in certain amounts is a tough adjustment for anyone, I imagine, but having an eating disorder history complicates it further.

I debated for several months about whether I'd open up about this here, having known for a good year+ that I wanted to come back to blogging.  After several failed medicated cycles, I find I'm ready to write about it. 

As you can imagine, the focus of this blog is going to shift a bit from what it used to be.  I still plan on covering timely topics related to eating disorders, food, feminism, the portrayal of women in our media, and all the things you're used to seeing here.  I feel I'm ready to do that again from the identity of someone who's recovered, not someone who's in an eating disorder.

But I also plan to focus on the journey of infertility; on what it feels like to be diagnosed with and then try to live around PCOS; and on the intersection of all these themes, old and new.  Because boy howdy, do they ever intersect.

So there you have it.  Welcome back, [hypothetically-still-here] readers.  And welcome back, me.  I've missed you!

Helpful Holiday Eating Disorder Support Ideas

The other week, I sent [redacted] an email asking her, in all caps, WHY, WHYYYY I ever go to Blisstree?  So often that site is a miasma of body-negative, food-freaked-out bleh that I just can't even go there.  (And yet, I do.)

However, here's a piece there that really, for me at least, gets it right:

How To Cope With Holiday Weight and Eating Stress... Without Triggering An Eating Disorder Relapse

Non-AP capitalization style aside, this is finally a Blisstree piece to which I am happy to direct some traffic.  Doubtless that fact is buoyed by the author's being in recover herself.  Regardless, it's short, sweet, and written in accessible yet not dumbed-down language.

Something else about it that specifically stands out: the piece outright discusses purging, which so much ED-related media doesn't.  Anorexia being the daintier disease (in popular culture, at least), bulimia and the other disorders that typically involve purging are sort of the ugly stepchildren (despite the fact that their sufferers are much more numerous).

And I definitely second the suggestion to audit the media you consume over the holidays, though frankly, even at this experienced stage, that hadn't really occurred to me.

Anyway, give it a read, if you like.  It's stamped Cynical Nymph Approved.

Mental Illness, "Overmedication," Us

I'd like to say a word about psychopharmacology.  This word's been percolating for a couple of busy weeks and today presents my first opportunity to express it here.

Obviously I haven't been blogging predictably for a while.  Part of this is generic busy-ness.  Part of it's apathy and self-defeat.  But part of it's crippling, numbing depression.  (Okay, I admit, that and the apathy and self-defeat might be related.  Just a bit.)

Look, it's been a helluva Fall.  The past several weeks in particular have been difficult.

And for whatever reason, in the midst of all the difficulty, I made the patently farcical decision to titrate off of my SSRI.

Uh, yeah.  Awesome idea.  That went about as well as you might expect, particularly given my absence in these parts as of late.  (Which usually implies a not-so-hot spell.)

So, I titrated off of my meds.  Some vagueblogging-worthy stuff occurred.  I ended up in my therapist's office this Tuesday, sobbing.

I started stepping back up to my normal SSRI dose Tuesday night.  I already feel better.  Everything isn't roses and rainbows and kitten farts, but I feel better.

In a certain slice of our culture, it's correct to conclude that we're an "overmedicated" society.  There's this assumption that we're "overmedicated," that we as a greater entity are happy to pop a pill rather than… whatever other option we might have.  Even when we're the ones directly benefiting from psychopharma meds, as in the link there, some of us (including me sometimes) are dedicated to the belief that our culture is overmedicated, pill-happy.

But what does that really mean?  This month I've been percolating the idea that maybe it's just an extension of our Puritanism to insist, even if we are individual evidence against the theory, that we are An Overmedicated Society and that medication is Usually Not The Answer.

Well, what do we mean, "overmedicated"?  What do we mean when we say that?

Do we mean to support the stigma against psychiatric treatment?  Because the trope that Americans are ready to pop a pill rather than deal with a "real" problem supports exactly that.

Do we mean that medication should be reserved for "real" problems rather than depression, which we should white-knuckle through? Or rather than personality disorders, which aren't directly impacted by medication according to current evidence?  Because medication can mean the difference between having and not having the extra psychic energy to mount a fierce battle against, say, borderline personality disorder, or bulimia.

But, you know, I don't care what we mean.  The implication of "overmedicated" is, eventually, "over-treated."  The implication is hierarchies, is real struggles and ersatz ones.  Is a continued stigma in reaching out for support for mental illness.  Is, at the end of the day, continued bullshit.

We're not "overmedicated."  We're under-treated.

Please take a second to imagine a U.S. in which psycho-social counseling and other treatments were readily accessible and universally unstigmatized.  Really, really take a moment and imagine what that might look like.

Now tell me with a straight face that you sincerely think we'd still be "overmedicated."

I know I don't think so.  I don't know - I might be in denial.  I might be exactly identical, psychopharmacological speaking, in this alternate reality as I am here and now.  But maybe not.

Look at me, write to me, with a straight face and in good faith, and tell me that more accessibility from day one might mean less need for psychopharma medication at day seventy-three hundred (or day two thousand, or day whenever).  (I'm at day eleven thousand two hundred eighty-something.)

They'll Probably Write a DSM-V Entry About Me

I just realized, you guys:  I have become a Bizarro Toddler.

By which I mean that during this weight gain kick I am going to have to hold over my own head, as culinary rewards, fresh fruits and vegetables.

I was just* sitting here with some shrimp, zucchini, and wagon wheel pasta (yes, wagon wheel, a.k.a. best pasta ever), and I am literally thinking to myself, "You eat your pasta, missy!  Yes, all of it!  Nooo, you can't have any zucchini until after you eat that pasta!"

At breakfast it's, "No you may not have peanut butter on an apple.  You will have it on toast.  Then you can have some fruit."

I guess this means I should now hate cookies?  Yeah, no.


*last night (sched'd this post due to out of town trip)

The Appeal of Pro-Ana

Late last week the NY Times blog Well profiled a website, Proud2BeMe, the aim of which is to provide an alternative of pro-ana and thinspo sites.

This is the key passage for me:

For a recent study, she and Nicole Martins, an assistant professor at the university, talked to 33 pro-ana bloggers, women ages 15 to 33 who were willing to be interviewed. The study, published in August in the journal Health Communication, showed that participants were motivated to blog as a way to cope with a stigmatized illness and a means of self-expression and social support.

Pro-ana has always been a seeking for peer support.  I haven't been on a pro-ana/pro-mia site in a long time (yes, the latter exists, but as with so many things bulimic in the eating disorder world, it tends to get brushed under the media rug in favor of the sanitized view of anorexia).  But when I did frequent them (mostly in high school) (yes, they existed then) I can say to the best of my recollection that the participants were never anything but kind, warm, and open-minded.  

I don't know if my experience was typical, but when girls went into treatment or gained weight, or started LiveJournals (they weren't called "blogs" then, not quite yet) talking about their recovery?  The response I remember was always very supportive.  I don't know about now, but then, these weren't sites about keeping each other sick (at least not deliberately).  

And to be totally honest, they were a space without men.  Actually, scratch that.  There were some boys and young men on the LJ pages where I participated or followed.  But they were very... how to describe it... funhouse-mirror feminist.  Feminist except in that eating disorders are an angry, proud symptom of everything anti-feminist in our culture, much in the way that hysteria can be seen as a symptom within that earlier culture.

They were sites about not judging one another.  Yes, in a very disordered way, but there it is.

And that's more than I can say for the commenters on this piece.  >_<

• Eliot W. Collins

• Raritan Borough, NJ

I rarely see anyone who is obviously anorexic. I do see many people who are obviously obese. They are everywhere.

Charming.

Running and Weight Gain

A Quick Word:  Beginning with this post, you may start to see Content Notes here on a semi-frequent basis.  These will most often appear when I am going to talk about calories, pounds, miles, or other measurable, competitive things.  I'll note the specific sections, not the entire post.

I enjoy running, now that I'm into it, and I really don't want to have to stop so that I can gain weight.  But I can't afford a nutritionist right now, to sit down and do meal plans with me.  So I've got to figure out on my own (with the help of my therapist, but she isn't a nutritionist) what I can eat safely (in the symptom-use sense) that will allow me to gain weight.

[Content Note: Calories and pounds ahoy]

In order to gain one pound per week, you have to consume about 500 calories per day more than you are burning, for a total of about 3,500 calories a week.  (This is assuming a normally functioning metabolism and etc.)  

The less you weigh the fewer calories you expend during physical activity (again, assuming everything else is functioning with chart-like precision).  So if I'm only burning, according to the Mayo Clinic, about 153 calories every two miles I run, I only need to be adding 500 calories a day, consistently, to what I'm eating, and about 153 on the days when I run.  I mean, I'm not exactly training for a marathon here.  Or a half-marathon.  Or a 10K.  I could probably handle a 5K.  Maybe.  Sorta. 

(Now you can backwards-math it if you want to know how much I weigh right now, but I'm not spelling it out for all eternity on the Internet, because it is such an embarrassing number.)

[End Content Note]

We're really only talking about padding on some extra calories to meals or foods I would already eat.  But add in the emotions and fears and crap that comes with weight gain, or with the idea of weight gain... and suddenly things are complex.  There's only a certain amount of "just do it" I really have in me.

But anyway.  That wasn't the point of this post.  My point is:

DO YOU KNOW HOW BLOODY HARD IT IS TO FIND A WEIGHT-GAIN-FOR-RUNNING MEAL PLAN?  

Really, I feel like I broke Google.

You can find, quite literally, bite-by-bite plans for weight LOSS while running.  The best you can (easily) find for weight GAIN is on Livestrong.com* and I'm just so gratified to see it exist at all that I won't really get into my disappointment over not finding meals there easily planned out for me, like I can REALLY EASILY FIND on all kinds of WEIGHT LOSS WHILE RUNNING sites.  (I mean, entire weeks of meals you can find.  I found one with TWO weeks' worth.)

There actually is a page on Livestrong.com that spells out a sample day for gaining weight with nutritionally sound foods, but a) I won't link to it here because in the context of an eating disorder blog I don't want to go, "Here! I'm eating way less than this right now! That's how you lose weight!" and b) the foods listed are things that elicit the following first thought from me:  "But once I gain weight I can't eat those foods anymore because they cause weight gain.  So obviously I can't eat them now, because I'll never be able to stop eating them, and then I'll never stop gaining weight."  Do you see what it is like inside my head?

So.  Tuesday's plan: Eat something with peanut butter for breakfast.  Don't panic.  Take it from there...

* I've actually become a fair fan of the whole Livestrong site, since it does have an overall easy-to-find weight gain category, something that absolutely can't be said of, say, Runner's World.  Not surprising, I guess, since Livestrong's origins are in cancer treatment and recovery support, where weight gain can be a significant concern.

Weight, To Scale

I did a silly thing.  A really silly thing.  I used the gym scale wrong.

The gym scale is much like a doctor's office scale.  It's got two metal sliders: a little one and a big one.

Did you know the big slider is not just at intervals of fifty?  The little slider is by ones up to "50," with clearly marked halves and tenths.

But the big one, as it turns out, marks fifty pounds, then ninety pounds (signified by a "40"), then one hundred pounds, then one hundred fifty, then one hundred ninety, two hundred, etc.

Guess what I just noticed about the big slider this week?  Yeah.  In my defense, the notches for "40" and for "100" are really close together.

I am not a compulsive weigher (or at least, I'm not since the husband threw out my little digital scale in the winter).  Since June I've probably weighed myself sixish times.  The first of those, in mid-late June, was when I thought I'd gained a certain amount of weight all of a sudden.

I weighed myself as a reality check about four weeks ago, and my weight was low-ish.  (Well, okay, I call it "low-ish."  My therapist calls it "still a really low weight.")  I weighed myself Tuesday and it was all of a sudden healthy-ish, even though none of my clothes fit differently, and my bras were still too big.

"How odd," I thought. "Just like in June, only this time I don't feel like clawing off my own skin.  Yay!  I must be getting healthy!  I mean, I imagine I've put on some muscle as I've been jogging more quickly, but wow, I never imagined I'd get to that weight and not feel disgusted with myself at first!"

Then, on Wednesday, I looked at the scale again.

Then I said, ".... Oh."

Then I adjusted the big slider to the right.  Then I had to move the little slider to the left, left, left some more.

At a remove, I'm fascinated by my reaction in June (when I am pretty damn sure I was doing the exact damn thing with the stupid scale) versus my reaction on Tuesday.  In June I felt as if I were going to fly apart, so visceral was my feeling of engorgement.  Tuesday I felt.... good.

Wednesday I felt embarrassed, and not just because of the silly scale mistake, either.  I felt embarrassed because some larger part of me had finally wanted to gain that weight.  Tuesday I felt scared, but proud.

I am having such trouble taking enough food into my stomach at one time to allow for appreciable weight gain.  The feeling produces such unmatched anxiety that it is hard to hold on, and to remember that feelings are like waves, with peaks and lulls.  At the same time, I am embarrassed about my body.

It feels as though most of my mind is ready to move ahead, but my body has a humiliating hold over some little part of it still.  Hm.

Someone bring me the pliers.

Blog Love: Binge Eating Rats and Nutella

I'm in blog love.

This blog has been around for a while, but I only discovered it via Twitter this weekend*.

It's a PhD's brain blog, and she's talking about binge eating rats.  And Nutella.

It's basically the perfect blog post (for me).

Here she's describing how a study created binge eating behavior in female rats:

The female rats were exposed to this palatable food…but not permitted to eat it. They were allowed to smell it and ALMOST to touch it. This caused the rats a certain amount of frustration and stress, and when exposed to the actual nutella mixture, they will then binge eat on it, much more than animals seeing nutella for the first time.

Fascinating.  Truly.  I find that utterly fascinating -- and not at all surprising -- in the context of animal behavior (including human animals).

She essentially just described the restrict/binge cycle that fuels most eating disorders.  (In anorexia a binge is not an objective binge, but subjective binges occur more often than not.)

When I started reading this post, I thought, "Oh no.  She's talking about appetite?  Does she really not know that eating disorders, including binge eating, have nothing to do with physical appetite?"

I love having my wrong assumptions thrown in my face, times like these.

The post itself doesn't really acknowledge the eating disorder spectrum-wide presence of this same cycle, which is fine.  It's not an eating disorder blog, and the post is talking about binge eating rats, not generally about human eating disorder patients.

What she doesn't state and what I'd like to highlight is that reducing or eliminating the binge eating symptom (or whichever ED symptom) doesn't reduce or eliminate the disorder.  Rather, like in addiction, once you achieve a reduction in symptoms (or "uses" if you will), you then begin to work on the disorder itself.  The disorder isn't the symptoms, but you can't work on it in the midst of symptoms, not really.  And that, more or less, is the point of psychopharm treatment in eating disorders.


*Someone was dressing down Naomi Wolf's new book Vagina: A New Biography, and pointed here to argue that if the science Wolf describes were really as groundbreaking and yet sound as Wolf wants it to be, someone like Scicurious would've been going on about it for a while already.

English to Eating Disorder Translator

"Baby, you look so much healthier.  Like, looking at these pictures of you from six months ago, you can tell in your face how much healthier you are."

What he means: Your skin is glowing.  You smile more.  You don't have that pallor of malnutrition.

What I hear:  Your face is puffy.

What that means: I look fat.


"You look so much better now."

What he means:  You look so much better now.

What I hear:  You really gained weight!

What that means:  I'm going to keep gaining weight, uncontrollably.


Feh.


"I know this is hard, but I also know you want a healthy life together, like I do."

What he means:  I know this is hard, but I also know you want a healthy life together, like I do.

What I hear:  I know this is hard, but I also know you want a healthy life together, like I do.

What that means:  He knows this is hard, but he also knows I want a healthy life together, like he does.


There we go.  That's better.

(Body) Love In The Time Of "Globesity"

So, this happened.


I would be lucky if I were able to have only two reactions to this release, and if those two reactions were the following:

1)  LOL, "Globesity."  I would have LOVED to've been in the room when the marketing team came up with that one, LOL.

2)  LOL, Bank of America Merrill Lynch still wants people to take its advice, LOL.


Sadly, I am not that lucky.  (Is anyone?)  Instead, my reactions included the following:

1)  >_<  cringing

2)  ಠ_ಠ  disapproval

3)  \(-_-)/ tossing my hands in the air and giving up

The cringing comes from an overwhelming feeling of Here We Go Again-ness.  It's a little hyperbolic, since I expect this press release won't exactly take over the Internet tubes.

The disapproval comes from immediately calling to my knowledge that something like 5% of weight loss tactics prove successful in the long-term, and that often they prove harmful. (Aminorex, Mediator, Fen-Phen, Redux, Meridia, Acomplia, etc.)

(Which is to say nothing of the anorectics still on the market that carry significant side effects such as pulmonary hypertension, acute glaucoma, etc.)

(Which is also to say nothing of the hilarious meta information you can pull up about these drugs if you google their names.  Example: "An experimental wonder drug, Rimonabant, helps you lose weight, quit smoking and it also helps protect your heart."  Except it did the opposite, in that it greatly exacerbated suicide risk.  Whoops.)

But the third thing?  The tossing my hands in the air and giving up?  That comes solidly from trying to exist in a weight-loss-obsessed culture while trying simultaneously to gain weight and to keep sanity.  (And I do not say that colloquially.)

It's quite an experience, trying to go against most of the food- and body-related messages that are everywhere - just everywhere.  I would like you to imagine being online, watching TV, walking down a street with ads, waiting in line next to magazines at the drug store, going down aisles at the grocery store.  Now take note of how many words and images bombard you with just two basic messages:  LOSE WEIGHT.  LIMIT WHAT YOU EAT.  This is not hard for you to imagine: if you live in a Westernized society, you probably live this most days.

Now, please imagine that instead of losing weight, you are actually supposed to be gaining weight.  Please imagine that instead of limiting what you eat, you are actually supposed to be giving up your hyper-control of food.  Please imagine that doing this with your food is actually changing your body and changing its shape, its weight, and its size.  Now, please imagine that in the most twisty chunk of your grey matter, you are really, truly terrified by these changes.  Panicked.  Horrified.

Now please tell me how all the LOSE WEIGHT, LIMIT WHAT YOU EAT messaging is healthy for you.

Weight can be a factor in health - high or low.   But the diet industry, the obesity panic, and now apparently the investment banks... They are not adding to the health of the human population.  They replace self-love with torture, and sanity with knee-jerk madness.   I am trying to love my body as it changes... er, or at least to not hate it... but this crap isn't only hurting people like me.

(via Marianne, via s.e. )

Eating Disorder Recovery: Body Over Mind

It's been an up and down time, literally.  My weight was really quite down for a while there.  I broke below the three-digit mark for a couple of months, which hadn't happened since 2003.

And now it's back up.  Just... boom, like that, all of a sudden.  Back up above BMI-chart-underweight.  Back up to something near BMI-chart-healthy-weight (which is lower than my historical set point weight, but whatev).

And I hate it.  I hate it, I hate it, I hate it.

There is only so much reasoning, only so much logicking, only so much Pro And Con Listing I can do.  I hate it.

The husband loves it.  He's been more helpful than not, though he does suffer from Heteronormative Man Syndrome, which means trying to solve problems before just listening.  (For that matter, I also suffer from Heteronormative Man Syndrome with him sometimes.)

But there's only so much he can help.  This one's on me.  And I hate it.

I wish I could better describe the internal experience:  That I've been tricked and betrayed by my body... that I know (without believing) that my body's just doing its thing, and that it's not tricking or betraying me at all... that I also know (without believing) it's my mind that's tricking and betraying.  I can know, and know, and know... and still not believe.

And that, of course, is the disorder.  That's how having anorexia or bulimia or ED-NOS is different from... well, shit, from normal modern life for a horrendous percentage of the Westernized world.

In recovery (from an eating disorder, from OCD, from addiction, from depression, from anything) you hear the refrain from those who went before you:  It'll get easier, it'll get easier.  So while my mind is still rebelling at that promise, I'll try to follow my body in the meantime.

But, oh, do I hate it.

How to Approach Someone with an Eating Disorder, According to Daytime TV

In the spring I went to a taping of Anderson Cooper's daytime talk show.  I'd forgotten about it until Monday (congrats, Silver Fox) (he shook my hand at the taping) (I kind of didn't want to wash it afterward) and it finally dawned on me to hunt down some clips online to see if any of the cameras they stuck in my face (audience reaction shots) ended up with me on syndicated television.

At some point the show appears to have had a segment on teen eating disorders, because there were a few pieces of web content about what triggers eating disorders, etc.  This is all via a very media-friendly-looking licensed psychologist, Dr. Ramani, who seems to make the talk show circuit.  The list of triggers was very age-range-specific to teens, and isn't really anything you've not read a hundred times before.

The How to Approach Someone with an Eating Disorder I find a little more problematic.

Number One
Parents must create a healthy food space and model healthy eating and exercise behavior.

Okay, but what does "healthy food space" mean?  What does "healthy eating and exercise behavior" mean?  There aren't clips readily available on the site, but I assume that to Dr. Ramani this means what it means to most eating disorder specialists: food as physiological and social enjoyment, not as a moral issue, a varied diet and exercise/sporting activities geared toward having fun and feeling good.

Great, but do you know what "a healthy food space" and "healthy eating and exercise behavior" mean to parents I've known?  They mean never drink your calories, broken record statements like "are you sure you want the whole bagel?", and constant vigilance of going up a size... and for them, that IS a healthy food space.

Number Two
Create open lines of communication.  Be present with your daughter.

Or son.  I mean, statistically daughter, but here we run up against the evils of daytime TV.

Number Three
It is critical that they see a physician...

(This one's long, and perfectly sane.)

Number Four
Don’t let fear stop you from talking to your daughter.

This one dovetails well with part of the slideshow's intro:  "In terms of approaching them, parents often feel fearful and their first attempts can often be accusatory and put their girls on the defensive."  Amen.  Been there, done that, and obviously it worked really well, since that was fifteen years ago.

Number Five
Talk to a mental health practitioner with a specialty in this area about how to approach your child specifically. You do not need to suffer alone.

Agreed, but be aware that your daughter may well lie to the mental health professional, and that mental health professionals only have the patient's word if it's a first-time meeting.  "Do you ever purge?" the first psychologist I was taken to asked me.  "I mean, I've tried it once or twice," I told her, instead of the truth.  "Well," she said, "Now that I've seen you I'm not so worried about you."  And again, we see how well that worked, since that was almost ten years ago.

Number Six
Make sure you and your partner are on the same page...

This... this has got to be a tough one.  My parents were always on the same page here, as it were, so I can't volunteer any criticism or tips here.

That's it.  That's the daytime TV website version of how to approach (your female teenaged) someone with an eating disorder.  Nothing you haven't heard before, but it certainly leaves a lot of grey areas that could edge into the problematic.

Recovery Relapse (Yes, Really)

It is possible - just possible - that April and May were total shit.  I am admitting to nothing outright, but let's just say that it's possible and leave it at that.

Put another way, sometimes I feel like the only person on earth who can attend a wedding rehearsal dinner involving pizza and a birthday party involving cake, and come away losing weight both times.

Despite being in really excellent care right now, and despite really, honest-to-god trying, I have actually gotten to my lowest weight since at least June 2003.  Lose.  Lose, lose, lose.  Loser.  I feel like one literally and colloquially.

I've been keeping a food log with my therapist, and it does give me a fair amount of insight into, "Okay, that really is NOT enough food to maintain this weight," as well as, "Wow, I sure do eat a lot of apples and bananas."

I am just so angry with myself that I want to cry.  I've always been an angry crier.

I can't blame myself totally (not in the sense that I blame other people for my own actions) because April and May were... Wow, you guys, they were epic, and their epic nature was not of my making or under my control. 

The rest of June and July are going to be tough, but better.  I hope.  I pray.  (I don't pray, literally.  I... concentrate.)

It is my intent to blog more frequently, but the blog might turn into a spate of navel-gazing for a little while (ha, I mean, more than usual) in tandem with some "homework" for my treatment.  You've been warned.

For now I'll leave you with a flower.  It's blooming at my East River park right now, and it is a singularly comforting shade of yellow.

The NY Times, Meat Eaters, Ethical Eating, Lazy Thinking

Let's chat about this contest in the NY Times Magazine, asking entrants to reason out the strongest ethical argument for meat eating.

As someone who is currently embroiled in a battle with myself to make it okay to eat anything (steak, macaroni & cheese, oatmeal, whatever), I read this from a very specific point of view.  Short version: "Animals are sentient beings and I try to eat ones that I know have been treated well.  However, right now, I have to pay most attention to eating protein in appropriate amounts and to getting re-attuned to my own intuitive eating cues."  (You should know by now that this is what passes for a "short version" with me.)

So from that somewhat specific yet hardly unique standpoint, how do I read this contest?  (Literally read and figuratively "read.")    First, I kinda dig the winning entry.  I particularly appreciate what many vegetarians and vegans I've known tend to ignore in chat (with me, at least): soy production is not necessarily much less stressful to the earth than some forms of meat production.  A soy farm using petrochemical fertilizer is above and beyond a small or mid-size organic, cage-free poultry operation, in terms of damage to the local ecosystem.

Unfortunately, the winning essay doesn't actually correlate with the real world most U.S. citizens live in today.  If you're living in the Sonora Desert in a yurt, then yes, you presumably have access to the ethical options the author describes.  But if you're living in a Sonora Desert in an adobe ranch house with your Honda Civic taking you back and forth to Whole Foods, then going out and hunting lizards is not for you.

Let's skip back to the contest wrap-up piece itself. (Emphasis mine.)

Some critics insisted that even contemplating a life without meat was an indulgent luxury, a silly game for a wealthy first-worlder. I found this puzzling — as if the poor feast nightly on roast suckling pig and only the 1 percent eat boiled tubers. Over all, rich nations eat much more meat than poor ones, and raising animals for food takes more agricultural resources than raising crops. In any case, a vast number of the world’s ethical vegetarians live in India. Caviar is a luxury. Ethical discussion is not.

Problematic statement is problematic.  Actually, Ariel Kaminer, what the poor in the U.S. do is cut high-fat hamburger meat with rice and vegetables to stretch the protein farther, whereas the middle class and rich buy the 90% lean ground beef and mix in free-range eggs when making their Italian meatballs.

What the poor do is buy ham and bologna cold cuts that are such a high percentage water and sodium that their texture resembles rubber more closely than pig or cow flesh, whereas the middle class and rich get the stuff sliced at the deli counter that's antibiotic free, fresh roasted in the store, etc.  Ethical discussion is, at some point, a luxury.  Deal with it.  Moving on.


A few months ago Mark Bittman (I think it was him - he's a heavyweight in the NYT Dining section, and one of the judges here) noted that McDonald's has requested that its pork suppliers phase out their gestation crates, and he rightly pointed out that this was, as the kids say, kind of a big deal.  McDonald's is a huge buyer of animal products of all kinds, and what they say essentially goes.  People can rant and rave against the ethical evils of McDonald's, but their new policy on gestation crates will create huge, forward-moving waves in the hog and pig farming industry.

Having said that, this was an interesting snark inclusion:

The contest is anti-pig-istI don’t get why the contest graphics failed to include a pig. Pork is a more popular meat than goat, lamb or veal. Lobster, fish and squid are not meats. Since there was no pig shown in the graphics, it made me feel people who eat pork were not welcomed to participate. BLASMAIC, WASHINGTON, ON THE 6TH FLOOR BLOG

Honestly, it is strange that a pig isn't included, since gestation crates are one of the better-known ethical violations going on in factory farming, and this is a discussion on the ethics of meat eating.  I'm not sure where the writer jumped from "no pig" to "pork eaters not welcome," but the point stands.


People saw conspiracy in this contest, and misogyny, and racism, and more. Honestly, all I see is lazy thinking.

Eating Disorder Recovery: Check-In

As you might have noticed, I haven't been around much during the slide into the worst part of my relapse, nor much so far during my early weeks striving for recovery (again).

This is mostly because the worst part of my relapse tied directly into things I can't get into on this blog for my own privacy (for all that this blog is at least semi-anonymous).

It's also also because ~dearth of interesting ideas~

As a general update for those who are playing along at home:

- My weight has finally started to go back up.  I had my annual GYN exam Friday and (in jeans) I was back up to my weight from about October.  If you saw me in October, you're going, "Seriously, that's it?" right now.  And yeah, seriously, that's it, but I'm calling it a win.  (Point of interest for longtime readers: my doctor actually laughed [with me not at me] at what a painful-looking job I did on my last wax.)

- Today I had my first ever super exciting echocardiogram.  (Pro tip:  it was cold.)  I meant to ask for the pictures to be emailed to me (because who doesn't want to look at their own heart? I sure as shit do) but I forgot.  Pretty sure I forgot because I had to fast before this appointment.  I may have a history of anorexia and all, but I do not do well with fasting.

- Last night I had an intake meeting for a NYC-based organization called the Center for the Study of Anorexia and Bulimia.  This will be to find an individual therapist who is more effective for me than the one I was seeing in 2011, as well as possibly for group therapy.  I'm going to a separate monthly support group for the first time on Thursday night, through a group called ROAED.

- I have been (for a whole 8 days now) going to the gym in our building's basement.  I can say without exaggeration that this is - for whatever reason - the first time in my life that I've gone to the gym without undue obsession over calories burned.  No idea why, but I'm not looking a gift horse in the mouth.  [redacted]'s jaw will hit the floor when I tell her that I actually ran today.  (Okay, I ran for 4 of the minutes.  What.  It counts.)

I have more to say.  About marriage and recovery and how it's a whole other beast recovering while partnered than recovering while single.  About trying not to play the Cassandra with hand-wringing over, "Oh, it's not so entirely horrendous now, but it's going to be, oh, it's going to be!" About things that are more interesting than bullet-pointed lists, generally.

But that can come later.

Eating Disorders: Magical Realism

I am really, super tired of feeling like I want to scratch off my own skin.  I haven't even been feeling that way that long, really only about 48 hours.  But it's here.  The mental piece of knowing I'm consuming more nutritive things is no longer alone.  Now it's being slowly but surely joined by the feeling of body parts filling out, just ever so slightly.

The husband has been asking me how I'm feeling.  Tuesday I told him that I was still mostly feeling fine, that perhaps this wasn't going to be as uncomfortable as the formal weight gain I've gone through in the past.  Those programs (partially because of insurance limits) tend to focus on high calorie meals all the time, as much weight gain as quick as is physically healthy.

Realistically speaking you have to expend serious effort to gain any more than about 2 pounds of fat/muscle (as opposed to water) in a week.  (The same is true for losing fat/muscle as oppose to water.)  Realistically speaking the things that recoup "padding" first are things like organs (ever seen a healthy heart in autopsy photos? it has some fat on it).  

When the husband asks how I'm feeling and I share that there are moments of discomfort, he reminds me that the discomfort isn't based in reality.  And that's true, of course.  It's not.  But simply knowing a feeling isn't based in reality is, of course, not enough to just stop feeling it.

My fear is now, as it has been before, that I will continue to gain weight (which I will) but that I will not get used to it.  That I will hit my body's natural set point, and just never feel comfortable there.

Realistically speaking, there are a lot worse ways to feel trapped in your own body and mind.  Magically, that reality does not make me feel any better.

Eating Disorder Recovery: What Do You Want to Eat?

When you first start trying to eat like a "normal" person again, there's usually a period when you feel just obsessed by food.

Now, eating disorders are of course functionally obsessed with food anyway - what you are eating, what you aren't eating, how much you're eating, how little you're eating, what you're going to eat and keep, what you're going to eat and "get rid of."

But in early recovery, the feeling of obsession takes on a different quality.  Since it's been however many weeks/months/years since you were "allowed" to eat what you want, suddenly you have to... you know... figure out what it is you want.  At every. single. meal.

Going from not thinking about what you want because there are only certain things you eat in your disordered routine, to having the option of deciding what you actively want to eat, at least three times a day, is an unexpectedly major adjustment.

I mean, we're talking about, there is a lot of food to choose from, setting aside things like money and assuming you're not working around allergies/sensitivities.  Bagel or toast?  With egg or cream cheese?  Any cheese on that egg?  Any tomato on that?  Or will it be oatmeal or granola and yogurt or yogurt?  What about the fruit on that - strawberries or banana or other berries or mango or kiwi or what? 

Or what if you want to be really brave and eat something everyone else calls "bad"?  I mean, those are all fairly "healthy" foods I just rattled off.

And that's just breakfast. 

And we're still not at the "actually gaining perceptible weight" bit yet.  Oh, no.  That comes later.

No, early on the challenge is all around, "It's okay to want to eat that," but even more so around, "It's okay to have to think about what you want to eat."  Allow me to get cheesy for a sec and extrapolate from there:  "It's okay to think about what you want."

Oh, lord.  Well, I've had my cheese quota for today, then.

Recovery Redux (Redux)

Basically every day over the about two and a half years it took for my weight to reach bottom, almost every day, I said to myself, "It's going to suck putting this weight back on and eating healthily again.  It's going to suck royally."

And it does.  It does, in fact, suck royally.  Imperially, even.

I haven't actually begun to even gain weight yet, but rather have just been getting more nutrients and calories into my body.

And yet.  It sucks.  Royally.  Imperially.

I'm distracting myself a lot with work, or sudoku, or rereading The Lord of the Rings.

I'm thinking happily about all the summer clothes I have, and love, that are too big right now.  I'm taking deliberate time to appreciate the physical energy I have.  

I'm breathing through anxiety.  I'm going through nutritionist litanies in my head, about how feelings are like waves, they have peaks and they never last forever.

I'm surviving, so far, but it sucks.  It sucks royally.

You guys, it hasn't even been one. week.


This sucks.

Questions Not to Ask Someone With an Eating Disorder: Did You Gain Weight?

It was a bad week.  A bad, bad, bad, bad week.  All things considered, my eating really wasn't that bad.  At least, it wasn't bad, bad, bad, bad eating.  I actually managed to probably eat more than usual.

Combine the out-of-the-ordinary eating with the bad, bad, bad, bad week, and I'm just proud I got through it without imploding.

So what do you not do after something like this?

You don't ask me, apropos of nothing, probably not even thinking of the change of eating or the tough week, "Did you gain weight?"

You don't ask that of an eating disorder patient, period.

You don't ask that unless you're a doctor, a counselor, or a nutritionist.

You don't ask that in the manner you'd ask an alcoholic, "Did you go to AA?" or the manner you'd ask someone with borderline personality disorder, "Did you sign up for the DBT group cycle that starts next week?"

First of all, I don't know if I gained weight.  I haven't weighed myself in about a week and a half or two weeks now.  The last time I weighed myself, it was the lowest weight I've seen since 2003, and it was officially anorexic.

At this point, I know my struggle well enough to know that if I weigh myself around now, no matter what the number, I'll take it the wrong way.  If my weight's the same, I'm relieved but also ashamed.  If my weight is down, I'm ashamed but also have a little frisson of accomplishment.  If my weight's up, I'm ashamed but also proud but also panicked.

You don't ask an eating disorder patient, in the manner of checking whether an assignment was completed, "Did you gain weight?"

It doesn't work like that.

I gain weight -- and keep it on -- when I start to feel emotionally safe doing so.

I start to feel emotionally safe keeping on weight when food and body and weight stop taking the places of things I'm really trying to say or do or feel or figure out.

Food, etc., stop usurping the places of real experiences and challenges when I feel allowed to figure out what those experiences and challenges are, and conquer them head on or enjoy them for themselves.

I don't gain weight in a week and keep it on and then everything's okay because I gained some weight.  That's not how it works.  Don't ask me that.  Don't ask anyone with an eating disorder that.

Ask how I'm feeling.  Ask what I'm thinking.  Give me time to figure out the answers, and if you're going to ask, listen to me -- really listen to me -- when I give you answers.

That's how it works, no matter who you are to me, no matter who I am to you, if I am someone with an eating disorer.