{image credit :: kygp}

Your eyelids reluctantly lift from their resting place as the harsh light washes over you, signaling it’s time to rise from this intoxicating slumber. You’d like to pull the warm comforter back over your head and disappear into the abyss of ignorance – the place where you can forget the shame of last night.

But your body won’t let you forget. You feel the distinctively sharp pains deep in your belly; you still feel the food sitting high and heavy. Your mind spins in circles, looping in and out of the names that last night held such beauty and power, but now elicit a feeling of disappointment. Oreo and Oscar Meyer and Special K and Hostess. Those bastards – letting you down once again.

You promised yourself this wouldn’t happen again, you wouldn’t let food leave you feeling bent and broken in the morning. But here you are – alone, frightened of the voraciousness of your hunger, and desperate to get out of this cycle.

Handling the day after a binge episode is most certainly not for the faint of heart; it is one of the most difficult challenges that we face in overcoming emotional overeating and binge eating. When all we want to do is hide under the covers is the precise moment at which what we need to do is call on all of our reserves and prepare for battle. We are no longer just fighting against the temptations of trigger foods, but also against the insidious voices that try to undermine our recovery.

When you’ve just binged and come out on the other side, try these tips to bounce back:

1. Journal. And then journal again. Try to think of a binge episode as an opportunity to discover something totally new and interesting about yourself. No matter the circumstances and how familiar they might be, each binge is different and has its own identifiable triggers – environmental and emotional. Journaling is a fantastic way of analyzing the thoughts and feelings you were having prior to, during, and after the binge. If you’re getting stuck in the embarrassment or frustration you’re feeling now and can’t even remember what was going on before eating, then just explore those feelings. Your truth lies within the words – or images – that you can get on paper. There’s no wrong or write (pun intended!) way – just let it flow.

2. Eat protein. Not just protein of course, but make sure you incorporate protein rich foods into your diet after a binge. Many of those who binge tend to do so on high carbohydrate foods, and there’s a scientific and perfectly comprehensible reason for this. Carb-rich foods help the amino acid tryptophan to produce serotonin – the “feel-good chemical” in our brains. When we binge and eat lots of carbs, we increase our serotonin levels and voilà! – we feel good. But as you might expect, as our blood sugar and serotonin levels even out or drop, we can feel sluggish, irritable, and depressed. Eating protein-rich food ensures we’re getting enough tryptophan and keep our mood in check.

3. Start using those affirmations you’ve been collecting. You’ve heard them before. Maybe you’ve even written them in your journal, put them on your vision board, or recite them in the shower. Well, now is the time to pull out all the self-love wisdom you can muster and pour it on yourself. Some of my favorites: A lapse is not a relapse. I treat myself with kindness and patience. I forgive myself and others, release the past and move forward with love in my heart. Every day is a chance to recreate my life. What are some of your favorites?

4. Exercise. Gently! Exercise should not be used as a punishment – ever! Don’t plan on setting any marathon PRs today or burn XXX calories in hot yoga. Instead, focus on doing something that makes your body feeling utterly amazing and do it mindfully. This means keeping present with the way that your body moves and feels, even as you take a gentle walk or stretch out your limbs. Shifting your perspective from seeing your body as your enemy to seeing it as your ally will help prevent treating it with disrespect in the future.

The moral of the story is to be kind and patient with yourself. Tearing yourself down or throwing your eating schedule off even further with restriction or more binging will just make it more difficult to develop the healthy relationship with food and yourself that you want. Try something new this morning and start with self-love. And some protein.

photo © 2010 Keith Ramsey | more info (via: Wylio)

I just got back from a sweaty four-mile run, and as I sit here typing I’m noticing the familiar pangs of post-exercise hunger creeping in. My body is signaling to me that it has expended my energy stores – it wants fuel to keep operating. I know that if I don’t feed myself soon (usually within 30 minutes after intense physical activity), I’m going to start getting light-headed, irritable, and unable to focus.

This post-workout hunger – and the necessary response of eating – are what experts consider the reason that exercise doesn’t usually lead to weight loss. Yes, you read that right. Exercise and weight loss do not go hand in hand.

Study after study suggests that, contrary to popular belief, spending more time on the elliptical does not lead to a smaller figure. That might be frustrating news to the 45 million Americans who belong to fitness clubs, a number that has increased since 2001 according to the IHRSA.

While not everyone joins a gym to get skinny, it is the primary reason cited for exercise. Sometimes it’s snuck into a litany of other reasons – to keep up with the kids, get my blood pressure under control, to make my partner happy – but people will usually still identify weight loss or weight control as a reason for hitting the treadmill.

Perhaps disappointing to these individuals, doctors and researchers have fairly solid evidence that exercise won’t result in a slimmer waistline. In a 2009 Time magazine article, Eric Ravussin, prominent exercise researchers and faculty at Louisiana State University stated unequivocally,  ”In general, for weight loss, exercise is pretty useless.”

Ravussin and others in the field explain that exercise tends to increase and stimulate our hunger, resulting in a reversal of the energy expenditure we just created once we eat. And we need to eat! Experts agree that it’s important to nourish your body after a workout to replace glycogen in your body.  It’s also important in order to avoid excessive hunger that could lead to a binge later.

So why I am telling you how ineffective exercise is for weight loss? Because there are so many reasons to exercise that have nothing do with our size – reasons that got so lost in the bombardment of messages of how our cardio routine can blast belly fat.

In a 2009 study, participants who considered themselves sedentary and had body mass indices in the obese range, took up supervised exercise for twelve weeks. What researchers found was that weight did not significantly change. Before you call the experiment a wash though, consider that most of the individuals did increase their aerobic capacity, decreased their blood pressure and resting heart rates, and improved their mood.

Other benefits of exercise include building healthy bones and joints, reducing the risk of diabetes and cancer, and improving circulation. Even more fascinating, exercise, especially mindful exercise, has been shown to improve mood, increase learning ability, and improve body image. And that’s all without the scale changing a bit.

Once we can let go of the association between exercise and weight loss, we can start to focus on doing things that we actually enjoy. Rather than a punishment to whip our bodies into a certain size or shape, we can approach exercise as a way of honoring our bodies as another expression of our selves. This means taking rest as seriously as movement, and finding activities we truly love– even if the calorie expenditure is low.

After nearly two years of focused work, with a fair share of bumps along the way, Helena has at last reached what her physician considers a healthy weight for her frame. She is eating nutrition-rich meals and hasn’t resorted to her trusty elliptical machine to ward off anxiety about donuts or job layoffs in more than a year. She has reconnected with the friends who, two years ago, told her that they felt disconnected from her, that they just couldn’t “get in.” Tonight they’re heading out to karaoke, an activity Helena used to adore because she could show off her powerful chops.

Would you call Helena recovered? In recovery? Partially recovered? Still in the grips of an eating disorder?

Think about that for a moment.

Now, would the label you assign change if I told you that Helena still counts calories almost every day? What if she only occasionally read nutrition labels – a former obsession – and only to check the amount of calcium and protein in her food? What if she still hates the way her legs look and cries regularly about not measuring up to her friends? What if instead she doesn’t hate the way that she looks, but is cautiously proud of her body – harboring fear, however mild, that her weight could shoot up? What if her food and weight obsessions were gone, but her perfectionism had translated into other areas of her life – like her work as a financial analyst?

Now what would call Helena? Fully recovered? Partially? In recovery? Nowhere close? If your label changed, think about why. On what did you base you assessment?

Assigning labels to the odyssey that is recovery is a challenge faced by clinical researchers, clinicians treating these individuals, and perhaps most significantly, individuals themselves. At the Academy for Eating Disorders international conference recently, I had the opportunity to hear Anna Bardone-Cone, Ph.D speak about her work in defining recovery.

Dr. Bardone-Cone recognized just how disparate definitions of recovery are across the literature on eating disorders. Looking at how various researchers defined recovery, we see that some do by the simple (though admittedly not so simple) restoration of weight, some by the absence of symptoms (e.g. restricting or binging), and some by more complex rubrics incorporating a person’s thoughts or attitudes. The problem is that when researchers are comparing treatments and other factors based on recovery that is defined differently, we really cannot compare at all.

There are other implications of a lack of consistent recovery definition as well. For one, individuals who struggle want to know what recovery will look like. While every single person’s journey will look different, it provides guidance and hope for individuals to understand just what they are working towards. It’s important, too, for individuals to know that recovery – full recovery, as I define it – is not simply about having a regular period (for females) or stopping their binge eating.

I am someone who believes that the idea of full recovery is real and can be attained by anyone with the right resources. These resources include a commitment to the process and a team of personal and professional support.

So what does full recovery look like? Like I said, the details might look different for different individuals, but I believe that recovery involves three main areas: physical, behavioral, and emotional. What this means is that those in full recovery are physically healthy and medically stable, are not using eating disorder behaviors, and they have developed a healthier attitude toward things like shape, weight, and food.

Does this mean that a person in recovery never bemoans the size of her thighs? Dr. Bardone-Cone says no, and astutely remarked in our workshop that we can’t expect those recovering from eating disorders to be super-people, free from the worries and concerns that are part of normal development and living in our society. We do of course hope that they have the skills to combat those thoughts when they arise, however. Occasional thoughts and concerns don’t mean a person isn’t recovered, just like occasional aches don’t mean that a person who had the flu once still has it.

Others prefer to use the terminology that is often used in circles of those who struggle with substance abuse and addictions and to refer to themselves forever as “in recovery.” Often the idea behind this semantic difference is that one will be aware and mindful of the possibility of returning to old habits in the face of stressors (as a person with a history of alcoholism might always need to be aware of the temptation to drink).  Personally, I respect any perspective on recovery that feels genuine and helpful to a person in maintaining health and happiness.

However you lay it out, the fact is that there is tremendous hope out there for those struggling with eating disorders, and for those who have struggled in the past. Despite recent press that paints a picture of recovery of elusive, it’s not at all. It’s difficult, sure. But it’s also attainable. If you’re still wondering about what recovery might look like, Aimee Liu’s new book, Restoring Our Bodies, Reclaiming Our Lives, is a fantastic resource full of first-person accounts of the recovery process.

Do you believe that full recovery is possible?

{Image Credit :: loswl}

Thank you to everyone who sent kind vibes and words my way last weekend for the half-marathon that I ran. I was thisclose to my goal of sub-2:00, with a time of 2:00:45. The perfectionist in me felt a tinge of disappointment (hey, I’m human!), but I was able to focus on the things that I was incredibly proud of – like, finishing, for instance. Not only did I cut 25 minutes off of my previous time, but I felt so much better physically and emotionally after this race. While my legs were of course aching, my feet sore, and my muscles exhausted, I felt incredibly strong and grateful crossing the finish line, doing my last mile as my fastest one.

Not only was my body more prepared this time around thanks to time, mindfully exercising, speed work, and cross-training with yoga, but so was my mind. There were several points during the race when I started to notice my thoughts go in an unhealthy and hopeless direction, like when the strong wind felt like it was pummeling me backwards. I made a decided effort, however, to refocus my thoughts and shift my attention to how I was feeling in my body – tired, but powerful. Despite the lack of crowd support (we’re talking deserted rolling hills of nothingness), I was my own cheerleader.

I also experienced a pivotal moment around mile eight. Chugging along on the pavement, I suddenly had the thought, “I want this.” For the several days previous, despite publically declaring my race goal, I had convinced myself that it didn’t matter if I achieved my goal – it was enough that I was trying. And it was, in a sense. I had worked extremely hard to get where I was at, so two hours or three hours or eternity didn’t matter. Sort of.

What I realized though, was that I was convincing myself that my time didn’t matter because I was scared of admitting that it was important to me. If I acknowledged that, I would have to experience the potential sadness and disappointment if I didn’t meet my goal. So instead of pretending that I didn’t care for the sake of preventing difficult feelings, I decided at that mile to say it aloud… I want this.

It was an invigorating feeling, one that made me run harder and faster than I had the previous seven miles. In retrospect, perhaps my burst of energy made me more tired later in the race, but it felt amazing. It was liberating to acknowledge to myself that I wanted something, badly. Despite not quite making my time, I feel really amazing about the race. I left feeling strength and gratitude, and I was touched by those who sent me messages of encouragement.

Aside from recovering from achy legs, I did stumble upon some really great things this week that I of course want to share with you:

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• Dr. Dana, the brains behind the Body (& the Brood), wrote a fantastic piece outlining how self-compassion is an antidote to negative body image. I love the first line: “Poor body image tends to take root in neglected soil.” So true!
• Over on HuffPo, Hale Dwoskin shares a simple but radical way to stop dwelling on your problems. It’s definitely worth a try.
• Speaking of running (I promise I’ll stop soon…), I’d be interested to hear your reactions to this “debate” on Runner’s World where two experts weigh in: Can You Be Fit and Fat?
• Have you seen the Inner Beauty Mirror UnContest over on The Beauty Message Challenge? Check out the site for details on how you can both improve your body image and score an iTouch. Win, win!
• Last, I can’t help but put a plug in for the April edition of the Self-Discovery, Word by Word series. Mara from Medicinal Marzipan is our host and she has chosen a transformative word… Go check it out!

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Reader Comment of the Week :: Per the random number generator, the winner of the blogoversary giveaway is… Dorry of Living with Healthy Hunger!

Thank you to everyone who commented, tweeted, and facebooked. I have had a wonderful year getting to virtually know so many of you, and have become a better clinician, blogger, and person because of it…

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Signing off, but wondering… Have you ever almost achieved a goal? How did you feel?