Thursday, February 26, 2009

AAT: The Purging Trap

In this chapter (which is located in the workbook 'appendix') author Linda Craighead explains why people, who want to compensate for breaking food rules, overeating or bingeing, choose to purge. She also discusses how purging undermines attempts to stop bingeing and eat normally, how to resist urges to compensate by purging, how some people choose to purge after eating small amounts and how to cope with planned binge/purge episodes. Above all, Linda emphasizes: "THE MOST IMPORTANT REASON TO STOP PURGING IS THAT IT ACTUALLY GIVES YOU PERMISSION TO BINGE. Purging ... keeps you stuck in the binge-purge pattern of bulimia. Bulimia is a difficult pattern to change ... (because) you are afraid to stop compensating until you stop binge eating, yet compensating undermines the very motivation you need to stop binge eating. Why stop at moderate fullness as long as you know you can compensate? How do you (escape) that vicious cycle?"

MOTIVATION TO PURGE: Deciding what to do after you think you have overeaten, broken a 'rule' or even binged is another point of intervention, where you can choose to return to normal eating or compensate with further restriction, exercise or even purging by vomiting or using laxatives. People choose to purge for 2 reasons:

(1) Purging gives you physical relief by reducing the pressure in your stomach after you binge eat very large amounts.

(2) Purging makes you feel better psychologically by reducing your guilt and your fear of weight gain, if you believe purging 'gets rid of' the calories you consume during a binge.

"BAD NEWS" ABOUT PURGING: Likewise purging greatly decrease your chances of losing weight or recovering from overeating or bingeing habits in several different ways.

(1) Purging seems to work in the short run. "If you overeat because you like the taste of food going down", purging provides immediate solutions to problems caused by overeating. However, like many short term solutions, purging causes long term health problems with increased purging and greatly decreased motivation to stop overeating or bingeing. Because purging initially may seem reasonable or even safe, "you start to rely on purging instead of relying on moderating your intake." If you give yourself permission to purge, you automatically give yourself permission to binge.

(2) Purging teaches your body to crave and tolerate larger and larger amounts of food, rather than learn to stop eating when you feel moderately full. "Your biology is not going to help you learn to prefer moderate fullness when you don't let it keep whatever food you eat ... You find it very hard to get satisfied. It seems like it takes a lot of food to feel full."

(3) Although the author mentioned 'research that suggest that repeated vomiting may result in delayed gastric emptying", I think that's a 'cause by correlation' suggestion. Repeated vomiting may be correlated with delayed gastric emptying, but not directly cause that. I learned from my personal experience that vomiting tends to cause more reflux by relaxing the lower esophageal valve (LEV) which, when closed, prevents reflux. Treating that reflux with acid blockers further reduces the amount of acid necessary to keep the LEV closed. Above all reduced stomach acid decreases the ability of the stomach to digest food. So less acid will cause the stomach to empty more slowly.

(4) Above all, purging to relieve discomfort after overeating or bingeing may mask gastrointestinal problems, caused by food intolerances or allergies. Only after I ignored my 'food rules' to eat whatever I craved and almost eliminated purging when I felt discomfort after eating, did I finally seek a diagnosis for excruciating gastrointestinal pain after eating. Then I was diagnosed with celiac disease (gluten intolerance) and 6 other (delayed reaction) food allergies. Did purging cause those diseases? Absolutely not! I inherited the celiac gene. So eating gluten, especially bingeing on gluten, caused reactions which damaged my gut and allowed other food allergies to develop. Nevertheless purging after overeating relieved discomfort that should have told me that certain foods caused problems.

GOOD NEWS ABOUT ABSTAINING FROM PURGING: "While you may not like how purging feels or its longterm effects on your health, you probably believe that purging is the only reason you have been able to lose weight or ... you are able to prevent weight gain." However, purging does NOT 'get rid of' all the calories you consume during binges. Above all, "treatment studies support the conclusion that few women gain weight when they stop purging". I would add that my weight stayed in a 3-5 pound range while I learned to eat normally (start when physically hungry and stop when physically full) but slowly decreased my binge/purge episodes from daily to once every 3-6 months. AAT teaches you to stop binges and overeating as well as reduce urges to compensate. "As your overeating decreases, you will have less motivation to purge, and as you resist purging, you will have more motivation to stop at moderate fullness."

RESIST THE URGE TO COMPENSATE:

(1) "Acknowledge that you have the urge to compensate ... (Remember) na urge is just a feeling ... you have a choice about how you want to respond to that feeling (or even) not to act on it.

(2) If the urge to compensate develops while you are still eating, "take action immediately to get away from any further opportunatiy to eat ... (with) the idea of purging in the back of your mind, it is much harder to resist eating more ... You think 'It doesn't really matter if I eat more, because I'm going to purge anyway.' ... if you (intend) to purge, it is better for you to (keep) the amount you eat small, (because) you are trying to become aware of your moderate fullness signal ... Every time you get stuffed, you are teaching your body to require larger amounts of food to feel satisfied ... If eating triggers a weak (purge) urge ... you will certainly feel even more likely to purge if you eat more. Above all resist the urge to (say) "what the heck and eat more ... (as well as) the urge to compensate (no matter what you have eaten."

(3) "Ride out the urge to compensate" with distraction, because "you do not want to focus on how uncomfortable your stomach feels." You can list distraction methods on an index card which you carry with you. You can put yourself in situations where purging is difficult, especially where you are with other people. Just as you can 'surf' urges to binge, notice that urges to compensate increase, plateau and diminish like waves. "Sometimes an urge will subside and return (repeatedly), but each time it crests and flattens out." Above all remind yourself that "compensation does not undo all the damage of binge eating ... purging makes you more likely to binge next time, because you still have permission to purge." When you refuse to compensate, you may retain a few more calories, but you will withdraw permission to binge, "so you will (take) far fewer calories in the long run."

PURGING AFTER EATING SMALL AMOUNTS OF FOOD: If you purge continue to purge when you are no longer bingeing ... you (may be) using purging ... to maintain a low weight ... you are not wiling to take the risk to see that ou can maintain your weight simply by eating normally ... To overcome your fear of weight gain, commit to not purge for 4 weeks without allowing yourself to weigh. Give your body a chance to show you that purging is doing nothing for you. You need ... (to give your body) this much time to restabilize its weight (and resolve) water retention problems.

PLANNED BINGE-PURGE EPISODES: "When you first started binge eating, you most likely idd not intend to purge (but) you just got so upset when you ate toomuch that you had to do something to feel less anxious ... (So) You started planning to purge whenver you binged." When you believe you can 'undo the binge by purging', you lose the motivation to limit what you eat. "Some women find it much easier to purge after eating large amounts, so once they decide they are going to purge, they eat more on purpose ... Some women experience the 'what the heck' response after purging ... (So) they may as well binge and purge some more ... often several times in sequence ... Once that pattern gets establish you may have to plan the whole episode ahead of time, because it may take several hours." There are 2 types of planned binge/purge episodes:

(1) In the first type, "you have strong urges to binge but you kep putting them off ... (however) you evenging get frustrated (by) trying to get those thoughts out of your mind. Since you have permission to purge, it starts to seem ... reasonable to just get it over with ... (and) you plan a binge/purge episode (hoping to) get some relief (or release) ... Planning this release actually helps you restrict prior to that time. IN ORDER TO REDUCE THIS TYPE OF PLANNED BINGE/PURGE EPISODE, PRACTICE MORE REGULAR ANTIDEPRIVATION EATING. "You must honor strong cravings to eat certain foods so your urges to binge does not build up to the point that you feel such intense pressure to give in."

(2) The second type of planned binge is a 'learned coping strategy ... (in which) you have learned to use bingeing as a way to numb or change negaive feelings and you also have permission to purge ... (So) this type of episode is a form of emotional eating." TO REDUCE THIS EMOTIONAL EATING PLANNED BINGES "find alternative ways to manage your negative emotions" in order to give up those episodes. "Planned episodes will be the most difficult to eliminate ... Start with (eliminating) the unplanned episodes that are triggered by excessive restriction or ignoring fullness ... (Then) you will be able to see more clearly when bingeing and purging is triggred by negative emotions.

WITHDRAW PERMISSION TO PURGE: "You will be less prone to relapse (when) you completely withdraw permission to purge ... Say to yourself: "Purging is simply no longer an option. No matter what, I will just sit with my uncomfortable feelings. Even though I feel like purgine I know intellectually that no singe episode of eating has that much effect on my weight. (So) I can't use weight as an excuse to purge ... Allowing myself even one episode of purging will put me back into (thinking) that I can get away with overeating ... That mindset is much morel ikely to undermine my ability to manage my weight than whatever calories I retain by not purging ... In treatment studies, women who stop purging are more likely to remain recoverd a year following the end of treatment than women who cut back but still occasionally purge."

MY OWN RECOVERY EXPERIENCE SHOWS THAT WITHDRAWING PERMISSION TO PURGE WILL GREATLY FACILITATE RECOVERY. As long as I knew I would let myself purge, I continued for years to binge about once a month. After I withdrew permission, I binged much less often and learned to stop eating when I felt moderately full whether I 'broke rules' about what or when I ate or even ate to cope with fatigue or emotional distress. However I also recommend that anyone who has difficulty with withdrawing permission to purge should consider whether they have gastrointestinal issues which make distracting themselves after overeating or eating small amounts very difficult. After I was diagnosed with celiac disease and food allergies, so I identified and abstained from foods which caused excruciating gut pain, I could more easily distract myself from urges to purge after overeating. Enduring discomfort from overeating is much easier than enduring excruciating gastrointestinal reactions from food intolerances or allergies. I also realized that I could EASILY abstain from foods which I knew causes painful reactions, even though I usually felt 'deprived' when I restricted foods which were 'less healthy' or contained 'more calories' but were otherwise safe for me to eat.

AAT: Effective Emotional Eating

In this chapter author Linda Craighead describes how to manage emotional eating and how to make emotional eating 'effective' to minimize 'harm done'.

EMOTIONAL EATING: attempts to fill psychological needs, rather than satisfy physical hunger. You may use this kind of eating when (1) "you don't really feel hungry (but) you just feel like eating; (2) you crave a particular treat food; (3) you know you recently ate, so you can't be biologically hungry. Because "from early on, we have all been given food for many reasons besides hunger", we associate food with feeling better. So when we feel bad psychologically, we think we must be 'hungry' for food that will make us feel better. "If (we) eat normally most of the time and do not binge, (we) will be able to maintain a stable weight even if (we) occasionally eat for emotional reasons. However, if (we) want to lose weight, (we) may need to reduce the frequency of emotional eating."

AAT EMOTIONAL EATING GUIDELINES: "Stay tuned into your stomach no matter why you start eating. Your stomach is quite reliable and will not lead you astray ... Over time, you (will) develop better self-care skills (besides eating) ... (So that) you won't need to eat for emotional reasons as often as you do now. In the meantime, use your stomach fullness signal to protect yourself from excessive emotional eating that wil only amplify (any) weight concerns ... Unlike other approaches to emotional eating ... designed to help you resolve your underlying emotional issues so you won't feel the need to eat (emotioinally) so intentensively, AAT starts by taking decisions about eating out of the emotional realm. How much you 'want' is not longer the basis for your eating decisions. Instead, you choose to use hunger and fullness to decide when to eat and stop eating. Rather than simply giving in to emotionally driven urges to eat, you (tell yourself):

"It doesn't matter if I feel anxous, upset, or bored, or I am celebrating and enjoying food. I have made a commitment to stop as soon as I feel stomach distention. At that point, food has done all the good it can do for me. Continuing to eat will detract from whatever good the food can do for me and wil create more negative feelings. In the moment, it may be hard for me to remember that I will feel worsel ater. that is why I use my stomach as a stop sign, instead of allowing my mind to make excuses to eat more. Of course I don't want to stop eating. Right now, I think more food will make me feel better. But I know that is magnical thinking. I wish more food would make me feel better, but it's won't. Getting stuffed always makeS me feel worse."

THAT AFFIRMATION CAN EMPOWER YOU TO GO BEYOND ANY PSYCHOLOGICAL REASON TO EAT!!!

HOW TO HANDLE URGES TO EAT FOR EMOTIONAL REASONS: When you have urges to eat, when you are not physically hungry, you can: (1) try distractions; (2) urge surf (acknowledge and observe your urge to eat w/o acting on it, (3) tolerate the feeling w/o eating; or decide to 'use' the food, but do so effectively (stop at moderate fullness).

DEPRIVATION LEADS TO EMOTIONAL EATING: "If you have been dieting a ong time, particularly if you have been folllowing a strict diet, you are likely to have a backlog of deprivation feelings. AAT Guidelines tell you "to eat what you want and get moderately full" ... However, if you have been higly sensitized to the feeling of deprivation, it may takeseveral months of normal eating for your general feeling of deprivation to diminish ... With AAT, you will still feel tempted to eat when your favorite treats are available, but (you can) eat treats sufficiently frequently so that your general deprivation level remains love. Then urges are not overwhelming (and) you con't have to binge. You can choose to eat treats sometimes, especially as part of your scheduled meals and snacks, and you can choose not to eat treats at other times ... Deprivation is tricker when (it's unrelated to) choosing foods you want. If you feel deprived, but can't identify any specific food you crave, your ... deprivation probably comes from not allowing yourself adequate pleasure in other areas of your life, rather than simply ... restricting kinds of foods you eat.

USE EFFECTIVE EMOTIONAL EATING TO LIMIT THE HARM DONE: "You can learn to use food more effectively to feel better occasionally without relying on it to fix all your feeling ... Effective emotional eating means you give up using emotions as an excuse to get stuffed ... When nonfood alternatives are not easily available or are not working for you, you (can consciously decide) to allow yourself self-soothing eating. Each time you (succeed) in using food to soothe yourself without getting stuffed, you limit the harm done and you gain confidence in your ability to use, not abuse, food ... If you (don't want to) stop at moderate fullness, at least stay awre so you can identify the point of diminishing returns and stop as soon as you feel uncomfortable. Using conscious decisions to eat teaches you to notice when the pleasure of eating diminishes, the point at which food has done all it can do for you and you need to try some other strategy. When you feel worse after having a treat, you know you have NOT used food effectively."

MANAGE EMOTIONAL EATING AND LIFE STRESSES: "You may manage your eating ... as long as life is going well, but you may not ... maintain your focus on eating when something significant ... disrupt(s) your routine ... You probably feel as though you (can) only cope with one area of your life at a time. So you alternate bettween working on ... eating and dealing iwth other issues. This either/or approach leads back to yo-yo dieting and weight loss and regain." AAT encourages you to deal with eating and life issues simultaneously. Choose to eat normally no matter what else happens in your life. "Whether there is (excess) food available or (your) emotions ... trigger eating, you (can) stay tuned into your stomach and allow it to tell you when to stop eating. You never (rationalize) getting completely stuffed." You may need to eat emotionally, "but as long as you don't get stuffed, you are not likely to gain weight."

This chapter offers a step by step aproach to manage urges to eat. The author suggests ways to cope with various kinds of urges:

(1) For weak urges to eat emotionally, "try distraction (and) get rid of tempting foods or leave the environment;

(2) For moderate urges, "practice urge surfing or "acknowledge you want to eat and just observe your desire to eat without acting on it ...(so that) the urge initially increases, peaks and starts to decrease (and help you realize urges are just feelings which fade on their own if you acknowledge them).

(3) For strong or persistent urges (which return), "acknowledge it and make a conscious decision ot eat. Remember you already (know) you are not feeling physically hunger (and) are eating only for taste ... (So) you need to obtain the most pleasure possible from (whatever you eat) ... Thus it is critical that you eat the right type of food you want and that you eat slowly and mindfully (in order) to enmoy what you eat to the fullest, so the food (can) do its job ... to make you feel better.

Next the author lists activities to alter physical sensations and emotions directly so you can self-soothe without eating and activities that are highly positive or engaging (to) distract you or provide pleasure without eating.

Then the author asks you to "identify and challenge (1) thoughts that are encouraging you to eat even though you aren't hungry; (2) excuses to keep you from trying an activity besides eating; (3) what interferes when you try to tolerate an urge to eat without acting on it.

Finally the author emphasizes "DON'T TRY HARDER; TRY DIFFERENT ... You already try hard not to eat when you aren't hungry." Rather than repeat the 'same old things that don't work ... figure out what works for you now. There is always something else you can try ... just be willing."

Wednesday, February 25, 2009

AAT: Challenging What the Heck Responses

Linda Craighead (author of 'Appetite Awareness Workbook') says:

"The key to reducing binges to normalized overeating is to stop the 'what the heck' response ... Anytime you overeat or break a food rule, you are vulnerable to having a 'what the heck response. The way you think and feel about having overeaten (or having broken a rule) determines whether you allow this event to turn into a binge. Each time you notice the 'what the heck' response try to identify which of the following types of unhelpful thinking was involved":

ALL OR NOTHING (AON) THINKING: can help people feel relieved or released, after they binge. They think in terms of polar opposites. So they label foods 'good or bad' or themselves either a 'success' or 'failure'. With AON thinking any unplanned eating becomes 'bad'. However this dichotomous view undermines their ability to stop in early stage of a binge. Once they cross a line, they don't think they can redeem themselves. So they release themselves from trying to stop eating. To stop AON thinking, change how you define success and failure. So you 'succeed' anytime you can stop short of a full-fledged binge. Stop thinking there exists a magical point where 'all is lost and you might as well go all out (and binge)." Think about calories as continuous, not dichotomous information, which will motivate you to stop whenever you can.

MAGICAL THINKING: "is a way you trick your concious mind into being unaware of reality for a period of time." Adults use magical thinking when they "really don't like the harsh reality" they are in ... (They) can excape reality for a moment by suspending ratioinal thought processes (like awarness of the caloric nature of food). This kind of thinking allows them to rationalize or "make excuses that justify continuing to eat". The worst rationalizations let them believe that waiting to get back on track (with eating) later will be easier, because in reality every calorie counts.

DENIAL: "or the 'I don't care' way of thinking ... keeps you from facing the painful reality that you DO care about your weight, even though you don't want to stop eating right now. So you temporarily discount something (like your weight) that is very important to you. Saying "I don't care" cuts you off from whatever motivatation you have to stop a binge. When you catch yourself in denial, challenge that style of thinking by acknowledging "both sides of what you really feel; for example, 'I do care about my wieght, but I'm feeling hopeless' ... Then you can deal with our real (ambivalent) feelings instead of pretending (not to care)."

HOPELESSNESS: makes you "feel resigned throughout the binge episode ... You don't get ... much relief at any point during the binge ... (but) you also don't believe you will feel better if you stop eaitng, so you undermine any motivation you might have to stop. Hopelessness comes from exaggerating negative events (like considering any slips as proof you will never succeed) and all or nothing thinking. To challenge hopelessness remind yourself that you CAN change eating behaviors, because you eat every day. You don't have to wait long for another opporutnity to change. To combat hopelessness, base your goal on your behavior, not your wieght or your shape, because those can only be changed indirectly. If you binge frequently, begin to stop a little earlier than before in each binge episode,

ANGER OR REBELLIOUS FEELINGS: All or nothing thinking can make you alternate between extremes of hopelessness and anger or rebelliousness, instead of finding a more moderate viewpoint about your struggles with eating or weight. However, focussing on what you can do, rather than thinking 'life is unfair' can help you get past extreme thinking. "Once you stop bingeing, your overeating will gradually decrease as wll, because your prevence for how your stomach feels will change ... For now, do whatever it takes to stop short of 'completely overstuffed'.

CONSCIOUS DECISIONS TO OVEREAT CAN TRANSFORM BINGE URGES: "When you make a conscious decision to eat or even overeat, you have not given up control; you (can) stay aware and watch what the ofod is doing or not doing for you ... You (can stop) binge eating entirely once you devlop better strategies to meet your food and nonfood needs." Using self-observation will teach you that 'overeating is a less negative option than bingeing. Expanding your awareness or 'using your wise mind' means you use all the information available about all possible options to make the most effective decision. That process requires "committing to doing what works, even when you don't feel like doing it. "Eventually your (binge) urges will weaken and usually disappar, because your sie mind knows that bingeing never really works.

CHALLENGE FEARS OF WEIGHT GAIN: Consciously deciding to overeat will not cause you to gain wieght, because you will only occasionally make that decision--only when you have a strong urge to binge. "Overall you will not be eating any more total calories per week than you did before you were making conscious decisions to eat.

WHEN YOU HAVE A STRONG URGE TO BINGE: stay conscious and 'focused on your stomach so you can stop as soon as eating no longer feels good' or the point of diminishing returns, when food no longer tastes as good as before or your stomach starts to feel uncomfortably full. Your stomach is the first place your body will register discomfort with large amounts of food ... Reducing amounts in binges is surprisingly easy for many people, especially those who usually respond with all or nothing thinking--either you binge or you don't. THERE IS NO POINT AT WHICH EATING MORE DOESN'T MATTER.

CHALLENGE EXCUSES AND IRRATIONAL THINKING: In order to prevent binges, challenge unhelpful thinking that encourages you to tune out and continue eating. Look for your excuses to binge and ask yourself whether those make sense when you think rationally about how food and calories work in your body. Here are common excuses for continuing to eat past comfortable fullness:

I might as well finish the package (or plate or bowl).

I can't throw this out (or I can't waste food).

I paid for it (or she cooked it), so I should eat it.

It will be easier to start over tomorrow (or on Monday).

You use excuses to 'buy time' before you get back on track after overeating or binges. Become aware of your excuses in order to get back on track as soon as possible. "Use your wise mind to look for a more reasonable, balanced thought that will encourage you to stay (or get back) on track.

CHANGE YOUR PREFERENCE FOR OVERFULLNESS: "When you are tuned into stomach sensations, you (will) notice the stuffed feeling you used to like doesn't really feel that great. Once you give up getting stuffed, you then notice the more subtle uncomfrtable feelings associated with overfullness ... (Then) comfortably full actually feels better than overfull ... Altering your preference from full to moderate fullness is more (challenging). Stopping at moderate fullness is not aversive, but more of a learned preference.

AAT: Binges vs. Overeating

In the "Reduce Binges to Mere Overeating" chapter Linda Craighead says:

"Psychologists typically define a BINGE as any episode in which you experience loss of control; an objective binge means the amount was also clearly large while a subjective binge meas the amount was not clearly large ... Unfortunately loss of control is itself, hard to define (and) means different things to different people ... (However) AAT avoids the (binge definition) problem ... by asking you to separate your ratings for physical fullness from your ratings of your psychological feelings. (The AAT Workbook includes forms for rating hunger, fullness and feelings about eating.) ... The goal is to first eliminate episodes in which you get stuffed, regardless of whether or not you feel loss of control."

WHY SOME EATING EPISODES FEEL PARTICULARLY DISTRESSING:

" ... distress comes from having two very strong but conflicting feelings at the same time. Psychologists call this AMBIVALENCE ... you have an intense desire to eat and you also feel strongly that you sould not be eating becaus of your concern about weight. You resolve this conflict (for the moment) by tuning out your conscious awareness of the thoughts that say "Don't eat!" or "Stop eating", so you are able to eat ... All variations of this tuning out of some of your feelings (are) the OH WHAT THE HECK response. As soon as you tune back in, you realize that you feel very distressed. You may experience this whole phenomenon as simply regret (after eating) or as having loss of control (during eating)."

AAT suggests that you ELIMINATE BINGES BY USING CONSCIOUS DECISIONS (CDs) to eat to counteract your tendency to dissociate (tune out) parts of your awareness". So you "give yourself conscious permission to eat the type of food you really want ... You don't just give yourself permission to get uncomfortably full or stuffed." You just need to be 'willing to give yourself conscious permission, a decision which "undermines any sense of loss of control ... At first you are likely to overeat to some extent, but gradually you will become more able to stop before you feel uncomfortable, then ultimately before you even feel completely full."

WHAT THE HECK BINGES: Often "people don't plan to binge ... (they) just overeat, for whatever reason and the overeating turns into a binge through the 'what the heck' response (which) resolves conflicted feelings ... (by) tuning out ... awareness of thoughts that say 'stop eating', so (they) can keep on eating."

EMOTIONAL EATING BINGES: Emotional eating can also turn into a binge, because "you wanted to eat to change something about the way you are feeling ... When you start eating for emotional reasons you (can choose to): (1) stop at moderate fullness, (2) keep eating past moderate fullness so you overeat, or (3) plan to binge. Someone who binges often uses food like other people use food, to make themselves feel better. " ... people who binge typically eat excessive amounts in their (usually not too successful) effort to change uncomfortable feelings.

PLANNED BINGES: For some people a binge goes beyond moderating the intensity of uncomfortable feelings, by creating an altered state of consciousness. Those people typically say they become numb or oblivious during a binge. So they plan binges in order to deliberately seek an altered state. Nevertheless, those binges still are 'emotional eating' binges because they alter the emotional state.

DEPRIVATION BINGES: are the most obviouis types of binge, where you want a specific food, but won't allow yourself to have it. Although you can push away the deprived feeling, it returns until you give in and most likely binge, rather than eat a normal portion. "If you are restricting a lot, especially restricting types of food, or you restricted a lot at some point in your past, a vague feeling of deprivation can be easily triggered whenever you don't allow yourself to have food (or something else) that you want." During a 'deprivation binge' you (not someone else) refuses to give yourself what you want. AAT advises that you reduce food-specific deprivation. "Eat what you want, because forbidding specific foods triggers more intense feelings of deprivation than limiting amounts ... Make conscious decision to choose antideprivation eating when food is available and a strong urge has been triggered ... When you choose anti-deprivation eating, you stay tuned into your stomach sensations, so you can notice (and stop at) moderate fullness intead of overeating or bingeing."

FRUSTRATION BINGES: occur when you don't have control over getting what you want. The main ingredient of a frustration binge is feeling powerless or hopeless, which make you "lose motivation to stay focussed on getting what you really want ... You reconize at some level tha a binge is not going to solve your real problemand even that it's likely to make your wieght problems worse ... you settle for what you can get, namely food."

LEFTOVER BINGES: seem "more like a bad habit that is left over from an earlier time when you did binge and follow a pattern ... You experience some sense of control over these binges in that you can put them off, but you can't seem to give them up altogether ... Leftover binges are due to emotions which differ from emotions that trigger other binges ... Once binge eating has been established as a way to cope with negative ffelings, even minor disappointments or vague felingsof idscontent can be enough to trigger a leftover binge." I can TOTALLY relate to 'leftover binges'. I can sucessfully abstain from bingeing for long periods, but, when I feel overwhelmed by negative emotions (including deprivation), I still binge.

SEPARATE PSYCHOLOGICAL ISSUES FROM EATING DECISIONS: Practice making eating decisions based on your stomch, which keeps you on the normal eating path regardless of how you feel emotionally. Challenge your thoughts when you try to use emotions or stress as an excuse to get off the normal eating path. It's possible to focus on eating and other issues at the same time, because normal eating does not require the same level of attention and effort as restricting or dieting do.

REDUCE THE POWER OF EMOTIONS: Although you can challenge thoughts and feelings that take you away from normal eating, you are allowed to decide to eat for emotional reasons. You just need to (consciously) acknowledge what you are doing and stop at moderate fullness. You don't have to know why you want to eat when you aren't hungry, but you need to use your stomach fullness as your stop signal, regardless of where you started eating. Not all eating problems are emotional, but when you eliminate other paths that lead to bingeing or overeating, you can see whether you need to address emotional issues.

Over the years I have binged less and less from emotional issues and more often from feelings of deprivation due to unnecessary food restriction. Because I already have 7 medical (food allergy) restrictions, the notion of 'antideprivation eating' of any food, for which I don't have a diagnosed allergy, helped me reduce bingeing from once a month to once every 3 months during the past year. I realize the binges which occurred every 3 months were entirely triggered by deprivation feelings when I decided to limit safe (non allergic) food, because they weren't as 'healthy' as other (but less appealing) foods. Nevertheless I can quickly return to the 'normal eating' path, when I resume 'antideprivation' eating of all my 'safe' foods.

AAT: External Cues to Eat

In the 'Take Back Your Power' chapter Linda Craighead describes how to take control of decisions to eat when we are challenged by environmental or external (vs. internal stomach sensation) cues to eat. Some of those external cues include: the presence of tempting food, social circumstances which can pressure or obligate us to eat, and packaging and serving sizes of foods which can influence how much we eat. In light of all those external cues, Linda suggests that "each time you start to eat, ask yourself:

Why am I eating right now?
Is it mealtime?
Is it because I'm hungry?
Am I responding to something in my environment, or to people in my environment?
Or, did the desire to eat just pop into my mind?"

"Likwise, each time you stop eating ask yourself:

Am I stopping now because I am moderately full?
Did the serving size or the packaging provide a helpful external signal to stop?
Am I stopping because I think other people might notice if I eat more?"

"You will never become imune to the effects of the environment, but you can shift the balance of power. When you eat without making a conscious decision, it is mindless eating (which is) the easiest kind of eating to give up, because it is not doing that much for you ... Eliminate mindless eating (by) ... making a conscious decision each time you start to eat and (use) moderate fullness as your cue to stop, instead of eating until the food is gone ... you are likely notice that most of the time you stop when you finish whatever was served or there was no more food. Eating this way is fine if you (are) very good at predicting your fullness response. If you know exactly how much (your body needs), serving sizes will help you. However external stop-eating signals are a problem when they do not support your internal appetite signals ... External signals can encourage you to keep eating past moderate fullness even when internal signals tell you to stop."

I am often influenced by how much food is on my plate. I don't want to stop eating until I finish what I served myself. I fear feeling 'deprived' when I consider stopping when I still enjoy the taste of the food, even though my stomach feels full. I try to serve myself a portion that usually satisfies me, but I also leave some foods (like sliced fruit or baby carrots) in a bag or container. So I can easily put away what's left when I begin to feel full. However, focussing only on physical fullness, not psychological satisfaction, decreases those 'deprivation' feelings, especially when I tell myself I can eat that same food at another meal.

Linda also discusses social external influences of overeating:

"People in your environment may not support you in taking charge of your eating ... if you choose to ... eat from within, you may need (to learn about) asserting your rights to regulate your own food intake and to enjoy what you choose." Many people who try to tell you how to eat "will respond very well to empathic assertion".

Linda differentiates ASSERTION or "learning how to effectively get what you want out of a situation" from EMPATHIC ASSERTION or "attempts to get your needs met while maintining the best possible relationship with the person you are dealing with". She suggests 4 steps for 'empathic assertion':

"(1) Make sure you understand your eating rights.

(2) When you make a request, be very speicific about what you need from that person or what you want them to stop doing.

(3) Make sure you understand where the other person is coming from. Instead of getting (or staying) angry, try to find out why they keep doing something that is bothersome to you.

(4) Rehearse what you want to say ahead of time. (Use) the format illustrated in the sample below:

I understand that you only want the best for me but when you ________, I feel _______, and it is harder for me to stay committed to following my own appetite signals. It will help me if you ________.

"If empathic assertion does not work, you may have to resort to stronger versions of assertion (which) include 2 additional components. First express your anger or resentment very explicitly ... Second (if necessary) specify a consequence if the person continues to undermine your efforts."

Linda does not 'recommend strong assertion unless you absolutely have to use it, (because it) can damage a relationship and ... escaleate other conflicts ... with that person. However, at times, strong assertion works amazingly well."

I included Linda's suggestions about empathic assertion, because many people, including myself, believe assertiveness alienates people. So we allow others to influence our eating in social situations and later regret not listening to our internal cues of hunger and moderate fullness. I also tend to use agressive assertion rather than empathic assertion, when I feel threatened by others' suggestions about how or what I eat. Fortunately mentioning that I have 7 food allergies makes even the strongest saboteur pay attention to my desire to decide for myself what and how much to eat.

Tuesday, February 24, 2009

AAT: Stomach Signals

In the chapter entitled 'Discover Your Stomach Signals' author Linda Craighead describes how hunger works and how to recognize moderate fullness. I will discuss what most helped me.

HUNGER AS AN ALARM SYSTEM: " ... hunger is set up to work as an alarm system, not as an indicator of how much our body needs food ... It is quite possible to ignore your hunger for awhile if you are sufficiently distracted ... Your hunger signal gets stronger each time it returns until you have to eat in order to turn it off ... When you have been tuning out your hunger, you may not feel very hungry even though your body needs nutrients ... you can need food even when you don't feel very hungry. Once you start to eat, our attention is refocused on sensations associated with hunger, so you are likely to get back in touch with how hungry you are. People usually eat too fast and have trouble controling the amount they eat when they are truly hungry. Your biological drive to eat kicks in once you start to eat, and this pressure makes it harder to maintain control and stop when you want."

I often mistakenly believed that stronger hunger cues meant I needed more food to satisfy hunger. So I would serve myself a larger meal or even snack while I prepared the meal and expect to eat the same size meal I usually eat PLUS those premeal snacks. Then I would feel uncomfortably stuffed, even though I started eating when I was VERY hungry. Now I understand that hunger is like a snooze alarm, which gets progressively louder (or stronger for hunger sensations). If I let myself get very hungry, I need to remember that my stomach is the same size and will need approximately the same amount it needs when I'm moderately hungry.

LET YOUR STOMACH BE YOUR GUIDE: " ... stomach fullness as your cue to stop eating ... will work no matter what you are eating. Moderate fullness is indicated by the first sign of stomach distention ... You are moderately full when you first feel that your stomach pushes out or presses against your waistband. If you have trouble identifying this signal, you may find it helpful to put your hand on your stomach before you eat and check it several times as you eat ... When you listen more to your stomach and less to your mouth, you will find it easier to stop after moderate amounts of food. Your mouth is focused on taste, so you may end up feeling deprived if you don't eat as much as you want. Your stomach signal is based on fullness, not taste. Your stomach signal is the secret to eating less without feeling too deprived. You don't debate the issue or try to justify eating more. By using stomach signals, you take the decision to stop eating out of the psychological realm. If you focus on getting psychologically satisfied, anything less feels negative. When you goal is just to get full, you can feel good about stopping at moderate fullness ... To detect moderate fullness, you have to pay attention while you are eating in order to notice as soon as you start to feel full. At first you may not be able to stop as soon as you feel moderate fullness. With practice you get better."

Taking eating out of the psychological realm by focussing only on stomach fullness, rather than psychological satisfaction, is mind blowing for me. For years I have tried to satisfy specific food cravings, fully experience every bite of food, and stop when I felt full. However, I didn't WANT to stop when I enjoyed the eating process. I also feared that I would binge if I didn't experience 'satisfaction' as well as 'fullness'. (Several 'normal eating' gurus emphasize the importance of stopping when 'satisfied' as well as full.) More recently I have easily stopped when I felt moderately full, because I consider 'moderate stomach fullness' my 'stop sign'. If I don't feel satisfied or crave another kind of food, I make a mental note to eat that food at a future meal. Also I began to value how my stomach felt after a meal more than my tasting/chewing experience during the meal.

MINDFUL EATING: " ... means eating slowly and paying close attention to the taste of food in your mouth plus the feel of food in your stomach. Regardless of why you start eating, pay attention while you eat. By eating mindfully and monitoring fullness, you can prevent many eating episodes from turning into overeating episodes through ignoring fullness. Sometimes you may still ignore fulllness deliberately because you are enjoying the taste, but you are less likely to eat as much food that you don't enjoy."

I'm still learning what 'moderate fullness' feels like for me. The 'stomach pressing against my waistband' guideline doesn't work as well for me, because I take magnesium supplements which can cause bloating. So I can feel bloated, rather than full. Also I often wear mid rise jeans which don't press against my stomach. Nevertheless I feel some inner pressure or full sensations, which help me stop before I feel uncomfortably full.

RECALIBRATING YOUR APPETITE: "Your ratings of hunger and fullness are subjective. Only you can assess your internal state. Due to normalized overeating in our environment, you may not feel full as soon as your are biologically full because you think full means psychologically satisfied. By paying close attention, you can recalibrate your 'appetite meter' so that it will more accurately reflect the true state of hunger in your body."

I've already noticed that I'm reassessing my notion of 'moderately full', since beginning to review this book. Even after years of bingeing and purging, I know I can eat according to natural hunger/fullness sensations.

AAT: Points of Intervention

Author Linda Craighead in Appetite Awareness Workbook describes 7 specific points, where we can either stray from normal eating or get back on track. I'll list those points, quote Linda's explanation and/or suggestions, and describe my experiences.

(1) Getting Too Hungry: " ... if you are too hungry when you start eating, it is difficult to stay aware and stop at moderate fullness."

I can ignore hunger until I walk into the kitchen. Then I feel famished, don't want to wait to eat, and often snack as I prepare a meal. At the table I overeat the food I prepared, because I really wanted the prepared food, but filled my stomach with stand-up snacks during preparation. Sometimes I can just stop when I feel full, even if I don't eat much of what I prepared. More often, I feel 'deprived' and eat that meal beyond moderate fullness.

(2) Breaking Food Rules: "Even if you do not overeat, you may become upset with yourself if you eat something that you consider too fattening or you eat at the wrong time. You may say to yourself, "What the heck," after breaking a food rule and then overeat or binge ... If you replace food rules with flexible guidelines, there are no food rules to break."

Even though I have 7 food allergy restrictions, I NEVER binge on my allergy foods, because I dislike painful allergy reactions from eating those foods. However, if I restrict foods, which don't give me uncomfortable symptoms, but which I don't consider 'healthy', I create 'food rules'. Unless there are immediate consequences for eating those foods (like gut pain or reflux), I can't restrict 'safe' foods without feeling 'deprived' and eventually binge on those foods, until I remove my 'rules'.

(3) Ignoring Fullness: "The experience of satisfaction is largely psychological and only partly related to your appetite regulation system ... Stomach fullness signals are weak. At first you hardly notice when you start to feel full ... the fullness signal does become stronger as you become more full. Unfortunately, for most people, feling full means feeling close to 'stuffed' ... You lack awareness of early stomach fullness signals (because) ... When you focus on the taste of food in your mouth, you are not attending to fullness. In addition you may have overeaten so often that you no longer recognize early fulless signals ... Many peole do not pay attention to fullness while they are eating (but) notice it after they have become uncomfortably full ... Some peole prefer feeling overfull (and) ... don't feel satisfied until they experience significant stomach fullness."

What really helped me from this section was separating 'satisfaction' from 'fullness'. If I don't choose to eat exactly what I craved, I want to ignore my stomach fullness, so I can eat the food I craved after I'm full. I often value psychological satisfaction over 'fullness'. I know I can have both if I carefully choose what I eat according to my cravings. However, I often save my 'craved' food for 'dessert' after I'm already full from other foods. Or I can get up from a physically filling meal, seek a 'sweet taste', and eat to the point of uncomfortably full, rather than eat just a 'taste', when I don't physically need more foods. Once I'm full, I have no physical signal to stop, other than extreme discomfort. So I'm learning that when I feel full, but still crave specific foods or tastes, to tell myself "Too late. Plan to eat that at your next meal." I also suspect that expecting dessert or a sweet taste when I'm overly full, may be a way of distracting myself from discomfort. I now realize that any additional food will make me MORE uncomfortable.

(4) Eating When Food Is Available: "The real problem with eating when food is available is that youa re likely to ignore fullness. You weren't hungry to begin with, so it won't take very much food to go past moderate fullness ... Minimize mindless eating--the times you eat just because the food is there, and it isn't even that special ... Eating when food is available might be eating for pleasure, it might be a habit, or it might serve an emotional purpose. In any case, this kind of eating feels quite normal ... but, eating when not hungry promotes weight gain."

My most challenging 'eating when food is available' is continuing to eat what's on my plate after I feel moderately full. I'm no longer hungry, but I'm already full. So the only stopping point is absence of food on my plate. If I can accurately judge how much food I need for a meal and serve myself exactly that much, I won't feel overly full as I 'eat when food is available'. However I would feel more comfortable is I just let my 'moderate fullness' cue tell me when to stop eating.

(5) Emotional Eating: " ... is only a problem is you do it too frequently, or if you aren't able to stop at moderate fullness ... When you start eating because you are upset, you want to eat until you get some relief from the feeling. The amount of food it takes to alter emotional states is more than the point of moderate fullness ... when you eat for emotional reasons, you are more likely to choose comfort foods. If you break a food rule (by eating those foods), you may then end up bingeing ... Once you learn that food is an effective way to alter your emotions, you are flikely to use that strategy more ... often. (Then) the association between eating and feeling bettter becomes very strong ... (which) is what most people mean when they say they are 'addicted' to fod. When you feel bad, you know that eating will make you feel better, at least for a short period. Thus, you experience intense desires to eat (or even binge) that are similar in many ways to the cravings of addictions ... When you eat a moderate amount and you don't feel better, it's very tempting to think that a little more might do it (make you feel better). Emotional eating often turns into overeating or a binge."

I suspect 'emotional eating' describes how I eat when I feel slightly uncomfortably full, but crave more food. I want to 'feel better' psychologically, even though I KNOW more food will make me feel WORSE physically. I occasionally binge when I feel deprived of favorite foods (which I have restricted as 'less healthy' than other foods). I feel less psychologically deprived, when I binge on restricted foods and ignore how binge eating deprives me of physical comfort.

(6) The What the Heck Response: " ... is most often described as a feeling of intentionaly giving up control for a moment, or of not caring what you eat iat a given time ... an important intervention point (because) you must cross this point to start bingeing. If you break a food rule or overeat, you STILL have to trigger the 'what the heck' response to turn the episode into a binge. At this point, you can make a different decision ... you can choose to tolerate the negative feelings associated with overeating or breaking food rules and stay on the normal eating path ... (so) you don't compensate by purging, exercising or stricter dieting. When you are quite worried about your weight, you are vulnerable to the what the heck response ... (which) is a result of ... all or nothing thinking. Events or feelings are categorized as either good or bad, right or wrong, perfect or terrible. When you are subject to this way of thinking, once youdecide you are bad, then eating more can't make you feel any worse. Giving up or losing control actualy provides you an immediate sense of relief from your efort to maintain control, even though you eventually feel more like a failure for having given in."

I can sooo relate to that 'oh what the heck' moment of decision, when I decide that I tell myself I no longer care about stopping at comfortable fullness, when I tell myself that eating as much as I what of anything I want (especially foods I have arbitrarily restricted) matters more than learning to obey my physical fullness cues. However, my 'oh what the heck' decision always depends on a decision to compensate by purging.

(7) Plan to Binge (or Overeat): "The problem with planned overeating (at a social occasion or as a special treat) is that you may still feel bad as you are doing it and then give in to the oh what the heck response ... Women don't usually plan to binge unless they have completely given up trying to control their weight or they have a plan to compensate for the binge ... Planned binges are far more common among individuals who plan to compensate by purging or by excessive exercising ... Those compensatory behaviors ... allow a person to escape some of the immediate negative consequences of bingeing. However, they create other, usually even more serious, long-term health consequences."

I recall holiday dinners when I planned to overeat, but felt so guilty that I continued to overeat while cleaning the kitchen, so that purging seemed inevitable. Purging regularly (though less often as time passed) caused one irreversible consequence, tooth erosion, which necessitated lots of crowns and other dental repair. Most other consequences were reversible or greatly minimized as I decreased purging episodes. So I want to tell people who rationalize purging, because the damage has already occurred, and say 'what's the use of learning to eat normally?', that normal eating can reverse the consequences of reflux, swollen facial glands, indigestion or other gastrointestinal problems, unless you have undiagnosed food allergies or intolerances. However, avoiding purging while eating normally will let you recover from symptoms caused by binge/purge episodes. Then you can recognize symptoms caused by other gastrointestinal conditions.

I'm learning from AAT that using stomach cues to decide when and how much to eat will prevent physical discomfort and psychological regret from eating according to psychological cues. I can still eat foods I crave and soothe myself emotionally, if I eat only when I'm hungry and stop when I'm moderately full. The next AAT chapter will clarify stomach signals.

Monday, February 23, 2009

Appetite Awareness Training

I recently reread "Appetite Awareness Workbook " by Linda Craighead, PhD. When I first read that book (1-2 years ago), I liked the author's suggestions but wasn't ready to use her techniques. Now that book seems very helpful. Maybe that shows "When the student is ready, the teacher will appear." I will review (and quote) that book in this and future posts.

Appetite Awareness Training (AAT) is very similar to other intuitive or 'normal' eating approaches. However, AAT emphasizes STOPPING when full even more than starting to eat when hungry. Although I easily learned to only eat when physically hungry, I continued to eat past comfortable (moderate) fullness about once a day for years. So I value what AAT taught me about how to stop eating at moderate fullness.

The author says "The most fundamental concept of AAT is that you learn to use internal, stomach-based signals to make decisions about eating. Obviously, you have to first notice your stomach signals ... the first step is to identify the 2 critical stomach signals: moderate hunger and moderate fullness." People with histories of restriction or overeating (or both) learn to ignore or override those signals. Waiting too long to eat 'tunes out moderate hunger signals'. Bingeing or overeating tunes out moderate fullness signals. I realize that I continued to tune out those moderate hunger/fullness signals, even as I attempted to learn 'normal eating' over the years. Some IE approaches (namely ThinWithin) emphasize starting to eat only when really hungry (or at a '0' hunger level). So I have often ignored moderate hunger in order to identify 'REAL' hunger. I also override (keep eating past) moderate fullness signals once I finally start eating.

The author describes 4 eating paths:

(1) The "'normal eating' path is not 'typical' but 'feels right, because the normal eater focusses on regulating the amount (not type) of food. The normal eating goal is to avoid getting too hunger before you eat because it is too easy to overeat when you start out very hungry, and pay close attention as you eat, so you can stop at the critical moderate fullness."

(2) 'The normalized overeating path is when you continue to eat past your moderate fullness signal.' Although I almost always start when I'm moderately hungry, I often follow that path. Eating for pleasure, eating cues from available food (like leftovers and/or dessert) and emotional eating can all influence 'overeating'. However "The goal of AAT is to stop at moderate fulness no matter why you start eating. When you can maintain this boundary on amount, you will stay on the normal eating path instead of ending up overeating or perhaps triggering a binge ... Everytime you overeat (choose to ignore fullness), it is harder to notice and stop at the moderate fullness level next time." I see how I have continued to 'practice' overeating whenever I ignore my moderate fullness cue.

(3) On the 'restricted eating path' you "deliberately refuse to eat when hungry or when you really want a particular food ... Deprivation can lead to restriction backlash' or the 'oh what the heck' response." That response always precedes my decision to binge. I don't refuse to eat, but I often delay eating when hungry. However, feelings of restriction deprivation also precede my binge episodes. The author says "Excessive restriction, either of calories or of types of food, is the most common reason that women develop binge eating." I did both when I first began binge eating years ago. Now I endure many medical (diagnosed food allergy) restrictions, which can feel like deprivation. However, restricting any nonallergy foods is a direct path to bingeing via restriction deprivation.

(4) The 'binge eating' path feels abnormal, distressing and 'out of control'. However, "the first goal of AAT is to eliminate eating large amounts and getting stuffed, regarless of whether or not you feel loss of control". The author lists 3 routes to binge eating: (1) planned binges; (2) breaking a food rule; (3) overeating can turn into a binge through the "oh what the heck" response. I liked how the author described "what these (binge) episodes do for you in the short run", even though "binges always end up feeling distressing". People don't do things they don't enjoy. "Some people enjoy the process of eating large amounts of food, even when they feel uncomfortable ... Many people report feeling numb or tuned out during the binge process, so we infer that their binges help them avoid experiencing negative emotions ... (which) is the POSITIVE consequence that maintains binge eating. Because this reason isn't usually obvious, many people have a difficult time explaining ... why they binge. The most negative consequence of binge eating is that is maintins your lack of awareness of the critical moderate fullness point. You frequently override your moderate stomach signals, and consequently you lack awareness of these signals. That lack of awareness leaves you quite vulnerable to overeating ... As long as you binge, you ... mask the very signals you need to be using."

The author next describes 7 points of intervention, places you can make different decisions that will take you from the 3 abnormal eating paths back to normal eating. I'll list in my next post those 7 points and describe how ignoring those intervention points influenced my abnormal eating.

Update on Mg Citrate and Aspartame

Magnesium citrate is more easily absorbed than the Magnesium Aspartate with Potassium (and Taurate), which I took for several years. I don't have nearly the level gas and bloating which I experienced with the Mg Aspartate. I can't tell if Mg citrate works more efficiently, because I also have a cold which can decrease vitamin C which affects regularity. However, I also realize I won't know how Mg citrate works long term for another week or so. (EVERYTHING seems to help initially. SIGH) I'm surprised (and embarassed) to learn that the magnesium supplement I had taken had caused so much gas and bloating. Nevertheless, Mg citrate causes more cramping pain and nausea, at least initially ... so typical for 'treatments'. Fortunately I can drink ginger tea, which relieves nausea as well as symptoms from the cold my husband shared with me. Now I just need to endure the Mg Citrate side effects for awhile to see whether my body adjusts, or maybe I could take less to avoid cramps, or whether the affect on regularity is worth the side effects.

Meanwhile I still await a reply from my naturopath about aspartame's affect on magnesium. Tomorrow will mark 2 weeks of abstinence from aspartame. The most obvious effect of abstinence was less headaches (before I caught a cold) and more stable blood sugar (so I feel hungry, not shakey, when I need food).

Saturday, February 21, 2009

Disappointed but not Hopeless

I'm still seeking answers for my symptoms. I may 'feel' hopeless at times, but I never completely give up. I may have a pity party and sometimes binge, rather than coping with feelings of disappointment or helplessness. However I know self-pity and overeating just distract me from what I want/need to do, i.e. recover from symptoms. Yesterday I learned that my naturopath never answered my email inquiry about aspartame, because he was out of town, on vacation. I hope to hear from him early next week.

I've observed over the years that magnesium supplements decreased my gut symptoms (Mg relaxes smooth muscles like intestines). So I decided to try a more absorbable form of magnesium. Since I've heard Mg Citrate is prescribed to prep patients for colonoscopies, I purchased some today. However, I'll start that supplement tomorrow, because I usually take Mg with meals. I'm going to a play after dinner tonight. Since I don't know how I will react to Mg Citrate, I'll take that after breakfast and dinner tomorrow.

To be continued ...

Friday, February 20, 2009

Deprivation vs. Helplessness

Yet another comment by Karen Koenig on her "Food & Feelings" board about feeling 'deprived'. Karen wrote about 'healing deprivation':

"Once you've identified areas in which you feel deprived (love, attention, food, opportunities), understand that the primary, underlying feeling you're dealing is helplessness. Make sure to read the chapter on helplessness in my FOOD AND FEELINGS WORKBOOK and try to complete all the exercises in the chapter. Focus on how you now have power and can make choices. When you feel deprived, stop and attend to the feeling, ie, recognize it and remind yourself that that was then and this is now. Remember that you can't make up for or change the past. Having "more" now will not erase the distress of having "less" then. Reframe your beliefs on deprivation and keep in mind thoughts of abundance. If you're having difficulty with this issue, browse through my blog archives at"Normal" Eating and reread the ones that discuss deprivation and abundance. How 'bout posting a list of rational thoughts from reframed beliefs about choice and abundance?"

When I reviewed the helplessness chapter in my "F&F Workbook", I realized how I often focus on secondary emotions, like anger, anxiety, guilt and disappointment, rather than the primary feeling of helplessness, especially during the past 2 weeks. I know I feel helpless about my ongoing gastrointestinal symptoms. 2 weeks ago I read a study which suggested Splenda inhibited beneficial intestinal microflora (or 'good' gut bacteria). Although I don't use Splenda, I wondered whether the 2 artificial sweeteners I use (aspartame and saccharine) could affect gut motility. So I decided to abstain from those sweeteners (and substitute natural sweeteners). Initially my symptoms decreased, but they returned a few days later. Because I expected better results (decreased symptoms), I felt very disappointed when my symptoms returned after that initial decrease.

I experienced similar disappointments after every treatment for gastrointestinal dybiosis. I get a test which indicates bad bacteria, fungus or parasites. I endure treatment (and side effects of nausea, cramping pain, bloating, etc.) to kill off the 'bad guys' in my gut. I take probiotics (more bloating) after the 'treatment' to restore normal gut bacteria. I feel better (less bloating, gas and irregularity) for awhile (1-3 months), but slowly all my uncomfortable symptoms return.

So I keep looking for causes for those symptoms. I've exhausted my naturopath's 'bag of tricks'. I know mainstream docs would run all the tests for diseases they KNOW how to treat (cancer, gallstones, etc.). However, my symptoms and history are not indicative of those 'mainstream' diseases. My symptoms are consistent with damage from long misdiagnosed (by mainstream docs) celiac disease. I know I'm not consuming any food allergens. I know gut dysbiosis treatments help for awhile. So I had hoped aspartame (which is implicated in soooo many symptoms) might have caused my gut symptoms.

Maybe I haven't abstained from aspartame long enough. My headaches (which I attributed to sleep deficit or low blood sugar) disappeared within 3 days after avoiding aspartame. However, getting worse gut symptoms, rather than feeling better, doesn't seem like a good sign. So once again I feel disappointed, angry that my naturopath has 'given up' on me, scared that I may feel worse and worse, but mostly helpless. I'm also tired of feeling disappointed. Maybe I should change my expectations from hoping that I can find and treat the cause of my symptoms to accepting that I will always struggle with gut cramps, bloating, gas and irregularity or that I will always have a love/hate relationship with food. I enjoy the taste and experiencing satisfaction from hunger, but I hate digestive problems.

So how did I jump from disappointment to helplessness to deprivation? Helplessness and disappointment were familiar emotions during my childhood. I don't like to think about the ongoing anxiety I experienced about my mom's unpredictable mood swings. I felt powerless (helpless) to defend myself against her physical attacks. I continually felt disappointed when I obeyed my parents and excelled in school but was never praised, only punished or scolded for less than perfection. I felt disappointed when I was denied what my older brother was given. I felt disappointed when I was compared to him or my cousin and judged to be never good enough. So disappointment and helplessness are familiar, yet uncomfortable feelings.

As Karen Koenig mentioned in her F&F Workbook chapter about helplessness, I prefer to focus on an action-oriented emotion, like anger or anxiety, which motivate me to DO something, anything, rather than acknowledge feelings of helplessness. Likewise, because I experienced lots of helplessness during childhood, I quickly jump to anger or anxiety as adult, rather than let my 'helpless' feeling remind me of all the times during my childhood when I experienced helplessness. I can easily overreact to adult 'helpless' feelings, because I never acknowledged or resolved all the situations which made me feel helpless as a child. So the adage "That was then and this is now" reminds me to focus on current emotions like helplessness, not let unresolved childhood emotions overwhelm me.

When I began abstaining from aspartame, I hoped that would resolve my symptoms. However, I also realized I felt deprived when I added more familiar foods (artificial sweetners) to my ever growing list of restrictions. Rather than focus on what I can't eat, I always try to focus on what I can eat. So I celebrated Valentine's day with allergy free (naturally 'agave' sweetened) brownies and nonalcoholic wine with dinner. I don't mind doing without, when I believe abstinence will help me feel better. However, when I didn't feel better, I just felt deprived ... deprived enough to continue overeating for the next several days. Now I realize I was not only deprived of a familiar sweetener, but hope of recovery from gut symptoms. So I tried to distract myself from hopeless, helpless feelings by feeding my sense of deprivation with 'food'.

Obviously feeding my 'deprivation' didn't work. Rather than feeling fulfilled, I just felt too full. When I cleared away my disappointment, I was left with familiar feeling of helplessness about my body. Now I need to consider what I CAN do, whether or not aspartame abstinence resolves my gut problems. I'm not totally powerless over my health. So I will contemplate what I can do to feel better.

Thursday, February 19, 2009

Deprivation and 'Settling'

'Feeling deprived' has continually influenced my choices to either overeat or binge. So I liked Karen Koenig's post about childhood deprivation in response to a thread about 'greed and overeating' on her "Food and Feelings" board. Karen said:

"Growing up deprived of food/love/attention skews how you look at the world as an adult. You too often think: Will I get my fair share? I better take more in case I don't get later. Do I deserve more? Do I deserve enough? Is enough what I want or what someone tells me is right for me? Fear of being deprived drives decision making and since deprivation is a deep well, you feel as if there's never enough. Rarely do I meet disregulated eaters who don't have other sufficiency issues. In fact, I call the whole condition having an "enough disorder." The way to effective self-regulation is through asking yourself questions such as Am I satisfied, Would more or less be in my best interest, How will I feel with more, How will I feel with less. Doesn't matter if you're talking about food, work, doing for others, TV, shopping, spending. Knowing what's enough is called a life skill."

As I mentioned in a previous post about 'passions' I believe we crave as adults what we missed as children. My mom restricted what I ate, controlled what I wore and told me to stay in the house and do household chores after school, rather than play outside. I was deprived of love and respect, but as a child I mostly felt deprived of more obvious things. Now I have difficulty saying 'enough' to food, clothes, late night tv in bed, and being outside on sunny days. (I can easily say 'no' to household chores.) I may feel more deprived of foods, when I feel deprived in other areas of life.

Memories of childhood deprivation makes me resist and often rebel against my inner voice of reason, especially when I feel overwhelmed with currently feeling 'deprived'. My inner self-talk while overeating or even bingeing reflects that battle between a restricting parent self and a rebellious child self. Until I resolve my 'enough disorder', I may continue to obey and then occasionally rebel against perceived 'deprivation'. Asking myself Karen's suggested questions ("Am I satisfied?", "How will I feel with more?" and "How will I feel with less?") can help me thoughtfully explore 'how much is enough', when I eat, when I shop for clothes, when I do household chores. Those questions can help me feel like an adult making loving choices, rather than a restrictive parent controlling a rebellious child.

Abstinence from bingeing can seem like deprivation from freedom to eat whatever and as much as I want. Food allergies and gastrointestinal problems already limit what I can eat. Physical comfort limits how much I can eat. Hunger and fullness limit both when and how much I can eat. So I will never have total freedom with food or eating. I can never make up for deprivation in childhood by eating with abandon in the present. Nevertheless part of me rebels against that truth when I choose to binge, probably because I still believe at some level that 'purging' lets me ignore reality and 'get away with' total eating freedom. So I want to consider what other ways, besides bingeing and purging, can I 'plunge into oblivion' (as Geneen Roth labels binges in "Breaking Free from Emotional Eating")?? What else can I do when I feel overwhelmed with life, gastrointestinal symptoms, and uncomfortable feelings like confusion, fear and even guilt? Can I let myself have a 'day off' when I feel like I need freedom?

I also realize that frustration about my chronic gastrointestinal symptoms lead me to rebel against restrictions about hunger/fullness eating, even while I still obey restrictions about food allergies, artificial sweetners, etc. How ironic that I can even binge on allergy safe foods. I fear the pain of allergy reactions more than I fear guilt and possibly worse irregularity after binges. So even when I choose to binge I don't rebel against all restrictions. I still accept the food allergy restrictions as necessary and helpful. I just rebel against stopping at enough food. I tend to go back and forth between listening to my body and stopping before I'm uncomfortably full and eating with abandon to the point of discomfort. I choose to binge, because I know I can resolve the discomfort of overeating when I purge. So why not binge and purge occasionally, like once every 3 months? Why not reward longterm abstinence with a binge/purge episode? BECAUSE ... I really don't enjoy the food after I feel overly full. I miss the flavor of food I eat after I'm full. Purging causes more regularity problems, although short lived, when I quickly return to 'normal eating'. Purging erodes dental enamel. (I already have crowns and composite 'backers' on several teeth. Purging exacerbates reflux (I continue to reflux very easily for a few days after purging). I actually see more negative purging than bingeing now. However I really dislike feeling uncomfortable after overeating. So I won't binge unless I plan to purge. Hmmm ... what would I 'give up' if I never binged again, besides the negative discomfort and problems from purging??? THE SENSE OF FREEDOM, the plunge into oblivion, permission to do or give myself whatever I want, when I want it.

What struck me as I considered how feeling 'deprived' influences my choice to overeat or binge was: EVERY TIME I CHOOSE TO OVEREAT OR BINGE, I AM 'SETTLING'. Instead of going for what I really want, I choose what's easily accessible, just as I did during my childhood. I couldn't make my mother love me or treat me equally or even stop abusing me, but I could eat the foods she restricted, when nobody was home. I wanted to be loved. I wanted to be free to go outside and play after school. I wanted to be with friends and their parents who treated me better than my own mother treated me. However, I obeyed my mom who told me to stay in the house, do chores and school homework. Instead of doing what I really wanted, I 'settled' for eating forbidden foods. I rewarded myself for obeying my mom by eating the foods I liked, but was forbidden to eat. I knew my mom would never reward or even praise me for obedience. So I rewarded myself for doing what I really didn't want to do. I 'settled' for food instead of love. I still settle for less than I want and reward myself with excess food.

Every time I feel physically satisfied, but reach for more food, I want to ask myself, "Why am I settling? What do I really want? If I could have anything else, beyond food, what would I choose? If I leave this table or kitchen and go anywhere else, where would I go? If I could start today to live the life I want, would I continue to eat? If not now, when?

Tuesday, February 17, 2009

Finally a Connection

For years I've taken magnesium supplements to cope with chronic irregularity. I've also tried to avoid what depletes magnesium, like excess sugar, caffeine and alcohol. However, I've continued to struggle with irregularity despite daily magnesium supplements, treatments for conditions that affect gut motility (like CD, food allergies, low beneficial microflora (good intestinal bacteria). Occasionally I need even higher doses of magnesium to treat irregularity. When I feel desperate, I take Milk of Magnesia laxative, but I dislike its side effects (cramping pain). Yet, I seem to need more and more magnesium to maintain regularity.

Because I still wonder whether aspartame consumption affects regularity, I did a google search on aspartame and magnesium deficiency. Lo and behold, I found numerous studies which implicated aspartame in fatal heart attacks, because asparatame toxicity depletes magnesium. I only read one definitive study that showed "Aspartame administration also affects the excretion of magnesium from the organism, since it decreases the concentration of magnesium in both urine and feces." However, that one study was enough to convince me to continue to avoid aspartame.

Maybe my longterm use of aspartame increased my magnesium deficiency to the point that I need 950-1200 mg of magnesium aspartate with potassium supplements for 'regularity' now. That's scarey!! The good news is that I stopped consuming aspartame a week ago. So hopefully, my body will eventually recover from aspartame toxicity. So I won't need to take so much magnesium. For now, I will continue to avoid whatever depletes magnesium, like aspartame, and continue to consume magnesium rich foods and take magnesium supplements.

Monday, February 16, 2009

"Normal" Comfort Eating

I've been having another pity party, as I hinted in my last 'good/bad news' post. I felt physically crappy, which often affects my mood and outlook on life. (No, I won't use that overused term 'depressed', because I CAN still function.) Worrying about what causes chronic bloating and intestinal cramping pain can influence what I choose to eat: Should I eat more fiber? Drink more water? Eat smaller meals? Eat larger meals? Abstain from anything that feeds 'candida' fungus? Reread all the labels in my house to ascertain whether I've accidentally consumed any allergens? All those questions can take me back to 'diet' mode without any clear direction or answers for my symptoms ... kinda like my recent choice to abstain from artificial sweeteners. I know how unnecessary restrictions affect me ... Part of me responsibly obeys those restrictions, but the other part rebels and sometimes overeats foods (she thinks) are unnecessarily restricted.

I knew I've been feeling physically uncomfortable and emotionally hopeless. I also knew I was soooo tired of trying new dietary restrictions or additions to cope with my symptoms. Mostly I wanted something easy to digest and very soothing for lunch today. (Last night's dinner was a warm chicken salad with lots of vegies, which is very easily digested and soothing.) Above all I wanted something SWEET. I considered having for lunch one of my valentine (homemade) brownies with a scoop of chocolate ice cream and a few apple slices smeared with peanut butter. However, on a walk before lunch, I realized all that chocolate could cause more reflux. So I began to obsess about a thick slice of my homemade 'morning glory' bread (with apples, apricots, carrots, spaghetti squash, walnuts, etc.) topped with almond butter and creamed honey. After I returned from my walk, I decided to add baby carrots and apple slices to my 'comfort food' lunch.

As I slowly enjoyed the bread, nut butter and honey combo, I realized how seldom I eat such really sweet foods. I also observed that I had consumed a large carb load, because I felt relaxed and even drowsy after lunch, which was probably a good thing to relax my cramped intestines. Nevertheless, I realized eating small (a fist full portion) bread/nutbutter/honey lunch was more satisfying than any binge foods I ever tried to use for comfort. Of course, I mindfully enjoyed (actually 'oooo'ed and 'aahhh'ed over) that gooey concoction. I ate that lunch for over 30 minutes.

Perhaps, because I fed my body exactly what it craved, I feel better now, no cramping pains and pleasantly relaxed. Above all, I ate that meal when I was physically hungry and stopped when I was comfortably satisfied. Of course, I felt satisfied! I ate a small portion of exactly what I wanted. So this is what 'normal eating' is all about ... THANKS, Karen Koenig, Geneen Roth, Susie Orbach and all the other 'normal eating' gurus!!! Eating exactly what my BODY (not my mind) wants may be the 'cure' I need for physical discomfort. At least that feels better than questionable (undiagnosed) dietary restrictions and/or additions.

Good News, Bad News

I'll start with the good news: After a week of abstinence from aspartame, I no longer have those headaches, which I thought were either caused by sleep deprivation or low blood sugar. I DID suffer a pretty bad headache after a few days of aspartame abstinence. A friend advised me that those were 'withdrawal' headaches. However, I still suspect inadequate sleep the night before that bad headache. Nevertheless, I have not gotten my usual 8-9 hours of sleep for the past few days, but I also have not suffered headaches. So maybe aspartame did cause my headaches ...

Also drinking water with meals (rather than sweetened tea) enables me to enjoy subtle tastes and natural sweetness of foods. I use stevia for tea and agave for cereal or on strawberries (that really weren't ripe). However, the hype about artifical sweetners causing cravings for sweets isn't true for me. I still crave sweet tastes occasionally, but I was not previously driven by sweet cravings. (I could binge on peanut butter or baked salmon as easily as I could binge on ice cream or grapes.)

Now the bad news: I have not noticed any significant improvement in gut motility, i.e., I'm back to irregularity, bloating and discomfort. What initially seemed like improvement was just one of my cyclical 'blips'. I feel very disappointed. Yesterday (maybe because it was a gray day), I felt VERY hopeless again about ever having a 'normal' gut or relief from discomfort. I've tried sooooo many different treatments to resolve gut motility. For those of you who want to suggest their personal constipation 'cures':

NO, I won't resort to laxatives, which only treat the symptoms. I'm looking for causes. Besides, most laxatives use either senna or sorbitol which cause excruciating pain for me. I already eat lots of fiber. I drink lots of water and other fluids. I abstain from 7 diagnosed food allergies (which can cause irregularity symptoms). I abstain from caffeine and alcohol, which can affect regularity, but also reflux, which is an intermittent problem for me. I exercise daily (1 hour walk, 15 minutes of yoga, pilates, weight lifting, etc.). I take NO OTC or prescribed drugs. However I use HCl supplements to digest foods which supply magnesium, which I also take as a supplement. Oh yeah, I've also treated for candida (5 months of Nystatin with low sugar diet), which can influence irregularity.

I really don't know what's left ... except move to Maui, where I never seem to have regularity problems. Maybe Maui water, which tastes 'flat' but has no added calcium, unlike Seattle water, is the 'cure'. However I've also experienced improved gut motility after taking high dose probiotics. After finishing a high dose treatment and following that with several weeks of lower dose probiotics, I decided to see how I did for awhile. Now I suspect that I'm back to my 'normal' impaired gut motility.

I often joke that the only thing predictable about my body is irregularity. Yet I sometimes feel hopeless about ever escaping daily symptoms of bloating and cramping pain. I had HOPED abstinence from artificial sweetners was the 'cure' for impaired gut motility, as well as relief from headaches. Unfortunately I haven't experienced continual improvement in gut motility since abstaining from artificial sweetners. However, I will continue that abstinence, because I don't want to consume unnatural chemicals with questionable side effects. Nevertheless I currently think I'm @#$%^& if I do and @#$%^& as far as regularity 'cures'.

Saturday, February 14, 2009

Life Without Artificial Sweeteners

I thought I already had ENOUGH dietary restrictions, but here I go again LOL ... After reading a study which showed Splenda alters gut microflora in rats (reduces beneficial intestinal bacteria), I wondered whether other artificial sweetners caused bacterial dysbiosis (imbalances). Decreased beneficial bacteria causes impaired gut motility which can affect regularity. For years I struggled with symptoms of impaired gut motility (indigestion and constipation), despite treatment for food allergies, bacteria, Candida and a parasite. Although I don't consume Splenda (sucrolose), because it's derived from sucrose (to which I have diagnosed IgG mediated allergy), I have consumed aspartame and saccharin regularly for years.

I have for limited periods tried consuming only stevia (a natural plant derived sweetener). So I could easily substitute stevia for 'Equal' or 'Sweet n' Low', as well as use other natural sweeteners like agave, honey, maple syrup or beet sugar. I'm willing to try anything (for awhile) that might improve gut motility. So 5 days ago, I began to abstain from all sources of aspartame and saccharin. I already abstain from all the alcohol derived sweeteners, like sorbitol, which cause me painful gut symptoms. I also began to drink hot water, rather than tea, with meals in order to limit the amount of sweet beverages I consumed. I discovered that I prefer water with meals, because I can easily taste natural sweetness and other subtle flavors of food, when I don't drink sweet beverages with meal. So I drank my stevia sweetened tea between meals. I also used agave to sweeten hot cereal and for baking brownies for Valentine's Day.

Initially I experienced signs of improved gut motility (more regularity, less gas). Then I slipped back into my 'normal' (irregularity) for one day, before continuing to improve. However I also noticed less headaches, DESPITE less sleep. (I always blamed inadequate sleep or low blood sugar for my headaches.) Aspartame users often complain about headaches. I'm still uncertain about whether abstaining from aspartame and saccharin will permanently improve gut motility, but I'm willing to continue my experiment of artificial sweetener abstinence. Stevia costs more than the pink and blue sweetners, but I only need one stevia for 2 cups of tea, vs. one each of the 'pink' and 'blue' ones. Maybe I adjusted to less sweet tastes.

Whatever happened, I can easily continue this experiment indefinitely. I suspect I can adjust to anything I truly believe is beneficial. I don't feel like I'm giving up anything, just substituting. That 'substitution' perspective helped me easily adjust to finding 'safe' foods with 7 food allergies. So I suspect that a positive 'attitude' can help me through anything.

Wednesday, February 11, 2009

Low Blood Sugar Experience

I needed lunch long before I returned home this afternoon. Fortunately I carried with me leftover 9 slices (3/4) of apple from yesterday's lunch, just in case I was delayed at the mall. Of course, I was delayed at the mall! LOL I can't go to pay a bill without at least looking and maybe trying on a few items. So I left the mall past the time I really needed lunch. Buying a meal at the food court with my 7 allergies is really risky. So I ate my apple while walking home (30 minutes). Then I ate 2 baby carrots while warming up the refried bean guacamole wrap I intended to eat for lunch. After I slowly ate that wrap I felt very full, almost uncomfortable. However I still craved something ... but what? I considered several sweet treats, but I knew I was full. So I had the following conversation with myself (I'll call the wanting part 'rebellious child' who wants more despite feeling full, and the reasoning part 'loving parent, who reasons with the child):

RC: I want something else to eat, maybe a dessert.

LC: Are you still hungry?

RC: NO, I feel full but not satisfied. I want something sweet.

LC: What do you want the food to do for you?

RC: Make my stomach more comfortable. Give me energy.

LC: Will eating more make you stomach feel better?

RC: No, I will just hurt more, but I feel tired. Food will give me energy.

LC: What else can you do when you feel tired?

RC: I can sit and post online or I can sew.

LC: How about a cup of tea while you sit and post and then sew for awhile?

RC: But I want sweetened tea with a little ginger to soothe my stomach.

LC: How about Chai Redbush which has stevia and ginger as well as rooibus?

RC: OK. GIMMEEE.

By the time I finished that conversation, my stomach felt better after digesting some of the food and my body felt more rested after posting. Most of all, my blood sugar 'caught up'. So I felt satisfied as well as full. Now I can enjoy my tea while I finish a sewing project.

Tuesday, February 10, 2009

What's Left to Eat?

When I tell people I have diagnosed food allergies to gluten, dairy, soy, eggs, cane sugar, vanilla and nutmeg, I am usually asked "WHAT'S LEFT TO EAT?" Finding safe (nonallergenic) foods can be challenging, because my allergies are often INGREDIENTS in common American foods, rather than specific foods. However, I was not diagnosed all at once with my allergies. Over a period of 3 years I learned (through Enterolab stool tests for IgA mediated allergies and ELISA blood tests for IgG mediated allergies) which foods caused my painful (and sometimes scarey) symptoms. Then I gradually learned which foods were free of my allergies. Of course, I must still obsessively read food labels, because 'safe' products often change their ingredients to add my allergens. (My first clue is often 'new, improved version'. LOL) Nevertheless, for readers of this blog who wonder what I eat, I decided to keep a meal by meal (plus snacks) food journal which describes what I eat. Rather than wait to post after a few days of entries, I will just keep editing this post to add new meal entries. Here are today's meals and times (which show a meal's 'staying power'):

9:30am Breakfast: 1/2 gluten free Seattle Brown hamburger bun (like a small English muffin) with 2T. peanut butter (fresh ground at Whole Foods with no additives), 1/2 chopped comice pear, cinnamon, 1 tall mug of hot water. (Later: a tall mug of rooibus tea w/ 1 tsp Agave.)

2pm Lunch: Ham sandwich (2 slices GF SB bread, 1 T homemade mayo (cashew base), lettuce, 2 slices tomato, 3 slices Hillshire Farms honey ham (cane sugar free), 2 baby carrots, 1/4 Gala apple, tall mug H2O.

5:15pm Snack: 2 tsp. peanut butter, 1 cup ginger tea w/ 1 tsp. Agave.

7pm Dinner: Homemade spaghetti sauce (w/ onions, garlic, zucchini, carrots, red peppers, mushrooms, tomatoes, shrimp) on gluten free spaghetti (small petit pan full or 1-3/4 cups); 1/4 cup Truly Decadent dairy free (coconut milk) 'Passionate Mango' frozen dessert; tall mug hot H2O.

Later: 1 tall mug ginger tea w/ stevia (1 packet)

WEDNESDAY 2/11/09

9:30am Breakfast: 1/4 c. Bob's Red Mill Mighty Tasty Gluten Free Cereal (buckwheat, corn, brown rice and sorghum) w/ 1 T. rice bran, 1 dash cinnamon cooked in 1 c. hazelnut milk with 1/2 chopped comice pear, 1 T. almond butter, 1 tsp agave; tall mug hot H20 (Later: 1 tall mug Pau D'Arco tea w/ 1 packet stevia)

1:50pm Snack: 3/4 (9 slices) Gala apple

2:45pm Lunch: 1/2 bean guacamole wrap (homemade guacamole w/ refried black beans spread on large rice tortilla); 2 baby carrots; tall mug hot water. (Later: 1 tall mug Chai Redbush tea w/ 1 stevia)

7pm Dinner: crookneck squash, sauerkraut with apples, 1 mild Italian turkey sausage (about 2 cups altogether, previously frozen leftovers dinner), small ginger cookie, tall mug hot water
(Later: 1 tall mug ginger tea w/ stevia)

THURSDAY 2/12/09

SNACK 8am: 4 oz. apple juice

BREAKFAST 10am: 1/2 GF SB hamburger bun, 2 T. peanut butter, 1/2 chopped comice pear, cardamon, cinnamon, tall mug hot water.
(Later: tall mug Pau D'Arco tea w/ stevia)

LUNCH 2:50pm: 5 baby carrots, sandwich w/ 2 slices SB GF bread, 4 slices deli honey ham, 2 slices tomato, lettuce, homemade mayonnaise, 1/4 cameo apple, 1 bite ginger cookie, tall mug hot water. (Later: rooibus tea w/ stevia)

DINNER 7:15pm: 1-3/4 c. (petit pan full) Casserole (chicken, wild rice, red onions, kale, red pepper, carrots, garlic); 1/3 c. Truly Decadent dairy free (coconut milk base) chocolate frozen dessert; tall mug hot water.

(Later: tall mug ginger tea w/ 1 heaping tsp. agave)

OK, that's enough boring food journalling. I'm starting to repeat menus. The people who wonder what I eat never responded to this post. Only one person who questioned the amount of protein I eat (esp. for breakfast) and maybe overlooked the value of nonheme vegan protein source combinations. For that commenter and anyone else who wonders why I don't eat more .... (fill in the blank), I only weigh around 100#. I don't want to waste the earth's resources, food or $$ by eating more than I need. "Diet for a Small Planet" (which taught me about combining nonheme protein sources for complete protein) still influences my choice to eat as little as I need to satisfy physical hunger, rather than as much as I can get.

Friday, February 6, 2009

Feeding Fears Not Hunger

As I continue to explore what motivates me to eat beyond satisfaction at meals, I realize that I want to do one thing, but instead do the opposite, just as Paul wrote in Romans 7:15: "I do not understand what I do. For what I want to do I do not do, but what I hate I do." That reminds me of Karen Koenig's comments about 'confusion' in her "Food and Feelings Workbook", which say:

"A hallmark of mixed or conflicting feelings is repeatedly SAYING you want to do one thing, but not DOING it, or doing its opposite. For example, let's say you're sick of focusing on how much you weigh, but can't quite bring yourself to put away the scale. You've been battling with this dilemma for ages. The problem is that you're in touch with only one set of emotions, the 'positive' ones (the pros) telling you that it's a healthy move to ditch the scale. The other set of feelings, which is comprised of your fears (the cons) is hidden out of awareness. When you think about it, there are real reasons you'd be scared to stop weighing yourself: dependence on a number to tell you what and what not to eat, lack of trust that your body can take over the job, fear of getting fat or of no longer being thin."

While I have no problem with scales (I weigh about once a month), I can understand how fears about what could happen when I stop eating at 'just enough' keep me eating past comfortable satisfaction. Most of those fears originated from actual experiences. At the time, overeating seemed like a valid way to prevent reoccurence of those situations. However, those fears are no longer valid. So here are my 'FEARS' and the truth about those situations. IF I STOP EATING WHEN I FEEL SATISFIED, I FEAR:

(1) I WILL GET LOW BLOOD SUGAR SYMPTOMS RATHER THAN FEEL 'HUNGRY' BEFORE MY NEXT MEAL. Like my other fears, this fear is based on actual experiences when I experienced scarey low blood sugar symptoms, especially when I was away from safe (non allergic) foods. However, I learned to prevent low blood sugar reactions by eating balanced meals with fats, proteins and fiber. At home I can drink apple juice or hazelnut milk to restore my blood sugar without ruining my appetite for the next meal. On walks away from home, I carry money to buy fruit or juice which can restore my blood sugar quickly. Above all I've learned that WHAT I eat (enough protein, fiber and fats) will keep my blood sugar balanced more than HOW MUCH I eat. So I can just stop when I feel satisfied, rather than overeat to prevent low blood sugar symptoms.

(2) I WILL FEEL GUILTY ABOUT WASTING FOOD. I try to serve myself portions that I've learned from experience are just about enough to satisfy hungry. If I have much more than I need, I can store that for another meal. If the food won't keep well for a future meal, then I can store the food and throw it out after it takes on a life of its own (mold!) in the refrigerator OR I can throw it out after the meal. I can't always predict how much my body needs to satisfy hunger, but I don't have to abuse my body by overeating, when I misjudge how much I need.

(3) I WON'T CONSUME ENOUGH HIGH FIBER FOODS. That fear is based on years of confusion about what caused my chronic irregularity and misinformation from clueless docs who didn't understand the cause of that irregularity. Diagnoses of my 7 food allergies and subsequent abstinence from allergy foods helped somewhat resolve that irregularity. However my problems were caused more by impaired gut motility, rather than lack of fiber in my diet. Some of that impaired gut motility was caused by hypochloridia (insufficient stomach acid). So taking HCl with meals improved stomach digestion. More of my slow gut motility was caused by various bacterial, fungus and parasitic imbalances in my intestines, also linked to hypochloridia (because normal stomach acid kills those 'critters' in the stomach). After treatments for each of those imbalances killed bad bacteria, fungus and a parasite, I always experienced improved gut motility (and regularity) for awhile. More recently I took really high dose probiotics which really improved intestinal health, by flooding my gut with good bacteria to crowd out those other bad guys. So I can choose higher fiber foods, but not needlessly overeat for fear of becoming irregular.

(4) I WILL FEEL DEPRIVED AND EVENTUALLY BINGE ON FOODS I DON'T LET MYSELF EAT FOR DESSERT WHEN I STOP AT SATISFACTION. Again that fear is based on real experiences. As I described in previous posts, I did cycle between restricting and bingeing on sweet foods. When I allowed myself to eat my former (allergy free) binge foods at meals, I changed how I viewed those foods. They became 'just food', rather than binge foods. I stopped bingeing. However I then feared that I would binge when I felt stressed, if I didn't eat 'dessert' after lunch and dinner. Even when I felt satisfied by the meal, I rationalized eating dessert, because I feared I would feel deprived and later binge, if I didn't have 'dessert'. I definitely didn't want to return to bingeing (and purging). So I continued to overeat at meals to include my dessert. Eventually I realized I just wanted a sweet 'taste', not a whole portion. So I began to eat just a bite or 2 of something sweet to satisfy my craving for 'taste'. Now I can often just stop when I feel satisfied. If I miss that sweet taste, I include that sweet in my next meal. I no longer fear 'deprivation' induced binges, because I realize I previously to cope with feeling overwhelmed with physical and emotional challenges, not just because I felt 'deprived of sweets'. I also realized overeating to include a sweet dessert deprives me of physical comfort when I leave the table.

I began writing this post a few days ago. Since then, I rarely overeate. I stored or thrown away food still on my plate when I felt satisfied. The realization that I overate to feed FEARS, rather than my body, helped me 'let go' of food as I understood those fears are no longer valid. What I feared doesn't happen now. As I feed my body, not irrational fears, I prefer to stop eating before I feel uncomfortable, rather than rationalize overeating. Before I eat, I can choose foods with high fiber, fats and protein, and/or sweet tastes. However when I eat, I can stop, when I feel satisfied, no matter what I ate before that point. Rather than listen to fears in my mind, I can 'just say no more' and let my body choose when I stop.