Gonna Lose Weight in a Healthy Way . . . For Real This Time

May 22, 2011 6:46 PM

Recovered bulimic/anorexic trying to lose weight in a healthy way -- any Mefites been there, done that?

I have been in recovery from an eating disorder (a combo of bulimia/anorexia) for several years. Part of the recovery was gaining back a good deal of weight, and now I am high-normal to low-overweight. I would like to lose some weight, but I am definitely nervous about going down an unhealthy path again. A couple years ago I tried Weight Watchers, but the Points counting kind of put me back in a bad mindset and I dropped it when I noticed myself getting a bit nutty about it. Now I think I am definitely in a place where I can try to lose weight in a healthy way, but I know I should be careful to tailor the program with my past in mind.

I'm wondering if anyone out there has gone through a similar thing? What worked/didn't work for you? Did you follow a specific diet? I really don't want to count calories -- how did you track your program without slipping into old habits?

Thanks!

posted by imalaowai to Health & Fitness (13 answers total)

You really need to pose this question to a physician, therapist, or other licensed, trained professional who knows your medical and mental health history and is qualified to treat eating disorder patients. It would be irresponsible for us to make suggestions without that knowledge and training.
posted by decathecting at 6:50 PM on May 22, 2011 [7 favorites]

Yeah, got to agree with decathecting. The mortality rate for your illness makes it nothing to fool around with.

You might also consider forgetting about weight loss entirely and just focusing on eating the freshest, liveliest food possible and doing physical activities you enjoy.
posted by ottereroticist at 7:19 PM on May 22, 2011 [7 favorites]

Seconding decathecting's suggestion to talk to your doctor.

In the mean time, you can try adding more fresh fruits and vegetables to your diet. I find that I gain weight when I've come to rely too heavily on processed foods, and some fresh fruit in addition to my regular food is a nice way to ease myself out of a junk food rut.
posted by ladypants at 7:20 PM on May 22, 2011 [1 favorite]

Best wishes for good health to you.
posted by ottereroticist at 7:20 PM on May 22, 2011

Agree with decathecting, and want to offer a personal anecdote.

I was never diagnosed with an eating disorder but definitely had some disordered eating habits and unhealthy mental stuff that led to near-clinically-unhealthy weight loss some years back. Right now I am in the healthy BMI range but sometimes wish/prefer to be at the lower end of it. I used to obsessively count calories back in the day; now, when I want to decrease weight, I still count calories, but have increased my daily "allowance" to one that's healthy (based on lots of internet research). Interestingly, I can compromise on engaging in this behavior but no other others. If I find myself doing any weight-related behaviors other than that (not assuming that you are not a strong person, but don't want to trigger, so won't describe anything else), I take a mental step back and remind myself that for me, being healthy means being happy and doing those unhealthy mental things will lead to an unhealthy physical and ultimately unhappy place. This is just my story, so I expect YMMV.

Also, I don't have a lot of money right now, and as a small framed person losing a little bit of weight means my bras and pants no longer fit and I need to buy new ones. So for me, the reality right now is that being X lbs over "ideal" is preferable to not putting Y dollars into emergency fund/being in Y dollars of debt.

I applaud your commitment to physical and mental health. Good luck to you!
posted by shortskirtlongjacket at 7:25 PM on May 22, 2011

I worked with clients in your situation in my years in private practice as a holistic nutritionist. However, I am not YOUR nutritionist.

You're correct in your concerns about Weight Watchers and similar programs taking you down a potentially dangerous road. Others are absolutely correct in recommending you work with a professional to help you figure out whether and how to go about this. You really have to stay on top of the psychological side of this thing (and clearly you are trying to stay on top of it since you asked this question).

The right approach for you really depends on you and your illness -- how it manifests, especially psychologically; how you recovered; and how the illness began in the first place.
posted by hansbrough at 8:06 PM on May 22, 2011 [4 favorites]

In the mean time, you can try adding more fresh fruits and vegetables to your diet. I find that I gain weight when I've come to rely too heavily on processed foods, and some fresh fruit in addition to my regular food is a nice way to ease myself out of a junk food rut

Completely second this. DEFINITELY speak with your therapist and doctor, but in the meantime putting some vegetables and fruits in your body should help you mind and body.
posted by sweetkid at 8:16 PM on May 22, 2011

Former anorexic here.

The right approach for you really depends on you and your illness -- how it manifests, especially psychologically; how you recovered; and how the illness began in the first place.

THIS. You might have not be able to ever go on a formal diet without risking a relapse. I grew up around a lot of "omg I gotta diet 'cause I'm fat" talk from a very early age. It's always been triggering as hell to me.

Nthing checking with doctors and eating healthier foods. Focus on developing a healthy attitude towards food and eating, and work from there.

Best wishes.
posted by luckynerd at 8:31 PM on May 22, 2011 [1 favorite]

Note: Talk to an experienced therapist about this.

BUT here is my non-therapist advice . . .

This is a really, really, really complicated issue. It's a great first step that you're able to detect when diets aren't working well for your mental state.

First, you have to accept that you aren't going to lose weight quickly. The quickest weight loss involves a lot of diet control and calorie counting and as you know that's the worst thing you can possibly do.

The #1 rule is to not weigh yourself. That's not going to help.

If you don't already exercise, first find an activity you enjoy. Don't worry about prescriptions (30 minutes of cardio, 30 minutes of weights, etc). Think of something you've always thought would be really cool, dancing, lifting, rollerblading, speed-walking, whatever, and start getting involved in that. Half of this is developing joy and appreciation for your body outside of its weight and body fat--developing appreciation for it as the delightful biological wonder it is and it's ability to do rather than just appear. Once you're able to do that, healthy nutrition habits are a hell of a lot easier to adopt because you are pretty much driven to adopt whatever program is going to make your body feel (rather than just look) its best.

As for diet, initially focus on adding rather than removing. That is, make sure with every meal you're eating vegetables and a good serving of whole protein. "Good serving of protein" is approximately the 1.5-2x the size of your hand or more. Preferably in the form of meat or eggs. Post workout, always have a piece or fruit and some form of protein.

After a period of time when you have developed a good rhythm with your physical activity and your adding, then move on to removing--replacing more and more of your calories from healthy foods. Start trying to cut down on sugar and junk food intake (this will help with any binging issues, sugar is often a trigger for people), but don't freak out if you have some once in a while. I suggest going by your gut with this in terms of frequency of intake. Don't schedule cheat days but don't resolve to Never Eat It Again. Each time you're confronted with a junk-type food be honest with yourself--what's the occasion? How good is the stuff your'e going to be eating, anyway? Is it like the best ice cream in the world or Good Humor out of a convenience store? Have you been eating it every day?

At this point, try portioning--2/3 of your plate vegetables/fruits, 1/3 protein, use healthy fats for cooking or garnish (e.g. nuts on a salad or something). Still no calorie-counting, just thing about the proportion of things on your plate.

Do not try to make up for binges or too many cheats by cutting out good food. Treat them as if they never happened.

The whole time you really need to focus on your hunger signals and figuring out cravings vs. binge urges vs. real hunger. ED can really screw these things up so now you have to actively work on developing the ability to listen to those signs again.

As your activity level increases and your food intake improves, you will probably see some body composition changes, though not dramatic. I would not recommend actively focusing on body composition changes until you've gone through the above process and have really learned to trust your body's signals and your relationship with food. And even then, I would start with something like adopting Paleo or low-carb, where you're restricting the types of food you're eating rather than quantities. The benefit of either of those plans is that they also tend to help with cravings.
posted by Anonymous at 8:37 PM on May 22, 2011

I've gotten past an eating disorder/disordered eating (like shortskirtlongjacket, I was never diagnosed, but probably because I didn't get "caught") and lost quite a bit of weight in a healthy way. Everyone is different, and what works for me might not work for you, but here's my experience:

First things first, find a therapist you like and who has experience with treating people with eating disorders. Even if you don't feel like you need one now, they'll be invaluable if you find yourself slipping into unhealthy habits or thought patterns.

Most diets, at least the kind with a name and "program" and books and so on, can lead an eating-disordered person to take them too far, and you're wise to be wary of them. It's easy to start stretching the limits and turn it into something unhealthy.

The biggest and most important changes for me weren't changes in my diet, but changes in my perspective. Instead of narrowly focusing on calories like I used to, I started taking into account the nutritional benefits food had to offer, and how different foods made me feel physically. I'm the same way with exercise: before, if I exercised at all, I would flail around on various machines, hating it, keeping my eyes fixed on the "calories burned" display. Eventually I discovered that there were exercises I liked for their own sake, and that the post-workout rush was a way better and more immediate reward than the number on the scale. Plus, it's cooler to say "I ran a mile today" than "I burned X calories."

If you identify your mental pitfalls with weight and nutrition (this is where the therapist comes in handy), you'll be better able to plan around them, and to get yourself out of them when you need to. Maybe it's a compulsion to analyze every bite that goes into your mouth, maybe it's all-or-nothing thinking, maybe it's judging yourself too harshly for eating certain foods, etc. Knowing how to disarm those will be more effective than any diet plan that addresses only what you eat.
posted by Metroid Baby at 9:06 PM on May 22, 2011 [1 favorite]

One thing which I've seen with some people in recovery is transferring that obsession about calorie-counting into something else. Exercise is one, but even eating "the freshest, healthiest foods" can turn into an obsession. "Is this really free-range?" "Has this been cooked in the same pan as something less healthy or nonorganic?" Sooner or later you're back into that space where you're spending more time obsessing over labels than eating the food -- and, most importantly, nourishing your body.

So, yes, discussing this with a professional is definitely the way to go.
posted by Madamina at 9:14 PM on May 22, 2011 [3 favorites]

AskMetafilter never agrees so hard that we are entirely unqualified to answer a question. Even if we were therapists, and even if we were your therapist there would need to be a lot more questions.
posted by Blasdelb at 8:20 AM on May 23, 2011

I agree about talking to a professional and perhaps resigning yourself to not being able to Go There At All depending on the severity of things as it's nothing to mess with and really easy to slide back into. That said, like posters above I never had a full blown eating disorder but definitely didn't have a healthy relationship with food and self image when I was younger (pretty common for women...), and used to get obsessed with calorie count and little cheat-y hunger tricks and all that. When a few years ago I actually was heavier than my frame really wanted to default to I made a promise to myself not to count calories or buy a scale, but instead focus on quality/freshness of the food I consumed, getting good macro balance (more protein, fewer carbs, less eating out and junk food/empty snacking), eating at regular intervals (this alone has helped my attitude towards food tremendously...I used to be a frequent meal skipper and wondered why I felt like crap so often), limiting caffeine...things that actually mattered to my health and how i felt physically, what would energize and nourish/sustain me, NOT "how do I look skinnier/lose this water weight by next week to fit into this dress for a party" or whatever. I took the same approach with exercise--no more obsessing for hours about "toning" or appearance, but focused on endurance and strength, things that would make me feel strong and sturdy, and required fuel/food (weight lifting and hiit). I set healthy general guidelines--eat out no more than once a week, eat a real breakfast every weekday, make sure to get protein in every meal every weekday--but don't let myself monitor everything every single day because that just personally felt like a slippery slope into obsessing (and I make sure not to think about how I eat on weekends, but that doesn't work for everyone if it leads to cycles of binging and guilt...YMMV). So I guess maybe if you think of guidelines ahead of time, make sure they're sane/healthy (with your doctor, say, given they know about your past), and don't let yourself make them stricter as you go along.
posted by ifjuly at 11:31 AM on May 23, 2011