Help me make sense of food
October 18, 2015 7:41 PM Subscribe
Help me make sense of food? Hey, first post on this site, but I've been reading for years. I don't mean to make this long but just want to cover all the bases so you guys have enough info. and don't need to ask me followup questions:
I am a late 20s female with an eating disorder that is basically anorexia without the fear of gaining weight or thinking that I am overweight, which is classed as EDNOS in the new DSM, I guess. I restrict my calories but it isn't even intentional. It's in response to intense psychological trauma which caused a big disruption in my life. I am on autopilot with this thing most of the time, I don't go out of my way to count calories or anything. Realizing that the way I eat is very abnormal, I became curious about just how many calories I DO take in so I wrote down what kinds of things I eat when I do eat, and counted the calories. It's around 500-800.
The pattern is that I will not eat for a day or two at a time, or if I do it's like, an apple and a cup of yogurt. I have extreme distortions in my perception of the quantity of food that I eat. I started to become aware of this when I would get up from the table for whatever reason, return, and see that what I actually ate was about 1/5th of what I thought I ate. I am in constant scarcity mode, as if I am living during a war. And I am, psychologically. I have PTSD.
This has been occurring on and off for 10 years. Upon moving out at 18, I weighed 87 lbs and was amenorrheic, but things look a lot different now physically. However, I am still engaging in disordered eating patterns, same as before.
I see a psychologist who knows about it, so I have that covered. I made my physician aware a few weeks ago, finally. Right now I'm unemployed, have no money whatsoever and am on the state's public insurance. I don't know how to deal with this alone but because of the insurance I'm on, getting care for this thing isn't happening quickly. I'm not in a crisis to the point of having to be hospitalized, so I have to go see my Dr. who hopefully will refer me to some kind of outpatient program, but this shit is going to take weeks. I want to know what I can do now, today, tomorrow and the day after as far as eating goes.
I don't know what, when, or how much to eat. The food that I do try to eat, no matter what it is - whether fruits, veggies, or meat, gives me gastrointestinal distress and makes me feel queasy. I am aware that my metabolism, GI system, and everything in my body has been altered. I have no sensations of hunger, so right now I'm doing the "mechanical eating" thing where I make myself eat perfunctorily, rather than because I am getting the hunger signals. Whole milk yogurt helps a lot.
Please, if there are any dietitians or others with comparable knowledge around, do you have any advice to get me through for right now? Thanks ever so much.
I am a late 20s female with an eating disorder that is basically anorexia without the fear of gaining weight or thinking that I am overweight, which is classed as EDNOS in the new DSM, I guess. I restrict my calories but it isn't even intentional. It's in response to intense psychological trauma which caused a big disruption in my life. I am on autopilot with this thing most of the time, I don't go out of my way to count calories or anything. Realizing that the way I eat is very abnormal, I became curious about just how many calories I DO take in so I wrote down what kinds of things I eat when I do eat, and counted the calories. It's around 500-800.
The pattern is that I will not eat for a day or two at a time, or if I do it's like, an apple and a cup of yogurt. I have extreme distortions in my perception of the quantity of food that I eat. I started to become aware of this when I would get up from the table for whatever reason, return, and see that what I actually ate was about 1/5th of what I thought I ate. I am in constant scarcity mode, as if I am living during a war. And I am, psychologically. I have PTSD.
This has been occurring on and off for 10 years. Upon moving out at 18, I weighed 87 lbs and was amenorrheic, but things look a lot different now physically. However, I am still engaging in disordered eating patterns, same as before.
I see a psychologist who knows about it, so I have that covered. I made my physician aware a few weeks ago, finally. Right now I'm unemployed, have no money whatsoever and am on the state's public insurance. I don't know how to deal with this alone but because of the insurance I'm on, getting care for this thing isn't happening quickly. I'm not in a crisis to the point of having to be hospitalized, so I have to go see my Dr. who hopefully will refer me to some kind of outpatient program, but this shit is going to take weeks. I want to know what I can do now, today, tomorrow and the day after as far as eating goes.
I don't know what, when, or how much to eat. The food that I do try to eat, no matter what it is - whether fruits, veggies, or meat, gives me gastrointestinal distress and makes me feel queasy. I am aware that my metabolism, GI system, and everything in my body has been altered. I have no sensations of hunger, so right now I'm doing the "mechanical eating" thing where I make myself eat perfunctorily, rather than because I am getting the hunger signals. Whole milk yogurt helps a lot.
Please, if there are any dietitians or others with comparable knowledge around, do you have any advice to get me through for right now? Thanks ever so much.
Response by poster: I didn't see an edit option but I need to clarify: my eating pattern is that I won't eat for a day or two at a time and then when I DO eat, it is only 500-800 calories or thereabouts. I have never had a 2,000 calorie day, ever.
posted by a knot unknown at 7:51 PM on October 18, 2015
posted by a knot unknown at 7:51 PM on October 18, 2015
I'm just a civilian too but have you tried variations on the yogurt, if that's successful? Kefir and lassi, yogurt-based beverages, or quark if it's available in stores around you? Quark, as I encountered it in British supermarkets, was a dairy product with the consistency of cheesecake but the flavor of yogurt, sold in a small container like single-serving yogurt, which was quite pleasant to eat by itself or with fruit mixed in.
My mother, before she passed away (from respiratory and cardiac problems), had a lack of desire to eat and consequent difficulty getting enough calories, but one thing that did work some times was blueberries or strawberries in a small bowl with light cream poured over them and a little powdered sugar.
Good luck. I hope the referrals and a specialist appointment to get you taken care of go quickly.
posted by XMLicious at 8:08 PM on October 18, 2015
My mother, before she passed away (from respiratory and cardiac problems), had a lack of desire to eat and consequent difficulty getting enough calories, but one thing that did work some times was blueberries or strawberries in a small bowl with light cream poured over them and a little powdered sugar.
Good luck. I hope the referrals and a specialist appointment to get you taken care of go quickly.
posted by XMLicious at 8:08 PM on October 18, 2015
Have you tried smoothies, or products like Ensure?
posted by prefpara at 12:01 AM on October 19, 2015 [1 favorite]
posted by prefpara at 12:01 AM on October 19, 2015 [1 favorite]
Best answer: It would probably be a big improvement for you to eat at least 1000-1200 calories every day. Make sure to eat things with fat in them- will help fill you up a bit and keep your blood sugar / mood stable.
Here are some cheapish, healthy things to eat. For context, I'm a woman with a very healthy body size (I'm a size 4 and strong like bull), and this is what I eat when I'm eating pretty healthily (there is quite a bit more ice cream and fast food in my actual diet).
Breakfast (On any given day, I'd probably eat two items from this list, with a coffee)
A single-serve cup of Greek yogurt (get the kind with fat and sugar, not the diet kind)
A hard-boiled egg with a soy sauce, hotsauce, or salt/pepper
An apple or a banana
A cup of unsweetened oatmeal, made with hot water and flavoured with 2 tablespoons of something tasty, like peanut butter, raisins, dried cherries, or frozen blueberries.
2 pieces of brown toast or a bagel, with a spread that has fat in it (butter, cream cheese, peanut butter)
Lunch and Dinner ideas:
A large slice of pizza (about the size of both my hands)
A fast-food hamburger, but skip the fries
A piece of fish about half the size of your hand, broiled, with 1-2 cups of cooked veggies
A whole wheat pita with chicken and veggies in it (like a shwarma)
Tuna mixed with mayo, on whole wheat bread
Sliced turkey lunch meat on whole wheat toast, with mustard, mayo, tomato.
A pack of ramen noodles, boiled without the flavour packets, then drained & topped with a fried egg, soy sauce, and a handful of steamed broccoli on top.
Snacks (I might eat 2-3 of these snacks per day):
A cup of raw veggies (baby carrots, red pepper, or snow peas are my favourites) dipped in hummus
6 Triscuit crackers with slices of cheese on top
A stick of string cheese
15 almonds
A handful of unsweetened dried fruit (I like apples, prunes, or apricots)
Fruit - like an apple, pear, banana, peach, cup of berries, etc
posted by pseudostrabismus at 3:02 AM on October 19, 2015 [1 favorite]
Here are some cheapish, healthy things to eat. For context, I'm a woman with a very healthy body size (I'm a size 4 and strong like bull), and this is what I eat when I'm eating pretty healthily (there is quite a bit more ice cream and fast food in my actual diet).
Breakfast (On any given day, I'd probably eat two items from this list, with a coffee)
A single-serve cup of Greek yogurt (get the kind with fat and sugar, not the diet kind)
A hard-boiled egg with a soy sauce, hotsauce, or salt/pepper
An apple or a banana
A cup of unsweetened oatmeal, made with hot water and flavoured with 2 tablespoons of something tasty, like peanut butter, raisins, dried cherries, or frozen blueberries.
2 pieces of brown toast or a bagel, with a spread that has fat in it (butter, cream cheese, peanut butter)
Lunch and Dinner ideas:
A large slice of pizza (about the size of both my hands)
A fast-food hamburger, but skip the fries
A piece of fish about half the size of your hand, broiled, with 1-2 cups of cooked veggies
A whole wheat pita with chicken and veggies in it (like a shwarma)
Tuna mixed with mayo, on whole wheat bread
Sliced turkey lunch meat on whole wheat toast, with mustard, mayo, tomato.
A pack of ramen noodles, boiled without the flavour packets, then drained & topped with a fried egg, soy sauce, and a handful of steamed broccoli on top.
Snacks (I might eat 2-3 of these snacks per day):
A cup of raw veggies (baby carrots, red pepper, or snow peas are my favourites) dipped in hummus
6 Triscuit crackers with slices of cheese on top
A stick of string cheese
15 almonds
A handful of unsweetened dried fruit (I like apples, prunes, or apricots)
Fruit - like an apple, pear, banana, peach, cup of berries, etc
posted by pseudostrabismus at 3:02 AM on October 19, 2015 [1 favorite]
Have you spoken to a doctor about your lack of appetite and GI distress? It could be as much physical as psychological. I know if I felt queasy whenever I ate, I wouldn't have much of an appetite either.
Try eating small portions regularly of single foods - see if there's anything you can eat, in small quantities and in isolation that doesn't upset your stomach or make you queasy. Try setting an alarm to remind yourself to eat every hour. It doesn't have to be a lot, a small piece of fruit, a slice of toast, a kid's yoghurt. etc Try looking up diets for people with gastric bands. If you eat so little and so infrequently, you probably can't handle a lot of food at once - a lot like having a gastric band, although your stomach should be capable of stretching, you don't want to stretch it too far, too soon
posted by missmagenta at 3:16 AM on October 19, 2015 [4 favorites]
Try eating small portions regularly of single foods - see if there's anything you can eat, in small quantities and in isolation that doesn't upset your stomach or make you queasy. Try setting an alarm to remind yourself to eat every hour. It doesn't have to be a lot, a small piece of fruit, a slice of toast, a kid's yoghurt. etc Try looking up diets for people with gastric bands. If you eat so little and so infrequently, you probably can't handle a lot of food at once - a lot like having a gastric band, although your stomach should be capable of stretching, you don't want to stretch it too far, too soon
posted by missmagenta at 3:16 AM on October 19, 2015 [4 favorites]
I feel for you. And I am not a dietitian, but very interested in fueling myself for endurance events.
I came to mention 'reverse dieting' - it's basically adding calories in very slowly.
Goal 1 should be to eat something every day AND then look at adding calories in once you have 800 calories per day.
I wish you well.
posted by WayOutWest at 3:38 AM on October 19, 2015 [4 favorites]
I came to mention 'reverse dieting' - it's basically adding calories in very slowly.
Goal 1 should be to eat something every day AND then look at adding calories in once you have 800 calories per day.
I wish you well.
posted by WayOutWest at 3:38 AM on October 19, 2015 [4 favorites]
(caveat: I'm also not remotely a professional)
Have you tried broth? If it doesn't upset your stomach you can start taking sips of it throughout the day.
Along the lines of what missmagenta suggests, you might try keeping a food diary, where you try one new food at a time in small quantities for a few days and see what effects it has, if any. If you seem to be tolerating it, add another new food in small quantities for a few days, etc. This might also be useful information to bring in to your doctors when you see them. I'd start with foods that are generally considered easy to digest, like rice, broth, baked potatoes and sweet potatoes, etc. If cooking seems daunting, take a look at the baby food section at a supermarket and see what you can find with the simplest ingredients.
Good luck.
posted by trig at 3:44 AM on October 19, 2015
Have you tried broth? If it doesn't upset your stomach you can start taking sips of it throughout the day.
Along the lines of what missmagenta suggests, you might try keeping a food diary, where you try one new food at a time in small quantities for a few days and see what effects it has, if any. If you seem to be tolerating it, add another new food in small quantities for a few days, etc. This might also be useful information to bring in to your doctors when you see them. I'd start with foods that are generally considered easy to digest, like rice, broth, baked potatoes and sweet potatoes, etc. If cooking seems daunting, take a look at the baby food section at a supermarket and see what you can find with the simplest ingredients.
Good luck.
posted by trig at 3:44 AM on October 19, 2015
The good news seems to be that this doesn't tie into body image, and you sound like you actually want to change. Those two aspects are what make overcoming this so difficult for most anorectics.
I would suggest putting together some easy snacks / meals (pseudostrabismus's list is great), and setting a reminder on your phone at specific times during the day -- it's how people with complicated medicine regimes keep track of their pills, and if you can see it that way for your own health, it may be easier for you to follow than just telling yourself "I should eat".
They also make multi-compartment pill organizers large enough to hold a few nuts, some baby carrots, cheese cubes, etc, but small enough to keep in your bag, so you can have some easy calories handy if the alarm goes off and you're not near food.
posted by Mchelly at 3:53 AM on October 19, 2015
I would suggest putting together some easy snacks / meals (pseudostrabismus's list is great), and setting a reminder on your phone at specific times during the day -- it's how people with complicated medicine regimes keep track of their pills, and if you can see it that way for your own health, it may be easier for you to follow than just telling yourself "I should eat".
They also make multi-compartment pill organizers large enough to hold a few nuts, some baby carrots, cheese cubes, etc, but small enough to keep in your bag, so you can have some easy calories handy if the alarm goes off and you're not near food.
posted by Mchelly at 3:53 AM on October 19, 2015
There are some good suggestions here. As someone for whom food was related to abuse (I went the other way in terms of eating too much, but never tasted anything or connected it to hunger) I would suggest taking some time also to experience food in all the other ways. Taking a cooking class might be one way, although it could also be overwhelming. Try visiting farmer's markets, browsing bakeries and fancy grocery stores, maybe pick up a food magazine that appeals to you or a memoir like the new Ruth Reichel. (I may have gotten the spelling wrong; I'm typing this underground.) Food possibly is making you queasy because your body's not used to it, but it also could be that PTSD is contributing a lot.
Some other tips which may or may not work for you are to eat in the presence of those you trust the most, or sitting outside, or under a blanket fort. Conversely, while you adjust to eating you might do it less mindfully, distracted by TV. You might workout first so you've spent adrenaline.
I found food from other cultures than the one I grew up in helped a lot, because they were new flavors without the emotional baggage. My big discovery was Indian food: samosas, dal, panak paneer and yes, the dread butter chicken, all helped me break through my habit of not actually tasting things and eating to deaden my emotions and then not eating to get light headed. I am not suggesting Indian good but more seeing if the adventure can overcome the past.
Experimenting with texture can help too. Bubble tea squicks a lot of people but for me for whatever reason it's like a party in my mouth and tapioca is awesomely calorie-rich. But it might be smoothies, or toast, or avocado on flatbread. Don't be afraid to try processed things while you are exploring; you can move your tastes around later. If you like yogurt you might like curries with yogurt or goulash with sour cream, cream soups, puddings, trifle, even pates. You could try milkshakes or mango lassi.
For me part of the turning point came when I decided in a way to be the mother of my own body and treat my eating the way I would treat my then-hypothetical child's, finding ways to build on what my eating habits were while presenting (intellectually) a better way to my (sore) spirit. It sounds like with this question you are really onto that. Go you!
posted by warriorqueen at 6:14 AM on October 19, 2015 [2 favorites]
Some other tips which may or may not work for you are to eat in the presence of those you trust the most, or sitting outside, or under a blanket fort. Conversely, while you adjust to eating you might do it less mindfully, distracted by TV. You might workout first so you've spent adrenaline.
I found food from other cultures than the one I grew up in helped a lot, because they were new flavors without the emotional baggage. My big discovery was Indian food: samosas, dal, panak paneer and yes, the dread butter chicken, all helped me break through my habit of not actually tasting things and eating to deaden my emotions and then not eating to get light headed. I am not suggesting Indian good but more seeing if the adventure can overcome the past.
Experimenting with texture can help too. Bubble tea squicks a lot of people but for me for whatever reason it's like a party in my mouth and tapioca is awesomely calorie-rich. But it might be smoothies, or toast, or avocado on flatbread. Don't be afraid to try processed things while you are exploring; you can move your tastes around later. If you like yogurt you might like curries with yogurt or goulash with sour cream, cream soups, puddings, trifle, even pates. You could try milkshakes or mango lassi.
For me part of the turning point came when I decided in a way to be the mother of my own body and treat my eating the way I would treat my then-hypothetical child's, finding ways to build on what my eating habits were while presenting (intellectually) a better way to my (sore) spirit. It sounds like with this question you are really onto that. Go you!
posted by warriorqueen at 6:14 AM on October 19, 2015 [2 favorites]
I also restrict when I'm very stressed. As others have mentioned, sometimes drinks can be a lot easier. It's by no means health food, but a decent way to get some calories and protein: I like a Jamba Juice smoothie with whey protein added in. Those things are huge, and for some reason it's easier for me to drink that than to eat anything.
It's really good that you're making yourself eat things throughout the day. Do you like cheese? Triple cream brie is another one of my go-tos for times like this.
posted by fiercecupcake at 6:39 AM on October 19, 2015 [1 favorite]
It's really good that you're making yourself eat things throughout the day. Do you like cheese? Triple cream brie is another one of my go-tos for times like this.
posted by fiercecupcake at 6:39 AM on October 19, 2015 [1 favorite]
Anorexics and Bulimics Anonymous is free, does not require insurance, and can give you support and tools RIGHT NOW.
posted by Brittanie at 8:18 AM on October 19, 2015 [3 favorites]
posted by Brittanie at 8:18 AM on October 19, 2015 [3 favorites]
Maybe the best place to start is with some sort of meal replacement--Ensure/Boost, that sort of thing. How do you feel about eating a couple energy bars every day?
It seems to me like an effective strategy would be to get yourself to eating your 500-800 calorie diet every day, maybe every other day to start. Once you get that baseline down, try pushing it up to 800 every day, then 900, etc.
posted by feckless fecal fear mongering at 12:44 PM on October 19, 2015
It seems to me like an effective strategy would be to get yourself to eating your 500-800 calorie diet every day, maybe every other day to start. Once you get that baseline down, try pushing it up to 800 every day, then 900, etc.
posted by feckless fecal fear mongering at 12:44 PM on October 19, 2015
It's possible that a food allergy or syndrome like celiac is causing your extreme disinterest in food, rather than just the PTSD. The food diary suggested above could help with that possibility.
posted by Margalo Epps at 6:21 PM on October 19, 2015
posted by Margalo Epps at 6:21 PM on October 19, 2015
Best answer: Not a nutritionist / doctor / etc. But I do tend to eat less often than I should and I have been broke and unemployed in the past. Maybe I can help you make sense of what's happening to you and suggest one or two things.
I think you will feel uncomfortable and bloated a lot as you change your eating habits. It's not going to feel good when you eat enough to be full. Your stomach sits above your intestines, catches your meal quickly, and slowly releases it to your intestines. Your stomach is too small, as the stomach adapts in size so that it can do its job. You will probably need to eat more than three times a day, in very small amounts, until it adapts and stretches to your new eating habits.
I was interested in learning how to add calories, so that I was more likely to meet my caloric needs, even if I wasn't eating a lot. Dairy is very good for this: you can buy large blocks of cheese cheaply, and grate it to add to a lot of dishes. Adding vegetable oil, even where it might not otherwise make sense, also works. Add oil, or butter or cheese to all of your veggies, on top of your beans and rice or chili, on top of soups.
When you pan-fry anything, even eggs, pour the drippings from the pan onto the food when you plate it, and eat the drippings. Mop up what's left with bread.
If you like whole milk yogurt, you can turn a gallon of milk into yogurt overnight: heat it on the stove to just below boiling (shooting to get above 180F), let it cool to skin temperature (below 110F), add one small container of yogurt with live cultures (doesn't have to be whole milk). After 12 hours, covered, at room temperature, you'll have yogurt. It's about 3 quarts of yogurt and a quart of whey. The whey can also be drank and used in smoothies, shakes, coffee, tea, anywhere you'd use milk. Drain the yogurt through a colander into a big bowl to separate the yogurt from the whey.
People trying to bulk up talk about the GOMAD diet, referring to adding a gallon of milk a day to their diets. It works, although I don't think you could do that. But dairy is definitely good for adding calories easily.
Snack! I also bought the cheapest pretzels in the store and had them around to snack on between meals. This also helps keep your stomach full and encourages it to grow. It can also lead to constipation though, so don't depend on just snacks for the day.
Good luck.
posted by Wilbefort at 11:01 AM on October 20, 2015 [1 favorite]
I think you will feel uncomfortable and bloated a lot as you change your eating habits. It's not going to feel good when you eat enough to be full. Your stomach sits above your intestines, catches your meal quickly, and slowly releases it to your intestines. Your stomach is too small, as the stomach adapts in size so that it can do its job. You will probably need to eat more than three times a day, in very small amounts, until it adapts and stretches to your new eating habits.
I was interested in learning how to add calories, so that I was more likely to meet my caloric needs, even if I wasn't eating a lot. Dairy is very good for this: you can buy large blocks of cheese cheaply, and grate it to add to a lot of dishes. Adding vegetable oil, even where it might not otherwise make sense, also works. Add oil, or butter or cheese to all of your veggies, on top of your beans and rice or chili, on top of soups.
When you pan-fry anything, even eggs, pour the drippings from the pan onto the food when you plate it, and eat the drippings. Mop up what's left with bread.
If you like whole milk yogurt, you can turn a gallon of milk into yogurt overnight: heat it on the stove to just below boiling (shooting to get above 180F), let it cool to skin temperature (below 110F), add one small container of yogurt with live cultures (doesn't have to be whole milk). After 12 hours, covered, at room temperature, you'll have yogurt. It's about 3 quarts of yogurt and a quart of whey. The whey can also be drank and used in smoothies, shakes, coffee, tea, anywhere you'd use milk. Drain the yogurt through a colander into a big bowl to separate the yogurt from the whey.
People trying to bulk up talk about the GOMAD diet, referring to adding a gallon of milk a day to their diets. It works, although I don't think you could do that. But dairy is definitely good for adding calories easily.
Snack! I also bought the cheapest pretzels in the store and had them around to snack on between meals. This also helps keep your stomach full and encourages it to grow. It can also lead to constipation though, so don't depend on just snacks for the day.
Good luck.
posted by Wilbefort at 11:01 AM on October 20, 2015 [1 favorite]
Response by poster: For anyone who might find their way to this question and also has similar issues, I found an amazing site that puts together a daily meal plan tailored to your desired caloric intake, whatever it may be, and includes a complete account of all the macro/micronutrients: http://www.eatthismuch.com
Thanks everyone for all the tips, too.
posted by a knot unknown at 6:32 PM on December 13, 2015
Thanks everyone for all the tips, too.
posted by a knot unknown at 6:32 PM on December 13, 2015
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Elly Satter's Secrets of Feeding a Healthy Family might have some useful information for you. She is big on teaching people to eat for enjoyment and feed themselves responsibly, so some parts of the book might help you learn how to prioritize and plan meals, which would be a first step to eating better. It should be available at your library, or I will send you my copy if you need it.
posted by peanut_mcgillicuty at 7:47 PM on October 18, 2015