Dieting would kill me, but I need to make some changes
January 18, 2020 8:23 AM   Subscribe

I had an eating disorder, and I can't diet. I am gaining a lot of weight, and I'd like to stop gaining weight if I safely can. Does anyone have resources or ideas to help? Bonus: anything on negotiating menopause when you have an eating disorder history? NOTE: my number one priority here is to avoid eating disorder relapse. Please don't give me general dieting advice unless it really takes into account the eating disorder part. [Content Warning: discussion of eating disorders and dieting]

As a teenager and young adult, I had a serious eating disorder that required multiple hospitalizations and came close to killing me. I've been in recovery for 20 years, and I've achieved that by basically refusing to restrict food in any way. I assumed that if I ate what I wanted and paid attention to hunger and satiety cues, my body would let me know what it needed. For 20 years, that worked for me, and now it's not working so well. I suspect I'm nearing menopause, and I've gained a fair amount of weight recently. I don't want to go on a diet, because diets are not in any way safe for me, but I also think I should probably make some changes so I can hopefully stop gaining weight. Does anyone have any ideas and resources for people with an eating disorder history who are trying to safely make dietary changes?

Some things that I absolutely can't do are count calories, weigh myself daily, or otherwise do anything that involves numbers that I could fixate on. I also tend to delve obsessively into new projects or hobbies no matter what they are, and I absolutely can't do that with this one, because that would end in tears and possibly inpatient treatment and/or suicide. I'm not kidding about that: I would much rather gain weight than have an eating disorder relapse.

Bonus question: I'm a little freaked out about menopause and how it's going to interact with my weird eating disorder issues. I'm worried that going through a bunch of involuntary bodily changes is going to mess with my sense of control, and my impulse is going to be to reassert control through unhealthy eating and exercise obsessions. Is this a topic that anyone has researched or written about? Anyone done this and have any advice?
posted by ArbitraryAndCapricious to Health & Fitness (18 answers total) 11 users marked this as a favorite
 
I am sending you all my respect for being in recovery for TWENTY YEARS and having the presence of mind to know what could trigger a relapse. That is a huge accomplishment that took an unbelievable amount of work. Is there any way that you can possibly afford to talk to a registered dietitian who has a background in disordered eating? This is exactly the kind of thing they know how to do safely, in a way that avoids relapsing. I feel like trying to manage this without some professional help would be really difficult. Even if you can only do one session with this person they might be able to point you toward other resources that could help.
posted by corey flood at 8:40 AM on January 18, 2020 [38 favorites]


For menopause or early menopause symptoms, you could consult with an endocrinologist to discuss treatment options you may have after getting screened for various issues related to your hormones. A therapist with experience working with people who have survived serious eating disorders could also be an important part of your treatment team, and they may be able to refer you to a nutritionist with a similar background and experience to complement the support.

As someone who has survived hospitalizations for other life-threatening issues, I do tend to think in terms of 'treatment teams' now, and coordinating care among specialists who have experience and compassion for my specific issues, so I encourage you to seek specialized support (MeFi Wiki) that is tailored to your particular needs.
posted by katra at 8:42 AM on January 18, 2020 [2 favorites]


I have had health issues in which I started seeing a nutritionist With experience with eating disorders along with anyone else I needed to see to keep my sanity in check because wow even a long time in recovery my relationship with food can get frought fast. It also have me reassurance when I was doing things that were appropriate for my situation.

Take gentle care
posted by AlexiaSky at 8:56 AM on January 18, 2020 [1 favorite]


I'm in ED recovery too, and finding that in my early thirties I'm gaining weight even with the same diet and habits with which I maintained my weight in my twenties.

What about finding fun, social ways to move your body? I'm thinking something light-hearted and time-limited (ie. a club or team that meets once or twice a week) so it can't turn into a compulsion or a way of purging calories.

I know you mention paying attention to hunger and satiety cues. Was intuitive eating part of your initial recovery? I'd really recommend Laura Thomas' podcast 'Just Eat It' - I think she has a book as well, but I haven't read it. If you are regularly eating past the point of satiety, mindfulness and intuitive eating might help. Many people find they lose weight when they start to focus on intuitive eating, although its philosophy is entirely antithetical to dieting and is grounded in self-compassion.

Eating disorder recovery means that food isn't causing you immense distress anymore. If you're finding that food and weight are starting to cause you distress, there's no shame in seeking out professional help. It doesn't mean your recovery is broken or undone. You are allowed to talk to a dietitian, OT, or therapist and get some outside perspective on how you're feeding your body, if it feels out of control.
posted by unstrungharp at 9:42 AM on January 18, 2020 [5 favorites]


I recommend Corinne Crabtree and her free and paid resources, especially her podcast, Losing 100 Pounds With Phit n Phat (ignore the name, her content is amazing). She focuses on the mental work involved in eating healthily, and is very much not of the restrictive eating/fad diet camp. I've been listening to her for about six months now and she's helped me hugely with my own disordered eating.
posted by Tamanna at 9:57 AM on January 18, 2020 [3 favorites]


Get an allergy skin test and blood test to check for allergies and intolerances. Find out if there are specific foods you need to avoid and see if that changes your weight trajectory. Data source: I have struggled with ED and gained a bunch of weight and inadvertently discovered that I had become allergic to two specific common foods after my hormones changed with pregnancy. Eliminating those foods but not otherwise restricting my diet has been really helpful.
posted by annathea at 9:59 AM on January 18, 2020


Highly recommend seeing a dietician or nutritionist who specializes in eating disorders. My idea of what that type of person would be like (stern, calorie-focused, food police) was so far from the reality (warm, inventive, thoughtful). I can’t recommend it enough.
posted by sallybrown at 10:16 AM on January 18, 2020 [2 favorites]


Congrats on your recovery and the strong self care you are showing.

Your body is changing in its needs and old patterns might need a little tuning. I hope you find answers that fit your life.

Anecdote: someone close to me in my life does OA and has a food system from their nutritionist that is about regularity of times, food pre-prep, etc. The nutritionist weighs the person at their 2x/year checkups, but they never discuss it. My person thrives on the regularity, prep and ritual of making simple nutritious food, and the healing spiritual practice of self work and service from OA.
posted by gregglind at 10:35 AM on January 18, 2020


I have an eating disorder too, and your question triggered me so badly I closed the page and considered closing my Metafilter account because I think you’re going to get some very dangerous answers here. But I couldn’t stop thinking about it.

There is a reason your body gains weight during puberty and menopause. It is protective. Please read the link and explore the studies discussed.
With age, fat cells have also been shown to become less metabolically active, lessening their role in diseases associated with aging like diabetes. The clinical research of Reubin Andres, M.D., a gerontologist at the National Institute on Aging and a professor of medicine at Johns Hopkins, found that the fewest deaths occurred in those whose weights increased as they aged. “It’s acceptable, possibly even highly beneficial, for normal, healthy adults to gain gradually about a pound a year beginning around age 40, so that by the time they’re in their 60s they weigh about 20 pounds more than the Met Life tables would suggest,” he said in Food & Nutrition Digest.
I am not reading any other comments because I have a feeling they will cause a dangerous relapse. I think you might know that too. There is no way to lose weight without disordered eating. But I do think you would greatly benefit from an anti-diet dietician (there are many! Most work remotely!) who can talk to you about eating intuitively without weight loss as a goal. Please make sure anyone you consult on or offline is someone who also is educated on eating disorders. Anorexia is more deadly than gaining weight and this question makes me worry about your recovery no matter how much you frame it as not being about dieting.
posted by the thorn bushes have roses at 10:47 AM on January 18, 2020 [33 favorites]


I also wanted to share a link to NEDA, because menopause is a common time for eating disorder relapses, this page talks about what that might look like.

Also, I would be remiss if I didn’t also link to this incredible research paper laying out why focusing on weight does nothing for our health. There are many studies discussed within that will give you ideas for how to prioritize real health regardless of size.
posted by the thorn bushes have roses at 10:59 AM on January 18, 2020 [11 favorites]


I have the same experience - eating disorder (restrictive) in my teen years, which I dealt with by not restricting what I ate at all during my 20 and early 30s. Now, I'm mindful of what I eat and focus on nutrition and variety, not calories or fat.

What worked for me the most, though, was finding exercise I enjoy. I walk my dogs every day in the forest, I do resistance training at the gym, and I love spin classes. I only do exercise that I enjoy and I don't count the calories I've burnt. I have found regular exercise to be the best way to feel good about myself - it has changed my relationship with my body completely and gives me peace. It has so many benefits outside of anything to do with weight. The key thing is to find things that you genuinely like, which can be the hard part!
posted by thereader at 11:08 AM on January 18, 2020


Disclaimer: I have had an eating disorder, but it was confined to a specific time of my life forty years ago, and I haven't struggled with relapse. But boy do I feel you on the being freaked out by perimenopausal changes. One approach that (I assume) wouldn't introduce an opportunity to obsess over anything would be to take HRT. It can definitely help with weight gain and also with mental health.
posted by HotToddy at 11:40 AM on January 18, 2020


As a parent of a toddler, I've become a big fan of the site Feeding Littles (which is just about literally how to feed your kid, not any sort of health or diet stuff). One of the folks who runs the site talks about her history of disordered eating and often mentions Intuitive Eating (here's a post called "How Intuitive Eating Changed My Life"). May or may not be helpful?
posted by rossination at 12:15 PM on January 18, 2020


I also came here to mention Intuitive Eating, and also Health at Every Size (HAES) and book. I am not sure if they will be helpful for you but maybe check them out. I have not had an eating disorder, but there was a time when I was focused on losing weight when I felt I was heading in that direction, and backing away from that to instead focus on health outside of weight (which for me has mostly meant exercise) has been very helpful for me.
I'm sorry I don't have anything specifically on the menopause angle, but hopefully the links above will still give you some useful info.
posted by 2 cats in the yard at 12:39 PM on January 18, 2020


I see HotToddy already mentioned it. I came to say that you could explore whether hormone replacement therapy would be appropriate for you.
posted by Badmichelle at 9:41 PM on January 18, 2020


Also would recommend meeting with a registered dietitian specializing in eating disorders, intuitive eating, and body positivity and acceptance. I know quite a few wonderful RDs, please PM if you need any suggestions. Most of them take virtual clients.
posted by buttonedup at 5:02 AM on January 19, 2020 [1 favorite]


I'm so proud of you for being so determined to keep yourself in the sphere of safety. That is the first priority. I think you should try to reframe your thinking. I came here to repost what 'the thorn bushes have roses' said. Gaining weight is not a bad thing. Having more fat on your body increases your chance of survival against cancer and other illnesses. If all other health is maintained, your weight increase is in your body's best interest. If it is triggering your body dismorphia, then this is a case for a therapist to help you reconcile your feelings with your body, not for a nutritionist to counter-act the changes your body is naturally making.
posted by FirstMateKate at 10:31 AM on January 20, 2020 [2 favorites]


I swear by Eat This, Not That. (I just discovered that the book has been completely updated!) I know that attempting any sort of major diet would end up in total failure for me. However, Eat This, Not That is all about making individual food swaps - some as minor as buying one brand of, say, corn flakes, instead of another, and it's much more doable for me.
posted by SisterHavana at 4:04 PM on January 20, 2020


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