Off-Topic Conversation: Eating Disorders

[treelee]

^I don't make the rules, so I'll try my best respect them, but in regards to if it walks like a duck... Well if you have to "borrow" "science" (I say science in quotes because evidence based treatment is woefully under researched and hard to find) from the ED recovery community to get yourself back on track... well you probably have an ED and you're not fooling anybody. But that's all I'll say about it.

[Lena999]

I spent 3 months in hospital but I am still struggling with anorexia. If anything I am worse now. I wish someone shared a recipe to just... Not think and do what I need. The feeling of guilt is the worst.

Foodwise, during this step I made a few simple, but easy rules.
- 3 meals a day, one full plate per meal, whatever I wanted.
- No second helpings, you don't wanna end up with a binge eating disorder
- drinks limited to black coffee, tea and water.

With the above 'diet' you can fulfill your cravings and stop counting calories. If you are still undereating you will gain weight through this, but not too much. What this diet does is stabilize your metabolism and your eating pattern so your body starts to get away from the survival mode anorexia causes. It also takes away the mental task of keeping track of food, which I found to be very liberating. It helped me focus on my mental health.

I am now at a healthy weight and bf% and barely have to do any work to keep it that way. I no longer track my food intake. My eating habits are stable and have been for over 5 years. I still use the above 'diet'. In my opinion, excessive focus on food is never good.

Hope this helps!

i don't think prescribing a diet for someone still struggling with anorexia is a good idea...especially because this is the internet and you're not qualified...you don't know how impressionable this person is you're speaking to

I mean I get where you're coming from but I think that everyone who goes to a topic like this for help knows that we aren't licensed professionals giving advice. We're just a bunch of people sharing experiences. What worked for me might not work for her but this was the method that helped me get out of the ED pit without weighing food, counting cals, etc. Also, note that this 'diet' (I put it in quotes for a reason) doesn't list ingredients to eat and doesn't set a calorie cap. The only thing that's capped is the drinking because that's usually where unseen calories end up.

Should she seek help from an actual dietician? Yes, that would be ideal. However I also know how hard it is to continue to seek help after treatment and not every dietician has experience with ED's. Anyway, your point still stands so I will edit my comment to emphasize the seeking help part because a licensed pro worth their salt will help much more than some anonymous forum online ever will.

Edit: turns out I can't edit my old comments, so this will just have to do. I did reread it and I did mention the disclaimer of everyone's ED recovery being different blah blah blah so we'll just have to hope that's enough

[FoodGusher]

sorry i should have edited that to be shorter and more coherent...especially the first paragraph...don't think this forum allows editing. but i was excited i finally had somewhere to vent about this lol.

No, thank you, I like what you wrote.

I'm baffled by this so called Minnie Maude "method" and am trying to understand why it's a) popular and b) called a method. What's methodical about basically going on an uncontrolled bingeing spree? And I don't see how completely cutting out exercise can be healthy, either.

This is not how learning to find your way back to normal and healthy eating works. This is not how reaching a set point works, this is not how anything works, except for becoming obese and unhealthy. To me, this doesn't sound like a method but a mess.

I actually worry about Stephanie after seeing her most recent pic. She's been gaining a lot of weight FAST and I'm dreading to see where she's going with this and how she's gonna deal with the results.

[lokiofasgard]

they may know we're not professionals but it doesn't matter, as i said in my post eating disorders are anxiety disorders therefore the person suffering is irrational. they're looking for any hope and your diet plan does sound somewhat reasonable, for someone without a disorder though. i know you mean well but for me personally if i saw that when i was at the height of my eating disorder this is what i would do. i'd have a nice big plate of salad with "whatever i want" (and low calorie dressing) three times a day and restrict myself to no caloric fluids. no second helpings though because idon't want to binge. and no snacks in between so i'll just think about food between meals but not eat it. and i'd end up thinking i was "recovered" because i was eating three times a day and it would mentally fuck me up because why am i still physically starving etc. i'm not saying this is everyone just trying to give an example of how your words will get twisted with an eating disorder brain in spite of good intentions.

anyway i do wish we could edit posts tho lol.

Thank you. This explains my thought process well. I feel like snacks are not ok and only having three meals a day is. Which is fucked up. :'D

[Lena999]

(Just to make sure everyone knows incase it wasn't abundantly clear: my post was in no way describing or promoting this so-called Minnie Maude 'method'.)

I guess this whole thing with my diet advice just underlines why topics like this are a bad idea. And honestly just ED recovery vloggers in general, because everyone's experience is different and what is good advice for one person wouldn't be for someone else. In regards to Stephanie I wish she would do her recovery in private. Part of what got her in this bind making her relationship with food a public reality show. She's literally making the bulk of her money off of those food challenge vids. Going public with her attempts at recovery means again she's trying to please viewers for money, which is always a bad idea.

[treelee]

^ I'd kind of forgotten how weird and culty minnie maud was. Remember the old youreatopia website? I never did minnie maud since I ended up in a treatment center where I actually trusted my team, but also because I tend to think it's too extreme and you can still get over fears and problem foods without eating them to the extreme (for example my dietician had me eat a normal portion of pasta every single night until I got over feeling like it had any power over me and I didn't even want it anymore. It takes longer and more patience, but in the end I think it does more to fix your relationship with food than downing an entire box of pasta in one sitting whenever you feel like pasta. But again, it's what worked for me). Also remember #pintparty? Oh god. That one killed me because I clearly remember TRYING to finish a pint of B&Js several times (almost as a challenge with friends) before my disorder really took hold and I just couldn't, so I know my natural appetite/hunger for ice cream wasn't infinite. I KNOW that my natural appetite for ice cream kind of goes away after a couple servings. But MM seemed to say that that wasn't true and you should eat as much junk as possible.

I think my favorite piece of drama was that it was discovered that the founder of it all gwyneth olwyn used to post on Calorie Count forums under an alias hedgren and would claim she's a physician there but has never come forth as one professionally.

[zellalewis]

yeah youreatopia is what i was referring to. every one of her followers got obese but they were literally in a cult so they just followed her orders and kept eating hoping it would magically resolve itself. i remember her on caloriecount as well. one time she said she had a whole list of tabs proving her set point theory and i asked to see the links but alas i never did. i tried to do my own version of minnie maud like i said cos i was afraid my metabolism was fucked but that obviously ended horribly. that website wasted an entire year of my life i could've spent properly recovered. but my treatment center wasn't the best either. that's another story though.

but yeah i don't even want to say her name. i remember how she would actively encourage her followers to eat processed food because it's easier for your body to digest. and said that top level athletes were all unhealthy de facto because it's not natural to exercise that much. now she has the nerve to call her new website edinstitute.org as if she's some sort of qualified authority and i just kind of die inside when i see people link it because that name is so misleading. like...does this institute have a physical location? or a payroll of employees? well anyway. i do wonder what happened to all those girls after the website got shut down (i assume it did, seems like it posed some sort of public health risk to say the least).

That's messed up. I remember coming across that URL back when I was looking for a good reason to recover. I don't remember exactly what page I read, but if that's what she's done to her followers, I'm glad I don't.

[treelee]

So the Stephanie buttermore thread started getting super off topic so I didn’t want to refute the claims there, but someone said you NEVER start on low calories in Ed recovery and that’s absolutely false. If you are at risk of refeeding syndrome (which the poster also falsely said was only gastroparesis, but it’s actually electrolytes going out of whack because the body triggers the synthesis of glycogen which lowers serum concentrations of electrolytes and this can be fatal), you start on the absolute minimum meal plan (usually about 800 calls). And your blood needs to be checked frequently to make sure no supplements need to be taken and then the meal plan is slowly increased to a restoration plan over days to weeks. If you fasted or are an extremely small amount in the last 5-7 days, or are at a low weight, or purged a ton you can be at risk. Sorry for the rant but it’s just plain dangerous to spout that refeeding syndrome isn’t about electrolytes and edema but just the slowing of the stomach emptying. It’s rare but it can be fatal and that’s one of the main reasons jumping into recovery with no md at least to monitor vitals/bloods is dangerous. How sad would it be to see someone jump head first into recovery and accidentally kill themselves. Obviously this is unlikely to happen to just a chronic dieter like Stephanie, but promoting this all in without explaining to someone who might be restricting even more is still dangerous. At my worst I went through this. I had to be taking huge amounts of potassium and phosphorous every day for several weeks and had to get my blood drawn daily.

Also gastroparesis is common in eds. I was wondering if anyone else dealt with pretty severe gastroparesis? I know I did and I didn’t have any extreme hunger because I was always so full I was nauseous for weeks on end.


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[Hagatha]

At least with that nonsense about refeeding syndrome the poster who thinks she's the leading expert on eating disorder recovery has shown that she really doesn't know what she's talking about. I hope vulnerable people aren't being sucked in by all the dangerous just-massively-overeat-you-dont-neeed-medical-or-psychological-support rhetoric that's going on in there.

[sparda]

I find the whole "proper recovery" rhetoric to be far more harmful.

[Hagatha]

I agree. Implying that the only way to "properly recover" is by jumping straight into overfeeding without adequate support is both mentally and physically dangerous. Sadly, people without the knowledge and experience to understand this are the ones grandstanding on the subject. Eating disorder recovery is a complex medical and psychological issue and posters haranguing people on a gossip forum as if they know it all really need to take a seat.

[sparda]

So far no one among those talking about "proper recovery" supported jumping straight into overfeeding.

[treelee]

^Yeah, just to clarify I wasn't implying you need to do a slow reverse diet, but a lot of times if you go to professionals they'll start you at a minimum and work you up from there. You get to a surplus within the first week or two, so it's not slow by any means, but jumping straight into 5k cals/day isn't going to work for everyone and delaying it a week or two isn't really a big deal and can actually be safer for some people.

I'm all for recovery looking however it looks for you, but I also know that if you do it completely alone and with no accountability it's pretty easy to get stuck in pseudo recovery and still have lingering habits.

[sparda]

To treelee: I mean of course you need to take care of any actual medical risks. To be fair refeeding syndrome is generally only an issue when you're very very underweight and have been restricting very heavily, but anyways, I do agree that you need to be careful if there's any sort of danger.

Don't really agree with the rest, though. Better said, I do agree with it, but pseudo recovery is incredibly common in *any* kind of recovery, be it with or without professional support - inpatient programs, for example, tend to discharge patients at certain goal weights which are usually far too low, often even at the lowest end of the healthy BMI range, which is basically a recipe for relapse. Most therapists also focus way too much on supposed "underlying psychological issues" and dissect your childhood and your family relationships to try to get to the "root of the problem", while completely disregarding the fact that Anorexia is increasingly thought and proven to be a genetic/metabolic illness. All in all, spotting lingering behaviours is extremely hard for anyone but the actual sufferer - and very often even for the actual sufferer - and no one but him/her can do the final jump towards real, full recovery. You can trick anyone else and make everyone believe that you're okay, and sadly the ED therapy field is dominated by the idea that recovery is supposed to be some sort of "lifelong battle", which is bullshit, therefore in their minds as long as you're kind of functioning at a healthy-ish weight then you're "recovered"; but in the end you're the only one who truly knows which actions and behaviours are still driven by the ED, you are the only one who knows whether you're choosing to eat that food in that quantity because you truly want it or because your ED is telling you to do it, you are the only one who knows whether you're doing that walk because you truly want it or because your ED is telling you to do it, and so on. And I don't think any particular method is more helpful in that, per se.

[treelee]

Hi I'm new to the thread so idk what previous posts you guys talking about. But I've actually read a book called Sick Enough by an ED complications and recovery expert. I remember specifically her saying that if a patient has refeeding syndrome that although the common protocol is to slowly increase calories, it is however not a justifiable approach. She explains that in her own practices, she gives certain medications that work with refeeding syndrome and gastroparesis issues so that the patient can get back to eating a normal amount of calories asap. Anyone suggesting 800 calories as a start to recovery is kinda... nuts. I think the knowledge of proper ED recovery protocols aren't practiced as often as everyone thinks. Eating disorders and the damage they do are very nuanced and cause a lot more harm than people realize.

^That's interesting. It's pretty common for ED treatment centers to start you out real low (800-1200) and quickly up you over a few days to a normal amount and then build the surplus. I didn't mean to suggest that was THE way. Just that that's what a lot of professionals still do.

[winterkat]

To treelee: I mean of course you need to take care of any actual medical risks. To be fair refeeding syndrome is generally only an issue when you're very very underweight and have been restricting very heavily, but anyways, I do agree that you need to be careful if there's any sort of danger.

Don't really agree with the rest, though. Better said, I do agree with it, but pseudo recovery is incredibly common in *any* kind of recovery, be it with or without professional support - inpatient programs, for example, tend to discharge patients at certain goal weights which are usually far too low, often even at the lowest end of the healthy BMI range, which is basically a recipe for relapse. All in all, spotting lingering behaviours is extremely hard for anyone but the actual sufferer - and very often even for the actual sufferer - and no one but him/her can do the final jump towards real, full recovery. You can trick anyone else and make everyone believe that you're okay, and sadly the ED therapy field is dominated by the idea that recovery is supposed to be some sort of "lifelong battle", which is bullshit, therefore in their minds as long as you're kind of functioning at a healthy-ish weight then you're "recovered"; but in the end you're the only one who truly knows which actions and behaviours are still driven by the ED, you are the only one who knows whether you're choosing to eat that food in that quantity because you truly want it or because your ED is telling you to do it, you are the only one who knows whether you're doing that walk because you truly want it or because your ED is telling you to do it, and so on. And I don't think any particular method is more helpful in that, per se.

I agree with all of this so much. ED programs are so focused on weight as a marker of recovery, when in my opinion weight isn't the important part. And like you said most girls make weight and get to go home when they are very much still in a pseudo or quasi recovery. I've heard of inpatient programs that actually deny patients more food if they ask for it. I guess this is to prevent the potential swing of the disorder to turn into BED, but I think that's dangerous to do. Cause again this extreme hunger seems to be a concept that is so out of reach for some people. Especially extreme hunger in a person that doesn't look completely emaciated like Stephanie. What people don't realize is that you can have an eating disorder and be underweight, normal weight, or over weight. Weight shouldn't be the focus.

I think a big part of this is limited resources. I had a clinical instructor who used to work in inpatient care for EDs and they often were forced to discharge patients before she felt they were ready because there were very specific criteria needed to stay and they no longer met them. Inpatient had their own criteria and insurance had their own set of criteria, so sometimes the place would be able to let them stay, but insurance wouldn't cover it and the vast majority couldn't afford it without insurance. They had a very limited number of beds and waiting lists. The goal was to get them at least close to weight restored and normal looking lab values so their bodies wouldn't give out in the short term. The mental health aspects took much longer to address and would be continued outpatient after discharge. But there were also limited mental health professionals who also had long waiting lists, so there could be people who were discharged but weren't getting in to therapy for months. The health care system, at least in the US, is broken and can be a nightmare to navigate.

As for refeeding syndrome, I actually took care of a gentleman during one of my first hospital clinicals who was being monitored after refeeding syndrome. It wasn't because of an ED, but due to celiac disease and not following a gluten-free diet. It was incredibly eye-opening just how many things can potentially go wrong and all of the things we had to look out for.

[treelee]

Anyone else here done ro-dbt (radically open dbt)? I found it by far the most helpful form of therapy I tried. It’s targeted towards over controlled personalities as opposed to under controlled ones like regular DBT. A lot of people with ed and/or a lot of anxiety tend to be on the more over controlled side so it really helps with that.


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[sparda]

yes that's because they're inpatient. you're transferred to outpatient immediately after and given a meal plan to work with. if you have a weight that you were maintaining prior to the ed the dietitian will usually get you back up to that weight.

Yep, exactly, one of the problems. Dietitians and therapists tend to bring you back to your pre-ED weight while ignoring all the symptoms that still very often linger, or are in plain sight, and also ignoring that fat overshoot is a real thing.
I got back to my pre-ED weight by following the meal plan religiously, but I was so damn hungry all. the. time. Not being able to sleep kind of hungry. Yet my therapist was basically like, since you are at a healthy weight now this is all in your head and we need to sort that out, you don't actually need to eat more blah blah blah. Truckload of bullshit. Unfortunately I believed her, so I started to feel guilty if I wanted to eat more (and especially more, OMG, "junk food")...so I started "eating healthy"...and then inevitably I relapsed.
My dietitian even prescribed me appetite suppressants because I was at a healthy weight but still terribly hungry. Like what the fuck?? How on Earth can you prescribe fucking appetite suppressants to a recovering anorexic??

All in all, I feel that way too many therapists and dietitians work well to get patients out of the immediate danger zone, but they tend to fail badly when it comes to getting them to proper, full recovery. They tend to validate and reinforce the patients' own fears, either consciously or subconsciously, and settle down for "good enough" rather than actual recovery. And again, they all tend to ignore the scientific literature on the matter - namely the key genetic findings about Anorexia.

they get you to a safe state and discharge you. inpatient is super costly so insurance will only pay until you're no longer in crisis.

The problem is that getting to a BMI of 18,5 doesn't put you automatically off the danger zone.

[jaenerys]

did i miss something? it said there was a reply and now i don't see any of this person's posts. did they say something offensive? sorry if i'm not allowed to ask.

back to the topic, since this isn't allowed in the buttermore thread, has anyone seen her instagram review page? where she reviews junk food products? does anyone find this strange? i know when i was super absorbed in my ed (and still have the habit to this day) i felt a need to record and rate/review everything i ate for some reason, so others could use it as a reference guide. it's why i started a yelp profile. i guess it's just another food obsession thing but i can't quite pinpoint the subconscious reasoning behind that. am i alone in doing that?

someone got banned so that might be the reason.
And yeah, stephshollowleg or something like that ..... another example of how obsessed she was with food, as if we needed more proof. This lady is just a few pounds from a mental breakdown