It’s 4am here so apologies in advance for my lengthy ramblings! I can’t sleep!
I spoke with my nurse last week about my purging. It was a hard conversation as I find it excruciatingly painful to admit that I feel no control around food and that I am overeating or eating things that I know I will just purge but don’t have the power to not eat (for the most part I do this with my head in my hands on the table as I can’t even look at her!). It was difficult to explain how my mind can know eating something is a bad idea but then to do it anyway. I can never seem to get across how my mind seems to shut down and suddenly the food is in my mouth, I feel sick and purging happens.
She tried the ‘sit with the feelings’ route again and I’m sure it’s frustrating for her that I cannot seems to do this. At a certain point I can, for example if I ate two biscuits I could cope with it, but if I’ve eaten four, six or a whole packet then there is no way this is going to happen. This says to her that it is a psychological thing and that there’s a critical amount which I can deal with; I agree with this somewhat but there is also the physical issue that a whole pack of biscuits does not make one feel well and that purging relieves that.
The solution to this it to stop eating at that point that I cross into ‘need to purge’ territory. But this comes back to the original problem- I can’t! I began crying at this point as it’s not fun to admit out loud what a fat horrible greedy person I really am. Bless my nurse though she didn’t engage in that talk and instead rationally worked through the issues.
- Eliminate hunger: She’s not convinced that sometimes the cause of my overeating is not simply hunger. I disagree as I am eating plenty (probably about twice as many calories daily as I ever ate before) but there is a chance that sometimes my exercising (i.e. long runs) might be putting my at a deficit. I’m reluctant to make up all these calories as if I’m maintaining as I am surely I would put on weight if I did?
- Food is food, not good or bad: Basically anything that’s not vegetables is still an unsafe food. This doesn’t mean I don’t eat them, I do, and I enjoy them and they are a part of my life now, but somewhere in the depths of my mind an alarm goes off when I think I’ve overstepped the mark with ‘bad’ foods. I’m unlikely to need to binge and purge after a grapefruit but a handful of chocolate peanuts and things go crazy. I need to see food as food and leave it at that.
- Be flexible and have confidence: Unsurprisingly I’m an all or nothing kind of girl. It’s no chocolate peanuts or the whole bag, it’s one allowed slice of toast and anymore then the whole day is ruined, it’s three meals and three snacks or grazing and purging all day… While I need to be focused on what I was eating and when in the beginning to eliminate hunger and introduce new foods (see 1 and 2!) she now thinks I need to be more flexible with this and start to trust myself. It’s okay for me to eat apple crumble after a long run and then have lunch later. It’s okay for me to have cake at work and then leave have a smaller dinner if not as hungry. If I get too full then I need to stop eating and then can have more later if I want. I need to be able to stop and think ‘Am I hungry? Is this what I need or is it something else?’ This is a tricky one as it’s a fine line between being flexible and restricting but in terms of purging I need to be able to identify how my body is feeling and learn that if I don’t eat something now that doesn’t mean I can’t ever have it again.
- Reframe willpower: I refer to willpower a lot when it comes to food and behaviours. I often say I wish I had more willpower around food and then I wouldn’t be in this mess. However I only associate willpower with not eating. So skipping a meal is willpower, refusing a chocolate is willpower, reducing portions is willpower. I never associate not purging or eating a fear food with willpower though- only things that are related to weigh toss take willpower- which is ridiculous! Being flexible and confident in listening to my body is actually where it’s at- that’s what I need to be thinking about, not willpower. If I make it about willpower I’m setting myself up to fail as it takes huge amounts of effort; yet if I make it about what my body needs that I let sense take over.
As always I think this is going to be easier said than done but I’m determined to give these steps a try and see what happens. I have three weeks until my next appointment so if I can cut down my purging somewhat I’ll be pleased.