Recovery...

[Kellie]

The recovery process will take time and it will not be easy. Many people have asked me how long it will take, but I cannot answer such a question nor should anyone else feel that they can. Everyone is different and everyone will recover at their own pace. You cannot put a time limit on recovery. I can tell you that the eating disorder will not disappear overnight like many people wish for. Going to bed at night, hoping and praying it will not be there in the morning, will not help you. You will only feel worse when you awake to find it still present in your life. Acceptance is best. Accept that for now you do have an eating disorder, but remind yourself it is only temporary. The more you move forward in your own personal recovery, the more the eating disorder will be left behind to become part of your past. Recovery is difficult, but then again, so is living with an eating disorder. I know that I used to want a quick fix and be recovered immediately. I discovered that there were no quick fixes. I hated living daily with an eating disorder and wanted so badly for it to go away so that I could feel good, experience happiness and start living. I came to realize that I had two choices: 1) I could hold on to the eating disorder, stop fighting and give in to it. OR 2) I could make the decision to let go of the eating disorder, fight it daily, and receive help and treatment. No matter what choice I made, I knew neither decision would give me instant relief from how badly I was feeling. After facing those choices I knew the best one was the second. By choosing the second choice, I accepted that for a period of time I would continue to feel badly, if not worse, but eventually things would seem brighter, I would feel better and I would recover and have my life back. If I choose the first choice, I would have continued to feel badly and there would have be no chance for recovery and no chance at life. I guess what I am trying to say is that when you decide to recover, accept that it is a process and it does take time. You are not going to feel better immediately. It can take a long time to feel better, especially depending on the underlying issues that you need to deal with, but always know that in time, you will feel better. Recovery is very difficult, but it really is worth it. I hope the sections below will be helpful to those beginning the recovery process and those who are already on their journey to eating disorder freedom. I wish you all the best and may God be with each one of you as you fight to destroy the eating disorder that has held you a prisoner for far too long.

[Kellie]

On your journey to recovery you will experience good days and bad days. Recovery takes a lot of time and hard work. It's important that you recognize the "warning signs" of a relapse. If you are able to recognize that this is happening, it is important that you share this with those helping you. You may not want to admit to those helping you that you are experiencing a relapse for fear that you may disappoint them or that they may get angry with you. I can assure you that will not happen. They are there to help you and they will appreciate your honesty. Many people experience periods of relapse during recovery. It is during this time that you must rely on your support systems to help you get through this. Below is a list of warning signs that may indicate that you are experiencing a relapse. If you are experiencing any of these signs, I would urge you to speak to your therapist about it.

• Increase in obsessive thinking about food and weight
• Wanting to be in control all the time
• Perfectionistic attitudes
• Wanting to escape from stressful situations
• Feeling hopeless about work, relationships or life
• Believing you will be happy and successful if thin
• Feeling of being "too fat", even though people say otherwise
• Wanting to isolate
• Unable to use your support systems
• Being dishonest with those helping you about your symptoms
• Looking in the mirror often
• Daily weighing
• Avoiding certain foods because of the calorie content
• Purchasing mostly diet foods
• Skipping meals
• Excessive exercising
• Wearing only loose fitting clothes
• Thoughts of suicide
• Feeling disgusted with oneself after eating

[Kellie]

The urge to binge can be caused by many different things. You may have had a stressful day at work, someone may have said something to hurt your feelings, you may be feeling lonely, etc. Whatever the reason, it's important that you have a plan to prevent the binge from taking place. A good idea would be to make up a list of "things to do" to help prevent you from bingeing. Keep the list handy so that it can be accessed whenever the urge to binge arises. Below I have listed a few alternatives to bingeing that you may find helpful and may want to include on your own list.

• Call a friend or your therapist and discuss what is happening.
• Go for a walk or leave the environment that is tempting you to binge.
• Write in your journal about how you are feeling at that moment.
• Try to get your mind on something else. Watch T.V., read a book, do a puzzle, etc.
• Sit down and try to figure out the real reasons why you want to binge.
• Take a bath to relax or try some deep breathing exercises.
• Make a list of foods you are planning to binge on, seal them in an envelope and throw it out or burn it.
• Soak the binge food in water.
• Put on some of your favorite music, shut yourself in your room and dance and sing to it with your eyes closed.
• If you love music and have extra time, learn to play a few songs with an instrument and practice when you feel like bingeing.
• Go into a church or chapel
• Visit a friend
• Do some crafts
• Pamper yourself (i.e. polish your nails, get your hair done, get a massage, etc.)
• Take a yoga or a stress relieving class.
• Dream of your children laughing.
• Write a page long letter to yourself about how you are a good and worthy person.
• If you have a quote the gives you strength when you read it, recite it to yourself when you are feeling down.
• Draw or color a picture of something powerful.
• Flush the food you are planning to binge on down the toilet.
• If you prevent a binge from occurring, calculate how much that binge would have cost. Put the money in a jar each time you succeed in not bingeing and use that money to do something special for yourself like getting a massage, buying a new outfit, etc.
• Trying playing with you dog or petting your cat if you have a pet. If you do not have a pet you might want to think about whether or not you want one. Pets have proven to be very helpful in calming and comforting people. I would only recommend getting a pet if that is what a person really wants and is willing to take on the responsibility of having one.
• If you enjoying gardening, get involved in planting a garden, etc.
• Rearrange or redecorate a room.
• Shout at your eating disorder. If you are standing at the cupboard or refridgerator about to binge, slam the door and shout NO! Shouting at your eating disorder give you power.
• If possible, make it so you are unable to plan a binge. For instance, if you live with someone, make sure they do not tell you when they will be coming home.
• do some mild exercising like bike riding (but only short distances)
• take the money you were about to buy binge food with and buy something for someone you care about. Spend time picking out the gift, writing a nice letter to the person and sending it - by the time that's done - the tide might have gone out.

If you have any suggestions that you feel would be helpful to someone trying to prevent themselves from bingeing/purging and would like it included on this list, please email me your idea and I will add it to the list. colleen@mirror-mirror.org

[Kellie]

For many people the holidays are a time of joy and celebration. It is a time to gather with family and friends, get caught up on each others lives, share a few laughs, and many look forward to sitting down and enjoying the traditional holiday feast. For people with eating disorders, the holidays are not quite so enjoyable. In fact, they can be the ultimate nightmare. For many, the holidays bring tremendous stress, anxiety, and fear. I would usually begin preparing for the up and coming holidays a few weeks in advance. I always felt that if I lost a few pounds before the holidays, then I would be able to allow myself to eat like everyone else. Of course, that never happened. I had never been able to truly enjoy any holidays because of the fear I had of all the food that was present. Whether it was Christmas, Easter or any other holiday, I could never relax and enjoy the day because I knew the moment would arrive when I would have to sit down at the table and face all that food. Usually with my in-laws I could get away with not eating very much. I especially liked having people over to my house, because I could keep busy in the kitchen and spend less time at the table. When I was with my own family, I would sit and eat with everyone else, but the meal was never enjoyed because my head was always too busy adding up all the calories in my head and the fear of getting fat would grow stronger with each bite of food. I always looked forward to the moment I could leave, so that I could rush home and purge. The days following the holidays were just as bad. The guilt I would feel was enormous and I would feel desperate to try and make up for all the calories I had consumed. I would really restrict my intake and I would exercise more. Holidays were a time that I just never looked forward to.
For other people, food is not the only thing that makes them dread the holidays. Being around family members may also cause a lot of stress, especially if the families tend to fight a lot or drink too much. The holidays may bring up painful memories from past holidays. You may also have to be around certain family members who make you uncomfortable or who you do not particularly like. If the families are also aware of your eating disorder, you may be subjected to comments about what you are or are not eating. You may feel pressured into eating more than you are comfortable with in order to please the people around you.

I do not think I have ever met anyone with an eating disorder that really looks forward to the holidays. Making a plan of what you will do ahead of time, may be a good idea to help you cope during these stressful times. Below is a list of a few things that may help you during the holidays:

• Make a list of things you can do to help relax and distract yourself from the feelings of fullness after a big meal. e.g. go for a walk, take a bath, read, visit a friend, go for a drive, etc.
• Have the phone numbers of friends and crisis lines available to you.
• If you have to be at a function with certain people who make you uncomfortable, plan ways to excuse yourself from their immediate presence.
• Try not to count calories and try to avoid the scale.
• If you feel yourself starting to panic because you are feeling too full or if you allowed yourself to eat foods that you consider to be forbidden, remind yourself it is okay to eat what you did, that food will not make you fat, and it is only normal to eat more during the holidays. Most people do and it really is okay.
• If you have a period where you end up bingeing or purging, do not beat yourself up over it. Just put it behind you and move forward.
• Prepare responses to make to people who may say something to you that would make you uncomfortable.
• If you feel you need to, set some boundaries for yourself by telling people ahead of time that you do not want anyone to comment on your appearance or your eating.
• Be sure to plan some time for yourself to do something that you enjoy. It is very important to take special care of yourself during the holidays.

I really do believe that you need to do what is right for you during these times. Do not allow anyone to pressure you into eating more than you can handle. You are not eating for them, you are eating for yourself. If being with certain family members or going home for the holidays is too stressful, you may have to seriously think about not going. Do not be afraid to disappoint people by not showing up and if you can, be honest about why you will not be attending. Holidays are a very stressful time for people with eating disorders and it really is important that you do whatever you need to do in order to make them easier on yourself.
I no longer get stressed out during the holidays, except of course for the last minute rush of holiday shoppers, but I do not experience anxiety about the meals. Recovery took time and enjoying holidays did not come easy, but I no longer dread Santa's yearly visit nor fantasize about killing the Easter bunny. As long as you keep fighting and never give up, food will no longer prevent you from enjoying the holidays. You will be able to think of them as a time to gather with loved ones, you can make your own special memories, and you may even be able to start looking forward to them. So whatever holiday is approaching, I wish you all the best and I hope that you all have a very Happy Holiday.
I would like to thank Sharon Sward for giving me permission to include the below "Happy Holidays" in this section.

HAPPY HOLIDAYS

(What if

H

unger means you eat when physically hungry instead of emotionally hungry.
A ttitudes about your size has to with the size of your heart instead of the size of your body.

P

arents accept and value you for who you are, not according to how you look.

P

roblems are resolved in ways other than stuffing your feelings with food.

Y

ou spend as much time and energy on helping others, as you do on how you look.

H appiness comes from within rather than from expectations of others.

O

ccasions for the holidays emphasize relating to others instead of emphasizing food.

L

ove of self means you deserve to treat yourself in the best humanly possible way.

I

dentity of self involves more than how you look.

D

isapproval of self is changed to approval of who you are.

A

cceptance of what one can not change includes your body features.

Y

ou treat yourself as you treat your best friend.

S

ociety values you for being you without emphasis to your weight or size.
Written by:
Sharon Sward, President of Eating Disorder Professionals of Colorado
Author of You Are More Than What You Weigh
Radio Talk Show Host on self-esteem, weight, and eating disorders

[Kellie]

"Today I will eat like a normal person. I will not have a slip because today is going to be a good day."

Many people suffering with an eating disorder wake up each morning saying those exact words to themselves or something similar. When I finally admitted to having an eating disorder, I think I said those words to myself every morning for two years straight before I decided to seek help. Every morning I promised myself I would have a good day, but it never happened. By promising ourselves that we will not have a slip, we are actually setting ourselves up for that to happen. One of the most important things for someone in recovery to remember and accept is that we cannot recover perfectly. Instead of waking up each day promising yourself that you will not have a slip, try telling yourself that "Today I will do my best. If I have a good day, I will be proud of myself. If I have a bad day, I will not dwell on it, I will forgive myself, I will put it behind me and I will continue to move forward in my recovery." Relapses are a very normal part of recovery and they are to be expected. They can last for a day, a week, a month or longer, but a relapse does not mean that you have failed. Usually when someone has a slip or is experiencing a relapse, they tend to believe that they have failed and that they are hopeless. Some will punish themselves for having those slips which can cause the relapse to continue. Instead of focusing on the bad days, try reminding yourself of all the good days that you have had and all the progress you have made.
Relapses can come on quickly and many different things can trigger them. Stress, family conflicts, financial and work problems are only a few to mention. Being in therapy and dealing with the underlying issues usually does bring on a relapse and at times the eating disorder can go out of control. The more you deal with and come to terms with the issues causing the problem, the less you will turn to the eating disorder behaviors as a way to cope. You will also learn new and healthier ways of coping so that you will be prepared to deal with future problems when they arise.

Below is a list of suggestions that might help you prevent a relapse or deal with one after it happens:

• If you are experiencing some of the Relapse Warning Signs, be sure to discuss this with your therapist so that he/she can help you.
• Do not punish yourself after a slip or relapse. Remind yourself that no one can recover perfectly and relapses are a normal part of recovery.
• During difficult times it is important to reach out and talk to someone about how you are feeling and what is happening. Many people tend to isolate themselves during those rough periods, which only makes things worse. When we keep our feelings and emotions locked up inside ourselves, that is when we really rely on our eating disorders as a way to cope with or block out those feelings and emotions.
• If you had a slip or relapse, sit down and figure out why it happened. By doing that you can see why it happened and make a plan for how to prevent it in the future when faced with a similar situation.
• Make a list of situations you feel might cause you to have a slip or relapse. Look over each situation and make a plan ahead of time for how you will handle them without resorting to the eating disorder behaviors as a way to cope.
• Do not fool yourself into believing that you are cured if you are eating normally but have not dealt with the underlying issues causing the eating disorder. Unless those issues are dealt with, relapses will eventually happen.
• Dealing with the underlying issues can be very difficult and most people do relapse when faced with painful memories, feelings and emotions. Many people try to isolate during the rough periods, but it is during times like that when you need to reach out for extra help and support.
• It is important that you have extra support during those difficult times to help you get through them. If there is a support group in your town, you might want to think about joining it. Being around others that know and understand how you feel can be very helpful. If in therapy, try seeing or calling your therapist more often, especially on the days when you feel out of control. If your family or friends are supportive, do not be afraid to let them know that you are having a difficult time so that they can help provide you with the extra love and support that you need.
• Be careful that you are not switching from one compulsion to another. It is very common for people to turn to alcohol, drugs, gambling, sex, self-injury, etc., as a way to cope when they are not engaging in the eating disorder behaviors.
• Take time out each day to take very special care of yourself. Most people with eating disorders are too busy trying to please and take care of others that they neglect their own personal needs. Do something that you enjoy and find relaxing. It might be going on a nature walk, reading a good book or taking a nice hot bath. It does not matter what it is, just as long as it is something that you like and it is done for yourself.
• This can be hard at times, but try to think positively. If you believe you will never recover, then you won't, but if you believe that you will recover, they you will.
• Do not dwell on past slips and relapses because they are in the past and we cannot change the past. Do not worry about how you will handle tomorrow because it is not here yet and we cannot predict the future. Recovery is a one day at a time process. All any of us have is today and we need to live for this day.
• Buy a daily devotion book to help you begin the day. "Beyond The Looking Glass" is a book for recovering anorexics and bulimics and provides devotions for each day of the year. "Beyond Feast or Famine" is a book for compulsive eaters and it also provides devotions for every day of the year. These books can be a great way to help you start each day in a positive way.

Making a plan ahead of time and learning new and healthier ways to cope is a good way to prevent slips or relapses from occurring. It is not always possible for us to put that plan into action and we do have slips. It is okay when that happens and you have not failed. Instead of punishing yourself for those slips, you can learn from them and they can make you stronger. Recovery is a long road and at times you may feel like giving up, but it is important that you do not stop fighting. None of us are hopeless and we all have the power within ourselves to recover.

[Kellie]

Not only is it important to deal with the underlying issues causing the eating disorder, it is also important to work towards developing a healthy eating pattern. Many people are afraid to start eating normally for fear that once they start eating, they won't be able to stop. This won't happen. Beginning to eat normally takes time and it should be done slowly so that you don't start to panic and lose control. Your ultimate goal will be to learn to eat 3 non-dieting meals and 2-3 snacks per day. Carbohydrates such as cereals, pasta, rice, bread, fruit and vegetables should make up 50-60% of your total daily intake. Fat is also an essential nutrient and should make up about 25% of your total daily intake. Proteins such as eggs, red meats, dairy products and poultry should make up about 10-15% of your total daily intake. A qualified nutritionist can help you to gradually develop a healthy eating pattern. Below is a list of suggestions that might help when trying to return to normal eating. If you are anorexic, try eating 6-8 small meals per day. Small meals will be easier to eat then 3 normal meals. Small meals will not leave you feeling quite so bloated and full. It is important to remember that in the beginning, you will experience bloating that can be uncomfortable. Many think this is a sign they are becoming fat, but it is natural for this to happen. It is only temporary and can last from 6 - 8 weeks. Instead of thinking of the bloating as you becoming fat, remind yourself that it is a part of the refeeding process and it is a sign that your body is healing. If you are bulimic or a compulsive eater, try eating 3 non-dieting meals and 3 snacks each day. Try to eat them at the same time each day. You may find it beneficial to follow a meal plan in the beginning so that you will know what you will be eating in advance. Do not allow yourself to eat more than planned. Eating more could lead to feelings of "I've blown it" and may cause you to binge or purge. In the beginning try to avoid foods that tend to trigger a binge or cause you to much feelings of guilt after eating. Later on you can reintroduce those foods into your meals. If anorexic, you may wish to begin the refeeding process with foods that will be easier to digest. (i.e. applesauce, mashed potatoes, macaroni & cheese, oatmeal, etc.) Once the body starts to get used to having food, you can then begin to introduce more solid foods. Throw out your scale. Scales can prevent you from your reaching your goal of healthy eating. Also, it is important to remember that you are not a number and that number on the scale can never change the wonderful person you are inside. After eating, try and distract yourself with an activity you enjoy or if you feel very uncomfortable, try deep breathing exercises. Stop counting calories. Counting calories will prevent your from eating normally. Concentrate on learning about what normal eating is. Sometimes watching others eat can help to show us what normal eating really is. Start living one day at a time and one meal at a time. Sometimes it helps to think of food as medicine. You may not want to take it, but it is necessary for you to eat it, in order to recover. You can also think of food as fuel. Your body needs that fuel in order to be able to function properly. Remember that the voice in your head is lying to you. You need to do the opposite of what it tells you. If it tells you not to eat, go against it and eat. By doing this, you will be able to start taking back the control the eating disorder has. Many people believe that if they don't eat, they are the ones in control. The reality is, if you do not allow yourself to eat, the eating disorder is the one controlling you. If you exercise excessively, try to slowly cut back. In the beginning practice "mechanical eating." This means to eat your meals at predetermined times, whether you are hungry or not. The physiological mechanisms that signal hunger and fullness may not be functioning properly. In time, these signals will return, allowing you to know when you are hungry and when you are full. Remind yourself constantly that NO food will make you fat, as long as it is eaten in moderation. Stop buying "diet" foods. Buy foods that you would like to eat, do not buy them because they are low in calories. Normal eating does take time and it should be done slowly so that you do not become too overwhelmed. It does take a lot of hard work in the beginning, but in time it will become a normal part of your day.

[Kellie]

July 30, 1996

To All Victims of Eating Disorders,
The first step towards recovery is admitting that you have an eating disorder. If you have been able to do that, you should be really proud of yourself, because it is not an easy thing to do. It is important to remember that recovering from an eating disorder does take a lot of hard work and time. You did not develop your eating disorder over night, and it will not go away that quickly either. Recovery can happen and it will, as long as you want it.
On your journey to recovery you will experience good days and bad days. Imagine that you are on a roller coaster ride. You will have a lot of ups and downs, but when the ride comes to its final stop, you will feel an inner peace and you will be free.
On the days when you feel trapped, hopeless and feel like giving up, those are the days you need to fight even harder. Never give up, because recovery is worth fighting for. Those inner voices can become very loud at times, but you do have the choice not to listen to them. Remember that those voices are only lying to you, and if you continue to listen to them, they will destroy you. You are stronger than those voices and you can go against them. The more you go against them, the weaker they will become. Each time you do succeed and ignore those voices, you are another step closer to recovery.
It is very important that you do seek help and support during your recovery. No one can do this alone and it is okay to ask for help. I tried for a long time to overcome my eating disorder on my own, but it just is not possible. Many of us find it difficult to seek help or feel too ashamed to admit to another person that we have an eating disorder. There is no shame in having an eating disorder and there is help available. You need someone to help you deal with and come to terms with the underlying issues that are causing you to do this to yourself. It's not easy to open up to someone and talk about how you are feeling, but it is necessary. I was always the type of person who kept everything to myself because I didn't want to bother anyone with my problems, but now that I have started talking, I feel like a big weight is being lifted off my shoulders. I still find it difficult to reveal my true feelings, and it can be scary at times, but I continue to do so, because I know it's what I have to do in order to free myself from my eating disorder. I personally feel, you have to heal the mind, before you can totally heal the body. Each day I continue to try my hardest to provide my body with the nutrition it needs and deserves. I don't always succeed, but I continue trying. I know that I will probably never be truly at peace with food and my body, until I deal with the issues that caused me to do this to myself and until I learn how to love and accept myself.
Thinking about living a life without your eating disorder can be frightening. You may wonder how you will live without it. When I first started receiving help, I was afraid to let go of it, because I didn't believe I could live without it. Even though I was afraid to live without it, deep down I knew that I could not survive with it. I wanted to live, which meant I really had to start fighting to make that happen. I also needed to remind myself that I could not recover perfectly and I needed to stop trying to. Every time I had a slip, I would get so angry with myself and I would end up punishing myself more. During recovery you will probably experience periods of relapse. It's natural for this to happen and it's to be expected. Don't get angry with yourself and don't dwell on it. Instead, remind yourself of all the positive things you have done and all the progress you have made. You can also learn from those relapses, and in the long run, they will make you stronger.
I have suffered from an eating disorder for twenty years and although I'm not totally recovered, and still have a ways to go, I have come a long way and I am confident that one day I will be totally freed from this eating disorder that has robbed me of so many precious years of my life. Looking back over the years, it sometimes amazes that I'm still alive, but I am very grateful to be alive, because I know that so many other people weren't as fortunate as I am. Those negative voices are still present, but I have chosen not to listen to them and I go against them daily, and so can you. I've also been blessed with a wonderful support system. I have a loving husband, family, and friends. I have been fortunate to meet many wonderful people through the internet that also suffer from an eating disorder. I have support from a family doctor who takes special care of me, and last, but certainly not least, I have the support from a wonderful therapist. He encourages me, supports me and most importantly, he listens to me. He has never given up on me and he believes in me. If it wasn't for him, I would have given up on myself a long time ago.
Recovering from an eating disorder is not easy, and at times it may feel impossible. It's important to keep fighting and never give up, because you are worth saving. Your eating disorder has been your only means of coping for a long time and it will take time to learn new and healthier ways of coping, but it is not impossible. Even though we need help and support to recover, the decision to recover is up to us. No one can make us recover and we are the ones that need to accept the help and take the necessary steps in order to make that happen. You also need to have faith in yourself and you need to start believing in yourself. If you believe in yourself, you can do anything you set your mind to and you can recover. There is a beautiful life waiting for you beyond your eating disorder, but it is up to you to find it.
I hope the information I have provided on this web site can be of help to you or to a loved one that is suffering from an eating disorder. It is my dream that one day no one will have to experience the pain of an eating disorder. Remember that eating disorders can be beaten, you don't have to be a prisoner to this anymore. You have suffered long enough and now it's time to set yourself free.
Good luck to you all and God Bless you.
Colleen

[Kellie]

Recovering from an eating disorder takes time. You did not develop your eating disorder over night and it will not go away that quickly either. It is important to remember that no one can recovery perfectly and there will be slips and relapses during the recovery process. This is normal and it is to be expected. The Relapse Prevention Plan is something that may be helpful to you in preventing a relapse. Things Which May Cause Slips and Relapses Stress Dealing with the underlying issues in therapy Becoming overwhelmed by feelings and emotions Death of a family member, friend, etc. Marital and family problems Feelings of loneliness, shame, guilt, anger, and abandonment. People’s reactions to changes you are making in your life Fear of change and/or living without the eating disorder These are a few things that can cause someone to have a slip or relapse. At the time, the person may be overwhelmed by any of the above and end up resorting to old methods of coping. Create your own list of things that you feel may cause you to have a slip or relapse: __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ List each situation that may cause you to relapse on the left and on the right, list a healthier way of dealing/coping with it. (You may list more than on way to cope for each situation.) __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ Most people with eating disorders are very hard on themselves. Putting themselves down, calling themselves names, convincing themselves they are a failure, etc., are all things that can lead to slips and relapses. The section below will be a difficult one to complete, but it is important to try and change negative attitudes you have about yourself into positive ones. On the left side, list the negative dialogue you use on yourself or hear. On the right side, challenge those same negative statements and replace them with positive ones. When you find yourself overwhelmed with negative thoughts, take out this list and practice telling yourself the positive ones. Even if at first you do not believe them, the more positive messages you give yourself, the more likely you are to start believing them. NEGATIVE POSITIVE __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ Whenever you find yourself making negative comments to yourself, be sure to pull out this list, write down the negative statement and turn it into a positive one. Try to do it each time you catch yourself being hard on yourself so that you do not spend the whole day, week, etc. with this negative thought going through your head. You do not deserve to put yourself down, you are a wonderful person and it is important that you learn how to love and respect yourself. By being able to take the negative statement and turn it into a positive one, you will be taking the necessary steps towards learning to love and accept yourself for who you are. The more positive messages you give yourself, the better you will start to feel about yourself. In times of crisis, it can be difficult to remember healthy ways of coping. Many people in crisis do resort to familiar ways of coping. Making a plan ahead of time can be helpful. Make a list of 10 things you can do instead of using the eating disorders as a way to cope. After the list is completed, keep it in a place where it can be accessed when needed. ( i.e. refrigerator, cupboard, etc.) __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ It is also important to reach out during times of crisis, when you are feeling scared, alone, out of control, etc. Talking about your feelings can help to relieve some of the anxiety that you may be having and can help to prevent a slip or relapse. Reaching out also helps to remind you that you are not alone. Below write down names and numbers of people you can reach out to. You may find it difficult to reach out, but the more you do it, the easier it will become. The person that you call will be glad that you did, will welcome the call, and be there for you the best way that they can. NAME PHONE NUMBER __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ __________________________________ ___________________________________ During the recovery process it is not always possible to avoid slips and relapses. Many people tend to be very hard on themselves if they do have a slip or relapse. It’s important to remember that no one can recover perfectly. If you have a bad day, you can forgive yourself, put it behind you, and continue to move forward in your recovery. A good saying to remember is,"Yesterday is but a dream. Tomorrow a vision of hope. Look to this day for it is life."We cannot change yesterday so it is important not to dwell on what happened yesterday, we cannot spend time worrying about relapsing in the future, because we cannot predict the future. All any of us have is today and we must live for today. Do the best that you can and be proud of yourself for having the courage to continue to fight your eating disorder. It takes a lot of strength and courage to do that and that is something you can be proud of. If you do experience a slip or relapse, it is sometimes helpful to try and figure out why it happened. Below is a list of things that you can do if you experience a slip or relapse. Sit down and try to figure out how you were feeling before the slip/relapses occurred. Write about how you felt before, during and after. Make a plan of how you will handle the situation, feelings, emotions, etc. when it happens again, but in a healthier way. Call someone and talk about what happened and how you feel. (i.e. friend, therapist, family member, etc.) Remind yourself that just because you had a slip/relapse, does not mean that you have failed. It only means that there are feelings inside that need to be dealt with. Be gentle with yourself and do something nice for you. (i.e. soak in hot bath, take a nice walk, read a book, etc.) Remember that there is no shame in having an eating disorder, there is no shame in having a slip or relapse and it is okay to reach out and talk about it Below make a list of things that you can do to help yourself get past the feelings you may experience after having a slip or relapse: __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ __________________________________________________ ___________________ Remember that you are not alone and even if you do have a slip or a relapse, you will get through it. Recovery takes time, but if you want to recover, you can and will. I hope that this relapse prevention plan will be a helpful tool for you in your recovery process.

[Kellie]

One thing many people, not just victims of eating disorders, have trouble accepting, is the set point theory. Set point is the weight range in which your body is programmed to weigh and will fight to maintain that weight.
Everyone has a set point and just like you have no control over how tall you will be, or what color your eyes and hair will be, you also have no control over what your set point will be. Your body is biologically and genetically determined to weigh within a certain weight range.
Set points vary for each individual person. That is why it's not a good idea to go by the weight charts that you see in medical books or hanging in your doctor's office. For instance, a woman at a height of 5'5" with a small frame may have a set point range between 120-130 lbs, but another woman with the same frame may have a set point range between 130-140 lbs. Their set points may be different, but that is the weight range where their bodies will fight to maintain.
Everyone that has ever tried dieting knows just how hard it is to lose weight and keep it off. In the first few weeks of dieting, weight is usually lost, but almost always gained back. Many people become frustrated because after a few weeks of dieting, they usually stop losing weight or start gaining it back, even though they are still restricting their food intake. That is a sign that the body is trying to fight to retain it's natural weight.
When you go below your body's natural set point, your metabolism will react and start to slow down to try and conserve energy. Your body will start to sense it's in a state of semi-starvation and will try to use the few calories it receives more effectively. You may start to sleep more, your body temperature will drop, which is why you hear so many anorexics complaining of being so cold, and after too much weight loss many women experience the loss of their menstrual cycle. Basically their reproductive system shuts down because their bodies probably could not handle a pregnancy. Many people that are dieting also experience uncontrollable urges to binge. That is because your body is telling you that it needs more food than you are providing it to function properly.
Just as your metabolism will slow down when you go under your body's set point, it will also increase if you go above it. The body will try to fight against the weight gain by increasing the metabolism and raising the body's temperature to try and burn off the unwanted calories.
There is no test available to tell you what your body's natural set point is. The best way to determine what it is, is by eating normally and exercising moderately. If you have been dieting for years, it can take up to a year of normal eating for your body's metabolism to function properly and return you to the weight range that is healthy for you.
Learning to accept the fact that your body needs to be at a certain weight is a good way to stop the vicious cycles of dieting. The more you try to go below your body's set point range, the harder your body will fight to retain it's natural weight. Engaging in a healthy eating and exercise routine, will allow your body to go to the weight it wants and needs to be at. Learning to love and accept who you are, will help you to accept your body's natural set point. It is unfortunate that we live in a society that is obsessed with thinness, but we have to stop believing that thinness equals happiness. What everyone needs to do is stop judging people by how they look. If we can all accept each other for who we are, no matter what size we are, people will be much happier. Except, of course, for the diet industry, because they would be finally out of business.

[Kellie]

Mirror Mirror
Eating Disorders
Colleen Thompson

[Done-With-It!]

Holiday are the hardest time for most people with e.d.'s. The e.d. centers that I know go on waiting lists.

I know for me it's always been the hardest time of the year.
Anyone else?

[Dreamz]

YES!!!

Me - especially xmas. When all the family are there I always feel like I have to prove myself and it makes me miserable. The funny thing is that my family love me no matter what for who I am and they would never never do anything to make me feel like less of a person but sometimes that makes me feel like I have to impress them even more.

I've been working on it though - and whenever I feel miserable or like I have something to prove, I just listen, listen to my family laughing, or listen to the crazy stories they're telling each other and remember that I'm part of that.

It's working...baby steps!!!

[Done-With-It!]

Funny how that works, I feel pressure to around my family, but because of bad circumstances this will be my 2nd Christmas ever being alone, away from my family, and it sucks.

My mom is a HUGE Christmas person, she goes all out on decoration, wrapping the Christmas presents, she always just makes it amazing.
I know it's killing her that this will be our 2nd Christmas apart, me too.
Christmas just isn't Christmas without her.

I have plenty of places I could go, friends or family, but I don't feel up to it this year, I really would just like to be around my Mom, cuz then if I don't feel good, or don't want to dress up, etc. I don't have to, and I don't have to entertain.

But, lol, if she were coming here as usual, I'd be all stressed.
But I guess that stress is a good kind of stress.

Well Dreamz we both have a lot to be Thankful for, we won't
be running to the bathroom to get a fix to be happy,
and that is enough to make Christmas for close to perfect.

[Done-With-It!]

Bump ;-)

[Done-With-It!]

The Beginner's Guide to Eating Disorder Recovery By Nancy Kolodny, MSW, LCSW

---

Choosing a Therapist
(Excerpt from The Beginner's Guide To Eating Disorder Reocovery)
"I'm scared to change. I'm afraid I'll fail. I'm afraid I'll succeed." - Terry L., age 18
Changing something that's familiar to you, even if that "something" is harmful, can be difficult to do. When that "something" is an eating disorder, the motivation to change can be further complicated by your history, especially if you've previously tried and failed to overcome your problem or have spent a lot of time denying that the problem even existed. You may have little hope that you'll succeed this time and assume that you'll always be "stuck" in your current patterns. You might be skeptical about therapy and therapists. It's only logical, then, that you'd hesitate to ask for, much less accept, assistance. Instead, if you've been through this before, try to "reframe" your present situation in positive, proactive terms. Whether you're having a temporary lapse in recovery or a more severe, prolonged relapse, think of the flare-up as a wake-up call that you need additional help to renew your commitment to life without an eating disorder.
If you're starting this process of recovery for the first time, your initial challenge may be to admit that your problem won't go away by denying it exists. In fact, the opposite usually happens: the added strains of secrecy and lying make the situation worse. What will make it go away is your willingness to face up to reality and to work hard on your recovery. In either case, it takes a lot of courage to decide to face up to an adversary as tough as an eating disorder and then let a group of virtual strangers help you redirect your efforts and energies toward recovery. But you can do it.
How to Find the Help You Need and Want
Once you decide you're willing to try therapy, the next step is to find the right kind of help. If you're a teenager or young adult, your parents or guardians will help you do this. They've probably made most decisions about your health care, to date, and it's possible you've never before had a voice in this process. But this is one time where your input is both desirable and important. How do you begin? What are your options?
1. Find a qualified therapist who has special training in working with anorexics and bulimics.
The Academy for Eating Disorders (AED) (703/556-9222; www.aedweb.org) and the International Association for Eating Disorder Professionals (IAEDP) (877/540-5691; www.iaedp.com) maintain memberships lists of qualified therapists. Both of these organizations have stringent requirements for professional training before they will allow health care professionals to become members. (This doesn't mean the therapists who aren't members of either group are untrained or unprofessional. It may just mean that they have not applied for membership or haven't yet fulfilled all the continuing education and training requirements for membership.) The AED also publishes an annual directory of health care professionals with information about each member's practice (the geographic location of the office, if they work with children and adolescents or adults, if they do individual, family, or group therapy, how to make contact by phone, fax, or email). A number of other directories also exist online at websites such as the Eating Disorders Referral Center (www.edreferral.com), Something Fishy (www.something-fishy.org) and Pale Reflections (www.pale-reflections.com). In addition, most hospitals with inpatient eating disorder units as well as other independent eating disorder treatment facilities list their staff members as part of their website information.
2. Shop around.
Since finding the right therapist is such an important part of recovery, call and/or interview as many people or places as you need or want to before making your decision. This is a common practice which is expected by most therapists. A family member might help you do the ground-work, but the more you're involved in this process, the greater will be your commitment to therapy. In a way, this is similar to beginning a class in school that you're initially hesitant about. Maybe you're afraid you'll be bored or worried it will be too hard. If you sit in the back of the room, never answer questions, rarely participate in discussions, then those negative expectations will probably come true. But if you sit up front, raise your hand a lot, and get involved in activities, you might like the class so much that you want to come back to the next session.
3. Make a "shopping list" of the qualities of the professional "helper" or "helpers" with whom you see yourself succeeding.
Answer the following questions:
*Does the gender of the doctor or therapist matter to you? Why?
If you are a girl, would you prefer a female practitioner? If you are a boy, would you prefer a male doctor or therapist? What are the reasons for your preference? Have you had a particularly good or bad experience with a same-sex or opposite-sex health care provider in the past that has caused you to feel this way?
*Would the age of the doctor or therapist alter your willingness to work with this person? Why?
For instance, could you discuss your problems more openly with a young therapist because you'd feel more in sync? Do you think you'd have more confidence in someone older who had more professional experience? Is your reasoning based on actual past experiences with older versus younger teachers or doctors? Is your reasoning based on gut feeling?
*Does the therapist's style of working with patients matter to you?
Do you feel so overwhelmed at this moment that you think you'd prefer a directive, authoritative therapist with a clear-cut approach? Or would you like someone with a more flexible approach? Are you looking for someone who is willing to give you all the time you need to tell your story and explore your problems? Or do you want to work with someone who will dive right in and try to get things resolved quickly?
*Would you be willing to be seen by a health care provider who had worked with and was recommended by one of your friends or relatives, or would you prefer going to someone unknown by anyone else in your network of relationships? Why?
Some people find that knowing about a therapist's personality and reputation from the firsthand experience of a friend or relative eases the tension of initial visits and makes the thought of therapy a bit less unnerving. What qualities match the items on your own "therapist shopping list"? On the other hand, you might be concerned about privacy and confidentiality, and feel threatened by the thought that someone else who knows you also knows your therapist. Perhaps you're concerned that you won't be able to speak openly and honestly with a therapist who has a connection to your family or peers.
*Is there a chance that the location of the office might affect your willingness to work with the doctor or therapist?
As odd as this question might seem, many people are put off by the location of some offices. This is often the case when appointments take place in hospital-based offices, because some people find hospitals to be intimidating. Perhaps the location is hard to get to: maybe it isn't within walking distance from home, school, a bus or subway stop, or is so far from home that driving there and back takes a long time. Lots of people get sloppy about keeping appointments if getting to them is such an effort that the payoffs don't seem to outweigh the inconvenience involved. Think about this ahead of time so that the office's location won't turn into your excuse to avoid or stop therapy after you've begun.
4. Make a list of anything you would want to ask a therapist.
Here are some questions I'm frequently asked by prospective clients.
* What is your educational background?
* How long have you been a therapist?
* How and why did you become an eating disorder therapist?
* Do you or did you have an eating disorder?
* Are you a licensed professional?
* What is your preferred treatment approach?
* How much does a session cost?
* Do you accept insurance?
* Do you have a sliding fee scale if I don't have insurance that will cover your services?
* Do you prescribe medications? How do you decide what medications to prescribe?
* Will you work with me alone and have my family work with another therapist, or will we all work with the same therapist or therapy team?
* Do you offer group therapy?
* How often would we meet? How do you decide how many times we will meet?
* Can I contact you between our scheduled sessions if I need to? Will those interactions be confidential?
* Can I communicate with you by email? Will those emails be confidential?
* What will you do if I disagree with your suggestions during therapy?
* How long will it take me to know you're the right therapist for me?
* What if you and I don't click? Can you refer me to someone else? Will you be angry with me?
* Can I be forced into treatment against my will?Any concern you have is valid; it's better to ask too many questions than too few.
When Negotiation Isn't an Option
The last question in the above list, "Can I be forced into treatment against my will?" is a very common fear of people who struggle with eating disorders. The answer to it is "Yes," if your eating disorder is so far advanced that your life is currently in danger.
In such a case, your preferences may have to be overridden by the choices that others must make, on your behalf and in your best interest, to save your life. You won't have a chance, then, to negotiate and choose a particular style of therapist or treatment situation. You may find yourself in an emergency room at a hospital, or on one of the inpatient facilities discussed in Chapter 8. Until your health has stabilized to a point at which life or death is not the overwhelming and overriding concern, don't expect to negotiate about anything, much less your ideal therapy situation.
How to Improve the Odds for Success
Once you've thought about the therapy environment in which you see yourself succeeding, and the style of therapist you'd like to spend such intense moments with, you may be more ready to talk about this with your parents, guardian, or any other appropriate person. Comparing your preferences with those of your family members should result in a win-win situation for everybody, even if it involves some compromise between what you want and what your family thinks you need. Whatever therapy situation you eventually end up in, give yourself credit for being actively involved in the selection process, approaching things logically, stating your needs and wants, and accepting the challenges of recovery.
Whomever you choose to work with, you must be honest and accurately represent your problem.
It's especially crucial that you tell them about any and all physical problems along with the emotional issues that are bothering you. For example, if your parotid glands are swollen because you've been vomiting, admit it and don't pretend you've just had a bout of the flu. If your menstrual periods have stopped, don't say that they're irregular. If your gums and teeth are affected by bulimic vomiting, don't blame the problems on too much candy as a child, or poor heredity.
No therapist is a mind reader. If you don't speak candidly, he/she might not ask you about the issues or situations that you feel are problematic and important to discuss. Worse, the therapist may diagnose and want to treat you first for something other than an eating disorder because you've been dishonest about your signs, symptoms, concerns, etc.
A New Base of Competence
By doing all this thinking and preplanning, you've effectively changed the focus of your life from problems to solutions, from negatives to positives. You've made a commitment to therapy and taken the first steps. You're now at a potential transition point in your relationship with family and friends; you've confronted yourself and your eating disorder; you've admitted the need for help and taken the steps to find it; you've shown your strength and guts, and your willingness to grow. You've proven that you can be assertive and self-aware; your words and actions show that you can be capable, rational, and assume appropriate control of some aspects of your life. You are building a foundation of competence-success breeds success, and confidence comes with competence. Competence is a powerful word that implies readiness, skill, ability, fitness, and proficiency. From this stage of recovery on, others will continue to believe in and respect your competence as long as you remain well-informed and honest about the changes that are happening in your life. Familiarizing yourself with the clinical definitions of anorexia and bulimia that you will find in the Appendix of this book might make it easier for you to discuss your symptoms with your therapist. Take your responses to the EAT-26 (in Chapter 4 on anorexia) or your answers to the statements about bulimic behaviors (in Chapter 5 on bulimia) with you to your initial therapy sessions. Also, bring your written responses to any of the exercises throughout this book. The more concrete, current data you share about yourself, the more raw material your therapist will have to work with.
Ten Things to Remember About Finding a Therapist
1. Your input in finding a therapist is a desirable and important element in the selection process.
2. If possible, find a therapist who has special training in eating disorders.
3. List what you think would make your therapy experience successful, including characteristics of the type of place and kind of person you imagine helping you.
4. Take the time to compare and contrast your preferences with those of your parents or guardian, and see what kinds of compromises can be reached so you all feel confident.
5. Write out a list of questions you want a therapist to answer to help you and your parents decide.
6. It's okay to talk with several therapists before making the final decision about whom you will hire to work with you.
7. If your health is in grave danger, your choices and preferences may have to be overridden by immediate choices others must make to save your life.
8. No therapist is a mind reader. Once you make the commitment to therapy, it's crucial that you're honest and describe your physical and emotional issues with as much accuracy as possible.
9. Choosing a therapist is an unmistakable signal to family and friends that you have the courage, strength, and willingness to challenge and change your eating-disordered ways.
10. Your willingness to learn and share about your self and your disorder with your therapist will greatly increase your feelings of competence and confidence.

From:
The Beginner's Guide to Eating Disorder Recovery
By Nancy Kolodny, MSW, LCSW
Additional Resources:

Eating Disorders Information
About Eating Disorders
Anorexia
Dangers of Anorexia

[Done-With-It!]

Relapse prevention

The road to recovery is usually long and hard. No one travels it gracefully. There are many slips, trips, and lapses. Those who eventually do recover learn to pick themselves up when they fall, brush off the dust, and keep going. By doing so, they keep temporary lapses from turning into full-blown relapses. Here are things to do when relapse threatens:
Relapse prevention: anorexia nervosa

It sounds simplistic, but it is true: if no one ever dieted there would be no anorexia nervosa. Instead of dieting, design a meal plan that gives your body all the nutrition it needs for normal growth and health. If you want to work towards a healthy weight, then limit (but don't eliminate) your intake of fatty and sugary foods and refined carbohydrates. Eat lots of whole grains, fruits, vegetables, and enough dairy and protein foods to maintain strong bones and healthy muscles and organs. Also get 30 to 60 minutes of exercise or physical activity three to five days a week. Unless you are working under the supervision of a coach or trainer, anything more rigorous is excessive.

When you start to get overwhelmed by "feeling fat," instead of dwelling on your appearance, ask yourself how your life would be better if you were thinner. What would you have then that you don't have now? Friends? Self-confidence? Love? Control? The admiration of others? Their acceptance? Success and status?

Then realize that being unhealthfully thin will bring you none of these things, only a fragile illusion of success that has to be constantly reinforced with even more weight loss. All of the items listed in the preceding paragraph are legitimate goals of healthy people, but working to achieve them directly is much more effective than trying to be successful by losing weight. If weight loss brought happiness, then starving Third World children would be ecstatic with joy. They are not. They are miserable and depressed, just like people who have anorexia nervosa.

Accept that your body shape is determined in part by genetics. Accept that you may never have a totally flat stomach. Even if you are very thin, your internal organs will give your belly a certain roundedness, especially after you eat. That's normal, especially if people in your family tend to store fat in the midsection.

If you feel yourself slipping back into unhealthy habits, call your therapist and schedule an appointment. Returning to counseling in no way means you have failed. It means only that it's time to reevaluate and fine tune your recovery plan.

Relapse prevention: bulimia nervosa

Never ever let yourself get so hungry that the urge to binge is overwhelming. People who recover from bulimia say that they eat regularly. Because they are never ravenous, they have no physical reason to binge eat. Hunger is the most powerful binge trigger there is. It is a recognized fact that the longer one has dieted, and the more severely calories have been restricted, the higher the risk of binge eating.

Never ever deprive yourself of good-tasting food, even if it has more fat and calories than "safe" diet foods. If you refuse to eat appealing foods that you really want, you will feel deprived and crave them. Then you are vulnerable to bingeing. Remember Adam and Eve in the Garden of Eden? The one food they were not supposed to eat was the one they could not stay away from.

Until you have achieved some balance and perspective, stay away from temptation. Don't go to all-you-can-eat salad bars. If ice cream is a binge trigger, don't keep it in your freezer. When you want potato salad, for example, or rocky road ice cream, go to a sit-down restaurant and order a single portion, ideally as part of a balanced meal. By doing so, you accomplish three things. You avoid depriving yourself. You avoid the urges to binge created by deprivation, and you also learn how to integrate normal food into a reasonable and healthy meal plan.

When you do feel powerful urges to binge, postpone the act for thirty minutes. Surely you can wait half an hour. During that time think about what is going on in your life. What stresses are you facing? What is missing right now from your life that you need in order to be happy and avoid the looming binge? Make a list of things you could you do instead of binge eating to deal with your situation. If you are truly committed to recovery, at least some of the time you will choose one of these healthier behaviors instead of binge food.

Take charge of your life. Stop using words like, "I wish," "I want," "I hope," and "I can't." They are weak victim words. Say instead things like, "I choose," even if you are choosing to binge. Say, "I will," even if the thing you will do is vomit. These are words that express responsibility, power, and control. If you can choose to binge, then by implication at some future time you can choose NOT to binge. If you will vomit, then next week or next month or next year you can choose to say, "I WON'T vomit."

If you feel yourself slipping back into unhealthy habits, call your therapist and schedule an appointment. Returning to counseling in no way means you have failed. It means only that it's time to reevaluate and fine tune your recovery plan.

Relapse prevention: binge eating disorder

Same as for bulimia, above

If you feel yourself slipping back into unhealthy habits, call your therapist and schedule an appointment. Returning to counseling in no way means you have failed. It means only that it's time to reevaluate and fine tune your recovery plan.

Relapse prevention: everyone

Nourish yourself physically, emotionally and spiritually. Accept that everyone has needs, legitimate needs, and you don't need to be ashamed of yours. Learn how to meet your needs in healthy, responsible ways. If you make yourself feel needy, you will be tempted to look for comfort in diet books or the refrigerator. Especially make sure that every day you spend time with friends. In person is best, but phone calls and e-mail are better than nothing.

Also every day spend time doing things you are good at, things you can take pride in, things that demonstrate your competency and abilities. Allow yourself to enjoy your accomplishments and refuse to listen to the nagging inner voice that insists you could do better if only you tried harder.

Schedule something to look forward to every day, something that's fun and pleasurable. Watch comedy videos and laugh out loud at outrageous jokes. Play something -- a board game, a computer game, a musical instrument, tapes or CDs. Go outside and enjoy the birds, trees, flowers, and fresh air. If you live in the middle of a big city, go to a park. Make something with your own hands. Figure out how to give yourself a fun break from the daily routine, and then do it.

Keep tabs on your feelings. Several times during the day, especially in the first stages of recovery, take time out and ask yourself how you feel. If you notice rising stress, anger, anxiety, fear, sadness -- and even strong joy -- be alert to the possibility that you may try to dull these strong emotions by turning to, or away from, food. Find a better way of dealing with your feelings such as talking them over with a trusted friend.

Do someting meaningful every day, something that gives you a sense of having made the world a better place, if only in some small way. If you do this consistently, you will build a sense of your dignity, value and ability to make a difference in your world.

The 12-step folks have a useful formula. When they feel on the verge of falling into old behaviors, they say HALT! Then they ask, "Am I too Hungry, too Angry, too Lonely, or too Tired?" All of those states are strong binge triggers. Additional triggers for people with eating disorders seem to be Boredom and Unstructured time. If you find yourself stressed by any of these feelings, figure out a healthier and more effective way of dealing with them than binge eating or starving.

If you feel yourself slipping back into unhealthy habits, call your therapist and schedule an appointment. Returning to counseling in no way means you have failed. It means only that it's time to reevaluate and fine tune your recovery plan.

A healthy lifestyle insulates against major relapse

Get at least eight hours of sleep every night, more if you need it. Sleep deprivation seems to impair the way the human body uses insulin, which can lead to overweight and possible problems with blood sugar.

Do thirty to sixty minutes of physical activity every day. It does not have to be done all at one time, and routine activities such as climbing stairs and yard maintenance count.

Nurture supportive relationships with friends, family members and romantic partners. Enjoy being with people you like and who like you back.

Deliberately make choices. Don't make the mistake of thinking that you are the victim of forces over which you have no control. As soon as you reaize you are making choices, you can decide to choose other possibilities.

Do something fun every day. Let yourself experience pleasure too. When you play and enjoy yourself, you don't have to turn to diet books or binge food for release from daily stress.

No smoking. Anything. Ever.

And if you use alcohol, no more than two standard servings per day for males and one standard serving per day for females.

No abuse of prescription drugs or use of recreational drugs. In addition to hurting your body, these substances impair brain function and muddy your thoughts. If you want to be healthy and free of relapses, you need your wits about you. If you are dependent on alcohol or other drugs, get treatment and get clean. Many people with eating disorders are also chemically dependent.

A nutritious breakfast every morning. Ninety-six percent of everyone who loses weight and keeps it off eats breakfast every day, according to Ann Yelmokas McDermot, a nutrition scientist at Tufts University (USDA Nutrition Research Center)

Plus all the things your mother has probably nagged you about: Wear your seat belt when in a car. No unprotected sex unless you are in a strictly monogamous relationship. Insist on counseling or leave relationships if you are being physically, sexually, or emotionally abused. Also get counseling if you have painful issues in your past that have not been resolved.

THIS ARTICLE CAN BE FOUND AT
http://www.anred.com/relpr.html

[Done-With-It!]

Eating Disorders

Help and Support

Support groups help patients and families talk about their experiences and help each other get better.
If you have an eating disorder, a support group is a great way to gain support, find ways to improve your self-concept, and know that you are not alone in the struggle!

In This Article:
	Self-help tips for eating disorders		Support groups for family members
	Eating disorder hotlines and helplines		How can I improve my body image?
	How do I help someone with an eating disorder?		References and links
	Find an eating disorders support group

Recovering from an eating disorder is challenging, but very doable - and essential for your well-being. Seeking help and support from others will help you sort through the underlying issues causing your eating disorder and help you to learn new, healthier ways of coping. Support is available for you if you have an eating disorder or if you are a family member, friend or partner of someone with an eating disorder. You don’t have to go it alone!
What are some self-help tips for eating disorders?

Self-Help for Eating Disorders
Excerpted from: Self-help tips [Internet]. Anorexia Nervosa and Related Eating Disorders, Inc. (Chicago, IL); 2005 [cited May 2006]. Available at: http://www.anred.com/slf_hlp.html.
Note: if you have even the smallest suspicion that you are in medical danger, consult a physician immediately. Eating disorders can kill, and if you are already in trouble, you need medical attention, not self-help tips.
For anorexia nervosa:

• Don't diet.
• Get 30 to 60 minutes of exercise or physical activity three to five days a week.
• Ask someone you trust for an honest, objective opinion of your weight. If they say you are normal weight or thin, believe them.
• When you start to get overwhelmed by "feeling fat," push beyond the anxiety and ask yourself what you are really afraid of. Then take steps to deal with the threat, if it is real, or dismiss it if it is not real.

For bulimia nervosa and binge eating disorder:

• Don't let yourself get too hungry, too angry, too frustrated, too lonely, too tired, or too bored. Don't let yourself get pulled in too many directions by too many people, too many demands, and too many responsibilities. All these states are powerful binge triggers. Watch for these states, and when they first appear, deal with them in a healthy manner instead of letting the tension build until bingeing and purging become the only release you can think of.
• Stay comfortably busy and avoid unstructured time. Empty time is too easily filled with binge eating.
• Make sure you get enough sleep, at least seven hours every night.
• Don't diet. Dieting means depriving yourself of nourishment and pleasure. Dieting and deprivation are powerful triggers of binge eating. Note: A healthy meal plan, one that manages weight and reduces risks of medical problems, is NOT dieting in the usual sense of deprivation. A healthy meal plan respects nutritional needs and is flexible enough to include reasonable amounts of fun foods.
• Make sure that every day you spend time with friends and loved ones -- in person is best; phone and email can substitute, but only once in a while. Enjoy being with people you love and those who love you. It sounds corny, but hugs really are healing.
• Take control of your life. Make choices thoughtfully and deliberately. Make your living situation safe and comfortable.
• Choose every day to bring pleasure into your life, at least for a few minutes: do something relaxing, something energizing.
• Monitor your self-talk. Challenge self-critical nagging. Deliberately choose to change the subject and count your blessings when you fall into negative thoughts about yourself, your appearance, your abilities, and your accomplishments.
• Keep tabs on your feelings. Several times a day ask yourself how you feel. If you get off track, do whatever the situation requires to get back to your comfort zone.
• A reminder: If these tips don't work for you in seven days, talk over your situation with a resource person -- physician, counselor or therapist. If you have even the smallest suspicion you are in medical danger, don't wait one day longer. Talk to a physician immediately.

For more self-help suggestions, see 10 Tips Which May Help You to Help Yourself (Keele University)

What are some telephone hotlines and helplines that can help with an eating disorder?

If you think you have an eating disorder, a telephone hotline can provide you with information or a referral to a professional for treatment:

National Association of Anorexia Nervosa and Associated Disorders
847-831-3438, Monday through Friday, 9 am to 5 pm, CST
National Eating Disorders Association
1-800-931-2237, 8:30am – 4:30pm, Monday through Friday, Pacific Time
National Call Center for At-Risk Youth
1-800-USA-KIDS, 24 hours, for children and teens

What can I do to help a family member or friend who may have an eating disorder?

You may suspect that your friend or family member has an eating disorder because of signs and symptoms that you have noticed. Confronting a friend or family member who has an eating disorder is a delicate matter—most people with anorexia or bulimia deny the condition. Remember:

• If you encourage the person with an eating disorder to get help, you may help save the person’s life.
• Support from friends and family can really help people recover even when they are receiving professional help and advice.
• Whenever you intervene in someone’s life, they may not appreciate it – especially at first. If you have good reason to believe their life is in danger, proceed with this awareness and with sensitivity for their feelings.

For more tips on what you can do to help a family member or friend who may have an eating disorder, see When You Want to Help (ANRED) and What You Can (And Can’t) Do (Something Fishy)

HOW TO TALK WITH SOMEONE WHO SHOWS SIGNS OF AN EATING DISORDER
Excerpted from: Bulimia Nervosa: A Resource Guide for Family and Friends [Internet]. ECRI (Plymouth Meeting, PA); 2006 February [cited May 2006]. Available at: www.bulimiaguide.org.
First, learn all you can about eating disorders. Remember that even though you are informed about bulimia nervosa, only a professional trained in diagnosing eating disorders can make a diagnosis. Avoid using your knowledge to nag or scare the person into treatment. The goal of a discussion should be to express your concerns about what you've observed and persuade, but not force, the person to seek help.

• Plan a private, uninterrupted time and place to start a discussion. Be calm, caring, and non-judgmental. Directly express, in a caring way, your observations and concerns about the person's behavior.
• Avoid words and body language that could imply blame.
• Ask the person if s/he is willing to explore these concerns with a healthcare professional who understands eating disorders.
• Ask the person to describe the feelings they get from the behavior you've observed.
• Avoid suggesting overly simple solutions like "Just stop overeating and you won't have to purge."
• Take a break if the person continues to deny the problem.

See also: Recommended Do's for being supportive and Recommended Don'ts for being supportive. Remember that this is a delicate matter; it's a good idea to be prepared. There are additional articles listed below in references and resources that can help you feel better-equipped to discuss this sensitive issue.
How can I find an eating disorders support group?

Each of the following organizations maintains an online database proving referrals to eating disorders support groups. To find a support group or self-help group near you (be sure to select “support groups” when conducting your search), check the following:

• National Eating Disorders Association USA & Canada
• Eating Disorder Referral and Information Center USA
• Overeaters Anonymous (OA) (for bulimia and binge eating) USA & Canada
• Something Fishy Treatment Finder: Support Groups Worldwide
• Pale Reflections Eating Disorders Community Treatment Finder Worldwide
• Eating Disorders Association Self Help & Support Groups UK

You might also:

• Contact a local eating disorders professional or clinic to ask for a referral.
• Check with your doctor, local hospital, or medical center to see if they offer a support group for individuals with an eating disorder or can refer you to one.
• Call your local college or university counseling center to see if they offer a support group for individuals with an eating disorder or can refer you to one.

In addition, online help for eating disorders can be very effective. Many people with eating disorders feel ashamed to seek help face-to-face and benefit from anonymous online support.

• You can try participating in an online chat room on eating disorders: ANAD (Anorexia Nervosa and Associated Disorders) Message Board and Chat Rooms. Read the introduction, proceed to Eating Disorders Resources and Support, then register with a username and password, and you’re part of the chat room.
• Something Fishy provides a comprehensive list of online support options.

How can I find support groups for family members of people with eating disorders?

There are many ways for family members of someone with an eating disorder to find support groups for themselves. Here are some suggestions:

• Check the online databases that provide referrals to eating disorders support groups. Many groups are designed for family members.
• Call an eating disorders helpline for a referral.
• Contact an eating disorders professional in your area and ask about support groups for family members

For online support, Something Fishy’s Support for Friends and Family offers bulletin boards and chat rooms for friends and family members.

What are some ways to improve my body image?

If you think you are in danger of developing an eating disorder, many of the self-help tips in the section above can help. Commit to taking care of yourself and maintaining a healthy body image and self-esteem:

• Pay attention to negative self-talk. Learn how to change negative thoughts about yourself so you feel good about yourself.
• Stay active and eat nutritious meals. See Helpguide’s Healthy Eating series for tips on creating a balanced, nutritious diet.
• Make time to soothe and pamper yourself. Enjoying alone time for a bubble bath, a rejuvenating picnic in the park, or some kind of creative activity that allows self-expression and exploration will help encourage healthy self-esteem and relaxation!

For more tips on improving body image, see Twenty Ways to Love Your Body! (National Eating Disorders Association), Improve Your Body Image (Something Fishy) and Improving Your Self-Confidence (BBC).

References and resources for eating disorders help and support

Helpguide's series on eating disorders:


Eating Disorders: Types, Warning Signs, and Treatment

Eating Disorders: Help and Support

Anorexia Nervosa: Signs, Symptoms, Causes, Effects and Treatments

Bulimia: Signs, Symptoms, Effects, Treatment and Support

Binge Eating Disorder: Signs, Symptoms, Causes, Effects and Treatments



Self-help

Self-Help Tips – Tips for recovering from anorexia, bulimia, or binge eating disorder (Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED))
Eating Disorders Survival Guide – Provides guidance in locating treatment, self-help tips, and support groups. (National Eating Disorders Association)
Twenty Ways to Love Your Body! – List of helpful tips for changing your body image and self-concept. (National Eating Disorders Association)
Helping a friend or family member

What are some ways to start a discussion with someone who might have bulimia nervosa? (ERCI). See also:

• Recommended Do's for being supportive – Help in knowing what to say to the person with bulimia.
• Recommended Don'ts for being supportive – What not to say.

Eating Disorders – What to do when you suspect your child has an eating disorder. (Nemours Foundation KidsHealth)
How to Help a Friend with Eating and Body Image Issues – Guidelines for talking with a friend or family member about their eating disorder. (National Eating Disorders Association)
What Should I Say?: Tips for Talking to a Friend Who May Be Struggling with an Eating Disorder – Suggestions for how to talk with a friend or family member about a possible eating disorder. (National Eating Disorders Association)
When You Want to Help a Friend or Loved One – Suggestions on helping a loved one with an eating disorder. (Anorexia Nervosa and Related Eating Disorders, Inc. (ANRED))
Do's and Don'ts for Helping Friends – Suggestions for helping a friend with an eating disorder aimed at college students. (Dartmouth University)
Online referrals for finding a support group

The following sites provide online referrals for support groups (be sure to select “support groups” when conducting your search):

• National Eating Disorders Association USA & Canada
• Eating Disorder Referral and Information Center USA
• Overeaters Anonymous (OA) (for bulimia and binge eating) USA & Canada
• Something Fishy Treatment Finder: Support Groups Worldwide
• Pale Reflections Eating Disorders Community Treatment Finder Worldwide
• Eating Disorders Association Self Help & Support Groups UK

• Eating Disorders Foundation, Inc. (Australia)

Prevention / Improving Body Image

Eating disorders prevention: parents are key players – What parents can do to prevent eating disorders in their kids. (ANRED: Anorexia Nervosa and Related Eating Disorders, Inc.)
Improve Your Body Image – Provides numerous tips to help improve your body image and self-esteem. (Something Fishy)

http://helpguide.org/mental/eating_d...lp_support.htm

[LAStarlette]

I printed this out. Thanks