Trigger warning: weight and bmi numbers

My slip into restricting a couple of months ago was triggered by seeing my weight for the first time in nearly a year. It was ten pounds higher than it had been the year before. And I was horrified. Mortified. Humiliated. Furious. And really really really confused. It had been two years since I stopped binging and purging and I had gained 30lbs – 20 in my first year of recovery and another 10 in my second year of recovery. And I was really fucking pissed off. Even the first twenty was seven more than the BMI 20 I had set as a target and five more than the target my nutritionist suggested. So that was hard enough. But to have gained even more? I was devastated. I thought I must be over-eating. That was the only way this could have happened right? So I cut back. But cutting back meant not eating when I was hungry or stopping before I was full and before I knew it I was completely overwhelmed with ED thoughts.

I managed to get back on track and ED has quieted down significantly (although still louder than before I slipped). But my feelings about my weight haven’t really changed. I am mortified, pissed off, confused. If I haven’t been overeating why oh why did my weight go up (I should mention that my weight had been stable at 10lbs less than my current weight for about eight months before I stopped weighing myself)? If I am eating when I am hungry, stopping when I am full, and leading a fairly active lifestyle (chasing babies and puppies but no formal exercise other than weekly soccer game) and this is where my weight has landed, does that mean this is where my body wants to be? In my most rational moments I can see that that might make sense. But most of the time I feel like that can’t be right and I clearly did recovery wrong to get to this weight.

I stopped binging and purging in october 2009 and for a long time I pinpointed that as my recovery start date so it seemed ridiculous for my weight not to have stabilized a year later. But if I am honest, I did not stop restricting and overexercising for many months after that and I did not really relax into “normal” eating until close to a year later. So maybe my body wasn’t done restoring weight at current weight minus ten lbs. Maybe it just hung out there for a while doing internal repairs and dealing with a raging metabolism and I (and my nutritionist) just assumed it was done.

See when I started gaining weight I set myself a target of BMI 20 because I read somewhere that that was the healthy minimum. It seemed so pro-recovery at the time because in previous recovery attempts I had set my target even lower. And when I read genetic set points I looked at my mom and my sisters and my mom’s sisters and they are all really thin people so the helathy minimum seemed like enough. Of course, I conveniently left out that part where my mom and one of her sisters had (have) diagnosable EDs and that my older sister has disordered eating and my younger sister is, well, younger and also a serious athlete. So maybe not the best points of reference.

Gaining to BMI 21.something was really hard but eventually I did come to accept it. It was like I all of a sudden remembered what the word minimum meant. Besides I had reached a BMI 20 in my previous recovery attempt and had relapsed so maybe that extra little cushion wasn’t such a bad idea. My BDD raged about my appearance but mentally I could handle the numbers. Plus I thought I was done gaining weight and there was a comfort in that – in just getting used to that weight as opposed to panicking about getting even bigger.

And then – about three months ago – I got on that scale and discovered that actually I had gained ten more pounds putting me at a BMI of 23 (holy crap putting that out there in the world is really really scary – no one but me knows my weight – trying not to panic – deep breathes). And OMG that meant that I was closer to an overweight BMI than an underweight BMI and clearly that was NOT OKAY (even though I know BMI is total crap and even if it wasn’t being slightly above the middle of the healthy range should not be a crisis).

So I am trying to come to terms with it. And not doing a great job. I thought about getting my childhood growth charts because I thought if I had proof that this was where my body wanted to be it would be easier. I scratched that idea after my boyfriend asked me what I would do if my charts indicated something else. He said that I should stop trying to “justify” weighing this much. That it is fundamentally OK. That I am physically healthy (mostly) and mentally healthy (mostly) and that if I need justification that should be good enough. Have I mentioned that I love this guy?

The idea that I had gained more than I needed to to be physically healthy was really bothering me but what good would it have been to be at a lower but physically healthy weight if I could not maintain it because my mind was still sick? And maybe I did overeat somewhat at some point to get to this weight (I went through a period of being very scared of being hungry because I was so terrified of relapsing again). But I am not overeating now. Or maybe my set point is higher that it would have been if my ED had not put my body through years of abuse. Who knows. Does it even matter how I got here?

Could I be physically healthy at a lower weight? Yes. Could I be mentally healthy at a lower weight? Maybe. Can I stay physically and mentally healthy if I put myself into a negative energy balance to reduce my weight? Absolutely not.

So as much as I am struggling with accepting my weight and BMI numbers, and as much as I hate my physical appearance right now, I am determined to tolerate them. Because you know what? I hate ED more.


Recovery Resolution: Body Dysmorphia

My recovery resolution for 2010 is to be more proactive about dealing with my body dysmorphia. The problem is that I really have no freaking clue how to do that. I know that for a lot of people body dysmorphia is more of a by-product of their eating disorder than a co-morbid condition and that it resolves after weight and nutritional restoration and maintenance. But my body dysmorphia definitely pre-dates my ED. In fact I think I’ve had body dysmorphia pretty much forever.

Trigger warning: includes explicit body dysmorphic thoughts

When I was a little kid it was just this feeling that my body was just not right. Not the right size, not the right shape, not what I was supposed to look like. I think it was around middle school that I started thinking I was too big. I was obsessed with the girls on my gymnastics team who were smaller than me. I wanted so badly to look more like them. It wasn’t that I thought I was fat or was worried that anyone else thought I was fat. I knew I was perfectly normal and healthy. But I also knew that I would feel more at home in a smaller body. I didn’t connect that to my weight or to eating. In fact, food was probably one of the only things I wasn’t anxious about as a kid.

Then came the eating disorder and my body dysmorphia became much more focused. It became attached to the number on the scale and the size of my clothing. It was no longer just a wish that I was smaller. It was an overwhelming need to make myself smaller, to see the numbers go down.

As I gained weight in recovery, my body dysmorphia raged. There were days at a time when, if it hadn’t been for dog, I  would not have left the house because I was horrified at the idea of anyone seeing me. When I did go out I was sure people were laughing at me behind my back for looking so gross. I showered with my eyes closed. I wore baggy sweatshirts (with several t-shirts underneath) all the time. Even in the summer. In Boston. I daydreamed about hacking off my rolls of fat with a kitchen knife. I researched how much liposuction costs. More often than not I thought that I could not survive going through life in this body.

I have been at a healthy weight for 20 months now and things have gotten better. I only have to wear two shirts now (as long as they’re not tight fitting). Only occasionally do I think people are staring at me and thinking mean things. I still avoid looking at my body but I don’t have to keep my eyes closed in the shower just in case I should happen to look down accidentally. I don’t let my boyfriend (of 4.5 years) see me without a shirt. In fact last time we tried that I had a massive panic attack. But I don’t have a panic attack every time he touches me anymore. I know that going through like in this body, even if my body dysmorphia never lets up, is by far the better option.

My boyfriend asks me how I can think I am fat when I know I wear a size X jean and I know that that is not a large size. And the thing is I do know that now. When I was deep in ED-land and even for a long time into recovery I honestly thought that everyone else saw me the way I see myself. I thought my boyfriend and my friends and my nutritionist were just being nice because they didn’t want me to relapse. I thought that, if I didn’t have an ED, no one would bat an eye when I said I wanted to lose X number of lbs. I am not that delusional anymore. I know that I am not fat by any objective measure and that no one else sees me that way I see myself. Problem is that’s not enough to convince my body dysmorphia to leave me alone. When I argue with it that I cannot be obese if I wear a size X it says “well maybe you are not overweight but your stomach and hips and misshaped”. When I say that everyone else thinks I look fine  it says “that’s because they don’t see you without clothes on. Your shirts hide your rolls of fat”. And when I say that my boyfriend says nice things about my body it says “boys will say anything to get laid”. There is no reasoning with something that is so fundamentally irrational.

Which brings me back to my original point (bless you if you just read that entire ramble). I have no fucking clue how to make progress with my body dysmorphia. My general strategy is kind of keep the peace – don’t spend much time in front of the mirror, don’t wear tight clothes, don’t be naked in front of anyone ever. The problem with that strategy is that when I do have to do anything that challenges it I have panic attacks and am bombarded with urges to restrict or exercise. My lapse this fall was triggered by seeing my weight for the first time in quite a few months. I had stopped weighing myself because it was upsetting which seemed very pro-recovery but if I am never desensitized to the number, and live in fear of finding out, I feel like it will always present a real threat to my recovery. And I am not okay with that.

But how do I challenge my body dysmorphia without sending myself into a complete tailspin? I am a huge believer in exposure and response prevention therapy for pretty much everything so I have to think its the way to go for this as well. Start small. Challenge tiny things. See that nothing catastrophic happens. Challenge something bigger. And so on and do forth. Baby steps right? Thing is I can’t seem to come up with a first step that is baby enough. Everything feels enormous and overwhelming and terrifying. Where does that leave me?

ps. I am already on high doses of the recommended meds for BDD.

New Year’s “Resolutions”

I hesitate to call these new years resolutions because that term has become pretty synonymous with dieting/exercise/weight loss crap. New Year’s aspirations perhaps?

1. Go to bed earlier. Get more sleep at night and nap less during the day. Being a nanny means that I have to get up early and get to work early but that I get to nap during the day when the babies are sleeping. So I end up staying up later than I should at night and counting on napping to get through the day. When I start school this summer (knock on wood) I will be forced to change this sleep pattern so might as well start now.

2. Apply to school. (And get in). The application requires that I write a personal statement that included my educational history, my educational and career goals, any formative cultural/travel experiences, and any emotional hardships I have endured. In 750-1000 words. Ha.

3. Drink less beer.

4. Watch less tv that I don’t enjoy.

5. Read more novels. See more live music. Go to the movies more often.

6. Cook a wider variety of foods. This isn’t an ED thing, just a laziness thing.

7. Tell my boyfriend (J) I love him more often. My family isn’t big into talking about emotions. I don’t think I had said ‘I love you” more than a handful of times before I was a teenager and starting making a point of telling my little sister I loved her. I still wince internally when I say it. Usually when J says he loves me I just kind of mumble “you too” in response which is totally lame.

8. Keep the apartment tidier. We are both giant slobs and by the end of the week the apartment looks like a cyclone came through it and its gross and makes it not a very relaxing environment. We let it build up so much that it is an overwhelming task to tackle the mess instead of just doing a bit each night.

9. Make some friends. I have been in Seattle for nearly a year and a half now and still have very few friends and no really close ones. Making friends does not come naturally to me. J can go into any group of people and find a common interest and make conversation and like instantly have friends which is so utterly foreign to me. I wish it came easier but I need to acknowledge that it doesn’t and be more proactive about it.

10. Do a better job of keeping in touch with my friends who are far away.

11. Start volunteering at the Seattle Animal Shelter.

12. Find a way to practice my Spanish before it completely disappears. Going to visit my little sister on her semester abroad in Costa Rica sounds like a pretty good option.

Whoa. So looks like I’ve got my work cut out for me for the year ahead. And that doesn’t even include specifically recovery related goals. I think those deserve a post of their own.

Year in Review

A (slightly belated) overview of 2011:

January: Joined a rec league soccer team which was a pretty big deal in several ways. I wrote in an email to a friend that I was amazed that my body was healthy enough to play a 90 minute soccer game and that my mind was healthy enough to go out with my teammates afterwards for beer and nachos.

March: One year in my healthy weight range!

May: Celebrated 4 years (minus a six month-ish break up period) with my amazing boyfriend.

June: Had a good visit with family and friends back in Boston.

August: One year in Seattle. I LOVE this city.

September: Completed (and got a good grade in) my second college course at UW. The class was hard and brought up a lot of feelings of inadequacy and fears of failure. But I asked for help and was successful. And decided to apply to go back to school fulltime in 2012.

October: Celebrated two years without binging and purging while simultaneously slipping into some restriction.

November: Attended the FEAST symposium! It was awesome and I met so many amazing people and shared laughter and tears and good food. It was also challenging and emotional in a lot of ways. I can’t wait for the next one. Oh yeah I turned 26 too.

December: Had a pretty hard month with ED thoughts, anxiety, and depression but pushed through and am doing well getting back on track with eating. Celebrated the new years with good food and great friends.