RD 4 ED: Nutrition Help for Eating Disorder Recovery

Weight Distribution: The "Pregnant Belly" and "Puffy Face" Won't Last Forever!

2013-05-19T14:15:00.000-07:00

One of the most common complaints I get from my clients who are gaining weight during eating disorder treatment is the amount of weight that settles in their stomach and face in comparison to other parts of their body. I've had clients tell me that they feel as though they look like they have a "pregnant belly" and a "puffy face." They share with me that they cannot stand the way they look and they cannot bear to go on looking the way they are. They then go on to ask me if this distribution of weight is normal or not.

If you are reading this and going through the same thing during recovery from your eating disorder, please know that this initial weight gain in the stomach and face is completely normal to experience and that it will NOT last forever!

Your weight will redistribute to other parts of your body! The trick is to be patient with your new body and give it time. The redistribution of weight will not happen over night, within a few days, or even within a few weeks. It can take several months, sometimes upwards of 6 months to a year for the weight in the face and stomach to readjust to other parts of the body. Hang in there though...it will happen! An eating disorder wrecks havoc on the body and it takes time for the body to sort things out with its fat, carbohydrate, and fluid stores. It will take time for your body to trust that it will be fed normally again and to spread the weight throughout your body.

Don't believe me on this? Here is a blog entry from one of my favorite recovery focused eating disorder blogs titled Progression Obsession that addresses this issue from first hand experience...and how her weight actually did redistribute!

Stop Being So Harsh On Yourself...Amazing Video...A Must Watch!

2013-04-17T19:35:00.001-07:00

If you struggle with your self image, you've got to watch this (click below)!

2 People Described The Same Person To A Forensic Artist And This Is What Happened

Get Our From Behind Your Laptop, Tablet, and Smartphone

2013-04-16T19:35:00.000-07:00

Three reasons why you should consider taking a break from (or limiting your use of) social media sites during eating disorder recovery...

1. Social media is superficial. People are always using social media to post about the fun things they are doing and the cool people they are with. Each photo seems to be one with a perfect pose, at a perfect angle, and with a perfect smile. It's easy to get caught up and believe that other people's posts are a direct reflection of their life. We are led to believe that everyone else's life is perfect. Let's face it though...despite what is reflected on a social media site, nobody's life is perfect. People only post what they want others to see. People rarely post about their struggles and this can leave us wallowing in self pity, while we compare and wish our lives (and appearance) were like someone else's. Additionally, with each post, comment, and picture, we leave ourselves up for critique while others look at these and decide if its worthy enough for them to take the time to "like" or comment on it.

2. Social media is ad city and host to triggering posts. The days of social media simply being a way to reconnect and keep in touch are gone. Take the Facebook "home" page for example. Our "home" page is now littered with ads; muddled with posts, products, and companies our friends like; and cluttered with things that Facebook suggests we view. Somewhere along the line, social media sites have become less to do with staying connected and more to do with marketing a product that we are led to believe we need in order to be healthy and happy. Furthermore, some people find it appropriate to constantly post about how much they just exercised or how much weight they lost. Viewing these types of posts can be triggering and can cause some people to feel inadequate.

3. Social media may isolate us. The more time we seem to spend on social media sites, the most isolated we may become. Think about it...the connecting we do on social media is only surface level. The more time we spend hiding behind our laptop, tablet, or smart phone, the more likely it is that we will end up missing out on the smiles, laughs, comfort, company, and support of actually spending time with the people we care about.

How to Keep Your Social Media Use in Check

Spend a limited amount of time on social media sites. Don't forget about the other things you could be doing with your day!
Use social media to find people you have lost touch with, but rely on face to face conversation as a way to reconnect.
Stop comparing yourself to others. Remember that we are all unique and special in our own way.
Remember that nobody has a perfect life despite how perfect someone else's life seems to be on a social media site. Do not allow yourself to wallow in how much better someone else's life seems to be based on a picture or status update they posted.
Use social media to promote positive messages.

Back to Basics: Twenty Something Year Old Meal Planning Tips

2013-04-08T19:12:00.000-07:00

Last week, my husband and I were looking for something new to make for dinner (as we had gotten stuck on the same old dinner meal rotation). We had some older cook books lying around and decided to take a peek inside for some "new" ideas. Inside the Better Homes and Gardens New Cook Book copyright 1989 (I couldn't believe we had a cook book that old floating around), I found a write-up on Meal Planning. Although more than 20 years old, I found the information contained in it still to be quite relevant and nicely simplified. Here is what it read (my thoughts in relation to your eating disorder recovery are highlighted).

Meal Planning

Spending a little time each week planning meals can save you lots of time and money at the grocery store, as well as help you put more nutritious meals on the table faster.

As stated in my blog post I wrote about a year ago titled, Plan Ahead: Meal Plan Tips for Eating Disorder Recovery, "make a grocery list. I know it sounds simple, but it will help more than you now. There are isles and isles of food in the grocery store and it's easy to get caught up in one food item's health halo or get triggered by seeing a certain food item. How many times have you gone to the grocery store, wasted an hour, and come out with a smorgasbord of random food items that don't go together, just to discover you have to go back to the store the next day? Make a grocery list and stick to it. It will keep your eating disorder urges in check and save you time and money at the store."

Seven Steps to Nutritious Meals

Paying attention to these seven steps as well as the Basic Food Groups (see page 428), makes planning delicious, attractive, and nutritious meals easy.

Select a main dish from the Meat Group, one that includes beef, pork, poultry or fish.
Add bread or cereal, say rolls or rice pilaf, to compliment the main dish.
Choose a hot or cold vegetable.
Select a fruit or vegetable salad to compliment the main dish.
Choose a beverage. This is an excellent place for a serving from the Milk Group.
If desired, add a dessert. Fruits and milk-based desserts, such as pudding, can help you meet your quotas from the Basic Food Groups.
After you've met the first four food group requirements, add extras, if you like from the fifth group, fats and sweets. Remember to include these foods only in moderation.

As you plan your menus, think of all the meals for the day. Make sure that the foods you choose tally up to include the recommended amounts from each of the Basic Food Groups. If you have an egg for breakfast, for example, you only need one serving of meat, fish, or poultry the rest of the day. Keep in mind, too, that some dishes, such as casseroles and salads, combine foods from two or more food groups.

Main message = focus on an entree with a variety of sides from different food groups. Plain and simple. We don't necessarily need to focus so much on the nutty gritty of nutrition each and every time we plan our meals out. Sometimes, being so precise can get too overwhelming as it can be easy to get too caught up in trying to put together a perfect meal, and we can get discouraged if it contains an item that isn't considered a nutrient power house. By keeping the basics in mind, we will likely adequately nourish ourselves and end up with an overall intake that is actually a nutrient power house once it is all put together.

I realize that for many people who struggle with an eating disorder, over simplified guidelines as described in my cook book are not enough structure for recovery. That is where your meal plan comes in. Sure, a meal plan requires more rigidity than the general tips suggested by Better Homes and Gardens. However, thinking through the basics as described can be a good starting point when menu planning for eating disorder recovery. Think through the basics of your meal plan first (ex: food groups if you are using an exchange based meal plan). Then, figure out the exact details, such as the amount of each food that your meal plan requires.

I also believe that desserts can be incorporated into a normal and healthful eating pattern. The trick is consuming desserts in moderation within a balanced and varied intake. Incorporating desserts is also important for eating disorder recovery and something that I do recommend that my clients challenge themselves to (which I will probably cover in more detail at some point in an upcoming blog post).

I do not totally agree with the example provided in my cook book that discusses eating one egg at breakfast and then only needing to eat one other protein source during the day. For many people, this may not be enough. Most eating disorder recovery meal plans require a 2-4 ounce serving size of a protein source at lunch and dinner, many times also having a small protein source at breakfast as well. However, aside from this section, I thought the info provided by Better Homes and Gardens in 1989, provided some helpful tips and information.

Meals That Sparkle

Keep meals exciting by planning menus with a variety of colors, forms, flavors, textures, and temperatures. Proper seasoning also is important. To jazz up your meals:

Choose dishes whose colors complement each other. Avoid choosing foods of the same color. A meal of chicken, fried potatoes, and baked beans, for example, would be pretty drab. Dress up plain foods with sprigs of parsley, bright red radishes, ripe olives, or slices crab apples.
Vary the sizes and shapes of the foods you serve. Leave some foods whole and serve others sliced, cubed, mashed, or cut into strips.
Provide a combination of mild and no-so-mild flavors. For example, serve sweet-and-sour Oriental dishes with rice and chili with corn bread.
Serve crisp foods with soft ones. Good foods for adding crunch include breadsticks, croutons, and lettuce.
Plan a balance of hot and cold foods.

The more appetizing your meals look, the more likely you will be to stick to your meal plan. If you see a boring and colorless meal that is all of the same consistency in front of you, you might be more likely to skip it (which can lead to more restricting or other eating disorder behaviors later on).

Color = nutrition. A variety of colors on your plate will make it more likely that you are getting a variety of nutrients as different colored foods contain different vitamins, minerals, and phytochemicals.

Furthermore, mixing up your meals as stated above with "mild and not-so-mild" flavors amidst a balance of hot and cold foods, will keep you from feeling bored and deprived with your meal plan. Eating the same thing too often can keep you stuck in rigid disordered eating patterns as well as be a trigger for a binge later on (as people tend to crave what they do not allow ourselves to eat).

Solving the Time Bind

When you're short on time, depend on fast-cooking or convenience foods. Choose one of the recipes in this book marked "fast," then plan the rest of the meal around it. Make the other courses simple. Lettuce with bottled dressing and ice cream or sherbet with prepared toppings are tasty time savers.

Save the more-involved menus for days when you have the time to spare and feel like cooking. You may also want to set aside a day to prepare several meals at one time to have on hand for future busy days.

Cooking doesn't always have to be complicated and take a lot of time. Choosing "fast" recipes as described, as well as batch cooking (where you freeze the left overs for later use) or using a crock pot can also be helpful tips for cooking well balanced meals when you are in a time crunch. I also agree with the suggestion to use some prepackaged items at times. Heck, it's even a-ok to forgo the cooking and make a frozen meal from time to time.

Write It Down

Equipped with recipes and newspaper food ads, sit down and write menus for several days or a week at a time. At the same time, write your shopping list. Be sure to list everything you need to make the recipes you've selected, including staples you're low on and nonfood items. The more planning you do, the less time you'll spend at the grocery store and over the stove.

Finally, take note of the menus your family especially likes. Then save your menu plans and use them again. Once you've collected several favorites, your meal planning will be easier and faster.

Also as described in a blog post I wrote about a year ago titled, Plan Ahead: Meal Panning Tips for Eating Disorder Recovery, "save your menu planners each week and rotate them. Variety is important within your food intake, but you do not necessarily need to come up with a new recipe for each meal. Get a good base of meals and snacks going and rotate them, throwing new items in every so often."

Meal Plans: Exchange System or Calorie Counting?

2013-04-03T19:05:00.002-07:00

Throughout this blog, I have written about meal plans for eating disorder recovery that are based off of the exchange system. I work in an eating disorder treatment center that uses the exchange system for meal plans, have had clients benefit greatly from it, and therefore am a major supporter of its use. There are some other treatment providers, however, who use a calorie counting approach to the meal plans they prescribe.

The common question is, which is the best way to approach a meal plan for eating disorder recovery: the exchange system or calorie counting?

First, let's begin with the definition of a calorie. A calorie is actually a specific amount of energy, or heat, that it takes to raise the temperature of 1 gram of water 1 degree Celsius. The number of calories in a food is a measure of how much potential energy that food contains. One food calorie (as listed on a food label) actually refers to a kilocalorie or 1,000 calories. Technically speaking, one kilocalorie (or one food calorie in that piece of bread from your sandwich at lunch) is the amount of energy (if that piece of bread was burned to ashes in a research lab) needed to raise 1 gram of water from 16 to 17 degrees Celsius.

Somewhere along the line, a calorie became less about the potential energy it can offer our body in order to sustain life, and more about the judgement associated with how many (or how little) calories we consume. In our diet and appearance obsessed culture, we are unfortunately taught to believe that we should feel guilty, shameful, fearful, sinful and weak if we consume a "high calorie" food. Furthermore, we are programmed to believe that we should limit the amount of calories we consume and that we should feel superior, deserving, and worthy if we are successful at it.

Often times, number association, such as calorie counting, can be a huge part of an eating disorder. Because the number of calories we consume has somehow become a measure of self worth and morality, calorie counting (even in the form of a meal plan) can become a method of restriction, control, and obsession that can be a trigger to a slippery slope of eating disorder behaviors. For many people who struggle with an eating disorder, calorie counting, even in the form of a meal plan, is something they need to steer clear of if they want to live a life in recovery.

For those who have a difficult time seeing a calorie for simply what it is, a unit of energy (and fuel for your body), it is probably best to follow a meal plan that is based off of the exchange system (rather than calorie counting). The exchange system can be a fresh start and a new way of looking at eating (as the exchange system places emphasis on learning what a balanced plate of food should look like for you within each of the food groups). It can re-channel some of the negative associations you may have about foods, which you have been calorie counting for so long.

I do find that the majority of the clients I work with prefer to use the exchange system for their meal plans. Despite my bias and experience with using the exchange system, there are some people who have found calorie counting beneficial in recovering from their eating disorder. As far as which method is superior, I suppose that it really depends on the person. For the majority of people suffering from an eating disorder, I would suggest they follow an exchange based meal plan. However, if you are able to let go of the negative associations placed on calories and you are able to use calorie counting as 1) a way to appropriately nourish yourself with a variety of food from all of the food groups 2) a tool to assist you in decreasing rigidity with food 3) a way to help you abstain from engaging in eating disorder behaviors, calorie counting may be helpful in eating disorder recovery.

In the end it's all about what supports (rather than prevents) recovery from your eating disorder.

Decrease Rigidity With Your "Rigid" Meal Plan

2013-03-28T18:13:00.001-07:00

"My meal plan is so rigid...Aren't I supposed to be learning to be less rigid with my food?"

The above statement is an example of what I occasionally hear from my clients. Yes, a meal plan can seem rigid. However, to some extent, it has to be...and for good reason!

It's no secret that a meal plan is what assures you that you are meeting your nutritional needs. A reason much less talked about, however, is that a meal plan is a teaching tool. A meal plan will teach you what a normal plate of food should look like for your needs. Your meal meal plan is what will actually usher you to normal eating habits again.

Sure, thinking through your meal plan can take a lot of thought in the beginning and at times, it can be down right confusing and frustrating. In the beginning, it can take a lot of effort to remember all of the exchanges that you need, a lot of time to figure out which foods fit within each exchange group, and a lot of work to remember what the portion sizes are of various foods within each exchange group. Then, it can take even more effort, time, and work to figure out how everyday meals and snacks fit into your meal plan.

When you are first put on a meal plan (by your dietitian, of course), it may feel like too much work to give your meal plan a fair shot. However, do not give up on your meal plan. It will get easier and you will learn that following your meal plan will be worth it!

The more effort you put into your meal plan in the beginning, the less you will need to think about it as time goes on and the more automatic following your meal plan will become. The rigidity of your meal plan is what will actually help you learn to become less rigid down the road.

Sure, it might take you some time to figure out how a dish at your favorite restaurant can fit into your meal plan. Once you figure it out though, you will likely remember how to do it. This means that the next time you eat at your favorite restaurant, the less you will need to think about it (as well as each time after that). Additionally, you will be able to apply the "know how" of one meal to a similar meal, each time taking less effort, time, and work than the meal before that.

Once you learn that you can trust your meal plan with various meals (and individual foods), the more risks you will be able to take and the less rigid you will be able to become. The little bit of rigidity with your meal plan in the beginning of eating disorder treatment is what will pave the way to becoming less rigid and more flexible in the future.

Updated Resources

2013-03-25T11:40:00.001-07:00

Below are the most recently added blogs to the "ED Resources for Recovery" tab of this site. Many of the below blogs were submitted to the 2013 NEDA Awareness Blogroll (yes, my blog is on Blogroll list as well). There were so many great blogs on the list, that I had to share! Happy reading!

Adios, Barbie Blog

Anne-Sophie Blog

A Nourishing Word Blog

Alison's Insights Blog

A Year of Positive Affirmations Blog

Be me...Being the me, I was created to Be Blog

Best We Can Blog

Don Blackwell, One Dad's Perspective on Life, Love, Faith and Hope Blog

Dr. Deah's Body Shop Blog

Gurze Eating Disorders Blogs

Eating Disorder Recovery Blog

EDEducate Blog

Emme Nation Blog

Exchanges The UNC Eating Disorders Program Blog

Healing for Eating Disorders Blog

Hello Life: A Year Without A Scale Blog

Life Beyond the Diet Blog

Loving Imperfection Blog

Map To Recovery Blog

Monte Nido Blog

Nikki DuBose Blog

OneGirlArmyStrong: Musings of a Recovering Bulimic Blog

Progression Obsession Blog

Rest In Peace E.D., Hello Ariane Blog

Rhea's of Hope Blog

She'll Be Free Blog

Small Steps Upward Blog

Testing My Wings Blog

*I try to link only positive and recovery based webistes/blogs. If you find that I missed something and a blog or site that I link to is not recovery focused (or is especially triggering), please let me know so I can delete the link.

Respiratory Control

2013-03-24T14:49:00.001-07:00

When your anxiety increases, your ability to think clearly decreases and your rationale thoughts can become clouded with your eating disorder voice. Additionally, physical symptoms of anxiety including racing heart, shortness of breath, feeling lightheaded and dizzy, hot flashes or chills, and nausea can distract you from your ability to think clearly.

Respiratory control is a technique that can be effective in managing the physical and cognitive symptoms of anxiety and can be a valuable skill in your tool box of recovery based coping skills. Below are the steps for respiratory control.

HOW TO DO RESPIRATORY CONTROL

1. Inhale through your nose (instead of your mouth).

2. Each breath should be slow and relaxed yet "normal sized" (do not breathe deeply).

3. As you fill your lungs with air, slowly push your diaphragm (or stomach) out. This is the opposite of what our diaphragm normally does when we breathe. It may be helpful to place your hand over your stomach to be sure you are doing this step correctly (as the hand on your stomach should rise during this step).

4. Pause before you start to exhale by saying a word like "relax" to yourself.

5. Exhale slowly through your nose (instead of your mouth). As you exhale, slowly pull your diaphragm (or stomach) in. This is the opposite of what our diaphragm normally does when we breathe. Again, it may be helpful to place your hand over your stomach to be sure you are doing this step correctly (as the hand on your stomach should fall during this step).

6. Pause again by saying a word like "relax" to yourself and continue to inhale and exhale as described.

Respiratory control should be practiced each time you feel your anxiety rising (as it can be just as helpful as taking a fast acting anxiety medication). I recommend practicing respiratory control for a minimum of (a combined) 30 minutes per day. You may have to put a lot of effort into practicing respiratory control correctly at first. However, the more you practice it, the easier it will become. Once mastered, this is a coping skill that you can use without anyone else knowing you are practicing it.

How to Provide Meal Time Support

2013-03-17T20:14:00.001-07:00

Meal times can be stressful and challenging for someone with an eating disorder as "food becomes attributed with unusual and extra meaning." If you are reading this blog, you yourself are probably a sufferer of an eating disorder, or you are likely a loved one of someone who is battling an eating disorder. Furthermore, as a reader of this blog, you can probably relate to the stress attributed to meal times that I am referring to.

Recently, I came across a great online booklet (written by the Auckland Eating Disorder Service in New Zealand) that provides several tips for providing meal time support during eating disorder recovery. You can click here to view it. This resource provides an introduction to meal time support, what works in meal time support, what doesn't work in meal time support, role modeling, boundary setting, communication, coaching, how to provide meal time support, as well as appendices for quick reference. Check it out and pass it on!

How to Fit Everyday Meals Into Your Eating Disorder Recovery Meal Plan: Part 10

2013-03-14T19:28:00.001-07:00

greens and various other vegetables to your liking (1 vegetable)
grilled chicken breast or Morning Star vegetarian chicken strips (2-4 ounces protein, 0-1 fats)
1/4 cup cheese of your liking (1 fat)
1/4 cup dried fruit or 1/2 cup chopped fresh fruit (1 fruit)
1/4 cup black beans (1/2 grain)
1/4 cup croutons (1/2 grain)
2 Tablespoons regular salad dressing or 4 Tablespoons light salad dressing (2 fats)

-3/4 cup broth based soup (1 grain)
-1 cup skim milk (1 milk)

Dinner (3 grains, 2-4 oz protein, 1 vegetable, 3-4 fats, 1 milk):

-salad with the following:

greens and various other vegetables to your liking (1 vegetable)
grilled chicken breast or Morning Star vegetarian chicken strips (2-4 ounces protein, 0-1 fats)
1/4 cup cheese to your liking (1 fat)
1/4 cup black beans (1/2 grain)
1/4 cup croutons (1/2 grain)
2 Tablespoons regular salad dressing or 4 Tablespoons light salad dressing (2 fats)

-1 1/2 cup broth based soup (2 grains)
-1 cup skim milk (1 milk)

How to Fit Everyday Meals Into Your Eating Disorder Recovery Meal Plan: Part 9

2013-03-13T19:14:00.002-07:00

Lunch (2 grains, 2-4 oz protein, 1 fruit, 1 vegetable, 3-4 fats, 1 milk):

-1-1 1/2 cups casserole dish (2-4 ounces protein, 2 grains, 2-3 fats)
-peach (1 fruit)
-small side salad with 1 Tablespoon regular salad dressing or 2 Tablespoons light salad dressing (1 vegetable, 1 fat)
-1 cup skim milk (1 milk)

Dinner (3 grains, 2-4 oz protein, 1 vegetable, 3-4 fats, 1 milk):

-1-1 1/2 cups casserole dish (2-4 ounces protein, 2 grains, 2-3 fats)
-1 dinner roll
-small side salad with 1 Tablespoon regular salad dressing or 2 Tablespoons light salad dressing (1 vegetable, 1 fat)
-1 cup skim milk (1 milk)

*although chocolate milk is technically not a grain, I will count it as a grain for my clients who are nervous about the additional carbohydrates and therefore calories it contains when compared to white milk.

How to Fit Everyday Meals Into Your Eating Disorder Recovery Meal Plan: Part 8

2013-03-12T19:50:00.000-07:00

One of the most common questions that I get asked from my eating disorder clients is how normal meals at home can fit into an eating disorder recovery meal plan. Therefore, over the next 10 blog posts (this is post # 8), I will be breaking down 10 everyday meals into an exchange based eating disorder meal plan.

For example purposes, I will be using the same mock meal plan (and specific exchange system) that I provided in the blog post titled Meal Plans for Eating Disorder Recovery. *Please remember that I am providing the following meal plan as an example only (as nutritional needs are based on multiple factors including gender, age, height, weight, and activity level). To determine an eating disorder recovery meal plan for your own individualized nutritional needs, visit a registered dietitian that specializes in eating disorder treatment.

Meal # 8 Grilled Cheese and Tomato Soup

Lunch (2 grains, 2-4 oz protein, 1 fruit, 1 vegetable, 3-4 fats, 1 milk):

-grilled cheese sandwich made with 2 slices of lightly buttered bread and 3 slices of cheese (2-4 ounces protein, 2 grains, 3 fats)
-sliced apple (1 fruit)
-1 cup raw vegetables (1 vegetable)
-1 cup skim milk (1 milk) or 3/4 cup tomato soup (1 grain)

*having the tomato soup, milk, grilled cheese sandwich, apple and raw vegetables would put this lunch meal over by 1 grain exchange. However, many people would prefer to have tomato soup with a grilled cheese sandwich. Therefore, if my client really wanted the soup with the sandwich, I would say go for it and just leave off the milk exchange. Why? Because this food combination makes sense, the calories are essentially a wash between the two exchanges (a grain versus a milk exchange), and calcium is being consumed through the cheese. It will all even out and we all need to be flexible sometimes!

Dinner (3 grains, 2-4 oz protein, 1 vegetable, 3-4 fats, 1 milk):

-grilled cheese sandwich made with 2 slices of lightly buttered bread and 3 slices of cheese (2-4 ounces protein, 2 grains, 3 fats)
-3/4 cup tomato soup (1 grain)
-1 cup raw vegetables (1 vegetable)
-1 cup skim milk (1 milk)

How to Fit Everyday Meals Into Your Eating Disorder Recovery Meal Plan: Part 7

2013-03-11T19:02:00.002-07:00

One of the most common questions that I get asked from my eating disorder clients is how normal meals at home can fit into an eating disorder recovery meal plan. Therefore, over the next 10 blog posts (this is post # 7), I will be breaking down 10 everyday meals into an exchange based eating disorder meal plan.

For example purposes, I will be using the same mock meal plan (and specific exchange system) that I provided in the blog post titled Meal Plans for Eating Disorder Recovery. *Please remember that I am providing the following meal plan as an example only (as nutritional needs are based on multiple factors including gender, age, height, weight, and activity level). To determine an eating disorder recovery meal plan for your own individualized nutritional needs, visit a registered dietitian that specializes in eating disorder treatment.

Meal # 7 Steak (Filet Mignon)

Lunch (2 grains, 2-4 oz protein, 1 fruit, 1 vegetable, 3-4 fats, 1 milk):

-grilled 2-4 ounce filet mignon (2-4 ounces protein, 1 fat)
-medium/large size baked potato with 2 Tablespoons sour cream and 1 teaspoon butter or 1 Tablespoon butter substitute (2 grains, 2 fats)
-1/2 cup seasoned, tossed in small amount of olive oil, and grilled asparagus spears (1 vegetable, 1 fat)
-1 cup watermelon (1 fruit)
-1 cup skim milk (1 milk)

Dinner (3 grains, 2-4 oz protein, 1 vegetable, 3-4 fats, 1 milk):

-grilled 2-4 ounce filet mignon (2-4 ounces protein, 1 fat)
-medium/large size baked potato with 2 Tablespoons sour cream and 1 teaspoon butter or 1 Tablespoon butter substitute (2 grains, 2 fats)
-1/2 cup seasoned, tossed in a small amount of olive oil, and grilled asparagus spears (1 vegetable, 1 fat)
-1 cup 1% chocolate milk (1 milk, 1 grain)

*although chocolate milk is technically not a grain, I will count it as a grain for my clients who are nervous about the additional carbohydrates and therefore calories it contains when compared to white milk.

How to Fit Everyday Meals Into Your Eating Disorder Recovery Meal Plan: Part 6

2013-03-10T11:22:00.000-07:00

One of the most common questions that I get asked from my eating disorder clients is how normal meals at home can fit into an eating disorder recovery meal plan. Therefore, over the next 10 blog posts (this is post # 6), I will be breaking down 10 everyday meals into an exchange based eating disorder meal plan.

For example purposes, I will be using the same mock meal plan (and specific exchange system) that I provided in the blog post titled Meal Plans for Eating Disorder Recovery. *Please remember that I am providing the following meal plan as an example only (as nutritional needs are based on multiple factors including gender, age, height, weight, and activity level). To determine an eating disorder recovery meal plan for your own individualized nutritional needs, visit a registered dietitian that specializes in eating disorder treatment.

Meal # 6 Fish

Lunch (2 grains, 2-4 oz protein, 1 fruit, 1 vegetable, 3-4 fats, 1 milk):

-marinated tilapia filet (2-4 ounces protein, 1 fat)
-1 cup quinoa seasoned and tossed in 1 teaspoon olive oil (2 grains, 1 fat)
-1/2 cup sauteed fresh bell peppers and onions (1 vegetable, 1 fat)
-1 mango (1 fruit)
-1 cup skim milk (1 milk)

Dinner (3 grains, 2-4 oz protein, 1 vegetable, 3-4 fats, 1 milk):

-marinated tilapia filet (2-4 ounces protein, 1 fat)
-1 cup quinoa seasoned and tossed in 1 teaspoon olive oil (2 grains, 1 fat)
-1 dinner roll with 1 teaspoon butter or 1 Tablespoon butter substitute (1 grain, 1 fat)
-1/2 cup sauteed fresh bell peppers and onions (1 vegetable, 1 fat)
-1 cup skim milk (1 milk)

How to Fit Everyday Meals Into Your Eating Disorder Recovery Meal Plan: Part 5

2013-03-09T17:15:00.002-08:00

Lunch (2 grains, 2-4 oz protein, 1 fruit, 1 vegetable, 3-4 fats, 1 milk):

-breaded and baked chicken breast (2-4 ounces protein, 1 grain, 1 fat)
-1/2 cup brown rice (1 grain)
-3/4-1 cup fresh fruit salad (1 fruit)
-1/2 cup sauteed fresh vegetables (1 vegetable, 1 fat)
-1 cup 2% milk (1 milk, 1 fat)

Dinner (3 grains, 2-4 oz protein, 1 vegetable, 3-4 fats, 1 milk):

-breaded and baked chicken breast (2-4 ounces protein, 1 grain, 1 fat)
-1 cup brown rice (2 grains)
-1/2 cup sauteed fresh vegetables (1 vegetable, 1 fat)
-1 cup 2% milk (1 milk, 1 fat)

How to Fit Everyday Meals Into Your Eating Disorder Recovery Meal Plan: Part 4

2013-03-08T10:27:00.000-08:00

Lunch (2 grains, 2-4 oz protein, 1 fruit, 1 vegetable, 3-4 fats, 1 milk):

-1/4 of a 10 or 12 inch pizza (2-4 ounces protein, 2 grains, 2-3 fats)
-3/4-1 cup melon (1 fruit)
-small side salad with 1 Tablespoon regular salad dressing or 2 Tablespoons light salad dressing (1 vegetable, 1 fat)
-1 cup skim milk (1 milk)

Dinner (3 grains, 2-4 oz protein, 1 vegetable, 3-4 fats, 1 milk):

-1/4 of a 10 or 12 inch pizza (2-4 ounces protein, 2 grains, 2-3 fats)
-1 bread stick (1 grain, 1 fat)
-small side salad with 1 Tablespoon regular salad dressing or 2 Tablespoons light salad dressing (1 vegetable, 1 fat)
-1 cup skim milk (1 milk)

How to Fit Everyday Meals Into Your Eating Disorder Recovery Meal Plan: Part 3

2013-03-07T08:56:00.002-08:00

Lunch (2 grains, 2-4 oz protein, 1 fruit, 1 vegetable, 3-4 fats, 1 milk):

-1 hamburger or veggie burger patty (2-4 ounces protein, 1-2 fats)
-1 hamburger bun (2 grains)
-1 slice cheese for burger (1 fat)
-other toppings including lettuce, tomato, onion, pickles, ketchup, mustard as desired(condiment)
-1 cup strawberries (1 fruit)
-1/2 cup steamed green beans with 1 teaspoon butter or 1 Tablespoon butter substitute (1 vegetable, 1 fat)
-1 cup skim milk (1 milk)

Dinner (3 grains, 2-4 oz protein, 1 vegetable, 3-4 fats, 1 milk):

-1 hamburger or veggie burger patty (2-4 ounces protein, 1-2 fats)
-1 hamburger bun (2 grains)
-1 slice cheese for burger (1 fat)
-other toppings including lettuce, tomato, onion, pickles, ketchup, mustard as desired (condiment)
-1/2 cup baked French fries or baked sweet potato fries (1 grain, 1 fat)
-1/2 cup steamed green beans (1 vegetable)
-1 cup skim milk (1 milk)

How to Fit Everyday Meals Into Your Eating Disorder Recovery Meal Plan: Part 2

2013-03-06T11:26:00.001-08:00

One of the most common questions that I get asked from my eating disorder clients is how normal meals at home can fit into an eating disorder recovery meal plan. Therefore, over the next 10 blog posts (this is post # 2), I will be breaking down 10 everyday meals into an exchange based eating disorder meal plan.

For example purposes, I will be using the same mock meal plan (and specific exchange system) that I provided in the blog post titled Meal Plans for Eating Disorder Recovery. *Please remember that I am providing the following meal plan as an example only (as nutritional needs are based on multiple factors including gender, age, height, weight, and activity level). To determine an eating disorder recovery meal plan for your own individualized nutritional needs, visit a registered dietitian that specializes in eating disorder treatment.

Meal # 2: Spaghetti

Lunch (2 grains, 2-4 oz protein, 1 fruit, 1 vegetable, 3-4 fats, 1 milk):

-1 cup spaghetti noodles (2 grains)
-1/2 cup meat marinara sauce made with ground beef, ground turkey, or Boca/Morning Star vegetarian soy crumbles (2-4 ounces protein, 1-2 fats)
-1/2 cup steamed broccoli with 1 teaspoon butter or 1 Tablespoon butter substitute (1 vegetable, 1 fat)
-3/4-1 cup raspberries (1 fruit)
-1 cup 2% milk (1 milk, 1 fat)

Dinner (3 grains, 2-4 oz protein, 1 vegetable, 3-4 fats, 1 milk):

-1 cup spaghetti noodles (2 grains)
-1/2 cup meat marinara sauce made with ground beef, ground turkey, or Boca/Morning Star vegetarian soy crumbles (2-4 ounces protein, 1-2 fats)
-1 piece garlic bread (1 grain, 1 fat)
-1/2 cup steamed broccoli (1 vegetable)
-1 cup 2% milk (1 milk, 1 fat)

How to Fit Everday Meals Into Your Eating Disorder Recovery Meal Plan: Part 1

2013-03-05T20:29:00.002-08:00

One of the most common questions that I get asked from my eating disorder clients is how normal meals at home can fit into an eating disorder recovery meal plan. Therefore, over the next 10 blog posts, I will be breaking down 10 everyday meals into an exchange based eating disorder meal plan.

For example purposes, I will be using the same mock meal plan (and specific exchange system) that I provided in the blog post titled Meal Plans for Eating Disorder Recovery. *Please remember that I am providing the following meal plan as an example only (as nutritional needs are based on multiple factors including gender, age, height, weight, and activity level). To determine an eating disorder recovery meal plan for your own individualized nutritional needs, visit a registered dietitian that specializes in eating disorder treatment.

Meal # 1: Tacos

Lunch (2 grains, 2-4 oz protein, 1 fruit, 1 vegetable, 3-4 fats, 1 milk):

-two 6 inch flour or corn tortillas (2 grains)
-1/2 cup taco meat made with ground beef, ground turkey, or Boca/Morning Star vegetarian soy crumbles (2-4 ounces protein, 1-2 fats)
-1/4 cup shredded cheddar cheese (1 fat)
-2 Tablespoons regular fat sour cream or guacamole (1 fat)
-other toppings including shredded lettuce and chopped tomato for tacos (condiment)
-1/2 cup steamed corn and peppers (1 vegetable)
-1 piece fresh fruit (1 fruit)
-1 cup skim milk (1 milk)

Dinner (3 grains, 2-4 oz protein, 1 vegetable, 3-4 fats, 1 milk):

-two 6 inch flour or corn tortillas (2 grains)
-1/2 cup taco meat made with ground beef, ground turkey, or Boca/Morning Star vegetarian soy crumbles (2-4 ounces protein, 1-2 fats)
-1/4 cup shredded cheddar cheese (1 fat)
-2 Tablespoons regular fat sour cream or guacamole (1 fat)
-other toppings including shredded lettuce and chopped tomato for tacos (condiment)
-1/2 cup steamed corn and peppers (1 vegetable)
-1/2 cup rice or beans (1 grain)
-1 cup skim milk (1 milk)

Eating Disorder Meal Plan Tips: How To Estimate Serving Sizes

2013-02-25T20:23:00.002-08:00

Having the correct serving size on your plate for each eating disorder meal plan exchange is important to assure that you meet your nutritional needs for your recovery. When you first start to follow a meal plan, it can be helpful to measure and weigh your food out to confirm that you are accurately following your meal plan. Doing this can also serve as a visual teaching tool so that you can eventually eyeball your portion sizes. Although you may want to continue to measure and weigh your food out the entire time you are on a meal plan, being so precise and rigid can be time consuming, inconvenient, and appear abnormal (especially in social situations). It is important for eating disorder recovery to eventually move into the mindset that "close enough is good enough." With some practice, eyeballing your serving sizes can actually be quite accurate.

The best way to successfully estimate portion sizes for your eating disorder meal plan is to compare serving sizes to tangible things. If you Google "tips for estimating serving sizes" (or a similar phrase), you will be provided with an abundance of items that look like portion sizes of specific foods. Although there are a lot of helpful tips out there for estimating serving sizes, there are so many tips out there that it can be difficult to remember which specific item looks like what specific food and which particular serving size. For example, portion sizes are compared to things like a deck of cards, a check book, cotton balls, a tennis ball, dice, a chap stick tube, a light bulb, your thumb, a CD, a baseball, marbles, dominoes, a cassette tape, a ping pong call, etc. The tips are endless and it can be difficult and anxiety provoking to remember what item matches up with what serving size.

The easiest thing to compare many of your portion sizes to is the palm of your hand. After all, you always have your hand with you. Many grain, fruit, vegetable, and 2-4 ounce protein servings look like the size of the palm of our hand (see pictures below). *If you cannot remember any other tip out there for estimating serving sizes, remember the palm of your hand tip.

**As we all know, palm sizes can differ from person to person. Therefore, if you believe that your hand is a bit smaller or larger than average, don't panic. This tip can still work for you! For example, if you notice when measuring and weighing your food that most serving sizes take up the space in the middle of your palm, then you should just use the middle of the palm of your hand (instead of the entire palm of your hand) as a guide for eyeballing your serving sizes.

Source: The hand technique for teaching portion size was first introduced by Dr. Kazzim Mawji BM and is used widely by many healthcare professionals throughout the world.

PROTEINS: 2-4 OUNCE CHICKEN BREAST

PROTEINS: 2-4 OUNCE PORK CHOP

PROTEINS: 2-4 OUNCE HAMBURGER PATTY

PROTEINS: 2-4 OUNCES FISH

PROTEINS: 2-4 OUNCES BEANS (LEGUMES)

1 GRAIN SERVING: 1/2 HAMBURGER BUN

1 GRAIN SERVING: 1/2 CUP RICE

1 GRAIN SERVING: 1/2 CUP PASTA

1 GRAIN SERVING: 1/2 CUP MASHED POTATOES

1 GRAIN SERVING: 1/2 CUP FRENCH FRIES

1 FRUIT SERVING: 1/2 GRAPEFRUIT

1 FRUIT SERVING: 1 PEACH

1 VEGETABLE SERVING: 1/2 CUP GREEN BEANS

1 VEGETABLE SERVING: 1/2 CUP CORN

National Eating Disorder Awareness Week: February 24 - March 2, 2013

2013-02-25T19:48:00.000-08:00

This week is National Eating Disorder Awareness Week. According to the National Eating Disorders Association, "NEDAwareness Week is the largest education and outreach effort on eating disorders in the United States, taking place February 24-March 2, 2013. The aim of NEDAwareness Week is to increase awareness and education about eating disorders and body image issues for effective recognition, early intervention and direction to care. Everybody Knows Somebody who has been affected. Everybody can get involved." Click here for more info.

Meal Plans for Eating Disorder Recovery

2013-02-06T19:28:00.001-08:00

The importance of following a meal plan is something that I mention throughout this blog. There are different types of meal plans, all with the same general goals: 1) to stabilize your eating patterns and 2) provide you with adequate nutrition. The most common type of meal plan for someone with an eating disorder is one that deals with exchanges of food. This type of meal plan is based off of the diabetic exchange system and focuses on X number of servings within each of the food groups (servings of grains, proteins, fruit, vegetables, fats, and dairy). Meal plans usually include breakfast, lunch, dinner and between two to three snacks per day.

Below is a general list of serving sizes within each food group for an exchange based meal plan. *There are often slight variations with this type of exchange system. The list below is to provide you with a general understanding of what this type of meal plan entails.

MEAL PLAN EXCHANGES

GRAINS (1 EXCHANGE)
-1 slice bread
-1 small dinner roll
-1 6” tortilla
-½ bagel
-½ English muffin
-½ hamburger bun
-½ - ¾ cup cold cereal
-½ cup hot cereal
-½ cup cooked rice
-½ cup cooked pasta
-1 small baked potato
-6 crackers
-1 pancake
-½ 6” pita

FRUITS (1 EXCHANGE)
-1 piece fresh fruit
-½ cup canned fruit
-3/4-1 cup fruit chunks
-¼ cup dried fruit
-½ cup fruit juice

VEGETABLES (1 EXCHANGE)
-½ cup cooked vegetables
-1 cup raw vegetables
-½ cup vegetable juice

MILK (1 EXCHANGE)
-1 cup skim milk
-1 cup 2% milk (1 milk, 1 fat)
-1 cup chocolate milk (1 milk, 1 grain)
-6 oz. Dannon Fruit on the Bottom yogurt (1 milk, 1 fruit)
-6 oz. Yoplait Original yogurt (1 milk, 1 fruit)

PROTEIN SERVINGS
-Beef, chicken, turkey, fish, cheese, tofu, eggs, peanut butter (I count the fat within protein sources towards fat exchanges in the meal plan).
-1 cup beans, peas, and lentils (I count the carbohydrate content in legumes towards grain exchanges in the meal plan).

FATS (1 EXCHANGE)
-1 teaspoon butter or margarine
-1 Tablespoon butter substitute (ex: I Can’t Believe It’s Not Butter; Country Crock)
-1 teaspoon regular mayonnaise
-1 Tablespoon light mayonnaise
-1 Tablespoon regular salad dressing
-2 Tablespoon light salad dressing
-2 Tablespoon regular sour cream
-1 teaspoon oil
-about 1 Tablespoon nuts and seeds

Below is an example of an exchange based meal plan for someone with an eating disorder. It is important to remember that everyone's nutritional needs are different and are based on gender, age, height, weight, and activity level. *I am providing the below meal plan as an example only. To determine a meal plan for your own individualized nutritional needs, please visit a registered dietitian that specializes in eating disorder treatment.

EXAMPLE OF A MEAL PLAN

-Breakfast: 2 grains, 1 ounce protein, 1 fruit, 2 fats, 1 milk.
(Meal example: 1 cup oatmeal, 1/2 cup raspberries, 1 cup skim milk, 1 hard-boiled egg, 1 Tablespoon almonds).

-Morning snack: 2 snack exchanges.
(Snack example: Kashi granola bar).

*Some dietitians prefer to require X number of servings within specified food groups at snacks (the above snack would be classified as 1 grain, 1 fat). I, however, prefer to allow more flexibility at snacks. I require a certain number of exchanges at snacks, each exchange being about 65 calories. This way, my clients can have anything they want for snack (as it is just a matter of portion size).

-Lunch: 2 grains, 2-4 oz protein, 1 fruit, 1 vegetable, 3-4 fats, 1 milk.
(Meal example: turkey sandwich on 2 pieces whole wheat bread with 1 piece of cheese and 1 Tablespoon light mayo, 1 cup raw veggies with 1 Tablespoon dill dip, apple, 1 cup skim milk).

-Afternoon snack: 2 snack exchanges.
(Snack example: 1 chocolate chip cookie).

-Dinner: 3 grains, 2-4 oz protein, 1 vegetable, 3-4 fats, 1 milk.
(Meal example: 1 piece lasagna, 1 piece garlic bread, 1/2 cup steamed vegetables, 1 cup skim milk).

-Evening snack: 2 snack exchanges.
(Snack example: 1/2 cup juice, 1 piece string cheese).

Motivation for Eating Disorder Recovery

2012-10-28T12:04:00.001-07:00

Although I prefer much of the time to write my own advice, I cannot help but link to some articles from the ED Bites Blog that I find most helpful for continuing motivation. Every client I have provided these articles to reports that they are indeed extremely helpful. So, here they are!! You rock Carrie Arnold!

Like Begets Like

Momentum

The “I Don’t Wannas”

Recovery Actions, Recovery Thinking

When Bad Body Image Isn’t About the Body

Halloween is a SCARY Time of Year!

2012-10-28T11:42:00.001-07:00

If you are suffering from an eating disorder, it’s not the zombies, witches, haunted houses, scary movies, or ghosts that frighten you. Instead, it is the plethora of candy all around. Here are some simple tips to help you manage this Halloween:

Do not deny yourself candy this Halloween. Instead try to indulge with a sense of mindfulness and moderation. If you are not sure how to eat mindfully and in moderation, try working some candy into the meal plan your dietitian has you on (at least I hope you are seeing a dietitian). In my experience, snacks are usually a good place to work sweets into. We all tend to want what we cannot have. Therefore, if you do not allow yourself a sweet treat every now and then, you are likely to crave it even more. Allowing sweets in moderation will actually decrease the likelihood that you will overeat or binge on them.

Remember that a calorie is a calorie is a calorie…no matter where it is from! It is possible to work candy into your intake and not gain weight from it! Seriously! See the Debunking the Junk section to help challenge your eating disorder thoughts that candy will automatically equate to weight gain.

Do you find yourself unable to make a choice once in the candy isle because you get caught up in label reading? Do you find yourself drawn to use eating disorder behaviors for fear of what a sweet treat might do to your body after you consume it? Do you find yourself triggered to binge eat once you allow yourself sweets? If so, ask someone in your support person to help you. Maybe you need someone to go to the store with you, or someone to stay with you to help you abstain from eating disorder behaviors. If you foresee a triggering situation, seek out help from a treatment team member (dietitian, therapist, etc) or someone in your support system (friend, family member, significant other, etc).

Great Quote!

2012-07-09T20:51:00.000-07:00

I have been super busy lately and haven't had a chance to write anything new. I heard a great quote recently and had to post it...

“Strive for excellence, not perfection.”