Chewing And Spitting Food

Posted on by ncfed

One of our readers has asked me if there is such a thing as chewing and spitting disorder. There is no such thing. It’s just a behaviour that is common in people with eating problems.   I had an au pair once whose waste paper basket was full of half chewed candies and chocolates all hidden in tissue paper.  She never knew I knew.

It makes sense. People want tasty food but they are scared to eat it in case it will make them fat. In some cases there is a small craving and in other cases a big craving. They just want the taste of the food to help them feel nice but they don’t want the rest of it. So they spit it out. No calories. Simple.

You can have your cake and eat it too it seems.  But it’s not so simple. It seems that the brain needs something called volatiles in food, substances that the back of the nose can smell. When we get a whiff of  tasty food that is high in volatile compounds like chocolate and ice cream, the brain gets a hit of opioids like dopamine which make us feel good.  Basically, chewing and spitting is like snorting cocaine.  The downside is that you can become addicted to it and what seems like a bad habit becomes a compulsion.

For another thing, we do take in lots of calories when we chew food and spit it out. We can get a hefty dose of sugar and fat that clings to the tongue and unwittingly passes into our digestive system. If you chew and spit a box of chocolates you will absorb about a third of it.  Better to eat three whole chocolates and put away the rest.  But when you have an eating problem, once you start it feels impossible to stop. You are possessed.

Chewing and spitting is particularly common in people with anorexia who struggle with cravings and it is an almost bulimic sort of thing to do. I have found high levels of anxiety and shame in people who do this. They often wonder what people would think of them for spitting out food, they often think they are the only one who does it.

How do we help people to stop?  There is a list of things that might help.

  •  Good nutrition helps reduce cravings and make it less likely that a person will buy and start chomping on food they are afraid to eat.
  • Building forbidden food into a normal meal plan, like having some chocolate as part of a meal makes it less forbidden and less desired.
  • Teaching someone to eat mindfully, being very present and eating slowly will help stop the habit.
  • Helping someone to manage their emotions better will reduce the anxiety that leads to chewing food and spitting it out.
  • When someone is spitting something out I often wonder what it is that they are spitting out really. Quite often it is something that they want to say to someone but they are afraid of the consequences. Or they feel they may feel that they do not deserve to have an opinion.  Find out what the spitting out might really mean? What are they really rejecting.
  • Finally make sure that the person knows that they aren’t the only person spitting food out. And before you rush to try and stop the behaviour, find out what it is doing for the person.  Chewing and spitting is sometimes the only way someone knows to get rid of tension and anxiety. Help them to find other ways to do this and the behaviour will eventually stop.

Eating Disorders in Pregnancy

Posted on by ncfed

This is a guest post contributed by Hari Malhi of Meds4All UK

Having an eating disorder while pregnant can be particularly difficult due to all the hormonal changes in the body. A research study carried out in the UK found that about 7% of pregnant women were experiencing an eating disorder. This number is likely to actually be higher as some women either hide the signs of their disorder or deny having it to begin with. Additionally, common symptoms associated with pregnancy such as vomiting and weight gain can also disguise the presence of an eating disorder.

 The results from a recent study

According to a study led by a team of researchers at the UCL Institute of Child Health, eating disorders are quite common among pregnant women. The study, which included over 700 women, found that 25% of them were extremely concerned about their weight and body image. However, only a very small percentage of them tried extreme behaviours to lose weight, such as over exercising, skipping meals and induced vomiting.

One in 12 pregnant women said their eating habits were out of control at least twice a week. They reported episodes of binge eating and not being able to maintain a strict diet. In the final analysis, one in 14 were deemed to have an eating disorder.

The researchers recommended the following: pregnant women need to be assessed for an eating disorder when they attend their antenatal check up, as pregnancy can be a time of increased risk for the mother and developing baby.

What are the risks?

Pregnancy will often heighten some of the symptoms of an eating disorder, meaning if patients have bulimia nervosa, they’re likely to experience more dehydration and an increased level of chemical imbalances in their digestive system. Women struggling with bulimia often have increased rates of postpartum depression, which in turn leads to more difficulties with breastfeeding. Furthermore, it’s not safe for pregnant women to take too many laxatives and diuretics as these could cause harm to the baby. These types of medication take away fluids and nutrients before they can nourish the baby.

If a woman has anorexia nervosa she may not be able to put on enough weight while pregnant. Therefore, she carries the risk of conceiving a baby with an extremely low birth weight. The majority of anorexic women do not have regular periods due to their low calorie intakes and/or high levels of stress. An irregular period makes it more challenging for those who are trying to get pregnant in the first place.

Other health complications

If a woman has an eating disorder while pregnant, there are several other potential health complications involved including:

  • Higher risk of a caesarean birth
  • Breathing difficulties
  • Severe depression
  • Miscarriage

Since the growing baby gets all its nourishment from the mother, it’s all the more important for pregnant women to eat a nutritious diet and sustain a healthy body weight for many months before and after giving birth.

Do you need to seek help?

Help is available from NCFED and other qualified healthcare professionals if you are concerned about eating disorders. (please ask for our top tips document on choosing a therapist). One to one counselling may be helpful in allowing you to deal with issues you may have regarding body image, food and weight gain. It could also be helpful to get advice from a nutritionist who has a history of helping patients with eating disorders.

Taming Tiger Parents

Posted on by ncfed

Girls at risk of eating disorders? Absolutely. Instagram, social networking, pressure at school non-stop? Sexy selfies?  Oh my god aren’t I glad that this passed me by when I was an adolescent.

But our girls, what defence do they have against this onslaught of pressure which is attacking their peace of mind and their self esteem? What defence does the ordinary child have to keep their body image intact?

I’ve written on my books page about two well-researched books written by Tanith Carey a journalist and friend. The first, Where Has My Little Girl Gone?   The second more recent Taming the Tiger Parents.  In her books Tanith counts the cost of todays pressures and insults on girls and boys which result in unhappiness, eating disorders body hatred and other forms of self harm.

In her book Taming the Tiger Parent, Tanith offers parents practical, realistic solutions that will give parents permission to take their foot off the gas and reclaim a more relaxed family life. Packed with insights, experts’ tips, real experiences and resources, this book is a timely guide to safeguarding a child’s well-being in a competitive world – so they can grow into the happy, emotionally balanced people they really need to be.

 

How To Find A Good Eating Disorder Therapist

Posted on by ncfed

I have just read three accounts of eating disorder suffering and recovery. Two people suffered for years and sort of recovered. One person is still struggling with a horrible eating disorder. All of these people have encountered poor therapy from people with good general  skills and incomplete and faulty methods for working with eating disorders. I have felt very sad about their pain and cross about their experiences.

What makes a good eating disorder therapist? NO! its not having had a problem yourself and thinking you are an expert. NO! it’s not having one way of working which is a one size fits all approach. NO! it’s not having someone who insists that they have had years of experience working with eating disordered sufferers. NO it’s not someone who smiles nicely to you and gives you a nice cup of tea.NO! it’s not someone who tells you its not about food so we dont have to talk about it,

Reading how these people have been “treated” has sent shivers down my spine. If you have an eating disorder you need to know how to sort out the rubbish from the  guardian angels. There are thousands of therapists out there who claim to belong to eating disorder associations and dont know what they are doing,

I will shortly publish my ten top tips for knowing how to pick the therapist who knows what they are doing. You will have questions to ask them and if they dont give you the right answer RUN AWAY AND FIND SOMEONE ELSE.

If you want a personal copy of my TEN TOP TIPS I will send one to you by email. Just contact us on admin@ncfed.com. I don’t  care which therapist you find, one of ours or someone else. Just find one who really knows what they are doing.

Does TV Make You Fat?

Posted on by ncfed
I’m not the only person who enjoys watching TV. However recent research has pointed to the risk of it making us fatter.

Experiments done by Professor Jane Wardle at the University of Surrey has proved that people who eat while watching TV increase snack eating subsequently by a significant amount

Two identical families (2 adults 2 children) were given identical meals before testing computer games. One family ate on their knees in front of the TV and the other family ate at a table. The TV family ate 3 times more snack food (crisps and sweets) than the family who ate at table.

Conversely…

Dolly Mittal and her team reporting in The Psychologist in 2014 have shown that snacking while watching TV, as opposed to snacking while not watching TV, lead women in particular to eat more later on, partly because the effect of the TV is to affect the memory for how much we snacked on earlier.

32 women of unexceptional weight spent 20 minutes eating snack food, half while watching TV and the others while sitting quietly. Later at lunchtime, the TV watchers ate twice as much food as did the women who had snacked while watching TV.  In a follow up study, the researchers investigated the types of TV, from comedy to a boring documentary. The same TV-overeating occurred, and it seemed that the type of programme watched made no difference at all.

Since it is proved that obesity in childhood  is directly related to the number of hours of TV watched per week, it may be useful to take your TV out of the kitchen and stop eating in front of the telly as much as possible, and for life.

I await with interest research on Facebook making us fat… perhaps.

Intermittent Fasting Our Version

Posted on by ncfed

From our of our counsellors, Harriet Frew

IF you can keep your head when all about you  Are photo-shopping and measuring thigh gaps too

IF you can trust your body when others doubt it, And be understanding of their doubting too If you can be respectful of your body And take care with kindness and appreciation everyday You will achieve more peace and satisfaction. I think it really is the only way.

IF you can feel your feelings and emotions;   IF you can think your thoughts and stay in tune Not blocking them or using dissociation;

But treating them as friends to have at home.

IF you can bear to trust your inner instincts Than twist yourself to be what others want So speaking truth and being your own person

Even when it’s hard to bear the brunt. IF you can love your food and enjoy eating  And turn away from having to have control And listen to your body and it’s needing Ruled no more by weight or size as goals. If you can really listen to your body And wonder what it really does desire So no food ever is forbidden No need to fight or indulge in body war.

IF you can work with change and keep your patience:   It does take time; keep hopeful and go on.

Hope, desire and willingness for action. Little steps and victories one by one.

IF you understand that life’s a journey With ups and downs and blips along the way

Perfection keeps you locked within a prison: Get up, fall down, embrace the shades of grey.

Weight Restoration: Guest Blog

Posted on by ncfed

I just love your thoughts and contributions to our website. Here is one from Hannah Brown celebrating her recovery from anorexia. I hope that this will help some of our readers and is offered with love. Here it is…

Weight Restoration Vs. Weight gain- the importance of semantics.

As anybody knows the crux of the journey back from the depths of anorexia is to restore weight after what will have probably been quite a dramatic loss.

Previously, weight gain has been the concept favoured by professionals. ‘Gaining weight’…the one thing that sufferers have been trying to desperately avoid in previous years- now suddenly gaining weight is the only option.

In my latest admission however the concept has changed to WEIGHT RESTORATION. A one word difference, surely it can’t make that much difference?

Consider for a moment the art of restoring a stately home, restoring it to it’s former glory. Bringing life back into a shell, giving it a personality and a purpose.

For me I know the importance of gaining weight, not only for the physical benefits but I know that my cognitive abilities will greatly improve once I have weight restored. My brain, is after all a muscle, it needs fuel and energy to work and for someone who works hard academically, my brain is possibly my most important muscle so I need it to be switched on and ready.

Fighting Anorexia is incredibly difficult but by WEIGHT RESTORING  I believe that I am restoring my frame to it’s former glory. It is more than simply gaining weight, it is so much more than watching the figure on the scale go up every week.

In todays society weight has become an obsession, and this is echoed in recovery. Often I feel that I might as well walk around the ward with my weight tattooed on my forehead.

I am weight restoring, but this process means that I am restoring myself to my former glory. I am bringing life into my once tiny frame, and giving myself the sparkle of life. My eyes are shining, my hair is glowing and my skin is healing. I have strength and power and am restoring my personality. The segments of my life are falling back into place, piece by piece. Just like the house being restored to a home. I am gaining character and wellbeing.

Day by day,

Hour by Hour

The process of restoration, of a home or of ones self requires many actors. Builders, architects and designers… Similarly in restoring myself I need the support and help of many:  Doctors, parents, friends and Partners. Weight gain implies something quite independent and almost simplifies the process… Restoration is a project, a long term dedication. It requires hard work and is quite frankly exhausting. Often the process can take  months, years even and very often there are huge hurdles to climb, obstacles to negotiate and the unexpected to face.

But is it worth it?  At the end of the house restoration you are left with a beautiful home, tailored to your needs and your creative ideals. It is your home and your sanctuary.

Ones body is exactly the same, it deserves the love and passion necessary to restore it back to its full potential. To give it life, colour and vibrancy.

It is definitely worth it, so, so worth it.

Anorexia In Men. Ryan The Brave

Posted on by ncfed

Ryan has posted an inspirational video on YouTube about his recovery from anorexia and his quest to raise money to complete his studies so that he can go out into the world and help other men to escape from the deadly clutches of eating disorders.

You can look at Ryan’s video at http://www.youtube.com/watch?v=qQwWOFpVQQs&feature=youtu.be

It will bring tears to your eyes. If anyone want to help Ryan to realise his dream, you know what to do.

 

 

Obesity And NICE

Posted on by ncfed

Obesity!  There has been a lot in the press about obesity this week with the publication of NICE guidelines for obesity treatment, information that our girls are the fattest in Europe and publication of research associating sleep in the light with obesity. Even I have had my say, see me on the BBC website

In the London Times today an article shows us that low fat custard has more calories than ordinary custard (thanks, Asda).

Fat is on my mind as well because I am about to train a group of 70 obesity professionals from all over the world.

Oh dear, do I really think that the NHS should be spending billions on 12 weeks of free attendance at slimming clubs?  Do I really think that 3% weight loss will save the NHS a lot of money on medical problems associated with obesity?   Well I don’t think I do.

The chances of people maintaining a 3% weight loss I think are nil. That’s based on evidence. It’s not going to cure diabetes or liver disease. It isn’t going to make fat people feel better or even look better which is why they try to lose weight in the first place.  How did these idiots come up with such a stupid idea.

Ah I think I know why …. lobbying pressure from the slimming club industry!  Money!  If only I had shares in a commercial weight loss company!

On the other hand, lots of people are fat because they are ignorant about what a healthy diet really is. Do we believe, as the food industry would have us do, that sugar coated frosties are better than no breakfast at all?

Do we think, as they would have us think, that low fat yoghurt full of sugar is better than normal yoghurt (which is a low fat food).

People need to wake up and get real about what is in the food we eat. Its right to correct ignorance which the slimming clubs might do. But I think that many of the so-called army of helpers are also ignorant and improperly trained. Perhaps the Government should invest in properly trained obesity specialists who can do the same job in the community, like practice nurses. These people won’t just give out diet sheets, they will understand motivation and proper nutritional wisdoms, and they will know what kinds of activity really can help – not just “going to the gym”.

FAT CHANCE!

 

I Am Not My Eating Disorder! And I’m Better!

Posted on by ncfed

Here is what one of our people has written about her recovery with one of our therapists.

When my journey with H began in May/June 2013 my life revolved completely around my compulsive disordered eating behaviour. I was caught up in a relentless ritual of binging and purging averaging 30 times a day, which had persisted for nearly 10 years. This had pretty much robbed me of my twenties, and I had been told by a GP that I was to quote; ‘a hopeless case’ and ‘would be inflicted with my disorders’ for the rest of my life.  My health, studies, finances and relationships were in constant jeopardy. It seemed both my secretive and public displays of compulsive binge eating had robbed me of any dignity and self-worth. I was also engaged in cycles of dangerous binge drinking behaviours around every 6-8week. These resulted in week long black outs, which rendered me bed ridden and often in various A&E departments through physical injury or dehydration.

Below I have summarised a non-exhaustive list of treatments I had received in the 10 years of being afflicted with my bulimia/compulsive binge-purge behaviour. None of these really had any significant impact on my rituals or associated psychology, some even had a negative impact.

2004-2013

  • CBT & CAT (NHS)
  • 1 outpatient treatment admission (4 weeks – NHS)
  • 4 x Inpatient admissions (Woodbourne Priory –for 9 months, QEPH for 1 month (+ 2 x self-discharge short stays))
  • Counselling (private, NHS, University practitioners)
  • Hypnotherapy (4 x practitioners)
  • Homeopathy and acupuncture
  • Anti-depressant and anxiolytic drug therapy (x6 flavours)
  •  Alcoholics Anonymous and Over Eaters Anonymous

Below I have outlined the main areas in which my work with H has helped transformed me from the former shadow of myself into the person I could and should really be. This is my path from up to £30 of food consumption, <8h binges and <50 vomits DAILY, to someone at a consolidation phase of full recovery.  Structure – and commitment to it!

From my first session working with H I understood that beating this problem was going to be a team effort! I had to commit to my part of the deal – keeping organised, documented and structured eating times. I also had to abstain from highly refined sugars and carbs (which by my own admission I was addicted to).  The former is something I found particularly challenging, but even when I didn’t succeed the process knowing I had a plan to stick to really helped me get ‘in the moment’ about what and when I was eating. A large part of this work involved breaking habits (eating whilst driving, stopping for food at service stations and works canteen).  What really helped me with this at first (and still does), is having all the meals and snacks I need for the day prepared and taken with me for the day in discrete packages. I got my partner involved with this process; I trust his judgement implicitly so I know his definition of a ‘snack’ or ‘meal’ portion is going to be about right for my needs. This stopped all the canteen visits and unnecessary trips to the supermarket. 

The psychology of ‘taking control’ of my own recovery early on in the process gave me great confidence, and stood me in an empowered frame of mind for the more emotional work to come later.

 I am not my eating disorder – I am me, and I am OK!

I think a significant portion of work I have done with H has been focused around re-establishing my identity. I learned to acknowledge that my eating disorder was simply an exhibited behaviour and did not define me or reflect who I was. This freed me from punishing self-judgement and was very important re-establishing my confidence. Additionally, I learned that I should not define myself my successes or failures in life. I have come to understand the importance of being authentic and free to be myself, free from the fear of failure and the burden of perfectionism.

On a related theme, much work has been based upon how I respond to the opinions or comments of those around me. I have been learning to embrace the fact that I cannot change how other people chose to respond or behave towards me. I am free to vocalise my thoughts and feelings assertively and with immediacy in any situation. This approach reduces the probability of harbouring resentments the associated frustrations that comes with bottling emotions.

 I also need to be aware of getting ‘hooked in’ to peoples comments or opinions and that I have a choice as to how to respond. In short, I alone have control over my own emotions and how I feel about things. Ultimately whatever I feel about things should not lead on to negative behaviours such as binge eating/drinking. The Thought → Feeling → Behaviour pattern is something H has worked quite closely with me on, and having the ability to modulate my thought processes has certainly helped level out my mood states which have progressively improved over time.

 Tolerance! – ‘I can bear this!’

Tolerance of situations and circumstances that I find uncomfortable has been a significant work focus over the last 10 months. My perceived inability to cope with difficult circumstances has historically led to a heightened anxiety and an apparent need to comfort eat in order to ‘cope’. My tolerance of boredom and motivation to do tasks I find particularly challenging or difficult has in the past led me to use excessive eating as a procrastination tool and form of avoidance tactic.  Heather has helped me become aware of triggers which might lead me towards such a negative mind-set, and also evaluate previous similar situations as evidence that in reality I really can cope. Instilling an ‘I have done it before, I can do it again’ kind of mind-set is the best way I can describe it. I have a simple mantra of ‘I can bear this’ and ‘I am capable’ ‘just get on with this task’, which really helps stop me catastrophizing situations that really aren’t that big of a deal.

 Compassion

I have a tendency to be really hard on myself and can be quite self-punishing if I do not achieve my own personal expectations (or what I perceive others expectations to be). In session we have touched on the concepts of being compassionate to oneself (and others), and being vigilant about squashing negative internal dialogues. I have been encouraged to be aware of what kind of a story I am telling myself in my thoughts; is it unhealthy or unkind? Would I expect this of someone else? Am I viewing this in the right way? This has helped me be a little kinder to myself and be mindful about unhelpful thinking patterns. I am also aware of triggers that might lead me down such pathways (e.g. running a bad race, an experiment going wrong at work) and allow myself extra processing time to deal with them.

 Feel the fear and do it anyway

I think this heading is covered by little segments of all of the above sections. In a nut shell, FEAR doesn’t lead to FOOD (or any other emotion for that matter!). I can tolerate uncomfortable feelings, I practice uncomfortable situations with assertiveness and I bear misplaced feeling of hunger I understand are only in my head. I have learnt (and continue to learn) tools and techniques for dealing with my thoughts that have essentially made the eating behaviour redundant. I do not need it, it has become an unnecessary pathway and the less I use it the more unnatural it becomes. I am currently in the phase of relapse prevention, where I’m being shown how to deal with mishaps with compassion and re-assert eating structure quickly and effectively.  

 Summary

The above five points perhaps only scratch the surface of how working with Heather has helped me over the last year, but it has been a positive experience for me to consolidate what has been important to me in my recovery. I hope it provides insight into what kind of therapeutic approaches have been so profoundly beneficial for me in this wonderful year of personal growth. I am now in a position where I am for the most part completely free from bulimic and compulsive eating and drinking behaviours. Recently I have averaged around one vomit per month, which compared to 30+ daily is nothing short of miraculous and has far exceeded my wildest dreams in terms of recovery. I am also T-total in terms of alcohol, and have had no drinking episodes for a considerable time period. My physical health has recovered rapidly, I have more energy and concentration to focus on my studies. I enjoy running and cycling with my partner and a local club, and am competing in my first triathlon on Sunday. 

One final point I’d like to mention as it’s particularly striking for me is that with H’s work, it is not just the eating/drinking behaviour that has been abolished but all the compulsive thought patterns and emotions that accompanied it. Sadly, I have come across a lot of extremely miserable T-total alcoholics and people in recovery in the past. I had feared that if I recovered I would be the same; lost, empty and unfulfilled, like that part of their psychology persisted and just wouldn’t let them go. Reality has proven to be the complete opposite for my journey; I have so much head space to just be happy and free! I don’t crave binge eating/vomiting in the slightest, I don’t miss it, I don’t even think about it going about my daily business. It’s like that part of my life never existed, and it’s just awesome!