I have at least 10 stories I’d like to share with people who have disordered eating. This one is about my experience with inpatient treatment. My personal pattern was bingeing, not eating, bingeing, not eating. But in treatment, I was lumped together with bulimics and anorexics, and there was no effort to individualize our treatment plans. Maybe you can see where this is going.
I would qualify as bulimic/anorexic, to use the typical label. But getting the label doesn’t mean that my symptoms and needs were going to be met by a cookie cutter treatment. No one individualized my treatment based on my personal needs.
Hospitals have to save people from starving themselves to death. I get that. Inpatient eating disorder programs are programs of force. Rules were arbitrary, created and followed mindlessly even when they did not apply to every individual. All three of the inpatient programs I have been through served food that I wouldn’t feed to my children on the most hectic day. In the name of healing, I was forced to have a caloric beverage with every meal. The fruit punches, lemonades and sodas listed sugars as the top three ingredients. It was horrifying to be forced to drink three or four of these containers a day. Did they really think giving me something as addictive as street drugs would cure me or control binge eating?
I’m a vegetarian. One day on the menu there were black beans and cottage cheese and I wanted to order both. No. I was told that I could not order these two foods in a restaurant and they don’t go together. Now, they would not have been my first choice to put together, but based on the offerings and what I could eat as a vegetarian they were the best offerings. Both are good foods. I was forced by the nutritionist helping me plan my menu to order cottage cheese and pretzels! Yes, the people treating me for an eating disorder thought pretzels were going to be a better choice for me than black beans. The list of fake foods they wanted to give me was endless: sugar-laden cereals, baked goods, mandatory desserts. Mind you, I was not underweight at all. I just needed to maintain my already slightly overweight weight – in light of the fact that I had been extremely overweight most of my adult life. Their practices were contrary to everything I knew about food and addiction. Their practices actually added fuel to the flames of addiction. I pleaded with staff to feed me a high-protein breakfast but was forced to eat sugar and carbohydrates for breakfast. That left me feeling hungry and dissatisfied an hour or so later. I have a tendency to binge eat if I get too hungry so this was a horrible set up for me. I was miserable and felt hungry almost the entire time I remained inpatient which only further depressed me because I WAS eating and ‘thought’ I must be crazy because I was still always hungry.
They documented that my blood sugar levels dropped dangerously low after eating meals and yet still insisted on feeding me high carbohydrate meals that triggered a big insulin response and put me back on the rollercoaster ride.
I learned nothing in those programs about feeding myself. I was presented with trays of food and watched like a prisoner instead of being guided and taught the skills needed to honor my body and establish healthy wholesome eating. Fortunately for me, I already knew how to plan, shop, and cook. But I did feel bad for all of the patients who clearly did not have those skills. I witnessed extremely obese women being served trays of food that were sugar laden and wondered how on earth are they trying to “help” this person. Sadly, I left feeling hopeless and worse off than I was before I went in.
How can anyone change their eating habits if they don’t know how to plan, shop and cook? Why aren’t the people who are trying to help us encouraging and teaching wholesome eating and basic eating addiction principles?
As for outpatient therapy – although helpful in many ways – it was missing huge components as well like actually eating real food. There is something fundamental and healing about doing the thing you are struggling with while in a supportive environment. Making the actual concrete changes in a supportive, nonjudgmental, educational environment goes a long way towards true healing. Admittedly some of the reasons for my eating disorder come from psychological issues that needed to be worked through, but some of the reasons really come from my individual biology. And those have to be worked through too! Food education, actual experiments and eating – core concepts of The Suppers Programs – were entirely missing in my outpatient treatment and were desperately needed as a component of my treatment and eventual healing.
Food does affect our mood and appetite. For years I was told “it’s just food,” as if all food was created equal and I should just view all food as fuel and I should just eat it. It really wasn’t that simple for me. Certain foods – like high carbohydrate foods – never satisfied me. If I ate them I would eat large quantities and still never feel full or satisfied for long. I needed to learn what kind of foods help me feel satiated and keep my blood sugar levels more even throughout the day. At Suppers, I learned to embrace breakfast instead of living in fear of initiating eating each day. Instead of conventional breakfast foods that are high in starch and sugar, I learned to start eating things like vegetarian chili and lentil stew for breakfast. This one activity alone changed my life. Breakfast transformed me from a triggered, insatiable eater all day to someone who has a problem I can manage, still struggling, but I can manage. In all of my years of therapy – both outpatient and inpatient – no one ever helped me figure out how to eat for metabolic and emotional stability. It took a basically free-to-users program to get me on the right track as far as actually eating food goes. This is a big deal for someone with an eating disorder! After all, severe eating disorders are deadly.
I didn’t tell you, I’m a psychologist. I see many people in my private practice who struggle with food and weight issues. They may not come to me for those particular reasons but they are an aspect of their life and overall healing that I am always aware of in the background as we work together. Suppers has been vastly influential in my work life as well. My understanding of nutritional harm and the ways in which it affects the brain, body, and mood helps me view my clients’ problems from a new perspective. When they tell me they eat a Hershey’s kiss and then devour the entire bag, it lets me know that their body may have a physically addictive relationship with those kisses. Expecting addicted people to do portion control and exercise willpower is like offering a recovering alcoholic just one glass of bourbon. It’s cruel and also ineffective. People in my profession need an education in this. It is now known that sugar operates on the same pathways as cocaine. But the disciplines that train psychologists and addictions counselors to work with people who have eating disorders don’t require even one hour of nutrition education. If I approach my patients thinking I need to fix their willpower, I am probably not going to help them. When I think there may be a physically addictive food driving their overeating, I would be more effective if I guide them into figuring out which food experiments to try.
I know my text books and training didn’t teach me to view food problems this way, but my personal experience and ever-expanding knowledge of food and the ways it affects the body and the brain do give me tools to help my clients differently now.
I am so grateful for this in both my professional and personal life. Knowledge is power. Suppers experiments led me to insights and wisdom that empower me in the face of food.