What they don’t teach you in eating disorder treatment: anything about nutrition
It was a face off. A battle of wills. Me vs. the doctors. I was at the Center for Eating Disorders at Sheppard Pratt in Baltimore.
I was sitting at a dining table with 20 other sick girls.
Sheppard Pratt Eating Disorder Unit Dining Hall, 2008
In front of me was an Italian hoagie sandwich. It was massive and bursting at the seams with layers of salami, ham, and pepperoni. A few shriveled strands of lettuce hung from the bun like tired arms off the side of a bed.
A nurse crouched beside me and told me to please apply the small container of goopy Italian dressing before eating it.
The whole scene is impossible to forget. I was terrified of fat and I felt physically revolted. I couldn’t breathe. Tears streamed down my face.
Being in the hospital felt confusing. I didn’t know how to behave, how to get out, or if I even wanted to get out. I felt on one hand like I didn’t belong, and on the other like I was unfixable.
The only thing I knew is that I didn’t want to play their game that day.
I sat there, along with a few other girls who wouldn’t touch their food. Finally we were brought our meal replacement shakes, which we forced down aggressively and obstinately, as if choking ourselves to prove a point.
By this time, I had been struggling with anorexia and bulimia for 6 years, and I would continue to struggle for about 6 more.
The stay in this hospital probably saved my life. As did my stay at PeaceHealth Medical Center in Eugene six years earlier. As did all of the support I received from physicians, dieticians, and therapists along the way.
But when I reflect on the nutritional intervention that was the most important turning point in my recovery, it didn’t happen with the support of my recovery team. It happened years later, by accident, during a misguided diet experiment.
Ten years into my recovery, I discovered that my anxiety, mood swings, cravings, and desire to binge-and-purge plummeted dramatically when I included nutrient-dense foods like protein, fruits and veggies, unprocessed carbs, and natural oils and omega-3s fats in my diet.
It was the Paleo diet.
The importance of eating nourishing foods might seem obvious now, but it really wasn’t to me then. I grew up on cereal, peanut butter crackers, and Cambell’s soup. It’s no discredit to my parents–that’s how lots of us in the 80s and 90s grew up.
But the point is, I hadn’t learned that what you eat makes any difference.
The only unit I thought mattered was calories.
In recovery, I was taught to systematically incorporate fear foods into my diet, which for me included things like pizza, ice cream, donuts, butter, candy, cookies, and muffins. I was taught not to restrict these things.
But in practice, I had no control over myself around these foods. If I ate Oreos, I was eating an entire pack, which I’d devour in frenetic fashion until my stomach couldn’t physically expand anymore. I’d follow it up with a period of purging and restriction until the cycle repeated.
Even though I eventually gained enough weight to be medically stable, my brain and body had still, in effect, been abused and malnourished for a decade.
Enter my post-college crush who was all about his gluten-free lifestyle, and the influence of my newfound CrossFit friends who were following the Paleo diet.
I was feeling hopeless about my recovery and desperate for the attention I’d received as a 90-pound waif of a human, so I decided to try Paleo in an effort to lose weight.
Did I lose weight? I don’t remember.
What I remember was–in two weeks–feeling alarmingly superhuman. For the first time since I was a kid, my thinking became clear without effort. My energy improved. My emotions stabilized.
I felt less vulnerable to the little things that would have previously sent me spiraling towards starvation, indulgence, or self-harm.
My joy for movement returned and I no longer felt the need to punish myself for living in the 120-pound body I’d grown to occupy. I still felt compelled to binge some days, but the physiological compulsion to inhale food faded.
I’d get a few Oreos deep into a binge and suddenly feel… indifferent.
I’d accidentally stumbled upon one of the most important keys to my recovery: nourishing my body with protein-rich and colorful foods.
There were other skills I had to learn along the way, but they became exponentially easier once I stumbled upon this massively important piece of the puzzle.
I can’t even begin to overstate just how important learning and practicing the fundamentals of good nutrition were to my recovery.
When it comes to food quality (what you’re eating) vs. food quantity (how much you’re eating), I now see it as a no-brainer:
Regardless of what your goals are, quality is king. And that’s because quality impacts so much more than just your waistline: it impacts your energy, your attention, your thoughts, your emotions, your capacity for movement, and your sex drive.
What part of your life doesn’t it touch? Why I never learned this in treatment is a true mystery to me.
And forget learning, even! If they were force-feeding us anyway, why didn’t they force-feed our tired, malnourished, and abused bodies the very highest quality foods on the planet?
How much different would our recovery have been? I’ll never know.
But I do know that in my work now to help people improve their relationship with food, focusing on food quality in an unrestrictive way is a top priority.
And I get to see the effects in real time: a focusing of attention, a settling of emotions, a more balanced view of food and their bodies, and a more optimistic outlook on life.
Recovering from patterns of disordered eating and healing your relationship with food is an incredibly complex and personal journey.
But if there were one piece to make all the others easier, it’s this: eat protein and colorful foods 3x/day. And then anything else you want. ❤️