Recently, I have been reading about the disparity in medical responses based on gender. One study*, published in Academic Emergency Medicine, found that women who went to the emergency room with severe stomach pain had to wait almost 33% longer than men with the same symptoms. Research has shown that women’s pain and health concerns are often routinely underestimated and downplayed by medical providers. 

A different study focused on another alarming role doctors are playing in the treatment of eating disorders- people in larger bodies are reporting being largely overlooked by their providers, even being told they couldn’t have an eating disorder due to their size.** Even when eating concerns are causing significant health concerns and distress, the idea of someone in a larger body having an eating disorder is dismissed prematurely in evaluation. 

I hear anecdotal evidence of this all of the time in my office- oftentimes, concerns about eating have been downplayed by well-meaning healthcare providers. It can be hard to move forward in seeking treatment when you have been told your weight is “healthy” or that you don’t “look” like you have an eating disorder.  

And yet, inner wisdom may still be pointing you towards seeking additional help, realizing the intrusive thoughts about your body and food can’t possibly be healthy and wondering how to even hope for some freedom from the distress it causes.  

If this struggle sounds familiar to you- you have come to the right place! Working with providers who are trained and skilled at treating eating concerns can be an incredibly validating experience. Your body does not have to reach a “sick enough” status in order to be worthy of care. If you struggle with body or eating concerns, you are worthy of being taken seriously, heard, and helped.  

Sources: 

*https://onlinelibrary.wiley.com/doi/full/10.1111/j.1553-2712.2008.00100.x

**https://www.womenshealthmag.com/health/a32303881/atypical-anorexia/

Each fall, I love watching the world around me color into brilliant autumnal tones. Plants change color before my eyes, revealing bright hidden hues right before winter frosts come and take the plants into dormancy. It’s one last golden hurrah before succumbing to the sleep of winter.  

You may have heard that trees lose their leaves in preparation for spring when growth gives the plant a new beginning. It’s a familiar cycle of loss and renewal that is analogous to life. Recently, I was selecting some shrubbery that will add to the fall color in our garden, and I read more about the mechanism that allows plants to change color when they sense the dormancy of winter is approaching. And it fascinated me!

Plants can sense the seasonal changes are coming through the subtle shifts in light and temperature as fall approaches. Temperatures cool, daylight shortens. The goals of the plant then shift: no longer is the focus on growth, but survival. The long summer days allow a plant to absorb seemingly endless sunlight through its leaves, carrying nutrients that allow for growth and root development. The plant thrives, grows to new heights, stretches into previously unknown territory. 

As the seasons begin to change, the plant can sense that this type of ongoing rapid development would be ill-timed, and energy is then redirected into surviving the coming winter. Green leaves are no longer an asset but a liability. And so the plant stops sending water into them, allowing them to dry (and providing us with a magnificent fall show!) In many plants, a swelling will occur where next spring’s new growth will be the mechanism that pushes the dried-up leaf off the tree and into the wind. 

Learning about this caused me to consider how shifting priorities and the need to make room for new growth impact our own lives. Many times, eating recovery clients will recognize that their current habits are no longer serving them well, and priorities must change. It can be a painful time, with fear of letting go, uncertainty, and difficulty trusting that there is life beyond what is so familiar and known. It may even cause you to cling to the old habits and priorities that keep you from progressing to a new season of your life, scared of what might happen were you to allow those things to fall away, trusting in the pattern of rebirth.  

But it can also be a brilliantly alive time- full of new color, new possibilities, and hope for ongoing, continued growth and development. Letting go can actually be a brilliantly alive and beautiful time in your life.  

The question: “can I really live a life free of obsessional thoughts about food and my body?” can be answered over and over again as you observe the falling leaves this autumn. Just as spring comes, eating recovery is possible.

We have a brand new 16 year old at our house, and with that has come the experience of teaching another young driver the ropes.  Having been a driver myself for- well, many years- I recognized while teaching my daughter that there are a lot of things about driving that I forgot I once didn’t know or understand.  

Road signs, for example- somehow, my brain has managed to intake information from a road sign (speed limit, turn lane instructions, sharp turn warnings) and make needed adjustments without spending a lot of time actually thinking about or processing the warning signs.  It’s become a streamlined, automatic process.  

Personal relapse warning signs in recovery

At times, relapse in eating recovery can feel like it blindsides you without a lot of warning.  Part of the individualized work done in treatment is understanding what your own personal “caution: sharp turn ahead” warning signs look like.  

Do you see the new school semester approaching and recognize some personal warning signs of stress?  Do you feel more present depressive symptoms and have awareness of your mental health shifting?  

Matching skills to meet signs 

Just like when you are driving through a canyon and you see a sign indicating a sharp turn ahead– you instinctively slow and become more alert of your surroundings– you can also learn to match the needed recovery skills with personal warning signs you work to become attuned to.  

Similarly to when you once learned to drive, skills in eating recovery can feel overwhelming or confusing as you first begin to practice them.  But with practice and guidance, you will begin to trust your own intuition and skill to handle the road ahead.  

Focus on micro habits of mental wellness 

Responding to personal warning signs is highly individualized, but a good place to begin is to examine what I look at as the “micro habits” of mental wellness.  Generally, when stressed, people start to neglect the basics that keep them going in the right direction. These little habits that our well being rests upon- things like sleeping enough, staying hydrated, eating to nourish our bodies, staying connected in our meaningful relationships- can start to feel like “one more thing” and become neglected.  

When you recognize your personal warning signs, it’s helpful to take inventory of these micro habits.  How are you prioritizing time for yourself?  Are you remaining mindfully aware of your eating?  Do you need a nap?  

Noticing your signs and making little adjustments to ensure successful navigation can help you develop insight into yourself and build a roadmap helping you understand the unique terrain of your own recovery.  As you do this work, these processes will start to become more automatic- noticing and responding to warning signs- and will continue to ensure you safely arrive at your intended destination. 

Motivation can be a slippery little sucker.  Anyone who has had a hard task in front of them can tell you from experience- motivation is not a constant companion on the way to the achievement.  Motivation isn’t always going to be there for you, pushing you towards your goals.  To be successful, motivation must be joined by perseverance.  

Change equation 

A common way to look at motivation towards change is this equation:
When the pain of remaining the same outweighs the pain of changing, change will occur.  Most of us will work to avoid pain, even if that means having to make changes we’d rather not make under other circumstances. When we look at that through an eating recovery lens, you may recognize that point in your own life- the moment of desperate realization that you don’t want to stay in the pain of your disorder.  A moment of wanting help, even if it would require you to try new things. The trouble is, the momentum from the motivation gained in that moment of pain doesn’t always last through to full eating recovery.  As motivation ebbs and flows, perseverance comes on the scene to ensure goals are met and recovery is achieved.  

If we were to create an equation for that, it would look like this: motivation PLUS perseverance equals recovery.  

The role of perseverance

Perseverance can be defined as persistence in doing something despite difficulty or delay in achieving success.  While we expect recovery to be linear, it’s just not. On the diverging path of recovery, perseverance is what is often keeping you moving forward.  

Motivation is a mover and a shaker, but perseverance is the slow and steady tortoise that’s going to get you across the finish line of your recovery race.  

Don’t give up when motivation wanes

Remember, when you feel a lack of motivation to continue in your eating recovery work, it’s not because you are failing or doing something wrong.  Motivation on its own was never going to get you all the way to recovery.  You aren’t feeling a lack of motivation because you don’t have the ability to recover from your eating disorder.  No one feels motivated all the time!  Motivation just has to be met with perseverance. 

What does that look like in practice?
-Don’t get overly discouraged on the days you want to give into disordered thoughts and behaviors.  You might observe the way you are feeling, while reminding yourself that this is a normal part of recovery and that you will be practicing a “perseverance day” today.

-Develop some personal mantras towards perseverance.  “I’m someone worth the work of the mundane recovery days”; “consistency IS recovery” and “I’m a woman who has her crap together” are all perseverance driven mantras.  Remind yourself of the work you are doing to develop this important “adulting” skill of perseverance!

-Act as though you are already someone skilled at persevering through tough days.  When you are feeling the urge to act on disordered eating thoughts, remind yourself, “I’m someone who I can count on to do what is needed in recovery, even when it’s tough” and keep doing what you know is right- following through on your meal plan, reaching out to your support system, attending your treatment appointments.  

 Remember the equation: Motivation + perseverance = recovery 

Don’t give up on yourself when things get discouraging.  So many times, the act of giving up keeps us from discovering the very important truth about ourselves that we are absolutely capable of doing incredibly difficult things!