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For proper recovery, your brain must be properly nourished. Things that you have been using to control your eating disorder such as restrictive eating, purging, and food avoidance may be the things that keep it going, which can be an uncomfortable thought. Early behavior change has shown to be the best predictor of recovery and anxiety.


Steps to break free:

  • Being aware of your triggers and early warning signs so you can intervene before the feeling gets overwhelming

  • Start eating regularly, adequate and appropriate variations of foods

  • Include fear foods


Identify your triggers and come up with ways to manage your stress and anxiety.

Do you know what triggers a binge for you? How are you going to manage the stress and anxiety associated with these feelings?

  • Is the trigger something you might have to work through with a psychologist?

  • You may have to look at different areas of your life. Are you lacking anything in areas of your life such as:

- Leisure

- Health and personal development

- Work and education

- Relationships


If you are, what are you missing? How can you change this? and how will you follow this? It is important to set boundaries for yourself, identify what could be causing you to feel stress or anxiety, and addressing the issue. This helps uncover the underlying cause of your stress and anxiety and help you recover in the long term.


But what can you do to reduce you stress in the moment when it suddenly comes on?

  • Journaling (just writing down your feeling and emotions)

  • Listening to calming music

  • 5-10 minutes of deep breathing and/or meditation

  • Finding an activity you enjoy such as gardening or painting

  • Spending 20 minutes in nature


Optimal Energy

Optimal energy occurs when a person eats regular meals and snacks throughout the day, preventing a drop in blood glucose levels, and entering a state of semi-starvation. Optimal energy improves overall body and brain function and well-being and can prevent a binge eating episode.


Balanced diet: structure (regular food intake), quantity (adequate food intake) and variety (eating multiple food groups).


Structure can be important when overcoming an eating disorder (3 meals and 2-3 snacks)

  • Give structure to your eating habits so they can be normalised

  • Prevents infrequent or delayed eating

  • Keeps blood sugar levels stable

  • Prevents grazing, picking and unstructured eating patterns

  • Challenges your rules around food and eating

  • Establishes eating habits that will reduce incidence of binging

Tips

  • Plan out the timing of meals and snacks the night before (gap no longer than 3-4 hours)

  • What are you going to eat and where is it coming from?

  • What foods/snacks can you prepare in advance? Can you take on the go snacks with you?


When a binge comes on


Urge surfing. This means riding out that emotion and tolerating your own anxiety long enough for it to pass (like trying not scratching a mosquito bite).

  • Set a timer for 30 minutes or 5-10 minutes if 30 is too hard. See if you can delay the binge for this time. When the timer stops, check yourself, and notice what happened to the urge. If your urge is still too strong. Write down that you delayed for 5, 10 or 30 minutes, and that was successful that you managed to delay the binge! In the future delay for 60 or 90 minutes. Eventually, you will be able to surf your urge until it goes away for good!

  • Find a distraction while you have your timer set.

Including your fear foods


This will be anxiety producing at some points, but the goal of this is to learn what your behaviours are, what are your triggers and how to reframe your thinking around emotions and eating. If there is no anxiety there is no change, so you must put yourself in these uncomfortable environments to make change.


I will be asking you to eat differently, reduce the use of restriction and challenge your ideas around food. We need to provoke anxiety in the short term, but you will learn that eating regularly has greater positive benefits, and the anxiety will fade. This is evidence based. Itis normal that it will be anxiety producing when you have used restrictive eating as a safety behaviour to control weight, which may reduce your anxiety in the short term, but increases it quite significantly in the long term. I am asking you to give up your safety behaviour.



Information for this handout was provided from ‘Centre of Clinical Interventions’: Disordered Eating; Workbook- Break Free from ED; https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Disordered-Eating


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Be Curious, Not Critical! Let’s reframe our thinking. How did something make you feel? What did you learn instead of critcising your behaviours.

EDUCATION What are the impacts of binge eating?

  • Physical health problems: unstable blood sugar, disrupted hunger and fullness signals, liver dysfunction, and increased acid reflux.

  • Negative emotions and thoughts: binge eating makes people feel distressed, self-criticise, and have intense feelings of guilt, shame, and disgust. These feelings can increase the chance of another binge.

  • Avoidance and distress intolerance: although binging can make you feel good in the short term, binging to avoid certain emotions is not a helpful way to deal and overcome these emotions in the long term. This can cause you to struggle and continue to binge when similar feelings arise in the future.

  • Keeps the eating disorder going. Binging increases concern about eating, weight, and shape, and leads to new attempts to further control your food intake and/or exercise to make up for the binge you just experienced. This keeps you stuck in a vicious cycle of restriction, and further causes more binges in the future.

What are some potential triggers for binge eating?

  • Physical hunger: our bodies will try to correct an energy deficit, so it doesn’t starve (e.g. if we haven’t eaten enough, or we are restricting).

  • Psychological hunger: Following rigid dietary rules can cause us to crave the foods we are trying to avoid. Our brains are natural rule breakers, and most of the time, these rules can be too strict and lead to us breaking them. When we break a rule, this can lead to ‘all or nothing thinking’ where people feel like they have failed so they give up for the day and think they can get back on track tomorrow.

  • Distress: people describe binge eating as a way to regulate, control or numb intense feelings that are either emotional or physical feelings such as tiredness, pain, anxiety, sadness, and frustration.


Why is restricting unhelpful? When we restrict food, we are ignoring our body's natural hunger cues and blocking out intuitive eating. Attempts to control eating, weight, and shape lead to binge eating and broken rules. When we don’t eat enough, our physical hunger leads to a state of semi-starvation, and our brains naturally drive us to eat more to prevent starvation. Pretty much our bodies crave the energy-dense foods we are trying to avoid increasing energy and brain function. Our brains are natural ‘rule breakers’ and will push the boundaries and want to go over what we have restricted.


Weight

There is no evidence to suggest that intuitive and regular eating contributes to obesity. The whole point of intuitive eating is that you teach your body your natural hunger cues. So, each day at a similar time, your body tells you when you’re hungry, and you eat on those cues curbing any cravings you might experience if you haven’t eaten enough. Each person has an individual ‘set-point’ weight range. This ‘set-point’ is dependent on our body’s makeup and genetics and is supposed to maintain optimal health. When we eat intuitively, regularly, sufficiently, are flexible with our foods, and include moderate exercise, our bodies will trend towards it’s set point range. Each person has a different ‘set-point’, some people have a higher ‘set-point’, and others may have a lower ‘set-point’. But everyone is different, and fighting against your genetic set point by restricting or participating in eating disorder behaviours is not sustainable long term and can make you very unwell. BMI also isn’t an accurate measure of individual weight and can be damaging when used in isolation to measure someone’s weight as muscle weighs more than fat! Having a goal of weight loss is not healthy when trying to recover from an eating disorder, as this mindset is a behaviour that will keep you stuck in a vicious cycle. The number on the scale can be impacted by:

  • Fluid intake

  • Weight of clothing

  • Time of day you are weighed

  • How much you have eaten that day

  • Bladder and bowel movements

  • Hormonal changes (including menstruation- can go up by 2kg)

  • Scales you are using

  • Some medications

  • Weather

Therefore, it can be more important to look at trends in weight over time than an independent figure on the scale. Each individual has a ‘set- t that can fluctuate naturally up to 3kg.

What is Semi-Starvation? Eating a low-energy diet or restricting food throughout the day increases your risk of binge eating. When your body enters this state of ‘semi-starvation’ it will begin to crave energy- dense foods to get its energy levels back up again. This commonly leads to individuals consuming energy-dense foods, and a lot of it, leading to a sense of loss of control. Symptoms of semi-starvation occur when food intake is inadequate or irregular. Our hunger works within certain times, and symptoms of starvation will occur when we haven’t eaten in 3-4 hours. We only get about 3-4 hours of energy from the food we have eaten, so it is important to have a meal or a snack in this timeframe to prevent a drop in our blood sugar levels, and therefore energy and concentration, as well as prevent intense cravings.

By eating regularly, this prevents binging behaviours. You will notice, by eating every 3-4 hours, your energy levels and concentration will improve and stay stable over the day. When we restrict and/or don’t eat enough, you will notice a huge decline in energy and concentration. By having breakfast every morning, this sets our energy up for the day, from here have a snack 3-4 hours later, then lunch, another snack and dinner! Test this theory out and report on how it makes you feel.

It is common for hunger cues to be disrupted after prolonged periods of restriction especially in those with an eating disorder. This doesn’t mean you won’t be able to listen to your hunger cues, it just means you will have to learn to listen to your body, and understand when your body expects food and when it has reached satiety. Mindful eating practices can be a good place to start.


Information for this handout was provided from ‘Centre of Clinical Interventions’: Disordered Eating; Workbook- Break Free from ED; https://www.cci.health.wa.gov.au/Resources/Looking-After-Yourself/Disordered-Eating


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What is the 'Medi-Port' Diet?

A combination diet of the Mediterranean and Portfolio diet. Both dietary lifestyles have been extensively researched in decreasing the risk of cardiovascular disease and improving cardiometabolic biomarkers such as LDL-C (cholesterol) and triglycerides.


As the title indicates, the Portfolio Diet is a “portfolio” of plant foods that you can choose from. By incorporating plant sterols from fortified foods, soy products, fruits and vegetables, this simply blocks the absorption of cholesterol from foods in the digestive tract. The Mediterranean diet consists of healthy fats, fibre and anti-inflammatory foods that help rebalance our lipid profile, bind to cholesterol and excrete it from the body, and reduce inflammation associated with cardiovascular disease.


Try including:

Nuts 1 palm size (30- 45g per day)

• Walnuts

• Almonds

• Macadamia

• Cashews

• Pinenuts

• Hazelnuts


Plant Protein (at least 1 serve per day)

• Soy protein powder (20 grams)

• Tofu (150g)

• Tempeh (150g)

• Soy milk/yogurts (1 cup)

• Edamame (1/2 cup)

• Soy cheese

• Legumes: lentils, black, navy, edamame, Chickpeas, kidney, lima beans (1/2 cup)


Soluble Fibre (2 servings per day)

• Legumes: black, navy, edamame, chickpeas, lentils, kidney lima beans (1/2 cup)

• Oats (1/2 cup)

• Broccoli and Brussel sprouts (1 cup)

• Eggplant (1 cup)

• Sweet potato (1 small, ½ cup)

• Chia seeds (1 tablespoon)

• Whole wheat breads (rye, oatcakes, spelt, wholegrain) (2 slices)

• Avocado (1/4 whole avocado)

• Apples and other fruits (1 whole fruit)


Plant Sterols (2g per day) Look for ‘Plant Sterol Esters’ in fortified foods Plant sterols naturally occur in soybeans, corn, broccoli, squash etc. however, to get the required 2g, you will need to incorporate plant sterol fortified foods such as:

• Carman's cholesterol-lowering oats (2g plant sterol per serve)

• Australia’s Own Dairy milk

• ProActiv spread


Healthy Fats

• Oily fish: Salmon, mackerel, anchovies, sardines, herring (SMASH) 100g per serve

• Avocado

• Hemp and chia seeds

• Flax seed meal (ground)

• Walnuts


Fruits and Vegetables

• Include 2-3 servings (1 whole fruit) each day

• Include 5 servings per day (1 cup of salad, ½ cup cooked)

• Leafy greens are a great option but look at including wide varieties and colour.

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