Saturday, August 15, 2009

A Runaway Train



It rained all day today. I started a walk with Sage early this morning and half way noted the sky turned dark and the wind came up out of nowhere. I debated whether to keep going or turn around and head home. I decided to push forward. Not good. After what seemed like a few minutes the heavens opened and the rains gushed. Sage was not happy as her tail pressed between her legs and her ears slicked completely back.

We abruptly turned around in a walk/run pace and headed home. We were soaked. After peeling off my wet clothes and slipping into something dry I began to work on my manuscript on compulsive eating. It continued to rain the entire day and I sat in this very spot painfully making revisions and cutting out paragraphs that did not fit.

Writing about a subject so close to my heart reminds me of days struggling with weight and food. Sometimes I get accused of simplifying the ability to release the obsession to food. It was not an easy decision to make. I cried, bargained, and relapsed for decades before accepting I have an eating disorder. It has been years since I ate simple carbohydrates. I think about chocolate, doughnuts, and thick loaves of Italian bread from time to time, but I know eating them would only pull me back into out of control eating and low grade depression. It is not worth it.

As I wrote and revised I thought about many patients who relapsed and began compulsively eating after a few months of relief. Although each has their own story, they often resemble each other. Often I am asked how do you stop a binge? It is as difficult to redirect thinking as it is to stop a train when it is going full speed. It slowly grinds to a halt.

A binge must be stopped before it starts or it will run full speed out of control until the stomach is full beyond "normal" capacity and shame and remorse for the behavior begins to set in. My questions are: What was going on before the binge? Were you hungry? Did you miss a meal? What did you last eat? Were you tired or possibly irritable and angry? Are you overwhelmed about something? Answers to these questions teach awareness and triggers to binge.

Writing and revising my manuscript reminds me of times when I experienced the questions above. I eat meals no later than 5 hours apart. I prefer four. I make sure I get at least seven hours of sleep and exercise daily to release stress. My food is whole food never simple carbohydrates and always balanced with nutritious foods to keep my body running smooth and ward off cravings.

A patient who relapsed and began compulsively eating was certain she did everything to stay on her healthy eating course. We went through each question and discovered she skipped dinner the day before because she was too tired. The next day she felt she could eat more than her usual meal to make up for the meal she missed the day before. She felt full and fat after eating and proceeded with thoughts of imagined weight gain. Old familiar self-talk ensued. She felt angry, out of control, and foolish for eating more than she needed. This led to out of control eating.

Another patient forgot to take her lunch to work and decided to wing it with fast-food. She intended to take the bun off her sandwich and order a side salad skipping fries. The instructions to the cashier were misunderstood. By the time she got back to the office to eat her food she realized she had the wrong meal. She was very hungry as it was six hours since she ate. She wolfed the food down without thinking: similar to a runaway train.

What is the moral of this story? You must be prepared with each meal never depending on someone else to get it right. I take my meals with me unless I know exactly what I am eating and it fits my food program. This is the part where some get annoyed and call this rigid. I call it lifesaving. I see it as vigilant. I spent too many years suffering with obesity and obsessive eating which is now replaced with peace and tranquility, not to mention normal weight.

The rain is starting to subside and the sounds of birds singing is filling the once steady pound of water against the windows. The sun is peaking out between a few lingering clouds. Maybe Sage is ready to go out and run around in the yard as she easily forgets her fear of storms.


Photos by Dr. Lisa Ortigara Crego