Help! Do I Have an Eating Disorder?

“Most powerful is he who has himself in his own power.”

~Seneca

Have you ever gone back for an extra serving of food when you weren't hungry? How about mindless eating between meals on occasion? I’m sure most of us at some time or another took an additional serving (or two) of food or ate unplanned meals especially during holidays, birthdays, hurricanes and long weekends. Let's face it temptations to over-indulge are all around us. But when is it a problem—an illness?

When was the last time you binged on a block of spinach or a bushel of apples? I'm willing to bet not too often. How about a box of brownies, chocolate chip cookies, or a bag of potato chips? Ah...hitting a nerve am I? If you watch your friends, acquaintances, or how about a stranger in a restaurant, I’m certain you will witness at every turn someone who binge eats. Do you?

So, what makes the difference between an occasional over indulgence and an eating disorder? When is it an eating disorder? And of course addiction plays into the mix too. What about food addiction? To make matters more confusing, when is it binge eating disorder and when it is food addiction? And, could it actually be a combination of the two?
 Let’s face it, millions of Americans hide, steal, and hoard food anticipating a secret binge. After their indulgence they're filled with remorse and shame promising to never over eat again. One of the least discussed and most common eating disorder is binge eating disorder. Binge eating is defined as over eating a large amount of food in a small period of time, at least three times a week for six months or longer. Binge eating, or compulsive eating—as it is more familiarly known—affects more than 20 million people in the United States alone. And yet, we focus more on bulimia nervosa and anorexia when it comes to eating disorders.

Although bulimia and anorexia nervosa are the eating disorders that pop into most minds when discussion of dysfunctional eating surface, in my practice, the majority of my eating disordered patients suffer from binge eating disorder and/or obesity. This isn't to say all bingers are obese or even overweight, because some actually can be of normal weight. Also, not all overweight persons binge eat. And where does food addiction fit into the mix?

 Confusing? Yes, for sure it is…

 The biggest challenge is to sort through whether the patient has food addiction, binge eating disorder, or a combination of the two.

The food addict also eats a large amount of food in a small period of time, and like compulsive eating, it comes with consequences that can be lethal, such as obesity, heart disease, relationship issues, body image, and et cetera. The big difference between the two disorders is food addicts crave specific foods that are uncontrollable no matter what attempts they put forth to stop (i.e., dieting, restricting, exercising, et cetera).

I liken food addiction, an uncontrollable craving for high sugar and processed foods, to recreational drugs such as cocaine, heroin, and nicotine. And the food addict needs to consume the sugary/starchy substance in order to function—to feel "normal." In all addiction cases, the substance dependent consumes larger amounts of their drug for longer periods than were normally intended with persistent desires or repeated unsuccessful attempts to quit—even if it interrupts social, recreational, and family interaction—because the addicted substance takes precedence.

When it comes to treatment for binge eating disorder it is often not about the food but rather about the emotional deficits. When it comes to treatment for food addiction it is about the food—specific foods that trigger the compulsion to consume large amounts of it no matter what the cost. Although binge eating disorder and food addiction share many of the same symptoms, food addiction shares the emotional component of binge eating disorder as well as the symptoms such as obsession with body, weight, mood shifts, closet eating, stealing, where compulsive eating is about the inability to deal with emotions.

I suffered from food addiction and binge eating disorder as far back as I can remember—I just didn't know what it was called. I thought there was something wrong with me mentally. I craved chocolate, doughnuts, chips, and anything gooey and sweet beyond normalcy and I tried every diet under the sun—including diet pills, commercial diet centers, starvation, over exercising, none of which helped me tame the compulsion to eat beyond full in spite of the detrimental consequences, which in my case was obesity.

I wish I knew then what I know now about eating disorders, treatment, and spiritual recovery. Perhaps I could have avoided all the pain and suffering with my weight up and my weight down—an endless battle—until now. Today, I live life without the torture of worrying about getting heavy, craving foods I can’t control the amount of. And spiritually my cup is full.

So, if you are one to eat an extra serving, two, or three beyond holidays, birthdays, hunkered down for hurricanes, and long weekend temptations, when you weren't hungry, to the point of devastating consequences that hamper the quality of your life, perhaps you may suffer from an eating disorder such as food addiction, binge eating disorder (compulsive eating) or both intertwined.

 My 20 years experience as a clinical psychotherapist, a PhD in addiction psychology, certified eating disorder specialist, certified addiction professional, and national board certified clinical hypnotherapist has not only made me a recognized expert in my field, but also made me privy to understanding the experience of those (and myself) releasing their obsessions with food and turning to their connection with the divine energy (known as God for some) and people.

 http://weightcontroltherapy.com/

Photos by Dr. Lisa Ortigara Crego

 

Six Reasons Dieting Fails for the Food Addict

Before I released excess weight for good and became known as a certified eating disorder specialist (CEDS),  I spent nearly three decades at various arms of diet centers such as Weight Watchers, Ediets, Twelve Step programs, mostly as the recipient of diets initially and worked as a clinical psychotherapist/addiction psychologist certified as an eating disorder specialist later. But a more accurate title for that job in my earlier days might have been certified diet failure doctor and uninformed therapist: while I lost a great deal of weight and showed the way to thousands, I’d watch one after the other go through the revolving door of failed diet plans.

Like the ongoing dieters, I too joined the up and down weight loss program initially. And while it may not be possible to pinpoint what exactly makes for a great weight loss program, it’s pretty easy to identify some of the avoidable mistakes that can virtually guarantee your weight loss and release of food addiction that will get relegated to a success story. See these mistakes below:

1.     DIET CENTER  HOPPER

Mary joined every weight loss center known to mankind with white knuckle determination and gritted teeth. She was going to lose the weight no matter what. And, of course, the no matter what turned into another failure.  Whatever food program you lose weight with is the very same one you will maintain with. If you can’t figure out how to make the “diet” doable for everyday life, you’re probably not on the right food program for a food addict.

2.     DIET BOOKS

Although hundreds of diet books line the shelves of bookstores, virtual and brick and mortar, It’s close to impossible to eradicate every single little mistake in the diet that was not intended for long periods of time. But what’s not really forgivable are promises that you can eat an ounce of dark chocolate daily and a glass of wine with dinner once you reach a certain level in the program. A true food addict cannot indulge even a small morsel of sweetened chocolate and succulent red wine or they’re crashing. A cocaine addict wouldn’t have just a small smidgen of coke once they reached “maintenance” now would they? Of course not!

3.     DIET FADS

Start eating cookies today and lose weight! Yes, YOU read this right you can eat cookies and lose weight. Eat one cookie for breakfast, one for lunch, and a reasonable dinner, and you too can be thin. Diet fashionistas are the perfect candidates to lure to fad diets. The food addict begs, steals, and bargains, promising after this one last binge to never binge-eat again. So offer the cookie diet to the desperate dieter and she's roped in! But the truth be told, after lured, in a short period of time, after the "honeymoon"  has passed, the binge eating resumes. We are addicts and require real food every four to five hours and must avoid sugar, flour, and wheat to prevent a relapse, so fad diets must be avoided—they don't work—not ever.
4.     30 POUNDS OFF IN ONE MONTH DIET

Yes, you read this right. You too can lose 30 pounds in 30 days! Everyone’s winning at their weight loss with our nutritious packed boxed meals. All “gourmet” meals are prepared for you to take the guess work out of preparation. Yeah right. A food addict first would starve as there isn’t enough food in the small box and second, a food addict would go into a full-blown binge because boxed foods are notorious for hidden sugar, flours, and wheat.

5.     ERRORS OF IGNORANCE

Of course you think this time will be different when you go on the “miracle diet” because you are determined NOW. And you’re convinced the special grapefruit concoction, with Brazilian leaves proven to drop weight while you sleep, is a perfect fit for you. Trust me, there is no magical concoction of leaves, plastic suits that enhance sweat, or any other doohickey that works long term. It simply doe not exist not now—not ever. I swear!

6.     THE HARD SELL

Dante’s juicer is proven to cure you of all illness and restore your body to the size when you were a teenager. Millions of satisfied customers are now wearing bathing suits and win the lotto too.   Not.  There is no quick fix. A change of lifestyle, attitude, and a turn toward a Higher Source you have a good chance of success at your weight loss and releasing food addiction.

Yes, no doubt there are tons of promises of weight loss on every corner billboard, magazine, late night television commercial and broadcast on radio signals around the globe. But before I released excess weight for good and became an addiction psychologist,  certified as an eating disorder specialist (CEDS), I toiled nearly three decades making one "diet" mistake after another before realizing what makes a winner at weight loss and recovery and what keeps a person tied to diet mentality committing one diet error after another. It's your turn to stop going through the revolving door of failed diet plans and this time take charge, make a permanent step towards winning and put to rest the vast array of diet mishaps.

http://weightcontroltherapy.com/

Thanksgiving!

Be comforted dear soul! There is always light behind the clouds.

~Louisa May Alcott, Little Women

Thanksgiving is a day of thanks, a day of praise, a day of gratitude for the fortunate. Who is fortunate? Is it the rich person? Perhaps the one with a roof over the head? Or is it purely existence?  Is the fortunate one the person present living? It's different for everyone. My fortunate is the ability to stay present—in the now—and give thanks and praise. Present living was not always a possibility for me in the past, but now, living in this moment befriends me. Of course it's not always so easy when life is filled with trials and tribulations. 

Is there always a light behind the clouds?

Can you sit still on this day of Thanksgiving and connect to the present even if there’s a dark cloud over you? Have you ever tried to stay quiet in the mind driven by gratitude? It's pure heaven. The mind always wants to think about what needs to be done next or what we already did. It's not so easy to focus on the here and now and bask in grace and gratitude when daily worries distract you from the abundance that is yours. Mortgage payments, troublesome spouses, out of control children, roofs leaking, a headache, even sour milk can interfere with your gratitude on this day of Thanksgiving, but your Higher Source (Whomever you turn to—God, Jesus, Sun, Energy, etc.) during challenging times showers continuous blessings and love down on you.

What makes me fixed on staying present when chaos surrounds me is deep breathing my way to calm—the present moment. Like you, many of my loved ones are not here on this day of giving thanks, they died or live in another state but they remain in my heart, which encourages me to sit still in gratitude for what I have in the here and now.

I took a long luxurious bike ride this morning along the Inter-coastal and Atlantic ocean with the most spectacular view before me side by side with one of my sons. As we pedaled our way up the bridge we witnessed the sun peak out over the purple/orange backdrop on the ocean shoreline breathing in the sea air.  My legs are strong and my energy abound. My bike moves with me as if we are one. A new day is about to begin. I am in the now—present.

Thanksgiving was not always a time for me to sit in gratitude. I’m a recovering food addict, and in the past, today marked the eating frenzy that launched my holiday eating. Actually, truth be told, that’s not true,  my out of control food fest began from Halloween until January 1 when I’d make my New Year’s resolution. On Thanksgiving day I’d until I could eat no more—until the food was all the way up to the rim of my throat and my pants cut into my bulging stomach—promising I’d diet come Monday. And Monday never came.

I am an addict addicted to processed foods and this holiday for most food addicts is lethal because there is no end to the eating or at least until we are so full the pain is greater than the need for that one more bite.

Food addiction is a loss of control over eating coupled with the physiological tolerance and psychological dependence that occurs when a specific stimulus (food) is ingested. Typically, this addiction can result in negative consequences for basic life functions and relationships with family; social situations; intimate relationships; the sufferers relationship God and spiritual development; or in relation to the law, health, and work life.

Early in childhood I was fixated on sugar—never getting enough and going to great extremes to obtain it: stealing, hiding and hoarding. Although I didn’t have an awareness of food addiction, I knew something was wrong. In hindsight, I realize I ate out of control and bargained with myself and God to stop—after this one last pastry. I felt shame if I got caught stealing food or money to buy food; yet, I didn’t have the mentality to understand I was compulsive eating until my adolescent years when weight began to pile on. And even then I didn’t know there was an actual eating disorder called, binge eating disorder—and that I had it.

What I did know was my friends ate when they were hungry and stopped when they had enough and didn’t hide or sneak their foods nor had shame. Food addicts have a severe and ongoing disturbance in the manner in which they handle food. The depiction of addiction to food resembles the hallmarks of any addiction. The food addict is caught in the grip of a compulsive, habitual behavior that can’t be controlled.

The binge eater begins eating when she didn’t plan to and can’t stop eating when she wants to. Addiction is the persistent and repetitive enactment of a behavioral pattern the person recurrently fails to resist and that consequently leads to significant physical, psychological, social, legal, or other major life problems. Loss of control over eating and obesity produce changes in the brain, which is similar to those produced by drugs of abuse.

Today I practice mindfulness. The dictionary defines mindfulness as calm awareness of one's body functions, feelings, content of consciousness, or consciousness itself. I am totally conscious of my fingers dancing over the keys putting words together. I am told mindfulness is the path to liberation and enlightenment. It is the intense purpose of staying in the now. I get this. 
 

So, today I am present. I refuse to think about what needs to be done next or what I already did. I am present with each breath in and out. I am present to the sounds of birds singing and the whispers of the wind as it folds through the palm trees out my window. I am here and now. What makes me fixed on staying present is is the peace and tranquility it brings. And of course the whiff of turkey baking in the oven doesnt' hurt! 

Photos by:  Dr. Lisa Ortigara Crego

Chemical Reactions To Food

I’m often asked how I went from 234 pounds to 139 pounds after years of bouncing up and down with my weight. Let’s be clear, I was the yo yo dieter of the year from early adolescents through my thirties. My weight and my relationship with food were a constant struggle for me until I began to understand my chemical reaction to certain foods.

After years of trial and error, research, clinical knowledge, weight loss, and stability of weight, I became a gentler spirit once I accepted sugar, flour and wheat caused me great distress. I learned highly processed, high fat, high sugar foods immediately produced a massive headache, irritability, and an all out food binge.

These days, I follow a simple formula breaking down each meal with structure (four meals a day each consisting of specific foods: fruit, protein, fat, vegetables, low fat dairy, and whole grains) and commitment rather than eating randomly. I also include daily exercise such as walking or biking along the ocean and try and live my life as a prayer.

No, I am certainly not perfect (and realize I sound as if this is so easy), and life is not always bliss. I would love to eat any food I want, but I realize the consequences aren’t worth the indulgence. I do get mad at life when I’m tired and work too many hours, or when I have to turn down an invitation to an event because the atmosphere won’t be conducive to my bringing my own foods, or when everyone will be eating a delectable piece of chocolate cake and I’ll be stuck eating a piece of fruit with yogurt.

But, no matter what life struggles present themselves, I know that binge eating simply isn’t an option—nor are sugar, flour, or wheat on my food list, because I understand that the sleeping giant of addiction within will wake, and chaos will return with a vengeance if I ingest any of these. I compare my situation to that of a heroin addict, who can't have just a smidgen of heroin; he must abstain completely to stay clean.

When I began to follow these specific guidelines—even when I didn’t want to—my negative mind chatter quieted, and for the first time I could become still, and hear God’s whispers. I connected to my inner strengths, and a spiritual understanding emerged in me. I found inner peace, God, and love. Love for myself, others, and the universe evolved inside me.

Not only was I calmer, kinder, and less self-centered, but I began to perceive a bigger picture. I saw food as real and not real: God’s food and man’s food. I chose food of the earth, sea, and air rather than processed and boxed. I turned to God, and the "noise" in my head ceased, and the addiction flattened. These days, I eat to live rather than live to eat. Healthful foods and a refreshed faith are now my fuel to retain optimal health and weight.


Photo Taken By:  Dr. Lisa Ortigara Crego



Binge Eating Disorder vs. Food Addiction

Do I have Binge Eating Disorder or is it Food Addiction, or Could it be a Combination of Both? Have you ever gone back for an extra serving of food when you weren't hungry? How about mindless eating between meals on occasion? I’m sure most of us at some time or another took an additional serving (or two) of food or ate unplanned meals especially during holidays, birthdays, and long weekends. Let's face it temptations to over-indulge are all around us.

So, what makes the difference between an occasional over indulgence, or binge eating? What about food addiction? When is it a food addiction? To make matters more confusing, when is it binge eating disorder and when it is food addiction? And, could it actually be a combination of the two?

When was the last time you binged a bushel of apples or a bucket of broccoli? I'm willing to bet not too often. How about a box of cookies, bag of potato chips, or chocolate bars? Ah...hitting a nerve am I? If you look around I am certain you will see at every turn someone who binge eats. Do you?

Millions of Americans hide, steal, and hoard food anticipating a secret binge. After their indulgence they're filled with remorse and shame promising to never over eat again. One of the least discussed and most common eating disorder is binge eating disorder. Binge eating is defined as over eating a large amount of food in a small period of time, at least three times a week for six months or longer. Binge eating, or compulsive eating—as it is more familiarly known—affects more than 20 million people in the United States alone. And yet, we focus more on bulimia nervosa and anorexia when it comes to eating disorders.

In my practice, the majority of my eating disordered patients suffer from binge eating disorder and/or obesity. This isn't to say all bingers are obese or even overweight, because some actually can be of normal weight. Also, not all overweight persons binge eat. And where does food addiction fit into the mix? The biggest challenge is to sort through whether the patient has food addiction, binge eating disorder, or a combination of the two.

The food addict also eats a large amount of food in a small period of time, and like compulsive eating, it comes with consequences that can be lethal, such as obesity, heart disease, relationship issues, body image, and et cetera. The big difference between the two disorders is food addicts crave specific foods that are uncontrollable no matter what attempts they put forth to stop (i.e., dieting, restricting, exercising, et cetera).

I liken food addiction, an uncontrollable craving for high sugar and processed foods, to recreational drugs such as cocaine, heroin, and nicotine. And the food addict needs to consume the sugary/starchy substance in order to function—to feel "normal." In all addiction cases, the substance dependent consumes larger amounts of their drug for longer periods than were normally intended with a persistent desires or repeated unsuccessful attempts to quit—even if it interrupts social, recreational, and family interaction—because the addicted substance takes precedence.

When it comes to treatment for binge eating disorder it is often not about the food but rather about the emotional deficits. When it comes to treatment for food addiction it is about the food—specific foods that trigger the compulsion to consume large amounts of it no matter what the cost. Although binge eating disorder and food addiction share many of the same symptoms, food addiction shares the emotional component of binge eating disorder as well as the symptoms such as obsession with body, weight, mood shifts, closet eating, stealing, where compulsive eating is about the inability to deal with emotions.

I suffered from food addiction and binge eating disorder as far back as I can remember—I just didn't know what it was called. I thought there was something wrong with me mentally. I craved chocolate, doughnuts, chips, and anything gooey and sweet beyond normalcy and I tried every diet under the sun—including diet pills, commercial diet centers, starvation, over exercising, none of which helped me tame the compulsion to eat beyond full in spite of the detrimental consequences, which in my case was obesity.

I wish I knew then what I know now about eating disorders, treatment, and spiritual recovery. Perhaps I could have avoided all the pain and suffering with my weight up and my weight down—an endless battle—until now. Today, I live life without the torture of worrying about getting heavy, craving foods I can’t control the amount of—and spiritually my cup is full. So, if you are one to eat an extra serving, two, or three beyond holidays, birthdays, and long weekend temptations, when you weren't hungry, to the point of devastating consequences that hamper the quality of your life, perhaps you may suffer from an eating disorder such as food addiction, binge eating disorder (compulsive eating) or both intertwined.

My 20 years experience as a clinical psychotherapist, a PhD in addiction psychology, certified eating disorder specialist, certified addiction professional, and national board certified clinical hypnotherapist has not only made me a recognized expert in my field, but also made me privy to understanding the experience of those (and myself) releasing their obsessions with food and turning to their connection with the divine energy (known as God for some)and people.

Photos by Dr. Lisa Ortigara Crego

Why Can't I Stop Eating?

So, you ask yourself,'Why can't I stop eating?' or 'What's wrong with me that I’m eating a huge amount of food—when I’m not even hungry?'

Did you ever consider you may have an eating disorder? Okay, it's harsh to even consider the idea. Nobody wants to be "labeled" with a disorder. I get that. I have binge eating disorder and denied it for years until one day (after gaining and losing and gaining close to 100 pounds) I came to my senses and admitted I had an eating disorder and gradually changed my relationship with food; hence, my journey to recovery began. Was it easy? Certainly not! Was it doable? Absolutely!

Let's face it, change doesn't come easy for most of us and learning we might have a disorder that requires cognitive/behavioral changes is darn right scary. So what does one do? I believe the answer begins by making choices towards a healthy life style. We can hunker down to what is familiar—not willing to budge—or we can step out of our comfort zone and try recovery strategies that may seem foreign at first.

As an expert in eating disorders, I have found answers not only for myself but also for my patients who have binge eating disorder, bulimia, anorexia, food addiction, or a combination of all four. You may wonder if it’s possible to move in and out of binge eating, purging, and restricting—the answer is yes. In fact, it’s not uncommon to dance between a mix of eating disorders.

You may find it interesting to learn, bulimia and anorexia are the eating disorders most familiar, but not most common. Patients often gasp when they learn that eating a large amount of food in a small period of time with little regards for consequences (and not purging) actually has a name and is considered an eating disorder that is more common than bulimia and anorexia. Most of my patients (including myself) have binge eating disorder without purging food. After an episode of bingeing, often the person harbors guilt and shame promising after this last binge they’ll get back to their diet and never engage in volume eating again.

Once my patients get past the fact they have a disorder, and that it actually has a name—binge eating disorder—they move into acceptance and a recovery plan.

So now, when you ask yourself, ‘why am I bingeing', you may want to take a closer look at what's going on in your life? Let's be clear, if you spend the evening hunkered down in a coma-state watching television, and to your surprise realize you inhaled an entire bag of potato chips, you are not automatically a binge eater. A binge eater frets over the fact they lost control over their food and may even fear they can't stop eating once they start and an intense fear of weight gain. Furthermore, it's not uncommon for a compulsive eater to hide their food and binge alone—filled with shame when the binge is over.

The cause and recovery strategy for compulsive eating is up for grabs—with many theories. Some say it is a chemical imbalance and name it food addiction. Some find it is an emotional crisis and bingeing is a way to avoid something bothersome. And still others find it is a spiritual deficit. I say, it's a three-prong problem: spiritual, emotional, and physical.

Most of my patients contact me because they want to lose weight and they tried every "diet" imaginable and still can't stop eating. Eating beyond full is common with a person suffering from binge eating disorder. What is causing this behavior? Perhaps you're sensitive to sugar, flour, and wheat due to a chemical imbalance causing you to crave more and more food, especially from sweet and starchy food choices.

You may have trouble resisting a binge because you suffer from a food addiction and/or an eating disorder. The answer is not simple and it requires a process that involves change in thoughts and behaviors. The first step for you is to get familiar with trigger foods and start weaning off of them. After a binge (or before would be ideal!) ask yourself a series of questions:

1. Was I hungry? When was the last time I ate? If it was more than five hours you most likely were hungry.
2. Was I angry about something? Is there something going on in my life that I feel out of control, anxious, hopeless, and/or helpless?
3. Am I lonely or feeling alone?
4. Am I tired? Did I get an ample amount of sleep?
5. Am I stressed? Do I have too much to do and little time for relaxation and fun?

If you answered yes to any of these questions, it may be the first place to address your eating issues. Also, pay attention to the foods you’re eating. Perhaps you are sensitive to processed foods such as: bread, cakes, cookies, flour, et cetera. So, if you ask yourself, 'Why can't I stop bingeing?' or 'What is wrong with me that I'm eating a huge amount of food when I’m not even hungry?', you may have an eating disorder or a chemical imbalance that triggers uncontrollable cravings and volume eating. My suggestion is to seek a certified eating disorder professional who can help you address these issues and move into recovery and quality living.

Spirituality Inhibited by Active Binging

Spirituality Inhibited by Active Binging

I discovered working with a small intimate group discussing recovery that Spiritual healing alone works if you aren’t dealing with a chemical imbalance. We all experienced a blockage from our spirituality when we were active in binge eating. We lived in a self-centered world and yet never ended up with what satisfied us. We learned we can’t give of ourselves because we’re immersed in addictive eating blocking the connection to God. In our self-centered world we’re unable to love ourselves—we’re centered in self-hate.

Healing requires a three prong mindset: physical, emotional, and spiritual. How can we heal our bodies if our mind is toxic from our chemical response to certain foods? In turn, if we are emotionally bankrupt how do we find our way spiritually? Can we be spiritually connected when we’re knee deep in a food binge?

I can only speak for myself and the answer is—not totally. Yes, the binge dropped me to my knees begging for relief; however, once the food partially digested I was ready for another binge. What comes first cleansing from the binge or reaching out to God?

At times when I was loaded with sugar I struggled with negative images of God, feelings of spiritual unworthiness and shame, fear of abandonment by God, intense difficulty surrendering and keeping faith, and dishonesty and deception. I believed in God yet had deep spiritual struggles creating a major impediment to my ability to recover from my eating disorder.

This is not to say there were not previous times in my life where I felt a connection to God and a degree of personal spirituality. I still attended weekly Sunday mass intermittently but lost these connections through the course of my eating disorder. In essence, I realized spiritual healing can happen but first I needed to address my chemical imbalance on a physical, spiritual, and emotional level.

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

Celebrating and Mourning Simultaneously...

Happy Birthday America! Today is the Fourth of July...a day worth remembering and reminiscing. Today is the day America decided to become independent of Great Britain. This day represents freedom to make our own rules and be responsible for our welfare.

My day began with sunny, blue skies, white puffy clouds, birds singing. A picture perfect South Florida day! A time for America to remember and celebrate what was and what is. Although a truly glorious day, somewhere someone is mourning. Someone is sick. Someone is losing someone. I think of Mom and recall several Fourth of Julys after she suffered a massive stroke (days before her 64th birthday), I was filled with sadness and questioned how the world could still be moving forward while I was suspended in gripping emotional pain.

The same holds true on this fourth day of July celebration. Even though some of us might be grappling with an emotional, physical, or spiritual loss, the 4th of July must go on. It is no doubt a time for celebration, which includes: picnics, boat outings, Barbeques, et cetera. Of course, with celebrations come foods, drinks and temptations. This is the American way! But...perhaps not everyone is so festive. Many suffer from illnesses and losses. Certainly Michael Jackson's family is mourning their loss. And in my own life I have losses and family members suffering from illnesses and aging.

I can't help but wonder what role food plays in illnesses, losses, and death. Take Michael Jackson for instance. He was a 50 year old icon, weighing in at 112 pounds at the time of his death. It is my understanding he was somewhere between 5-8 and 5-10 in height. In my line of work (eating disorders, body image dysmorphia, and mood disorders) this would be a huge red flag. Did he suffer from a low self body image? It seems evident by his history of plastic surgery and total change in body appearance he did. Did he suffer from addictions to prescription drugs? With all the surgeries and other medical issues he had he was in chronic pain and may have become addicted to prescription medications. I have witnessed in my practice as a certified addiction professional, addictions to medications quite common. Did he have an eating disorder tied in? Maybe. I did not hear anything regarding this; however, he definitely was not of a normal weight and did seem to have an issue with growing up. Perhaps he kept his body frame boy-like to avoid growing up.

Many female anorexics keep their body's girl-like, stop menses, and appear to harbor a flat chest to hide their femininity perhaps to be in control. My Mom did not restrict, she was the opposite. She wore her weight and then some. She ate large portions of high fat, salty foods. Perhaps she grew her body rather than restricted to accomplish the same goal of hiding her feminine side. As pointed out with Michael Jackson, men are not free from eating disorders and/or body image dysmorphia. My uncle, a rather large man, died from cancer. He ate heavy meals, did not exercise, wore extra weight, and may not have been spiritually connected. He died young...late fifties. I believe unprocessed foods play a huge role in healthy minds and healthy bodies. All of my self-hypnosis CDs address the importance of clean eating, exercise, and spiritual recovery.

And so here we are on this glorious day. The Florida sun tucked away for the evening as festivities of 4th of July come to a halt. I wonder, as the last bits of fireworks fall from the sky, sounds still within ear shot, how many close this day with full bellies and empty bellies both rumbling from restricting or binging. Many are alone and lonely, turning to food for comfort...or not. Eating disorders come in many guises. It does not matter if your black or white...or somewhere in between. It does not matter if you're rich or poor...or somewhere in the middle.

Look at Michael Jackson, Elvis Presley, Elizabeth Taylor, Oprah...all rich and famous, all suffered/ suffering from eating disorders and/or addictions of some type. Today, I celebrate America's Independence. I celebrate my independence. I broke away from food controlling me...and now live free. I hope those suffering and hurting today will find independence from pain and sadness...and the loss of loved ones. Life is to be celebrated. America is to be celebrated. Let's wave our flag proudly. We live in a country that offers help and hope to all.

Photos by: Dr. Lisa Ortigara Crego

Yo Yo Dieting

When I explain what is really going on with binge eating and food addiction patients often resemble the deer in the headlights look. It is like they are caught! As Oprah often says, "It is a light bulb moment!" Suddenly understanding their up and down weight loss and gain becomes clear. The yo yo dieting syndrome has an explanation...an answer. It's not their fault!


Yo yo dieting is more the norm than not. The other day I was watching a recorded Oprah show (April 30, 2009) interviewing Kirstie Alley and a second person (a non-movie star) Michael Hebranko. Both were telling their heart-felt stories of losing and gaining weight. A story I know all too well. I felt their pain and urgency. Not only do I understand their yo yo diet syndrome, the patients I work with day in and day out share a similar story. What is the answer?

As I watched, Kirstie promised with such conviction she would lose her weight again and owned the "secret" way to drop weight quickly. I sadly shook my head thinking about how many times I promised to lose the weight and that I had the quick weight loss secret too. Kirstie swore she lost 20 pounds in a few short weeks and would reach her "goal" weight come November(which I need remind you she had promised for her bikini debut back in 2007). Oprah interjected, suggesting she might be setting herself up for failure. I (alone watching this taped video) was cheering Oprah for stepping in and recognizing Kirstie's "diet" mentality perhaps being detrimental to her success. Sadly, at no time did Oprah or Kirstie acknowledge abstinence from their drug(s): sugar, flour, and wheat. It reminds me of the addict who promises they will never take another hit, snort, or shoot up again, but without admission to the addictive components, rather only looking from a "will power" frame of mind. I was hearing diet and addiction mentality.

Michael Hebranko was different than Kirstie in that he was not a movie star bearing the glitz and twinkle. He reminded me of one of the first patients I saw in my early days of practice. He was wearing close to 1,000 pounds of weight like Michael. I made weekly house calls (back in the 90's when I was new in my profession) and conducted psychotherapy. He was a delight to work with. He understood sugar, flour, and wheat were drugs to him and agreed to abstain. He understood developing a spiritual connection to something greater than himself was the key. Like Michael, he dropped hundreds of pounds. When he was at a safe place weight-wise we agreed he would drive in for therapy. Instead, he began to binge. Again, like Michael, he put his weight back on. Unlike Michael my patient passed away. He was only 27 years old. Addictions are stronger and bigger than our will to stop using.

Michael, unlike Kirstie, was aware he needed to take one day at a time and practice recovery. He was no longer reaching for the "quick" fix. He was humble and focused. He seemed to have an understanding that certain foods were triggers for him, but I did not hear words of abstinence from these foods, particularly flour. He also recognized a higher power (he called God) as he kept referring to God in the interview and how thankful and grateful he was for this second opportunity to correct his weight. He released 300 pounds. Although he had several hundreds of pounds to go, he was focused on the here and now, working his program one meal at a time with progress not perfection. I think he will make it!

Although I personally never weighed more than one hundred pounds above my ideal weight, I can relate to both Kirstie Alley and Michael Hebranko. When I was in the food I promised I would stop. I too vowed to lose the weight and never binge again. I meant it! After I would drop some weight and start looking good I would fall into a binge. It was not until I realized I had to let go of the addictive foods in order to be free of the obsessions and cravings. It was not a question of will power but rather of letting go of an addiction to specific foods. As simple as it sounds it worked. My weight corrected and I am free of cravings. Many patients I work with also are free from cravings and have returned to their normal weight. I wish I could say they all followed my path, but truth be told, many are on the same ride as Kirstie Alley and Michael Hebranko, gaining weight they lost.

Statistics show about 5% of people keep off the weight they have lost for more than a year. And, those that have the weight off for more than 5 years have a better chance of staying thin. Thank you God I fall into this category! I believe Kirstie is setting herself up for failure vowing once again to wear a bikini in November and rushing to lose her weight. This is diet mentality. I did not hear the same diet talk from Michael. I heard a clear understanding it was a process that would take time. He seemed to understand eating balanced meals and taking one day at a time was the ticket to his recovery. Although I did not hear specific talk about spiritual recovery, Michael echoed some thoughts regarding God. Kirstie did not mention any spiritual understanding. Perhaps this could be part of her missing link. It is not about the food, nor is it about the weight. It is about having an addiction to food. It is about turning to a physical, emotional, and spiritual recovery.

So, as I finished watching Oprah’s interview with two very familiar stories it allowed me to reflect where I had been and where I am today. Their story is my story; however, I am on the flip side of it and live life free of weight, worry, and diet mentality. No more deer in the headlights. The answer is eating free of sugar, flour, and wheat and turning it over to a power greater than our own. This power can be whatever is fitting for each person. It could be God, energy, the sun, et cetera...



Photos taken by: Dr. Lisa Ortigara Crego

Eating Disorders and Certified Eating Disorder Professionals

Today is one of those glorious Sunday afternoons when the sun is out and the birds are chirping. It is one of those days where the world feels right and excitement, for no apparent reason, looms above. And yet, somewhere out there someone is suffering alone from an eating disorder. Someone is wondering when the binge will end and the weight will be released. That someone used to be me. It is a lonely, scary place to be.

Today I was reading an e-mail from The International Association of Eating Disorder Professionals (also known as iaedp) and learned something I was not aware of. To date, iaedp is the only organization in the world that certifies professional competency to treat eating disorders through its Certified Eating Disorder Specialist (CEDS) and Certified Eating Disorder Specialist-Nutritionist (CEDS-N) certifications (Cumella, 2009). There currently are only 104 CEDS or CEDS-N professionals with active certifications. Interestingly, I am one of the 104 certified eating disorder specialists, and yet there are 923,000 healthcare providers who can offer counseling services in the United States! How could this be? Only 104, or 0.01%, have a CEDS or CEDS-N!

More interesting, to date, there are 642 healthcare providers in the US and Canada who claim to specialize in eating disorder treatment; however, only 104, or 16%, have evidence of their competency to do so through a recognized certification program, the CEDS or CEDS-N (Cumella, 2009). This baffles my mind! Eating disorders are chronic, progressive, and fatal. We need more certified experts working with patients with such a deadly disease.

I read a few years ago that by the year 2015 if preventative measures are not in place we could see 75% of the population overweight or obese. This is a huge number! Think about it, 75 people out of 100 will be wearing extra weight. What will this do to healthcare? What is the answer? I believe we need to move closer to "real" food and further from "processed" foods. Sugar, flour, and wheat, along with high fatty foods seem to be the culprit, especially for us who suffer from eating disorders. And there are plenty of us!

Today, as a provider certified to treat eating disorders, I carry a qualification that few have achieved. It seems unthinkable there are 923,000 healthcare providers who can offer counseling services in the United States, and yet there are only 104, or 0.01%, certified as eating disorder specialists! I think what makes me most uncomfortable is learning healthcare providers are claiming to specialize in eating disorder treatment and yet few have the education, certification and/or authority to do so. The International Association of Eating Disorder Professionals is recognized for certification programs that train and prepare practitioners to deal with a disorder that is growing with each passing minute. Perhaps if the word gets out more and more will sign up to join the certified eating disorder specialists to help those suffering from eating disorders reach a place of recovery.

Although there are many hurdles the eating disorder professional must jump through in order to stay abreast to the ever-changing field of eating disorders, it is well worth the efforts. Every day I am reaching out and helping someone who is suffering as I had. Every day I know someone is dying from this disease. Every day I know I can reach out my hand to another and lift them out of their pain. Nobody has to suffer from this disease. There are answers and help that can take you to recovery. I know...I live in recovery every day.

It is no secret there are millions suffering from eating disorders. As I sit here comfortable in my own recovery on this beautiful Sunday late afternoon I wonder how many out there are feeling alone, binging, purging, or restricting today. I know I will be able to go to sleep tonight with no shame or regrets for having eaten foods that are causing me to binge, crave, or purge. Thank God I never purged with food, but I certainly did my share with over exercising and an occasional bout with laxatives. Just writing the words down makes me wiggle with discomfort. It is hard to believe a decade and a half ago I was really suffering and yet I looked so good on the outside. I was working a program for the most part...but then the disease would rear its ugly head with no warning. Tonight, I will be able to close my eyes and drift off to sleep knowing I am in a good place spiritually, physically, and emotionally.

References:

US Department of Labor, Bureau of Labor Statistics. Retrieved May 3, 2009 from http://www.bls.gov/oco/cg/cgs035.htm#emply

Academy for Eating Disorders. Retrieved May 3, 2009 from http://www.aedweb.org/public/results.cfm

Cumella, E. J. (2009). News for Eating Disorders Professionals. International Association of Eating Disorder Professionals. Retrieved on May 13 from: http://www.iaedp.com/

Photos taken by: Dr. Lisa Ortigara Crego

Sitting on the Dock: Pelican and Me

I am sitting on the dock with a mug of tea watching this very pelican and wondering if he(she?) was thinking about anything in particular. He looked so comfortable, like he didn't have a care in the world. As for me, I was close to comfortable, sitting with my hot tea on the very same dock I have sat on a million times for the past 40 years. Tons of memories flooded in. Like the time when I was on the edge of becoming a teenager and I helped my grand parents move into this very beach house.

I remember the first time my feet touched Florida soil and I knew I was home. I had no doubt this was where I belonged. It took many visits until I actually made the move and left my entire family in Chicago, as I was Florida bound. I was in my late 20's. Back in my formative years, I sat on this very dock in my bikini trying to tan and feeling fat. I was 115 pounds! I was already obsessed with sugary foods and dieting. I was already sneaking into my grandmothers chocolate coconut patties, mango marmalade, and whatever old candy bars I could find in the fridge that my grandfather had. I remember eating a candy that was on its way to turning into rubber. This did not matter...it was chocolate and it was sweet...and it made me "feel" better when I ate it.

I had no idea I was entering into binge eating disorder, an eating disorder that is still up for discussion in the DSM-IV-TR (the Diagnostic and Statistical Manual of Mental Disorders, 4th ed.). I also did not know I had food addiction, which is why when I put the sugar and chocolate into my mouth I instantly felt better; at least for a moment. The question that often arises from my patients is whether food addiction and binge eating are the same thing? I too asked the very question over and over.

What is food addiction? Food addiction involves engaging repeatedly in episodes of binge eating regardless of adverse consequences, while in aggressive pursuit of a mood change. Hmmm...sounds to me like they are intertwined to some degree. What is this aggressive eating? Well, it is the compulsion, an irresistible impulse, to eat a specific food(s), especially in an irrational state or contrary to one's will. The urge is about ingesting this food no matter what.

What is binge eating? Binge eating is eating a large amount of food in a small period of time regardless of the consequences. In my experience as a certified eating disorder specialist and as a recovering food addict, binge eating and food addiction go hand in hand.The Compulsion is always present in the disease of addiction, whether it is cocaine, vodka, or a chocolate bar. My research has led me to know the food addict has a metabolic, biochemical imbalance, which results in the characteristic symptoms of addiction. The foodaholic is obsessed with food (usually sugary, high fat, starchy foods) ingesting large quantities of these foods to destructive and/or negative consequences physically, emotionally, mentally, and relationally.

Given the definition of binge eating and food addiction, it is apparent they are intertwined in most cases. Could a person binge eat and not be a food addict? There are many eating disorder specialists that would agree one can be a binge eater without having a food addiction; however, an acctive food addict always binge eats. I am a food addict and I binged. Yes, binged...past tense. I am still a food addict but I choose to live life in recovery rather than in the disease. There is a price for my sanity: not eating sugar, flour, and wheat. It is a small price, given I have no cravings or irresistible urge to eat sugar, flour, and wheat. It is a small price to pay when my body is a "normal" weight and I am not going on and off of diets? It is a small price to pay when the insanity and chatter in my mind is completely silent, peaceful, and full of serenity.

So, as I am sitting on the dock, watching this pelican while sipping on my mug of tea, I think I figured out what my new feathery friend is thinking about. He has been watching the water intensely and as soon as he saw the little fish in plain view he made a beeline towards it and scarfed it up. He was waiting for food...but not the way I used to sit on this dock thinking about food 40 years ago. I was thinking about sneaking into the fridge and the pantry to steal the foods and then figure out where to hide it so I could eat it fast and furiously...and alone. My new buddy (the pelican) was looking for food as fuel...nothing more...nothing less. He was eating for survival. So...I sit here, comfortable and at peace for I truly have not a care in the world. Life is good!

Photo taken by Dr. Lisa Ortigara Crego