Eating Disorders - fieldi

28 Recovery Through Nutritional Counseling
to the first hunger signals by eating complex carbohydrates (bread,
rice, pasta, and so forth), these cravings for sweets can be minimized.
The person who remains skeptical about converting to a diet high
in starch should consider the following: Several years ago, overweight
students at Michigan State University each lost an average of
14 pounds after being fed twelve slices of bread a day for eight weeks
and instructed to eat whatever else they wanted. More recently, at
Hunter College in New York City, students who ate eight slices of
bread a day for ten weeks—plus whatever else they wanted—each
lost about 9 pounds (Reiff and Reiff 1992). True, students may have
been making a special effort to cut back on their food intake to
ensure that their weight loss efforts would be successful. But one
must take into account that bread, like other starchy foods, has a
stick-to-the-ribs quality that satisfies as well as satiates in about
twenty minutes. Because complex carbohydrates contain no fat and
only 4 calories per gram (fat has 9), complex carbohydrates will also
give energy rather than be stored as fat.
Lesson 4: Exercise
It is hoped that use of the food-intake sheets has become a habit by
now and that some patients have started to feel comfortable filling
in the “feelings” column. We are not referring to all feelings, just
those that are food-related—like feeling too full, being aware of not
eating enough, or experiencing guilt over bingeing or purging.
At this stage in treatment, exercise should be discussed, especially
if the patient is bulimic or a compulsive overeater. Why do we need
to exercise? How often and how much exercise is necessary to stay
healthy? Because the eating-disordered patient tends to be a compulsive
exerciser, what is normal and how much exercise is needed
for weight loss needs to be established. In order to have a body—or
specifically, a heart—that is at the same biological age as one’s
numerical age, one needs to exercise aerobically three to four times
a week for thirty to forty minutes (Bernardot 1992). For weight loss,
exercising five to seven times a week for forty-five to sixty minutes
has been recommended. I discuss exercise with the patient because
it can help her feel better about herself. If she is not exercising
enough, she will in most cases feel healthier by increasing her phys-