Eating Disorders - fieldi

and allowing herself to consume a low-fat or normal-fat intake, she
can resume a pre-eating disorder state, that is, normal hunger will be
felt at regular intervals and she will be able to eat what normal people
are eating.
Dan W. Reiff’s graphic descriptions of these various hunger patterns
are illustrated in Figures 2.2, 2.3, and 2.4. This visual representation
of hunger is most helpful for the eating-disordered patient
because it describes where she is and what her goal should be. The
typical hunger and food-intake pattern of a person who has recovered
is what a young woman, who eventually responds to her body’s
signals of hunger, will experience when she starts to trust hunger.
Finally, what she has been longing and waiting for has become a
reality: She is at her normal weight, she eats when she is hungry, and
her weight is stable. A “healthy control” becomes a reality, and she
eventually trusts that she can reach the ultimate goal: to eat when one
is hungry; to stop whenever one decides one feels full; and, in between, not
to worry, obsess, or think about food.
Lesson 7: The Effect of PMS
Recovery Through Nutritional Counseling 33
Having an eating disorder can be extremely frustrating. Such a
person is often torn between trying to help herself get better by
eating and trying to lose weight to maintain control. She therefore
needs to feel empathy from a treatment team she can trust. She
needs to understand what has happened to her body in order to be
motivated to get better. One of the last obstacles to confront her in
her struggle to eat better is PMS (premenstrual syndrome). PMS
affects about 40 percent of today’s women for as many as ten days
to only a few before their menstrual period. Most of those women
affected feel bloated, moody, fatigued, headachy, and frequently
fat. The experienced “bloat” is the result of water retention that
can vary from one to seven pounds. It can be identified by tight
rings on a swollen hand. The increased moodiness is thought to be
related to hormonal changes; the afflicted patient frequently
describes it as going from seeing the glass half-full to seeing it halfempty.
It is also a time when the patient may regress in her treatment,
that is, she’s viewing herself more positively and realistically
but then PMS strikes and she again is questioning and criticizing