Eating Disorders - fieldi

herself. She frequently feels hopeless (“I will never be able to overcome
this eating disorder”). She experiences an increased need for
sleep and rest but rarely allows herself the luxury of listening to her
body’s signals; sometimes she mixes up the need for sleep, thinking
that by eating more she will have more energy to help her get
through the end of the day. Even worse, water retention during
PMS makes her feel fat. This immediately sends a message to her:
“Gain control and lose weight.” At the same time, the body has an
increased caloric need of about 200–350 calories a day (Wurtman
1989). Rather than listen to her increased hunger signal, she tries
to restrict herself and eat less—but then she pays a price. Because
she is not providing her body with the extra needed calories from
complex carbohydrates, later in the day her body starts craving
plain sugar. (Her body does not have the time to wait for complex
carbohydrates to break down into simple sugars, so now it
demands pure sugar instead.) This scares both the anorexic and the
bulimic patient. At a time when the bulimic patient thought she
might be over the hurdle and promised herself never to binge
again, a PMS sugar craving may lead to one last binge. Again, it is
important to listen to the body’s signals—they are there for a reason;
by listening to them and responding with the appropriate
action during this more difficult time (i.e., eating 200–350 calories
extra a day, mainly from complex carbohydrates), peace will follow.
About three days after menstruation the water retention is gone,
and she returns to her premenstrual weight.
Lesson 8: Expectations
Recovery Through Nutritional Counseling 37
Other matters need to be addressed in nutritional counseling, but
some issues may be adjusted to the patient’s knowledge, such as lessons
about proteins, fats, processed foods, vegetarian combinations,
eating out in restaurants, foods in social situations (particularly during
holidays), food myths, and so forth. No specific timing is
assigned to these issues. Rather, questions or problems should be
addressed when they arise.
Of great importance is that expectations remain realistic. When
a concern is mentioned in counseling, the patient has to allow herself
enough time to master the problem fully. For example, before