Eating Disorders - fieldi

Recovery Through Nutritional Counseling 41
We gradually increased the calories and Lisa started to gain
weight—for her, quite a lot. She did not eat all that was listed on
her food plan and still she gained 15 pounds, which was very scary
for her! What she absolutely hated was to get on the scale. It would
ruin her whole day and give us a good reason to start dealing with
this very hot issue.
By this time Lisa was no longer underweight. Physically she
started feeling better, but her clothes did not fit. She realized that
in the long run it was better for her to normalize her weight and
her eating. To do so she needed frequent reminders, motivation,
and support, so she increased the frequency of her sessions to
twice a week. As Lisa improved nutritionally, her bulimia improved
and became less intense; her physical craving for food diminished.
Still, she did not have total control. By increasing her awareness
of her emotional life, she began to realize how bingeing took the
place of dealing with upsetting situations. After much practice, she
was able to label these situations and her accompanying feelings,
and realize that under no circumstances would eating solve her
problems. Eating might temporarily numb her emotional discomfort,
but it would never help get rid of it. Thus she recognized the
importance of separating eating from feelings: Eating is what we
do when we are hungry; overwhelming feelings have to be
acknowledged and brought into therapy in order to bring peace or
resolution.
Because eating to numb uncomfortable feelings had been a bad
habit for more than five years, we had to come up with activities
that Lisa could do when she felt the urge to binge—a “substitute
list.” In the beginning she said, “It sounds stupid and like a waste
of time,” but the list assisted her in many ways. Even the slightest
act of brushing her teeth helped, because, afterward, she did not
feel like putting food in her mouth for at least an hour, enough time
to prevent her from bingeing.
Other coping ideas on Lisa’s list were going out for a walk, listening
to music, and drinking a large glassful of water to help her
feel full. In addition, Lisa would continually talk to herself about her
long-term goal—to stop purging! If she binged without purging, her
calorie intake would be excessive and that bothered her. All this
helped her to gain control.