An Unhappy Birthday

I’ve never really liked birthdays. In fact, I grew up dreading them. My mother almost always forgot the occasion. Relatives I hated swarmed in from out of town. People watching me eat meant I had to eat more. I felt I didn’t deserve any of the presents I received. The passage of time made me anxious about how little I’d accomplished. I frequently spent the day in a hospital of some sort. And then there was the cake.

The cake! Oh god, the cake! The cake was the worst part. I’d spend all year worrying about the cake, planning for the cake, calculating how many calories were in the cake, devising ways to compensate for the cake. A slice of cake had 1000 calories, right? So, if I ate nothing else that day, I could have half a slice and not gain any weight, right? Or I could eat normally and exercise for five hours to burn it off? Or I could purge it? No, that would only get rid of 30% of the calories, providing I did it properly, and I’d still have 666.66 calories in surplus. What if I restricted for two days before? Could I have a whole slice then? Or could I just have a bite? How many calories were in a bite? Or a tiny bit of the frosting? Just a lick! That was my favourite part anyway. But there would be crumbs on the frosting. How would I account for those calories? It wasn’t worth it. I just wouldn’t have any. But I would exercise extra anyway—just in case, to burn off the cake I didn’t eat.

That was my birthday every year, and it was miserable. Like many people, I used birthdays as an opportunity to beat myself up, to get down on myself for all the things I hadn’t done, for everything that I wasn’t. The event emphasised my biggest insecurities—failure and fatness—and I spent the holiday punishing myself for my ‘obesity’ and ‘idiocy’. Needless to say, it was not much of a celebration.

It was my birthday last week, and although my circumstances were not ideal, I tried to make the best of it. I bought myself a book I wanted. I didn’t receive many other gifts, but I’m glad I have this text for my research. I attended two dance classes. They weren’t the challenging jazz ones back home at Pineapple, but they gave me an opportunity to work on my technique. I redeemed my birthday reward for a free drink at Starbucks. Maybe I ordered my hot chocolate with nonfat milk and scraped the whipped cream off in a panic, but at least I challenged my fear of liquid calories. I spent some quality time with my cat Katherine. It was sad not to be in London, but Katherine is so adorable and sweet. I stopped at my favourite bakery. My cake was delicious even though my friends were not there to share it with me. Did I have the best birthday ever? No, not by any stretch of the imagination, but I know that I’m lucky to be alive having this birthday at all.

Birthdays can be hard, I know. You don’t have to like them, and you don’t have to celebrate them. You can treat them like an ordinary day if you want to! Just please, please don’t use them as excuse to hurt yourself–mentally or physically. Acknowledge who you are and where your at. You may not be who or where you want to be, but you are someone, somewhere. I hope you can appreciate that.

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Disclaimer: This cake was from the Saturday before my birthday. I enjoyed a chocolate cake on the day itself, but the icing smudged on the bus trip back to my flat, and consequently I didn’t get any good pictures.

“Am I Dying?” and Other Hunger-Related Questions

Hunger is a tricky thing for people with eating disorders. We’ve disregarded it for so long that we forget what it feels like. I, for one, ignored my hunger until it became a perpetual part of my reality. I started experiencing it again in recovery, and I was honestly so confused; I kept asking my dietician “what’s happening to me? what am I feeling? what is this? am I dying?” Today’s post answers these questions and more. Read on to learn about hunger:

Question: What is hunger?

Answer: Hunger is the physical sensation generated by the body when needs more nutrients. It is caused by hypothalamic processing of the hormone ghrelin (lenomorelin), which is secreted by gastrointestinal tract in response to blow blood glucose levels and/or an empty stomach.

Q: How do you know if you’re hungry?

A: We all know about the obvious stomach growling, but hunger can manifest in many other ways, too. Symptoms include a churning, hollowness, or tightness in the stomach, lightheadedness, dizziness, or fainting, headaches, muscle cramps, shakiness/jitters, rapid heartrate, exhaustion and fatigue, irritability/agitation, lack of concentration, and even nausea.

Q: What should you do if you feel hungry?

A: Generally, if you’re hungry, you should eat. Exceptions include if you are fasting for a surgical procedure, on a meal plan that dictates your intake times, or have been otherwise advised by a medical professional not to do so.

Q: Why are you hungrier on some days than on others?

A: Hormone, activity, and stress levels can all influence your hunger. For instance, women tend to require extra nutrition prior to their menstrual periods (on account of increased calorie expenditure), and cardiovascular exercise has been shown to stimulate appetite. Growing children will also consume more calories than average, and studies have shown that lack of sleep leads to inversely proportional food consumption.

Q: What if your hunger can’t keep up with your metabolism or vice versa?

A: A healthy individual’s hunger and fullness cues will be accordance with their body’s nutritional needs, and they will eat enough to maintain a healthy weight at a reasonable activity level. Of course, this is not the case for all people; a number of factors including metabolic syndromes, chronic dieting, eating disorders, autoimmune diseases, certain medications, and economic factors can disrupt the body’s natural rhythm, resulting in skewed conditions on either side. In such cases, dietetic services are required to prevent and treat the effects of malnutrition.

Q: How does hydration affect your hunger?

A: Apparently, 37% of people confuse thirst with hunger. This is primarily due to the lack of stomach volume presented by each.

Q: How do you know whether you hungry or thirsty and what should you do about it?

A: At times, hunger and thirst present with similar indicators, notably dizziness, fatigue/exhaustion, headache, nausea, muscle cramps, tachyarrhythmias, and stomach churning/emptiness. Thirst is often accompanied by the following differentials–dark urine, dry mouth, and perspiration. If you are thirsty, you should rehydrate with fluids or eat foods with a high water content (like melon). In the past, dieticians have advised patients to drink water fifteen to twenty minutes before a meal to make sure they are actually hungry, but due to frequent disordered manipulation of this guidance, doing so is no longer a common practice; instead, nutritional professionals recommend you hydrate throughout the day and honour your hunger signals.

Q: What is emotional hunger and why wasn’t it mentioned above?

A: Emotional hunger is a psychological craving for a certain food. It was not included in the above designation, as it is a separate biochemical process. Emotional hunger is a psychological phenomenon while physical hunger is physiological.

Q: How can you tell if your hunger is emotional or physical?

A: While both physical and emotional hunger can make you crave certain foods, they are very different in nature. If your body is craving something, it is because it needs a specific nutrient contained therein; any food containing that nutrient will satisfy it, and your craving will subside. In instances of emotional hunger a food is desired on account of its associations; that food and only that food will do. Emotional hunger also tends to be accompanied by a (typically negative) emotion; it comes on suddenly and does not respond to physical hunger/fullness cues (the processing and secretion of the hormones ghrelin and leptin respectively), leading to an over- or under eating of the specified food.

Q: What should you do if you experience emotional hunger?

A: A little emotional eating won’t hurt you. It’s perfectly normal to celebrate your promotion with a slice of cake or to pick up pizza from your favourite restaurant after a bad day. Just don’t make it a habit. Food can facilitate celebration and comfort, but it is not (and never should be) a substitute for actually dealing with your feelings.

Is there anything else YOU want to know about hunger? Drop your questions in the comments below, and I’ll try to get back to you as soon as I can. Have a delicious day, everyone, and Happy Spring! xo

Our Unhealthy Bodies Can’t: The Problem with Project Heal’s New Campaign

“My Healthy Body Can” is the title of Project Heal’s new campaign. In conjunction with Straight Curve Film, the organization is encouraging participants celebrate their recovered bodies by posting pictures of themselves engaging in various (presumably physical) activities that they are now healthy enough to enjoy. The endeavour and its endeavourees are admirable, but there are some very obvious issues here.

This is a remarkably ableist, exclusive, and offensive campaign. With its tagline, “My Healthy Body Can” this movement neglects and excludes a huge portion of the recovery community–the chronically ill, the disabled, individuals who settled at unconventional body weights, and those with irreparable damage done by their eating disorder. What about them? Their unhealthy bodies can’t. Does that somehow disqualify them from celebration? Does that deprive them of support? Does that discredit their achievements? Does that discount their recoveries?

It shouldn’t. They have had to fight even harder for recovery. Treatment resources are harder to come by, care is more expensive, certain problems are taken less seriously, and every day is a struggle to balance the mental and physical components of their recovery. Some of of them will never recover from their eating disorders; some of them literally can’t.

I am one of those people–one of the unhealthy, one of the excluded, one of the perpetually sick. I will never recover from my eating disorder. I have incurable cardiovascular, endocrine, reproductive, digestive, and metabolic damage from ten years of severe anorexia. I suffered a heart attack that has led to irreversible myocardial tissue death and dangerous tachyarrhythmias, which will only get worse; I do not get periods, have a less than optimal body fat percentage, and can never bear children; I eat a specialized diet of 4000 calories a day, catered to my numerous acquired food tolerances and permanently low electrolytes, to barely maintain a below minimum BMI; I see doctors weekly, exercise daily, and take medications (nearly) hourly to keep my liver running, my kidneys working, and my heart beating, but, despite all that, I will someday need transplants anyway. My body is not and never will be healthy, and because of that, there are many things I cannot do. Maybe you can ride your horses and do your yoga (thank you, Amalie Lee for that gem!), but I’ll be here in a hospital, hooked up to a heart monitor, trying not die.

So, Project Heal, I’ll ask you once again. What about us? I see you’ve replied to your dissenters with a copy-and-pasted link to a tokenistic (phrase borrowed from the wonderful Michelle Elman) blog post, but I think I speak for everyone when I say, that isn’t good enough. Please apologize, please revise your campaign slogan, and better yet, please help us. We want and need, deserve and demand change. Increased support and resources for the minority members of the eating disorder recovery community–for those of us who don’t have the perfect, conventional recovery–are essential. Our unhealthy bodies can’t, but we matter, too; we deserve help, too; and most importantly, we can recover, too.