My predisposition to an eating disorder started early, in much the same way I believe my predisposition to fibromyalgia started early. I was 11 when I started my first diet. Grade five or six. I embarked on this diet with the full in-my-best-interest support from my mother, may she rest in peace, who was also always dieting. Ever since, until about four years ago, I was either dieting to lose weight – or overeating and gaining. No in between.
But it wasn’t until after my fibromyalgia diagnosis in 2003 that I developed a full-blown eating disorder, for which I received treatment over nearly two years at the amazing Centre for Addiction and Mental Health (CAMH) in Toronto. Here are the 4 ways my fibromyalgia contributed to this mental health issue, and what I did about it.
1. A Hyper-focus on Food
After I was diagnosed with fibro, I worked with a nutritionist to help identify foods that were causing inflammation and triggering fibro flares. This involved keeping a detailed food diary: everything that passed my lips was entered into the diary. In the words of Weight Watchers, a weight-loss program with which I’m intimately familiar, “if you bite it, you must write it.”
We then embarked on an exclusion diet: I had a long list of foods to avoid, and we’d only introduce them back into my diet one or two at a time so we could track how my body responded. It seemed that every waking minute of every day I was consumed with consuming food: what was in, what was out, what it was doing to me, and what I was missing.
2. A Hyper-focus on Physical Response to Food
Along with tracking foods and beverages, I also tracked how I was feeling every two hours. Did I have abdominal cramping or bloating? Gas? Was I experiencing fatigue? What was my level of pain, on a scale of 1 – 10? Did I have a rash? Was I itchy? Did I have phlegm in my throat? How about brain fog? What was the quality and duration of my sleep?
The good news is that this process identified that dairy causes a significant buildup of phlegm in my throat and sinuses and causes me to choke. And that eating wheat is followed by a sharp increase in fatigue. Soy promotes general inflammation, and caffeine seriously inhibits a good sleep.
3. Pre-occupation with Weight
I’d always been somewhat preoccupied with my weight, but after my fibro diagnosis, I started to really fixate on it. I’ve always hated how my body looked, regardless of how much I weighed, but the illness gave me another reason to lament the extra weight. Now I could also tell myself the fibromyalgia would ease up if I weighed less. So I pursued more and more radical weight loss programs, looking for faster and faster results. I ended up at Dr. Bernstein and enjoyed an incredible 40-pound loss in about 2.5 months. That’s fast. I felt great. Alas, it was short-lived.
If you don’t know anything about the Dr. Bernstein weight loss program, I’ll share this. It’s a low-calorie, low-fat, low-sugar, low-salt and low-carb diet. Carrots were taboo because they’re too high in sugar. A bread serving was the equivalent of two Triscuits, and you could only have two bread servings each day. Six medium-sized strawberries was a fruit serving, again, limited to two fruit servings per day. It worked out to about 6-700 calories per day, with visits to the office three times per week. At each visit, I’d get a shot in the ass or the tummy… I think it was vitamin B12. I was covered in bruises.
4. The Cravings Rebound
For the first couple of months, I was doing okay. As long as I was following the diet and getting those shots. Then I started suffering these massive cravings: my body was rebelling, driving me to eat carbs, sugar, and protein. But I felt like a failure because I couldn’t stay “on program”. I started gaining some of the weight back, stopped attending the appointments, and started hiding my eating from my family.
Over the next two years, I put all the weight back on, feeling horrible on the inside, and increasingly worried about what others were thinking about me and my yo-yo weight. And what I know now is that my relationship with Dr Bernstein has damaged my metabolism: already primed to fear an impending period of starvation, the Dr Bernstein plan really threw my body into protection mode: it now holds on to every little bit of energy as it does its best to protect me from the next bout of starvation. 🙁
My 2nd Try
I was getting re-married in a few months and couldn’t stand the thought of having pictures taken when I was overweight. So, once again, I started the most radical diet program I could find, digging deep into my pocketbook to re-join Dr Bernstein. Once again I had great success, dropping all the weight I wanted with a few weeks to spare before the wedding, scheduled for early in the new year. I bought new clothes, and we took a trip from Toronto to Vancouver to visit family and friends. I posed for pictures without a care.
But oh man did I eat! Chocolates, desserts, hamburgers, omelettes, you name it. I couldn’t control what I was eating and at that point, I didn’t want to. It was all so delicious and my body just screamed for it.
I Couldn’t Stop
It was about six weeks after our wedding that I started to get scared. I simply could. not. stop. I lay in bed one morning, afraid to get up because I knew I’d head straight for the kitchen and eat whatever it was I was fixating about at that moment. As I lay there, now knowing what to do, a story came on the radio that caught my attention. It was “eating disorder week” and there was a public open house down at CAMH. I called in sick to work and headed to CAMH instead. I listened to a few presentations and signed up for treatment.
Eating Disorder Treatment
My eating disorder treatment consisted of weekly group sessions where we addressed binge eating. We learned and practised mindful eating, and I unpacked all the ways my mindset around eating had become disordered.
Specifically, I learned how to:
- Stop catastrophizing about my weight, and about anything else
- Stop worrying so much about what other people thought about my body
- Give up on the all-or-nothing thinking that took one bite and turned it into a binge-eating session
- Pay attention to what I was eating and why I was eating, and
- Stop using food as both punishment and reward.
But the biggest thing I learned was how to identify my emotions. I had developed such a self-protective stance around my emotions that I was unable to identify what emotion I was feeling at any given time. I was terrified of the power and pain of my emotions and was using food as a mask. Those treatment sessions taught me not to be afraid of my emotions, and how to “be” with them and ride them out. Without food.
Today food plays a big role in how I manage my fibromyalgia. But my food management is now from a purely nutritional standpoint rather than a body image one. Dairy still makes me choke. Wheat still causes fatigue. I feel better when I am eating lots of dark green leafy veggies. It’s no longer an unhealthy relationship. I no longer binge eat. I’m still overweight, but I no longer obsess about it or worry about what others think. I’m content that I’m doing my best to manage my health, and I’m okay with that.