Lil Miss Fitness Freak

"And though she be but little, she is fierce"


2 Comments

Exercise As Part Of Treating Eating Disorders? Fitness Friday 35

Well ain’t that a controversial topic for discussion….

In the spirit of this week being #Eating DisorderAwarenessWeek, I thought I would bring that into our lil regular Friday Fitness chat.

ed-awareness

I knew it would be a big deal. I know that many will not agree with my words, but hear me out, have you ever thought that treatment and exercise could co-exist when looking at eating disorders?

hmmmm

I know what you’re all thinking.

Exercise is a method to fuel eating disorders

Exercise is a means of dropping weight and burning too many calories

How the hell is exercise going to help put weight on when clearly it just increases their energy requirements?

This is why this topic is a great one to discuss.

The points above are completely valid. In fact, those are the beliefs that many professionals give or yell if the thought of exercise is brought up.

Take me for example, during my short time at the Oakville outpatient program for family therapy, it happened to slip out that I was going to be starting to slowly get into training (this was a few months post-inpatient) and my therapist freaked the eff out. Like I’m not kidding, she actually called my house and my parent’s cells and left frantic messages saying  “Chelsea is not to workout!!!!”

Not that her words stopped it from happening, and honestly, we left that place faster than we came in (not because of that incident, but a bunch of other things..), but I’m just trying to give you an idea of how most clinicians feel about this topic

I.e. They are mostly against the thought of exercising.

no-exercise-today

…or ever…

Like I said, these arguments are all valid concerns and I see where they are coming from…

~I was a compulsive exerciser

~Most use it as a way to burn more calories and loose weight

~Most don’t know limits or when to stop

~Many can let it consume them and take over their lives

So I will say again, I understand their fears, but look at it from another perspective. When you just say NO and/or NEVER AGAIN, where does that get you? It teaches the individual nothing about control or other benefits aside from the superficial ones. It tells them that they have lost a free right to do something many people do. It places restrictions on them, which can lead to them deciding to go and do it anyways. Lastly, it prevents them gaining some of the many benefits you get from exercise that can be critical to the health of a person struggling with an eating disorder (*provided they are stable enough to perform exercises) such as bone and cardiorespiratory strength, helping with psychological disturbances, distraction from nagging negative and obsessive thoughts and potential social opportunities.

There are many people I have seen who have gone from treatment to the gym and are strong, independent people who are in control and did not slip back into old habits. They successfully took their health into their hands and chose to use exercise as a way to ‘come back’ and heal. A way to gain strength when their body was so weak before. A way to build confidence in themselves and eventually find that the gym is more than a place to burn calories. It’s gives them a place to deal with their emotions and re-build themselves physically and psychologically.

brain-on-exercise-final1-385x385

So with all of that being said, I wanted to present you with some research on the topic and how these types of interventions have faired in the treatment of eating disorders. I mean, you have heard my story and I could give you anecdotal evidence of the possible benefits for some, but does it actually show more pros than cons in treatment settings?

Lets find out.

To be honest, I was shocked at the number of articles I actually found. I still believe most are completely dead set on NO EXERCISE but there was a surprising number of studies and pilot programs in treatment facilities exploring the use of exercise as intervention. 

I will stick to the main findings of each study and link each so that you can read more if you desire. I am also going to label them in order of earliest to latest. Lastly, I could have found more, but for the sake of your attention span, I left it to these interesting ones.

Thein et al (1999) –> “Pilot Study of a Graded Exercise Program for the Treatment of Anorexia Nervosa”

Main Findings: With the addition of exercise (amount based on % of ideal body weight IBW), the experimental group (diagnosed with AN) showed no difference in change in BMI or body fat, suggesting that the exercise did not inhibit the primary goal of weight gain. The EXPT group also saw a general increase in quality of life measures while the control saw a trend downward from their initial testing.

Szabo and Green (2002) –> Hospitalized anorexics and resistance training: Impact on body composition and psychological well-being. A preliminary study

Main Findings: Study included a non-AN group (exercise group and non-exercise group) with a group of girls currently in an inpatient facility for AN (exercise and non exercise groups). They were both on an 8-week training program of resistance-based exercises. There were trends found for the psychological variables, however it was speculated that perhaps 8 weeks was not enough. Interestingly enough, there was no decrease in weight of the ED-exercise group but a significant drop in those not in the exercise group.

Lutter and Smith-Osborne (2011) –>Exercise in the Treatment of Eating Disorders: An Alternative View

Main Findings: Exercise was significantly associated with greater improvements in eating disorder and depressive symptoms where the number of METS was associated positively with improvements in the measures of depression (BDI) and eating disorder behaviours (EDI). This study was interesting because the exercise was equine based.

Hall et al (2016) –> Use of yoga in outpatient eating disorder treatment: a pilot study

Main Findings: Adolescent girls (all met the requirements for AN/BN/EDNOS but were clinically stable) in an outpatient eating disorder treatment facility attended 12 yoga classes at one class per week. After the intervention, there was no decrease in BMI and significant improvements in anxiety, depression and body image disturbance scores. 

I did a yoga class or two when I was an inpatient at Sick Kids. This was for the advanced stages only but was a nice change of pace. Definitely saw first hand the mood enhancing features. 

This article by Hausenblas et al (2008) also provides a good overview of 6 further studies showing the benefits of exercise based interventions in eating disorder populations on social, psychological and biological factors if you’re interested in even more reading 😉

Finally, here is an article, Bratland et al (2009), that discusses how exercise based programs are managed in treatment facilities and how many places actually have them! It was limited to a few countries in Europe, but can provide some insight for how they could be implemented and managed here.

So…

To conclude, many articles find that there are benefits to exercise in both outpatient and inpatient treatments for eating disorders. Also, rarely did any study (I didn’t find any) report negatives (such as weight loss or stalling the weight gain process) of incorporating exercise into the programs.

I want to say that, yes I know it may take more work and there will have to be strict guidelines in place, like ensuring they are stable enough to participate, etc, but from what I see from research and from my own experience I definitely think that it would be something to really look into further and do more pilot studies on.

Weight gain is already hard enough, try to make it easier on us all. Plus, by being exposed to it in a controlled setting it can also help to make the transition back to ‘reality’ potentially more smooth.

Something I would like to know is if incorporation of exercise during treatment can lower the risk of over exercising or going back to negative exercise habits when they are discharged. 

What are you thoughts?

-Chelsea


7 Comments

But I’m Not Hungry…

But are you REALLY not hungry?

why-am-I-always-hungry

My friends, a post I read the other day a la My Little Tablespoon struck something in me. It inspired me to discuss the topic of hunger signals because it has been something I have learned over time as well. Her post was quite interesting for me as it explains some of the weird things that come along with recovery. She spoke about how sometimes you feel as if you are back to being a child and feeling vulnerable and fragile. When you choose to move forward against the ED is when you feel fear like a child who is facing a monster.

You come to realize that as you grow you are bigger then that monster and have to use your voice and your strength to shrink the monster into the small bully it really is. It was quite the thought provoking read to say the least, so, Cora, I thank you for that.

The other thing that stood out to me was this line

I don’t get the typical physical hunger ques of a growling stomach, but I knew I was hungry because I was having the hardest time focusing and felt extremely lethargic.

Maybe this thought hit me harder because of what happened yesterday during my restaurant. Yes, hell day was yesterday (my groups day to run the restaurant at University) and although it turned out pretty good in the end, there was a hiccup for my own health that really just did not sit well with me.

So heres a quick run-down of yesterday.

You see, I’m not allowed to eat during service (i.e. between the hours of 10:30 and 2:30 basically). I asked my prof/chef about eating and he said if you ever need to step out then it’s fine but yet the one time a manager of the restaurant day sat down to have a quick bite after working away for like 7 hours, she immediately got harped at.

You know it doesn’t look good for a manager to be eating while others are working….

Basically us managers don’t eat until everything is done (despite everyone enjoying ‘staff meal’) and if you don’t get up now your mark will suffer. So after one bite and a flush of embarrassment across her face, she ran back in to the kitchen until shift was over which was more then an hour and half later.

This is what happened to me yesterday, except, those feelings of lethargy are so much stronger for someone who is underweight and I actually began to get concerned for myself. Long story short, I had been prepared, I did eat a meal before service (despite it being secretly done in the bathroom and woofed down so fast I don’t think my body recognized it was food..), but after running around the kitchen for 5 hours I was left feeling very hungry around normal staff meal time (1:30)…The hunger pangs stopped but then on came the light headedness and tunnel vision.

I need food, like now…

So this brings me back to the topic of hunger signals others then physical hunger feelings.

So yes, this may be an extreme example to start with to explain my thoughts on this topic, but it was just the other effects that occurred besides the actual hunger feelings that got me thinking about it.

So physical hunger aside, there are times that you think you’re not hungry but your body fails to agree. It is getting low in fuel and is ready for some food and if for some reason it can’t growl at you, other signs begin to surface that show a lack of sufficient energy.

feed-me-right-meow-feed-me-plzzzzz.jpg

So what’s with the lack of physical hunger you ask?

In many cases of disordered eating or even dieting, natural hunger signals may become skewed or non-existent and thus cannot be something to rely on. For me, despite generally feeling that hunger almost always, there are times where I don’t feel hungry and instead, I just feel sleepy, unmotivated and unfocused. Often for me, that is the result of gas and such (sorry TMI) due to the increases in food and my IBS kicking up a fuss.

I used to wonder why I didn’t feel this insatiable hunger all day long on some days because I work out so hard. Now I know that perhaps my hunger cues still need time to come back around 100% in addition to the fact that my hunger may be masked by other things. I have also come to learn that there are other obvious cues that I need food and that I just need to be aware when they start to present themselves.

You don’t need the tummy grumblies to signal you to eat.

This hopefully isn’t a forever thing but unfortunately when you restrict at some point in your life, this throws your hormones off balance and thus those triggers may be absent. So instead, it becomes vital that you cue into your other signs in order to keep your body humming away. Some of these include:

Sudden tiredness

Tunnel vision

Unable to process information

Lack of concentration

Sudden irritability 

Sudden cravings

Feeling snacky

Etc.

Etc. 

I say time and time again, your body is smart. If your main cue of hunger is screwed up, your body comes up with other methods BUT most of us are just not in tune with our body enough or unaware that these are cues of hunger.

So what to do if your hunger cues are not so loud?

Listen to your body more. Sudden drops of blood sugar (aka I’m fasting right now and feeling hungry) can manifest themselves in those above symptoms. Try to practice and learn to dissect your feelings rather then waiting for hunger pangs. This takes time and practice, but becoming in tune with yourself will come.

Eat more often. If you’re on the go, have some snacks (remember balance! Not just a piece of fruit here unless you really have no other option) and eat one if you are coming on 3-4 hours after a meal unless  you’re stuffed.

Get on a schedule. I know this seems like a weird tip considering I just said to listen to your body but hear me out. If you have lost your hunger cues then a schedule may be what it takes to regulate your feeding enough for it to start to signal you again. If you actually get hunger signals then by all means EAT but when you are still in the stages of trying to regain your bodies natural patterns, you may need to consider this.

Finally, you need to be patient. Your body isn’t an elastic band that can just return back to normal. If disordered eating (or another disease/illness) had mad those signals silent, give your body some time to come back around. It needs a lil wine’in and dine’in before it will show you some love back.

So think about it. Do you always feel hunger or do you eat sometimes because you know you should?

This is important for me to know especially now that my stomach may put up a fuss more often due to the caloric increases so frequently.

What would you do if you had a very long class but wasn’t allowed to eat. Do you think that is right?

-Chelsea


4 Comments

Safe Fear Foods?

Monday thoughts coming at ya as I just finished my first exam this morning at 8:30am…and I’m slightly exhausted..and needed to mentally drain and recharge. So, to do so, I spent most of this afternoon gymmin it up (as usual 😉 but Rita came along too this time!), taking a much needed nap, eating some lobster for dinner and now chattering with you.

Hope that’s okay with you all. 😀

My exam was my online course and to be quite honest, I now officially know that I really dislike online courses because I just can’t be bothered to keep up with the readings…

Which leads me to cramming more then I would like for the exam.

Ugh.

I think it went fine, but I just don’t like how much more effort I had to put into studying for it then was really needed if I had kept myself on top of the four gazillion readings each week.

Do you like online courses?

Anyways, the reason for this post was a link up with zee typical Recovery Round-Up courtesy of Lord Still Loves Me.

recovery-round-up-lord-still-loves-me-link-up

I really like doing these because it creates a safe outlet and a pool of resources. Not to mention, it’s where we can share our challenges (so that we can get assistance and loads of support and love to get through them) and our wins.

Much love to our hostess, Julia, for starting it up.

I made some progress this weekend.

I had my #CheatMeal and it wasn’t ice cream.

….and yes I shouldn’t be calling it a cheatmeal or anything really, but that what those ‘eating out once a week’ meals are to me as of right now.

IMG_8331

‘Naked’ elk burger with goat cheese, sundried tomatoes (OMG!), sautéed mushrooms and onion, spinach and lots of mustard and franks hot sauce post picture. Devoured (cuz leg day…) fork and knife style along side a pile of ‘weeds’ or their house salad with added beets (cuz I love them and it reminds me of Chucks Burger Bar)

I had been wanting to try the elk burger at The Works for quite some time now but just always went with my ice cream. One, because I love it and Two, because it was ‘safe’

Safe?

So does that mean I have officially gotten over my fear of ice cream?

Sadly, no.

Instead, it has become more of a habit. One that I’m getting better with, but still have some guilt. So it’s really become a safe fear or safe cheat if you will.

That is what I wanted to talk about today, is this idea of ‘safe fear foods’

because as weird as that sounds, they do in fact exist and make some level of sense.

IMG_8252

A fear food is one that gives you great anxiety.

It over consumes your thoughts when you are going to have it.

For me, when I first started my #IceCreamChallenge every Friday I would legit start to worry about having it on the Monday before. I would start thinking that:

I must be unhealthy because I want something that is not good for my body.

I should be ashamed because I’m not eating healthy

What if this makes my stomach hurt?

What if I feel way too full…

Does that mean I had a binge?

Does 2 scoops of ice cream mean I had a binge???!?

Normal people don’t need 2 scoops of ice cream…

I must then conclude that I’m an unhealthy, weak, elephant and I should feel bad.

Sounds awful now that I write it on paper…err…share it to the internet world.

Now, 4 months later, some of those thoughts are still very apparent but the physical anxiety (sleeping issues, tight chest, etc) have mostly been non-existent.

You may think that is a good thing and maybe I’m making progress, and yes, that is progress in a sense (less guilt), but I was given a harsh reality kick when my housemate begged me to finally try the burger place out (which I swear I did really want to try!) and made me break my weekly habit of indulging in my safe cheat.

And so, the over consuming thoughts began once again.

693307b83c0acc697a9bbccd142a7387

So, that leaves me with the question:

Have I actually made progress in accepting the ice cream as something I CAN and DESERVE to have without guilt

OR..

Have I become more desensitized to it and that is why I’m mentally handling it better?

I pondered. I pondered some more.

I concluded that I think it’s a bit of both. Yes, it’s a habit and for the person who doesn’t like change, when change does occur, I become all kinds of freaked out once again.

This means I have to challenge myself and try out other ‘fears’.

But that doesn’t mean I should give up my ice cream either because I do think I’m actually starting to believe, just a lil bit, that I can have ice cream because I like it.

Also because when I skipped it for 2 weeks, the anxiety popped up again…Damn ED.

So yes, you can have fear foods that are deemed safe in your eyes. They are habits that you have formed and that makes you feel safer eating them. The challenge is to realize that this is true (instead of saying you hate everything else…) and step out of your comfort zone to make yourself feel uncomfortable once in a while.

I will have to return to The Works soon, one because I want my parents to try it (they love Chucks just as much as I do) and two because I did enjoy it and I shouldn’t restrict to simply one choice of things I enjoy.

206532332881195952_kftvffh4.jpg

To end on another positive note…

I kept the addition of the sautéed mushrooms and onions on my burger order despite them telling me they were cooked in a bit of butter.

Butter is something I haven’t touched (knowingly..) since I was forced to eat it in treatment. It’s a major fear for me and something I don’t think I will ever use willingly ever again.

I literally had a mild anxiety moment as the waitress waited for my response to her question…

Do you still want them?

Yes, yes I took them because a burger is not a burger without those mushrooms and onion in my eyes. I resisted the urge to not be satisfied with my order due to that component. That is where the majority of the guilt stemmed from for that meal and hopefully the next time I will not be as anxious.

Baby steps, but this week I challenged my safe fear food place.

…and I won.

-Chelsea


7 Comments

Support Makes You Strong

Trees.

15491712-strong-deep-business-roots-as-a-tree-trunk-with-the-root-in-the-shape-of-a-hand-shake-as-a-symbol-of

We see those huge, beautiful trees as something so strong. Something so proud. Something so rooted in its place in this earth.

Trees not only provide us with the breathes of life, but they also provide support for the many ecosystems that surround them.

You know what though?

A tree wouldn’t be able to serve those purposes if it wasn’t for the aid of the system around it.

It wouldn’t be around without the pollinators that spread those very seeds that brought it to life.

It wouldn’t be alive still without the microorganisms that break down organic materials to give it nourishment.

So if something that is the picture of strength and wisdom needs support to be able to keep thriving, why is it that when we ask for help we perceive ourselves as being weak?

Everyone needs support, whatever magnitude that may be. Asking for help NEVER signifies that you are incapable. Never says to others that you are a failure.

Sometimes, asking for help can make you one of the strongest people out there.

7406f27110a56c57e930371c1780c9fe

So you may be asking yourself why the hell I’m rambling on about this. It’s pretty random.

Well I am random….

I’m also randomly bringing this up because it’s something that I have had to come to accept throughout my recovery process.

I never used to like asking for help. I’m an internalizer and so I tend to keep my thoughts, worries, conflicts, etc to myself because I feel like they were my own issues to deal with

Why burden someone else with my problems if ….

…they only affect me…

The problem with that statement is two fold.

For one, I have associated negativity with the love, comfort and support that another person can give to me. Basically,  I felt as if providing me with support was some sort of favour they were doing for me or that they felt pity on me so they would do it not because they wanted to, but because they felt compelled to.

I have come to realize that this is not true. People don’t want to see you struggle. I have this urge in my self to speak up and help others if I feel I can in any way. I think sometimes I should refrain as I may be overstepping my boundaries, but the point is that we don’t like to see others hurt or stuck in a state of confusion if they don’t have to be.

The second issue is that second part. “It only affects me.” This is far from the truth because if you are struggling, the chances are that it will negatively impact anything further you try to do because you are occupied. You’re stuck either dwelling on something, hurting or just not knowing what move to make next. This inevitably affects not only you but anything else you try to do and anyone else you try to interact with.

So what does all of of this have to do with recovery?

I think that this is an important lesson for everyone to learn, regardless of their struggles in life…

You must learn and accept that one has be vulnerable in order to grow as a person.

But this vulnerability becomes even more important during recovery as you have to come to the realization that sometimes you’re just too tired to keep fighting and it’s in those moments where ED feels that he can creep back in a take you back.

It is in those instances where you need to ask yourself…

Does strength mean risking my recovery because I should be able to continue to fight when I’m completely mentally exhausted?

Or

Does strength mean admitting to someone else that you are having a rough time and just need a lil bit of support so that you can re-charge and blast forward once again?

e357a4f5ff993320c2235f3bea81dd4a.jpg

I know what my answer would be, what is yours?

 Linking up once again to Julia’s…

recovery-round-up-lord-still-loves-me-link-up…on this cold ‘gah it’s officially winter’ Monday.

Thank you so much to Julia for hosting such a positive and helpful resource partaay.

Have a great start to your week friends!

When was the last time you asked for support? this weekend when I ranted on discussed my struggles this week with body image with my Mom.

Who is your go-to? My Mom ❤

-Chelsea