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I have an eating disorder (ED-NOS: bulimia, anorexia, binge/purge, orthorexia). I went Paleo 9 months ago, thinking that eating whole foods (plenty of fat, meat and low-carb veggies) and intermittent fasting would restore my hunger/satiety signals and heal me from my disordered eating patterns. I stopped counting calories and weighing myself. When I started Paleo, I was at a healthy weight (BMI 21)

A few days ago, I found out that I had gained about 20lbs during the last 9 months, making me overweight at BMI=25.7. This indicates that even though I was eating whole foods with intermittent fasting, I have been overeating. I think my eating-related signals are not normal. I don't know what real hunger feels like due to my anorexic tendencies; I don't know what satiety means due to my bulimic tendencies.

On Paleohacks, I was advised to stop intermittent fasting, so I started eating breakfast since last Monday. But when I start eating, I don't know when I should stop eating. I try to eat when hungry and stop eating when full, but I really don't know what that means. I am trying to maintain a healthy weight with long-term lifestyle changes. The 20lbs weight gain has made me overweight....(BMI 25.7). I need to lose about 10-15 lbs to optimize health and maintain that new weight. I want to be healthy and have a healthy relationship with food/eating for the rest of my life. I am NOT trying to lose weight rapidly. I just want to learn the skills so I can eat normally.

Please help me. Paleo has helped me learn about WHAT to eat.But due to my past ED history, I have to learn HOW to eat. How can I know when to stop eating and when I should eat?

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Forget your BMI. Tell your doctor that, because of your history with eating disorders, weight isn't your primary concern at this juncture. What's your actual body composition like? How do you feel? Are you able to do the things you want to do? Work on identifying your hunger/satiety signals, but don't make it about the weight :) – Aleen Jun 25 at 21:29

9 Answers

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How do you feel at this weight? I have anorexic tendacies, and in my 20's through my mid 30's i struggled greatly. After having my first child, with which i gained a net 80 lbs, i found paleo. I loved the way paleo made my feel healthy;although, i could never seem to get under 135 for a signifigant amount of time. I ran, i ran fasted, i learned aerial fabric dance, but i could not break through to a solid 125 (my previous 'fat' weight). I finally realized that my set point weight is just higher than what i was used to in my anorexic youth. I am 5'4", 136 lbs, & a size 6 now, and i feel more healthy than ever. I can run like i never would have been able to in my conventionally appropriate BMI, which, by the way, is right now a solid 23- borderline ' overweight'.

I think that, fundementally, we ALL need to take a step away and look at the standards we hold ourselves up to, and see from where those standards originate. Are they external standards, stemming from how society might define you? Or do they originate from within yourself? I guess i'm saying that if you feel healthy acting healthy, then don't stress the BMI.

It takes a while to learn your body's cues, especially us who learned to ignore them for so many years....it will come. Its taken me 2 years of paleo to really relax and trust myself and my body. And there are still days that i take IFing too far, a flash back of my earlier anorexia. I would advise you to not IF until your body is more adjusted to healthy food intake.

You are on the right track! :-)

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+1 for not stressing on the BMI - in my opinion it's faulty and shouldn't be taken as gospel. – Stefanie Jun 25 at 4:18
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This will come with time, but for the time being, try to eat regular portions, then get away from the food and see if you feel full. Even if I am stuffed, if I am in the presence of really good (bad)/stimulating food, I will eat more. Have a regular meal, get up, get involved in something, and see how you feel in an hour or two.

Also, please remember that you are on a very long journey back to health and 9 months, while a great start, is just the beginning.

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Thanks. What's considered to be a regular portion? – coffeesnob Jun 25 at 3:05
Good question...Hard question...I know you want to stay away from counting calories, but I would put together a (insert number) calorie lunch and see how you feel. I personally would go with 500 calories, but you can start anywhere. – Chinaeskimo Jun 25 at 4:05
I've also heard that eating on a schedule can be a good way to retrain your brain. – Chinaeskimo Jun 25 at 4:06
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+1 for "a very long journey to health." and i agree with the mealplan/schedule template until you are on more steady ground. for me, i get a piece of protein (4-6ish ounces depending on how fatty it is and how full it makes me), a scoop/cup of starch, and a big scoop of veggies. i have struggled with what you describe for so long... my heart goes out to you. please feel free to fb message me - rebekah nelson kasper – Rebekah Jun 27 at 23:35
Thank you! I will stop looking for quick results, Chinaeskimo. – coffeesnob Jun 29 at 10:15
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Before paleo, I never knew the feeling of hunger. My body's cues that I needed food were headaches, grumpiness, inability to concentrate, etc. I now believe these were all signs of sugar addiction / carb crashes. Once I removed grains and sugar and processed crap, I finally noticed what I'm guessing 'most' people would describe as 'hunger' - a sort of empty feeling in my stomach, not exactly pain, but a desire to eat that I never felt before (but not the crazed desire of a sugar crash). Then I focused on developing a good daily routine of three meals a day (no snacking), mostly so I didn't have to think about food as many times a day, and I think this further helped my body to use food appropriately.

As for feeling full, I have the opposite problem - I get bored before I get full, so I'm usually struggling to maintain weight rather than lose it.

Anyway, I agree with other comments to definitely keep away from IF, and instead try to develop an eating routine of 3 meals a day, and leave the table / the kitchen when you're done. Maybe use pictures of recipes (or from all the paleo food blogs out there) to judge how much food should be on your plate, as a starting point if you're really struggling. Not as exact as counting calories, but maybe easier on your EDs.

Actually maybe a Whole30 or Primal Blueprint recipe book would help, as in theory you should just be able to follow recipes and voila, a 'standard' size meal is in front of you.

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Thank you! I never thought about getting an idea about the size of a standard meal from recipe books. – coffeesnob Jun 29 at 10:17
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At 25.7 BMI why do you NEED to lose weight? This is slightly overweight, not morbid obesity, and not enough to raise any health concerns. Don't obsess over it and drift back into disordered eating. Just figure out how to maintain.

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My BMI was 24.7 and my doctor told me I needed to lose weight because I was entering into the overweight category. It's the common assumption that your BMI should be under 25 to be considered "healthy". Personally, I think BMI is a load of crap, but I can't change modern medicine...... – Julianne Jun 25 at 18:56
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your doctor is an idiot... he flat-out told a person with ED to lose weight because you were overweight??? get yourself a better doctor with a gentler bedside manner! – Rebekah Jun 27 at 23:30
you can't change modern medicine, but why listen to it if you think it's a load of crap? how do you feel and get through your days? that's so much more of a meter of health. – Rebekah Jun 27 at 23:31
Thhq - this sounds like you are making a "diagnosis" to me. I hope you abide by your own rules and high expectations of others when you answer. – Crowlover Jun 28 at 1:38
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BMI isn't always good indicator of whether or not you are overweight, especially without knowing your body fat percentage. Muscle weighs more than fat so it's possible to have a high BMI with a low bf%. It sounds like you are eating well. How you feel and how your clothes fit is probably a better indicator of how well you are doing. I'd ditch the worry about BMI, but like Chinaeskimo and Rebekah suggested, figure out an "insert # of calories here" meal plan and see how you do.

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Before you let yourself worry too much about having a BMI of 25, I think you should read this: http://www.webmd.com/diet/news/20090625/study-overweight-people-live-longer Having a BMI of 25-29.9 actually seems to improve health and longevity. If you have been eating healthy and nutrient dense foods you will likely drift into a healthy weight, which it sounds like you have done.

The wikipedia page about the history of the BMI is pretty illuminating too if you want to learn how much of a joke it is. http://en.wikipedia.org/wiki/Body_mass_index It was created to categorize sedentary Belgian merchants in the 1800's into categories of relative thickness, and never intended to be used as health diagnostic tool.

Have you tried mindful eating to try and regain your satiety signals? There are a number of books and workshops that can be taken to learn how to do it. I have a theory that disordered eating that starts in the mind (if it isn't a hormonally driven and based on nutritional deficiencies, which should obviously be ruled out first), is the result of fearing food. And really are there any women in our society not indoctrinated to fear food? So this is not a "you" deal, this is product of your surroundings and upbringing issue, and the way almost all girls are socialized, so you can drop any guilt.....right.....now.

Of course you can't feel your hunger and satiety cues, you have trained yourself or been trained through the public shaming all women feel about eating to satiety, to pull away from food both mentally and emotionally. I would suspect if you can erase the fear, and really be present and with your food, unless your hormone signalling is way out of whack you would begin to feel those hunger and satiety cues. I think the first step might be to not worry about any correlation between food and weight because you are statistically at the lowish end of the healthiest weight category according to the WebMD article I listed at the top, just focus on how you feel as you enjoy your food.

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I will definitely look into mindful eating. Thank you. – coffeesnob Jun 29 at 10:33
I wish I could +1 this a million times! Mindful eating has saved me with my EDs :D – YoungPaleoLover Jul 3 at 5:03
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i am totally supportive of an intuitive mealplan that works for you. it takes a bit of figuring out, but once you get it, stick to it!!! my plan is 3 meals like i described on chinaeskimo's comment, and because i am in tune to my binging tendencies/hunger levels now, i know i also need a morning and afternoon snack, and sometimes an evening one. keep learning to listen to your body - it takes a long time after ED to regain it, but it is so worth it. it's also SUPER common for those who have practiced restricting to gain some "rebound weight" that is temporary and a healthy part of the healing process.

may i suggest a paleo/whole foods friendly nutritionist to set you up with a mealplan? that could be your saving grace.

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also, please feel free to facebook me like i said. – Rebekah Jun 27 at 23:39
Sorry Rebekah. I meant to say Coffeesnob in my answer, not Rebekah. Thanks – Crowlover Jun 29 at 4:37
Your 3 meal plan sounds like it may work for me as well. Thank you! – coffeesnob Jun 29 at 10:20
ah, got ya crowlover! i just didnt want to ignore you :) and yay coffeesnob! it's not my final destination i dont htink, just a format for now. – Rebekah Jun 29 at 20:21
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Coffeesnob, I think the following information on Interception and eating disorder will be very interesting to you. Interoception informs us of emotions, pain, thirst, hunger and body temperature. Best of luck

In the May June issue of Scientific American Mind (great journal and not too wordy..)

A Broken Sense of Self Underlies Eating ... - Scientific American
www.scientificamerican.com/article.cfm?id=inside-the-wrong-body
Apr 19, 2012 – Scientific American MIND. Inside this Issue ... 

Decoding the Body Watcher: Scientific American www.scientificamerican.com/article.cfm?id=decoding-body-watcher

Apr 3, 2012 – Scientific American Premium Cover ... Scientific American MIND ... 

focused) attention to interoceptive (internally focused) attention in the brain.

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sorry about the formatting. GREAT articles though and a self test and information to improve your interoception (internal awareness) – Crowlover Jun 28 at 0:27
i'm not sure what you mean here... is this in my answer about being intuitive? the article is interesting, but not really what i meant. observing all signals of health is what i was aiming for - muscle building, fatigue, headaches, emotions, anxiety, etc. not simply an absense of hunger. does that make sense? obviously an anorexic is going to claim they are intuitively eating only an apple a day, but they are not truly observing all markers of health. – Rebekah Jun 28 at 19:55
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ah, i see the part about mindfulness now. were you agreeing with my suggestion? – Rebekah Jun 28 at 19:56
Sorry Rebekah.. I meant to say coffeesnob. OOPS. I will edit. Sorry – Crowlover Jun 29 at 4:36
It looks like I have to buy the article. Where is the self test? Thank you! – coffeesnob Jun 29 at 10:21
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As someone that has struggled with the sensations of hunger and satiety for 44 years I can recommend slowing down your eating for the satiety part of it. If I'm not mindful about my portions I will over eat until it's too late and my belly feels like it's going to burst. I started eating Paleo three months ago and I have learned when to stop before it happens. I have a 35 minute commute to work and I don't start feeling full from breakfast until 25 minutes into the drive. I know this isn't normal but until I can fix the issue it keeps me from eating ad infinitum. For the hunger side of things - I don't IF very often but doing it occasionally helps me remember what real hunger feels like.

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actually, it is kinda normal. it takes 20 mins before your brain has registered fullness completely. take heart! – Rebekah Jun 29 at 20:22

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