Today, we watch what we eat. We follow meal plans. We don’t do dairy (or gluten or sugar). We wait to eat what we truly want until it’s “cheat day.” We weigh ourselves weekly or daily. We stick to rigid calorie counts or points or macros. We try the latest diet fad (no matter how extreme). We eat zucchini noodles instead of regular pasta and pretend cauliflower is the same as rice or mashed potatoes.
We believe in good and bad foods. We believe in “whole foods,” and “clean eating.” We believe exercise is a punishment for “over-indulging.” We believe fat must be feared—and avoided. At. All. Costs. We believe thinness is a panacea, a cure-all for our mental, emotional, physical and spiritual woes.
Some of these “tips” are recommended in magazines, books, on social media, by therapists, registered dietitians, and doctors. Which makes it especially tough to know when your eating or body issues are a problem, when they warrant help.
Because in a culture that promotes disordered eating, where disordered eating masquerades as some great marker of health, how do you know when you’ve gone too far?
Then there are the articles on eating disorders that focus on extreme examples, which might leave you wondering: Am I sick enough for help? I’m not emaciated. I’m not all skin and bones. I don’t hide my food. I don’t binge all the time. I don’t feel out of control all the time. I don’t always skip meals. I don’t use laxatives. I’m not addicted to alcohol, or other substances.
I asked Jennifer Rollin, MSW, LCSW-C, an excellent therapist, expert and founder of The Eating Disorder Center, to share a list of questions we can ask ourselves to decide when it’s time to seek help. These are her suggestions:
- Do I spend a significant amount of time in my day thinking about food and/or my body?
- Do I experience feelings of anxiety, guilt, and/or shame around certain foods?
- Do I frequently ignore my hunger cues?
- Do I fill up on diet beverages, water, coffee, and other products in an effort to mask my hunger?
- Am I afraid of gaining weight?
- Do I follow a series of “food rules?” Again, the diet industry has infiltrated our eating to such an extent that we don’t even realize we’re following random, external rules. They’ve become so subtle (which is what makes it so scary and dangerous). Rollin shared these examples of food rules: Feeling like you have to eat a vegetable (or protein) at every meal; having anxiety about eating white bread instead of wheat bread; eating at certain times of the day and experiencing anxiety about breaking that; telling yourself you aren’t “allowed to eat” after a certain hour of the day; always drinking diet or non-caloric beverages; and not being able to have two carb sources at one meal.
Claire Mysko, the Chief Executive Officer of the National Eating Disorders Association, suggested considering this question in her important piece on Everyday Health: “Are your thoughts and behaviors around food, weight, and body image making it difficult to enjoy life and feel good about yourself? If your answer is yes, it’s time to reach out.”
Ultimately, Rollin noted, if you’re wondering “whether you might have a problem, then that’s a clear sign that you’d benefit from seeking help.”
When seeking help, Rollin stressed the importance of working with a clinician who explicitly states that they specialize in Health At Every Size and eating disorders/disordered eating. It’s also critical to interview clinicians, and ask them if they take “a weight-neutral approach to treatment.”
Taking a weight-neutral approach to treatment means: not judging “a person’s physical health, mental health, or behaviors, on the basis of their weight or size. While certainly if someone is under their natural weight, it’s important that they restore to a healthful weight for them, weight loss is never a goal of treatment. Instead, we look at helping people to nourish themselves physically and emotionally from a place of self-care, rather than attempts at ‘weight control,'” said Rollin, whose team at The Eating Disorder Center works with people in Rockville, Maryland and worldwide via video.
You don’t have to have a label—bulimia, anorexia, binge eating disorder—in order to work with a clinician. You don’t have to hit rock bottom. You don’t have to cry every single day. You don’t have to weigh a certain number. You don’t have to wait until your eating and your life have gotten more and more narrow and limited and joyless.
Because it’s enough to hear a whisper within that says, I’d like to feel better, I’d like to eat dessert without feeling guilty or being scared, I’d like to enjoy a meal at any time, on any day, I’d like to learn to listen to my body, I’d like to have a healthier relationship with food and with myself.