Tip Day: Dealing with Dubious Advice

Wednesday is Tip Day, which means I'll be sharing with you some of my tried and true well-researched often improvised ideas for surviving recovery.

Dealing with Dubious Advice.

In a post a few weeks ago, one of my newest regular readers asked how I handled the ubiquitous health advice that seems to be everywhere.  Places like the American Heart Association recommend about 30 minutes of exercise per day.  Other places talk about limiting fat or carbs, or cutting back on calories and portions.

It's all well and good, but for many people with an eating disorder, it sounds so contradictory to what our treatment teams are telling us.  Eat more fat.  Take some days off exercise.  Pay attention to your hunger signals.  It's pretty crazy-making, trying to recover from an eating disorder and living in a world that is seriously messed up about food and weight.

So here are some ways in which I try to deal with the disconnect:

1. They're not talking about you.  These recommendations are for otherwise healthy adults with no big hangups on eating properly and exercising.  If you have an eating disorder, you're not generally healthy and this good-meaning advice can often backfire.  I often like to think of the recommendations that people drink a glass of red wine everyday.  If you're an alcoholic, drinking red wine is like playing with fire.  Any benefits of red wine will be dramatically overshadowed by the potential for relapse into alcohol abuse.  I'm not sure that cutting back on my fat intake will make me any healthier, but it will probably make me much more crazy.

2. They don't know you.  I hate sweeping generalizations (which may very well be a sweeping generalization in and of itself, but whatever).  They are often mostly true, but they also fail to consider the nuances of individual situations.  Think of something like wearing sunscreen.  It's a great thing to do, but someone with a significant Vitamin D deficiency might want to walk around for a bit without sunscreen to boost their Vitamin D production.

3. These are meant to be guidelines, not rules.  When I was in the midst of the eating disorder, if I read something like "Women should try to eat no more than X-Y grams of fat each day," I made absolutely sure that I only ate X grams of fat.  Not a milligram more.  The thing is, these aren't meant as die-hard rules.  It's hard for me to take guidelines as anything but literal rules akin to the Ten Commandments.  What the person writing this article is probably saying is try to eat around X-Y grams of fat each day, knowing that some days you're going to eat more and some days, less.

4. You're not the only one with eating issues.  Anyone can publish stuff on the web--it's one of the best parts of the Internet, in my opinion.  The problem is that you have have precisely zero in the way of credentials and still be thought of as very credible, even as you give out awful advice.  Sometimes, even the people with credentials are a little off their rockers.  What helps me is to remember the source.  The American Heart Association is really into heart disease and obesity prevention; their advice is going to be skewed in that direction.  Not that it's necessarily bad or wrong, but that's where it's coming from.

5. Talk to your treatment team.  If the advice you want to follow really is good advice, then your treatment team shouldn't have a problem with you following it.  So talk to them about it.  It can help clarify your motivations and help you make sure that your ED isn't trying to sneak back in.  If you're hesitating to tell your team about what changes you want to make to your food and/or exercise, that might be a sign that your motivations are more disordered than you are willing to admit.

6. Avoid it.  It's impossible to avoid all advice that might be bad for you--this kind of thing is everywhere.  But there are certain places (food and diet websites) where it's especially prevalent.  If it bugs you and throws you for a loop, don't go there.  Don't visit those sites.  I don't visit- they don't tell me anything I don't already know about how I can be healthier.

7. You are the exception.  All throughout the eating disorder, I thought I was the exception to the rules of biology.  I wouldn't have health problems.  I could start eating whenever I wanted to.  I couldn't eat that food without instantly getting fat, even though everyone else could.  It was almost laughable and pathetic.  Remember, though, that in terms of much of the "health" advice out there right now,  you are, in fact, the exception.  For you, stopping all physical activity may be the best thing for your health.  Or maybe adding more fat to your diet.  So enjoy the fact that you are special in this respect.

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hm said...

Got it- I think. The part about "they're not talking to you." My head spins with defenses when I read it, but I can see how it might be true. Also, the "you are the exception" part stands out to me, as I consider that I am happy to believe I am the exception if it means having a BMI that's too low, or food intake that is abnormally small, but angry and hurt at being the exception when it comes to the world getting to diet and exercise to their hearts' desire while I'm told I'm not allowed. It strikes me that that is inconsistent thinking on my part and therefore perhaps invalidates my anger and hurt.

Anonymous said...

Since we're dealing with people who put themselves out there as experts when they are really nothing of the sort, it might interest you to know that one of the links in your Anorexia News section - Catherine - is not affiliated with the newspaper she appears to be linked to and has been criticised by her readers for being triggering before. I have nothing against her (or you, your posts are great and not triggering at all), but her blog is not news, it is just another blog. Her negative attitude towards recovery really annoys me so I don't really read her posts anymore, but it surprised me to see her blog in your news links the other day.

Daniel said...

I've had this concern for a long time and after a while I finally realized a lot of what you're saying. It's not meant for every single individual, rather it's for a general population of healthy individuals.

It's hard to say that someone with and ED or iron deficiency, etc. is "unhealthy" or "not normal" but that's the truth and so a lot of these rules do not apply to those people, much like myself. I used to fret over target heart rate and 30 minutes a day of exercise and a cardiologist told me that THR is just a gimmick and that because I needed to gain weight, I needed to focus less on the intensity and calorie burn.

Great post, I'm really glad to see this in text - for some reason it just makes things a lot more clear than they may have already been.

Emily said...

Wow, thank you so much for telling me that it's okay to ignore these tips and advice given via various organizations. My ED just loves to take those little nuggets of advice and turn them into reasons why I need to exercise more and cut back on my intake of this and that. "I'm the exception"...I like that.

Cammy said...

THANK YOU for addressing this issue. It can be really hard to tone down exercise, increase fat intake, etc etc when our culture seems (hell, not seems, IS) obsessed with all of the trends that could easily lead a recovering ED sufferer back down a dark path. I like your analogy with alcoholism. It's hard to tune out the chatter and do what we know deep down is the right choice, one of those daily battles, but one worth fighting.

Renee said...

I actually felt stress just reading your post because it addresses what's been the most difficult aspect of recovery for me. I have IBS (likely as result of the ED), and the treatment of digestive problems could not be more different than treatment for anorexia. Every day, every meal I wrestle with the contradictions. Conventional docs don't want to tell a recovering AN that her diet plays a role in her symptoms, but of course it does. So then I seek out alternative docs or the the internet for more advice, but then it feels like I'm treading into orthorexia territory. I end up restricting many problem foods, then feel guilty about it because it seems restrictive... Insanity.

Katie said...

Renee, I had the same problems as you. I have fairly bad IBS, a milk allergy and several other intolerances. The main problem is that there is no strict advice for treatment of IBS. Some people with one version may benefit from a high fibre, low fat diet; others like me would be in crippling pain if they ate like that. I need a relatively low fibre, high fat diet with lots of easy to digest carbs to keep both my eating disorder and my digestive problems in check. The best diet for my IBS is quite amusing because it's about as far from orthorexic as it is possible to get - I get a lot of calories from simple carbs and desserts!

Anyway, going back to your post Carrie, I got over my obsession with this particular issue more than a year ago (there was one point where I spent all my time researching stuff to do with nutrition so I could eat "correctly"), but it's good to see that there are other people out there who are flying the flag for taking advice aimed at the normal majority with a pinch of salt. Or in my case, lots of salt, because I have low blood pressure :P

Heather Anne said...

Wow. Wow. Wow.
AGAIN - just what I needed.
Seems those dubious messages are tolerable when I am in a place where my disease thinks I am "Safe" - which is inevitably and paradoxically times when I am unsafe.

These constant stream of messages - mainly media generated have always bothered me. I, too, have been angered at why others can count calories, modify their intake and exercise their hearts out, but I am told not to do those things. The majority may be encouraged to do this, but we ARE the exception to the rule. Plus so many of these messages moralize food - "good" or "bad" (and by association and intake, we then believe ourselves to be good or bad)- this is something I believe very strongly in avoiding and for me is essential to my recovery.
For the people who say their "head spins with defenses" about why the are NOT the exception to the rule - that is in fact the disease trying to convince you. We have a disease that tells us we DON'T have a disease.

Again, thank you so much for these reminders. As much as my disease likes to convince me I have a small problem with food and not a life threatening illness - I know it is the nature of the beast to try to slip in the backdoor on the coattails of "health tips".

Unknown said...

i always find the special exception rule to be so interesting...esp bc we all do it!

hm said...

If our disease tells us we do not have a disease, and people WITHOUT this disease ALSO say they don't have this disease, then how does anyone know the difference between people with the disease and without it? Are we just supposed to take the word of the health care practitioner? But what if he/she is wrong, and making us gain weight for no reason? Not at all trying to cause stress or contention here- honestly asking- How do I know who to trust, them or me? Anyone have thoughts on this?

Carrie Arnold said...


It's ironic, isn't it, when one of the symptoms of your illness blinds you to the fact that you have the illness.

I hope this doesn't make me sound too presumptuous, but if you're here and reading my blog and relating to many of my comments (as you seem to indicate), then I'm guessing you have an eating disorder.

In the current atmosphere of fat phobia, no health professional is going to make someone gain weight if they don't need it. Frankly, it's a bad business model. But it might be a good question to ask your treatment team (not defensively, but out of curiousity) why they want you to gain weight. It helps me to hear things like this from as many people as possible and from as many different perspectives as possible. Maybe weight gain will help you mentally as much as it does physically. Maybe there's an entirely different motivation you were unaware of.

Just a thought.

Carrie Arnold said...

Anon (the second commenter),

Thank you for your feedback. Unfortunately, that's an issue with how Google classifies their news links, and it's nothing I can do anything about. I apologize, and as always, caveat emptor.

hm said...

Not presumptuous at all- made me laugh in surprise at the simplicity of that logic. If I think like an eating disordered person, then I must indeed be an eating disordered person. Ha! I guess living with disordered thinking for long enough can perhaps cause the simplest of logic to evade one's processing. And the "professionals" do insist that rational thinking accompanies full recovery. Hard to swallow when you do not want to admit that your thinking is, in the first place, irrational.

Autumn Whitefield-Madrano said...

Wow--Carrie, thank you. I work in women's magazines and it can be near-impossible to not let this stuff seep into my brain. Depending on the day I'm fine, or I start thinking that I need to do some of the activities that are essentially restricting that are recommended sometimes. This can serve as a guide for me on the latter sort of days--thank you for isolating and pinpointing these thoughts.

lucy said...

This post is so helpful with all types of dubious advice. I remembered it today after thinking about some particularly triggering and unhelpful advice a friend gave me.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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