I turned in my book manuscript draft in mid-February. Then I went on vacation. Last week, I came back and faced down a migraine. The last week has been harder than I thought it would be. My therapist mentioned that this might be the case, especially since I have a history of what I like to call post-adrenaline depression.

I hated final exams at school. I was a stressed-out basketcase. I rarely slept, couldn't eat all that well from anxiety (even before the ED...my love of snacking on pretzels helped stem the weight loss), was usually sick with a cold, and was irritable, moody, and generally not fun to be around. But my need to keep myself together in order to take the exams usually kept things from getting ridiculously out of hand. My myopia saved me, in a sense. After the exams were done, despite being uber-glad that they were over and I could read for fun! and sleep! and drink something that wasn't espresso! I almost always plunged into a depression afterwards. Maybe depression wasn't the right word. It was more like a serious funk--my mood dropped, I was apathetic and unmotivated, and, horror of horrors, bored out of my mind.

The last week has pretty much been a repeat of that. Not quite as serious because bills need to be paid no matter how much I (don't) want to work, and I got a couple of extra projects from one of my freelance places, which also helps. Productivity is my antidote to despair.

Along with this funk came a bit of decline in my eating. It was thrown off first by the end of the book-writing period in which things just got chaotic. Not restrictive per se, but I didn't have the time, energy, and brainpower to take the time I normally would in planning and preparing meals and snacks. I did really well during my vacation, eating responsibly and mostly not too little or too much. Then the migraine hit and I didn't eat nearly what I needed to for that day. I didn't do quite as bad as I initially feared when I tallied everything for the day, but there was a definite drop. The next day, I did eat what I needed but felt terribly guilty. And so the passive restricting began, followed by the active restricting.

It wasn't super severe, especially in comparison with some of the crazy stunts I've pulled in the past. My weight didn't massively go down. Mentally, though, I was having a rough time yesterday. Depressed, cold, apathetic and terrified of everything. Which is kind of what snapped me into action. I texted my therapist and we worked out a safety plan and I'm trying to get back on track. I did a full day of meals today and most of the day yesterday. I was horribly anxious this morning, but I'm pushing through it and it's lifting, mostly.

I have a busy rest of the week planned, which will help, since business helps make the ED stuff more obvious (I don't have the brainspace or time to obsess or engage in behaviors). It also gives me something to think about besides calories and existential anxiety.

So...that's where I am. Regrouping and pressing on.

I overslept today. My sleep schedule hasn't approached anything that could reasonably called a "schedule" for several weeks (night owl + insomnia = chaos!), so it's probably not all that surprising. The problem was that it was late enough to throw off my food schedule for the day. I'm not on some sort of tight schedule where I need to have breakfast at X o'clock and lunch at Y o'clock, and so on. But I do like to have at least some break between meals so I don't get too full.

So I made up my breakfast at some embarrassingly late hour and then sat down to eat. While I was munching on my peanut butter toast, I started to think: okay, so how am I going to get all my food in today?

I was thinking and making adjustments--I have a crochet group in the afternoon that meets at a coffee shop, so adding a latte would be easy to get in some extra energy without feeling overly full, and then get something to eat along with it. Or I could bring some trail mix. And then add something extra in the evening, and all should be good.

Which is when it hit me: instead of planning how to "get away with" eating less, I was planning how to keep in recovery.

I don't think I've ever done that before. I've gotten past the point where I look for opportunities to restrict, but it's been much harder to *not take them* when they arise. And this was a great excuse. After all, I was sleeping, which isn't really known for its calorie-burning potential. Since I didn't wake up until almost essentially lunchtime (I'm, like, seriously moritified over how late I slept, yo), just crossing breakfast off the list would have been super-duper easy.

Except I didn't. I shifted a few things, and added them in here and there and tried to be flexible. It wasn't always ideal, but I was committed to making it work. And that's a really cool place to be.

When I was driving home yesterday after one of the most non-ED-related mentally grueling days I've had in a long time, I had to stop for dinner. I was tired. And cranky. And had spent Lord only knows how many hours sitting in traffic the last few days, and I was cruising along well down a major interstate. I was petrified that I was going to hit (yet another) traffic snarl.

Yet the fact remained: it was dinnertime.

So I did something unusual. I pulled over at the next exit to the Chick-fil-A* and went through the drive thru. I realized, as I placed my order, that I was 31 and had just ordered my first drive thru meal. I've ordered beverages at a drive thru plenty of times, but never an actual meal. I've ordered fast food in the actual restaurant as well, also on my own, but again, not the drive thru.

Let me give this a bit of context. Drive thrus were illegal in my hometown because they were deemed a safety issue (eating and driving). They have a point there- I feel horribly guilty for eating and driving yesterday, but it really couldn't be avoided. I really don't like ordering stuff out (it has nothing to do with food and everything to do with my fears of talking to strangers. Apparently, you can be 31, have never eaten from a drive thru and also have an overblown case of stranger danger. Sigh), and since I've been on my own, I've pretty much had an eating disorder. Diet Coke, fine. Actual food, not so much.

But I guess all of that changed yesterday. I got crumbs on my lap and grease on my fingers and I survived. I didn't like it, and I survived. I much prefer eating dinner when I'm not behind the wheel, but I also think the dangers of not eating outweighed the dangers of eating and driving.

So that concludes the tale of Carrie and her First Drive Thru.

Random story postscript: Doing this blog post reminded me of my undergraduate advisor and a story she told me when we were at a conference. She was originally from Taiwan, and when she first moved to the US to start her PhD, her English was pretty limited. She said that for the first week or two she lived in America, she ate dinner at McDonald's every night because you can order by number and she knew she could count to ten. Now, whenever I have to order a menu item by number, I think of her. She was a really neat person.

*As a family, we rarely ate fast food and still really don't. I generally don't like a lot of fast food places, but I do enjoy me some Chick-fil-A. My RD made me to food exposures at all the major fast food chains so I know I can eat there, but still.

When I went on vacation last week, I knew there was a lot of activities I would want to do.  I spoke with my therapist about being more active than usual, which she said was fine, as long as I ate more to compensate.  So I ate a bit off the meal plan, and all worked out well.

We've discussed this in the past, the idea of eating "extra."  That is, eating outside of scheduled snacks and meals, or eating more food than "required" at those times.  Not surprisingly, this freaks me out.  I've never been a rule-breaker.  The very idea terrifies me.  Part of it is the sense that the rules are the rules, and you don't break the rules.  If I do think a rule is silly, I often am too anxious to go outside the prescribed letter of the law anyway.  I rely on rules (many of them self-imposed, but rules nonetheless) to help me cope with anxiety. Breaking a rule is anxiety-provoking in and of itself.  Breaking an ED rule is even more so.

But my therapist raised a really good point.

It's not "extra" if you're hungry or you've been more active.  That food is necessary.

I've often complained to her about how horrible I feel when I eat food that isn't on my meal plan*.  And almost every time, my therapist said that my weight stayed the same and so my body needed every calorie.  This meant that those "extras" weren't extra at all--they were more like little "necessaries."

Oh.

An extra is eating some dessert because it looks good, even though you've just had dinner and aren't all that hungry.  It's finishing all of your favorite entree at your favorite restaurant because you love it, even though you started feeling full near the end.  That sort of thing.  Eating in response to hunger is never "extra," even though the food may not appear on any piece of paper.

The obvious solution would be a new rule to "eat when hungry."  Except implementing this rule means changing the old rule of "eat what's on the plan," which means facing the anxiety of rule-breaking AND change, neither of which I do well at.  I also mistrust hunger signals and never quite know (unless I'm ready to gnaw on my neighbor's arm) if I'm really hungry or just think I am or if what I think might be hunger means I should eat something or get something to drink or just suck it up.

Quite a quandry.

*I'm guessing right now that I'm going to get comments saying I should ditch the meal plan.  The problem is that I would likely undereat without the guidelines. My instincts on what I "need" to eat aren't the greatest. A meal plan can be a double-edged sword, but I think the positives outweigh the negatives at this point.

I went to a local farmer's market this morning, since the weather was nice.  I was visiting the various booths, sampling things and just seeing what was available.  The farmer's market had more than just produce--there was quite a few stands with gourmet prepared food.  One was sampling roasted coffee, along with applesauces and such. 

As I was standing there, sampling the coffees, she kept saying how her foods were low in sugar and easy on the waistline.  And so on.

My first thought: is it that obvious that I've gained weight?

My second thought: why are you assuming that I'm worried about stuff like that?

I don't blame her, exactly.  She's just trying to sell her stuff.  I know from when I worked craft fairs that a lot of making a sale is trying to figure out what the customer is thinking.  I guess I fit the bill of the food obsessed: young, female, decently dressed.  And part of it was probably a reflection of what the woman herself was thinking, what she thinks when she decides whether to buy food.

But it irritates me that being diet-obsessed is considered the default mindset.  It's sad, really.  That it's safe to assume that the majority of people look for what's not in a food than how it tastes or what is in it (flavor, texture, etc).  I know plenty of people have to read labels, and that reading labels isn't necessarily disordered.  It can be a very normalized thing.  But still...  It's become so not only are people expected to be obsessed with food labels, but it's expected that they should be obsessed.

I know the lady was just trying to make a sale.  She did annoy me, but it was more the assumption that I found irritating rather than the lady herself.  It would be really nice if I could find somewhere where people didn't obsess.

A girl can dream, right?

I was thinking about my snack this afternoon, and several options floated through my head.  As I was contemplating what to have, I remembered my after school snacks from almost 20 years ago now.

The fluffer nutter was one of my favorites. 

For those of you that aren't in the know, a fluffer nutter is a peanut butter and marshmallow fluff sandwich.  Except my mom didn't make fluffer nutters with bread. She made them with graham crackers.  Actually, I didn't know that my mom's confection had a formal name until I was in high school or college.  Nonetheless, I loved my peanut butter and marshmallow fluff on graham crackers.

Of course, an eating disorder changed that innocence where all I thought of was "sweet-salty-crunchy-yumminess." 

Now I think about things like carbs and whole grains and high fructose corn syrup.  I wonder whether I'm eating too much added sugars. I worry what others might think of a 30-year-old eating a fluffer nutter for a snack.  I worry what others might think of a 30-year-old having an afternoon snack, period.

The truth is this: I don't remember what it feels like not to worry about every crumb I eat.  I remember that there was a time when I didn't, but I don't actually remember that feeling.  Some of that loss may be the inexorable process of growing up.  After all, I think about lots of things in a much more nuanced way than I did as a 10-year-old.  But there's a difference between being aware of the fact that straight up sugar might not keep you satiated for long, and fretting over what the sugar might do to your butt.

I don't know that this innocence is ever coming back.  And that's sad.  I'm tired of worrying so much.  I want to switch this off, just for a bit.  Yet the fact of the matter remains that it likely won't every go away, not really.  Not completely. 

I'm not saying that this worry will never stop consuming much of my waking hours.  After all, I'm not dropping substantial cash on therapy for nothing.  I am working to relax about food and, you know, pretty much everything.  But I feel like I know too much and have let too much of my life be taken up by these obsessions to ever go back to the carefree person that existed before the anorexia struck over ten years ago now.

At the same time, I think it's important to remember that this person did exist in the first place.  That I could manage my food and weight without interfering in every little detail, without worry and fear and gnawing anxiety.  That I didn't need to follow a food plan to the letter and yet I was okay and the world was okay.  It's a very different mindset to how I currently manage things.

I suppose sitting here and being all mournful about these changes is neither uplifting nor enlightening.  I don't want to just piss and moan over what used to be.  I don't do nostalgia.  I can't change the fact that I got sick and have been sick and have changed.  It is what it is.  Time passes and the person I was has become the person I am now.

I'm not missing a sandwich, I'm missing a mindset.  But that doesn't mean I can't still enjoy a fluffer nutter or two.

I had some extra yogurt pretzels last night.  Five of them.  They were leftover from Christmas, so they were in the shape of little trees and had candy cane crumbs on them.

It seemed like such a good idea at the time.

But then I freaked.  I had already fulfilled my meal plan for the day.  Now I had something "extra."  This was scary not just because of the additional calories, but because I was breaking one of my "rules" (i.e., Thou shalt not eat more than is required on thy hallowed meal plan).

I mentioned it on Twitter because I'm like that, and I got some wonderful support.

One of my friends says that her nutritionist tells her to "say yes amidst the resistance."

I seriously love that phrase.

It's hard for me to confront my own internal resistance because it is just so damn strong.  At the root of that resistance is anxiety.  Recovering from an eating disorder means that I have to confront issues in basically every aspect of my life.  Many of those issues have to do with food, and many of them don't.  To overcome all of them--to overcome any of them--I had to say yes despite the resistance.  I had to say yes to butter.  To days off from exercise.  To going out with friends.  To ordering off a menu.  To spending money.  To relaxing.  All of these created tremendous inner conflict.

To change or not to change, that is the question.

Not all internal resistance is bad.  I feel resistance when I think about purging now, which is something that was not always there.  But when challenging our fears, we have to accept the resistance.  Move with it.  Move through it.

One of the ubiquitous recovery quotes I was always given was this by Eleanor Roosevelt: "Do one thing everyday that scares you."

I'll confess, I've received this quote so many times, it seems a bit cliche.  That doesn't mean it's not true.  Saying yes amidst resistance is the same as doing something that scares you.

Feel the resistance.  Understand it.  Identify it.  And then let it go...

It's hard for so many people to understand why recovery can be so difficult.  All you have to do is eat, or keep your head out of the toilet, or stop binge eating, or get off the damn treadmill already.  It's one thing to know that this is what needs to be done.  It's quite another to actually do it.

For one, the neuropsychological changes caused by eating disorder symptoms can make it difficult to interrupt the cycle (it can make it almost impossible to see that there's a cycle that needs to be interrupted, for that matter).  For another, behavior change is complicated.  Very complicated.

I worked in public health for several years, and figuring out how to implement successful behavioral change--whether it's anti-tobacco messages or everyone's favorite current dead horse, obesity--was largely an exercise in futility.  It's easy enough to tell people that smoking is bad and you should eat more veggies.  It's also relatively easy to get people to absorb these messages.  It's quite another to get someone to put down the cigarettes and start eating broccoli.

This is known as the intention-behavior gap.  That's the technical name for knowing what you need to do and not doing it.

It's been a frequent issue in my recovery.  I can argue circles around myself to justify things, and come up with great reasons why it's to "hard" to eat lunch or take a break from exercise.  Behavior change is hard.  No one is going to argue with that--at least, no one who's broken a nasty habit or changed a major behavior.

But as I've progressed in recovery, as I've slipped and come clean and learned from my mistakes, I've learned that there are some general actions I could take so that my behaviors would match my intention of ongoing recovery.

I learned about batch cooking one summer when I was living in Baltimore and commuting into Washington DC every day.  It was two hours each way.  Getting home, wrung out and exhausted, at 8pm was not conducive to cooking dinner.  That wasn't an eating disorder excuse, that was just reality.  It would have been easy to turn that into a great reason to simply not eat, or to just nibble on some cereal before I passed out from exhaustion.  A conversation with my dietitian reminded me about batch cooking.  On Saturday or Sunday, I would cook all my meals for the week.  That way, when I got home, all I had to do was shove something in the microwave.  Easy peasy.

There were other things, like (when I was more in binge mode) not eating out of the box, packing my lunch the night before, or turning in my gym key to apartment management.

I've never been all that good at analyzing these things in the moment.  Usually, "the moment" is about damage control and getting more stable.  But looking back, I can generally (okay, with lots of help from my therapist) identify what went wrong.

What are some intention-behavior gaps in your recovery? How can you start to address them?

So a little article in Marie Claire magazine called The Hunger Diaries about online food and health bloggers has raised quite a stir.  The premise of the article is whether these health bloggers might be promoting an unhealthy and obsessive lifestyle.  The health bloggers say that their quotes were taken out of context and the dangers of such health blogs were horrifically overblown.

Generally, I don't read these blogs and really am not interested in these types of blogs, where food and exercise routines are documented in almost pornographic detail.  I think about food and weight quite enough, thank you.  Unless it's specifically helping me with my recovery, I'll pass, thank you very much.  Also, these blogs tend to make my competitive and judgemental side get twitchy.  She exercised more than me, I will think, which then takes me down the path of "She's stronger/better than me" => "I must exercise more and eat less." => RELAPSE.  So yeah--for any number of reasons, these blogs aren't for me.

So I can't really say anything about the accuracy of the article and whether some health bloggers might have disordered eating or an actual eating disorder.  That's not my place, I don't know, so I'm not going there.  But I do have several points to make that have gotten lost in the dust of the kerfuffle.

1) Don't believe everything you read on the internet.  Maybe I've watched a few too many House reruns, but the fact is: everybody lies.  And it's very easy to do so online.  Just because someone says they ran X miles doesn't mean they actually did.  Maybe they ran less.  Or more.  Who knows.  I'm not anti-blogger; after all, I am a blogger.  Yet the fact remains, people are complicated.  Things might get left out inadvertently.  You might have misinterpreted.  And just because someone calls themselves a "health blogger" doesn't mean that they are healthy or that doing what they are doing will automatically make YOU healthy.

2) "Health" is not an extreme.  In a lot of the comments on the Marie Claire website, people talked about these bloggers as being something the rest of us Big Mac chowing Americans would do well to emulate.  Um, hello.  Did you not realize there is a ginormous freaking gap between a steady diet of french fries and marathons fueled by kale brownies?  To me, health is not health without joy, and joy comes from real brownies, not kale ones.  I exercise regularly, eat a very healthful diet most of the time, and I humor my sweet tooth when I can.  You can take steps to improve your life without following the dictates of a health blogger.  Are they healthy?  I don't know- that's between the bloggers and their doctors.  Which leads me to my next point:

3) "Health" is an individual definition.  People have tried to define health for centuries and have really come up with vague descriptions.  What someone else defines as health (such as kale brownies and marathons) might not be healthy for someone like me in recovery from an eating disorder.  I have to take steps to moderate my impulses to exercise.  Ultimately, you have to define health in your life.  That definition needn't be static--it can change with age, circumstance, you name it.

4) Bloggers have an obligation to their readers.  These obligations will be different based on different types of blogs, but, like it or not, bloggers have an obligation to their readers.  I see my obligations as being honest about my own recovery (the struggles and the victories), and not passing along information I believe to be unhealthy or uninformed.  I can't vouch that everything I write about is 100% accurate--no one can.  But I can (and do) refuse to write on subjects that will be obviously misconstrued, not in line with my own authenticity, and not anything I wouldn't tell someone to do.  I try to be careful and say how something (such as a meal plan) has been helpful to me, but a meal plan isn't universally helpful.

5) Your readers are listening.  This goes along with the point above.  If people are reading your blog, then they are listening to what you have to say.  They are absorbing this information.  Remember this.  Unless your blog is completely private, you are writing to an audience.  When you talk about how great your workout routine is (and then describe it in detail), people are going to copy you.  No, you aren't responsible for the fact that they do copy you and that people can be idiots (sorry, too many House reruns again), but you are responsible for being cognizant of what you say.

6) Obsession can masquerade as health.  I'm not saying anything about these bloggers in particular.  Like I said, I don't really read them and so I'm making no judgements.  But I do have to applaud the writer for bringing up the thorny cultural issue of health being used as a smokescreen for any number of obsessive behaviors.  Part of the problem is that most of the obsessed really think they're just being healthy.  They see nothing wrong, and the unending kudos from adoring blog readers probably doesn't make it any more likely that people will see the light.  Many eating disorders have started by a simple effort to be more healthy.  Soon, it becomes a life-threatening obsession, but how can you be sick if you're just trying really hard to be healthy?  It's a fine line and it's hard to find out where to draw it.

So those are my thoughts.  What do you think of health blogs?  Do you read them?  Why or why not?  Share in the comments.

One of the hardest things for me to adjust to in recovery was all of the spare time and energy I had.  When I was in the depths of ED, I spent all my awake time perseverating about how much I ate, how much I exercised, what I weighed, and how much I hated life.  I could distract myself for brief periods--maybe for a few pages of an unusually good book or during a movie scene--but the ED always intruded.  This dragged me back to going over and over these things in my head.  Literally, these thoughts were my life.

As they receded, I often felt my brainpan was going to collapse without the constant pressure of those thoughts zinging around.  The obsessive thoughts lessened somewhat as I reached a healthy weight, but they still occupied freaky amounts of my time.  I didn't enjoy obsessing about every little thing, but I didn't know what else to do.  One of the things that left me so vulnerable to relapse was the fact that I didn't have anything to take the place of the ED that had occupied my thoughts for so long.

I found writing to be so helpful not just because it helped me sort through my thoughts, but because it provided me with something to do.  For the first time, I had something much more interesting, enticing and absorbing than the ED crap to think about.

I slowly began to find things that were not only more interesting to think about but could also be totally absorbing when I actually did them.  That's what I loved about mountain biking- I literally could not think of anything besides not crashing.  I hated the constant threat of danger, but I loved the challenge and the total mind-absorbing nature of it.  It's one of the main reasons I fell in love with cycling- I could daydream but the task at hand still demanded almost all of my attention.

I still struggle to clear my head while writing at times.  I'm aware that this is pretty normal, but I get a little more peeved when it's ED stuff creeping in rather than more normal, I-need-to-run-the-dishwasher kind of stuff.  And if writing doesn't do the trick (and I have some free time, which is becoming an increasingly rare phenomenon!), I can get involved in a good book as reading is another major passion of mine.

Finding my passion for writing didn't enable me to recover--there was a lot of hard work and therapy and facing my fears about food one at a time and meal after meal after meal.  But it's one of the best motivations to stay recovered.  Then I can actually get absorbed into books and projects and bike rides.  When I'm malnourished, all I can think about is food.  Now that my brain and body are (mostly) healthy again, I can focus on bigger and better things.

This quote from Around the Dinner Table has to be THE BEST explanation of the saying "An eating disorder is not about the food."

It's often said that it's not about the food, it's about the feelings, but it really is about the food, it's about eating no matter how you feel.  That's what recovery is.  And finding a new way to deal with feelings.  I guess that's sort of like telling an alcoholic that it's not about the alcohol, it's about the feelings that lead you to drink!  You still have to eat or stop drinking either way.

Yes, this.  This is exactly it.  No, an eating disorder really isn't "about" the food, but you also can't ignore the food at any point in recovery, whether it's at the very beginning or you've been doing well for years.

I'm at the point in recovery where feeling full after a meal is pretty normal.  It doesn't usually evoke any sort of odd emotions in me.  I don't get anxious, obsessive thoughts about how long I need to go without eating to "make up for" my last indulgence, or needing to engage in compulsive behaviors (exercising, purging) to undo the "damage" caused by my eating.  I still have conflicted feelings about needing to eat, but they almost never get in the way of my actually eating.

Still, sometimes when I get really anxious, feeling full starts to feel rather uncomfortable.  Times like, you know, now.  I mentioned the other day that I have been really stressed and exhausted lately, and although today wasn't quite as bad, I think the effects are rather cumulative.

I've learned (from years of experience) that anxiety messes with my hunger/fullness cues.  What often happens is one and/or both of the following: either I don't get hungry or I get really full, really fast.  Tonight, after my evening snack, the latter happened.  I know it's my physiological reaction to anxiety and not the amount of food I ate, which is a big step forward for me.

What used to happen was that this increased feeling of fullness would make me even more anxious and paranoid about eating because all I could think about was how full I felt.  It's not as bad as when you're nauseous and all you can think about is how awful you feel, but it's along those lines.  So yes, I focused on food and usually planned on restricting so I wouldn't have to feel so full.

Thus the vicious cycle begins.

I'm probably never going to stop being an anxious person.  I did meet with a new psychiatrist this week and got a prescription for lorazepam (trade name Ativan) to help with those really pull-my-hair-out moments.  I've come close to taking one numerous times, but I haven't had to take one since I got the prescription yesterday.  But even with meds, the anxiety is here to stay.  The SSRI I take helps with the really bad anxiety-induced nausea (as well as the depression), but I still get queasy a lot when I get upset.

It's hard to become so self-aware and have to develop an entire inner dialogue (what- you don't have discussions with yourself?) around talking myself off a mental cliff.  It's exhausting.  I really wish I didn't have to do it, or devote so much energy to staying on the same psychological level that so many others seem to gravitate to so easily.  But the situation is what it is.  My old therapist would tell me that this is when radical acceptance comes in handy--accepting that this is what I have to do, and yes it is unfair, but what are you going to do about it?

So yes, I'm full.  And yes, I'm uncomfortable.  But I have to remember that what's making me uncomfortable really isn't the food, it's the anxiety.  That's what I need to work on and deal with, not how much I'm eating.

I was catching up on some blog reading just now, when I stumbled across this wonderful post from Nattie about all of the ironies in recovery. I can't improve upon what she wrote, so I won't. I'm just going to cut and paste what she said:

I struggle with hunger cues. The major struggle is that they exist outside of the prescribed mealtimes of my meal plan. If I could only get hungry when it was convenient, that would be nice. I think I'd prefer not get hungry at all, but alas, that's not going to happen.

Last Friday, it was late and I had already eaten my evening snack. All is well until I start getting hungry again. Like really hungry. And what sounds really good to me at that time were some baked beans. I debated for quite some time about whether to eat those damn beans. I had already eaten "enough" for the day. The beans had lots of salt which means water retention (said in singsong voice). Blah blah blah. Those reasons were my anxiety talking. I was anxious about eating extra, about eating something significantly extra (I've gotten to the point where I can have an extra piece of candy and not freak the hell out), about, mostly, doing something different. Breaking the routine, doing something "risky."

Yes, I define risk as eating something new or different or extra. Anyone still wonder why/if I have an eating disorder? Didn't think so...

I ate the damn beans. I used the CBT skillz (all the work I've done on learning them totally gives them the extra "z") I had been working on with TNT and told myself the following:

• I was hungry. There was no doubt here.
• I had been unusually active on Friday (worked a half shift at the bakery).
• I don't have a history of emotional eating, so the hunger was almost certainly physical.
• The real risk was negligible- I knew that one serving of baked beans wouldn't hurt in the long run, even if my emotions weren't exactly on board.

I was hungry. I ate. Then I wasn't hungry.

Somehow, this shouldn't result in so freaking much drama. But there you go.

Tonight, something similar happened. I had already had my evening snack (the same thing, come to think of it, that I had on Friday) and I was still freakishly hungry. I wanted, more than anything, to not be hungry because I didn't want to eat again, and I didn't want to have to find something to eat again.

So I tweeted about my feelings, and reminded myself that I need not hate myself for needing to eat more. And that as much as I would like my car to get better gas mileage, I don't begrudge it the fuel when it needs it. I ate an apple and peanut butter.

I feel disgusting right now.
I feel disgusting and I know I did the right thing.

Maybe that last bit is the saving grace.

My parents are out of town for the next week, and I'm on my own in terms of food and eating. Well, not completely on my own, because I have some leftovers, and I have a book full of meal ideas that are meal plan compliant. There's plenty of food in the house, I shouldn't have to go shopping for anything other than produce or milk. So I'm pretty much set in that respect.

What has caught me off guard was how much harder it is to eat by myself. And not just eat, but decide what to eat, and then prepare it, and clean up after it. Not having to be in charge of all of that when my parents are around, I forgot just how much thinking all of this really required.

I can't help but think how easy it would be to start cutting corners. Not that I went into this week looking forward to the opportunity to restrict, which is something I would have looked forward to not all that long ago. I haven't even been having urges to restrict. I don't necessarily want to eat less. Yet somehow I've been finding it hard to eat enough.

Part of me is just tired at having to think about food so much. I haven't really been thinking of food in the starved, obsessive way that I used to, but I do still deliberate about what to eat much more than most people. And I'm really not totally comfortable making those decisions. I still wouldn't mind having someone pick out my meals for me (assuming I have some input and I wouldn't have to eat anchovies or anything). It's still just very overwhelming, all the food-related things to think about.

Yesterday, I was juggling about four different writing projects, and I really didn't want to have to plan in lunch and snack and dinner. I had lunch at about 1pm, which was pretty normal for me, but then I put my nose to the grindstone, and all of a sudden, I looked up and it was 4:45 and I hadn't yet had my afternoon snack. The last thing I wanted to do at that point was stop what I was doing, go downstairs, and find something to eat. I really wasn't hungry and I had piles of work to get done. In another life, I would have put my head down and bulled on through until someone came and got me for dinner.

I have to remember that I don't live that life anymore.

I did go downstairs and get a snack and take a breather and then I went back to work until it was time for a bike ride and watering the plants. Still, preparing and eating meals doesn't feel completely natural to me. I have the let's-refill-the-coffee-pot thing down pat, but serving myself food feels stilted and awkward. I'm aware that some of this awkwardness has to do with how long it's been since I've actually served myself a full-on meal. But I also can't shake this shame that I'm eating and consuming something. Or that my being in the kitchen and putting stuff on my plate is somehow abnormal and wrong. Logically, I know that there is nothing wrong and that people don't live on air. Yet I'm still embarrassed that someone will see me in the kitchen, actually getting something to eat.

(But if I wasn't getting something to eat or drink, why in the hell would I be in the kitchen anyways?)

It's obvious that I eat. I'm alive, therefore I must eat something. I also don't care what other people eat or judge them for it (unless they smack their lips when chewing. Then I do judge and I don't care.) I'm trying to trust that the horrible kitchen awkwardness will pass. I'm trying to take this one meal and one snack at a time.

I am eating. I am doing okay. And however hard and itchy and awkward it may be, I am doing what I need to do. I have my slips, my moments of not-so-accidentally-undereating. It's hard to give up the idea of the perfect recovery and get back in the saddle again. I'm tired of thinking about meals and snacks. But I have so much going for me now that thinking of food is really a small price to pay for the rest of this.

I blogged yesterday about Part One of Linda Hill's talk on The Noisy Brain, and, as I promised, here is Part Two of her talk from the 2010 International Conference on Eating Disorders. In the second half of her talk, Dr. Hill talked about the need for structure in AN recovery, specifically with respect to meal planning.

In the world of eating disorder recovery, Intuitive Eating is pretty much the holy grail of recovery. It's not a bad ideal, but eating when you're hungry and stopping when you're full can really only work effectively if your hunger and fullness cues are fully operational. In people with eating disorders, especially in early recovery, this really isn't true. At my last residential treatment center, we were taught Intuitive Eating (which wasn't a bad thing), but then we were also expected to be able to put this into action even as we were still in the beginning phases of normalizing eating patterns. Some people found this effective; I didn't. I failed at it miserably, and I had always blamed myself. Perhaps I didn't want recovery enough. Or maybe I wasn't good enough at fighting the ED voice.

You can imagine what a relief it was for me to learn that although the concept of Intuitive Eating is very useful, I can't rely totally on hunger and fullness cues to nourish myself. I definitely couldn't early in my recovery, and I still can't quite totally rely on them now. Instead, I need more structure to help me eat properly, and it's not a matter of personal failure but more of a matter of the very issue that made me so vulnerable to anorexia.

Dr. Hill talked about the need for structure in meal planning as it relates to difficulties in decision-making in people with eating disorders. Here's a segment of what she said (I inserted the links to help define some of the more technical terms):

Automatic emotional reactions don't seem to fire well because the insula is blunted. People with anorexia doesn't appear to have a free-flow ability [to move between emotional aspects of decision-making and evaluating long-term consequences]. Their planning ability seems to be firing overly well.

The AN/BN brain is impaired in identifying the emotional significance of stimuli, but it has an increased ability concerned with planning and executing tasks. There is an emotional blindness to decisions. If there is little or no internal regulation to help the person in decision making, it's easier not to decide. I need few to no options to help me in those decisions. [For people in recovery from anorexia], we need to increase structure and limit options for decisions. To compensate for inability to know what to do, the anorexic turns outward to social cues for rules and answers and to experience reward. In EDs, we begin with a meal plan, and then dose food level to match energy level. We take choice out of it.

So instead of saying "What kind of grain do you want with dinner?" it's more useful to ask "Did you want rice or pasta?" The first option is so open-ended and provokes so much anxiety that it's simply easier to skip that carbohydrate. The number of decisions I have to make when figuring out what to eat can be so overwhelming that I have to find ways to make it easier for myself. In my meal planning post, I wrote about how I have managed to work enough variability into my meal plan while simultaneously keeping the number of choices from getting overwhelming. My solution is the mix-n-match method (or what my dietitian jokingly refers to as the Deal-a-Meal) that keeps me from getting in an anorexic rut, fulfills my necessary exchanges, and allows for enough flexibility that I can go to a restaurant.

The balancing act can be rather precarious, and I think the eventual goal is to move off of a formal meal plan and into a more Intuitive Eating pattern. But the idea is that we use meal planning to shore up those areas in which we might have difficulties and let our strengths speak for themselves.

"Oh, I'm being so bad!"

I can't tell how many times I hear that at the bakery over the course of a day. It's mostly women who say this, although it's not exclusively women. I keep asking myself: how did dessert get defined as bad or sinful or off-limits anyway?

I'm aware that the history is rather complicated, and I've read many books looking at the subject. It all seems to stem from the premise that under-eating is somehow virtuous, and over-eating is a sin. After all, gluttony is one of the Seven Deadly sins, but dieting is nowhere to be seen. I find the religious overtones fascinating, too: desserts as sin and exercise as atonement. It seems these religious sentiments are particularly associated with Christianity (although living in suburban America, Christianity is the dominant religion wherever I've lived). I mean, have you ever seen a fat Jesus?

Yet with all of the evil and wrongs and despair in this world--the oil spill in the Gulf, the wars, the economic difficulties--we most frequently refer to "bad" in context with dessert. It's cake! Eating it doesn't make you a sinner or a saint. It just makes you an eater of cake.

So when yet another women gave me her order ("One cannoli and a red velvet cupcake, please!") and then lamented, "Oh, I'm being so bad!" I looked at her and said the following:

"Ma'am, you said please and you're not stealing anything. How could you be bad?"

She looked at me.
And laughed.
And ruefully admitted: "I guess not."

This next Tuesday, I leave for Austria, Germany, and the 2010 International Conference on Eating Disorders in Salzburg. I've been to the UK twice (even lived there for a semester in college), but I've never been to mainland Europe or any country whose native language isn't English. It's exciting, and it's also a little nerve-wracking. My silly brain comes up with all sorts of scenarios to worry about, such as: what if the volcano in Iceland starts erupting again? What if I have to take a bath rather than a shower (it's a "thing" of mine, baths)? What if I don't know how to order decaf coffee or Diet Coke/Coke Light? What if our luggage gets lost?

There are those "what ifs" that I'm guessing many travelers with anxiety can relate to. Of course, my history of anorexia means I'm also worried about the food. My knee-jerk concern is that I'm going to gain heaps of weight while away. Granted, most German cooking isn't exactly low-calorie, but I also know that I basically have no real tendencies to overeat. Then I worry that the ED might decide to stow away in my luggage and ruin the trip and make me scared of all the food. I'm not sure how I can simultaneously worry about both weight gain and relapse at the same time, but let me assure you that it is possible!

Part of what I've learned in recovery is to always make sure I have food with me in case of emergencies. These so-called emergencies can be anything as minor as I get hungry at a rather inopportune time (high on the Alps, say), to being in a town and not finding anything I like. Most people probably wouldn't fret all that much about these scenarios, but I know I have to anticipate such things to maintain my recovery.

So here's a sampling of what I'm bringing: packets of Carnation Instant Breakfast (to add to milk or coffee to amp up any breakfasts that might be lacking or have at night), instant oatmeal, squeeze packs of almond butter to keep in my purse (no utensils necessary!), protein bars, and a water bottle. I'm very familiar with all of these options, so if I get spooked by massive portions of schnitzel or I find myself in any other bizarre situation, I have something safe and standard to fall back on.

Part of me, of course, wouldn't mind bringing all of my food, but a) I know that's pretty disordered thinking and b) how would I pack my shoes if I had all that food. I am looking forward to being able to try new food and such--it's one of the things I like about traveling--but it the prospect does bring a little uptick in anxiety. Like so many things in life, it's a mixed bag. I can't recover if I'm always hesitating and hanging back and staying perfectly "safe." I need to push the envelope just a bit, so I can have the experience of succeeding at another eating situation.

What are some tips that you use to stay in recovery while traveling?

In recovery, one of the most difficult things for me wasn't just eating, but getting used to eating regularly again. I resented having to do the dishes because it was such a pain and it was so much easier when I wasn't eating and therefore didn't dirty anything. I hated having to pack a lunch- though it is time consuming and a pain in the butt, ED stuff aside. And I hated having to think about what I was going to be eating. When I was in the midst of AN, it was easy. I ate the same thing day in and day out. Same brand of cereal, same flavor of yogurt, same fat free salad dressing. It was a ritual to help relieve my anxiety about eating.

Working with my meal plan has been challenging because I'm not allowed to eat the exact same thing every day, and I also had to eat adequate amounts. Even six months after weight restoration, I still follow my trusty meal plan. It keeps me on track, and my dietitian worked in enough flexibility that I wouldn't feel penned in by meeting my requirements (my snacks are X exchanges, one of which has to be fat or protein). Throughout the past year, I've picked up a number of tips that really make meal planning much easier.

Batch cooking. When I was working full time, I made meals for the entire week on Saturday or Sunday. Because I lived by myself, I usually made two different meals that I could alternate and/or bring for lunch. The variety wasn't optimal, but living by yourself doesn't really allow for heaps of variety. Nonetheless, it worked. And then I didn't have to get home from work exhausted and have to think up something to cook. If I had leftovers, I portioned them out in individual serving sizes in freezer bags, and then just popped them in the freezer. Great for those times when you need something fast.

Plan the night before. In the moment, I often get anxious when I have to decide what I need to eat. Often, it was easier not to eat than it was to decide. So I began to decide what I was going to eat the next day when I could remain calm and rational. Not that I didn't get anxious, but I could make much wiser decisions when I didn't have to face both the decision and the immediate prospect of eating.

Deal a meal. I don't know if any of you remember "Deal a Meal" diet with Richard Simmons (did that totally date me? I think it did), but the general idea was that you got a bunch of index cards with various recipes/menus for breakfast, lunch, and dinner. Essentially, it was a weight loss meal plan. But after a while of working with my current meal plan, I developed a few staple meals and snacks that I could use. Such as: cereal, granola, milk, banana, sunflower seeds. Or power oatmeal. Or an egg sandwich. Lunch could be a sandwich or cottage cheese with peanut butter toast. Things like that. This way, I didn't have to plan each meal or snack from scratch- all I had to do was pick one of my options, and I ended up with a pretty wide array of options.

What tips do you use when cooking or planning meals that help you stay in recovery? Have you found anything that's less than helpful?

Many of the conversations I have with customers in the bakery are repetitive and predictable. Most of this is pretty expected: we have quite a number of items, but not that many. You can only ask for so many things. But part of the repetitive nature of the conversation has to do with people (mainly women) commenting about how fattening everything is, how can I be skinny and work in a bakery?!?, and how what they're buying is for "someone else."

I just want to shake some of them* and say "I don't care. Really. I'm not judging you for buying a sweet treat. I really don't care. What's more, I'm kind of glad you indulge your overpriced sweet tooth because it means I have a job. And it's not my dream job, but I do rather like getting a paycheck."

What these people are really doing is apologizing for buying something "fattening" and "tempting." I have plenty of issues with apologizing, to be sure, but the cultural mea culpa when it comes to eating is something else. I want to say "You are buying food in a grocery store- there's nothing to be ashamed of!"

A woman yesterday bought an eclair and said it was for her husband. She had just started Weight Watchers and wanted to "be good" so she was going to watch him eat it, "with tears running down my cheeks." All I could think was: and I'm the one with the eating disorder? Why must everyone else be so conflicted about something that my treatment team has been telling me for years is a good and necessary part of life?

More than that, it's really boring. I am so incredibly sick of thinking about food and weight and good and bad and should I or shouldn't I. To have these thoughts echoed in the people around me is just annoying. And so I want to say (to them and to me):

It's just food.
Really.
That's all.
You don't have to feel guilty
or ashamed
for eating food you like.
There's nothing wrong.
I'm not judging you.
It's just dessert.
Enjoy it.
And then move on.

*Not the least of which was the old lady who yelled at me for mislabeling the pecan cinnamon rolls as our regular cinnamon rolls. I told her that wasn't pecans on top, just streusel. She said no, it was pecans. I said it was streusel and grabbed several other boxes to show her. She got angrier and angrier, saying No, it's PECANS, until I finally convinced her that it was streusel by showing her the pecan rolls. And she said "Well, how can I see that without my glasses?"