An Argument for Recovery
Lynne Martin, RD
January 1, 2009
New Dawn Eating Disorders Recovery Center
As a clinical dietician working with patients with eating disorders, I commonly hear my patients say "I will only restrict, over-exercise or vomit till' I reach my weight goal" or "I just need to binge and vomit now to cope and I will stop when things in life get less crazy". They remark that despite having every intention to disengage from restrictive dieting, bingeing, vomiting or other disordered behaviors, they find themselves unable to stop. This inability to take back control and disengage from the eating disorder becomes more and more troubling for the sufferer, resulting in devastating effects on medical, psychological, social, and occupational/educational functioning.
Understanding the impact that restrictive dieting has on the body appears to have tremendous therapeutic value for my patients. Through this educational process, they begin to connect how their body's state of starvation causes a series of side effects that they might not have originally linked to their eating disorder, including preoccupation with food and or body image, increased depression, anxiety, sleep disturbances, inability to concentrate, and indecisiveness.
I review with my patients a study done on a sample of men in the 1940's conducted by a scientist named Ancel Keys. The study is known as "The Minnesota Starvation Experiment" and was conducted to gain insight into the physical and psychological impact of starvation among soldiers returning from war. The sample of men who participated were conscientious objectors to the war. They had no history of depression, anxiety, food or body image issues prior to participating in the study. However, while experiencing a period of months of extremely restrictive eating (i.e., semi-starvation), they began having side effects that individuals struggling from eating disorders often end up with, including inability to concentrate, low energy and motivation, severe depression, preoccupation with food, irritability, and body dissatisfaction. One subject suffered such severe psychological distress from semi-starvation that he was admitted to a psychiatric ward. Another admitted to stealing food and eating large numbers of raw rutabagas, huge amounts of gum, and eating scraps of food found in garbage cans. Following the semi-starvation phase of the study, several months of rehabilitation (i.e., re-feeding) occurred.
Especially during the beginning of this rehabilitation phase, many of the men reported episodes of binge-eating. That is, once these men had access to food again, they could not satisfy their intense hunger and would experience episodes of uncontrolled eating. Binge-eating and food preoccupation continued to be present for up to five months, but importantly, did resolve along with the other symptoms mentioned like depression.
As disturbing as this study is, its findings often provide relief to my patients. They can toss away their belief that they binge because they have no self-control or willpower and begin to see how their restrictive eating practice is what leads to their bingeing. They also see how eating consistently will help lift their mood and give them more energy so that they feel more satisfied in their lives. Our program at New Dawn provides patients with the tools needed to rehabilitate from months or years of restrictive dieting. Knowing this is possible has proven to be a very strong argument for recovery.
Lynne Martin holds a BASc in Applied Nutrition and is licensed by the commission of Dietetic Registration (RD). Her experience in the field of eating disorders treatment began 17 years ago when she worked for several years at Toronto General Hospital's Eating Disorder Program, a world-renowned inpatient facility. There she gained invaluable training integrating cognitive behavioral therapy with nutritional counseling in both individual and group settings. Lynne is a founding member of New Dawn Eating Disorder Recovery Center and played a central role in the development and implementation of the nutritional aspects of the program. She utilizes a non-dieting approach, helping her patients achieve healthy lifestyles at any size. She is a member of the American Dietetic Association.
