Restricting, HAES and the Food Psych ‘Philosophy’

Visualisation in Therapy

Welcome to a new kind of blog post here on Oh Yes She Did. The format is inspired by Leandra and Harling’s thought-provoking email threads that are frequently shared on Man Repeller, but the content will be very different (although, I can see a future where fashion is very much a topic of discussion).

My best friend, Claire, and I recently decided that a good way to keep in touch (she lives in Minnesota) AND have meaningful conversations about topics of mutual interest, was to start an email thread on a given topic and go back and forth commenting and sharing our thoughts until we felt the conversation had been exhausted. What follows, is our very first email thread — a discussion of Health at Every Size, Disordered Eating, and the Food Psych Podcast.

From Claire: Calorie Counting, Weight Loss/Gain, Restriction — At What Point Does it Become A Problem?

So I was listening to the Food Psych podcast (which I haven’t been doing lately but I decided it’s worth trying to get back into) and I couldn’t help thinking about this conundrum where I want to have a healthy relationship with food and not count calories, and yet I also feel my best at a certain weight and I need to eat a certain amount of calories to get back to/stay at that weight. And in the podcast they were talking a lot about how counting calories in any form is disordered and wrong and something no one should be doing. 

I know for me my relationship with food is better than it has been. I don’t restrict and I don’t beat myself up if I eat too many calories anymore. I no longer suffer from bulimia or feel any super strong urges to get back to that place. But my low weight that I maintained for 5 years was as a result of an eating disorder where I just never gained the weight back after I “recovered.” My weight stayed consistently low until I started some medications 2 years ago that cause weight gain, at which point I slowly started to put on weight until I got to the point I’m at now where I’m uncomfortable with my body and don’t fit into a lot of my (admittedly very small) clothing that fit a year ago. 

And so I end up in this place where I feel best with lower body fat/lower body weight, but that weight was as a result of an eating disorder so is this weight that I am now my “real” set weight? I’m back to weighing what I did in high school. And then with that, is it so wrong of me to feel better and want to be a lower weight? At what point does that become a problem? Is there any way to count calories and NOT be disordered?

x Claire

From Cristina: The Food Psych ‘Philosophy’

It’s really interesting you say that because I listen to the Food Psych pretty religiously and also feel so torn between wanting to have an intuitive relationship with food and fully accept and love my body at any weight, and the reality of being happiest at some “smaller” (undefined) size. It’s the same conundrum. And it’s funny because the more I start to understand some of the complexities of my mental health, the more I begin to feel like the Food Psyche’s unanimous, unwavering stand on the virtues of practices HAES and intuitive eating for EVERYONE is not only unfair, but flat our wrong.

Getting back to you, I think it’s so great that you can say your relationship with food has improved from what it was. To have recovered from an eating disorder is no small feat. What is interesting is that a lot of people who recover from eating disorders do so by tracking their calories (rightly or wrongly). I’m not sure if that was your story? 

I know the Food Psych would argue that food tracking is just another way diet culture has permeated the field of nutrition and eating disorder recovery. But I can’t help but wonder whether the HAES/Intuitive Eating approach would actually work for those in the thick of an eating disorder who are looking to recover? For me personally, the lack of control (or at least the perception of a lack of control) that comes with intuitive eating is disconcerting at best. At times, it’s downright terrifying. And I never had anorexia or bulimia, although, as you know, my relationship with food is definitely disordered. 

Maybe tracking isn’t the worst thing in the world if it means someone can heal their relationship with food enough to ensure they’re getting the calories they need to survive? And if your happiness is tied to how you feel in your body, which for most people it is, is it fair to tell someone that what they need to do to feel healthy, happy and good about themselves is “bad”? After all, the control in and of itself, isn’t the problem. It’s the obsession with a physical aesthetic that directly implicates food – how much we consume, what we consume, when we consume it, etc. 

Am I onto something? 

By the way, speaking of not feeling good in your body – I can relate. Even though I’m not on medication, I feel like I am barely maintaining control over how my body looks and how I feel in it. And I workout a shit load. And I eat pretty healthy. What in the living fuck would happen if I didn’t?

x Cristina

From Claire: Eating Disorders, Chronic Health Issues, and Fad Diets — Where the Nuance is Lacking

You make a good point that recovery from an eating disorder does kind of require calorie tracking. That was less of an issue for me as my predominant problem was bulimia, but my sister had very severe anorexia in high school and my mom kind of took over for her and gave her food to eat at the times she was supposed to eat it so she never really knew how many calories she was eating or was “supposed” to be eating. Probably not a strategy that works in adulthood because you don’t have a stay at home mom that can drop by school 3 times a day for snacks and supervised lunches. But I think that’s why so many people with eating disorders end up in the “wellness” sphere when they “recover” because they had to track calories on the way out and it turned into “oh I can track as long as I’m eating healthy” or whatever. 

I also feel like the Food Psych philosophy (it’s sticking, that’s what we call it now) lacks a lot of nuance. Part of the reason I ended up stopping listening and only got back into it recently is because there was a whole episode where they were saying that anytime a doctor says you need to follow a special diet for your gut health, it’s bullshit and if you ate the foods that are “bad” for you you’d find out you were wrong. They made exceptions for celiac but that was about it. And I just felt like that was wilfully ignorant. As you know, I have severe IBS and I take meds for it but I also have to follow a low FODMAP diet. And it’s not something I found by myself. It was years of doctors and tests and gastroenterologists. And the diet is actually the only proven thing that helps mitigate IBS symptoms. It’s extremely academic, there’s a university in Australia that’s basically got a whole department dedicated to keeping it up to date and learning more about the mechanisms. And then these supposed health advocates who are all registered dieticians are sitting there on the podcast saying I can totally eat all the foods I have to avoid, like garlic and onions, and avoiding them is a form of restriction for me. 

I do think that there are a lot of people who go gluten free or dairy free or whatever who really don’t need to. And they shouldn’t – I’m missing out on a lot of nutrients because of the foods I can’t eat and it actually makes me less healthy from that standpoint. And I know people, including one girl who is all self righteous about being dairy free, gluten free, whatever and her boyfriend let slip that she ate ice cream the other day and didn’t get sick. And my friend’s husband (my friend has similar issues to me – IBS is common y’all) was like “Uh, maybe she never needed to avoid dairy, idk what do you think about that?”

So on the one hand Food Psych has a point – people are using these fake intolerances as a way to restrict or be “better” with their food. But you also have to acknowledge that there are people like me who don’t have a choice and really DO need to avoid certain foods because they make us very ill

I understand why podcasts and such don’t do nuance, because they’re trying to make their point as strong as possible and because most people aren’t like me, most people are restricting. But it really irritates me when nuance isn’t included because it makes me feel alienated from the movement. So long way around to saying that I also have a complicated relationship with the Food Psych philosophy. And I still don’t know whether or not I think there’s no healthy way to track food/calories. On the one hand I feel better when I track. But on the other hand I often want to push you off the cliff and into HAES because I feel like it could benefit you. Which is super hypocritical. But that’s just a function of being human.

I would disagree with you on your last point because actually I think control IS the problem. Most eating disorders, be it anorexia, bulimia, orthorexia, whatever, are commonly comorbid with OCD. And even when it’s about achieving an aesthetic ideal, it’s a control thing. Even when you talk about it, you say you don’t want to stop tracking because you’re uncomfortable with the lack of control. When I had my eating disorder it was only tangentially about being thin. That was like a bonus side effect. It was really about controlling my life, carving out this thing that was mine that no one knew about, exerting will over my body. For example, when I felt extremely, what I’d probably say now was manic depressive, I’d puke to calm down the world. And I also did it as punishment when I wasn’t good enough. I think if you examine it, 90% of disordered eating is really about control. And disordered eating is on the rise for both men AND women, which I don’t think is coincidental in that it’s increasing alongside growing uncertainty in our world: climate change, debt, the rise of extremist political groups, inability to afford a house or a family, underemployment. 
Sorry that was really long. Oops. I hope it makes sense.

x Claire

From Cristina: Flawed Philosophy Much?

First of all, well done for a novel of an email. I have to admit, it has been a bit daunting thinking about how I’ll respond to it all. Given that multiple weeks have now gone by, it’s clear that I need to relax my personal expectations and just respond in the time that I have and with the words that naturally come to mind. Look at me being all anti-perfectionist and shit. 

You’re completely right that so many with previous ED histories end up in the “wellness” space upon “recovery” precisely because they can maintain control by counting/tracking calories. I guess I’m still of the mindset that as long as you’re healthy (i.e. at a sustainable weight and able to move your body everyday) then it’s less about how you go about getting the nutrients you need and more about just getting the fuel. It’s nice when a mother can ensure her child is eating by hand delivering meals, but obvs that’s not practical in most cases. So yeah… I agree with you? 

Super happy we’re in agreement on ‘Food Psych philosophy’ as a title and I completely agree that it lacks nuance. Similar to you, I stopped listening for a time because I felt like her sort of cut and dry approach was overly simplistic and didn’t leave space for some of the issues I have around food or know of others (like you) to have. I mean, ultimately, what she’s saying when it comes to something like FODMAP is that the science is what… Wrong? Irrelevant? Doesn’t matter? I found that perspective not only extreme, but also wilfully ignorant. The thing about restriction is that it’s only restriction if you want it and tell yourself you can’t have it because it’s “not good for you”. Without that internal conversation, there is no restriction. What if you legitimately didn’t like the taste of garlic and onions? (I mean… you’d be crazy, but that’s not the point). If you didn’t like the taste of them AND it just so happens that you have IBS and not eating them actually makes you feel better, that wouldn’t be classified as restriction. So… 1 point to Claire and Cristina. 

Completely AGREE here — SO many people jump on the anti-gluten or anti-[insert demonised food group here] because it’s “healthy” and/or popular to do so. But that behaviour is misguided and ill-informed. In terms of dairy, I will say that I think it’s really important to consume organic dairy (no antibiotics, organic pesticides or whatevs), but there isn’t any reason to cut it out entirely (although I personally don’t really like the cow-y taste of taste of most dairy, so I usually use non-dairy alternatives).

RE your friend who totally didn’t get sick from eating ice-cream, UM YEAH I KNOW those people too. It really bothers me when someone says they can’t eat something because they’re “sensitive” to it, when really all it is is a way to restrict calories under the guise of “eating healthier” or whatever. If you have to lie about why you’re doing something, it’s probably restriction. But yeah, 100% with you on the fact that the Food Psych leaves zero room for people whose bodies can’t process or absorb or properly breakdown certain foods. Philosophy flawed much? 

Also… Where are the counter arguments man??? That’s my problem. Like, sure she makes some incredibly strong and well-informed arguments and I support A LOT of what she says. But, as we know well from academia, an argument is only as good as the counter arguments it systemically acknowledges and then (in many cases) undermines. Like… no one philosophy is going to work for everyone in every case so why is that what we’re striving for here? Also, as you said, failing add nuance to your POV, alienates everyone who doesn’t quite fit your mould. And I guess this kind of ties in with your point of wanting to track for yourself, but feeling that someone like me could really benefit from NOT tracking and embracing a HAES.

There are approaches to food consumption that will be a form of restriction for me that wouldn’t be a form of restriction for you because the mentality behind it isn’t the same. And also, I don’t know about you, but I very much feel like this changes depending on the phase of life I’m in. 

On this final point, I have to disagree. I used the word control, but for me, it’s more the anxiety of not knowing how much I have had (calories, protein, carbs, etc.) because I want to be thin. Thin isn’t a happy by-product for me. It’s the goal. The control via tracking is just the method to achieve the goal. I also think that because I don’t really have OCD, it’s less about the control and organisation of tracking and more about the pursuit of changing my body. If that makes sense? I completely get how it’s different for you though and I know that what you’re describing is true for a lot of people with eating disorders.

I also have a hard time calling my relationship with food an eating disorder since I never purged or was anorexic. Then again, food has consumed so much of my mental space over the years that it would be hard to say, objectively, that I don’t have some kind of eating disorder. Disordered eating feels more apt. How is that any different though? 

In short (though this ended up being quite long), the Food Psych philosophy is flawed and therefore I feel like HAES isn’t for me in a lot of ways.

Thoughts?

X Cristina

From Claire: Wrapping it Up

Well I definitely feel like it’s time for you to get this up there and publish it, but I thought I’d add a couple of closing notes.

Interesting point about how in Food Psych there’s no opposing viewpoint discussions ever – because you’re right, there are multiple schools of thought that are academically/medically valid and you only help your case by at least discussing some other sides of the issue. I would love if she had someone like me on who has had an eating disorder and struggles with fat-phobia and restriction at times but also HAS to follow a restricted diet for chronic health issues. That’s a complicated topic that acknowledges that both sides of the issue can be true: people can be restricting unnecessarily/lying about it/hiding it under wellness AND/OR they can also be sick.

We know that what we consume impacts our health in certain ways so is it so crazy to say that people with severe IBS (which btw she doesn’t class as needing a special diet like celiac because IBS is a chronic illness that predominantly affects women and as such has been incredibly underfunded and under-researched and therefore yes there isn’t as much data out there about how a specific elimination of foods helps us BECAUSE OF A TOTALLY OTHER STRUCTURAL ISSUE that you’d THINK she as a feminist would understand) can’t possibly need to follow a diet that makes us healthy because we don’t have celiac, which is the only legitimate one apparently. It’s like saying people with depression shouldn’t take anti depressants or go to therapy because they don’t have schizophrenia so they don’t actually need it.

I think we’ve done a really good job talking around this issue and how it’s hard because it seems like this supposedly inclusive movement is in a lot of ways alienating to those of us who need it. Interested to see what your followers and readers think and what they have to say about it in the comments.

Also as to my last point seemed like a good segue to…..maybe our next discussion can be related to mental health and why people feel that only certain things count as serious enough to need help? Also ties into your point about your eating where you don’t want to call it an eating disorder because it isn’t as bad as that other hypothetical persons eating disorder. 

This long distance BFF pen pal system is my new favourite thing. Can’t wait to get into our next topic! Maybe we can actually respond to each other faster this time…..lolol.

Love, Claire

Final Thoughts

I really hope the above the discussion was of interest to you! If you have an opinion, please do feel free to jump in and share via the comments section. We would love to start a meaningful discourse and hear from people who are genuinely interested in healing their relationship with food while doing what is best for their body.

If you liked the format of this blog post, please also let me know! I think it really adds a lot to a platform when multiple voices get to contribute and whilst this is still a very personal space, I think posts like this could add a lot of value as a regular content theme.

xx Cristina

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