women and eating disorders

chelle

New member
Without question, many active women are at war with food and their bodies. They have gotten messages that food is the fattening enemy, thinner is better, and exercise can help shape a perfect body. The result is often full-blown eating disorders, milder disordered eating, yo-yo diets, a negative body image, and exercising as a form of punishment.

If you have the eating disorder anorexia (in which you severely restrict your food intake) or bulimia (in which you overeat and then rid yourself of the food by vomiting, taking laxatives, or excessively exercising) the advice in this column is probably not enough to help you resolve the issues you are struggling with (for more resources, see "For More Help"). However, if you have disordered eating patterns--you find yourself caught in the vicious cycle of dieting, exercising, blowing your diet, and then exercising even harder--here is some advice that can help bring peace to your food and exercise program.

Food Is Fuel
Just as your body needs to sleep, urinate, and breathe, it also needs to be fueled. If you think of food as being the fattening enemy, you'll struggle with every mouthful. You'll be better off if you think of food as fuel that you need to help you function and exercise at your best. Your body needs fuel to pump blood, grow hair, breathe, and--if you are a woman--menstruate.

Everyone needs to eat--even people who don't exercise. For example, the average 120-lb woman needs about 1,200 calories per day to simply lie in bed and breathe. She needs an estimated 600 more calories for general daily activities (dressing, brushing teeth, working, shopping, etc), and then even more calories (about 200 to 400 or more calories) if she exercises.

If you are maintaining your weight even though you eat far less food than you need (see "Get What You Need"), your body is likely conserving energy by slowing down its processes. You wind up with cold hands and feet, sluggishness during daily activities, and loss of your menstrual period.

To stop conserving energy, you should eat a few more calories per day, upping the amount a bit more each week until you get to an appropriate calorie intake. For example, on the first week, you could add a 100-calorie yogurt to your breakfast; on the second week, a 100-calorie can of tuna into your lunchtime salad; and on the third week, a medium banana as an afternoon snack.

With these adjustments, you will be more adequately fueling your body and you will be less obsessed with food and feel less hungry. Constant food thoughts are nature's way of reminding you that you want and need fuel. And don't worry: You can eat more without "getting fat."

Talk to a Professional
A registered dietitian (RD) can help you. Many of my clients confess "I know what I should do to eat right--I just don't do it." But in most cases, they don't know how to eat right and that's the problem.

Our society and the media have taught many of us to diet on too few calories. A the woman who thinks she should be eating 1,000 to 1,200 calories per day plus exercising for 45 to 60 minutes is trying to eat too little. She may overeat toward the end of the day because her spartan breakfast and lunch have contributed to a strong drive to eat. What she sees as being "addicted to food," "out of control," and "compulsively overeating" may simply relate to an extreme hunger and an inadequate food plan.

By getting a nutrition check-up with an RD, you can learn:

What an appropriate weight is for your body;
How many calories you should eat to maintain or lose weight;
How many grams of protein and fat you need to protect your health;
How much milk and other calcium-rich foods you should include to protect your bones; and
How to budget your calories into a balanced diet.
To find a local RD who specializes in sports nutrition, call the American Dietetic Association's referral network at 1-800-366-1655 or call your local sports medicine clinic or health club.

Make Fitness Fun
The "e" in exercise should stand for enjoyment, not exhaustion. Aim to have fun exercising instead of pushing yourself to burn off calories and redesign your body. Exercise should be for health, fitness, and, in some cases, competition.

If you truly need to lose weight, exercise can help by creating a calorie deficit that reduces stored body fat. You can do this by eating a little less, exercising a little more, or combining the two. But if you eat a lot less and exercise a lot more, you'll create such a huge calorie deficit that you'll feel driven to eat--and will likely overeat. You won't lose weight: You'll just become overhungry, exhausted, and, eventually, injured. Moderation is a better policy.

An exercise physiologist or a certified personal trainer at a local gym can help you develop a personalized exercise program that will focus your workouts on improving your fitness and stamina, not endlessly exercising to pound and punish your body to lose weight.

Your training program should include at least 1, if not 2, rest days per week. Your muscles need days off to heal and refuel. Otherwise, you'll feel chronically fatigued and be at risk for injuries.

If you fear that rest days mean fitness loss and fat gain, relax. It won't happen. Your eager appetite may scare you into thinking you'll be gaining weight, but that's not the case. On your rest days, your muscles are busy refueling. The carbohydrates you eat will be used to replace glycogen (which you use for energy). With each ounce of glycogen you store in your muscles, you'll also store about 3 ounces of water. As a result, the scale will go up, but this reflects a gain of water, not fat.

Rather than focus on the scale, be sure to notice the benefits of taking a rest day: You'll feel better and be more likely to enjoy your next day's workout.

Get What You Need
(Back up to article)

To estimate how many calories you need, first multiply your weight in pounds by 15. This is how many calories you need for your moderate daily activities. If you are very active throughout the day (apart from any workouts you may do), add 10% to 20%. If you are inactive, subtract 10% to 20%. Then, if you exercise routinely, add about 200 to 300 calories per 30 minutes of moderately hard exercise (such as running, step aerobics, or bicycling). This number is your total daily calorie need.

If you need to lose weight, subtract about 20% from the total calories. For example, the 140-pound runner who maintains her weight on 2,400 calories per day could lose weight by eating about 1,900 calories per day (20% x 2,400 calories = 480 or about 500 calories; 2,400 - 500 = 1,900).


If you are struggling with the extremes of disordered eating-anorexia or bulimia-or if you are a concerned parent, coach, or friend, you can turn to the following organizations for help:

American Anorexia/Bulimia Association, Inc
418 E 76th St
New York, NY 10021
(212) 734-1114

American Dietetic Association
National Center for Nutrition and Dietetics
216 W Jackson Blvd, Suite 800
Chicago, IL 60606-6995
(800) 366-1655

Anorexia Nervosa and Related Eating Disorders (ANRED)
Box 5102
Eugene, OR 97405
(503) 344-1144

National Anorexia Aid Society
1925 East Dublin Granville Rd
Columbus, OH 43229
(614) 436-1112

Overeaters Anonymous Headquarters
World Service Office
383 Van Ness Blvd, Suite 1601
Torrance, CA 90501
(310) 618-8835

National Collegiate Athletic Association
c/o Karol Media
350 N Pennsylvania Ave
Wilkes-Barre, PA 18773
(800) 526-4773
(provides videotapes on eating disorders)


*Ms Clark is director of Nutrition Services at SportsMedicine Brookline in the Boston area. She is a fellow of the American College of Sports Medicine, a fellow of the American Dietetic Association, and a member of its practice group, Sports and Cardiovascular Nutritionists (SCAN).
 
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