I mentioned a few weeks ago here about how my dietician J never talks calories with me, even though I've been upfront with her about the fact that I count and track them obsessively, and that it's hard for me to eat adventurously or branch out beyond my safe foods simply because it makes the calorie-counting equation so much more difficult - both logistically and emotionally. Eating foods with unknown calories makes me so freaking nervous. When I was gaining weight in the winter/spring of 2011 (from a low/sick weight to a minimum healthy weight, which is XX lbs more than I am now, and is again my minimum target), my old dietician used a concrete calorie-based meal plan and I pretty much followed it to the letter. This time around, I've been resistant from Day 1 (sorry J!) - partly, I think, because we haven't been on the same page at all about the calorie issue. I've told her over and over again how compulsively I calorie-count, and her response has always been to brush it off. She tells me not to worry about calories, that she's got it under control, and that me counting calories will only up my anxiety. All true...but after so many years, the counting has become a reflex - I couldn't stop if I tried.
So today, finally, we talked calories. As a general policy, J avoids using numbers with ED patients because she thinks - and I probably agree - that for most people, it's more anxiety-provoking than productive. She's the professional and I respect that, but I really appreciated that she treated me as an individual and accepted that I'm going to be counting calories anyway. I could probably rattle off the calorie content of most foods in any grocery store, cafe, restaurant, etc. pretty easily. It's not as if I can just erase all that from my brain, so we talked about using it as a tool rather than an extension of the disorder. Rather than creating my own arbitrary daily allotment, I can count calories to make sure I'm getting enough and not cheat myself by substituting lower-cal exchanges (e.g. counting a broken cracker as my "grain.") Using my powers for good rather than evil, if you will.
Then we went through my meal plan, writing out the calorie content of each item. I was pretty accurate in all my guesses, except that I tend to overestimate. Meaning that a Kaylee-serving of xyz food does not necessarily equal a J-serving. Oops. So the verdict was: even when I think I'm hitting the full meal plan, I'm coming in short calorie-wise compared to what J wants. Having the numbers out in the open was good for both of us in that it gave J more insight into what I'm actually eating, and gave me insight into what I'm supposed to be eating.
But. But but but. I'm gaining weight. I kept bugging her with that one over and over again: I'm eating fewer calories than you thought and I'm still gaining weight. And her answer every time: Yes, but it's happening too slowly. Even for outpatient. You don't want to be stuck doing this forever.