Friday, July 27, 2012

Counting to Gain

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.


  1. You really don't want to be stuck in this mode forever, it's one of those things where the only way out is through...and I know it's hard, but try to trust J. She sees a LOT of patients in weight-gain mode, and I'm sure she wouldn't lie to you about what is a fast or slow rate of gain.

    I understand what you mean about not being able to turn the calorie-counting off (you can't un-know them; had that conversation with my D. not infrequently), and I'm glad she finally agreed to talk with you about how to use that in a way that will move you forward or at least help you to keep from going backward.

    Hang in there, you impress me daily.

  2. I found that knowing the numbers and being able to use them as a tool was more helpful than the exchange system. You can't "cheat" that way. I'm glad J is so willing to use a variety of methods to help're bound to find one that works :) I agree with Cammy--you impress ME daily as well! (well, more like weekly because that's when I get around to reading blogs, but still!)

  3. I found it easier to know calories for a while too-- made it easier for me to be sorta spontaneous and go out for lunch w/my coworkers w/o having to do so much math w/r/t exchanges. And like you said, it's one more way to be accountable. I was waaaay overestimating the amt of food that I was eating too, and it wasn't until a stint of IP that I got a full grasp of what some servings were honestly meant to be.

    And re: couldn't stop if you tried-- I haven't thought about calorie counts in a very, very long time. I never thought I'd get past that, it was innate. I've done it since before food items had calorie labels [yes, I'm old, haha, I think that happened when I was probably in fifth grade or so?] and now with calorie amts posted in most restaurants it seemed inevitable that I'd always always always know those numbers. Not so. Sometimes when I'm zonked or had a particularly intense workout I'll be like, what's the most calorically dense thing I can snag from the vending machine on this ten minute break from work, but that's it.

    Just wanted to share that uh, when the body is fed the brain can often find better things to do with its space too.