If Only I'd Known

There was an article in the New York Times earlier this week about how the "Freshman Fifteen" is more like the "Freshman Three" or so, which made me laugh. Not in an out-loud HAHAHAHA way, but more of an isn't-that-ironic, thanks-a-lot-NYTimes-but-too-little-too-late way.

Honestly, a fear of gaining huge amounts of weight was a big contributor to my restrictive eating habits that intensified when starting college. After my initial big weight loss during middle school, I had slowly regained and maintained a healthy weight throughout high school. Then I basically starting restricting again the summer before freshman year. The idea being that I had to prepare for and counteract the inevitable Freshman Fifteen. I dropped a bit of weight then, pretty much maintained through the school year (2009-2010), and started losing again over the summer.

Obviously, the ED was caused by a LOT of factors and manifested itself way before I was even thinking about college, but I have to believe that a fear of the stereotypical freshman weight gain definitely played a role in triggering the relapse I'm still dealing with today. That's not to say that if I'd read an article over the summer of 2009 about how my fears of the Freshman Fifteen were completely unfounded I would've never returned to the eating disorder, but still. Makes me wonder. And laugh, a little.

Failing at Therapy

R wants me to gain weight so that we can move forward and talk about things other than food.

I want R to fix my brain first so that I feel okay with gaining weight.

Obviously, he's right and I'm sick. But the bottom line is: I don't feel capable of adding calories and gaining to the weight he wants. I just don't. At this point, my mind won't let me. I'd hate myself too much.

To clarify: my weight is NOT in a danger zone. It is lower than optimal, but not deathly (I swear!). So yes, I should gain the weight that R wants - or at least regain the weight I've lost since May - but it isn't a matter of life of death at the moment.

So it's hard for me to agree with R when he goes all alarmist on me about it. It's not that I'm not taking it seriously, it just doesn't seem like something that needs to be fixed right this second or else you won't make it through the semester. 

Right now, I just feel stuck. I'm not trying to intentionally antagonize R by being a stubborn little snot, but my brain is caught in a rut and the idea of changing up my meal plan with the goal of actually gaining weight is absolutely unfathomable. It's not that I don't think gaining weight is necessary - I do think it's necessary, to a certain extent. I want my period back. I don't want to be ruled by food rituals. I want to be able to eat in restaurants without freaking out before, during, and after. I want all of these things, but I just cannot see myself actually giving up what I have now. Which is, essentially, a pathological obsession with meaningless numbers.  Yay.

There was a moment in my appointment this morning when I actually thought R was going to fire me. He didn't, but did start pushing "more intense treatment." The options he laid out: 1) stick with what I'm doing by seeing R and J each once a week but actually follow the meal plan, 2) see R and J each twice a week, and have my mom come out for "support," 3) start going to group therapy in addition to seeing R and J, 4) start attending IOP in the center where R and J work, or 5) go home.

Obviously, I picked the first option. I basically told him IOP was NOT an option. Not interested. Not necessary, in my opinion, and not exactly feasible with my schedule. I know that health is the priority over school, but still.

So. I guess that's where things stand. I'm really going to try following the meal plan.  But if it were that easy, I would have done it already.

New Dietician

I had my first appointment with the dietician in R's office this week. The verdict: I like her, I think. She, J, is younger than my old dietician and has a much different personality, but is friendly and nonjudgmental and nice and didn't make me feel too awkward. So that's all good.

J spent the first half of the appointment asking questions about my history, current intake, habits, etc. Then she gave me a mini Nutrition 101 lesson, which was semi-interesting but not really necessary. I'm pretty much a nutrition expert - in theory if not practice. She looked over my food records from last week and said - I quote - "Oh good, I can work with this." Her official opinion is that I'm good about eating regularly and not skipping meals or snacks, but that my portions are just too small and my choices are too limited. Which I sort of already knew, but it's helpful to hear it from a professional.

So that was the good part. The bad: she wants to reset my ultimate goal weight to a significantly higher number. Like, SIGNIFICANTLY higher. I think she could tell how freaked out I got because she immediately added that this was a "longterm goal." Which confused me even more - longterm meaning in six months? A year? Five years? Ten? What if I get pregnant? It just seemed like the number J came up with was super high - definitely higher than anything I've ever weighed before. If I gained XX pounds over the next few months to get back to my original goal, why should I have to gain ANOTHER X pounds just to get into the new range?

It all seemed kind of moot at the time anyway, since I was feeling somewhat ambivalent about gaining any weight, much less the XX pounds J wants "longterm."

Anyway, we spent some time going over my food records and beefing up my meal plan. I was reluctant about it for obvious reasons, so J launched into an explanation of BMR and how I'd need a certain number of calories just to stay alive - a concept that I know is true, but that my brain still can't quite grasp. Metabolism scares me because I don't know enough of the science behind it, plus I don't think anyone's metabolism behaves exactly according to a scientific formula. So I don't understand how it works and that freaks me out.

Anyway, my go-to method of increasing calories is usually just adding protein bars. I asked J if she minded me eating multiple bars a day, despite my new commitment to variety. She said something interesting:

"When a patient is underweight, I tell her she can eat McDonald's every day to gain the weight back. The health risks associated with eating fast food all the time are less dangerous than the risks associated with staying underweight."

So...a fast food binge wasn't exactly the recommendation I was expecting from a dietician. Not sure I totally believe her, but she made her point. When you're underweight, it doesn't matter how careful you are to get in your fruits and veggies and whole grains - anything less than a weight-gain diet is not healthy for you.

The Rundown

So sorry for the lack of updates. There's not much going on beyond what I've already talked about. I'm hanging in there with eating, trying to stay on track as much as possible. I think my weight is pretty stable but I haven't really been keeping close tabs on it. You would think this is a good sign - that I'm less obsessive about weighing myself at EXACTLY the same time every morning like I usually do - but I historically get less rigid about the weighing ritual as my eating deteriorates. When the anorexia was at its worst last year, I barely ever weighed myself, even though we had a scale sitting right there in the bathroom. I was vaguely aware of my weight, as in I would hop on the scale every once in a while and register the number with a brief huh, that's lower than last time, and go on with my day. It's sort of similar now, except that my eating is way better than it was then and I'm still as nervous as ever for my weekly weigh-in with R. So, I'm not sure what to make of that observation.

In other news, I'm having a really good time with my friends and getting wrapped up in classes and schoolwork again. For the sake of my sanity, I HAVE to stay fairly busy, but it's a fine line between healthy-productive-busy and stressful-panic-self-destructing-busy. Lately I've been toeing that line, trying to figure out exactly where it lies. Schoolwork is starting to pick up, as are various club/research/work activities, and I'm trying to resist the urge to take on a million projects and throw myself into everything headfirst without first consulting my responsible, moderate, reasonable side.

I really hope my last post didn't come across as all doom and gloom, because I really am happy to be here and trying so hard to make it work. I don't think I was ever under any illusions that this would be easy, but the reality of it has still taken some getting used to.

Things I'm happy about:
1) My wonderful, compassionate, brilliant, endlessly supportive and understanding roommate.
2) My mom. We've been talking on the phone almost every day. I know she's super worried about me, and she is doing an amazing job of being available without prying.
3) Therapy. I really like R a lot, and I'm almost looking forward to seeing him this week. I feel like he is very purposeful during our sessions and sets a clear agenda and goal, whereas my old therapist W just sort of asked questions and listened to me ramble before moving on. So I'm thinking R is definitely an improvement and I could make some real progress with him. If only I didn't have to get weighed.
4) The delicious sushi I just ate for dinner. I was feeling fat and gross and really wasn't up to facing a restaurant, but my friends wanted to go and we ended up having a great time. Why don't I learn from these experiences?

Things I'm worried/stressed about
1) Schoolwork, exams, too much reading, blah blah blah.
2) The paper-thin walls of my apartment. Seriously, I can hear my neighbor snoring from the next unit.
3) Therapy. Like I said, I really like R a lot, but I HATE getting weighed. Last time he gave me to option of having blind weights, which I'm still undecided on. I have my own scale so I could theoretically check my weight anytime I wanted, but maybe having the blind weights with R will reduce some anxiety about my appointments so I can focus on the therapy part and not the weighing part.
4) Not having time to get to a grocery store. My food supply is majorly depleted. There are places on campus where I could eat, but not everything is Kaylee-friendly.

I think that's all for now!

New Therapist

Today I had my first appointment with the new therapist.  I didn't realize I was so anxious about it until yesterday/this morning when my stomach started doing these nervous rumblings and I couldn't sit still for more than two minutes at a time.  Homework did not get done.

I think I was just uneasy about jumping back into treatment after being able to sort of pretend to forget about it for a couple of weeks.  Like I got a little honeymoon period without all the therapy and weigh-ins and meal plans, which made recovery - and the ED - seem less real.

I was worried about the therapist being male, and that it would just be too weird to talk to him.  Was I supposed to bring up my period?  Would he bring it up?  Ew.  I was worried about getting weighed - I wasn't sure it would happed, but figured it was a distinct possibility.  So I worried that my weight would be too low and the therapist would think I was restricting.  And I worried that my weight would be too high and he would think I didn't need treatment.  I also worried about having to explain my ED history - how the hell do you condense something like that?  And how do you phrase it without sounding stupid and dramatic? Worryworryworry.

Long story short, I survived and the therapist - let's call him R - was super nice.  I was uncomfortable at the beginning, but I really think it had more to do with me being uncomfortable about therapy in general than it did with R being male.  He was really easy to talk to, even though he made a me squirm a couple of times.  But the squirming was because he was challenging me and trying to make me articulate my recovery goals and some disordered patterns I still have.  So I think it was good for me.

Basically I felt like he understood me without too much trouble, and was able to recognize pretty quickly where I am in recovery.  I signed a release for him to talk to W, my therapist from home, which will hopefully save us some rehashing of stuff I've already gone over in therapy before.

He did weigh me.  At first he wanted to do it backwards, which caught me off-guard because B never did blind weights.  After hearing that I'd known my weight all along, R left it up to me.  So I said that I would rather see my weight, and that I probably already knew what it would be anyway.  Then he asked what I thought my weight was, and my guess was correct within a pound (i.e. I weighed one pound less on his scale than I had predicted).

I was pretty (irrationally) self-conscious about my weight, and nervous that R would say I was too fat for therapy and he wouldn't want to waste his time on me.  Obviously this did not happen.  He started off by saying, "I don't think you need to lose weight."  Okay, well, duh.  I guess I didn't really expect him to tell the anorexic to lose weight.  But then he said he would like me to regain some of the weight I'd lost over the summer, and asked whether I would be willing to do that.  This was one of the points at which I squirmed.  But never fear - I did agree to gain the weight.  Still squirming though.

As for seeing a dietician - R said it probably wouldn't be completely necessary every single week, which is fine with me.  Been there, done that.  And I'm already kind of an expert on calories.  However, R and I both agreed it would be helpful to at least check in with the RD there at least every few weeks.  I tend to lose perspective on what "normal" eating and "normal" calorie amounts are, so hopefully an RD will be able to keep me on track.

So I think this was a positive development.  I'm not thrilled about being back in therapy and I wish it weren't necessary, but I'm open to it.  And at least the guy's nice.

That Feeling

To anyone who says fat isn't a feeling, I say: you've obviously never felt fat before.

I KNOW what they mean - fat isn't an emotion. Fat isn't a mindset.  Fat isn't something that should inform your decisions and your lifestyle the way that joy and empathy and curiosity should.

But fat IS a feeling.  A true, physical sensation.  You feel it with every ounce of your body, even if you don't have any actual fat on you.  You feel it when you move, when you sit, when you get dressed, when you shower, when you - God knows - step on the scale.

A couple of months ago when I was in the midst of gaining weight, I remember wailing to my mom, "But I feel faaaaat!"

Now, my mom is one of the most balanced eaters I'ver ever seen.  She tries to be healthy, but indulges occasionally and eats foods she loves with no guilt.  She exercises a few times a week because she loves running and being outside blah blah blah.  She has a normal, healthy body that she treats appropriately and appreciates for being functional.  No, I don't know where I came from.

So naturally, the concept of starving yourself is baffling to her.  In response to my meltdown, she was incredulous: "What?  You think you're fat?"

No, Mom, I didn't say I think I'm fat; I don't think I'm fat.  In fact, I know I'm not fat.  I know that technically, I'm underweight.  I know that people who wear size X jeans cannot ever be considered fat.  I can calculate my BMI in my sleep, and I know that no matter how I play around with the numbers (what if I were half an inch shorter....two inches taller...what if I gained/lost X or Y or Z pounds...what if I shaved my head/clipped my toenails/plucked my eyebrows before weighing myself again...) I do not fall anywhere near the "overweight" category.  So again, Mom, no.  I don't think I'm fat.

But I do feel fat. I feel it when I sit down to eat, and I feel it after I've finished eating.  Not because I believe that one meal will actually make me gain weight instantly, but because my body feels too big and squishy and uncomfortable.  I feel it when I consider taking a day off from working out, knowing that rest is fine and healthy and good, but also knowing that a long sweaty run will make me feel, at least for a little while, better.  Less fat.

Sometimes I wonder if my feeling fat is actually just me feeling normal, and I have forgotten what normal feels like.  I know that the intense physical dissatisfaction with my body probably has to do with emotions - like frustration, insecurity, depression, loneliness, etc.  But I also know that feeling fat is real, and I am insanely jealous of anyone who disagrees.

A Working Lunch

Today I watched another girl eat lunch.

Not in a creepy way - there was an all-staff meeting at the nonprofit where I work, so we were all crowded into a conference room from 12-1:30. All the interns were sitting around a big table and most people brought their lunches. (Not me, obviously. I had eaten at my desk ten minutes earlier. Still not totally okay with eating in front of that many people.)

This girl was sitting directly across from me and I couldn't really not watch her, but maybe a non-eating disordered person wouldn't have been as completely fascinated by it as I was.  Because I was completely and utterly enthralled by this girl.

Her lunch was pretty ordinary as far as lunches go. Sandwich, pretzels, cookies, lemonade. It was the type of balanced, non-obsessional lunch my dietician would craft and write out neatly onto my meal plan while trying to convince me that people eat stuff like that all the time. To me, though, it seemed like the idea of a standard lunch, like something you would see on MyPlate.gov. A standard lunch in theory, but not something I could imagine people actually eating in real life. Not something I could eat without getting fat.

But this girl was eating like it was no big deal. She even spoke up during the presentation to ask a question, the half-eaten sandwich still in her hand.  It was baffling to me that she seemed to have zero self-consciousness, even mid-meal.  Craziness.

I found myself trying to count up her calories as I watched the girl eat, wondering how much meat was on the sandwich, whether she'd used two slices of cheese, mayonaise or mustard, regular wheat bread or the thick grainy stuff. Because if I'd made the sandwich for myself, I would have known exact amounts of each ingredient, right down to the lettuce.

Then I began speculating on what she would eat for the rest of the day. Maybe there were X calories in the lunch...would she then have a snack later, or was this it until dinner? How much would she eat for dinner? What had she eaten for breakfast? Did she have the same breakfast every day? I had a sudden image of her eating cereal. What kind? How much? Did she measure it out first or just pour? Probably just pour. But then how would she know how much she was eating? Calories?!

And just like that, the 90-min meeting was over.

(Don't worry. I didn't miss anything important.)

Was this a productive exercise, obsessing over this girl's lunch? Nope. Especially not for me, since I obsess plenty about my own food and definitely don't need to take on anyone else's. It was eye-opening though, because I tend to assume that everyone obsesses about food as much as I do. Sometimes I need to be reminded that most people eat what they want, when they want, and maintain their weights just fine. See, Kaylee? If other people can eat normal amounts of normal food and stay the same weight, then so can you.

Then there's always the nagging thought: but what if I don't want to stay the same weight? What if I can do better?

I'm working hard to keep moving forward, even though my body image sucks and I hate everything about being at this weight. My therapist keeps telling me that it gets easier, that I have to give myself more time to get used to it, and then my body won't feel like a fat suit anymore. For now, I'm trying to hang in there, eat what I'm supposed to, trust that it will get better.

Because mostly what I felt after being a creeper and watching the girl eat today was jealousy. I wanted to be her so badly and be able to eat a normal, government-approved lunch without even knowing how much lettuce was on the sandwich.

Success?

Well, it was a loooong weekend. Definitely some ups and downs - but more ups than downs, I think. I'm pretty sure.

I had a crappy day at work on Friday. The usual boring uselessness. Then I saw my dietician and my weight was UP. Ugh. Not a lot (or even a very significant amount at all), but enough to take my shaky mood from bad to worse.

So I was NOT feeling up to the barbecue that night even though I was already totally committed and not going was not really an option. I even wanted to go. But, of course, I had to go through my ritual meltdown of tearing through my closet trying and re-trying on clothes and ripping my hair out.

Although I am pretty reserved by nature, I actually love people and nothing depresses me more than being lonely. Sometimes, though, the thought of having to put on my "normal" face and perform in a social setting is too overwhelming. ("I'm too fat/ugly/tired/stressed/busy/etc. to go!") I almost always end up having a great time once I'm there, but I guess my default is to stick to my regular, solitary routine and it takes a real push to get me out the door.

Long story short: I went to the barbecue and had a great time. My friends are hilarious and I haven't laughed so much in months. We ended up staying for over eight hours because no one, not even me, wanted to leave.

In terms of food, I got off easy. Another girl there was a vegetarian, so there were low-cal veggie burgers and salad. It ended up being a way smaller meal than I had even planned on, so I was starving when I got home and ate an extra protein bar at about 2 a.m. (VERY out of character for Kaylee) before going to bed.

Lesson learned: just go. You'll be fine.

The next day, my friend C came to visit. We ate dinner at home and hung with some other friends for a bit, but it was a pretty low-key night. I had therapy in the morning so I dropped C off at a coffee shop for an hour, then we went shopping. Again, though, I was low on calories. I had planned to grab breakfast at the coffee shop with C, but we were running late so I ended up only having a granola bar in the car. Lunch was small, and I didn't have any extra snacks with me. By late afternoon when C left, I was way under my usual calories. That, combined with two nights of very little sleep, had me falling apart by dinnertime.

My mom was cooking something elaborate and for some reason, it just seemed like too much.  Too many ingredients, too many unknown factors, too much to calculate.  I guess the little stresses of the weekend finally caught up with me and the idea of eating something new and unknown for dinner was just too much.

Even though I'd had a fantastic weekend, I was hungry and exhausted and basically in tears as I ate. My mom got to witness a full-on ugly cry, which had us both a little baffled. Yes, I had a good weekend. No, I don't want to talk about it.

These kinds of mood swings haven't been entirely unusual for me lately. I'm beginning to see how they are connected to changes in food intake, exercise, or stress. My body is definitely much stronger and healthier than it was six months ago, but sometimes I am terrified by how fragile my mind still feels.

I'm not exactly sure where this leaves me. My weekend was amazing in terms of reconnecting with old friends and catching up with C. Becoming socially engaged again is so important to me and always makes me feel so much better, so I am really proud of pulling that off. Foodwise, the fact that I avoided consuming thousands of excess calories and gaining thirty pounds overnight is always a success in my book...but I did eat less than I was supposed to and instead of feeling guilty about it, I feel relieved. So that, I guess, is a recovery fail.

My Life is This

My life is this: I wake up in my childhood bedroom after (not) sleeping all night.  Wait until I hear my mom leave for work, go downstairs, gulp a cup of coffee, and head out for a run.  Sweat a lot.  Shower, dress, breakfast, jump in the car and speed to work.  I'm still always late.  It was more important to fit the run in.  Not that anyone cares when I show up - I am interning at a nonprofit that clearly has no clue what to do with interns.  So, I sit in my windowless cubicle and stare at my computer screen and debate whether or not to eat my snack.  Then lunch.  Then snack.

I make approximately six trips to the bathroom - partly because I have a freakishly small bladder, partly because I also make six trips to the water fountain, and partly because I can't sit still in my chair for more than twenty minutes at a time.

By four p.m. I'm so bored I want to rip my hair out.  Thirty minutes to go.  At four-thirty on the dot, I bolt.  Speed home, change, head to the gym.  Pound the treadmill, bike, sweat, another quick shower at home, dinner, collapse.  Snap at my mother.  Debate snack.  Eat it.  Collapse.

No, I am not supposed to be working out twice a day, but it is one of the unexpected snags that has cropped up in my recovery.  I've always been active - I played pretty much every sport at some point growing up, and got really into cross country and track during high school.  Since then, I have been a self-proclaimed Runner with a capital R.  I had to stop in December because my doctor scared me about my heart and my bones.  I've only just recently taken it up again (with permission!) in the past couple of months and I'm already hooked.  Totally addicted. I am definitely seeing how it can become a trigger for me, as I think a lot of people with EDs find.

So, the solution would be to stop, right?  Or at least come clean to my parents or my treatment team about how much exercise I'm doing, before it starts eating away at my mind again?  Ha.  Even though I know that I should be easing into exercise, it has been hard to rationalize that when I feel the need to "make up" for the past few months.  (Note: I KNOW this is irrational and disordered and completely unhealthy.  I am not advocating this type of thinking or behavior.  I really wish that I had been able to follow my nutritionist's advice on exercise because I do feel trapped in my routines now and it is definitely a setback I did not anticipate.)

Also, it is hard to justify cutting back the exercise when I am eating plenty and basically maintaining an okay weight.  I am JUST weight-restored...sort of.  Technically, according to my nutritionist, I am still a few pounds below "healthy" BUT I am in my range (albeit scraping the bottom, apparently, and bouncing in and out from week to week) and for now, that's good enough for me.  So it is really hard to convince myself that if I suddenly cut out the running, my weight wouldn't shoot up.

So this is my summer - okay food and weight, sucky job, insane running that keeps me sane - but there's still a whole lot of summer left to go.