Food Addiction: A Love-Hate Relationship

The cycle of food addiction is all too common these days. Individuals with and without eating disorders suffer from unhealthy relationships with food. Like so many others, I have a food addiction. The common cycle looks something like this:
1. I dislike my body - I want to lose weight
2. I go on an unmanageable diet which may or may not include severe restriction and/or purging
3. I feel brain fog, severe fatigue, hunger and cravings
4. I become so hungry I binge
5. I feel guilty, full, bloated
6. I dislike my body and begin restricting again

Of course, often the foods that I crave are also the foods I restrict. These foods control my thoughts, I daydream about them until I eat them. The foods are usually high in carbohydrates, sugar and fat; they are the types of foods that make me feel disgusting every time I eat them, but often the elusive pull of my cravings eventually wins out over my willpower and knowledge of the foreseeable future torment.

Unknowingly, when I began the Candida diet, I removed my biggest obstacle in fighting the addiction, carbohydrates and sugar. These foods are addicting on their own, but combined with an eating disorder, they are mind controlling. I began to realize that cutting back on these foods was not enough, I needed to remove them completely from my diet. This sounds incredibly difficult to do, and it was initially, but over time I began to enjoy that food did not control my life, and I did not miss the ups and downs of the food addiction cycle. Removing the temptation was made easier because I made sure to eat more of the healthy foods which curbed cravings and kept me from being constantly hungry. Even now that I've been on the Candida diet for years, if I eat certain foods I begin to feel the guilt, the shame, the need to begin the cycle again. That feeling helps keep me on track. I know what it's like to live without the constant feeling of addiction, and I try to remember that in order to stay away from the foods that trigger my eating disorder.

Going on the strict version of the Candida diet was easier for me than most, because I used my obsessive nature to aid me in eating healthier. I made the diet a challenge. I used all the willpower I had always been using to harm myself, and I turned it into positive willpower. I admit, when i first began the diet my intentions were less than honorable, I felt that the diet would help me lose weight. Fortunately, over time, the diet still worked its magic on me both physically and mentally. I was able to maintain my weight easier, control my addiction to food, and live a more meaningful life. The longer I was away from the food cycle, the less power it had over me, and the less I felt I needed it to live. Ironically, most eating disorder treatments are focused mostly on refeeding and teaching individuals to eat all foods (good/bad) in moderation. Moderation has never been something I could do, especially when it comes to carbs and sugar. I look at these substances like drugs, and you never hear a drug addiction center tell their patients to learn to enjoy drugs in moderation! I think this diet has helped me to feel more powerful and in control, just as my eating disorder did, but in a more healthy and manageable way.

Occupational Therapy (OT) Overview

Since many people are mostly unaware of what Occupational Therapy is, I thought I would provide a brief overview of the profession by answering some common questions.

1. What is Occupational Therapy?

"A form of therapy for those recuperating from physical or mental illness that encourages rehabilitation through the performance of activities required in daily life." (Google Search) 

Unlike what it initially sounds like, Occupational Therapy is not all about helping people find or maintain jobs. In fact, occupation is just another word for activity. It is a fundamental concept in OT that individuals will be more motivated to attend therapy and complete a HEP (Home Exercise Program) if therapy includes functional and meaningful activities as opposed to repetitive and/or boring tasks.     

2. What types of settings does an OT work in?

An OT can work in many types of settings including inpatient/outpatient hospitals, skilled nursing facilities (SNF), schools, clinics (public and independent), communities, health centers, psychiatric facilities, etc. 

3. What populations do OT's work with?

OT's work with diverse client populations including pediatrics, geriatrics, adult rehabilitation, mental health including dementia and psychiatric conditions, hand therapy, vision rehabilitation, driving rehabilitation, sensory processing disorders, etc. 

4. What type of education do you need to become an OT?

In order to become an occupational therapist you must graduate with a Master's from an ACOTE-accredited program. There are many schools available which provide occupational therapy degrees, some include just a Master's program, and some which include a combined baccalaureate/master's program. I have provided a link below to AOTA's website which provides a list of accredited universities. I would suggest researching each program, as not all programs are created equal. I think one of the most important parts of my education were the 4 fieldwork experiences I had through my university. I had 2-level 1 fieldworks and 2-level II fieldworks. My level 1 fieldworks were shorter and less intensive, encompassing about 10 hours per week. My level 2 fieldworks were each 40 hours per week, where I was expected to be at the level of an entry level practitioner by the end of the fieldwork. These experiences were very helpful at bridging the gap between school/theory and real world occupational therapy practice.     

http://www.aota.org/en/Education-Careers/Find-School/AccreditEntryLevel/OTMasters.aspx   

5. What do you do after graduation?

After graduation, you must begin the process of registering to take the National Board for Certification in Occupational Therapy (NBCOT). This can be done by visiting www.nbcot.org. This website will walk you through the process of registering for the exam. I would suggest beginning the process soon after graduating, as it often takes a month or so before you are actually eligible to sit for the test. Once you apply and are in the process of waiting, you will begin to study (if you haven't already). This process can taken anywhere from 1-3 months, depending on how much time you spend per day. I began studying the middle of January 2014, and ended up taking the test the end of February 2014. I studied with another OT student I had worked with during college; we met about 3 times, once per week which helped keep me on schedule. My study sessions were based on the TherapyEd book by Rita P. Fleming-Castaldy which can be purchased through: http://www.therapyed.com/nbcotstudyguide.htm 

My studying was very sporadic at first, usually 1-2 hours per day, and I took many days off. The last two weeks before the test I studied about 8 hours per day, took countless practice exams and likely overdid the studying process, but hey, I'm intense!  

After taking the NBCOT you will wait about 1 week to get your online results of pass/fail. You can now begin the licensure process. You will have to have your scores sent to each state you intend to be licensed in, and yes, you will have to pay for each separately. Licensing can be a lengthy process, 1-3 months is not uncommon. Each state has its own process, so you will need to visit the website of the state you intend to be licensed in, and it will walk you through the process. Check the state's website often after all your paperwork is received, it is likely you will be licensed on the state website before receiving your hard copy in the mail.     

Stimulant Addiction

For many years now, I have struggled with an enormous amount of fatigue and exhaustion. Perhaps this harsh reality stemmed from countless years of eating disordered behavior and psychiatric medications, specifically Topamax; but either way, I often feel I lack the energy required for many daily activities. Unfortunately, in a feeble attempt to manage the debilitating fatigue, I resorted to using various stimulants over the years: energy drinks, caffeine pills, diet supplements, vitamins, and OTC medications.

My stimulant use may have began as a way to manage fatigue, but it progressed into a physical, mental and psychological dependency. Not only did I feel a greater sense of happiness and joy when I took stimulants, but I also felt thinner and often ate less, which only fueled my eating disorder addiction. Stimulants also make me more outgoing and often decrease my social anxiety. All of these reasons made stimulants an integral part of my every day, which allowed me to live the life I so desperately wanted. My stimulant abuse continued for many years, waxing and waning, and often the times I chose to decrease stimulant use was only a method to increase their effectiveness once I started taking them again.  

It was not until recently that I realized how unmanageable my fatigue and stimulant use had become. I often take caffeine pills in the morning and afternoon, and for a while was dependent on asthma medications to keep me going throughout the day. I began to notice the various side effects taking a toll on my body: acne, anxiety, irritability, headaches, and eventually total exhaustion unalleviated by stimulants. It was then that I decided to clean up my act and work on healing my body. I am currently in the process of decreasing my stimulant use, and increasing my vitamin and supplement use in an effort to normalize my adrenals and general hormone function. I am also looking to start exercising on a more regular basis and increase the amount of hours I sleep to at least 8-10 every night.

Can you choose to have an eating disorder?

This is a very interesting and highly debated topic. Many outsiders will look at someone with an eating disorder and wonder why they choose to live that way. Most people with eating disorders will defend themselves by saying, "I don't choose this, it's a disease" (or something to that extent). In my opinion, both are correct. Anorexia is clearly a disease/addiction, and most people need help in order to recover. This being said, I believe that many anorexics chose the lifestyle to begin with, and then became so consumed that their choice turned into an addiction. Looking at my own life, I made a clear choice to pursue self-starvation in order to lose weight and become thin. This process was intoxicating, and I slowly became less and less in control of my actions.

For many people, the process of developing an eating disorder is less clear. Some people may start a diet with perfectly good intentions and become addicted. Unfortunately, many people with eating disorders also choose to play the victim which only furthers their disease. Even addicts must choose to get better, so choice is always part of the process. Those who say they have no choice are not being honest with themselves or others.

"But you don't look anorexic..."

For quite a few years I have been in the recovery phase of an eating disorder. When first recovering, maintaining my weight was very difficult, and I often ended up losing and gaining weight over and over again. This cycle was brought on by my fear of looking fat or even average sized. The hardest part about gaining weight was the fear that people wouldn't think I looked anorexic. This thought in itself reflects how disordered my thoughts were. Because anorexia was such a big part of my identity, the thought that people wouldn't recognize my eating disorder made me feel that I was losing a part of myself, and unfortunately it felt like anorexia was one of the bigger parts of my identity. In order to get better, I realized that I needed to separate myself from the eating disorder.

Nowadays I approach the subject somewhat differently. I am in a very different place in my life than when I was very thin, and most of the people around me don't know about my past history of anorexia. I have decided to remain somewhat tight lipped about this because I feel that if others knew, I would feel more insecure about the way I look. There is always an expectation that comes with having an eating disorder, and I don't want people to question my food choices or weight, but I also don't want people to be weird about these subjects. I talk about food and weight the way any other average person might, and don't feel self-conscious or judged. Even though I have been in recovery for quite some time, the thought that someone might mention how "normal" I look still makes me feel uneasy.

Some might believe that I'm trying to hide my disorder or protect it by being secretive, but I believe I am just trying to protect myself. I spent so much time in my past trying to get people to see me instead of my issues, and I finally feel like I have a clean slate (being in college). I also feel that talking about my past eating disorder is unlikely to help anyone, and more likely to cause someone else to feel uneasy or to repeat the same actions.

My Struggle With Body Dysmorphia

A couple of years ago, around the time my anorexia became manageable, I started to notice some different compulsive behaviors emerging. These behaviors troubled me more than my eating disorder compulsions, because I didn't understand them. Things such as constant mirror checking, feeling repulsive, and excessive makeup application began controlling my life. For the first time in my life, I began to notice the power of facial beauty, and weight became slightly less important. In hindsight, I can see that my eating disorder only changed form, it did not become manageable as I had originally thought. My obsessions and compulsions became focused on a different target, but the feelings and emotions were still the same. I felt inadequate and insignificant.

When the obsessions and compulsions began to take over my life, I felt powerless and embarrassed that I could lose myself to vanity. This idea is still something I struggle with; this disease makes me feel superficial and dumb. It wasn't until I researched body dysmorphia that I began to understand that my behaviors were quite normal for people with BDD. For some reason, even though I know my body dysmorphia is equivalent to my eating disorder struggles, I have always felt very different about them. BDD feels superficial and embarrassing to explain to others, but anorexia was never something I felt ashamed of.

I think one of the worst parts of the disease has been how ridiculous I feel when I am having an "episode". My eating disorder was more of a constant struggle, whereas my BDD waxes and wanes. I am always self-conscious about the way I look, but only sometimes do I feel paralyzed by my obsessions and rituals. I call these times my episodes. During these times I often find that nothing I do makes me look any better. I feel repulsive before and after makeup, and may spend hours applying and reapplying makeup in an effort to make the sinking feeling go away. During this time I also feel an unhinging amount of anxiety and doom, and often withdraw from others as much as possible. These episodes are debilitating, all consuming and appear endless. Then, just as quickly as they started, they stop for a while. I am unsure why these episodes come and go, but believe they may have a hormonal link. I have been unable to find a solution so far, but am continually searching for a way to break free from these chains.    

Personal Disclosure

Personal disclosure is something I have struggled with for a very long time. I often find it difficult to tell others how I am feeling or ask for help because I do not want to burden them with my problems. This probably stems from my childhood when I was often taught to minimize my problems by comparing them to others with more serious concerns. This type of reasoning was not all bad, and I think would have been helpful had my personality been different. I was never the type to talk about my problems, I usually kept to myself and tried to solve things before anyone knew there was a problem. This type of problem solving, combined with the idea that my problems were never as bad as other's problems, made me feel ashamed of my struggles, and often caused me to further isolate myself. This type of thinking still causes me to withdraw from people today. When I am feeling depressed or struggling with my body image, it is extremely difficult for me to tell anyone. At times I will confide in my fiancé about my issues, but usually I am extremely vague or tell him about the problem after I have already solved it. This is something I am continuing to work on, and still only feel comfortable telling one person. I often am afraid that once I tell someone something, they will forever be able to hold it against me. This might sound paranoid, but in my past experience, others' knowledge about me has come back to bite me later. My trust issues only further the problem. I look forward to the day when I don't feel uncomfortable talking about my problems, and feel comfortable enough to ask for help. I encourage you to find someone trust worthy and close to share some of your personal feelings with. It may be difficult at first, but in time, you may find your problems seem more manageable when you have someone to confide in.