When Your Dietitian Tells You, "Yes, You Have to Eat That" and the Anxiety is REAL

Either you or a loved one has made the courageous decision to either start and/or continue to repair your relationship with food/weight/exercise/body image. Maybe you have committed to seeing a dietitian or a therapist (hopefully both). For those unfamiliar with the treatment of eating disorders/disordered eating, it can be to understand why a therapist is helpful in the recovery process. On the surface level it seems like as long as you find a knowledgeable dietitian and can scrap up the mental fortitude to eat in a normalized way, you should be just fine, right?!

What makes eating disorder recovery complex and incredibly challenging is learning to separate feelings from food and/or weight, all the while still managing to nourish your body appropriately. (This by the way can seem so foreign, daunting, and freakin’ scary because of some of the distorted thoughts and intense feelings you experience.)

When your educated dietitian tells you that your eating disorder recovery will indeed involving eating different food content and volume, you may be wondering how the heck you are going to do it when your anxiety is like none other! Once again, in moments of clarity you understand that your dietitian and therapist have your best interest in mind, but when fear and distorted thoughts hijack you brain and it feels like your body is rebelling, logic goes out the window. (There are brain-based and physiological reasons why this is happening, but I won’t go into them here.)  

Each time though you make the conscious but difficult choice to eat appropriately portioned meals without restricting, binging, purging, or exercising regardless of how you are feeling emotionally, you are working to recreate new neural pathways in your brain. With continued action, this allows for different patterns of reacting to food and emotional distress in your life.

I am a helper and healer by nature, and it can be hard on me to see others in pain. If it was possible that you could recover without feeling the uncomfortable feelings fueling your eating disorder (anxiety, sadness/depression, shame, fear, loneliness, inadequacy, uncertainty, disappointment, anger, etc), I promise would help you do so. However, it simply isn’t possible. You do have to ‘feel it to heal it’, and retrain your brain and body to react differently.

Also, if I helped you avoid uncomfortable feelings I would also be doing you a disservice because inevitably, if you are to live a rich, meaningful life and take risks, you will encounter these feelings at some point. When you stop to run away from your feelings and when you can trust that different coping skills suggested in therapy can help you to not stay immersed in them, then you will be equipped to better handle recovery, and well, life. (Because it’s not all rainbows and butterflies as you very well know.)

While all this positive ‘reframing’ and understanding the purpose of feeling your feelings may help somewhat, oftentimes you need other methods of calming yourself down. While the tips below work to reduce any emotional intense state, frequently those I work with say they are so anxious before/during/after eating.

So, without further adieu, here are my top 5 favorite anxiety-reducing techniques for eating disorder recovery:

4-7- 8 Breathing Technique

Breathe in for four counts, hold for seven counts, exhale for eight counts. Repeat for minimum of a couple minutes. Note your anxiety level after a couple minutes, and repeat as needed until you experience a noticeable calming shift in your mind and body.

You can vary the length of counts if you find it difficult, but it is important to try to make your exhale longer than your inhale. Breathing techniques are powerful tools that help calm you down by stimulating your parasympathetic nervous system. Plus you can do it anywhere, anytime, it’s rather inconspicuous, and it’s free! What is there to lose?

Butterfly Tap

Rest your hands on your quads, and slowly pat one leg and then the other with the same-sided hand. By doing this, you are eliciting bilateral stimulation which helps the brain lobes to connect and decrease your stress response. Plus, this helps with releasing a bit of that anxious energy out in a physical way that isn’t damaging to you.

If you wanted to take this technique up a notch, you could play your favorite chill music and work to synchronize the tapping with the beat of the music.

3- 2 -1 Grounding Technique

(This is a modified anxiety-reducing technique that doesn’t include focusing on smell or taste which could potentially trigger your anxiety or ED thoughts in some situations.)

Cue into your senses note 3 things you can see, two things you can touch, and one thing you can hear. Repeat again and again as needed until your mind seems less busy with the anxious thoughts and you can feel your body relax more.

 Practicing mindfulness by cuing in to senses and bringing yourself back to the present moment is another effective tool in retraining your brain and helping you to feel more peaceful.  One of my favorite quotes illustrates the importance of being in the present: “If you are depressed you are living in the past. If you are anxious you are living in the future. If you are at peace you are living in the present.” – Lao Tzu

Drink a cup of hot chamomile or calming tea, and then call or meet up with a friend. (Or vice versa, or both simultaneously. Whatever works for you.)

Practice being mindful once again. Notice the heat of the mug as you hold in your hands, pay attention to the tea’s fragrance, cue into soothing taste, and enjoy slow sips, taking breaths inbetween. Plus, if you buy Celestial Seasonings tea, they usually have a catchy little quote tied onto the tea bag too. (I’m a bit of a sap and I love quotes, and I’m sorry if you don’t. You are missing out. Just kidding, to each their own. J)

Reaching out for support when struggling emotionally too is so necessary. Whether you talk or just sit in the presence of someone you trust, the positive effects on your emotional state is proven, and substantial. In fact, research has proven around a 50% decrease in cortisol levels when you are in the company of others versus dealing with something stressful versus handling it by yourself.

Repeat a favorite saying, mantra, or prayer.

 i.e. “This too shall pass.”… “I’m stronger than I think I am right now. I’ve been through a lot, and I’m still here.”…“It might not be OK now, but it will be OK soon enough.”

Paying attention to how you talk to yourself is necessary. Buying into the thoughts such as, “I can’t do this. This is too much. I can’t stand it, etc. ” really can contribute to higher stress levels, and you definitely don’t want that, do you?!  Remember, you aren’t responsible for your first thoughts, but you can counter anxiety-provoking thoughts.

An honest and skilled therapist and dietitian will remind you that just because you use coping techniques does not mean you will feel better instantaneously. There will be some level of discomfort when changing your patterns.  However,  if you are open to trying various coping skills, it will allow you to feel like you can handle your emotions without limiting food, overeating, purging, or exercising. Food and feelings are inextricably intertwined in an eating disorder, but when you can manage your emotions while fueling yourself appropriately, you will realize the power you have to withstand whatever life throws your way (And that's a pretty cool skill, right?! #resilience).