Bulimia Help

Question: What is structured eating?

Ans.

Structured eating is eating eat three meals plus at least two snacks each day. It involves planning meals and snacks and the times when they will be consumed in a clock work structure.

The reason behind eating regular meals at regular times is to replace binging.

By replacing binging with normal eating you will eat less food overall. In turn you are less likely to gain weight.

Question: Why should I start structured eating?

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The overall goal of structured eating is to gradually reduce binging and purging and make the transition from chaotic eating to normal eating. After a while of practicing structured eating, normal regular eating will become the norm.

Question: What is food planning?

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Food planning involves scheduling meals and snacks at particular times throughout your day. By doing so you are taking control over binge eating by increasing your overall satiety.

Very detailed food plans include when, how much and what to eat.

Question: Why is structured eating important?

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Your goal is to start trusting your body and to get back feelings of hunger and satiety. It is difficult to feel such sensations at the early stages of recovery, which is why it is important to start eating at planned times throughout your day. Overtime feelings of hunger and satiety will return and you can use your body as the judge when, what and how much to eat.

Question: Do I need to start planning my meals & snacks?

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Yes. Meal plans need to be devised. Your meals plan should include all the times when you will eat, even when you do not feel hungry. This will replace chaotic eating (which is food restriction followed by binging) with normal eating.

Question: How do I do this?

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It helps to plan meal times in advance. We recommend that you plan tomorrow's meals the night before. This involves planning what you will eat, how much you will eat and when you will eat it. Your goal is to stick to your planned time, meals and amount. By doing so, you are allowing feelings of hunger and satiety to naturally return as you get used to eating normally and regularly.

You need to include a structure. This should revolve around breakfast, lunch, dinner, and snacks, leaving no longer then 3-4 hours in between. Try your very best to stick to your eating plan, no meals or snacks should be left out.

Question: How do I make it easier on myself?

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For some people an entire meal plan might be a little overwhelming at the beginning. Therefore it might be easier to break up your meal plan into sections throughout your day. This involves starting with the easiest meal you think you are able to handle and working up-wards. When you have achieved eating your easy meal you can then focus on the your next easiest meal. Keep doing this until your daily meal plan is complete.

Question: What should I eat?

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At the beginning it is important to stick to foods that you feel comfortable eating. This might be non-trigger foods or your 'safe' food for the time being to avoid triggering off  binging and purging. Please remember that if you are restricting your food intake too much then this will only contribute to future binging.

Question: Why will restricting my food intake lead to binging?

Because you will be physically hungry and will have less control around food due to your natural instincts to eat any food source around you at that time.

You might have trouble with meal portion size as you begin structured eating.  Bulimia can disrupt what normal portion and pace is, thus, creating fear around eating too much or too less at meal times. Our Guided Eating Sessions can help you with this. The Guided Eating Sessions are available for you to learn normal eating pace, portion size and satiety. Alternatively after eating a meal, if you still feel like binging then take it as a sign that you need to increase the amount of food eaten at each meal time.

Question: What if I binge?

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If you binge it is important to continue on with your food plan. By doing so you will prevent further binging and a further loss of control. Binging should not be considered as replacing meals and snacks. You must therefore return to your food plan and eat the next scheduled meal or snack. You will find that binge eating is minimized by doing this.

Question: What if I vomit after eating?

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Do not try to replace meals and snacks that were purged by eating immediately after purging. By doing this you might spark of another binge/purge cycle. Wait until your next planned meal or snack.

Generally the need to vomit usually follows a binge. However, some may feel the need to vomit even after eating very small amounts. Please remember that vomiting after eating only leads to future binging. Please have this in mind when purging urges comes on.

Self-induced vomiting can also lead to weight gain. One reason for this according to Agras and Apple (1997, p52), is because purging may give false signals regarding appetite. For example you might feel hungry when you are not. In turn this can lead to overeating, binge eating and weight gain. According to Garner et al. (1985, p 546) people who stop vomiting usually find a decline in binging behaviors

By dividing your day up into sections you can choose when to eat your meals to the time that suits you best. Plan your meals around the time that poses least risk of vomiting. This time might be when you are out of the house or at work. Start with the easiest meal in your day and work towards the next section of your day without vomiting, and so on.

Question: What if meal planning meals makes me more obsessed with food?

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This might happen, however, overtime you will soon see the benefits in your eating behaviors. You will notice that your weight is maintained and stops fluctuating (a common symptom of binging and purging). Normal eating can also improve your mental state, meaning you will be mentally stronger to deal with emotional issues such as depression, anxiety and food obsession (Polivy. J & C.P Herman 1976).

To prevent further food preoccupation try not to be obsessive with your meal planning. Do not strictly count calories or tally calories at the end of your day.

Question: What should I include in my food plan?

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At the early stages of recovery food is your medicine, therefore adequate calories and nutrients are crucial with meals and snacks. Without adequate calories and nutrition you remain susceptible to binge eating (Marcia Herrin 2003).

Basics foods groups of protein carbohydrates and fat need be included in your food plan. Protein is believed to be a particularly important food group to can help with appetite control. Fat is essential for satiety. Carbohydrates is known to prevent further carbohydrate binging and cravings. Induce these food groups.

Question: What about forbidden foods?

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At the early stages of structured eating and recovery it is best to avoid trigger foods. Stick to food you feel happy with eating. Our break free zone (coming soon) describes how to slowly start introducing previously forbidden foods back into your diet.

Remember the following points when meal planning:

• If your structured eating plan is too low in calories and nutrition then binging is likely to occur
• Normal serving size of any food (including trigger foods) will not cause weight gain.

Question: How do I know my calorie needs are right for me?

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There are many factors that can affect the energy needs for each individual including; genetics, age, height, muscle mass and activity level. Normal weight people learn to relay on their hunger and satiety levels to judge how many calories is right for them.

According to health professionals anything under 1500 is too low to meet nutritional needs.

Question. What if have 'unusually' low calorific need?

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If you restrict calorie intake for some time then your body will adapt and weight can maintain with this restricted intake..

People who do this may then start to think they have unusual low calorific needs because they eat low amounts yet remain a stable weight.

This is not likely to be the case. It is most probably your body has adapted to a lower calorie intake, yet will be undergoing a struggle as it does so.

With time your body will soon stabilize and normalize. You metabolism will return to normal and you will be able to eat normal amounts of food, and remain a stable weight.

Nutritional needs must be met to maintain health - anything below 1,500 is not recommended by health professionals.