Incorporating Science, Body, and Yoga in Nutrition-Based Eating Disorder Treatment and Recovery

The Integrated Eating Approach

Maria Sorbara Mora, Joe Kelly

• Publisher: Routledge
• Year: 2019
• ISBN:
  9780429000836
• Edition: 1
• Topic: Psychology
• Subtopic: Abnormal Psychology
• Index: Psychology

Incorporating Science, Body, and Yoga in Nutrition-Based Eating Disorder Treatment and Recovery is a valuable, innovative guide that demonstrates how clients and clinicians can untangle, discern, and learn from the complex world of eating disorders. With voices from every stage of recovery, this book illustrates how clients can claim mastery in food and life. As a nutritionist who specializes in disordered eating, the holistic method Ms. Mora created provides individuals with a true potential for healing.

Incorporating Science, Body, and Yoga in Nutrition-Based Eating Disorder Treatment and Recovery weaves strong, resilient, and vibrant threads of science, dietetic practice, and yoga therapy that harmonize with all treatment modalities. It will help treatment providers from every discipline to guide clients as they reweave their lives with nourishing relationships, embodiment, and ongoing growth.

1 The Person, the Disorder, and Recovery

Eating disorders dis-order our instinctive, inborn human relationships with food, eating, self, and others by (in effect) making them all about numerical values (calories, weight, steps, miles, amounts of time I spend with so-and-so, etc.) and formulas (when and where to binge, purge, restrict, excess-ercize, deny reality, avoid so-and-so, etc.).

As a result, clients are in pain, even if they don’t yet fully realize it. When people step through our doors, for the first or the forty-first time, their walking is talking. By showing up, they are saying: “I need help!”

Of course, our clients have been in pain for a long time already. Pain is a concrete and vibrant “I need help!” message from the body, mind, and/or spirit. For months, years, or decades, an eating disorder responded to the call for help. Its “answers” are rigid, narrow, and formulaic:

• Obsess over every calorie, fat gram, etc.
• Obsess over eating or not eating.
• Learn and practice how to purge with the least discomfort.
• Binge every time you feel discomfort or uncertainty.
• Purge every time you feel discomfort or uncertainty.
• Restrict every time you feel discomfort or uncertainty.

The eating disorder and its answers are ultimately unhelpful, harmful, and dangerous. They do not heal, but they do serve a function. They temporarily provide:

• sensation numbing
• release of sensation-stimulated tension
• sensation denial
• distance from reality and self
• predictability
• armor against appearance-based harassment and objectification
• distraction from sensations, reality, self, others, and life.

Unfortunately, all of these “answers” distance the person from their body, its pain, and healing. None of them lead the client closer to whatever is generating the pain and its message.

None of them answer (or even ask) the question: “What part or parts of me need help?”

By the Numbers

Obsession with weight is a common eating disorder pattern. It also runs throughout the complex constellation of body image, body awareness, body acceptance, body satisfaction, body distortion, and underlying self-worth.

All of these problems blur and/or deny a simple fact: weight is a number calculated by a math and physics formula (more on this in a bit).

When patients compulsively try to “control” their weight, obsess about weight, hate their appearance, and/or are dismissive of their body, clinicians must recognize:

• This obsession is information.
• This information signals that the client is entering the black hole of body image.
• Our job is helping patients recognize and explore the pain represented by that black hole.
• We can’t effectively do that by arguing about the physics formula w = mg.

What is w = mg? Newtonian physics defines an object’s weight (w) as the value of how the mass (m) of that object is influenced by the force of gravity (g). To measure something’s weight, multiply its mass by the acceleration of gravity. At this moment, in the universe, acceleration of gravity varies dramatically by location. At this moment, my mass is constant.

Scientists measure mass in kilograms and weight in Newtons (Isaac gets so many perks). On earth, every object with a mass of 1 kg weighs 9.81 Newtons.

Life outside the laboratory is more confusing. At Target, the “kg” number on a laundry detergent box refers to the contents’ weight, not its mass. Depending on local custom, we weigh our produce in kilograms or pounds. The British measure weight in “stones” and call their currency “pounds.” As if physics wasn’t hard enough already! As the scientists say, “I don’t buy potatoes by the Newton, but I do research by the Newton.” Junior high science detour ends here. Deep breath!

Say your weight on earth is 100 pounds. Your body’s mass is 45.3592 kilograms. If you travel to the moon this afternoon, your body’s mass will remain 45.3592 kilograms, but the acceleration of gravity is just 16.66 percent of gravity on earth. Therefore, you’ll weigh a little over 16 pounds on the moon. If you visit the International Space Station (ISS), your weight will be zero. That’s what weightless means: without weight (not without a body).

Imagine stepping on a scale on the moon. Now imagine doing it here on earth. Both scales calculate the same thing: our body’s mass times the acceleration of gravity. (Sorry, no can do on the ISS; you need gravity to stand on a scale.)

Weightless ISS astronauts and cosmonauts still have relationships with their bodies. You and I have a relationship with our bodies, no matter where or whether we calculate our mass times the acceleration of gravity.

Eating disorders and body image problems live in that relationship, not in numerical values like weight, gravity, mass, calories, pounds, stones, ounces, feet, meters, or inches.

Humans have relationships with all manner of people, places, and things (including gravity). As my co-author’s daughter once said while maneuvering a piece of furniture: “Remember, gravity is our friend!” It sure helps when moving furniture down the stairs. It’s very stubborn when moving furniture up the stairs.

Clinicians must understand that, when clients obsess about mass times the acceleration of gravity, they are communicating information about their:

• relationships with food and eating
• relationship with their body
• relationship with their authentic self
• relationships with other people, places, and things.

As clinicians we must resist one-dimensional responses to “w = mg” obsessions. Instead, we read between the metaphorical lines to help patients journey away from “I am my weight” beliefs, practices, and neural pathways. Effective treatment gives people consistent, “non-w = mg” eating and body experiences in the practice of self-care, self-acceptance, and self-love.

Of course, treatment and recovery don’t remove mass times the acceleration of gravity from the world. But they do offer the potential for transformed relationships with people, places, and things (like gravity). As a recovered friend puts it:

I now see weight for what it really is: one bit of data (among many, many others) that may, at times, provide some (but not all) useful information about how I am caring for my body. I rarely think about weight any more, which is quite liberating.

The barriers to healing and transformation are massive. And they are frequently occurring opportunities for us to guide and support our patients to put weight in its proper place at the proper time: one bit of data about mass and gravity. We usually need to focus on this data point early in recovery, and occasionally later on. Otherwise, we put w = mg on the shelf with other data, like the dictionary.

It Ain’t the Numbers; It’s the Relationships

Throughout Integrated Eating, we remind our patients: “In recovery, your body must come first. Despite what an eating disorder says, feeding your body and feeling its presence are more important and useful than using symptoms to (temporarily) numb and/or disconnect from your body.”

For example, we ask the people in our care to imagine a small child approaching an adult:

The child, too young to get her own meals, asks the adult: “Can you give me something to eat?”

In a sharp tone of voice, the adult immediately answers: “Not now, I’m busy.”

After a few minutes, the hungry child begins crying and pleading for food. The adult grows more agitated and impatiently replies: “No! I have important things to do.”

The crying continues and (if the adult bothers to look), they see a child in pain. This enrages the adult even more. They shout or growl: “Go away and leave me alone!”

We talk with the patient about the story and their reaction. We ask how they feel about the adult. We ask how they, in real life, would treat this hungry child (or any hungry child).

They say: “Well, I’d never treat them like that! That’s crazy. That’s cruel. Who would do such a thing? I would never deny a child food when they’re hungry.” We notice, acknowledge, and name their compassion.

Next, we suggest: “Imagine your body is a small, hungry child.” We often see jaws drop as patients perceive the parallels between:

1. the heartless adult and their eating disorder
2. the hungry child and their body.

Finally, we ask them to consider treating their own body with the same compassion they give a hungry child. We ask them to practice saying this to their body: “Yes, I’ll put down what I’m doing. Sit down, child, so I can feed you now.”

The hungry child story illustrates a disordered and distorted human relationship and its consequences. I believe that obsession with w = mg—in eating disorders and in our culture—is symptomatic of a disordered and distorted perspective on the function of human relationships.

When people with eating disorders get “stuck” on calories and w = mg, I suggest that the eating disorder places far more value on calories and weight than a miser does on money. Then I ask: “Are rich, miserly people the only people worth having relationships with?”

Healthy and fulfilling relationships between people aren’t determined by numerical values or formulas. Relationships don’t have mass controlled by the acceleration of gravity. Human relationships are created and developed through the interactions and responses of the two (or more) parties involved. Any “weight” or “gravity” we assign to relationships is purely metaphorical.

Each of us has a relationship with food and eati...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• Acknowledgements
• Introduction
• 1. The Person, the Disorder, and Recovery
• 2. Structured Eating Foundations
• 3. Structured Eating in Real Life: Morning
• 4. Structured Eating in Real Life: After Noon
• 5. Mindful Eating Foundations
• 6. Mindful Eating in Real Life
• 7. Intuitive Eating
• 8. Mastered Eating
• Index