Crazy Denny's and BED

On Tuesday Mark and I had dinner at Denny's. That's not a really unusual thing, as anyone who regularly reads this blog knows, but this Denny's was in Virginia. I always order the Senior Lemon Pepper Tilapia (hold the lemon pepper sauce), salad (no dressing), garlic toast, and double green beans as the two sides. I know that our local Denny's, and many others, just steam the green beans whole. That's how I like it. Some Denny's use cut, canned beans and put a bacon-y seasoning on it that has little brown bits in it. True, the bits could be artificial bacon bits, but once in an Orlando area Denny's, the waiter said it was real bacon. So...I asked the waitress about it and told her that if they used the bacon seasoning, come back and tell me so I could order two different sides. She never came back, so after the salad, she served me the tilapia and green beans, swimming in bacon bits. I was surprised, so I pointed them out to the waitress and asked for two different sides. This was HARD because I hadn't thought about it. I quickly just said cole slaw (because Mark had it) and mashed potatoes. Oops. Mistake. They came with gravy. Yikes. I haven't ordered mashed potatoes in a restaurant in a long time, and in Virginia I guess mashed potatoes AND GRAVY is just understood even if it's not verbalized. So here's a bowl of potatoes completely covered in brown gravy. I was nearly speechless, but I told the waitress that I bet it had meat in it. She said oh no, there's no meat, it's just gravy. I'm thinking "where does gravy come from?" But I said, "Well, I'd like to believe that, but I bet if I read the package ingredients it might include some meat products, so I don't want it." She cheerfully brought be a bowl of plain mashed potatoes.

Lessons learned:
1. Always say NO SEASONING or SAUCE on the green beans if in any doubt.
2. Always say Mashed Potatoes, NO GRAVY, if it comes up.
3. Better to order corn!

I have not been feeling in control this week. That's a common thread on these posts lately. I had a couple of good days last week, but then I went to Boston for five days and lost most of my control. It hasn't come back since last week, so the weight is creeping back. I had been pleased that I had lost more than half of the 11 pounds gained on the trip, yet this morning I have put back all but three of the pounds. I'm only 3 pounds down from April 12 when we returned from the trip, so at this point, a month after returning, I have only lost 3 pounds. Not a good month.

I would like to blame it on all the stresses and changes that are happening, but that's such a wimpy cop-out. There have been plenty of stresses in the last year, but I kept on track and the weight came off. I would like to blame it on the fear of surgery being gone. That's probably part of it. I know I don't have to face the surgeon telling me dire news about dying.

What I am sure I can blame it on is BED, Binge-Eating Disorder, and not using the tools that I have. I'm no longer writing foods down, measuring things, eating at the right restaurants when I have to eat out, walking, substituting sugar-free gum and hot tea for snacks, or staying out of the kitchen when I watch TV at night. These are proven tools that will work, but I'm ignoring them. My binges are happening with more frequency.

In July Evey is starting a Master's Degree program in Applied Nutrition with an emphasis on obesity and eating disorders. For her undergrad nutrition class she wrote a paper on BED and sent it to me yesterday. It's a review of literature type research paper that reminded me of what it is and how it feels. Although I'm not going to put her entire paper here, I would like to share a few sentences from it. (If anyone wants the whole paper, complete with references, just ask. I'm sure she would be happy to send it to you.)

"Some of the criteria currently set forth in the DSM-IV-TR include feeling no control over the act of eating, eating abnormally large quantities of food, and feeling guilty or depressed afterwards (American Psychiatric Association, 2000)."

Feeling "no control" is a key for me. When I start to binge, I do recognize that I'm doing something wrong and inappropriate, yet there is no part of my brain that wants to stop it, or can stop it. It's going to happen and it's later, when I may feel sleepy from overeating, that I start to get depressed and really beat myself up mentally over it. I'm sure drug addicts, smokers, and alcoholics get the same feelings.

"While the American Psychiatric Association (APA) is working hard to define this disorder, it can prove difficult to apply definitions to very subjective feelings. In attempting to diagnose this type of disorder they must take into account how much food is considered unusually large amounts, if that feeling of loss of control was present, and when a binge becomes different from something like holiday related overindulging (Bulik, Brownley, & Shapiro, 2007)."

That last sentence is interesting to me because many people overeat at holiday times. I certainly have been known to do that, but the main difference is that it will often trigger a binge that lasts months. Many of my diets were going well until Halloween. The act of eating candy on Halloween would set up a binge that usually lasted until after New Year's Day.

So what can I do about it?

"The above studies demonstrate outcomes of a variety of professional interventions. Not all individuals suffering from BED will necessarily seek or receive professional help. Some people in this situation may attempt their own dieting to lose weight, or restrict their intake as “punishment” for their feelings of guilt or as a way to regain control. A study done by White, Masheb, and Grilo (2009) looked at how strict intake restraint and lifestyle changing habits affected weight change in patients with BED. While neither of these types of diets is directly related to the binges of BED, they do represent two common methods for dealing with food related issues. The “regimented restraint”, as the authors dub it, included very strict dieting that may forbid entire food groups, or adhere to a very specific set of guidelines for eating. This type of restraint was found to be related to psychopathologies such as body dissatisfaction as well as with unreliable weight loss and variable weight gain (White, Masheb, & Grilo, 2009). The “lifestyle restraint” method, which includes general lifestyle changes such as striving to choose lower calorie foods, was found to be connected to more favorable outcomes. These included lower reported hunger rates, lower rates of depression, and less weight gain (White, Masheb, & Grilo, 2009). In the treatment of BED as a psychological, weight-related disorder, it would be beneficial to steer toward treatments that mimic the lifestyle restraint changes."

I guess I'm on a "lifestyle restraint" plan. It's still very hard!!

Any why do I have it?

"As research continues into all aspects of BED the question remains, what causes BED? As of now there is no known cause for this disorder, though some risk factors have been researched. Separate from risk factors, one study by Hudson, et al. (2006), identified a pattern of BED within families. The authors found that about 20% of the relatives of a primary subject with BED also had a diagnosis of BED, while that percentage was less than 10% for relatives of a primary subject without BED (Hudson, et al., 2006). Additionally, relatives of those subjects with BED had a much higher rate of severe obesity as measured by BMI than the relatives of those subjects without BED. Again the question of cause is left unanswered, but this study was able to identify that BED can be traced through families, likely due to genetic and environmental input.

I can't go back and ask my parents anything now about their eating habits, and memories are not always reliable. My instincts are that both my parents had BED tendencies. I can remember them both eating out of control, buying inappropriate snacks, hiding food to eat in secret, etc. All behaviors that I see in myself.

"While BED is being recognized as a valid psychological disorder in the medical community, I find that it is not yet there in public opinion. Unlike anorexia that has almost penetrated the public as a psychological abnormality of choosing not to eat, BED looks different to the public as it appears to be overeating. Many people overeat occasionally, and most people understand excess food consumption to be a cause of obesity. While not everyone with a diagnosis of BED is obese, nor is obesity a requirement for such a diagnosis, they do seem to be related. Due to this fact, I still get the feeling that much of the public believes if these individuals “just didn’t eat so much”, they would no longer be obese. I could not find any articles that addressed quality of life for those with BED or even discrimination as it related to BED. Based on previous documented discrimination against overweight individuals, though, I feel confident that many with BED have experienced this as well. Considering that bullying and abuse are risk factors for developing the disorder in the first place, I can only imagine how continued verbal abuse and negative imagery may affect those with BED. This mindset is unproductive for individuals who are obese both with and without a diagnosis of BED. Furthermore, such public attitudes may cause those who are struggling with weight to develop shameful or guilty feelings about their eating habits and cause future problems."

There is just so much in this last paragraph that I just had to include it all. I can't add anything else to it.

This knowledge is helpful. It puts the symptoms and issues right out there in front of me. Evey did a great job on this paper and was rewarded with an A on the paper as well as the class. It also shows she is going to do well on her Master's degree. I hope she has the opportunity to do more research on BED and help many people in the future, including me.

I hope today will be a day with my "lifestyle restraints" in place!!