It’s About TIME (with Doc Oz)

Parade Doc OzI’ve recently done a couple of posts about eating and eating disorders. If you haven’t read them, here they are:

Intuitive Eating

Disordered Eating Revisited

And a little more background, from 2015:
Eat, Drink, Repeat: Day 1 of a 3-Day Binge

I’m back again today with something I read this week from the September 9 issue of Parade Magazine:

 

“Secrets From Dr Oz: Why He’s Fasting and Using the Clock to Slow Dementia and Fight Disease.”

For those who are already embracing the “intuitive eating” approach, this might not appeal to you, since that program de-emphasizes a focus on weight loss. But I like that Dr. Oz is talking about weight loss, dementia, and other diseases in this piece.  And it’s all about TIME:

“New studies suggest that WHEN you eat matters for your health, longevity and even weight loss,” Oz says. . . . Before drive-thrus, microwaves and refrigerators, the human body evolved to go for long stretches without food. During these breaks, vital things happen. Insulin levels drop which makes stored body fat more accessible for us. Human growth hormone goes up, to help burn fat and build muscle. Damaged cell material is shed faster. All this may help us to:

Lose weight (or stick to a healthy weight.)

Slow Alzheimer’s.
Grow a healthier gut.

For more details about each of these, read the article here. (There’s also a short video with Dr. Oz included in the link.)

I was encouraged by his discussion of “intermittent fasting” because this is something that I had already embraced, with some degree of success with weight loss as a result. He promotes sleeping 8 hours (which I often do) and then fasting for 4 hours–preferably two of those before going to bed, which I also have embraced to help with my GERD (gastro-enterstinal reflux disease). I actually do better with a longer fasting time, like from 6 p.m. to 8 a.m., but most night we don’t have supper until around 7. When I’m being more focused on dieting, I often have my “supper” in the middle of the afternoon and then feed my husband at 7, after he exercises after work. When I do that, I find I lose weight and feel better. But it’s hard not to snack around 8-10 p.m., which can undo the benefits of eating earlier! If I snack after 9 p.m. I often don’t eat the next day until mid morning or even noon.

Of course this doesn’t “cure” my eating disorder (I’m struggling to give up Hershey’s kisses because I can’t seem to moderate them) but I’m healthier today, weighing almost 20 pounds less than I did three years ago, and I really want to keep going to get to an even healthier weight.

Anyway, I thought I’d share the link to this article for those who are interested. To continue the discussion about various approaches to dieting (or not dieting) please leave a comment here or on the Facebook thread. Thanks, always, for reading!

 

Warming Up to Adele (and short story collections)

a297b454e38ab19556dd1bbfaf6eeeceIf you read my blog regularly, you know that I have published four books, with four different publishers—two university presses and two small indie presses. And I’ve been published in three genres: memoir, novel, and essay anthology (as editor and contributor). You might not know that I haven’t always like short stories. But that has changed recently. Maybe because of my friends who have published some really good collections, like those by John Floyd, Niles Reddick, Lee Martin, Jennifer Horne, and Suzanne Hudson. (I blogged about John, Jennifer and Suzanne’s collections here.) Oh and M. O. “Neal” Walsh’s first book was a linked short story collection, The Prospect of Magic.

You also know that I had a negative experience working with a New York literary agent on my novel CHERRY BOMB, and eventually parted ways with her. And yet I find myself hoping for a different experience “next time,” and so I’ve just spent several months querying agents for my linked short story collection FRIENDS OF THE LIBRARY. Here’s an update on the journey.

Of the forty agents I’ve queried since May (remember that I queried over 100 for CHERRY BOMB?) here are my responses so far:

17 rejections, but several were personal and very nice. My favorite one said this:

I think you’re a great writer and this is a great concept. I had a hard time warming up to Adele.  I think her voice is getting lost in the stories she’s reflecting on here – I think this collection would be more powerful if we had more of a sense of who your narrator is.

Friends of the Library cover“Adele” is the fictional author (based on me) who visits ten Friends of the Library groups in small towns in Mississippi, speaking about her novel and her memoir. In each town, she gets involved in the very complex lives of some of the people there (all fictional people and situations) who are dealing with things like Alzheimer’s, cancer, domestic abuse, eating disorders, adoption, sexual abuse, kidnapping, and racial issues. She doesn’t have the same level of involvement in all of the stories, and maybe that’s what this agent is referring to. Maybe she needs to be more involved, so that her interactions change her and affect her life more.

What’s interesting about this agent’s comments is that I was just visiting with a couple of author friends this weekend about this collection, and one of them mentioned the idea of making the author/narrator into a protagonist for a novel, by connecting the stories. I’m not sure how to do that, since the characters in each story don’t really have anything to do with the characters in the other stories. I really like the book the way it’s structured, but I do plan to go back through it and see if I can figure out why this agent had a hard time “warming up to Adele.” I want my readers to love her, but especially to love the characters she meets in each of the small towns in Mississippi. And to embrace those towns and their history, their architecture, their music and art and culture.

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short-stories-writers-digestMeanwhile… (you know something’s coming when you see my ellipses, right?) I decided to go ahead and query three university presses for the collection. They each have the full manuscript, but I haven’t heard back from any of them yet. Only two more of the 40 agents I queried asked to read the manuscript, and I haven’t heard back from them yet (it’s been two months) so my gut feeling is that if one of the university presses is interested in the book, I will go with them. I really like working with academic presses, but I was hoping for a larger reach. Maybe that will happen if I ever get that next novel written. I’m actually considering expanding one of these short stories into a novel. I won’t tell you which one yet.

So that’s a sneak peek into this chapter of a writer’s life.

SWW at Pat Conroy event

Jonathan Haupt (back left) Director of the Pat Conroy Literary Center hosted this wonderful event with authors Nicole Seitz, Patti Callahan Henry (back row) and me and Cassandra King Conroy (front row) in Bluffton, South Carolina.

 

As much fun as I’m having touring for SOUTHERN WRITERS ON WRITING, it’s important to always be looking forward, working on the next project, or there won’t be a next book! This weekend I was in South Carolina for my 10th panel presentation for SOUTHERN WRITERS ON WRITING, this time with Cassandra King, Patti Callahan Henry, Nicole Seitz, and Harrison Scott Key. The event was in the Visiting Author Series sponsored by the Pat Conroy Literary Center in Beaufort. The turnout was great and I really enjoyed being with these amazing writers who generously contributed essays to the book and then traveled to Bluffton for the event. I’ve now moderated panels with 21 of the 26 contributing authors, and have four more events scheduled for this book (through January of 2019). So… come next February, I hope to have another book in the queue. And maybe I’ll have time to finally get that second novel under way.
Thanks always, for reading!

Intuitive Eating

On Tuesday I did a post about “Disordered Eating.” This is a follow up, so if you’re bored with this topic, check back in next week. If not, please keep reading.

1515intuitiveeatingThere were interesting discussion threads on Facebook and Instagram in response to my post on Tuesday—thank you! This is obviously a topic of importance to many people. One person left a comment on Tuesday’s post asking for a recommendation for an in-patient therapy program for her morbid obesity, and I’ve put her in touch with two people in her city who might have suggestions. And two different people who live in two different cities both mentioned the book INTUITIVE EATING by Evelyn Tribole and Elyse Resch.  These two women are both seeing nutrition experts for help with their eating disorders. I got the book on Wednesday and read most of it in two days. (And yes, I finished off another bag of Hershey’s kisses in the process.)

It’s a complex book and program, so I’m not going to try and do a full review here. I will respond to the book’s 10 Principles of Intuitive Eating and a few other excerpts from the book.

First let me introduce the authors. Evelyn Tribole, M.S., R.D. is a registered dietician with a nutrition counseling practice in Newport Beach, California, specializing in eating disorders. Elyse Resche, M.S., R.D., F.A.D.A., C.E.D.R.D, has been in private practice in Beverly Hills, California, as a nutrition therapist for thirty years, specializing in eating disorders, Intuitive Eating, and preventative nutrition. . (C.E.D.R.D. stands for Certified Eating Disorder Registered Dietician—yes, there actually is such a thing!)

twiggyAnd before I go any further, I’d like to share a link to a blog post I found while clicking around this morning: “Why Intuitive Eating is Making Me Sad.” I think this short post is important because the author is simply making the observation that this program or principle, which claims to be “revolutionary,” is really a return to the way people used to eat before the diet craze took over our world. I think her words are a good addition to this conversation. For me personally, I barely remember that pre-diet-craze time…. only a few years in the 1950s when I happily ate my grandmother’s homemade rolls, fried corn, and homemade ice cream without guilt. My grandfather who molested me when I was 4-5 died around 1956, and it would take several decades for me to make the connection between those acts and my disordered drinking and eating. By the time I was a teenager, my mother had already started in on me with the “fat talk” (this is explained in the book) and shaming, and my eating disorder was in full force in the 1960s. Just when Twiggy came on the scene and I wanted to be her. Thankfully my eating disorder never became as life-threatening as anorexia, although there were times when I wished I could be anorexic so I could be skinny. Yes.

So back to the book. I read 10 of the 17 chapters, and skimmed the other 7. It’s not that those chapters aren’t important. It’s just that they address things that I had already learned in my 67 years and didn’t need to revisit. FULL DISCLOSURE: I must say up front that I don’t embrace a major tenet of this approach, which is that the patient/client must put weight-loss on the back burner as they work through this program. I have lost almost 20 pounds in the past two years, but I’d like to lose at least 10 more, so I’m not willing to put this “on the back burner.” This isn’t a one-size-fits-all issue, and in Chapter 2: “What Kind of Eater Are You?” I didn’t fit any of the descriptions. The one that came closest for me was the “Emotional Unconscious Eater,” although I’m very conscious of my eating. This type:

“uses food to cope with emotions, especially uncomfortable emotions such as stress, anger, and loneliness. While Emotional Eaters view their eating as the problem, it’s often a symptom of a deeper issue. Eating behaviors of the Emotional Eater can range from grabbing a candy bar in stressful times to chronic compulsive binges of vast quantities of food”

So, Chapter 11 was possibly the most helpful chapter for me:

PRINCIPLE 7: Cope With Your Emotions Without Using Food

This chapter is summarized in the 10 Principles of Intuitive Eating I mentioned earlier:

Find ways to comfort , nurture, distract, and resolve your issues without using food. Anxiety, loneliness, boredom, anger are emotions we all experience throughout life. Each has its own trigger, and each has its own appeasement. Food won’t fix any of these feelings. It may comfort for the short term, distract from the pain, or even numb you into a food hangover. But food won’t solve the problem. If anything, eating for an emotional hunger will only make you feel worse in the long run. You’ll ultimately have to deal with the source of the emotion, as well as the discomfort of overeating.

The chapter goes into detail about various emotional triggers and the ways we use food for comfort, distraction, sedation, and even punishment, although that last one hasn’t been my experience. While there wasn’t anything “new” for me in this chapter—I kept waiting for the magic answer—the easy ways to find comfort without using food—it was reaffirming:

Becoming an Intuitive Eater means learning to be gentle with yourself about how you use food to cope, and letting go of the guilt. As odd as this may sound, eating may have been the only coping mechanism you had to get through difficult times in your life.

I identified with that statement, with one really big caveat: for years I used alcohol as my coping drug of choice. But one year ago tomorrow (yes!) I quit drinking, so food has moved back into the forefront of my struggles, with renewed vigor.

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The main things about Intuitive Eating that make sense to me are things that I already embrace. I am a mindful eater and am aware of when I am full and can often stop eating at that point. Like yesterday when I had lunch with a friend and only ate half of the two sushi rolls I ordered. I was full and comfortable with that amount. It wasn’t hard to stop eating because the food, which was delicious, made me happy. I was also enjoying the company of a friend, so I wasn’t lonely. The day before, I had buttered two halves of a blueberry bagel and toasted them for breakfast. My husband walked in and said, “something smells good,” and I realized that I was full after eating one half, so I gave him the other half. (I had also eaten a peach.) All this to say that I already get the mindful eating thing, and I actually practice it fairly regularly, where meals are concerned. And thankfully the binge eating has almost gone away during this year that I’ve not been drinking, so that’s interesting. I haven’t had a bulimic episode in many months. It’s the trigger foods (like Hershey’s kisses) that I’m struggling with controlling, and I don’t really see how this book addresses those issues directly. Maybe they will resolve themselves as I get healthier in general. If I ever reach the point, as page 163 in the book describes, “When Food is No Longer Important” (when a person reaches the point where they’re no longer using food to cope with their emotions):

You no longer have the “benefits” of using food…. One client noted that on tough days she knew she could always go home to her chocolate. Now, instead, she’s “stuck” with experiencing her feelings. You might even need to go through a grieving period for the loss of food as comforter and companion.

This is probably the most important paragraph in the whole book for me. This describes exactly what I’ve been able to do with alcohol for the past year. Almost every day (at least for the few first months) there’s a time when something triggers me and I want vodka so badly I can hear the martini shaker going in my mind and I can taste the magic on my lips. But since I made the decision not to drink, this is no longer an option for me. I have GRIEVED the loss of this comfort, but like grief over the death of a loved one, it’s getting easier with time. I’m thinking that I will need to make similar choices about certain foods (like Hershey’s kisses) that I can’t seem to limit. I already do this in some ways—like not buying kettle-cooked potato chips very often because I will eat the whole bag at once. But I do choose to buy those chips at times, maybe about once or twice a month. Maybe intuitive eating for me will mean making these hard choices more frequently, and allowing myself to “experience my feelings in a deeper, stronger way” as the book says. I used alcohol to numb those feelings for so many years, and now I’m trying to learn to quit using food in the same way.

The chapter of the book about respecting your body also hit a strong note with me. I already do the “nice things” the book suggests, like getting massages and regular visits to the nail and hair salon. And I’m embracing moderate exercise, which is discussed in another chapter in the book. I was an exercise “addict” in the 1980s when I ran an aerobic dance business. On days that I didn’t work out, I often didn’t eat. When we traveled I looked for an aerobic class to attend, and if I couldn’t find one I would panic. When I quit teaching aerobics at age 40, I began to gain weight again, and the struggle has intensified over the years. But I’ve finally made peace with exercising moderately on our elliptical machine in my office, and at the swimming pool in the summer. I’m not “driven” to exercise, nor do I feel guilty if I skip but it makes me feel so much better to MOVE my body, that I’m drawn to it fairly naturally.

I’ve also been learning to really enjoy food at times by eating mindfully, eating foods I really love in a nice setting. So I think I’ve been on the road to “intuitive eating” for a while, but I’ve got a ways to go with the trigger foods. And I would love to some day be free of my obsession with food and body image. You would think that being 67 years old would help, and in some ways it does. Also, surviving a life-threatening wreck five years ago (when I broke my neck, leg and ankle) has helped, because I have become more THANKFUL for my body and the life it provides for me, when I could have died or become paralyzed. The pain I’m left with does trigger unhealthy eating (as it once triggered the alcohol) but I’m learning to use other means to help deal with the pain.

Chapter 14 was helpful: PRINCIPLE 10: Honor Your Health With Gentle Nutrition. Again, it didn’t have a lot of information that was NEW to me, but it confirmed a number of things that I’ve been learning over the years that make me think I’m moving in a good direction. I think that for me, right now, today, focusing on how eating certain foods and certain amounts of food makes me FEEL is key.
The bottom line is, I’m tired. I’m tired of food and weight and appearance taking up so much of my life. One of the clients described in the book talked about her obsession with clothes and body image while preparing for upcoming social events. I do that when preparing for speaking engagements on my book tours. Like this weekend, when I’m flying to South Carolina to speak on a panel sponsored by the Pat Conroy Literary Center. It’s an honor and I’m excited about it, but of course I’m also keenly aware that the other women on the panel are thinner than me (two are quite a bit younger as well) and I worry about what to wear and I compare myself to these other women. I’m sure that the people in the audience are just there to hear about our books and our lives as southern writers, but I can’t help but worry about how I will look.

I’m hopeful that I’m moving towards making peace with these issues, and while I don’t think this book is a magic bullet, I do appreciate some of the wisdom its authors have shared. I’ll close with an excerpt from Chapter 16: The Ultimate Path Towards Healing From Eating Disorders:

The vision of a future, free of obsessive thinking and compulsive behaviors is very powerful. This hope can facilitate the patience it will take to get through the period of time that is needed for healing.

Thanks, always, for reading and please join the discussion here or on Facebook or Instagram.

Disordered Eating Revisited

eating-disorderAccording to an article in the American Journal of Psychiatry (2009):

Eating disorders have the highest mortality rate of any mental illness.

And yet, this mental illness was left out of the Mental Health First Aid training course I took last weekend, sponsored by the Church Health Center here in Memphis. They used to include Eating Disorders, but the course took longer than one day, so they cut it out. The mental disorders they included in the eight-hour course were: anxiety disorders, major depressive disorder, substance use disorder, bipolar disorders, and schizophrenia. I can see why they chose these disorders for the course, as each of them have specific things a person can do to help—mental health first aid—when they see someone struggling with an anxiety or panic attack, severe depression, substance abuse, and behavior that is dangerous to themselves or others. For someone with an eating disorder, the symptoms don’t always present in such obvious forms. And “mental first aid” for persons with this disorder is a bit more complicated.

Thankfully there’s a whole chapter devoted to eating disorders in the Mental Health First Aid USA manual they gave us at the training, and I came home and read it right away. If you’ve been reading my blog for very long, you know that my interest in this disorder is very personal, as I’ve suffered from eating disorders for most of my life. I don’t believe that my level of disordered eating has placed me in a life-threatening situation—the way that anorexia can, on the one extreme, or morbid obesity, on the other. And for many people like me, it would be difficult for someone to know how to reach out to us with any kind of mental first aid. By the time a person’s eating disorder has become life-threatening, it seems that treatment has a diminishing chance of success.

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Aerobic dance instructors at Phidippides Sports in Jackson, Mississippi, 1984. That’s me in the black tights, middle row on the left. Even at 116 pounds, I often wore black to make my thighs look skinnier. I was 33 years old.

 

With so much emphasis on body image in our culture, it’s not surprising that many people (especially women and girls) suffer from body image distortion and resultant eating disorders in an effort to live up to society’s standards for a thin body. This started for me when I was a young teenager and gained 35 pounds in one year as a result of hormone therapy I received following surgery when I was 16. I went from a skinny 95-pound bundle of energy (who could eat as much as I wanted and not gain weight) to a 130-pound late-blooming adolescent. (I also grew three inches taller.)  By the time I got married at age 19, I weighed 140 and was depressed. My bulimic habits, which began as a teenager, continued into  adulthood. I would eat in secret and lie about what I was eating. I tried various forms of exercise, and finally in 1982, I found something that “worked.” I began teaching aerobic dancing at my parents’ athletic store in Jackson, Mississippi (Bill Johnson’s Phidippides Sports) and dropped to 116 pounds pretty quickly. But my disordered eating and body image distortion only increased. Standing in front of a wall of mirrors in spandex, teaching my students, I still thought I was fat. On any day that I couldn’t work out, I wouldn’t eat. Bulimia was still part of my life, but less so with al the exercise.

kissesWhen I read the chapter on eating disorders in the Mental Health First Aid manual, I recognized immediately which category I fit into. I don’t have anorexia nervosa or bulimia nervosa (since bulimia isn’t a regular activity for me) so the third category, “Eating Disorders Not Otherwise Specified or EDNOS” includes Binge-Eating Disorder, which is the main thing I’ve struggled with most of my life. Whenever I post images—like this one of the Hersheys Kisses I ate on a recent binge—on social media, I get lots of responses from others with similar issues, so I know it’s fairly common. According to an article in Biological Psychiatry (2007):

A national survey of adults found that 1.2 percent had binge-eating disorder in the previous year and 2.8 percent had had it some time in their life. Approximately 28 percent of people with binge-eating disorder received treatment for mental health problems.

I think that last statistic is important, because in order to get healed from an eating disorder, I think a person needs help with the underlying cause. Again, according to the Mental Health First Aid manual (and an article in Lancet in 2003):

A range of biological, psychological, and social factors may be contributing factors. The following factors increase a person’s risk of developing an eating disorder:

Life Experiences
Conflict in the home, parents who have little contact with or high expectation of their children.

Sexual abuse.

Family history of dieting.

Critical comment from others about eating, weight or body shape.

Pressure to be slim because of occupation (model, jockey) or recreation (ballet, gymnastics)

Mom circle 1963. She was 35 years old and thought she was fat.

Mom circle 1963. She was 35 years old and thought she was fat.

I checked “yes” for ALL of these. I could never live up to my mother’s expectations, and experienced relentless verbal abuse from her, especially her criticism of my weight, hair, and clothes. She was always dieting and talking about weight (hers and others) although she remained slim all of her life. As a cheerleader in my teenage years and an aerobic dance instructor in my 30s, I was often in situations where I felt pressure to be slim. The year I spent as a coed on the Ole Miss campus added to that pressure. I kept comparing myself to the beauty queens my boyfriend had dated before me.

The manual also says that mental disorders in family members can contribute to someone having an eating disorder. My mother definitely exhibited substance use disorder (drinking) and I have reason to believe that she was sexually abused by her father, my grandfather, who molested me when I was a little girl.

So, what’s the Mental Health First Aid Action Plan for helping someone with an eating disorder? It’s tricky, to say the least. It requires that a person wanting to reach out and help someone must learn as much as possible about the disorder first, by reading books and articles, or talking with a health professional. Then they should choose a time to approach the person they are concerned about and do so in a way that is non-judgmental and compassionate. Some tips in the manual:

Initially, focus on conveying empathy and not on changing the person or their perspective… try not to focus solely on weight or food. Rather, focus on the eating behaviors that concern you. Allow the person to discuss other concerns that are not about food, weight, or exercise. Make sure you give the person plenty of time to discuss their feelings, and reassure them it’s safe to be open and honest about how they feel.

I think this is great advice. Some things NOT to do (that I’ve experienced personally and found not to be helpful) are: (these come from me, not from the manual)

Suggest a specific diet or nutrition plan that has “worked for them.” (Unless the person is ASKING for one.)

Use words or a tone of voice that is patronizing, even in an attempt to flatter the person with phrases like, “Oh but you are beautiful just the way you are.” This is fine if you are close friends with the person, but not helpful in mental health first aid.

Like the other mental health first aid approaches, this one has guidelines for assessing the person for crisis including:

 The person has serious health consequences (disorientation, vomiting, fainting, chest pain or trouble breathing, blood in their bowels, urine, or vomit, or cold or clammy skin and a body temperature of less than 95 degrees Fahrenheit.

eating_disorders_imageIf you come across someone with these symptoms, mental health first aid is important, and you should apply similar techniques as for other crises (the

ALGEE action plan I explained in my previous post.) But there are suggestions specifically for helping someone with an eating disorder who seems to be in a crisis. There’s too much information for me to share here, but I hope you will get the manual and read about this yourself.

I know this was a long post, and as always, thanks for reading. And of course I love to hear from you, either here or on the Facebook thread.

Here’s a post from a few years ago that has an excerpt from my essay “Eat, Drink, Repeat”:

“Eat Drink Repeat: Day 1 of a 3-Day Binge” (2015)

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