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Eating, and *real* health

October 17, 2012

This is a post I started writing a few days ago, on a not-so-great day, and I left it sitting as a draft because I was concerned about coming across as whiny and/or unrelentingly negative. But, a recent post at Shakesville helped me change my mind: Discussion Thread: How is your life not perfect? (with a followup yesterday, Discussion Thread: How is your life lovely?)

I can still be happy with myself and my life despite (and sometimes because of) my/its many imperfections. And, the fact is, being obliged by others to project nothing but undiluted happiness has been a source of much trouble in my life. My failures and flaws are part of what makes me human, and I need them as much as the many good things about my life…

Between the Perfect Lives conveyed by social media and carefully orchestrated photo-ops of the glamorous lives of the rich and famous and politically powerful, it’s easy to feel like you’re the only one whose life is occasionally, or more than occasionally, a mess.

And in the interest of giving ourselves and each other a break from feeling alone in our respective messes, let us share one way, or the many ways, in which our lives are imperfect, especially in the ways over which we ostensibly have control, but haven’t seemed able to take it.

Not surprisingly, a lot of the responses, the last time I checked, involved disability complicating people’s lives. And, as has come up here multiple times before, too much of our society has an investment in pushing the idea that only people who do live the One True Perfect Life can possibly enjoy theirs, or be happy. I do usually enjoy my life, these days, but we all have problems and just plain rotten days. The easiest way to keep having the same problems contributing to the same kinds of rotten days is not to talk about it in a way that might help you find workarounds and solutions–or just plain support.

Content note: discussion of disordered eating.

_________

To continue with my kick, which is actually starting to taper off.😉

The Feeling’s Back – by Suicidal Tendencies.
From the album How Will I Laugh Tomorrow (1988)

Source (with lyrics).

First off, sorry I’ve been having trouble getting around to replying to comments lately. This might help explain why I just haven’t had the spoons available, in spite of being very interested in doing so. Again, I has teh dumb, at least in the old “wrap words around ideas” module. But, I’ve also started trying to learn Java, which needs enough different skills that it seems to be going OK so far. We’ll have to see, but that will probably also eat extra spoons for a while.

Lately, I’ve been having a lot of bad feelings around eating and the prospect of gaining weight again, even though my hormones are messed up again right now from not eating enough. (“Because” as much as “even though”, AFAICT…) Deprivation from the tooth abscess really seems to have set it off, but at least I am aware now that it’s “just” a set of dangerous OCD loops, and not really me being a horrible person.* The infection is also trying to tank up again, which is kind of freaking me out.

Anyway, some booster FA blog reading led me to go back through some of the Shapely Prose archives, and I ran across a comment that got me thinking again in a more detached way about the problems I’ve been running into with changing what I’m eating for real health reasons. On Devouring the World, alphabitch said:

When I stopped dieting (about 19 years ago now), it took me quite a long time to figure out how to eat. Like, years. I couldn’t do it right away: way too scary. I’d been on a diet — or had failed to be on a diet — for about 16 years at that point and there were So Many Rules…

So I started out on the right foot anyway — explored, learned what “full” and “hungry” and “want to eat” and “need to eat” actually meant. But for quite a while I had to do it in the context of some other set of rules: I was a vegetarian for years — a vegan sometimes, I was devoutly macrobiotic for a while, etc. etc. But the idea of absolutely unfettered eating was just more than I could get my mind around at first. I had to have rules, and I had to believe I was following them because they were right. Orthorexia, I think they call that.

This. I only completely stopped dieting maybe four or five years ago, but I still did the orthorexia thing before that, often partly for “health” reasons but as an obvious part of the wider disordered eating (and nontheistic scrupolosity, to be honest) patterns. I did primarily go veggie for ethical reasons, but the rules there were no doubt useful. I went vegan a couple of times, the longest for almost a year, but that wasn’t sustainable for me then. My problems with food meant that I kept trying to restrict calories and fat, which is an excellent way to make yourself very sick indeed while eating vegan. Relying more heavily on wheat flour products and even (*barf*) lovely low-fat seitan with undiagnosed celiac made me even sicker, no doubt less able to absorb the fat and other nutrients I was consuming. In retrospect, I started showing (roundly psychosomatized) severe vitamin D and other deficiency symptoms then.

Low-fat vegan and vegetarian eating made me about the sickest and weakest I have ever been in my life, sicker than when I tried to get by on under 500 calories a day and compulsive exercise in my early teens. That was down to my own body’s needs, and I had one hell of a time changing what was making me so desperately sick without feeling evil. If anything about food and eating makes you honest-to-Glod feel like a weak, evil person, there is a serious problem there.

To point out something explicitly: With some other health problems at that point, largely from medications which were very bad for my system, I actually gained a large amount of weight while severely malnourishing myself. Simplistic calories in, calories out model, my bony broken osteomalacic ass.😡 That, too, was partly down to a particular type of food insecurity, which is actually common with celiac disease. A lot of people get fatter from it, which also leads to underdiagnosis. Your body tries to hold onto whatever energy it can, to keep itself alive. Frankly, I’m surprised I have any bones left, between one thing and another–and none started breaking, AFAICT, until I was in my 30s.

I kept craving high energy, nutrient dense cheese in particular, and finally started bolting it down when I was too starved. My body was also probably trying to get more calcium, whether I could absorb it properly or not. (Cheese has always been one of my main chemical hunger-gone-mad “binge” items. Where “binge” has usually actually meant a normal amount of food, bolted down out of desperation.) And hated myself even more for not being able to live up to my own ethical standards. Similar has happened when, for various reasons, I have had to start eating meat again at various times. It really sucks when real ethical concerns get all tangled up with disordered eating behavior and the misery from that.

I am easier with it now, but it still niggles at the back of my mind. And the urges toward harmful orthorexia were something I had to keep a watch on the last time I tried going veg, and then wild pescetarian, again. (Unsustainable for health and energy reasons, but I at least kicked myself less.)

As I mentioned before, going gluten-free didn’t pose a huge perceived deprivation problem. I already ate a lot of corn, potatoes, and rice, and had already been buying corn pasta sometimes just because I liked it. Substituting other flours and commercial items like pasta wasn’t a huge deal for me. (The price still bugs me, with ghost poverty tendencies. but…) The biggest continuing problem there is not being able to buy and eat what I want when I’m out without being very sorry later, which makes me crave things like flaky pastries and Krispy Kreme doughnuts more than I ever did before. I’m honestly drooling right now, just thinking about going into a bakery and eating a bunch of pastries. I also wish I could just order in a pizza sometimes, instead of planning ahead to make some or buying frozen to embellish. But, overall, that hasn’t been very triggering.

OTOH, just finding out I had type 2 diabetes was triggering enough, in itself. All the fatty blaming and scapegoating around that is bad enough. Even if you know full well that shit isn’t true, it’s hard not to feel like you’ve done something wrong. (Including, sometimes, around people who are pushing HAES.) With the blame and shame, an awful lot of people who usually have no idea what they’re even talking about feel entitled and even obliged to tell diabetics what they should be doing with themselves and their lives, because we’re obviously too stupid and lazy to know what’s good for us.

True story: I actually stayed with a diabetes-specializing GP who didn’t listen to me on anything, including intolerable “good first-line medication” effects that kept me from going out of the house much, just because he never jumped on me over my BMI or tried to blame me in any way for making myself sick. He saw a history of a pituitary tumor in the chart, and stopped there. He didn’t even push me to do much in the way of dietary or activity changes, because I looked “pretty fit” to him. (Maybe walking in with a bicycle helmet from cycling to the office helped, but more likely he’d have ignored/dismissed that if he were a blaming fat-hater. A high lean BMI has been more than enough to justify abusive behavior in past.) I wasn’t “fit”, I was extremely ill from multiple deficiencies and peeing out more energy than I could eat. And still trying to cycle around town, yeah.😐 Not entirely fat positive there, I suspect, but at least I didn’t come across as blameworthy. He was also wrong on the lack of usefulness of dietary changes, but I still really needed to hear that when I was diagnosed. A lack of blaming and shaming should be standard.

From some experiences I’ve read about, I am also extra-super-glad that I am not living with someone who piles onto the shaming and pressure, with controlling/insulting comments and manipulation thrown in. I think Mr. U is mostly a bit worried about my struggles around eating and body image, and wishes he could do more to help. Which also ought to be standard, but food/weight/diabetes policing and concern trolling is way too socially acceptable. I grew up with a bit different style of concern trolling there, from close family with their own OCD-entangled problems around food and their bodies, and it took me a long time to figure out how disrespectful and damaging this shit really is.

For several years now, I have been aware that eliminating a lot of carbohydrates would make my blood sugar levels easier to manage, from testing after eating different foods. I’ve been even more averse to making such drastic changes, though, because I have also done the low carb explicitly for weight loss thing (even worse, explicitly out of a “my husband no doubt finds me physically repulsive” OCD thing) before the diabetes was even diagnosed, and went more than a little crazy with it. I couldn’t tell if it made me feel any better from blood sugar effects, I was so busy with the same-old restriction and punishment through exercise.

Also, trying to control some of the metformin/Glucophage effects, I had to go pretty low carb. As in, maybe a quarter to half a cup of rice or pasta or half a potato per meal to avoid bad digestive consequences and the head spins. It did help some, but not nearly enough, and this is not an unusual set of side effects. (The stuff actually causes carbohydrate malabsorption, which is considered beneficial, so it’s more an intended effect.) By that point, I was personally underweight and weak from my blood sugar staying so high and worse-than-gluten daily skitters (and more malabsorption) starting maybe half an hour after every dose of the meds, but I still felt under extra pressure to try to lose more weight–because diabetes. I don’t think that ever should have been prescribed to someone with celiac-related IBS symptoms and history of malabsorption, at all; I’m sure that helped my health break down further and more quickly. Restricting food was easier with the constant nausea. My blood sugar levels went higher than they had been unmedicated, with debilitating swings, from staying so sick and stressed and dehydrated. It was an awful experience overall, and I had a hell of a time getting myself eating anything like normally again after I finally took myself off the meds, after almost a freaking year of getting brushed off.

So, I have some very bad associations set up very specifically around low carb eating.

I have had a problem with nagging and concern trolling myself over avoiding making drastic dietary changes, on mental and physical health grounds. It’s been hard to find a reasonable balance here.

Then, I ran across this excellent diabetes site a while back–which includes the must-read You Did NOT Eat Your Way to Diabetes. The REAL Causes.–and felt under more pressure. Which is becoming overwhelming recently, after running across this post: Why Zyprexa (And Other Atypical Antipsychotics) Make You Fat (and often diabetic, yeah)

TL;DR version, tying things together: Your system suddenly gets a metabolic switch flipped, very possibly epigenetically so it’s just not gonna reverse itself when you stop the meds, and your body can no longer properly use carbohydrates for fuel. The insulin builds up, and tissues go insulin resistant. This makes you gain an awful lot of weight, no matter how much you eat (at least involving carbs) or what you do, and “[m]ost cases (71 percent) occurred within six months of starting the drug and many cases were associated with moderate weight gain.” # Because it is very directly and drastically fucking with your metabolism.

I will resist, at least for now, ranting much about walnuts and sledgehammers and reckless endangerment with these types of meds getting used for so many things now in the US, and the problems with marketing. The situation was bad enough when I was inappropriately prescribed this stuff totally off-label for “treatment resistant”–i.e., in direct reaction to bad circumstances which were not improving, plus celiac deficiencies–depression and anxiety, about a decade ago. But, yeah, given my own experiences and observations, this mechanism of disruption is entirely too plausible.

My blood sugar does not rise at all after eating non-carb foods (and dairy, with the thankfully high threshold lactose intolerance). Non-starchy vegetables cause some elevation. If I add even a couple of high fiber, supposedly low GI oatcakes or a piece of fruit to a meal, well buffered by proteins and fats, it spikes afterward. I may end up needing some insulin too, but it seems clear that not eating the carbohydrates is necessary to avoid feeling like shit daily from the blood sugar weirdness, some nasty complications, and probably dying a lot earlier.

I am also concerned about all those things from setting off disordered eating. No pressure at all…

No freaking wonder the standard medical advice for all the different metabolic problems which fall under the Type 2 umbrella has proven ineffective at best for me. I’m not even sure my muscles can use glycogen properly now, though exercise does lower the glucose levels when I am physically able to do much of it with the osteomalacia these days. “[I]t has also been shown that antipsychotics inhibit glucose transport into muscle”#, which will give you muscle pain, weakness, and probably wasting. As people have been reporting.  And this would seem to be another lingering effect, as part of the whole metabolic enchilada. It’s an overwhelming mess.

So, I am trying for now to very gradually reduce the carbs, to try to avoid both the nasty relative hypos and triggering myself right back into bulimarexic hell.  (Where the physical reactions to food deprivation are also very triggering.) But I am now catching myself trying to emotionally abuse myself, in an OCD way, every time I so much as eat a piece of bread or a banana. It really is getting hard to deal with.

This change is also harder to deal with since I am not, say, traditional Inuit, and most of the meals I am used to eating involve some kind of carbohydrate. Living so far away from home and my own culture, I have also been cooking and eating more of my own ethnic foods for comfort and some feeling of connection. It was easy enough to adapt most things that weren’t already GF, but that’s trickier for very low carb unless I want to eat meat, green vegetables, and summer squash all the time. Do not pass go, do not throw in any potatoes and carrots.😦

I am already grieving, to some extent, over things like beans and cornbread. And feeling like nobody should be expected to give up all that. It also feels way too much like forbidden “bad” foods dieting-styley, just setting you up to want them more. I already crave sweets from restriction, and I have never even had much of a sweet tooth. I feel so physically bad afterward that I still choose to keep them to the kind of minimum that won’t have me snapping and eating a whole liter tub of ice cream at a go. Or gluteny pastries, indeed. I actually burst into tears when I ran across one post from Harriet Brown last night; thus my pastry obsession today.😦 Actually being hungry all the time from unstable and high blood sugar makes it harder, in a way, since people mostly do lose their appetites after enough starving.

Also, I am all for Fat Acceptance and the basic ideas behind Health at Every Size (as long as this is not taken as any kind of obligation or reflection on worth). Nobody’s worth should be judged by their body size or shape. It’s just very hard to apply to myself sometimes. Awareness that it is, indeed, the OCD biting me in the ass helps some, but I do also keep getting repetitive thoughts that gaining weight back from getting the glucose better managed would be a bad thing for me. That would sound totally ridiculous coming from anyone else, and I would feel sorry for them over having to deal with that crap, but yeah. This is also an overwhelming mess.

The kind of pain levels I’ve been having lately have also left me more susceptible to this stuff, including by making it harder to eat enough to avoid triggering some of the wacky mental loops. The “stuck in the worst stage of PMS” hormonal crud is also no helping right now. Those two things are not unconnected. The pain and stress are also, no doubt, screwing with my blood sugar. I am aware of these factors, and am still having a rough time.

It’s also hard for me to admit when I’m having trouble coping, given some history.

Sometimes I do wish I had access to antianxiety meds here, to blunt the symptoms just enough that it’s easier to apply actual coping techniques when things get really intense. Which is kinda what they’re for. I’ve had enough bad experiences in past that I have no reasonable expectation that professional counseling would help, rather than make the “Pure O” OCD component worse.

The best bet, I suppose: take it slowly, and be mindful of the harmful mental loops. I don’t know what else I could reasonably do, difficult as that approach is proving so far.

The hell of it is, I get the impression that this kind of mental conflict is actually extremely common, even among women in particular who have not gone all the way into clinical eating disorder in past. The line there can be, haha, thin between socially accepted dieting behavior and an actual eating disorder, though; see s.e. smith’s Dying to Be Thin, along with half the posts at The Fat Nutritionist, helping people relearn how to develop a healthy and not-so-distressing relationship with food. Michelle is doing some great work there; shame there’s so much need for it. I have to put in a plug for her whole “Humane Nutrition” category–what an idea, right? *wry smile*

I actually meant to point out before some comment discussion on How to eat, in a nutshell – lesson one: Permission. (great series, BTW!). specifically talking about diabetes and celiac. A few excerpts, with links to the individual comments:

As someone who has diabetes (I hate being called diabetic) it’s so annoying being asked, “can you have that?”

Yes. Yes I can. I can have this, and this, and all of this if I want it. I also don’t have to have any of that, or that, or that. Because I’m a human being who happens to have a particular way that my body manages energy, I might choose to operate within a set of self-defined guidelines, based on evidence and experience.#

Ugh, I have exactly the same problem! It’s like the diet mentality is so strong that dietary restriction for an illness must still surely be tied to weight-loss paradigms… I’ve had friends sneer at the idea of me eating potato & rice, and call it ‘cheating’ despite the fact that they know full well I’m not on Atkins – I have coealiac disease.

I hate that people feel they have the right to police other’s eating.#

Luckily, I haven’t run into that much public food policing, personally. That’s just too rude and interfering where I’m from, and I haven’t gotten more than a few dirty looks for eating in public while not-so-tiny where I’m living now. See also: , here. I was appalled to find out that some people are conflating GF and low carb, and using some version of that for weight loss, but yeah.😦

And a twofer, where I accidentally pasted in the headers again but am just going to leave it!:

Ellie
Posted October 4, 2011 at 12:46 pm | Permalink

…I am really, really looking forward to this. I was just diagnosed with Type 1 diabetes a couple months ago and it has hit every food and disordered-eating stressor I have. The highs, the lows, the random shifts I can’t seem to figure out, the new hunger cues, the rapid and persistent weight gain (which is of course objectively GOOD because I’m not peeing away all my nutrients anymore), the ever-looming threat of having to log all my food and present it to a doctor (soooo triggering) … I’m in the weeds right now. The more I try to care for my body, the more I end up abusing it in all kinds of ways.

  • Sim
    Posted October 19, 2011 at 6:32 pm | Permalink

    OMG, this post has me in tears. I can so relate. I have type 2, and I feel the exact same way. When I was first diagnosed I just stopped eating for a while because it was all too hard. Then i went all legalistic and policed myself so hard I became suicidal. Now, I must admit, I’m at the other end and eat whatever I damn well please, and honestly, I flat out lie to my doctor about it. After 4 years I am still trying to find that balance. I wish you peace and mental health🙂

This is another reason I decided to go ahead and post this: it really isn’t just me, having these reactions. Which made me cry in relief and sympathy, when I ran across the comments there.

But, yeah, another video I ran across recently, which I wish I could transcribe even though it’s a presentation with slides. I don’t have the energy to comment much here–even for a couple of quibbles ;)–but the different levels of balance needed for good health (and more happiness, and the whole well-being/tohi shebang) kinda tie back in with one recent post in particular. It applies equally well to the layers of nuttiness around food and health. While our society and often families are really screwed-up around this, it’s hard for an individual to develop healthy relationships in these aspects of life. I have just been lumping tohi into duyukta/duyukdv, but yeah.

I would have preferred an actual Tsalagi person doing this kind of presentation, but this guy did a good and respectful job of explaining some very different philosophical points. Source.

In this presentation, David Cozzo of the Revitalization of Traditional Cherokee Artisan Resources/North Carolina State University speaks on Duyukdv and Cherokee worldview at the 2012 annual meeting of the Society of Ethnobiology.

ABSTRACT: A culture’s worldview is intimately tied to shared linguistic concepts. Much has been written about Cherokee culture and history, but it is generally interpreted using Western concepts and terminology. The concept of duyukdv, often glossed as ‘harmony’ or ‘balance’, can be observed as an unnamed foundational principle running through many historical accounts of Cherokee culture, including the ethnomedical system and environmental ethic. However, much like the Chinese concept of the Tao, it is elusive. In this talk, I will explore the Cherokee concept of duyukdv as it is implied in historical accounts of Cherokee culture and values.

I do have to say that he’s getting things simplistic with his understanding of clan law and blood feuding, which also gets confused a bit with reactions to colonist collective punishment of indigenous people. The blood feuding urge can also hopefully get worked around. What is supposed to be happening to how many kinds of “souls” also varies a lot, but the disagreement doesn’t matter that much because it’s not all wrapped up in ideology; I hadn’t heard quite the version he was recounting before.  There is nothing but a surface resemblance between that and the Western humors model. Also, a good wider point about those who want or seek to be medicine people not being qualified to do that, just by virtue of maybe wanting an unbalanced kind of power; the same applies to leadership positions.😦 Yeah, I did have to comment a little…

_____________

* That’s the OCD and its disordered eating manifestations–not suggesting that anyone is a bad person either because they need to eat or because they have their own set of problems with this. Just to clarify.

One Comment leave one →
  1. October 17, 2012 7:20 pm

    wonderful, brilliant post!! it’s so well articulated…that journey to healthy eating which is so individual but very political too.

    I’ve had to give up all grains and I’m not eating beans for the time being either…a journey that took me several years of experimentation…that journey is not over…I hope to be able to reintroduce some stuff again as my health allows…

    I have a severe gluten intolerance too (perhaps it’s celiac, I’ve not had the DNA test, but plan to) and I did develop metabolic syndrome from the psych drugs (the drugs I’ve been free of for a while now, but, yes some of those changes appear permanent) and my blood sugar levels and lipids both are now in normal ranges with no need for additional medications to stabilize them…I’ll eat like a freak for that reason alone.

    in any case…my journey is similar to yours…though I can’t say I ever was truly eating disordered…I had typical issues around food that pretty much every woman in this country has…of course now in public settings I assume people think I am…but I’ve never been rigid or absolute…I have simply noted what my body can and cannot tolerate…

    oh! I did use to over eat quite often…light binging we might call it…since I’ve found what is for now the optimal diet for me I crave nothing and never over eat…that to me suggests I’m doing something right as I LOVE food.

    thanks for sharing this post…it’s really a very important piece of work…

    note the name change (you know me) I am now using my real name…this is Gianna Kali.

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