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Posts made in July, 2012

Announcing! The Paleo for Women Forums

Posted by on Jul 31, 2012 in Blog | 14 comments

Announcing! The Paleo for Women Forums

The Paleo for Women forums have finally been built (!) — and can be accessed here.

This is something about which I could not be more excited.  It’s one thing to try and have discussions in the comments off of a post, but it’s a whole other one to be able to delve deeply into specific and personal issues.  And it’s one thing to be able to discuss these issues on PaleoHacks or MDA, but it’s a whole other to find solace and unconditional support and love in a place like this.  Because that is what we are building with this community.  Science, yes, and experimentation, undoubtedly, and also solace and unconditional support and love.

Welcome.  :)

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The forums have been roughly divided into five different categories.

First is a place at which we can discuss all things female / hormonal health.  Troubleshooting PCOS, hypothalamic amneorrhea, some mix between the two, under-and over-weight, endometriosis, cysts, fibroids, PMS, PMDD, fertility, pregnancy, menopause, etc.

Second is a place at which we can discuss all things disordered eating.

Third is a forum I’ve created for documenting, or blogging, our own journeys.  Want to keep a journal of your disordered eating habits?  Your negative self-talk?  Would you like community support and accountability in your growth and development?  We’d love to hear about your struggles and triumphs, as well as support you, here.

Fourth is a meeting place.  I anticipate this forum being used less commonly than the others, but I believe it is important.  Post here, introduce yourself, if you are looking for a partner in accountability and support.  Sometimes it is helpful to have one go-to person, someone who understands, always at your back.  I used to play this role for many women, yet time constraints have made that near impossible now.  I think you might be surprised at how easy it is to find an empathetic and sympathetic ear.

Finally is the ‘rando’ forum at which all other things can be discussed, including other health issues, commentary on the paleo world, feminism, how much we all love Justin Bieber, etc.

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There remain a couple of other important points for the forum.  Yes, they are new, so no, no one (to date, July 30) has as of yet posted on them.  This is always true of new forums.  They take time to grow membership and content.  It’s okay!  Don’t hesitate to write anyway.  There are people out there looking for sympathy, and troubleshooting the same problems, and any kind of story you can tell or advice you can give will go miles in making the world a more comfortable place.  I mean that so sincerely.  Get it out there, and people will respond.

Some trusted women I have met through my work, especially who have been on the podcast, have volunteered to be moderators, and to spend a significant portion of their time responding to queries and managing the forums with me.  These are Manda, Juliet, and Lex.  They have all been on the Live. Love. Eat. podcast, which is where their personal contact information is archived, and can also be accessed through the forums themselves.

And finally: regarding my own advice and practice.  I recently took the ‘contact me’ page down from the website, having been swamped by the number of queries and pleas I had been receiving.  I did of course respond, and thoughtfully, to all of them, but I nearly lost control of my life as more and more of my energy was being funneled down that path.  I have since reopened a contact form, but I explicitly only wish to use it for work/idea related contacts and for contacts regarding Live. Love. Eat. the podcast.

That does not mean I wish to abandon anyone or this work, however.   This is the plan: if you have a question for me, instead of contacting me via email, post it on the forums.  I will see every single post that goes up on the forums, so chances are excellent that I will respond to you.   Near certain.   Much more certain than email, since unfortunately emails can get lost in the flood. Moreover, you may benefit from the advice, wisdom, and resources of others.  There’s plenty out there that I do not know, and there are plenty of women out there with diverse experiences.  Posting troubleshooting problems in the forums is probably the most efficient way to get you the information you need. I will be there, but other women will be there, too.  We all will be.

For people who become active in the forums, I would like to thank you in advance.  Please know that my gratitude in this regard is near boundless.  Perhaps we can work closely together on some projects in the future.

And that’s it!  If you have questions, please post them in the forum!  If it’s for some absurd reason inappropriate for that venue, please still feel free to contact me via the contact form, here.  I will of course happily engage with you.

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Hormonal Acne: Where It’s Coming From, and What to Do about It

Posted by on Jul 19, 2012 in Blog, Hormones, Hypothalamic Amenorrhea, PCOS | 124 comments

Hormonal Acne: Where It’s Coming From, and What to Do about It

 

One common trope in the paleosphere is that acne is caused by irritants to the gut lining and inflammation.   The idea is that food toxins create a permeable gut, which in turn permits toxins to enter the bloodstream and wreak havoc on our skin.   Several advocates have a good point when they say that “virtually everyone who has acne has a gut issue” — yet based on my own reading and experience I do not yet know if I can get 100 percent on board with that, having seen so many women’s acne cured by fixing their hormonal issues.  What I do know is that women experience acne at greater rates than men, that hormones can be significant contributors to acne, and that in women with any hint of hormone issues, hormones should be the first culprits targeted in the war against acne.   Guts should be attended to.  But there is only so much a healed gut can do when a woman’s hormones have jumped ship.

Hormonal Acne Presentation

When: Hormonal acne in many cases presents at certain times of the month.  Popular times include 1) at ovulation, which occurs ~week three of the cycle (which can be discerned by body temperature variations) (with the menstrual cycle starting on day one of blood flow), 2) the few days before a period, and 3) at the start of a woman’s period.  Cyclicity is not the only way acne manifests, however.  For women with hormonal problems such as PCOS and HA, hormonal acne can persist all of the time.

Appearance: Hormonal acne usually presents as cysts–which are those lovely, pus-filled, painful and inflamed sacks.  Hormonal acne may also present in more mild forms as comedones–those whitehead “bumps” that never break the surface–or even in some cases as smaller lesions that are not quite as angry and painful as full out cysts, and may appear more rash-like or just smaller than typical acne.

Location: And in terms of location, hormonal acne occurs first and foremost around the mouth: on the chin, below the nose, around the sides of the mouth, and sometimes up the jawline.  As hormonal acne worsens, however, it can spread to the cheeks and the forehead.   Other body parts can be affected, too, but only in severe cases, and once it has advanced.  If acne is presenting in locations on the body without being present around the mouth area, there’s a decent chance hormones are not the primary culprit.

The physiological mechanism of hormonal acne

Hormonal acne comes from up-regulation of oil production within the oil glands beneath the skin.  The glands become over-burdened by the oil when this happens–there’s just too much of it–and it erupts to the surface, having to simply “go somewhere.”

Inflammation can exacerbate this process.  The worse inflammation is, the more irritated the oil gland can become, and thus the more red, and the more painful.   Yet eruptions do not occur first without an oil problem.   This is the reason no amount of washing will ever clear up hormonal acne.  It comes from underneath.  The only way to fix it is with interventions in the bloodstream.

What causes increased oil secretion

In the case of hormonal acne, the primary drivers of oil secretion are androgens (male sex hormones), specifically when they are elevated relative to other hormones, particularly estrogen, in the blood.  When skin cells detect higher levels of androgens in the blood, their DNA responds by up-regulating oil production.

The most prominent androgen is testosterone.   Testosterone-driven acne is most obvious in women with PCOS, who often only find out they have PCOS once they experience acne and ask their primary care doctors or dermatologists about a cure.  Acne is one of the clearest indicators of PCOS and of the underlying hormonal imbalance for this reason.   This is also, interestingly, why men on steroids often experience acne around the mouth area.  Excess testosterone causes hormonal acne, plain and simple.

Yet it is not the only androgenic culprit.  Another androgen, called DHEA-S, causes acne production as well, though DHEA-S serves the female body less as a male sex hormone and more as a precursor hormone.  DHEA-S is produced primarily in the adrenal glands.   From there, DHEA-S acts as a building block for virtually all other hormones.  For this reason, HPA axis dysregulation is usually the first place to look to as the origin of DHEA-S problems.  Women with high stress levels, dysregulated HPA axes, or hypothalamic amenorrhea often experience increased DHEA-S levels.   Some women with PCOS do as well, depending on their etiology.  (See my post on the inter-related nature of HA and PCOS).  The presentation of elevated DHEA-S is less well-defined and understood than testosterone, but it is still crucial in understanding the relative balance between androgens and female sex hormones in the body.  Moreover, because it is produced by the adrenal glands, it speaks volumes to the amount of dysregulation and stress upon a woman’s HPA axis.  DHEA-S increases oil production when present in disproportionately high amounts.

Because hormonal balance is in large part what cells detect when determining how much androgen is floating in a woman’s bloodstream, low estrogen (relative to androgen levels) is also a significant driver of hormonal acne.   Estrogen has the power to off-set high testosterone levels in the blood.  This occurs via increased testosterone binding activity, which estrogen enables by increasing the activity of sex hormone binding globulin (SHBG).   For this reason, if low estrogen levels are restored–either in women with PCOS or HA or some mixture of the two–then testosterone levels are mediated and hormonal acne decreases.   Because hypothalamic amenorrhea often sends estrogen levels into the basement–particularly if a woman has low body fat levels–this is the primary mechanism by which women with hypothalamic amenorrhea cure their acne.   Because menopause significantly decreases estrogen levels, this is also the primary reason women in menopause can see a re-emergence of hormonal acne after decades of clear skin.

As a final cause, progesterone can also play a role in hormonal acne.  Progesterone, in high doses, acts as an inflammatory agent, and in this way causes acne to flare up.   Progesterone levels being highest during the days leading up to menstruation explains why many women experience outbreaks at this time.

Moreover, testosterone levels peak at ovulation, while estrogen levels simultaneously hit their low, which is why the other common time for women to experience cyclic breakouts is at the start of week three of their cycles.

Aggravators of hormonal acne

Stress: Stress plays an important role.  It acts as an inflammatory agent, especially if cortisol levels remain high for a long time, and then also if a woman then enters into adrenal fatigue, which triggers a chronically inflamed state.  Stress may also dysregulate DHEA-S production.   For this reason, stress is not necessarily the cause of hormonal acne, but does exacerbate it, and prevent proper healing.

Heat.  Heat is inflammatory, and also causes us to sweat, such that pores become clogged.

Inflammatory foods: grains, dairy, omega 6 vegetable oils.

Dairy: While being inflammatory, dairy is also the most androgenic of foods.   Pregnant cows produce a protein that inhibits normal testosterone processing in the human body, such that testosterone can rise beyond normal levels with high dairy intake.  This is true of women with pre-existing hormonal imbalances, yet it is also true of the general population.  Many people at least anecdotally least respond to dairy with acne more strongly than any other food.

Phytoestrogens: soy, flax, legumes and nuts in high quantities.   While phytoestrogens have the power to act as estrogens in the body, this role is ambivalent and should be treated with caution, especially with the skin.   Different estrogen receptors read different kinds of phytoestrogens differently, such taht phytoestrogens usually perform estrogen-lowering effects in skin tissue.

Low carbohydrate diets: Having sufficient glucose stores is important for skin healing, and can speed the recovery of acne lesions.  Glucose is also helpful for preventing hypothyroidism.

Poor sleep: Sleep both enables healing and promotes hormonal production (and as such helps restore hormonal rhythm and balance).

Hypothyroidism:  Without sufficient levels of T3, the active form of thyroid hormone, in the blood, a woman’s skin cells lack the ability to heal properly.  Many women who suffer hypothyroidism suffer chronic acne.

Dealing with hormonal acne

The way forward with hormonal acne is to get blood work done and work through the primary imbalances.  In general, hormone dysregulation that leads to acne can be broken down into a few categories: 1) high testosterone from PCOS (specifically overweight and insulin resistant PCOS), 2) low estrogen from low body fat levels, chronic restriction, or living in an energy deficit, 3) low estrogen from menopause, 4) high progesterone from general hormone imbalance, possibly as a result of an overactive pituitary and estrogen dominance, 5) any of these conditions worsened by stress or hypothyroidism, and 6) any combination therein.

The solution to all of these problems is to correct the hormone imbalance.  I have discussed methods of doing so above and elsewhere.  (See my posts on PCOS causes and treatment options, and some of my work on hypothalamic amenorrhea.) For most sufferers of hormonal acne, testosterone is elevated due to insulin resistance and PCOS.  The solution, then, is to eat an insulin sensitizing diet, to exercise, and to decrease stress.   For other sufferers, DHEA-S may be too high, so stress should be a big factor to examine.  And for many others, low estrogen relative to testosterone is the primary problem, and modes of increasing estrogen levels should be examined.  These include weight gain, stress reduction, and improved sleep quality.  For women with menopause, it may just “take time” or perhaps medical interventions are appropriate, depending on the severity of the problem.

Medication

There are drugs designed to help with hormonal acne.  Spironolactone and flutamide are the two primary ones that come to mind, as well as birth control.

The reason birth control pills are helpful for acne is because they enforce hormone regularity on a woman’s system.   The precise pill that is helpful for each woman varies by her particular condition– but in general, BCPs are comprised of estrogen and of progesterone.  BCPs can for that reason 1) raise estrogen levels–which either corrects an estrogen deficiency or helps balance the activity of runaway testosterone–and they can also 2) restore proper balance between estrogen and progesterone, which is important for keeping progesterone levels within their proper parameters.   Some BCPs also contain anti-androgenic substances, such as spironolactone, which is an added benefit for women who are living with androgen excess.  In all cases, I do not generally recommend that women get on BCP, as it can cause worse hormonal dysregulation in the long run (sort of like handicapping a delicate hormonal system), and does not solve the underlying problem.

Flutamide acts in a similar way to spironolactone, but less effectively, and with more side effects.   So spironolactone is typically the drug of choice.

Spiro has been hailed by many women as God’s gift to womankind.   For many women it begets truly miraculous effects.  Yet one should step cautiously with spironolactone.   If a woman’s primary problem is not testosterone excess, spironolactone will very likely do more harm for her skin than good.  (Check out the panicked discussion forums at acne.org to see what I’m talking about.)  Moreover, even for those who have testosterone excess as their primary problem, spironolactone merits caution for a variety of reasons.   First, spiro usually induces an infamous “initial breakout” which can last anywhere from weeks to months.  This isn’t always the case– sometimes women improve immediately.  Sometimes they never really do.   But the typical case is for women to see an initial worsening of their acne, followed by relief in the upcoming months, especially if they increase their dosages.   Secondly, spiro cannot be taken by pregnant women because it induces birth defects, so women cannot stay on spironolactone indefinitely.  This is problematic because spironolactone acts as a bandaid on the hormone problem, and does nothing to fix it whatsoever.  What spiro does simply is block testosterone receptors.  In a few cases, it cures women.  Yet in very many cases, if the underlying problem is not addressed while a woman is taking spironolactone, her acne will return once she comes off of the drug.   This is why I recommend that women only consider taking spironolactone if they want a “quick fix” while they work on their diet and exercise in order to improve their PCOS.  As a final note, spironolactone has a couple of other health concerns.  First, it lowers blood pressure, since spiro is actually a blood pressure lowering drug proscribed “off label” for acne.  Secondly, it acts as a diuretic, so women on it need to drink water constantly, and may not be able to consume alcohol anymore.  And finally, spiro acts as a potassium-sparing diuretic, such that women cannot eat potassium rich foods, lest they risk the chance of becoming hyperkalemic, which can–I swear to God–lead to sudden death.  It’ll probably lead to muscle weakness first, but an imbalance of electrolytes in the blood is no laughing matter, so women on spiro should limit their potassium rich foods as well as get their potassium levels checked periodically.  Potassium rich foods include bananas, potatoes, avocadoes, tomatoes, and leafy greens.

For these reasons, spiro can help, but it cannot be relied on long term.  It does not get at the root of the issue–drugs rarely do–and the true path to hormonal help is diet and lifestyle modifcation.

As a final note, bio-identical hormone supplementation can be helpful for women going through menopause.  Estrogen patches can release small amounts of hormone into the bloodstream, and can lessen acne considerably.   I do not think this is detrimental to a woman’s health, if it is in fact the case that her estrogen levels have simply dropped off during menopause.    However, it does, in my opinion, make it difficult for estrogen levels to rise and hormone balance to re-establish itself on its own.  This is a decision best left to the individual and to her doctor.

In conclusion

Hormonal acne is terrible, and for many women can seem incessant, and never ending.  Girls are assured growing up that they will eventually out-grow their acne, yet many women see it persist throughout their twenties and thirties, and some actually do not even see the acne manifest until their twenties and thirties.  Some women do not even see acne appear until after the birth of their first children, as their progesterone and estrogen levels are flying all over the map.

For this reason, drug interventions can serve as decent placeholders in moving forward.  It can help the pain and awkwardness of acne while diet and lifestyle fall better into place.   Yet there are downsides to medication, and large ones.  Medication is only ever a band-aid, and it can be a band-aid that in the long run leads to more harm than good.  One point I did not even touch on above is that playing with hormones is like playing with fire.  Sometimes things can go horribly wrong– on spironolactone and BCPs alike some women suffer weight loss or significant weight gain, increased acne, and significant–even frightening and life-threatening–mental health disturbances.  For this reason, meds may be best left alone, depending on the circumstance and the level of risk a woman is willing to bear.   On the other hand, there is in all cases a natural, food-based solution.  What it takes is time, experimentation, good blood work, and patience.  As in all things.

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January 2014 Update: For an even more thorough blog post on the causes of acne and overcoming it, see the new post on acne, here.

For more information on hormones and hormone balance, see my book, Sexy by Natureat its site or read reviews and buy it directly from Amazon.

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Episode Four of Live. Love. Eat.!

Posted by on Jul 18, 2012 in Blog, Podcast | 5 comments

Episode Four of Live. Love. Eat.!

Episode Four of Live. Love. Eat. has now been posted.  In it, we discuss motherhood, the nature of trust, and how control becomes an issue when we struggle with the trust of our bodies.

Each episode of Live. Love. Eat. is an interview with someone who has stepped up to share the story of her (or his) relationships with food and with her body.  She may be a disordered eater, she may be a paleo dieter, she may be totally at peace with her body or not.  The whole point being that I can do all of the writing on my blog here that I want, but I will never be able to do something as empowering, comforting, and inspiring as sharing with y’all the beautiful and brilliant lives of others.

Search on iTunes or download and/or subscribe from iTunes here.   We’d appreciate it if you left a review whether you like it or not.

If you’re not into iTunes, click here to download and/or subscribe.

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Episode Four is with guest Teal Hutton.

Having officially stayed in one place for almost a decade and a half (after many frequent relocations throughout her childhood and adolescence), Teal Hutton can say that she is truly at home in the beautiful Mid-Hudson Valley in Upstate New York. While Teal’s daytime secret identity is that of senior producer for a small but feisty web development shop, her real superhero powers include independent study (of whatever strikes her fancy), self-taught journalism, print and web design, knitting, falling in love, and an as-yet-unmatched knack for memorizing song lyrics. She is equal parts accidental home chef, amateur seamstress, aspiring homesteader, student of integrative nutrition, and most importantly single mama to a quick-witted and insatiable 4-year-old boy. Consequently, in her 33rd year, she still doesn’t know what she wants to be when she grows up. Teal’s experience of her son’s birth in 2007 — as a tremendous failure and her body’s first major betrayal — colored her relationship to her body and to food for the coming years, and triggered a cascade of health challenges and emotional pitfalls. Shortly after, Teal was diagnosed with Crohn’s Disease and secondary amenorrhea, and she’s spent the years since learning the difference between trust and control, and the direct connection between self-love and physical health. Teal can be reached at teal.hutton@gmail.com.

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You may read about the rest of our podcast episodes here.

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Podcast on women’s mental and physical health at Balanced Bites!

Posted by on Jul 12, 2012 in Blog | 7 comments

Balanced Bites is a website and paleo advocacy hub run by the brilliant Diane Sanfilippo, and aided by (among others) Liz Wolfe of Cave Girl Eats.  They record a weekly podcast together, typically responding to reader questions, and sometimes interviewing other paleo advocates.

They had me on this week!  That was so nice of them.

You can find it here at the site and download as an mp3, or here at iTunes.

In the podcast, we talk about overcoming disordered eating, health problems that arise from being too restrictive– ie, hypothalamic amenorrhea, other reasons for losing menstruation, and what to do about all of them.

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Binge/Restrict:The Most Common Pattern of Overeating, and How to Stop (with Love!)

Posted by on Jul 10, 2012 in Blog, Disordered Eating, Self-love-spiration | 72 comments

Binge/Restrict:The Most Common Pattern of Overeating, and How to Stop (with Love!)

This post is going to be timely!  I had not anticipated it working out this way, but this post is going up on the same day I am recording a podcast  focusing on disordered eating over with the amazing women at the Balanced Bites podcast.  If you are coming to my site from that podcast, you can find in the rest of my writing information on women’s hormones, PCOS and hypothalamic amenorrhea, weight loss, feminism, and body image / disordered eating.   I like to spit fire at society and to inspire women, too, which can be accessed by the “self-love-spiration” category tab.

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My work in women’s health began as an eating disorder counselor. These two issues are, in my opinion, intrinsically linked. Disordered eating in my own case led to poor physiological health. I would argue that this is the case for a large proportion of reproductively hindered and unhealthy women.

Sometimes the problems are treatable separately. Sometimes they are not. If I had to choose which I deem more important, it is a woman’s relationship with food first and foremost, hands down. Reproductive health does not eat away at the soul the way psychological health does. It does not follow us with all of our actions and behaviors. It does not have the immense power to cripple us physically, emotionally, and spiritually. At least most of the time.

So I have been counseling people on their relationships with food for several years now. I have become familiar with the important trends and issues. We disordered eaters generally fall into a few of broad categories. One of the largest, and the most prevalent in the paleosphere, is that of bingeing/restricting. The one question I get asked over and over again is: How do I stop overeating?

While there are dozens, if not thousands, of separate motivators for bingeing, and I cannot possibly address all of them at once, I can still speak to a more general and popular trend.   Most of us who struggle with overeating do so because we are in a constant battle with our bodies and our self-esteem.

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Having a negative self-esteem, particularly with regard to body image, generates a vicious cycle, which often proceeds as follows:

A) Negative self-esteem and self-talk, ie: “I want to lose weight / I don’t have chiseled abs / I am not pretty enough / I am not enough.”

B) Decision to eat less / exercise more.

C) A state of both physiological and psychological deprivation.

D) Overeating.

E) Increased negative self-talk.

F) Increased restrictive behaviors.

G) Increased severity and frequency of overeating behavior.

H) Increased desperation, negativity, and restriction.

I) Ad nauseum.

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The thing is is that most disordered eaters are well aware of the surface problem.  We have an inordinate desire to eat all of the time. Or we cannot stop eating once we start. Or both. And it adds even more frustration to our weight loss efforts because it makes us binge, and therefore stops us from losing weight as we would like to. This we understand well. Few of us understand truly, however–because it is such a difficult and deeply-rooted notion to confront–that the true problem, the real root of it all, is our lack of positive self-esteem, body-acceptance and self-love.

When we decide to restrict ourselves, we enter into states of both physiological and psychological deprivation. Our bodies become starved– depending on our behavior, for example, if we are fasting, or not, or eating very-low-carbohydrate, or not, or exercising too much, or not– and this manifests itself in several different hunger-inducing mechanisms: one example is a decrease in micronutrient stores, or another is simple sluggishness of satiation signals.    In sum, when we restrict our energy intake, we become hungrier beings.  We try to live in energy deficits, and for some reason we think it is going to be totally okay, yet it is impossible to trick the body out of knowing and responding to that fact.

One biological mechanism by which this increased need to eat occurs, among many, is the activity of neuropeptide Y, about which I have written before. If it is detecting lowered leptin (and other hormone) levels in the blood, it does several things: it up-regulates hunger signalling, it emphasizes sweet foods in doing so (partly why so many disordered eaters struggle with carbohydrates in particular), and it sends activation signals to hypocretin neurons. Hypocretin neurons, about which I have also written before, up-regulate wakefulness and the stress response. Hence why many women on restrictive diets have a difficult time resting and sleeping well.

The psychological deprivation may be worse. It puts us in a state of hyper-awareness about food.   The decision to restrict induces a constant struggle to eat less and exercise more, and it makes it nearly crucial for a woman to constantly check herself against her desires, lest her stock-piled hunger pick her up and shove her head-first into the overeating rabbit hole.  The more a person thinks about food, the more he doesn’t want to think about food, but the more he ends up emphasizing it in his brain and thinking about it anyway.   Then the more he messes up, and the more guilt he has, and the more negative he feels, the more strongly he needs to eat.    So deprivation is one huge psychological factor.  And so is the need to medicate against negative self-talk.  Food is a powerful, powerful drug.   And this whole process, a vicious, vicious cycle.

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Moreover, many women approach meals with the mentality: “how little can I eat?” which is perhaps the most fucked thing about many Americans’ relationships with food.  Then they (we) approach exercise with the mentality: “how many calories can I burn?” and each day with: “how am I going to get into an energy deficit, in order to make sure I get or stay lean?”  Yikes.  JS of gnolls.org has called this in personal correspondence with me the female half of the population’s desperate attempt to live at a “misery set-point.”   Far too many of us challenge ourselves, and then congratulate ourselves for, eating as little as possible.

We often, in fact, fall into cycles of under-eating early in the day and over-eating later in the day.  There are many physiological mechanisms behind this, but there is also a potent emotional factor.   In America today, it is generally better–hell, it is even more moral –to eat less rather than more.  So we wake up in the mornings, and we do not eat much.  And this is great all day, we get to feel great!   By the end of the day, however, our willpower (a real and limited resource) has met its end, and we over-eat.   We feel guilty.  The good thing is, however, that in the long run, we get to spend more time being self-congratulatory than feeling guilty because we typically spend most of the day in an energy deficit.  This is as good of an emotional satisfaction that we can achieve when we have this kind of behavior.   Still, though, it is a far cry from happiness.  And it continually begets itself as guilt and the counterbalances we have in place to mitigate that guilt’s crushing weight become increasingly extreme.

If it hasn’t become clear on its own yet, I’ll state it outright, and many times over:

The restriction that comes of negative self-talk necessarily begets overeating.

Necessarily.

And when you overeat, it is not. your. fault. It is not. It happens to you.

As awful as that is, however, the most wonderful thing in the world still follows.  It is that you can gradually shrug off these demons perched on your shoulders.  They attack you, but you can build up an arsenal of nourishment and love, and then the demons have lost their grip on you.

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Many women who binge and restrict would like to stop bingeing before they stop restricting. They think that they will lose whatever progress they have achieved, in terms of caloric deficits, if they stop restricting first. They anticipate continuing to over-eat, even while they are not restricting. This is an understandable fear — and trust me when I say that I understand how powerful fear can be as a human being in this precarious state.   However: this is impossible.  Deliberate restriction necessarily begets bingeing behavior.  Necessarily.  Restriction must be phased out of our lives before we can stop over-eating.  Willpower does not do the trick.  Hard-lined restriction does not win.   Love does.

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We fear weight-gain. We fear failure. We fear our bodies. Because we have always been at war with our bodies, and because we are probably frustrated with our bodies because of particular health struggles, we do not trust our bodies.   What motivation have we so far, honestly?   We do not know what powerful and beautiful partners they can be. We do not remember what it is like to eat intuitively.   We do not really know how.   Because of this, we fear letting go of our strict cognitive monitoring and control.  Without it, we may fail.

But leap we must.   This is why:

The only long-term solution to overeating is to stop restricting ourselves out of a need for self-worth.

This solution, I understand, can require a Herculean effort.   I have done it.  So I know.   The effort requires trust, it requires letting go of a bit of control, and it requires a bit of a leap of faith. The thing is, however, that it does not have to happen overnight. We can ease into intuitive eating gradually. We can let go of a few of our controls, slowly, over time, and we can watch the trust and power of our bodies come to life.  This process is a longer journey towards physiological health than a wholesale “forget it, I’m going to eat a lot all the time until I no longer want to,” but it enables us to work on our self-love continually while we are easing into the style of intuitive eating. These two facets will end up playing off of each other beautifully. The more we love and nourish our bodies, rather than restrict them, the more they respond to us, and the more we can love and cherish them. It’s a phenomenally beautiful and harmonious thing. It really, really, really is.

All we have to do is inch into that trust.

All of which is to say that it is scary, but it should also be exciting to embark on this journey.  And liberating. And beautifying. The more we love ourselves, the more free we are from our obsessions, and the more self-confidence and happiness we can garner. Letting go of social norms and of negative self-talk– this is a long journey. But it is a beautiful one of progress and self-exploration and growth, and for that reason I would not have it any other way.

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It is 100 percent possible to be beautiful and non-restrictive. In fact, I would argue exactly the contrary, that the less restrictive a woman is, the more self-love she can have, and the more empowerment and pride and health, and therefore the sexier she is. I believe this fully, I really, really do.

Additionally, as a final note, there is a way to restrict and to do so healthfully. This is important. I want all of us to achieve healthy weights. I believe this is achievable by entering into relationships with our bodies that are not based on warfare, but rather on partnership. We need to stop inflicting things on our bodies, and forcing it to do things it does not want to do. Instead, we can love ourselves, and treat ourselves gently, and move forward in productive partnership. We can approach a meal and say: “Do I feel satisfied at this point? Will I happily make it to my next meal if I do not eat more, knowing that I can always eat more if I feel the need to?” And we can approach exercise as: “Would you, my body, like to go for a run today? It could be fun and healthy for both of us.” And we can approach every day of our lives with nourishment, healing, and health primarily in our minds. Instead of forcing our bodies to become shapes they are not ready for, we can try to nourish them back into a healthy hormonal state that will become the real, powerful foundation off of which we achieve and maintain healthy body weights. This is good for our bodies, and it is good for our souls.

 

To read another perspective on the binge-restrict cycle, visit Dr Dea Robert’s blog on restrict/rebound.

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