Tuesday, December 03, 2013

Guest Post: Book Review - Food To Eat (for Eating Disorder Recovery)

Today's guest posting comes from our office's RD Rob Lazzinnaro who reviewed fellow RD Lori Lieberman and her co-author Cate Sangster's Food to Eat: guided, hopeful & trusted recipes for eating disorder recovery. Truthfully I've had this book for a very long time and realizing that my pile of books seems to be getting taller, not shorter, I asked Rob for his take.

Eating disorders are a highly sensitive topic. As a Registered Dietitian determining how to approach clients struggling with an eating disorder can be difficult as the disorder can essentially destroy one's relationship with food, and the road back to healthy eating can be long. For many, food becomes a source of anxiety, social tension, fear, and sometimes can be seen as the enemy. Food to Eat is a combination of practical tips on rethinking and changing how one eats, paired with a large selection of recipes.

About the authors: Lori Lieberman is a Registered Dietitian with 26 years of experience working with eating disorders, while Cate Sangster has struggled herself with an eating disorder for over 20 years; the combination of their two perspectives proves invaluable.

A few items from the book that I really enjoyed:

1. The “outsmart your eating disorder(ED) voice” question & answer snippets placed throughout the book. Truly they provide valuable insight into possible fears and concerns about the topics addressed. I imagine these questions accumulated during the author’s many years of both clinical and personal experiences.

• “So why would I take in fats, then, when they’re highest ounce for ounce (or gram for gram)?” [p.42]
• “But I’m not hungry so why should I eat?” [p.46]
• “But once I eat I get hungrier!” [p.46]
• “Why butter? Shouldn’t I use a healthier fat or none at all?” [p.68]

(you'll have to read the book to discover their answers)

2. In the segment called “putting it all together” [p.45-46] the authors provide recommendations for meal structure and timing, e.g. how often to eat. This brief overview provides an important starting point for addressing hunger. In my opinion it may be the most important segment of the book but as I point out below, I wish it were longer.

3. Some great recipes are included! Plenty of variety, textures, and cultural options with simple instructions that are accompanied by many of those fantastic ED voice Q&A’s. Also, the authors deserve a high five for including scratch dessert recipes in the book. While some might find their inclusion odd in an eating disorder book, in my opinion treats are a necessary part of any well thought out meal plan (though if your eating is disorganized and irregular, controlling them thoughtfully may prove exceedingly difficult).

A couple of items from the book that I think are important to flesh out:

1. I would have loved to see a longer discussion regarding the types of hunger that drive us. For many, reducing or eliminating physiological hunger through careful dietary organization can be a key factor in keeping emotional, environmental and social hunger cues at bay, which is why eating every 2-3 hours and not skipping meals may be one of the most powerful tools in the fight against eating disorders. That said, no doubt the content of what you eat may affect your hunger as well, which brings me to my next point.

2. Many processed and packaged food items are seemingly addictive in that they are designed to be difficult to resist, and our individual response to these items is not addressed in this book. Those struggling with an eating disorder may find it helpful to know that many foods items have been designed to be “triggers”. I am referring to processed food items that can send you in to a tailspin with just the right mix of sugar, fat and texture, and often leaving you hungrier after consuming them. I wonder the impact a shift from the highly processed world to a from scratch whole world might have on those struggling with eating disorders and dietary control issues?

Overall, the book proves to be an excellent initial guide for anyone personally struggling with an eating disorder. I also believe it can serve as a solid resource for clinicians.

If you'd like your own copy, here is an Amazon Associates link for purchase.

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  1. Rebecca9:18 am

    I agree with the last sentence of the author's paragraph #2. It would be interesting to see how a whole foods, plant-based diet, free from triggering manufactured "food", would help heal those in recovery.

  2. Thank you for taking the time to explore Food to Eat as a resource for eating disorder recovery. In response to your comments, allow me to respond.
    1. About hunger: eating disorder recovery and hunger is much more complicated then simply 'reorganizing' one's eating--although that surely is a necessary component! Hunger cues may not be present due to slowed metabolic rate, or due to anxiety, or meds or thoughts that stand in the way (all mentioned in the book). Restricted eating may be out of fear of overeating, or feeling undeserving. Yes, this could be a book in itself, but our goal was an approachable, usable tool that was action focused, not theory or research focused.
    2.Regarding 'addiction':
    Please see a past blog post I've written on this subject http://www.dropitandeat.blogspot.com/2012/09/what-ive-learned-about-food-addiction.html
    For individuals living with bulimia or binge eating disorder, the food itself is not the source of the disorder. Sure, higher fiber, less processed foods may contribute to a greater sense of satiety, but for such eating disordered individuals eating happens in spite of fullness. In fact, approaching recovery from these disorders from an addiction/OA perspective, a 'good' vs 'bad' approach to foods, is quite counter to the recovery process. That said, respecting environmental triggers (think Prof. Wansink's research) and mindful eating are more valuable approaches--also incorporated into Food to Eat.

    BTW, there's a 20% discount now til Dec 15 if you buy through www.food-2-eat.com AND it's gorgeous on the iPad!

  3. Anonymous11:32 am

    As a dietitian who also sees clients with eating disorders it is helpful to have a good resource that is user friendly. Disordered eating runs a very broad spectrum. For those with the most severe eating disorders, intensive inpatient treatment has the highest chance of recovery. However I can see this book being helpful for those with less severe disordered eating and as a concurrent support post-inpatient treatment.

  4. The typical eating disorder has a psychological or philosophic (belief & values) issue of some kind. Until that problem is identified and corrected, the client will just struggle; until the problem is mostly resolved a dietitians time is mostly wasted. But what do I know. Breath, smile and enjoy what life has to offer, Dao.

    1. On the contrary, unless the brain is refed there will be little insight, improvement in cognitive function, etc, at least for those with anorexia.

    2. Yes. I know nothing about thems. Unless they start at 250 to 500 pounds, they are beyond my experences.

  5. Anonymous12:29 pm

    On another topic ...
    Dr Freedhoff, would you have any comment on the article
    "There's no such thing as healthy obesity, new findings show"
    by Adrianna Barton, Globe and Mail, Tues Dec 3, 2013.

    She reports on research by:
    Dr Zinman, Mount Sinai Hospital Lunenfeld-Tanenbbaum Research Institute, Toronto