Hunger

Several months ago, I started a meal process group, where (out)patients (and I) have lunch together, process feelings about the meal, and then usually engage in some exercise about eating/body image. I figured I'd post some of the thought questions here, so that you might think about these topics and hopefully dialogue with one another.

Recently, I asked the group some questions about hunger:

1) How hungry are you right now? (I personally use Dr. Paul McKenna's Hunger Scale).



2) How do you know when you're hungry?

3) How would you describe the feeling of hunger to an alien, who had never experienced this before? (this one's from Karen Koenig)

4) What type of emotions do you usually feel when you experience the physiological sensation of hunger?

5) What, besides food, do you hunger for?

More Leg Room?

On a recent Jet Blue flight, I elected for their "More Leg Room" option, which the airline details here:

We all need Lots of Legroom™. And sometimes, we need Even More. If it's extra space you seek, you've come to the right place! We've made another slight reconfiguration to our Airbus A320 fleet to create Even More Legroom–super-spacious seats at the front of the aircraft* and at the emergency exit rows that provide even more of that much-lusted-after in-flight space. Treat yourself to an Even More Legroom seat and get 38" of comfortable seat pitch in which to stretch out, relax, watch TV, sample our complimentary snacks and enjoy the award-winning Jet Blue experience!

Jet Blue advertises the upgrade for as little as $10, though I believe I paid a bit more.

The extra leg room was enjoyable, akin to (leg-centric) first-class flying. But, the the seat width is exactly the same. It made me hungry for more butt room, more shoulder room, more room on the arm divider so that my neighbor and I wouldn't be forced into a game of passive-aggressive elbow war the entire flight. Oh, and I should note, that I had the window seat, he the middle, and about 30 minutes into the flight, he reached over me, closed the window shade, and returned to his business, without so much as a glance in my direction. Sorry, just had to air that one.

Have you tried the extra leg room option? Would you prefer extra seat width instead? How would you like your space?

Stories: Part IV

Printed with permission. . .

It does seem true that in our culture it's rare for there to be an uncomplicated relationship with food. We are sooooo fortunate to have plenty, why do we confound it? Perhaps it's a transmutation of guilt--for having and wasting obscene amounts when so much of the world is desperately hungry.

I've been on a project to transcribe all of my old diaries into my computer. Currently I'm on #33, which makes it at least the 25th diary (with a long, long way to go) where I'm dealing with the issue of food, eating, body image, and the western cultural imperative to be thin.

I've studied this and suffered over it for years and I don't feel any closer to understanding the imperative. I know that growing up it was implicit--'diet' was an ubiquitous verb. As a child if I went home from school with a friend my mother would ask when I got home if my friend's mother was 'heavy'. That was the euphemism.

drstaceyny writes under her profile on her blog: My contention is that every woman has an eating disorder-- not necessarily anorexia or bulimia per se, but a fixation on food/ weight/shape that is unhealthy, unwanted, and undying.

And, if I might add, wearying.

Like I said, for years I took on the subject, mainly from the point of view of why I felt so susceptible to it and the ways it jabbed me internally. Why could I not dismiss the perfection hysteria for what it is? Especially since I knew it wasn't rational, I knew it was cruel.

My current working theory is that there is a sort of anxiety-fueled need-to-win dynamic that drives it. I got a clear example of this dynamic when watching a comedy television program about a family. The father volunteered to take on coaching his son's dispirited soccer team. Obviously determined that he was going to be a nurturing coach he admonished the coach of the opposing team who was harshly screaming at his kids: "Hey! Come on, lay off, they're just kids! This is supposed to be fun!" To which the opposing coach responded by sneering to his team: "Hear that? That's LOSER talk!" Similarly, to consider swimming upstream from the main by shrugging off a cultural ideal of beauty was undermined by the idea that I was indulging in sour grapes: loser talk.

This issue has been present for most of my life, in varying degrees of intensity and urgency.

I put it in a bottom drawer for the past 3 years. Shortly after returning to Portland I was very low, very depressed. I met a physician who was confident in her ability to help me manage this medicinally.

The first antidepressant I tried was Remeron. I was shocked 3 months later at my GYN checkup when I weighed more than I had ever weighed not-pregnant. The dr. said confidently: "Everyone gains weight on Remeron. I'll often prescribe it to new mothers, stressed, underweight, and not sleeping." Well, this wasn't a time I was prepared to face down the whole weight issue and I asked my primary dr. if I could switch to something like Wellbutrin, which I'd heard had a side effect of weight loss.

The way the weight-loss side effect worked for me is that the experience of hunger was detached from my emotions. I might still feel hunger, but I didn't experience it as suffering. The eating motivator was thus less potent and I lost weight. So for the past 3 or so years I've weighed approximately my high school weight.

The thing is, the drug didn't have that much effect on my mood. Not really noticeably, anyway. Perhaps there was a subtle change to my background mood base and the alteration was so gradual that I didn't notice it. Last year when I started seeing Sharon, my counselor, I told her that I was taking antidepressants. She suggested that at some point I might want to wean off of them and "see who I was without the drugs." But I really felt I wasn't any different with or without the drugs; I felt like I knew 'who I was'. Time, situational change, and a year with both boys full time in school eased the depression symptoms; the medication didn't seem to have much effect beyond the hunger effect and a mild (not unpleasant) buzz.

It was really only the weight effect that motivated me to keep taking them.

I pushed to the back of my mind the awareness that a day of reckoning was coming where I'd face some questions:

1) What does it mean to be thin?
2) Is it important to be thin?
3) Why?
4) Is it still important to be thin when I'm 49/50/51?
5) Why?
6) What does it mean that it's important to be thin?
7) Is it legitimate to use anti-depressants as a diet pill?
8) Is it dishonest to be slender by these means?
9) To whom do I owe 'honesty' about this? If me alone, why should I feel uneasy about (dis)honesty? If someone else--no that just seems absurd. Should I carry a sign that says, "I'm slender because I take Wellbutrin"? Still, I'm dogged by the feeling of misrepresenting myself. (Then comes the 'puritan question'-- if I don't have a metabolism that makes me 'naturally', 'authentically' thin is the only way I can legitimately be thin is if I suffer to do it--either through eating less than I want or exercising mightily? Why should those means be more legitimate than an antidepressant with a convenient side effect? Who says?)

Of course this opens up a whole other can of worms, too. I can see when I read my journals that there was a lot of fevered energy that I now recognize as biological--the drive for a mate. I didn't know it then but it's plain now. A successfully sexually appealing identity once seemed very necessary.

What is the basis of sexual appeal when one is beyond childbearing age? Again, the question, is it important, is it worth an effort, is it even possible? A certain number of pounds hung on my frame now looks very different than it did when I was 20, 30.

And it's not as if I'm interested in entering the world of trying to attract a sexual partner. I have friends my age who are single, friends who are divorced, Out Looking. After 16 years of marriage there is no appeal in that for me. When I get dispatches from that field I have trouble relating personally--it seems like something that belongs to another age and another time. My friends seem very engaged: I just can't relate.

I suppose having two young children makes a mate search additionally irrelevant. It's rare that children from one man, particularly boys, have a successful relationship with a man-not-their-father who is close to their mother.

I started tapering down the antidepressants in January. It's been several weeks now since taking my last. My mood continues to be stable, but I didn't expect to experience any differences on that front. What I'm nervous about is whether or not I'll be having to confront the old demons about appearance and weight. And whether I'll finally be able to make some peace with them.

But She Got Much Back

A loyal reader forwarded me this website, a clothing company called "Little in the Middle," specializing in clothing for normal women. Specifically, the company caters to all of us "pears," who have smaller waists and larger hips and thighs.

I certainly appreciate the brand's philosophy--no more jeans gaping at the back! But, I'm staring to wonder is "Little in the Middle" as detrimental a phrase as "Big in the Bottom" when it comes to body and size acceptance?

Sex and Weight

Yesterday, I was interviewed by an online magazine on the topic of overweight* women and dating. Specifically, the interviewer asked questions about why thinness is glorified in women, how overweight women struggle in general and particularly with regard to dating. She wondered if overweight women might miss out on sexual opportunities and how these women might become more comfortable with sex. And then a bomb dropped: "What do you think about the idea that overweight women are easy?" (as in sexually promiscuous. . . as in, in order to compensate for their weight)

Is this true? And, even if it's a stereotype, since most stereotypes are based on a glimmer of truth, why do you think this is?

*her word, not mine

The Stomach Bug

I got it. Yep, the stomach bug. You know the kind when you eventually resign to taking up residence on the bathroom floor? That's the one. And, in the week-plus of recovery since (accompanied with little appetite and the requisite weight loss), I've been thinking about what the stomach bug means with regard to e.d.'s.

Would you secretly welcome the stomach bug in order to lose weight? Take the EWHAED's first poll (on the right) to let us know. . . .

I've Got Mail

I love getting letters from my readers, especially when they look a little something like this (posted with persmission):

Hi Dr. Stacey,

You may think this is a little compulsive, and, sure, it represents the extreme end of things, but I have neither of the following things:
- a mirror in my bedroom
- a scale in my house

Consequently, I'm extremely happy, and whether or not I feel comfortable in my body has to do with just that - whether or not I feel comfortable in my own body.

Do we even need a scale to measure weight? There are an enormous number of things around us that do the weight-measuring for us, without the numbers. Everything from our own clothing sizes to other people's comments on any ups or downs in our weight serve to remind us of just where we fall on the spectrum. A scale seems, well, superfluous.

So then, why don't I have a mirror in my room? It's also superfluous. If I want to pluck my eyebrows or put on makeup, I'll go into the bathroom. That decision involves taking an active part in my self image - that is, seeing myself when I want to see myself, using the mirror for an activity with its own purpose rather as a tool to open myself up to the opportunity to self-criticize endlessly. What role could a mirror in the bedroom serve that a mirror in the bathroom could not? Looking to see if I have something in my teeth, washing my face, even trying on new earrings . . these are all things that could happen in the bathroom, with purposeful intent.

The radical part in me thinks we should abolish scales - except in doctor's offices and laboratories. I think it's extremely weird that they developed as a part of our hygiene habits. Shouldn't what we do in the bathroom be about taking care of our bodies instead of encouraging terrible self image? Bathing, toilet, brushing our teeth, combing our hair - this all makes sense. But the scale? Everyone should do themselves a favor and lose it.

Can't wait for your book to come out!