Orthorexia: When Eating Healthy is Unhealthy By: Sarah Crissinger RN

Seattle is the fourth healthiest city in the United States and Seattleites are the second healthiest eaters according to a recent survey by Sperling’s Best Places (2013). You can’t go far without seeing a cross fit gym, yoga studio or a high end grocery store. The Paleo Diet, “eating clean”, and The Raw Foods Diet are commonplace in the Seattle culture and have undoubtedly helped some ward off early disease, increase health, vitality, and quality of life.  For some, what starts as eating healthier can become an all consuming obsession. The paradox is eating healthy can be unhealthy.

Orthorexia is an unofficial diagnosis that was named by Steven Bratman MD, who discovered the disorder after recognizing his own unhealthy obsession with healthy eating. Orthorexia is derived from Greek meaning right/proper appetite (Bratman, 2013). Obsession with being healthy and pure is what differentiates Orthorexia from other eating disorders. Like other eating disorders Orthorexics often have a need for control, and make food/way of eating a source of identity and validation. Perfectionism and black and white thinking often keep Orthorexics obsessed with following a diet strictly or they can struggle with accepting themselves.

Orthorexia embodies traits of Anorexia and Obsessive Compulsive Disorder as foods allowed in the diet are reduced to a point where unhealthy weight loss and malnutrition ensue.  Some attributes of Orthorexia can be; extremely limiting the types of foods eaten, such as any food with the possibility of having pesticides, GMO’s, being non-organic or specific ingredients and entire food groups (Nelson, Zerasky, 2011). Dr. Steven Bratman describes how some Orthorexics limit food intake to a dangerously low and even fatal level of nutritional variety by only allowing themselves to eat a couple types of food items (2013).  Additional components of the disorder are obsessive compulsiveness regarding food preparation such as excessive washing of foods and not being able to eat out or eat food prepared by others, and spending excessive time thinking about healthy food (Nelson, Zerasky, 2011).

 Healthy diets, such as the ones mentioned earlier, in and of themselves are not necessarily disordered but can cross the border into Orthorexia when; 1) Fixation on food becomes all consuming. 2) Personal relationships and other areas of life suffer due to rigidity to the diet often resulting in isolation. 3) Immense guilt, anxiety, mood swings and self loathing persist when the diet is not followed.

The tricky thing about eating disorders including Orthorexia is the denial of having one. Especially due to the food restriction in Orthorexia often stemming from a medical condition, food sensitivity, allergy, or wanting better health. If you feel like you follow a very strict diet to be healthy and other’s have shared concerns or you have noticed that the obsession in healthy eating is taking away from important areas of your life, Ramey Nutrition is here to support you. Ramey Nutrition offers individualized care that begins with an individual session with one of our Dietitians. We work with many therapists specializing in eating disorders in the Seattle area that we can refer you to in order to address deeper underlying emotional issues. Ramey Nutrition offers you a full recovery that results in a restored relationship with food, ownership over your health, and freedom to begin living your life fully again.

References:

Bratman, S.(2013) Orthorexia. Retrieved on 09/04/10 from: www.orthorexia.com

Nelson, J., Zerask, K.(2011) Orthorexia: When eating healthy goes awry. The Mayo Clinic.Retrieved on 09/04/2013

from:  http://www.mayoclinic.com/health/orthorexia/MY00768

California Shines, Ohio aches in battle for healthiest city (2013). Sperling’s Best Places. Retrieved on September

12, 2013 from: http://www.bestplaces.net/docs/studies/healthy.aspx

The Mask of Halloween by Kate Kaczor

The Mask of Halloween by Kate Kaczor

If you have taken a walk down our Seattle streets recently, you will have noticed a few changes. The air is a bit crisper, the leaves are changing colors, and pumpkins are seated upon the porches of most homes. It is clear, October is upon us. While October brings about many joys throughout the entire month, its claim to fame comes on its final day. The holiday designed to scare our pants off, Halloween, is one of the most celebrated holidays by Americans. We love going to haunted houses, having costume parties, and the pumpkin-flavored, well, everything.

The Halloween we know and love today has an ancient history. The holiday is said to have originated over 2,000 years ago in the area that is now Ireland, the United Kingdom and northern France by the Celtic population. The Celts celebrated their new year on November 1^st. They viewed this day as the end of the summer and harvest time and the beginning of winter and season of hunger and death. In preparation for the New Year, on October 31, a festival known as called Samhain was held. During this festival the Celts dressed up in costumes in hopes they could ward off the ghosts they feared would come the next day to create chaos and destroy their crops.

Halloween has changed quite a bit since the time of the Celts, but one thing has remained constant: the costumes. It is the one day out of the year where it is socially acceptable to dress up however you please and pretend to be someone else. It makes sense that this tradition of escaping our identity has been a constant in this holiday so closely associated with fear and terror. When we are threatened with some of our fears, whether it be spiders, witches, or screaming kids with candy, we often search for a way to disconnect from situations in order to avoid dealing with the fear. Our hope is that if we can avoid being ourselves, the situation that is causing the fear will simply disappear.

This may work out okay on Halloween. After the night is over, the ghosts and ghouls are put away, the kids are calmed down after their sugar fix, and life goes back to normal, until Thanksgiving at least. However, there is a point where this strategy to protect ourselves becomes harmful, where we become so afraid to leave shelter of the costume and strongly fear returning to our own identity.

This is something many individuals struggling with eating disorders can strongly relate to. Many of these individuals have faced situations that were too scary to handle at the time. In order to cope with this, they clung onto something that allowed them to disconnect from the situation and therefore, survive. They put on the mask of the eating disorder, taking on that identity and attempting to protect their own in the process. This can be highly effective in the moment and there is little doubt that the eating disorder does its job. It helps the person survive the situation without having to cope with such extreme pain. But then what happens?

If you are struggling with an eating disorder, you may view it as your lifeline, a lifeline you are not capable of leaving. You may think, “If the eating disorder helped me get through this situation, how will I be able to survive if I leave it?” “Will I be able to make it on my own if I let go?” “Am I able to fully face my emotions and life’s challenges, if I am myself?”

This situation can become very frustrating for those in eating disorder treatment. Often, patients come to a point where they desire to be free of the eating disorder, but at the same time are terrified to leave. There may be feelings of shame, humiliation, and defeat. It is important to remember, however, that it is perfectly normal to have this attachment to the eating disorder. Just as the Celts dressed up in costumes to help ward of the ghosts who threatened their existence, putting on the mask of the eating disorder is a tool we often use in order to get through a difficult time. Without the costumes, the Celts feared they would not survive the winter. It likely would have caused them panic and anxiety to remove the costumes and pursue other avenues such as preserving food or migrating to land with a better climate, even if it made logical sense to them. Clinging to the costumes may have prevented them from achieving their goals, but the thought of doing something different would have created fear. The costumes provided them with such comfort, and they were uncertain of the outcome if they changed their course of action.

The same is true for eating disorders. It is important to let go of shame, acknowledging that the eating disorder is not a character flaw; rather we may have needed it to survive. In recognizing this, we can take small steps to take off the mask and let go of the eating disorder. By taking those small steps we practice living life without the assistance of the eating disorder. There may be times when we return to the mask and that’s okay, we just need to remember that each time we choose to remove the mask and be our true selves, we are going down the path of recovery.

If you need support in letting go of your eating disorder, facing your fears, and living the life that is true for you, call Ramey Nutrition to get an individual assessment with one of our providers.

Sources:

http://www.history.com/topics/halloween

Eating in the Light of the Moon by Anita Johnson, Ph.D (1996)

Ramey Nutrition's Rachel Myhre, MS, RD, CD

• "When I first came to Ramey and met Rachel, I was understandably tentative opening up to a stranger about such a painful thing like an eating disorder. However, Rachel approached the relationship at the same pace as me, and I quickly realized how safe and cared for I felt. She is professional and personal at the same time. She's my dietitian, but she is also my friend and ally. Each session with her is different, but I always have something to think about or work on when I leave, and no matter how hard it was, I always know that her intention is to help me get better. Though recovery has felt impossible at times, with Rachel as my provider and the Ramey team by my side, I know it will be a reality for me soon." -Recently Recovered Patient TF
  

Signs and Symptoms of Anorexia, Bulimia, and Binge Eating Disorders

Signs and Symptoms of Anorexia, Bulimia, and Binge Eating Disorders

Eating disorders are a group of conditions marked by an unhealthy relationship with food. Eating disorders tend to develop during the teenage and young adult years, and they are much more common in girls and women. No one knows the precise cause of eating disorders, but they seem to coexist with psychological and medical issues such as low self-esteem, depression anxiety, trouble coping with emotions, and substance abuse.

For some people, a preoccupation with food becomes a way to gain control over one aspect of their lives. Although it may start out as simply eating a bit more or less than usual, the behavior can spiral out of control and take over the person’s life. Eating disorders are a serious medical problem that can have long-term health consequences if left untreated.

It’s common for people with eating disorders to hide their unhealthy behaviors, so it can be difficult to recognize the signs of an eating disorder, especially early on.

Anorexia Nervosa (AN): This is characterized by weight loss often due to excessive dieting and exercise, sometimes to the point of starvation. Someone with anorexia can never be thin enough and continues to see herself as “fat” despite extreme weight loss.

People with anorexia nervosa have an extreme fear of gaining weight. They often diet and exercise relentlessly, sometimes to the point of starvation. About one-third to one-half of anorexics also binge and purge by vomiting or misusing laxatives. People with anorexia have a distorted body image, thinking they are overweight when in fact they are underweight. They may count calories obsessively and only allow themselves tiny portions of certain specific foods. When confronted, someone with anorexia will often deny that there’s a problem.

The signs of anorexia can be subtle at first, because it develops gradually. It may begin as an interest in dieting before an event like a school dance or a beach vacation. But as the disorder takes hold, preoccupation with weight intensifies. It creates a vicious cycle: The more weight the person loses, the more that person worries and obsesses about weight.

The following symptoms and behaviors are common in people with anorexia:

• Dramatic weight loss
• Wearing loose, bulky clothes to hide weight loss
• Preoccupation with food, dieting, counting calories, etc.
• Refusal to eat certain foods, such as carbs or fats
• Avoiding mealtimes or eating in front of others
• Preparing elaborate meals for others but refusing to eat them
• Exercising excessively
• Making comments about being “fat”
• Stopping menstruating
• Complaining about constipation or stomach pain
• Denying that extreme thinness is a problem

Because people with anorexia are so good at hiding it, the disease may become severe before anyone around them notices anything wrong. If you think someone you care about has anorexia, it’s important to have them evaluated by a doctor right away. If left untreated, anorexia can lead to serious complications such as malnutrition and organ failure. However, with treatment, most people with anorexia will gain back the weight they lost, and the physical problems they developed as a result of the anorexia will get better.

Bulimia Nervosa (BN): The condition is marked by cycles of extreme overeating, known as bingeing, followed by purging or other behaviors to compensate for the overeating. It is also associated with feelings of loss of control about eating.

People with bulimia nervosa have episodes of eating large amounts of food (called bingeing) followed by purging (vomiting or using laxatives), fasting, or exercising excessively to compensate for the overeating.

Unlike anorexia, people with bulimia are often a normal weight. But they have the same intense fear of gaining weight and distorted body image. They see themselves as “fat” and desperately want to lose weight. Because they often feel ashamed and disgusted with themselves, people with bulimia become very good at hiding the bulimic behaviors.

The following are common signs of bulimia:

• Evidence of binge eating, including disappearance of large amounts of food in a short time, or finding lots of empty food wrappers or containers
• Evidence of purging, including trips to the bathroom after meals, sounds or smells of vomiting, or packages of laxatives or diuretics
• Skipping meals or avoiding eating in front of others, or eating very small portions
• Exercising excessively
• Wearing baggy clothes to hide the body
• Complaining about being “fat”
• Using gum, mouthwash, or mints excessively
• Constantly dieting
• Scarred knuckles from repeatedly inducing vomiting

If left untreated, bulimia can result in long-term health problems such as abnormalheart rhythms, gastroesophageal reflux disease, and kidney problems. However, bulimia can be treated successfully through cognitive-behavioral therapy,antidepressants, or both. It’s important to seek help if you think someone you care about has bulimia.

Binge Eating Disorder (BED): This is characterized by regular episodes of extreme overeating and feelings of loss of control about eating.

Rather than simply eating too much all the time, people with binge eating disorder have frequent episodes where they binge on large quantities of food. Like people with bulimia, they often feel out of control during these episodes and later feel guilt and shame about it. The behavior becomes a vicious cycle, because the more distressed they feel about bingeing, the more they seem to do it. Because people with binge eating disorder do not purge, fast, or exercise after they binge, they are usually overweight or obese.

Unlike other eating disorders, binge eating disorder is almost as common in men as it is in women. According to statistics from the National Institute of Mental Health, the average age at onset for binge eating disorder is 25, and it is more common in people under age 60.  

Common signs of binge eating disorder include:

• Evidence of binge eating, including disappearance of large amounts of food in a short time, or finding lots of empty food wrappers or containers
• Hoarding food, or hiding large quantities of food in strange places
• Wearing baggy clothes to hide the body
• Skipping meals or avoiding eating in front of others
• Constantly dieting, but rarely losing weight

Because binge eating leads to obesity, it can have serious health consequences if left untreated. Behavioral weight reduction programs can be helpful both with weight loss and with controlling the urge to binge eat. Because depression often goes hand in hand with binge eating disorder, antidepressants and psychotherapy may also help.

Recognizing the signs and symptoms of an eating disorder is the first step toward getting help for it. Eating disorders are treatable, and with the right treatment and support, most people with an eating disorder can learn healthy eating habits and get their lives back on track.

ADHD & Eating Disorders

There may be a link between ADHD and eating disorders.

“ADHD in teens may cause symptoms of boredom and restlessness that are temporarily relieved by compulsive or addictive eating behaviors. Overeating or binge eating may stimulate the dopamine reward system and dopamine pathways in the brain.” 

-Eric Hollander, MD

Read the rest of the article here!

Recovery Day Program Patient Testimonial

Ramey Nutrition is a good fit from my recovery because theprogram allows me to live in a real world setting while being in the recoveryprocess. Yes, I will admit, this hasn’t been anywhere near easy and I believethat is why I have had an intense time adjusting to there being more “freedom”with my recovery. This is something that I am DEFINITELY not used to with onlyexperiencing inpatient, residential and Partial Hospitalization Programs (PHP).When I did go to another program, it was acclaimed to be PHP, although it feltmore like I was trapped in a place and I HAD to recover. Being here at RameyNutrition I have the choice to recover. I am scared shitless of gaining weight,fearful of finding my true self. Having those feelings come up, having to facethem is something I am going to experience while I recover. It’s not going tobe easy or fun, and I am ready to be uncomfortable with eating and keeping fooddown. I am taking the next step to gain weight because I want my lifeback. I want to live, be happy, and spend time with my family.

I WANT LIFE AND I WANT ME BACK!!!!

            I am going to do everything in mypower to get that back. By committing myself to that, I WILL:

·        Eat

·        Gainweight

·        Goto therapy

·        Workmy ass off day in and day out, every second to be closer to life

·        Bereal, honest, open, authentic

·        Havedifficult days, struggle AND get through them, continuing to push forward

I am tired of dying and I am going to start living byreviving myself and I truly believe without a doubt that Ramey Nutrition is theplace for recovery and regaining my life back.

-         A.D.

Ramey Nutrition Recovery Day Program Patient

Recovery in Motion!

I am capable of greatness beyond my expectations. I am limiting my conviction because I feel trapped.

I am creating and owing my life. I am appreciating that my life is greater than my expectations; my strength beyond measure. I am unlimited potential and am investing 100% of myself in each moment until death comes...however it may. 

-AW, Ramey Nutrition Recovery Day Program

 http://rameynutrition.com/form/free2be

From 58 pounds to thriving By Chelsea Roff

How yoga helped an anorexic recover

STORY HIGHLIGHTS

• Chelsea Roff nearly died from severe anorexia and its complications
• She spent 16 months in Children's Medical Center Dallas
• She says she was lucky to get enough resources to put her life back together
• Now, Roff wants her story to be a "beacon of hope" for others who might be suffering

Editor's note: In the Human Factor, we profile survivors who have overcome the odds. Confronting a life obstacle -- injury, illness or other hardship -- they tapped their inner strength and found resilience they didn't know they possessed. This week we introduce you to Chelsea Roff, who had a stroke at 15 brought on by her severe anorexia. At the time she arrived at Children's Medical Center Dallas, she weighed 58 pounds. Now 23, Roff is a writer, speaker and yoga instructor.

(CNN) -- The first emotion I remember is rage. It was a violent, fire-in-your-veins, so angry-you-could-kill-someone kind of rage.

I wanted out. I wanted the pain to be over. I wanted to die. I was mad at myself for not having the courage to just do it quickly, angry at the hospital staff for thwarting my masked attempt.

I was convinced that I was "meant to" endure this, that my long, drawn-out starving to death would prove my willpower to God. In the days prior to my stroke, I'd had vivid hallucinations -- of Jesus on a wooden cross outside my bedroom window and a satanic figure sneaking up under my bedroom covers to suffocate me at night. I thought I was meant to be a martyr. I thought God wanted me to die.

As the fury subsided, delirium set in. I became confused, defiant and completely irrational. I told the doctors that they couldn't possibly keep me overnight, because my family didn't have insurance or money to pay. When a cardiologist responded that she wasn't sure if I'd live another week, I told her she was full of s---.

I hid the food they were trying to make me eat in my underwear, in flowerpots, even in my cheeks like a chipmunk -- certain no one would notice. I didn't want to get better. I was convinced nothing was wrong.

I remember having nurses turn me over in the middle of the night to tend to the bed sores on my behind, places where the skin was so thin that my tailbone was starting to protrude through the flesh.

I remember waking up to discover I'd wet the bed nearly every morning for the first three months I was hospitalized. I was ashamed, disgusted. I'd lost control of the muscles in my bladder; I was like an infant all over again. I remember shooting a nurse the bird when she told me I couldn't walk, only to crumble to the floor when I angrily pushed the wheelchair away to give it a try.

Unbeknownst to me at the time, my arrival at the hospital had launched an investigation by Child Protective Services back at my home in Austin. The caseworkers deemed my mother an "unfit parent" and my sister and I were placed under custodianship of the state. My care was left to the doctors and nurses at Children's, while my sister was sent to live with our godparents. My mother, herself an alcoholic and anorexic, had literally drunk herself into oblivion (she was later diagnosed with Wernicke's Syndrome, a form of alcohol-induced dementia).

I spent the next 16 months of my life in that hospital. I completed my junior and senior years of high school through a distance education program, talked my way through hundreds of hours of individual and group therapy and slowly, painfully worked to bring my body and mind back to life.

When Medicaid finally pulled the plug on funding for my treatment, I was unrecognizable from the day I'd walked in. I'd gained nearly 40 pounds, and the feisty, fiercely independent spirit I'd been known for as a child was on her way back in (close to) full force.

Although I was still significantly underweight and terrified to leave the security of the hospital, my medical team managed to convince the caseworkers to grant me emancipation. At 17, I re-entered the "real world" as a legally recognized adult.

My doctor at Children's helped me make arrangements to move into a garage apartment with a close family friend near the hospital. I got a job at a local Starbucks, started applying for college, and, by the grace of who-knows-what, was offered almost free weekly therapy by a psychologist who'd treated me at Children's.

Three months later, I took my first yoga class. I was lucky. I was blessed. I was given enough resources to put the fragments of my broken life back together.

My hope is that my story might serve as a beacon of hope for people grappling with their own inner demons in silence and isolation. Whether it's an eating disorder, abandonment, depression or addiction, please know:

There is a way out. You don't have to suffer alone. There are people out there who want to love you, who would be honored to bear witness to your pain. Healing doesn't happen in a vacuum. We are human and we have an inherent need to see and be seen, to touch and be touched. No one heals heartbreak alone.

For the broader community, I hope this story will diminish some of the stigma and misperceptions about eating disorders. Many of us have been taught that people with eating disorders simply want to be skinny, feel like they have to look like supermodels to be worth anything, or just have an unhealthy "need for control." Those are all symptoms of an eating disorder, not the cause.

I realized that I feel like a child who was once desperately thirsty, who was given enough water to survive and shake her thirst, and now feels compelled to go out and give water to anyone who's parched. "Look! Water! I know, isn't it good?! Drink up!!" When I see people drink the water, I can't even describe the feeling -- it's as if I'm experiencing the first sip all over again. It brings me incredible joy, even healing. It's an act of alchemy. It allows me to make light of some of the darkest days of my life.

I once had a therapist who, when asked how I could ever repay her for all she'd given me, told me: "Your life will be all the thanks I need." This is how I thank her. This is how I thank all those who helped me find my way out of the darkness. Share the water.

Destination Recover(ed): Day 677

Thanksgiving was pretty awesome this year. In the past it has always been a chaotic time. Ever year I intend on arriving at my Dad's early in the morning so I can feel like I got to spend enough time over there before having to leave to go to my Mom's for second Thanksgiving (which is a fucking nightmare if you have an eating disorder. As if ONE Thanksgiving dinner isn't traumatizing enough). I never want to leave my Dad's house when it comes time to go and I always wish I had gotten there earlier so it could feel like I stayed longer. So far this has never happened. I'm always running late. If I want to be at Dad's by 9am it's almost guaranteed that I will actually make it there around noon. We do a pot luck Thanksgiving at my Dad's. Dad and Mom always do the turkey (this year they deep fried it. *Awesome* fun times not blowing the house up!) and stuffing and then everyone else brings a side dish. We sign up on the list. It's fun. I made fresh from scratch (NOT from a can) green bean casserole and also fresh homemade cranberry sauce (plus I brought the kind in a can for my sister, who loves it). This year I was ready! This year I was on schedule! Car loaded Thanksgiving Eve, ready to roll out of my driveway at 7am to drive from Stanwood to Shoreline to pick up my friend Natalie by 8am and then make the 1.5 hour drive to my Dad's arriving around 9:30am! No muss, no fuss, no chaos, no anxiety. 
Per usual I was late this year ... BUT not as late as the previous years, so we're making progress already! Last minute I decided to  prepare everything for my Mom that she wasn't able to get done because she was working back to back to back to back schedules at work. I think it's awesome that my Mom is the big head honcho where she works but it requires an obscene amount of her life, especially during the holidays where she is on blackout and isn't allowed to take days off and her company requires that she work until midnight on the eve of eves, and eves of holidays, and then turn around and be there at 4:00am the following mornings. So I felt bad this year and prepped all her food and recipes. I got in my car by 9:00am to go get Natalie. 2 hours late. DEAD FUCKING CAR BATTERY. Apparently when I loaded my car up before I went to go to bed (aka watch a movie because I actually didn't sleep for one second that night) I left the light on above the console. Awww MAN! Are you effing kidding me?! Unfucking believable! :::*pouty face*::: Mom to the rescue (which is completely out of character and uncommon for my Mom). She hands me her keys and says, just replace the gas so I can drive to work in the morning. OMG, am I actually going to be THANKFUL for my MOM this year?! Keys in hand, food and supplies transferred, on the road. I picked up Natalie, and after making a few stops (Walgreens and QFC for the alcohol my Mom called to see if I could pick up) We were at my Dad's house 11:45am. Record Time. I may or may not have sped, but the fact that there was absolutely NO TRAFFIC may have also contributed. And the best part? We were the first to arrive! Everything else basically went off without a hitch, not exactly on schedule, but whatever, family was together, we food was eventually cooked and everyone was set at the table. We started a new Thanks Giving tradition, too. Normally we would go around the table and each give thanks for what we were thankful for that year, but this year was different. This is the first Thanksgiving since my grandpa passed away on December 1st last year. Last year he wasn't present at the table because hew as in the hospital, but we were all kind of in an emotional cocoon last year, everything was awkward without grandpa who was the always the Turkey Carver and giver of thanks and Grace sayer. This year, without grandpa, we started new traditions in his memory and it was beautiful and sad and I cried at the table. Mom carved the Turkey this year (because my DAD doesn't know how to carve a turkey and pulled out the power tools, so Mom took over). My sister Rashel was home this year after a very long year of her taking off to find herself. Dad & Mom weren't wrought with the pain of dealing with Rashel's absence and grandpa's last few days. My Sister Crystal is pregnant with my nephew, Jonah, and she is so beautiful at 8.5 months pregnant (and always) and her and her husband are so happy. My other sister, Shannon wasn't going through (and as everything panned out, never went through) a divorce. We weren't in the emotional turmoil of being at the hospital every single day for a month to be with grandpa and see him so ill. I wasn't just discharged from the hospital, the same hospital and subsequently the exact same room as my grandpa. Grandma wasn't crazy, or withdrawn from the grief. We were OK. We made it through the year. We survived. We had an abundance of love and reasons to be thankful this year. We do every year. I have an amazing family, and not just at holidays. I gave thanks for that this year. I gave thanks that I know we are not "normal" in the way that my siblings talk to each other every day and my sisters are my best friends. I gave thanks that we say I Love You when we see each other on holidays as well as Tuesdays or because it's a Saturday. I gave thanks that I can send my Dad a text at 4am on Monday morning because I just felt like telling him I was thinking about him and he'll text me back and say he loves me and thanks for making his day. I gave thanks that I can open my email and see a random message from my grandma that she loves me and "That Is All". I gave thanks for Scarlett and Sandy for their patience, unconditional love and belief in me. And I gave thanks that for this day, I was able to be present in my life and not worry about the food I was giving thanks for. I was able to engage in conversation and comprehend when people talked to me. I gave thanks that I wasn't bundled up in blankets, looking gaunt and dead, just trying to make it through sitting at the table because I didn't have the strength to hold myself up and the chair was so painful to sit on because my bones protruded and there was nothing to protect them. I gave thanks that my mind wasn't cluttered with my eating disorder, although it was still present it wasn't loud, and it wasn't in charge. Another day with my eating disorder so present is what I strive for. It's my proof of my recovery. It's the bounty of all the hard work and the painful days. It's something tangible that I can say OK, so this is what it's like. Now I know. It's not just like working your ass off doing the the fucking impossible without a clue of what you're actually working towards ... you can't miss what you don't know, and I feel like sometimes I'm just working blindly, not knowing what exactly the payoff really is going to be, other than this "word" recovery ... which means "not dying" "healthy" "not sick" but you don't know what the FEELS like, you just know that you don't want to die, that you don't want "this" anymore, that you're tired of fighting, that "something" has to change. Recovery. You just want recovery. So you do the work. You cry the tears and you scream because it's hard. Some days it's impossible. And you fight, anyway. But you don't know what it's going to be like. You're taking a giant fucking leap of fate, feet first without knowing where you're going to end up ...  I suppose it's like a blind person trying to imagine color. How do you do that? Where would your brain go to know what the color RED is if you've never seen it before? I decided to blog about this because for one day, for one meal, I was free. Whether or not I decided to eat or try food, it didn't matter. I was thinking about my family, present, engaged in conversation, laughing, crying, being alive. This is what it's going to be like to be recover(ed), and while I may be a long long ways from recovery, I am recovering.