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Post-Traumatic Dieting Disorder

Though I’ve treated hundreds of clients who are recovering from chronic dieting, it wasn’t until one remarked on her decades of restrictive eating making her feel as if she had Post-Traumatic Stress Disorder (PTSD), that I recognized their similarities. Recurrent restrictive eating may, indeed, feel traumatic and recovering from dieting—not just from emotional or binge-eating—may have lingering traumatic effects. Decades recovered from restrictive eating, the memories of those awful years are still painfully vivid: the deprivation I felt from saying no to food while others ate whatever they pleased, my obsession with thinness and the intensity of shame and self-hatred I felt after my relentless bingeing, my focus on what and how much I ate above all else that sorely needed my attention, and my low self-esteem because I couldn’t seem to feed myself well no matter how hard I tried.

Trauma has varying definitions, but we generally view it as an intensely overwhelming emotional upset in response to a terrible event (or series of events). People in psychology talk about big “T” trauma such as being raped, getting beaten, participating in or being a victim of war, or witnessing a murder, as well as little “t” trauma which is not necessarily a violent, extraordinary or extreme event, but a series of less intense, but equally disturbing and disruptive, happenings which markedly dysregulate the nervous system, such as chronic emotional abuse, rejection, abandonment, or neglect.

PTSD symptoms include: having painful conscious, unconscious and often intrusive thoughts about the event; feeling as though it is happening in the present even if it occurred long ago; experiencing excessive distress when thinking about the event; undergoing a distressing physical response to thoughts of the event, including anxiety or hyper-arousal; avoiding anything that is a reminder of the event.

This description is how many chronic dieters feel even when they are trying not to diet, especially when they’ve recently given it up but did it for a long time. They feel deprived any time they say no to food even when they know they’re making positive choices by rejecting foods that don’t feel good in or do good for their bodies. This deprivation feels the same as when they were denying themselves food for weight loss or to prevent weight gain. They have difficulty not thinking the distressing thoughts they had while dieting: they can never eat favorite foods again and are bad for craving them.

They’re anxious around food, especially when they’re not in control of a meal or the setting or fare that is being served to them. They become hyper-aroused and feel as if they’ll go crazy craving certain foods. They avoid restaurants, dinners at friends’ or families’ homes, parties, buffets and because they’re used to feeling out of control from dieting and only feeling safe (and sane) eating in their own kitchens. They live in terror of Halloween, Thanksgiving, Christmas, Hanukah, Kwanza, anniversary parties, weddings, or any event that involves food. They’re scared at work to walk past a desk with a jar of candy on it, avoid the break room that may have donuts or cookies, hate work parties whether they partake in treats (and feel guilty) or deny themselves (and feel deprived).

My client was on to something and I’m guessing that many of you still suffer, as she does, from Post-Traumatic Dieting Disorder. Perhaps someday it will be a bona fide diagnosis that we’ll read about in Psychology Today and it will be considered on a par with Binge-eating Disorder. For now, at least, know that what you’re going through in suffering the mental and physical aftermath of chronic dieting, may take some time to recover from. Be patient, kind and compassionate with yourself.

You’ll know you’ve recovered when you: feel relaxed and neither anxious nor irrationally aroused by food; can say yes or no to food without enduring emotional distress; look forward to eating out as much as you do to eating in; think of food as nourishment, not in good or bad terms; enjoy food for the pleasure it brings; don’t count calories or fat grams; and don’t constantly associate what you eat with your weight. Recovery means leaving a dieting, deprivational mentality behind and making eating decisions in and for the present, not from the past. If people can recover from PTSD, you can recover from dieting disorder.

Best,

Karen

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