Eat to Your Good Health

INTRODUCTION WHAT DOES IT MEAN TO BE HEALTHY? Good health is more than just being free from disease or injury. Good health also includes having total physical, mental, and social well-being . Eating well, exercising properly, maintaining a healthy weight, staying positive, and having balance in your life all promote good health. Good health helps you feel good, have energy, and maintain a positive outlook on life. Your mental health is just as important as your physical health. Letting go of your eating disorder is one way to move towards good health. WHAT IS HEALTHY EATING? Healthy eating is consuming the right amounts of a variety of foods from all food groups to obtain the nutrients your body needs to function at its best. Healthy eating promotes good health to help fight off chronic diseases such as heart disease, diabetes, cancer, and osteoporosis. WHAT IS AN EATING DISORDER? An eating disorder is a condition in which poor eating behaviors compromise an individual’s physical and mental health. Poor eating behaviors include restricting food, binging, purging, and compulsive exercise. WHAT ARE SOME DANGERS OF EATING DISORDERS?  Malnutrition  Ruptured stomach (gastric rupture due to binge eating results in an 80% fatality rate)  Serious heart, kidney and liver damage  Internal bleeding  Esophageal tears and rupture from vomiting  Depression, anxiety, obsessive-compulsive disorder and substance abuse  Tooth erosion/gum disease  Low self-esteem  Isolation and impaired social relationships  Mood swings  Constipation  Muscle loss  Osteoporosis  Electrolyte imbalance  High blood pressure, cholesterol, and triglycerides  Cardiac arrest  Death WHAT IS NORMAL EATING? Ellyn Satter, an expert on competent eating, says it best: “What is Normal Eating? Normal eating is going to the table hungry and eating until you are satisfied. It is being able to choose food you like and eat it and truly get enough of it -not just stop eating because you think you should. Normal eating is being able to give some thought to your food selection so you get nutritious food, but not being so wary and restrictive that you miss out on enjoyable food. Normal eating is giving yourself permission to eat sometimes because you are happy, sad or bored, or just because it feels good. Normal eating is mostly three meals a day, or four or five, or it can be choosing to munch along the way. It is leaving some cookies on the plate because you know you can have some again tomorrow, or it is eating more now because they taste so wonderful. Normal eating is overeating at times, feeling stuffed and uncomfortable. And it can be undereating at times and wishing you had more. Normal eating is trusting your body to make up for your mistakes in eating. Normal eating takes up some of your time and attention, but keeps its place as only one important area of your life. In short, normal eating is flexible. It varies in response to your hunger, your schedule, your proximity to food and your feelings.” EXERCISE AND EATING DISORDERS Exercise is a great way to move towards good health. Exercise is important to help you feel good and maintain your weight. Your exercise may be restricted, limited, and/or monitored due to your current medical and mental state. Following your meal plan, getting medically stable if needed, and decreasing your eating disorder behaviors are the best ways to gain back exercise if it has been lost from you. WILL I GAIN WEIGHT DURING TREATMENT? Gaining weight depends on your current weight and type of eating disorder. Most people will gain some weight during treatment regardless of their initial weight. Focus is on recovery first, than weight loss later as recommended. You can’t diet and recover from an eating disorder at the same time. In order to have a successful recovery, you need to pick one. HOW DO I USE THIS BOOKLET? This booklet provides exchange lists for meal planning, and essential nutrition education to promote healthy eating habits. Your registered dietitian will work with you to develop a meal plan that best suits your needs. A healthy meal plan includes carbohydrate, fruit, vegetables, dairy, fat, protein, and dessert. You may not be required to include all these foods each day in the very beginning, but eventually you and your dietitian will work together to incorporate all foods into your meal plan. This booklet is intended to coincide with regular nutrition counseling. Regular nutrition counseling is important to keep you on the path towards recovery. This booklet contains:  An introduction: pages 1 - 8  Exchange lists and according nutrition education: pages 9 - 50  Meal planning and a sample meal plans: pages 51 – 54  Hunger and Satiety education: page 55  Keeping a food journal: page 56  Resources: page 57  Reading recommendations for help with eating disorder recovery: page: 58 - 59  Glossary for important terms that you should know: pages 60 – 62  Hunger and Satiety Scales: page 65  Blank meal plan forms: pages 66 - 76  Sample food journal and blank food journals: pages 77 - 128  Index to look up specific foods or drinks: pages 129 - 133 EXCHANGES Exchanges help make meal planning simpler by categorizing foods into caloric equivalents. This allows equal food substitutions within the same category. For example, 1 slice of bread can be substituted for 1/3 cup of rice or ½ cup of grits because all equal 1 starch exchange. Your dietitian will help you learn the exchange system. Sometimes portion sizes can be deceiving and look bigger or smaller than they really are. You need to learn to trust your dietitian and know that she/he has your best interests in mind. If you feel uncomfortable about your meal plan, than make sure you clearly communicate that to your dietitian. It is better to let your dietitian know what you are capable of doing instead of accepting the meal plan while knowing that you honestly cannot follow it. Keep in mind that your dietitian may push you to eat more, eat less, try new foods, or take away foods. Try your BEST to follow these changes while being honest with yourself and your dietitian. Many foods such as egg substitute, fat free cheese, sugar free Jell-O, and fat free cool whip are not listed on these exchange lists for a reason. Your dietitian may choose to add these foods to your exchange lists depending on your situation. It is not advised that people recovering from eating disorders include “diet” foods on their meal plan. Once again, you cannot diet and recover at the same time. Any food that implies a weight loss message is considered a “diet” food. Weight control bars/shakes, diet Jell-O, diet cereal, and sugar-free or diet desserts are considered “diet” foods. You need to learn how to incorporate all foods, except “diet” foods, into your diet. A healthy diet includes fried foods, desserts, and pizza when balanced with fruit, vegetables, and whole grains. HOW DOES MEAL PLANNING WORK? Your meal plan will incorporate exchanges from different food groups to meet your recommended calorie goal, which is set by your dietitian. Your calorie goal is calculated according to your height, weight, activity level, sex, age, and current food intake. Your meal plan will include at least 3 meals and 1 snack per day. Your dietitian will work with you to not obsess about calories. This may take some work. For that reason, calories have been left off the exchanges lists and will not be discussed in this booklet. Do not skip meals. Your meal plan is part of your prescription. You can think of your meal plan like a prescription medication for an illness such as cancer. You must follow your meal plan and not skip any meals like a cancer patient should not skip any medication doses.