When Your Eating Disorder Isn't Your Only Worry (Part 2)

Eating Disorders and Medical Conditions

At the beginning of the year, I wrote about how eating disorders will often come along with other psychiatric disorders and how important it is to stay on top of both of them for your recovery. However, some of the complications in eating disorder recovery can also come from medical concerns. (Eating Disorder Health Problems and Complications) Plenty of diseases have dietary implications and if you're not ready to tackle both, either your physical health or your recovery will suffer.

The range of medical issues we're talking about here is vast. Sometimes it's an intolerance to something and sometimes it is something more serious, like diabetes or another endocrine disorder or a severe food allergy. Regardless, it can make eating disorder recovery a little more complicated. As if it weren't complicated enough, right?

Medical Conditions Affect Eating Disorder Recovery

Earlier this year, I talked to a few friends about how their medical conditions affected their eating disorder recovery. Each of them had a different experience, of course, but I learned something valuable from each of them.

My friend with polycystic ovarian syndrome (PCOS) had a lot of trouble with the hormonal swings in the disorder and the resulting eating disorder behaviors. Not only did she have to break the eating disorder patterns, but she had to work with her doctors to address the medical side of the PCOS. My friend was far more able to work on her eating disorder recovery when she addressed the medical issues. The take home message? Even if your medical illness doesn't necessarily affect what foods you can or can't eat, their effect on your mood and energy level can certainly affect your nutritional choices.

Dietary Restrictions Can Be Dangerous To Your Eating Disorder

I also have friends whose medical diagnoses directly impact what they can and cannot eat. Many of my friends in recovery have food allergies. Some of their allergies, like bananas (really?!) or chocolate (poor soul), are fairly easy to avoid in day-to-day life. You may never know the happiness that is warm banana bread straight from the oven, but on the whole, you won't need to make drastic changes to your diet. ("Diet" meaning "foods you normally eat.")

But what if your allergy is to wheat? Or peanuts? Or soy? What if diabetes dictates what sorts of foods you can eat and when? What if over the course of your eating disorder, your body lost the ability to digest lactose? Any of these could mean severe restrictions on what you can eat, and if there's anything an eating disorder loves, it's excuses. Whether it's an "oh, I can't eat that" or a viable excuse for why you run to the bathroom shortly after meals, your eating disorder will run with it if you give it the chance.

So how do you navigate the choppy waters of eating disorder recovery and food restrictions?

Use Your Secret Weapon: Your Dietitian

Okay, so it's not such a "secret" weapon. Your dietitian is an integral part of your eating disorder treatment team. You aren't paying him or her $95 an hour (or whatever the going rate in your area is) to read the number on a scale and say "good" or "bad." Your therapist (or doctor or average first grader) could do that. You pay your dietitian because s/he has gone to school for years in order to understand what the body needs to be able to function at its peak and where you can get those nutrients.

Your dietitian can help you create a meal plan that both meets your caloric and nutritional needs and keeps your body functioning at its best. Your dietitian may even have some ideas that you hadn't thought of. I certainly would never have thought of using rice or potatoes as a base for sauces and curries more traditionally eaten with pasta, but that is one way my friend's dietitian helped her navigate her celiac's disease. (And without paying out the nose for "gluten-free" alternatives at every meal.)

I've been working with my own dietitian over the past couple of weeks to figure out what I can and can't eat on the dairy spectrum. When I figured out that dairy was the problem, I assumed that I would have to give up everything. But following my dietitian's advice, I started slowly adding dairy back after off it completely for a few days. She gave me a very specific order in which to try foods and after a week or so, I learned that I can still eat cheese (which does not have carbohydrates - which is what lactose is) and some yogurts (the bacteria cultures begin to break down the lactose, which is what my stomach is unable to do).

If I hadn't worked with my dietitian on this problem, I would have gotten rid of all dairy products leaving me, effectively, vegan. That's a pretty nifty excuse to avoid lots of foods, right? Sure thing - which is why, for me, "I'm vegan" is usually a precursor to "I'm back in treatment."

There is definitely a lot more to be said on this (including the difference between allergies and intolerances and what that means for your eating), but I'll let you chew on this for a while. (Pun intended.) I'll follow up in the next week or so with some more thoughts.

Have dietary restrictions created difficult situations in your recovery? Have allergies or other food issues been a way for your eating disorder to camouflage itself in the past?

Jess can also be found on Google+, Facebook and Twitter.