June 22, 2013

I’m doing fairly well this week. I’ve successfully eaten breakfast everyday since my last post and my night eating has decreased. Last night I woke up out of a sound sleep to get something to eat. I got the leftover mac-n-cheese from dinner. Thankfully it was not a lot, but enough to be of concern. One good thing, I am cooking less food for dinner so I won’t have so many leftovers. If I were to cook more I would more than likely hoarding a good portion of the meal for a later feed. Temptations...temptations. 

I went back to sleep after eating. Just before falling asleep, I remember having a slight craving for something sweet. I think I will increase my fruit intake today so it will combat any cravings for sweets foods. One less thing to worry about as night falls. That way if I do have “the hunger” it will not be doubly compounded by the savory and sweet aspect.

For breakfast today I had scrambled eggs with half of a chicken sausage and coffee. It is mandatory for me to have quick cooking foods for day time meals. If it gets too complicated I'll end up turning to high carb snack which leads to a bigger down spiral for night time.

 

For lunch I ate a piece of chicken. Not enough food...I know. For dinner I plan on having chicken with rice and veggies. I hope this will appease my hunger. It’s amazing how the hunger gets to you. It feels like a creeping fog that eventually catches you and engulfs you. I think my eating issues will bet much better as I continue working on healing from the trauma and abuse I endured for so many years. There is a distinct connection. I am also releasing emotions through my art and writing. Therapy is going well also. I’m doing everything I can to beat this thing and live free.

I am going to give myself a pat on the back for this week. I had another bout of stressful events, but I did not crumble as bad as I did last week. Point for me.

Onward and Upward!!!!

Slippery Slope

June 2013

Week 2

 

 I continue to assessing and documenting my life with NES, always keeping in mind that the struggle is ever present especially in the now.

I am a long way from combating Night Eating Syndrome. I’ve made great strides in accepting that I have this condition and am actively working towards a healthier life and lifestyle. My struggle with this disorder is more prevalent now because I am seeing the reality of it. Writing this blog is a way for me to relieve my mind of some of the facts and feelings associated with this disorder. This is my attempt at taking a stand and be accountable for my actions no matter the root source or the outcome.

I’ve been doing fairly well managing my NES this past year, much better than a few years ago. For the most part, I am able to consume more of my caloric intake before 7pm which is monumental for me. In the past my caloric intake was next to nil during the day. Even though I would start eating around 4:30-5:00pm, I would only take a few bites before hoarded the rest for later.

This week I have been experiencing a little more stress then my norm and I find myself reverting back to some of my old ways. I am picking up on a definitive pattern. The onset of binge eating tends to occur when stress levels are on the rise; daytime appetite decreases rapidly as I fast approach full binge mode, that is, if I’m not careful. Note to self…continue working on managing stress. Can’t stop stressors from occurring, but I can change how I deal with them. There is one good thing in all of this...I am identifying the problems and working towards correcting them. Besides, beating myself up about this is not going to help. Let’s face it, it took more than a day to develop this disorder and it’s certainly going to take more than a day to cure it.

My most recent binge happened a few days ago. I hoarded some food from dinner specifically to consume during late night hours. I was fully aware of what I was doing and proceeded anyway. The urge was strong and I gave into it. I did not want to fight it and possibly cause a bigger binge. That night, I tried several things to relax like playing music or writing. This helped for a while, but I still could not fight the urge to feed before sleeping.  So I did. I consumed the foods designated for my night time feed and then off to sleep I went. The next day, I forgetting to eat breakfast. I did not eat a morsel until about 2:30pm. Not good, but not my worst. Of course eating later in the day throws everything off. I still cooked dinner, but opted to eat much later than my new norm.

The next day, I didn’t eat anything until after 5pm. This is getting very bad. I’m heading towards a bigger binge. I can feel it. I have to get focused and get back on track with my eating. It is imperative. I can’t afford to continue going backwards. I’ve come too far and my health is on the mend. I don’t ever want to get as sick as I was before buckling down to combat this dreaded thing.

Since Friday, my stressful period has calmed and all is well. Yesterday and today I ate breakfast, lunch, dinner and a snack. So far I do not have the urge to binge tonight. I've already put away the left overs from dinner. Now I’ve got to come up with a better strategy for maintaining a healthy eating plan during high stress times. I've really got my work cut out for me with this one.

There are slippery slopes on this journey and last week I slipped pretty hard. But I’m regaining my footing and so onward and upward…one step at a time…one day at a time.

Assessing the Development of My NES and Other Eating Issues

I’ve been spending more time talking to people about eating disorders. It’s been a freeing experience to talk about my NES and listening to others share stories about their eating issues. I was intrigued to find that there are different feelings associated with binging. Reading about the studies of different eating disorders is not the same as speaking to actual people and hashing out the small details. What’s most interesting is hearing how the binging experience makes them feel. I’m most interested in what emotions they have leading up to the binge, during the binge, after the binge. I’m also curious if the binge is planned or if it’s spontaneous.

Listening to others helps me to think about my relationship with food. I discovered that I have several levels of experiences with binging and food intake in general. From what I can tell, the way I binge depends on the level of stress and perhaps the origin of the stressors and triggers as well. There is a good portion that appears to be a more of a habit. Much like the formation of habitual and/or ritualistic behaviors associated with the development of addiction. It started off as a relatively benign act (or so it seemed) and then it grew into somewhat of a separate entity. The behaviors took on a life of their own and my mind simply adapted. I would even go so far as to say it’s like having an alter ego, being one way by day and another by night.

Eating at night was a way to release tension and to relax. I also loved the challenge of acquiring food for my night time feeds. I guess you could call it was the thrill of the hunt if you consider chiseling off pieces of frozen cake in the middle of the night hunting.  I would feel triumphant as if having conquered the giant and reaping the spoils. A sense of calm would come over me. Not quite euphoric, but close enough.

I have always associated feelings of euphoria with mouthing. It started with me sucking my toes to comfort myself and quickly escalated into increased mouthing and sometimes consumption of inedible objects. So I guess it’s no surprise to you that I’m diagnosed with PICA as well. As a young child, my biggest craving was bath soap. Ivory soap was the soap of choice. I loved the creamy saltiness of it. I didn’t much like taking baths growing up. Don’t ask me why, I’m really not sure. It just seemed that I could be doing so much more with my time. Eating soap made bathing more enjoyable. I looked forward to it. My mom would run the bath water for me. I’d get in and let the bar of soap float in the water for a few minutes. The soap would soften and then I would begin to eat. Always starting at the corners and slowly working my way towards the center. I never ate the entire bar in one night. It usually took me at least 3 to 4 nights depending. I don’t eat soap anymore and have not for many years; however, I do still have the occasional craving.

Food consumption or the shift of the meaning of food consumption started around the age of 4 or 5 years old. Changes in body mass were more prevalent. It seems that I was developing a pattern of gaining at least 10 to 13 pounds a year. By the time I was 10 I weighed just over 100 pounds. This is the pivotal point that marks the beginning of food deprivation and how that deprivation further locked me into a vicious cycle of cutting meal size by day and having an increased need for comfort by night. As the need for night time comfort increased I became bolder about acquiring the foods I needed. I would almost stop at nothing. Like a drug addict I’d steal money to make food purchases after school. Once home I’d find obscure places to stash my food, always careful to keep the evidence of my eating undetected. That’s why my unnatural weight gain was such a mystery to my parents.

By middle school my life was split was well defined into two levels of existence. During the day I deprived myself of food and at night I would gorge myself on all kinds of sweet and salty treats. I started with cutting out breakfast. Instead I would drink a glass of juice or milk. This made my parents proud which was no easy task. My parents were seldom proud of me. So my thought process was to increase my level of deprivation so they would be even more proud and perhaps love me some day. My mom would pack a normal sized lunch for me to take to school, but would only eat a small portion of it, hoarding the rest for later. I opted to take the city bus home after school because I needed time to go to a nearby store to purchase snacks and other food items.  I’d become obsessed with my new trend. I felt it was really working for me.

My parents, glad to see me making such sacrifice towards dieting would reward me with candy and treats from our store. Funny how history repeats itself isn’t it? I would gladly take my reward and add it to my hoard. Of course, my weight gain was still a mystery. There were countless trips to various doctors and endless dieting and still no positive long term results. No matter how many pounds I was able to lose I would gain it all back…plus.

At the age of 18 my mom decided to buy into a very popular diet. She paid $600.00 for the program plus purchased their prepackaged foods weekly. The food wasn’t bad, but I was forced to document what I ate. I hated eating according to the meal plan. This was a detriment to me, because it was taking me to a very uncomfortable place...eating more during the day. My focus remained on activities of the day including limiting food intake; however the food that I continued to eat at night was no longer acknowledged. It was as if the night feeds didn't really exist even though the behaviors were still very prominent.  

I tried to make myself look forward to eating the prepackaged meals. I was sure to document what I ate and when...forced to bear witness to every morsel I place in my mouth. This was excruciating at best. I hated having to pay so much attention to eating, especially during the day. I hated how it made me feel. I wanted it to stop. I gave though to purging, but talked myself out of it. As my distain grew my ability to eat the foods dissipated. I began starving myself again eating the smallest measure of food possible.  It was starting to pay off. I lost weight and was getting a lot of attention from men. I liked that. At this point I was barely consuming any calories before 6pm. I would chew gum and smoke cigarettes to appease my need to mouth. It wasn’t long before reaching the point where I was unable to keep any food or drink down during the day. I wasn’t purging voluntarily, but I do wonder if I was experiencing some sort of psychosomatic development. I actually thought I was having a reaction to the prepackaged foods. In hindsight I now recognized that I was in full daytime Anorexia mode. The thought of consuming anything in the light of day had become unthinkable.

I managed my night time feeds by eating large quantities of lettuce. Sometimes I would consume an entire head and a half in one sitting. I’d fulfill my need for night time comfort while giving way to appease a new fear of consuming calories. This is how I was able to lose weight for a while, but even that soon ended.   

I eventually stopped losing weight. It didn’t matter how little I ate. I guess I hit a plateau. That is a common occurrence when dieting, but seemingly unrecognizable as such to me. It just drove me to pursue more deprivation. In an attempt to detox for rapid weight loss, I went on a fast only consuming small amounts of apple and water when I felt weak. I did this fast for 13 days, stopping only because my eyes were turning yellow. I stood on the scale…not one ounce lost. I had given up and slowly began to resume old eating habits, still depriving myself during the day while hoarding and planning my binge for the night.

The battled between daytime Anorexia and night Binging continued for many more years.

I Get So Frustrated!!!!!

Writing about myself is one of the hardest things I've ever tried to do. Yet I can't stop trying. I need to get my words out, if for no one other than myself. I get so frustrated when reading others blogs. I love to read them and enjoy the content of their posts, but I find myself getting lost in envy over their fluidity of total expression. I wonder, do they struggle like I do? Do they sit at a little wooden desk and fret for countless days, months and hours...agonizing over every word, writing and re-writing...walking away and returning? Whenever I'm not in front of my computer I feel like I am about to burst at the seems. There is so much that wants to come out. Why is it so hard?!

Just when I think that I've figured it all out and am ready to open up the flood gates I go dry again. Where is inspiration? Isn't it enough to live the story that I want to tell? My words feel emotionless and sterile. Yes, that would best describe it. Perhaps I'm trying to hard. Perhaps it just me and my disconnection to life. My mind won't allow me to feel the fullness of my emotions. I guess it would be too much. Maybe I should just close my eyes and breathe... All I can see are words floating around in space...taunting me...haunting me. Memories flash before my eyes, yet I still feel nothing. I think I want to cry and scream, but I can't. There's nothing there...

I looked into the mirror once and saw a women mentally bludgeoned. I've been violated in every possible way. My spirit battered, broken and left for dead. My girth increasing and decreasing...increasing and decreasing...increasing and decreasing... I am OBESE!! I am UGLY!! I am UNWANTED!! I am UNLOVABLE!! There's no escape. I'm going crazy, I need to release. Please God help me!!!!

I can walk through a house of mirrors and never see my own reflection. Conditioned to ignore the obvious. I live an illusion. I always have. Where there should have been love...there was none. Where there should have been protection...there was none. Where there should have been comfort...there was none. Where there should have been laughter, joy, fun, adventure...there was none. I have been imprisoned by life, my parents, my conditions and even my own mind... Flawed from head to toe...inside and out. I am queen of the misfits...discarded like a broke Christmas ornament. I want to see beauty, but I can't. I know beauty lives inside. I want to be beautiful on the outside. I can't see myself because I don't want to. I don't want to face the ugly truth. My friends, they tell me I'm beautiful, but they are just being kind.

I crawl out of my hole and begin to pick up the pieces. I try to make sense of what's left of my life. I put on the face of strength for my child. I don't want him to see me broken even though he already knows that I am. You see, he knows first hand the pain that is mine. When he was a toddler we used to visit my parents on the weekends. It would take most of the day for me to manage the thought... Hours of crying and vomiting and then slowing getting ready to face the beast. My dad, never satisfied, would always criticize me. One day it had gotten so bad that my precious little one ran over to me, jumped onto my lap and wrapped his arms around my neck...screaming and crying. He turned to look at my dad as if to say...leave my mommy alone. I hugged and kissed him and told him it was okay. We went home. There were many occasions like this, but I dare not miss a weekend. My parents insisted that we break bread together every Saturday. My mother still presenting the face of perfection. Still perpetuating the lie. Will it ever stop?

My parents are gone now. Would it be wrong for me to say that I am grateful? Should I feel guilty for feeling this way? My son can since that I am still haunted by my past. It is on those days that he hugs me and rubs my face to ensure me that it's okay. I look at him in think how precious he is. He is perfect. He will never know the beatings, ridicule, disconnection, blame and hate that I endured. If only I too had been so precious to my parents.

I relish the joy and peace that we have in our home. My son will never have to question if he is loved. He will never feel the pain I felt. I thank God for that. I thank God that he made me strong enough to break the curse. I thank God for the blessing of my son and the gift of motherhood. Thank you God for showing me what parenting should be... How love should feel... What peace is...

It is because of my love for my son and my quest for healing that I take this journey. I want my son to have the absolute best of me. I want to be free. Not stuffing my pain, but releasing and letting it go...completely. That is my goal. And I will achieve this even if it takes me one letter at a time...

Food: A Link between Discomfort and Dysfunction

Many disorders are born out of dysfunction.

I grew up in a highly dysfunctional family. I'm sure you've heard stories like this before. I was trapped in the middle of my father's absolute control and my mother's need for perfection. An illusion forced upon the meek. On the other side of the door was our audience. No one knew the happenings behind the closed door. No one except a cousin who occasionally saw more than she bargained for.

My parents were entrepreneurs. They owned a barber shop and a convenience store. Dad worked and mom was a homemaker. We had two cars, but only one worked at any given time. My mom in her eternal quest for perfection, would wash and shine both cars so they looked brand new. It didn't matter that her car wasn't drivable as long as it looked good. It was perfectly acceptable that there was no leaving the house without permission. Mom would lobby for cab fair whenever she needed to run errands. She was allotted a small of time to get everything done. There was always a mad dash to clean the house, which was never dirty, run the errands and have dinner ready before dad came home...and then we'd wait. Dinner was never to be served before dad's arrival. Sometimes we'd have to wait for hours.

In the beginning...

Around the age of ten life took another terrible turn. It was at a routine well check where I was deemed obese. A word I had never heard before, but knew it was something bad. I weighed in at 101 pounds. Nothing much was said that day. A few days later a new routine was set. Get up, get ready for school, step on the scale and then breakfast. If a pound or two was gained that potentially earned me a beating before school. If that was the case, mom would apply alcohol and salves to the whelps and cuts, then have me change into long sleeves if necessary.

Meal portions were dramatically shrunken. I was always being hungry. Every evening, my parents would enjoy having desert after dinner. For obvious reasons, I was denied this privilege, but had to remain seated at the table until dinner was done. On weekends dad would bring candy, soda, cakes and chips home from our store. It was a welcomed treat.

An opportunity has arisen. My parent's room was right next to mine. On Saturday nights they'd close the door. Late night in the quiet of dark I'd sneak to the kitchen to steal treats. I had to be fast and always have an alternate plan should one of my parents come out of their room unexpected. There were many areas between the kitchen and my room where I could quickly stash the goods and act as if I had gotten up for a glass of water. Sometimes I'd say a quick prayer in hopes that they not find my wares before going back to bed. A binging hoarder in the making and my hoard...food.

My focus on the consumption food became one of the links between heightened levels of discomfort and dysfunction.

Food is now my enemy and my friend...my fixation.

Where do I begin?

A few years ago I was forced to make some hard decisions about my eating disorder, Night Eating Syndrome (NES).

At present time NES is not in the DSM IV/V.

The three main components identifying NES are Morning Anorexia, Night Binging and Insomnia. There is hope for us. Binge Eating Disorder recently added to the DSM-V under (EDNOS) Eating Disorder Not Otherwise Specified has given way to the possibility of two new additions to the DSM-V, Purging Disorder and NES.

I have been ignoring NES for 25 years. Three years ago my health took a turn for the worse. It quickly became evident that I needed to change my ways or else I would surely die. So I claimed my dirty little secret, frequent night time binges, and began looking into steps I could take to make positive life changes.

First steps toward recovery:

Acknowledge having an eating disorder.
Increase awareness of my own eating patterns. Note how I feel before/during and after meal times.
Identify possible beginning of NES behaviors.
Assess feelings, emotional state and reasoning behind late night eating.
Contact Psychologist to begin work on underlying issues.

No matter if you binged last week, last night or just a few minutes ago, it's not too late to get on the road to recovery.

 

 

Related Articles:

 

Night Eating Syndrome: Should it be Included in the DSM-V 

http://www.psychotherapybrownbag.com/psychotherapy_brown_bag_a/2009/10/night-eating-syndrome-should-it-be-included-in-dsmv.html

 



Night Eating Disorder
http://www.allianceforeatingdisorders.com/night-eating-syndrome

Issues for DSM-V: Night Eating Syndrome
http://ajp.psychiatryonline.org/article.aspx?articleID=99701

What is Night Eating Syndrome?

Night eating syndrome, or NES, also "midnight hunger", is an emerging eating disorder diagnosis, which primarily characterizes an ongoing, persistent pattern of late-night binge eating.^[1][2] NES was originally described by Dr Albert Stunkard in 1955^[3] and is currently proposed for inclusion in the next edition of the Diagnostic and Statistical Manual of Mental Disorders.^[4] The diagnosis is controversial; its validity and clinical utility have been questioned^[5] and there are currently no official diagnostic criteria. - Wikipedia.com

More information on the Characteristics of NES
http://jama.jamanetwork.com/article.aspx?articleid=191250

There are several night time eating disorders listed in varying resources. So while looking up more information you may want to check into these...

Nocturnal Hyperphagia
http://en.wikipedia.org/wiki/Kleine%E2%80%93Levin_syndrome

Nocturnal Eating Disorder
http://en.wikipedia.org/wiki/Nocturnal_sleep-related_eating_disorder

Parasomia (SRED) Sleep Related Eating Disorder (also linked to NED)
http://en.wikipedia.org/wiki/Parasomnia

EDNOS Eating Disorder Not Otherwise Specified

Exert from http://www.eatingdisordersonline.com/explain/ednos.php

According to the Diagnostic and Statistical Manual, 4th Edition there exists a category of eating disorders that do not meet the specific criteria for the two defined disorders, Anorexia Nervosa and Bulimia. When people exhibit behaviors in the spectrum of disordered eating but do not meet all the criteria for Anorexia Nervosa or Bulimia, they are given a diagnosis of an Eating Disorder Not Otherwise Specified (EDNOS). Over one-half to two-thirds of people diagnosed with eating disorders fall into the category of EDNOS. More people are diagnosed with EDNOS than Anorexia Nervosa and Bulimia combined.

Binge Eating Disorder (BED) is the only type of eating disorder under the category of EDNOS. A person meets the definition of having EDNOS if they have exhibit all the criteria for Anorexia Nervosa but have regular menstruation or a normal body weight, or if they exhibit all the criteria for Bulimia but purge less than two times per week or for a duration shorter than three months, or if only small amounts of food are purged, or if a person spits out food rather than swallowing it.

People diagnosed with EDNOS can experience the same negative psychological, social, and physical consequences as a person diagnosed with Anorexia Nervosa or Bulimia. The seriousness of their condition is no different than that for people diagnosed with specific disorders. The only difference is that the person may experience a spectrum of disordered eating behaviors and these behaviors may change over time.

Although BED is the only one of the types of eating disorders categorized under EDNOS, people who are considered to have Sub Therapeutic Anorexia Nervosa or Sub Therapeutic Bulimia are also given a diagnosis of EDNOS. To have Sub Therapeutic Anorexia Nervosa or Bulimia means that a person displays some but not all of the criteria for the full-blown condition.

Read more about EDNOS

Huffington Post
http://www.huffingtonpost.com/2013/01/04/eating-disorders-ednos-dsm-5_n_2398373.html

Wikipedia.com
http://en.wikipedia.org/wiki/Eating_disorder_not_otherwise_specified


Educate yourself

It's going to take some time before NES enters the realm of legitimized eating disorders. In the meantime you will need to education yourself on the subject and take carful not of your relationship with food.

Have your information handy when approaching medical professionals for help. NES is not commonly known or spoken off in general medicine. If your medical professional is not familiar with the term Night Eating Syndrome, you may want to try a couple of the other terms listed with exception the EDNOS which umbrellas only one eating disorder, Binge Eating in the DSM-IV/V.

My Experience

A seemingly lack of interest of the subject has been my experience with medical professionals. Though my concerns duly noted, they are still unaddressed. There is no definitive diagnosis so it is simply put into my file as a general note.

Medical professionals can be rather harsh when dealing with weight related issues. They don't understand for many, "obesity" is a band aid for internalized emotional scars. A self made barrier of protection. Obvious distain for one's heaviness and harsh words do not help the situation.

NES is very real and can be a debilitating disorder. I have lived with NES for 28 years and it has taken me until 3 years ago to figure out ways and strategies to begin helping myself.

I strongly recommend seeking council to help with this process. NES has a root and one of the ways to combat any problem is to find the root source. Having a psychologist to help you strategies your way back to a healthy relationship with food is key.

More Reading Materials about NES

Overcoming Night Eating Syndrome: A Step-By-Step Guide To Breaking The Cycle
by, Kelly C. Allison, PH.D., Albert J. Stunkard, MD, with Sara L. Their

Night Eating Syndrome
by Frederic P. Miller (Editor), Agnes F. Vandome (Editor), John McBrewster (Editor)

Night Eating Syndrome
Research, Assessment, and Treatment
Edited by Jennifer D. Lundgren, Kelly C. Allison, Albert J. Stunkard