The Pain and Pleasure of ED

WARNING: This post may be triggering


I've heard many things about pain associated with ED. Especially in cases where weight loss is severe. We've talked about this in a previous post. I wonder why I've not heard someone speak of the pain one can feel after or even while eating. I also want to talk about the pleasure involved in self inflicted deprivation.


On the course of this journey I've looked into several reasons as to why I've had so much difficulty eating an appropriate amount of food during the day. Some very interesting questions have come out of this search. I've posed these questions to myself and answers have been put in place. New healthier habits are beginning to form, but that does not guarantee there won't be times of weakness. For me the hard times don't always feel like a weakness. Sometimes it's more like a desire to reconnect to an old friend or a good feeling.


I admitted in a previous post that I struggled with consuming daytime calories because I gave into the mindset of not being able to eat as opposed to the fact that I didn't want to eat. That feeling still exists much of the time. I'm still able to combat the desire to starve most of the time with scheduled meals. Though the feeling still persists, I have to remember that it took more than a few days to develop this unhealthy desire and it's going to take more than a few days to overcome it.


As I continue my struggle I find more truths revealing themselves. It's interesting how much comes to you when you open yourself to the healing process. So here's another truth. I like how it feels when I starve myself. There's a feeling of lightness, a quiet calm comes over me as I watch the hours tick away without eating a morsel. I even feel like I can breath better, focus better, move better. There have been times I've had afternoon plans and purposely denied myself food so I don't feel weighed down while out. And yes, these things have happened recently.


I'm learning that the healing process does not mean overcoming an issue will dissolve it forever. It takes a concerted effort and the ever present commitment factor to succeed for the long hall. Just as with any type of addiction I have to take it one day at a time. If I fall, then I need to get up, brush myself off and begin the process again. There is no quick fix...no magic potion. I'm glad there isn't a quick fix. If there were, I'd never fully appreciate recovering. I'd never face the truth of how my recovery feels or how it feels to be sick. Both possess pain and pleasure...fear and reckoning.


The reality of the severity of my situation strikes again. Starving myself isn't working for me like it used to. I seldom have that light feeling anymore. What I have is fatigue and shortness of breath. Physical pain settles in as food lands in my stomach; bloating occurs, discomfort increases. I don't want to move, but it hurts to much to sit. I try walking, but the pain only gets worse. So I lay praying for the pain to go away. I don't want to feel this pain. There are days when I still want to starve. I am thankful on those days that I remember the pain of taking the first bite of food after denying myself food all day. I'm also aware of a newly felt urge to purge. I force myself to eat early enough so I don't the feel pain again.


When I eat, my jowl aches and burns as I chew. There are times I have to rest my mouth before I can resume chewing again. I'm usually not focused enough to enjoy food and If I do focus on enjoying my food I may want to eat too much. Can't afford to eat too much...can't afford to eat too little. I'm stuck between a rock and a very hard place.


As I write I'm beginning to feel hungry. It's been awhile since my last meal. This post is a grim reminder that I need to eat to avoid that dreaded pain. I'll grab a pack of crackers. That should do the trick. 


I wonder what makes hurting myself feel so good, empowering...sometimes exhilarating. I can see the link to the cause of the desire to hurt myself, but I don't understand the euphoria I feel while doing so. Where does that come from? I don't recall feeling pleasure from the pain that was issued to me by my parents. How does this psychological development take place?


I'll continue to ponder this thought while I eat cheese crackers.

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