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Thursday, March 7, 2013

Weight Loss and Recovery—Can they Coexist? Is Recovery Even Possible After So Long?


Remember Maggie who lost over 150 lbs.?

She’s experienced them all—she’s been labeled with anorexia, bulimia and BED (binge eating disorder)—now an official diagnosis in the new DSM-5, the manual of mental health diagnoses. And she’s been categorized as obese. She did not seek treatment for her disorders early in her history, when recovery is known to be more likely. Yet she’s done it, she recovered. And she didn’t truly start the process until she was in her 60’s.

Hooray for Maggie! Recovery is possible!
I'm writing about Maggie, once again, to offer hope that recovery is possible. Because it is. And because you may believe that even if you did recover, that you would never maintain it. And that it’s not even worth starting on the path, because you just might fail. There. I’ve said it. Now let’s move on.

About Maggie, present day.


This lovely, now 74-year old woman with a long history of eating disorders, has maintained her consistent recovery—and then some. If you haven’t read about her history through Feb 2011 in the link above, please read it now to appreciate where she’s been.

First, the stats. As of today, Maggie's weight is down from her initial weight of 387 pounds (back in 2002 when we started our work together) to 212 lbs. Yup, that's 175 lb. decrease. Most notable, though, is that she achieved this through healthy measures, normalized food intake, a move from binge eating and without disordered behaviors. I don’t think you’ll find the Biggest Loser winners accomplishing such behavioral goals, given the crazy-extreme measures they take on the show.

But let's look at the markers of health that really matter: her A1c, the measure of blood sugar control over a three month period, is now normal for this diabetic woman (it was out of acceptable range even for diabetics, previously). And she is no longer on the blood sugar-lowering medications she had relied on twice daily. All of her lipid measures (think cholesterol) dramatically improved, too. ‘Maybe it's the meds?’ ‘Don't statins do a great job at that?’ Well, her statin dose was cut in half. And statins do little to nothing to improve HDL, the 'good' cholesterol—yet hers improved significantly. As did her triglycerides (down 150 points), also not attributable to her medication! At 212 pounds, her cardiac risk ratio is lower than most individuals’ by far.

Maggie eats more than she ever recalls allowing herself to eat at any other time in her life—aside from pregnancy. She consumes regular meals and snacks daily. She does a water exercise program a couple of times per week—she's even overcome her anxiety of being in the water, with the assistance of a great therapist.

It's a lot of hard work, and you might get off course.
But you'll be glad to get there in the end.
It's been neither a few months, nor a whole year. Rather, it's been 11 years since we started our work together. Yes, it's a process (although not this long for everyone, I'll add). But Maggie only started her journey when she was 62, after about 50 plus years living with disordered eating and beliefs about what she deserved to eat and how to nourish her body.

Patience, dear readers. You can’t expect to undo a decade or a lifetime of unhealthy thoughts and behaviors in a couple of months.

Maggie’s next step is to believe that she's just fine as she is—high BMI and all; that weight loss shouldn't be the focus. It’s not so easy, though, given that her whole life her worth was tied up in the number on the scale. Even when those who constantly criticized her appearance were gone, she picked up where they left off with her own negative self-talk. It seemed the damage was done.

But can’t she still lose weight?


If she continues with her eating on course, and she feels well, and her weight continues to decrease—there's no problem with losing more weight, as long as her thoughts are kept in check. But I'm emphasizing that the goals that really need to be met, have been: she's taken control of her health, she's more fit than she's been in years, and she's eating more adequately than ever before. There's no binging or deprivation, and no compulsive exercise. And she feels well—physically and mentally. So we’ll just need to proceed with caution, because weight loss is a slippery slope for triggering eating disorders.


I hope Maggie will check out this blog (she has given me permission to write about her again, with her name change of course!) And I anticipate she'll see from your comments how she has inspired you and others to not give up and to have hope that change is possible. Yes, recovery really is possible.

Please share your thoughts with us!

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