Recently I've been forced to re-evaluate Health At Every Size. I don't dispute that as a slogan it may be true for some people; however, it has emerged that it is not true for me.
In the past I would dismiss arguments about health as a reason for weight loss on the basis of the fact that I am in my twenties and still healthy. Now, the facts are different. A close family member has been diagnosed with a terminal illness, which was triggered by their 25 years of obesity even though they are now in the normal BMI range and at a visibly good weight. This is genetic and the specialist has asked me to lose weight immediately. On top of this is the insulin resistance I have from PCOS which has a strong chance of continuing into full-blown diabetes, and the medication I take to manage PCOS symptoms which increase my risk of the genetic disease even more. Either way, no matter how young or healthy I am, death is staring me in the face.
I discussed this with my therapist, who is naturally reluctant to advocate a non-HAES-based approach. She basically said that I would have to come to my own conclusion. So here is my attempt to reason out a conclusion.
Diets don't work for me. I know from the PCOS diagnosis that the fear drives me to binge eat.
Eating whatever I want won't work for me. It may make me feel better mentally, but certain foods affect my insulin production, and it is my weight rather than my diet that is the problem with the cancer risk. I cannot stay at the weight I am now and be healthy.
This is the approach I am deciding to take:
- Undertaking a sustainable exercise programme that should be lifelong
- Adopting the suggestions made by the nutritionist for PCOS, which mostly involves swapping high-GI foods for lower-GI options, although it doesn't rule anything out
- Making an effort to include vegetables with lunch and dinner
- 'Desensitising' myself to binge foods, including potatoes, chocolate, and baked goods. This will take exactly the same form as the pasta experiment did: eating that food enough so that I physically (and mentally!) get the message that it is not 'banned' or a 'bad' food. This way, I naturally find myself eating less or craving it less. In the short term, this will not help my plans one bit. However, I think it is the only way I can reconcile intuitive eating and a gradual but permanent weight loss - reducing the fear that surrounds certain foods.
- Not focusing on weight loss. No scales, no goals, no calorie or carb counting.
- Fighting the 'diet mentality' where food has a moral value
- Being 'stricter' with intuitive eating. At present I'm doing OK, but if I were truthful with myself, some emotional or non-hunger-based eating does slip in. I know that intuitive eating is NOT an 'eat when hungry, stop when full' diet, but I can't lie to myself.
- Continuing to work on body image and self-acceptance.
This is going to be hard. I can sense resistance in myself at the idea that my chocolate will be "taken away from me". I just have to break that siege mentality and reassure myself that I can have chocolate whenever I want, only if I truly want it. This will take time, but I think it is the only way that I will become healthy - which for me, yes, does mean losing weight. I am sure it will take years, and will be made insurmountably more difficult by the years of painful weight loss scripts playing over and over in my head. In the end though, I am devastated that my family member is not going to be with me for years to come, and I know it would equally devastate my family if the same were to happen to me because I failed to look after myself. HAES at its core is a philosophy of self-care. It is time to give myself the care I deserve and need.
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