The Low Carb W.O.E.ating Disorders

Believe it or not, this post has been in my draft bin getting retooled and almost published several times over since last March!  But I've always never quite gotten it to publish ready, or whatever sparked the rant died down a bit so it got shelved for another day.  But recently the topic of eating disorders was inadvertently brought to the fore by Jimmy Moore in his Jessica Biel spiel.  So dust off this one I did ...  and still, it sort of languished until something happened the past couple of days over at PaleoHacks.  Someone asked about purging -- as in bulimia -- contemplating inducing vomiting to rid themselves of the holiday indulgences.  There were several, I thought, constructive responses and no nastiness ensued that I was aware of.  Perhaps the initial question was a joke or whatever, but in rather short order the question disappeared entirely!  Not closed, but vaporized.  Which left a bad taste in my mouth.  Not because of anything against the PH people, they are free to run their site by their rules and such, but because there seems to be a pattern I'm seeing in such circles of avoiding the topic of eating disorders altogether.  ED ain't paleo.  Shhhhhhhhh.....



I've long felt that had I discovered low carb at a younger age, I would never have struggled with my weight.   Protein really is my lifesaving macro.  I say this because I am not one of those who was predisposed to be obese.  Had my unnatural relationship with food not developed, there would surely be no CarbSane.  And yet I rethink on that from time to time when I see the obsessive behaviors of the young folks at PH and folks of all ages on various low carb forums and blogs.  It seems to me that if there is a "hip" thing to be these days it's a Grok or Grokette ... vegan/vegitarianism seems a bit passe and low fat is just so "old school", Jennifer Hudson and Jillian Michaels not withstanding.  And yet when I read posts by people who fast at the dinner table at family gatherings, agonize over eating one pastry, etc., I wonder if it's much more the obsession over some facet of eating  than what the facet is after all ... and sufficient protein is only so protective against this insidiousness.  In other words, for the low carber it's any carbs, for the Paleo it's whatever's non-paleo, for the calorie counter it's the calories, etc.  Had I "gone paleo" back then, would I have bored my very same friends equally to tears with my obsession over eating only grass fed meats or agonizing if dressing at a restaurant contained some soybean oil, or railing against all grains?   At least then I ate my pizza washed down with diet Dr. Pepper and vowed caloric purity for the next week or so in repentance and bored them to tears other ways with my obsessions.

To me, the concept of orthorexia is very real.  Unless you are that oddball who can adhere to some strict program for whatever it is we're talking about, orthorexia, to me, means magnifying way out of proportion the implications of even the tiniest deviations from course on such plans.   I'm starting to see more and more stories of cheats leading to binges, of falling off the wagon and not being able to get back on, of binging behaviors creeping into folks' lives who never had such issues before.   Some speak of eating uncontrollably for as long as they can remember.  That wasn't me, something changed, and it was done in the initial pursuit of a healthy weight -- or what I thought that was.  It pains me to see these folks falling into that same trap wrapped in a loin cloth or a strip of bacon.  I'm no longer sure that the same teenage girl I was wouldn't have fallen into that trap.

Anyway ... back to the low carbers.  And a lot of this is a bit dated, but since I took the time to write it at various points in time,  I'm going to just publish it up.

Since I was reading and participating on LC forums (mainly Jimmy Moore's for participating) long before I started reading, much less commenting on, various blogs and blogging myself, I feel like I'm privy to some not-so-secret secrets of low carbers that others simply are not aware of.  I'm sure more than a few LC cruise guests or conference attendees have been caught off guard by the size of Jimmy Moore.  It's not that he hides it, but he does not advertise it either.  By that I mean, he has the mea culpas here and there, posts some pictures and such, even discusses his troubles.  But most people don't read everything he writes.  Many, for example, pretty much only know that he's a 180 lb success story who hosts a popular podcast and has a catchy name for his webpire.  Every time I wonder why anyone writes to Jimmy for advice about weight loss I have to remind myself that most of those who do have no clue that he's really not the person to ask.  Reading his success story and looking at his going on 7 year old avatar pics these days, they would have little reason to wonder.  Heck, he's announcing his new podcast with the LC experts on YouTube recycling that "deep thinker" pose from 2005.  

If I seem to be more critical than others of some of these LC "celebs", it's because I read a lot about them and eventually by them on the wonders of the low carb lifestyle.  Less so now than two years ago when I was seeking answers to questions of my own.  Keep in mind, that aside from planned cheats, I was a pretty died-in-the-wool VLC'er at the time I first came to "know" these folks.  The problem is, however, that when you look a little deeper into so many of these merchants of metabolic magic, you start to feel like some straight guy who falls for Ru Paul, or even Sally Field in Mrs. Doubtfire.

A favorite acronym about such forums is WOL or WOE, which pretty much mean the same thing: Way Of Life/Eating.  The sentiment being that proponents no longer viewed Atkins and related plans as "diets", but rather their lifestyle forever and a day.  It's catchy, and with successfully maintained weight loss the traditional way, the permanent adoption of new habits to replace the old is the *gold standard*.  The trend now seems to be some version of viewing LC no longer as a weight loss diet, but as a permanent (necessary) way of life to cure all ills.  

Now because it's not promoted by the mainstream, the LC loving population tends to be heavily populated by veterans of many other diets and such who generally are floored (as I was) by the rapid and substantial losses that occur that first time.  The ad libitum nature of the diet is a huge draw -- You can eat all you want!  Thousands of calories and still lose!   No more starving with the calorie counting.   For the women, it's likely not much more than the fact that we get to eat enough protein vs. the 15% standard which is insufficient at weight loss-inducing caloric levels.  For men, I tend to think the draw if mostly getting to eat "man food" like steaks and bacon rather than boneless chicken breasts and steamed veggies.  

Maybe it's because LC seems like the last-chance diet for so many, or maybe it's the you-can-eat-all-you-want nature of the diet, or maybe it just appears this way, but folks with eating disorders seem to be more prevalent in LC circles.  Even if not more prevalent, they definitely seem to be in a greater state of denial.    I'm going to name a few names here as I list some variations on what I have come to think of as LCWOED's. ED's associated with identifying with a dietary WOE or WOL ...

1.  The Yo-Yo LCWOED:  In my opinion, whether it is by going on and off a plan or various plans, with or without outright binging, folks who repeatedly do this have a variation of bulimia -- it's the same phenomenon on a more drawn out timescale.  You're on a diet or off one, being "good" or "falling off the wagon".  The phases are just matters of days, weeks or months instead of day to day or even sometimes hour to hour.  That a classic bulimic vomits to avoid weight gain is not much different than adopting some extreme diet or fasting to undo the damage of days or weeks of "eating badly".  There are two subtypes of this LCWOED:

a.  The On/Off the Wagoner:  This type is dedicated to LC as the only way to dietary redemption, but ultimately unable to adhere consistently to the WOE.  Rather than finding a more moderate approach they can do consistently, the continue the classic yo-yoing they claim to have left behind with traditional low fat diets.  The most prominent low carber who fits this bill, as near as I can tell, is Amy Dungan.  But she has plenty, and I mean PLENTY of company on the various LC discussion boards.  "I'm baaack, again" is the repeated posting of this sort.   For too many, each return engagement is more short-lived than the last, and each absence more lengthy.  These folks often tend to weigh more now than they did before ever finding their LC salvation, but seem more convinced of LC as the way out.

b.  The Dedicated Yo-Yo:  This one is more troubling, but there are folks who remain pretty steadfastly low carb and yet pack on more than a few holiday pounds repeatedly throughout the years.  Jimmy Moore is King Yo Yo, and I guess Dana Carpender would head up the female wing of this contingent (though no where near to Jimmy's extent).  

2.   General Eating Disorder Denial:  Perhaps the "it's not your fault", "you had nothing whatsoever to do with getting fat" mentality that pervaids LC circles, but the ranks of those with obvious ED's are huge in the low carb world.  Whether it's downing an entire bag of macadamia nuts, or the entire pan of LC brownies -- a "good binge" if you will -- or going on an all-is-lost binge because you noticed the sausage you just ate contained a gram of insulin spiking HFCS -- binge eating, even bragging over eating thousands of calories on LC is rampant.  These folks, especially the latter, are the ones like King Yo Yo who struggle endlessly looking for that mystery metabolic mahem that is causing their weight to climb inexplicably.  The answer will lie in why you still overeat on low carb.  Yet overeating is such a dirty word in LC circles, these people can't see the forest for the trees of what underlies their weight problems.  I also think sometimes folks are afraid to admit ED because of the associated stigma.  At least I hope for some of these folks, they can eventually admit it to themselves.  Nobody else needs to know and we don't need YouTube videos of the rehab process whatever that might involve.

3.  The Recovering Carboholic in EDD:  This is probably the most pervasive LCWOED of all.  Talk of carbohydrate addiction fills popular diet books, and this eating disorder was triggered in many by none-other than Atkins himself.   By claiming an incurable carb addiction, the remedy is total abstinence.  These folks turn that remedy into an absolute mandate with no other options.  Rather than acknowledging that their behavior with food is ultimately not much or even no different from prior to LC, and dealing with what underlies their problem, these folks in a way play the victim of disease.  I just don't know if it is productive to consider yourself perpetually in some abstinence mandated recovery from a fictitious addiction.  I won't name any names here, but there are those who maintain for quite a while then regain when they turn to food in stressful times.  It is not some carb addiction at play in such cases.  Ultimately this assigning of mythical powers to an entire macronutrient is what is self defeating for most.

4.  The Carbophoborexic:  I've actually credited Atkins for being the last part of what "cured" me of my own eating disorders.  I was mostly over all of that before trying this diet the first time anyway, but the freedom of losing weight while eating ad libitum was especially profound to me.  And yet I've now heard from enough readers here and elsewhere, how going low carb contributed to the development of ED's.  I can surely see that.  Just as in my crash diet days, eating even a 100 cal snack was doom and gloom (heck, 20 cal could send me sometimes!) and reason to binge because I'd blown it anyway.  I can only imagine had I gotten sucked into this insulin thing ... even Atkins' admonitions about being knocked out of ketosis fail by comparison to this notion that one might have a wee bitty extra insulin locking fat away for hours or days on end.  Carbophoborexics will blame the scant carbs in cauliflower for weight gain and not the tablespoon of butter topping that half cup for weight gain.  Whether it's some carb threshold that they really think an extra 5g is the problem, or they take the words of Sisson seriously believing the 151st gram carb will lead to insidious weight gain, this eating disorder is the carb equivalent of anorexia.  To stay small (or smaller, or not balloon up further) carbophoborexics believe they can eat but scant carbs.  

5. Romanticizing the Long-ago Lost Stones:  I've wondered for some time what makes a person like Amy Dungan of Healthy Low-Carb Living tick.  For those unfamiliar with Amy, she lost weight back in 2001-2  with Atkins, maintained it for several months, then gained it back and more until 2007, the year she achieved her second weight loss success.   Recent pictures resemble the 2007 before picture and she has discussed gaining that weight back.  Yet she preaches the healthy joys of LC from her blog in an effort to help others, with only rare mention of how it's actually not working for her.  Oddly enough, in the midst of that second weight loss, Amy was blogging still about her losses of five years prior with no indication that she had begun the year weighing over 200 lbs.  I can especially relate to this aspect of Amy's weight changes as I never got much over 200 all the other times after weight loss rebounds, but after LC, tens of extra pounds were easy to pile on.  What I can't relate to is advocating for a diet if I was larger than my original before picture or giving out weight loss tips when I hadn't conquered that demon in a lasting fashion myself.  She's been doing just that for quite a while now, though it would be fair to say that for most of the decade or so of being a low carber, Amy has weighed more than her initial pre-Atkins weight.  I do wonder if she ever thinks about this and entertains changing approaches.

Then we have Jimmy Moore who, by any objective standard, is an obese man.  And yet he still refers to his 180 lb weight loss in 2004.  The only reason his regain doesn't sound so bad is because he highballs his low weight (actually almost 20 lbs lower than his 230 mark from 2004) and he weighed over 400 lbs to begin with.  Only in that context does his physique at this time qualify as exemplary of the benefits of LC eating for weight management or health for that matter.  Although he's modified the blurbs on his other blogs/sites, Jimmy's (now defunct) menus blog still sported the "About" blurb stating how he had lost and kept off the 180 lbs.  He even snapped at a reader for daring to suggest he might want to update that.  The fact of the matter is that Jimmy has been struggling with his weight almost since he lost it -- in the form of 20-30+ pound weight swings for years.  It is also true that with the exception of a few months here and there, Jimmy's true weight has been somewhere around 270-280 lbs for almost 4 years now. These two, and countless less public low carbers, are stuck remembering that first LC success trying endlessly to get back there, and they've convinced themselves that LC is the only way.    Judging from events of the past year I think it's safe to say he won't be considering changing approaches barring some drastic turn of events.   Perhaps this last ED is really an ID = Identity Disorder.  Folks for whom their way of eating is so intertwined with the very core of their identity, they can't separate the two.  I imagine in the quiet moments this is not a pleasant place to be.

So ... while I'm certain there are many well adjusted low carbers and paleo aficionados out there with perfectly healthy relationships with food, there are many who suffer from one or more of the aforementioned LCWOED's.  Eating disorders are nothing to make light of.  They are real, paralyzing and destructive to health both physical and mental.  I see too many who struggle with low carb looking to the wrong solutions for the problems.  Sure, changing what you eat, especially the nutritive value of it, can go a long way in fixing what's broke.  But replacing ordinary eating disorders with a way-of-eating disorder doesn't fix the underlying problem(s).  Ultimately, the WOE becomes an ED in its own right.  

And I guess in closing that was the point I was getting at.   Success DOES really lie in permanently changing one's lifestyle, because after all, it's going back to the old habits that got us into our respective messes in the first place that's the  problem for most.   For some the ED pre-existed and was just redirected, for others this new path had some unexpected turns.   BTW, I am not the L.Ron equivalent of ED's seeing everyone as having some level of eating disorder!  Heavens no!!  The disorder is not the foods you eat or don't eat, it's more the mental effort that goes into those decisions.  But I do think that stubbornly adhering to a lifestyle that is bringing about diminishing returns or even worsening one's health is a form of ED.  And maybe this is why ED in LLVLClue-land and, perhaps budding in the paleosphere, might just stand for the Elephant in Da-room that nobody seems to want to address.  After all, the promise of this healthy way of eating, complete with some psychiatrists on board, is that there should be no more deficiencies and dysfunctions now that you are eating as your genes intended you to or your pancreas demands.  There's no more reason for outta-whack homeostasis or appetites exceeding needs.  The problem lies, IMO, with the exaggerated promises of natural leanness, and not with those who find it's not quite working as advertised so they must be doing it wrong or there must be something extra specially wrong with them.  Because then what?  And how do the advocates explain your failure to achieve nirvana??

Just as traditional extreme diets were the gateway to ED's for so many of us, so too, it seems the VLC and paleo lifestyles can be.  So instead of worrying over throwing babies out with the bathwater, perhaps it's time to acknowledge that elephants rarely fit down drains.  While advocating a route to optimal health, realize that the path can easily diverge to the unintended.