Paleo™ ApprovED ... Enough.

11/29:  Another minor update.  There has been a ton of feedback both here and on Facebook and I'm personally quite touched that the overwhelming response has been positive.  These subjects are never easy to broach.  I will be posting an update as I have had many questions as to why I removed the picture that I did and inserted my sarcastic graphic in its place.  That too is a serious and extremely tenuous/touchy issue to address, but it really needs to be as it goes to the heart of this issue.  

In any case, just so everyone is aware, yesterday the MDA post was updated as follows:

This response is disheartening to say the least.  I think that most would agree that most if not all comments were respectful.  One of the last comments that was allowed was from one guy berating another for saying that she looked better before.  I don't see that as being any less appropriate than comments congratulating her for her after appearance.   Mark could have just closed the comments, but instead he (or whomever really runs that place in his name) attributed the term *trolling* to those who expressed concern.  No, name withheld here should not have to defend herself because someone over at MDA should have had the good sense not to publish this at all.  This is yet another characteristic of this community that is troubling.  I read many expressions of concern for this young lady's well being, concerns I share, and Mark's comments here will only serve to deepen her denial.  Shame on you Mark Sisson.  Shame.

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11/28:  I hope all of my readers have a wonderful day today.   I'm uncharacteristically not too busy, as I am not hosting for a rare change.  But I have stumbled upon a bit of bad timing with my last post.  It requires followup and that will be forthcoming sometime this weekend.  But not today.  

Enjoy your self.  Enjoy your family, your friends, your pets, whatever.  The only thing I plan to do today regarding food is to make sure my stuffed mushrooms and shrimp-deviled eggs are perfectly delish, and that I leave room for my sister's amazing, once-a-year-at-T'giving, pecan pie.  I hope you will do similar whatever and whomever you are.

Be HAPPY.  Be THANKFUL!

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Minor Update 11/28:  You may also wish to read:  When Orthorexia Goes Bad  It fleshes out some background and some additional thoughts on ED in general.

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Original post ...

Blogstress note:  I had not intended to spend time on this until after my "desk clears" of projects in the works and my real life job.   I had to make an exception, as I am genuinely angry, and this is where I can express that anger.  This will read a bit disjointed, but I ask that you give this a full read before responding and bear with this aspect of it.  It's not my most concise or well written effort, for which I apologize but ... time ... or lack thereof is my excuse.  Some of this was written a while ago, the rest yesterday and today.  It got too long so I am publishing it up blemishes and all while it is timely, and hope to post a Part II shortly.

This post, or one like it, has been written and left unpublished, or even deleted, so many many times in the past couple of years or so, I've lost count.  I am using the acronym ED = Eating Disorder, not that other one you can't seem to avoid in commercials these days.  I had been struggling to put the exact words to the phenomenon of eating disordered behavior in the Paleo™ (I use this to denote the identification with the popular paleo lifestyle, as opposed to Loren Cordain's trademarked The Paleo Diet) community for quite some time.  Perhaps a year ago now, in a random conversation on the internet,  it gelled out a few off-hand comments of similar meaning:  

In essence, Paleo™ has become a community in which eating disorders are not only socially accepted, or even just ignored, but actually promoted.   

This is not to say that everyone who identifies as "paleo" has an eating disorder, but that the culture in this community is (a) conducive to developing an ED, (b) accepting of ED behavior to the point of even glorifying it, and (c) outright promoted by various "leaders" of the so-called "movement".   And no, I'm not talking some abstract orthorexia that the Paleo™rati easily brush off as the jealous gripes of some Monsanto-funded-grain-and-sugar-addled malcontents.  I'm talking full fledged, bona fide eating disorders of the DSM variety.

I have from time to time been bold about speaking up, and yet reticent.  This is a deeply personal issue but I have had to deliberately dial back on that side of my blogging due to the vicious personal attacks and harassment.  But I can stand by silently on this issue no longer.   I have always been somewhat sympathetic to the fact that Paleo™ has helped many people with health issues and "what could be wrong about telling people to eat real food" ... I was raised by parents, Mom especially, that were into nutrition and I suspect Mom would feel rather right at home at a WAPF conference even to this day.  It has been quite a journey for me in the kitchen these past few years, in many ways cooking like Mom used to when I was a kid.  You mean she was right about those things?!!  And I've added a few more things like using bone broths for soup bases and cooking liquids for just about everything if I can keep up with the supply.  I find it quite heartening to see young folks, especially the young men that infamously wouldn't give a darn for many years, getting interested in nutrition and health ... and the families, how cute are they?    I'm also personally drawn to the women that claim to eat ad libitum and freely of these real foods and bubble away about their boundless energy and freedom from SpecialK, Weight Watchers and Lean Cuisine.  Quotes like this one from this article epitomize the "sell":

"We're brainwashed as women to think that if you want to look good, then you have to restrict your calories and do hours of cardio," Fragoso says. "For the first time, you no longer feel like you have to deprive yourself. I don't have to eat low-fat, low-carb food, pound the treadmill for an hour a day, and have anxiety and depression."

Fragoso being Sarah Fragoso of Everyday Paleo fame.  You can read more about her here.  I'm not pinning anything on Sarah per se here by quoting her, unlike some of the other women I have not seen evidence of eating disorders or downplayed negative health consequences.  I have been disappointed by content on her website written by others, but that's a topic for another day.  However there are others who echo the sentiments (sans the low-carb) above ... over and over ... glowingly embellished ... proud and paleo!  

And then you peel back the "label" just a little bit ....

In a recent Scientific American article, Ferris Jabr hits the nail on the head with this:

Proponents of the Paleo diet follow a nutritional plan based on the eating habits of our ancestors in the Paleolithic period, between 2.5 million and 10,000 years ago. Before agriculture and industry, humans presumably lived as hunter–gatherers: picking berry after berry off of bushes; digging up tumescent tubers; chasing mammals to the point of exhaustion; scavenging meat, fat and organs from animals that larger predators had killed; and eventually learning to fish with lines and hooks and hunt with spears, nets, bows and arrows.

Most Paleo dieters of today do none of this, with the exception of occasional hunting trips or a little urban foraging. Instead, their diet is largely defined by what they do not do: most do not eat dairy or processed grains of any kind, because humans did not invent such foods until after the Paleolithic; peanuts, lentils, beans, peas and other legumes are off the menu, but nuts are okay; meat is consumed in large quantities, often cooked in animal fat of some kind; Paleo dieters sometimes eat fruit and often devour vegetables; and processed sugars are prohibited, but a little honey now and then is fine.

So when Fragoso goes on to say (same article as previous link):

"Honestly, if this wasn't my career, I wouldn't call it anything," she says. "But it's also good that there's a name for it because it helps spread the word." (She suggests renaming it the "Real Food diet.")

I protest.  There are many real foods on the Paleo™  list of "don'ts" and some paleos, Fragoso included, seem to make concessions to a self-selected (e.g. arbitrary) few.   While many real foods may be part of Paleo™, there are too many that are not only excluded, but vilified.  The Wheat is Murder tees being one of the more offensive examples I can think of.

It is the "don'ts" list in which the seeds of eating disorders can be sown.  There is nothing more noble about instilling phobias about grains (wheat especially), sugar (even fruit), starch, and dairy, than there is noble about vilifying meat, eggs and fat.  And if in your head you are saying "but" ... shush.  Shuttie.  There is not.   There is no but here.  I am not talking fake foods you can't find in nature such as margarine and sucralose so don't even go there.  I am talking about real foods.  Eggs were demonized because they contained cholesterol on the misguided notion that dietary cholesterol raised blood cholesterol levels.  Seemingly to a one, those opposing starch and sugar consumption have failed to learn from this monumental blunder as they insist that diabetes is caused by consuming carbohydrates.  It is not.  Again, a topic for another day.  Bottom line, there is no evidence that even a substantial minority of the human population needs to eliminate one of the Paleo™ proscribed foods (grains, dairy, sugar, legumes), let alone all of them, while there are people that are sensitive to foods that are "allowed".

If you are celiac, or allergic to peanuts, or lactose intolerant, or fructose malabsorbant, or allergic to shellfish -- DON'T EAT THOSE THINGS.  A person who avoids something that is personally harmful to them is not eating disordered.  Obviously.  But did you hear?  Tick bites can make you allergic to red meat!  What if this spreads to 5% of the population?  Will the Paleo™ now change their tune on beef?  Somehow I doubt that, nor do I think it would be wise.  Which is my point.  That some can't consume certain foods or must limit them is not evidence or reason for the rest of the population to follow suit.  And how is this Paleo™ anyway?

The term toxic is thrown around this community with no thought as to its meaning anymore.  It is, in and of itself a toxic term.  So often misused to drum up fear.  And if you can define certain foods as toxic then you can use labels for the opposite such as "clean eating"  ... that morphs to the embodiments of purity and righteousness ... and off we go.

When it comes to advice, nobody would think that recommending further restriction is a good idea for someone that is already afflicted with some manner of disordered eating brought on by restriction.  And yet this is the "cure" so often promoted in this community, especially the sizable and vocal low carb contingency.  This is irresponsible at a minimum, and if the people making the recommendations were real, practicing, licensed dietitians treating people with ED, they would likely not be licensed and practicing much longer.  That this information is often disseminated by those with active eating disorders themselves is unconscionable.

One more "catch up" before delving into what brought me to this post today.  A little while back I was in a discussion on Facebook about clean eating and orthorexia.  The host was of the opinion that orthorexia is a made up disorder like adrenal fatigue because it was not recognized with a DSM designation.  This is fair to a degree, but as I basically argued in that discussion, does one need to fit a diagnosis to a tee to be ED?  And the flip side, if one was ever ED, did that disqualify them from future study and discussions on nutrition?  I'll address those briefly when we get to relevant points here.

Where I was coming from, however, is that some time several months after my first diet, I lost sight of reality.  I was clearly underweight for my frame/musculature, but unless I was in a bikini top you wouldn't really see this.  I still had muscular arms, the collar bones weren't too out of the ordinary vs. "normal" skinny people, and I still had thighs so overall I was not as yet "skinny".  But my rib cage and hip bones were visible, as was my sternum.  I was eating around 800 cal/day and exercising in addition to sports.   I wasn't anorexic by weight criteria, I had yet to succomb to binging (it would follow in short order).  I obsessed over 20 calories here or there.  I was fatigued.  And yet, to most I was the image of health.  Blonde hair, tanned skin, bright eyes, big smile, decorated three sport varsity athlete.  Yet eating disordered.  Would my medical chart have reflected it?  Not at that time.   If we accept that anorexia is a mental disorder, then at what point does one become anorexic?  Is it only when the person has become sufficiently emaciated?  I would argue no.  It is the behavior of restriction and coping mechanisms to suppress hunger and evade discovery.

In this regard, bulimia and binge eating disorder (BED) are much easier to diagnose.  And yet, there's all manner of fuzzy as well, because these disorders are not definitively tied to weight.  Most bulimics look profoundly normal, and while BED can lead to obesity, most obese are not binge eaters.  Then there's the matter of frequency and degree, which also occurs with the pre-anorexic.  How many hours a day spent obsessing is the threshold?  Stuff like that.

Before I go on, let me say that between the "fitspiration" stuff about the web, your mass media fitness idols like Jillian Michaels to the flip side where naturally slender is confused with underweight, and clearly overweight is celebrated ... it's getting more confusing than ever this body image game.  I've seen people say "this one's too skinny" where I would say they just look very fit, perhaps in competition form, and on the other hand I've seen people react badly when an overweight famous person endeavors to lose weight when there is no compelling health reason to do so other than to feel better about themselves.  I cannot possibly address that in a post of this nature, so I won't address it at all except to say there are two absolutes:

1. When overweight manifests in real health problems  
2. When underweight is health and potentially life threatening

Ditto on the spectrum of eating behaviors, except to say that you have a problem if you are experiencing hunger throughout the day and obsessing over food, and you likely have a problem if you engage in any secretive behavior regarding your eating habits.  If you wouldn't want your spouse, parents, sig. other, sibling, best friend, etc. to know ... you have a problem.  Hiding one's behavior is a red flag ... and no, others are not just jealous of your commitment to your physique or health.  You certainly have an eating disorder if:

1. You admit to it, even if not by name (e.g. binging)
2. You have actually been diagnosed as having one

So ....

image from this article

What got me so riled up?  Well, I always get a little annoyed with Before/After transformations, because the truth is, most aren't real, and of those that are, many tend not to last.  And then you have the clearly exaggerated or photoshopped.  Remember this one of someone trying to look like they gained a ton of fat?  See, carbs are fattening!  

Some may have seen this other one as well ... it's a real eye opener.  It's personal trainer  Andrew Dixon, who transformed himself from slovenly to ripped in ... under one hour!! 

for more info, check out this article

Then you get the real transformations that just don't stick and there's little way to verify that they have.  In the paleo community, you have many that were never overweight to begin with, or only had 10-20 lbs to lose but never had any sort of real weight problem.  The issue here isn't the individuals, it's the selling of some "magic diet" that really has no better verified track record for success compared to anything else.  

Mark Sisson posts these transformations weekly.  Here is the most recent one:  My Transition from an Ill, Frail, Anemic College Student to a Healthy, Strong, and Fit Individual.  

Here is the miraculous transformation.

Here's what made me angry.

I am going to strongly urge you to please go read the story before reading on here.  I'll put in some spacers so as not to risk your reading of my comments.  I'll also ask that you read slowly so as not to miss the details.

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Now you probably see why I asked you read first, then scan down.  You see, I flipped the before/afters.  More importantly than the pictures, however -- because as I tried to emphasize earlier, appearances can be deceptive -- is the story she tells.   

This girl is a lot like me, 30 years or so ago.  Without analyzing too much here, she was so very NOT fat before.  She was a well proportioned athlete with the kind of body one might expect for a tennis player of short stature.  I was a little taller, a little less well proportioned, a little heavier, but a lot like her "before".  In my story, a coach's prodding led to a deliberate weight loss, whereas this young lady's journey apparently began more innocently with unexpected weight loss after wisdom tooth removal.  

"My parents noticed how I seemed to drop a few pounds. Initially it bothered me because I am an athlete, a tennis player, and I thought I was losing muscle. Anyways, after five days since my tooth surgery I stepped on the court with barely anything to eat or drink and a swollen mouth. I managed to play the best tennis I played at the time and moved so effortlessly. I realized that those few pounds allowed me to be lighter on my feet. "

Now, when I started my diet journey, with a pretty reasonable diet initially, I experienced much the same thing when playing volleyball.  The first 5-10 lbs made me feel much lighter, like I could jump higher, move faster to the ball.   I'm sure if you measured this there was little if any real difference, but I can relate.

... I continued to eat smaller portions and transitioning into college that year and being on the tennis team I continued to eat smaller portions ... and worked out about two hours a day with lifts twice a week. I dropped about 14 pounds from late June to December that year (weighing in at 106.5 pounds).

That next semester I dropped an addition three pounds (103.5 pounds). I didn’t realize that when I started that weight loss journey I was so pudgy to begin with, but I liked what I saw in the mirror and I felt so much better about myself with that weight loss.

There are many red flags in the above paragraphs. However incidental the initial losses (5 lbs maybe?), she then deliberately continued.  Nothing wrong with that, particularly if the performance improvements continued.  But no doubt they did not, and there was decline.  But I'm sure that she was getting a lot of compliments and on a new scene, for those compliments to keep coming she needed to keep losing.  This begins the distortion of how *bad* you must have looked, and no way you want to go back there! Then the "just 5 more pounds" or "one more pants size" seems reasonable but you are in that weight loss -- my you look amazing, you've lost so much weight! -- glory/honeymoon. 

At this point, she had lost 17.5 lbs -- that's just shy of 15% of her initial body weight. I'm sure some in her life were already expressing concerns, but we hear none of that in her story.  But here is where it gets real:

When I came home for the summer of my freshman year I hit a plateau and was frustrated with the stalling of weight loss. I decided to drastically cut my calorie count and micromanage exactly what I consumed.        red flag 

By any objective measure her "plateau" would be her body fighting back.  This would be her normal weight if not a tad below.  I recognize where she was ... I've been there ... there was more weight to be lost and damn I will just have to eat less.  And she did.  Where we differ is in our timelines, was I had already done that to lose the bulk of my weight, but this makes little difference.  She was starving herself by her own admission.

With the drastic calorie cut, I started to beat that plateau.  red flag  In addition, I worked out more intensely than ever red flag  between playing tennis and running for 40 minutes or lifting daily.  I started to become over trained. My whole body and brain became fatigued. red flag  I initially took it as that I was just working out a lot and I tried to forget about being tired.  red flag  But, coming into sophomore year of college those symptoms never went away, only simply getting worse.  red flag  At this point I was down 24-25 pounds (96-97 pounds). red flag red flag red flag red flag red flag red flag red flag 

At this point of reading her story I want to scream. I know she's petite, but her body type is NOT that of an "natural ectomorph" as some MDA commenters would relate in support. This is a girl with thighs. A girl who was built with them and meant to have them, and saying that is not some distorted view from an obese American living among obese Americans that has lost perspective entirely.  Natural ectomorphs tend to be that way through childhood and tend to stay lean despite eating large amounts.  Natural ectomorphs do not require drastic restriction to break through frustrating plateaus.   But I digress ...

She is currently, by my math, down ~20% in body weight and under 100 lbs.  Her body fought weight loss with slow (3 lbs) losses in one semester and it took drastic measures, but the "plateau" budged, to the tune of another 7 lbs.  But I guess the MDA folks said to hell with the red flags, there's a "happy primal ending".  

At this point her body started to revolt.  She was tired, couldn't give her all in practice (she says barely 50%) and she was miserable.  Her relationship suffered.  She sought help.  Good.  But this part is probably the most troubling because it reeks of denial.  She says she had bloodwork done "in attempts to diagnose what was wrong".   The diagnosis was anemia, causes unidentified????  Also "extremely high" liver enzymes, causes unknown????  GIVE ME A BREAK.  THESE ARE CLASSIC SYMPTOMS/COMPLICATIONS OF UNDEREATING!!!!  Here is the very first link in a 2 second Google search on anorexia and liver enzymes.

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Multi-Organ Failure
In very late stages of anorexia, many organ functions deteriorate, which can lead to death. The main warning sign is high blood levels of liver enzymes, which requires immediate administration of calories.

Anemia?  Do I even have to "go there"?  Either her health services is utterly incompetent and ignorant of eating disorders in young college students ... or we're not getting the full story here.  Because if she wasn't referred for treatment for potential anorexia she dang well should have been.  No mention of suspected ED?   red flag

Now her digestive troubles begin including flatulence and stomach pains, to go with the fatigue. She's a little over the one year mark and she's continuing to lose weight. She would eventually reach a weight of 89-90 lbs. We are in danger zone there and if she is seeking medical attention, it is unfathomable that anorexia is not becoming part of the discussion.  No mention still.  She is down roughly 25% from her initial weight.   It is a good sign that 89 lbs frightened her, but her telling of the story here screams denial as if some outside force was causing her body to reject food and for her to keep losing weight.  There is no mention of her trying to regain weight ... tell tale ... when, in fact, as she tells us, her body took a "pause" at a reasonable weight until she forced it through drastic measures.  red flag red flag red flag red flag red flag  **eating disorder ... full blown** and it's been going on for months if not the better part of a year.

Lack of energy? No mystery. It sounds like she got some viral infection once tennis season was over, which forced her to stop the additional excessive exercising and gain a few poinds. Still, at 91-92 lbs but the digestive upsets still persisted.   She eats a bowl of Kashi that sends her insides in revolt, she researches, finds the anti-grain stuff and "our primal savior" Mark Sisson.   A ha!  It's the grains.  Go primal!!    She feels better immediately, no more flatulence and pains.  She uses the word epiphany.  So she continued on and began to improve.  But ...

Despite being strict on anti-grains and continual Paleo research, I had severe sugar cravings. Part of it was the tennis practices and the other was nutrient deficiencies and my body was craving instant energy. So I binged…a lot on cookies, brownies, fudge, ice cream, candy, etc… Other than that I was strictly grain free.  .... do I need a red flag here?

Frankly, I am surprised the binge monster didn't hit her sooner.  But there's at least an anecdotal lesson here -- further restricting the only thing that was giving her energy in her underfed, underweight state, caused her to crave those foods and binge on them.  Abnormal eating behavior to be sure ... but a normal response from her body!!!   I would note that her binges should have sent her guts into a tailspin, but there's no mention of gripping pain and vulgar flatulence.

Between January and June the cravings were unreal and my mood varied constantly and I would be so upset with myself for binging and getting cravings. As hard as it was I made baby steps. I said enough was enough and I need to be healthy and happy for myself. If I wanted a long, successful life I needed a healthy mind and the grains/dairy were not providing any of that for me.

 red flag red flag red flag red flag red flag  

**eating disorder ... full blown**

You have binging and the attendant guilt ... served up with a heaping pile of the garbage that is "carbohydrates can kill", "carbs give you diabetes", "fruit is not nutritious and turns to fat ... oh and can give you diabetes", "gliadins are scrambling your brain" ... Does she have a genuine grain and/or dairy intolerance?  I'm going to go with "not likely" -- until she forced her body down to an unnaturally low weight through, by her description, drastic caloric deficits, she had no such problems with either.  The sad thing may be that she's now given herself issues with these.  Sadder still is that if there is any hope that this can be reversed, she will receive no help and support from the scaremongering "experts" and followers of their largely baseless claims.  So now?

After deciding to completely cut out dairy, the cravings started to subside. I began consuming loads of meat, fruit, coconut, nuts, veggies, and most importantly BACON.

Ahh there it is.  The bacon.  It is a cure you know, for what I'm not quite sure anymore.

In comments, this young lady tells readers that the binging is a thing of the past but that it lasted 8 months.  Now she has improved since June of this year upon cutting out the dairy.  It is not really surprising to me that dairy might induce binging in someone restricting so much and at such a low weight.  At this point there is a likely physiological reason and reactive hypoglycemia from starvation-induced IR coupled with insulinogenic diary.

But there's a happy ending!!  She repeatedly tells us she's healthy and fit and happy.  Only she knows, but objectively anyone that deals with ED will tell you that we're not far enough out of the woods to declare victory here ...  Looking at this objectively you have:

1.  A young lady with no food or body image issues to begin with, loses weight incidentally

2.  Goes on diet to lose more weight, loses 14.5 lbs relatively rapidly, loses 3 more slowly before plateauing at 103.5 lbs down 15% of original body weight.

3.   THEN drastically cuts calories and increases exercise to break the "frustrating plateau"

4.  Experiences health problems and fatigue at 96-7 lbs but mentions no attempt to regain weight, and continues to try to exercise even when normal activity becomes tiring.

5.  Gets down to 89 lbs with troubling side effects that should have been red flags for medical treatment for an eating disorder.

6.  Gives up grains and develops 8 month binge disorder.

In the title of her "transformation" we are told she went from sickly to healthy and fit.  And yet, she says she has gained 3 lbs of lean mass compared to her low weight.  This puts her at 92-93 lbs by my math.  I really don't want to microanalyze someone else's body, but there is little improvement between the two pictures above, and what difference there is is almost certainly not lean mass.  

She has minimal flatulence ... a lot of energy ... manageable cravings.  She doesn't binge anymore.  But has she gained weight?  How are her liver enzymes?  Is she eating normally?  NO.  You can give up grains and dairy if they are problematic and still consume carbohydrates.  She is restricting carbohydrates to under 100 gram per day in an effort to maintain the weight loss that she forced through dramatic calorie restriction and overexercising (and if she's counting like Mark, that's probably 20-30 grams real carb from the fruit she eats, I see no starch on her list of foods).     Do you think this might be even the slightest bit influenced by Mark's Carb Curve and that insidious 151st gram of carbs?  Naaah .... that's just for the buy in.

But she is also intermittent fasting.  

Can you even imagine a doctor or dietitian or anyone thinking that this is a good idea for someone with an eating disorder ?????????????????????????????????????????????????????????????????????????????????????????????????????  Sorry, my keyboard got stuck there.  Can you imagine?   My first "coping" strategy to be able to eat somewhat normally some days was to fast one day a week, as in not eat for the entire day so around 36 hrs.  This worked for several months.  There can be no doubt about it, intermittent fasting is a way to restrict calories, and anyone that tells you otherwise, gives you a hormonal mumbojumbo story, glorifies some cultural eating behavior of the deep plains gathunters, is just fooling themselves.  

People can engage in IF without it being an eating disorder.  But people with eating disorders and fasting of any kind don't a good mix make! 

At best, this young lady is in the tenuous stages of ED recovery.  I say at best, because we're talking 2-2.5 years total now, of which she describes roughly 6 months of being over the binging.  It really does remain to be seen whether she has just found another coping mechanism that is working for now.  I hope I'm wrong, but I fear that I am right.  Again, no professional would condone this approach, and this has nothing to do with some misguided mainstream fat phobia.   Lots of comments there about her short stature and how her weight is probably normal for her, etc.  NO.  Her body told her, and everyone else, what a normal healthy weight was for her ~ somewhere around 105 pounds minimum.  Because she began practicing classic ED behaviors to get almost 15 pounds below that and her body revolted already about half way there.  

I cannot even express in written word how absolutely DISGUSTED I am at Mark Sisson and/or whomever is really responsible for the content on the website that bears his name.  Because this is not appropriate.  At best she really is in recovery -- wait a year and have her re-submit her transformation.   At worst, both the support and criticisms alike are bound to toy with her fragile mindset.  Compliments will reinforce her desire to maintain the restriction/low weight,  those of concern are being sidelined and this will cultivate her denial.   That she had a bona fide eating disorder is not in question (or should not be) and it is certainly too early to declare victory when she is still engaging in restrictive behaviors.

Yes ... I realize that in posting this I am guilty here too.  But I can't comment at MDA (never have been able to for some reason, even before Mark decided I was a sociopath since I couldn't be bought off) and I just cannot stay silent here.  I have, however, cropped the face from pictures shown here, and intentionally not used even her first name.  My hope, really, is that the post is taken down, but whatever cats are out of the bag anyway.  

Is there really nobody in paleo or at MDA capable of applying a "what if it were my daughter" gate on this sort of thing?  Or since these people fancy themselves doctors -- "what if it were my patient"?  Are these people really THAT clueless about eating disorders?  They can't be.  This is the height of irresponsibility.  There is NO question we are talking about an eating disorder here, not some fuzzy area.  She should be encouraged to continue to seek support, not put on display in some premature "success" story that is at the very least questionable.  WHAT is the message here?  That pure-paleo IF has cured this woman of her binge eating brought on by low carb primal, and has allowed her to maintain a less active underweight physique?  SICKENING.

Her fatigue may have been compounded by overexercising in addition to undereating, but it was caused by undereating, not by your usual scholastic athlete training.  C'mon, I am adrenally fatigued by this garbage!   When I was a varsity athlete in high school I spent at least 10 hrs a week in practice/training, and its not like I needed to sit on my butt to recover the remaining time.  In the summers I life guarded I swam between stations, and you could find me in the diving section when I was off duty, climbing the high board and diving unknown numbers of time.  Then sometimes I walked home, and I often did laps before my shifts, and then I'd go play volleyball or softball.   I started having fatigue problems when I stopped eating enough and added even more activity on top of this, but some are even saying cutting back to an hour a day is still too much for her.  Nonsense!   But part of her "success" has been to quit competitive tennis, and I can't help but think that this is because her energy is more of the "high" from being wired than genuine stamina.  I could be wrong, but since I've been there, done that, I don't think I am.

Ignoring, covering up and even promoting eating disorders is nothing new in this community.  But I've run out of time for now, and that will wait for a part two.   In the mean time, I will be thinking of this young lady and hoping she continues to improve in health.    I hope she stays off the internet and goes to a doctor to make sure she is indeed healthy -- that there is no more anemia or elevated enzymes, that she is eating an appropriate amount of food, that she has a regular menstrual cycle (I tend to doubt that she does, even now).   I HOPE we'll have an update in a year.  Because for now, all I see is someone who is still coping to control hunger to maintain a weight she had to force.  And who now has likely reduced her activity so that she can convince herself she has enough energy left for the rest of life.  I hope if she is reading this, she gets together with her HS tennis teammates to reminisce ... perhaps she'll remember the days when she had the energy to compete because she ate an appropriate amount of food. 

This kind of thing so very much tears at my heart because this was me.  Eventually my body caved ... I could cope no more.  And then it becomes a whole different ballgame when you've genuinely become "pudgy" to obese.   

I wonder what the psychologist to the ancestrals, Emily Deans, thinks of this.  She did, after all, speak on eating disorders at AHS13.  How you want to avoid the first diet.  I would hope she doesn't think this girl even needed the first diet.  I would hope she agrees with me that her current eating behavior is still not normal or appropriate.  I would hope she reaches out to Mark Sisson.   Perhaps Stefani Ruper might speak out.  I know she's busy, but this is her thing -- she so "bravely" called Mark out about women and fasting after all.  It would be nice to hear these two and others join in publicly opposing this sort of exploitation.   It would be nice if they worked to foster a welcoming atmosphere and healing from eating disorders rather than exacerbating them.

It is time for the paleo  community to address this VERY SERIOUS ISSUE.    Lives are at stake.  Do they care?

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Also of interest?:  The War on Moderation

If your takeaway message from this post is that I blame paleo for causing ED, you may wish to read:  Diets and Disorders