This diet is designed to help you cope with the stress that builds up during the day.

BREAKFAST
Half of a grapefruit
1 slice whole wheat toast, dry
8 oz. skim milk

LUNCH
4 oz. Lean boiled chicken breast
1 cup steamed spinach
1 cup herb tea
1 Oreo cookie

MID-AFTERNOON SNACK
Rest of the Oreos in the package
2 pints of Rocky Road ice cream
1 jar hot fudge sauce
Nuts, cherries, whipped cream

DINNER
2 loaves garlic bread with cheese
Large sausage, mushroom and cheese pizza
4 cans or 1 large pitcher of beer
3 Milky way candy bars

LATE EVENING NEWS
Entire frozen cheesecake eaten directly from the freezer

RULES FOR THIS DIET

1. If you eat something and no one sees you do it, it has no calories.

2. If you drink a diet soda with a candy bar, the calories in the candy bar are canceled out by the diet soda.

3. When you eat with someone else, calories don’t count if you don’t eat more than they do.

4. Food used for medicinal purposes NEVER counts, such as hot chocolate, brandy, toast and Sara Lee cheesecake.

5. If you fatten everyone else around you, then you look thinner.

6. Movie related foods do not have additional calories because they are part of the entire entertainment package and not part of one’s personal fuel, such as Milk Duds, buttered popcorn, Jr. Mints, Red Hots, and Tootsie Rolls.

7. Cookie pieces contain no calories. The process of breaking causes calory leakage.

8. Things licked off knives and spoons have no calories if you are in the process of preparing something. Examples are peanut butter on a knife making a sandwich and ice cream on a spoon making a sundae.

9. Foods that have the same color have the same number of calories. Examples are spinach and pistachio ice cream, mushrooms and white chocolate. NOTE: Chocolate is a universal color and may be substituted for any other food color.

Dr Fishman comments:

These are silly dieting suggestions. But food control, even with real diets, is not key to eating disorders.

Eating disorders have to do with relationships and, importantly, how relationships are handled.

Our treatment of Compulsive Overeating, Bulima and Anorexia Nervosa emphases how relationships play a central part; suffers must strive to have relationships where they have a voice, to be equal and, very importantly, where conflicts are effectively addressed. To the extent that conflicts are not addressed, this smoldering antagonism can lead to compulsive overeating and other eating disorders.

In our culture, individuals especially women can be pressured to have a certain weight, to be thin, to be “stylish.” If someone in a relationship is making them feel bad about themselves, it is understandable to internalize it and think there’s wrong with them—it must be their weight.

This leads to tunnel vision—focusing only on the eating and the food. Instead, if the conflict the relationship is addressed, it’s much easier to control one’s eating.

Getting away from the intellectual to the practical – eating disorders are relevant to the world of eating disorders. While it is necessary in many situations, especially for women, that there be a culture of thinness, women should be thin, that’s not sufficient to cause the eating disorder. If it were sufficient, anorexia would not be a rare disease.

The number of women in New Zealand and America with anorexia is tiny. So what makes the difference? One concept we use with our clients is the idea that when the woman feels bad about herself, something is going on in her life that is making her feel bad. She says to herself, “I would feel better if I weighed less or dieted and got down to a size 6”. Of course, this becomes dangerous, as anorexia as well as other eating disorders, have their own tyranny – that is, if someone gets thin enough, they can’t force themselves to eat.

To coin a phrase – they are looking for love in all the wrong places. It’s not women’s eyes that are smaller than their waistline they are transformed what is making them unhappy. What’s really making the difference is their relationships and those paradigms and people that are making them unhappy.

In my experience, when I have asked people ‘what makes you unhappy?’ they reply ‘themselves’. But that won’t lead to change. We are all unhappy with ourselves at various points. What will lead to change is looking around and seeing what are the relationships that are making you unhappy.

For example, a young woman who I am working with had a very bad week. She doesn’t understand people who are making progress with her weight control (in terms of her compulsive over-eating), just couldn’t understand why suddenly she had the worst week in 3 months. In therapy, I asked her ‘what was happening in her relationships that were making her so happy?’ Suddenly it dawned on her that the child she was caring for was going to be leaving her. Her mother had lost her job and wanted to care for her baby full-time. This young lady and her mother was devastated. Again, the focus is on the stress and out-of-control behaviour. She was so miserable and felt that food addressed the sadness that now surrounded her.

Dr Fishman was asked to contribute:

Psychiatrist Dr Charles Fishman, director of NZ Eating Disorder Specialists in Auckland, believes Prescott would have been given a very different reception if he had been a woman with an eating disorder.

“Bulimia is absolutely a hidden issue – it’s a private hell and a private shame”, he says. “Males who have bulimia are sometimes told they have a girls’ disease, which is an additional shame for them to bear.”

Recent research suggests that men could make up as many as 25% of those with anorexia and bulimia, and 40% of binge eaters.

Fishman says perhaps one in 10 of his patients with anorexia are men. Their obsession with weight is more likely to be hidden because many exercise compulsively rather than controlling their eating.

He believes both male and female bulimics tend to avoid conflict, and often come from families, in which food has a significant status. Fishman says the consequences of an eating disorder can be just as devastating for men as for women; one 19-year-old with bulimia had such low levels of potassium that his GP was surprised he was still alive.

Eating disorder services in New Zealand are widely considered to be-woefully inadequate and underfunded, making it unlikely that much extra attention will be given to male sufferers. But eating disorders are reported to be on the rise among men in Western countries, and Fishman expects a similar increase in New Zealand as society becomes more obsessed with men’s physical appearance.

Read the full text of ‘Slim Chance’ in the Listener online.

The organisers of New Zealand’s Fashion Week are taking an independent stand in the international debate over which models are too thin to do their jobs. Various international fashion weeks have issued guidelines and rules about how skinny is too skinny for the catwalk.

Fuelled by scathing media attention and the recent deaths of three South American models, apparently from complications of anorexia, the pressure has been on European fashion insiders to resolve the problem of unhealthily thin models…but the organisers of New Zealand Fashion Week have no plans to follow suit.

In New Zealand, one in three children is overweight or obese, a fact which has instigated a $76 million campaign by the government to fight the epidemic. While this action is to be applauded, kids are increasingly being exposed to ‘perfect bodies’ as portrayed on TV, in films, in magazines … just about everywhere. Younger and younger children are dangerously dieting in an attempt to lose or avoid gaining weight.

Parents are in the best position to influence their children’s behaviour. Rather than wait to see if your child does have a problem and then having to deal with them battling a tenacious eating disorder, there are things you can do now to stop eating disorders before they develop.

Click on the link below to download the article containing tips for parents to prevent eating disorders from developing in their children.

Download article: Prevent Eating Disorders from Developing [802 KB PDF].

This blog will answer questions and provide educational input for eating disorder sufferers and their families. While it will not replace your mental health clinician or GP, it will provide important information and an invaluable perspective on eating disorders.

The eating disorders that are discussed here are anorexia nervosa (AN), bulimia nervosa (BN) and compulsive overeating. While not identical disorders, they have something in common – they are relationship-based.

To be clearer, now I’m not talking about cause. There are many theories about what causes eating disorders. My focus is on why eating disorders continue. Relationship factors are what keep these problems going.