You spend your first week in the Eating Disorder Day Program getting a handle on things, adapting to the routine. You learn the rules of the house – both the unwritten ones and those extensively listed in the hefty binder you receive on your first day. You discover the personal dynamics in the group – the different subgroups, the cliques, the clashes, the returning patients and the newbies. Of course, since conquering your fears about food is a big part of the program, you start to learn how to eat a lot – often things you hope to never eat again (cue the lasagna). And then you face your first 3-day weekend with no rules, no supervision and none of your program cheerleaders to help ensure you eat every meal, every bite, every crumb.
Coming back to the Program on Tuesday is hard. You’ve just spent the weekend fighting the urge to exercise and skip meals as well as worrying about the effects of re-feeding on your body (bloating, stomach pains, weight gain). So you typically don’t skip your way into the clinic. With all this on your mind, you also have to face a new menu for the week and gear up to re-start the climb up your personal mountain of recovery. And, if all that wasn’t enough, Tuesday morning is your weekly weigh-in.
No matter the context, a weigh-in is almost always stressful. Here, every patient has a weight-gain contract. You have to gain 500 g per week or you get a red flag. Three strikes (flags) and you are out!
I was dreading the weigh-in this week. All weekend I battled my urges to cut back; to silence the obnoxious voice in my head that told me not to overdo it or I would gain 10 pounds. I ate my 3 meals, though I cut back on snacks, but I swear I could feel my clothes getting tighter. And given all that I had eaten during the week, I was sure I had not only reached my target for the week but likely overachieved it. I got on the scale, bracing myself for a significant gain and lo and behold, I had lost 300 g. WTF!?
I spent the next hour of group not listening. The small part of me still clinging to anorexia was triumphant. But that lasted about 30 seconds. Then I went to the worst case scenario. I was sure this was a sign that I would fail the program and get kicked out for inadequate weight gain; everyone would be disappointed in me; the world would end; fire and brimstone, blah, blah, blah. You get it. I went to the woe is me, I suck place. But then I snapped out of it. “OK Peiky, you can’t change what’s happened. This does not erase all the positives you had last week. You can only change what comes next.”
So I “came back” to the group in mind, body and spirit, just in time to eat the world’s biggest ham and cheese sandwich. Seriously… it was huge. When I got back home that night, I went through my food journal (a detailed document used to track every meal, drink, thought, emotion and behaviour) and saw how I could do things differently this coming weekend. And, rather than use food restriction as a way of coping with my emotions (my default pattern), I had Bravo pizza for dinner (special thanks to Charles for that).
So I recovered from the Tuesday weigh-in only to face the Thursday challenge: meeting the psychiatrist to discuss your progress. Dr “X” is a no-nonsense, compassionate, 5-ft dynamo that we sometimes fear but always channel when we need inner strength. Needless to say, always eager to please teacher, I was not looking forward to this little chat.
But to my surprise, she was warm and understanding and gave me some great advice. She even acknowledged my pizza meal as a win – though she made sure to remind me that one slice of gooey, greasy, tasty pizza won’t cut it for the week. Every day is a cheat day apparently…at least for now. For those of you who might be thinking lucky b***h, rest assured I don’t feel lucky.
So I survived week 2. And, while I had a few more disappointments than during my first week, this was a better one because I didn’t let myself get knocked down, because I haven’t once thought about quitting and because I feel stronger, happier.
I don’t know what the weekend will bring. But…at least I know I will be eating!
See you next Tuesday, scale.
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