Game Day: Thanksgiving and the Blitz

Ok, so here we are, on the eve of a major eating holiday. Tomorrow is Thanksgiving, the day on which overstuffing and overindulging are the cornerstones of this American holiday. Perhaps my senses are simply more alert this year, given the food-driven life I currently lead, but I am picking up a lot more "it's a day to get fat!" chatter this year than ever before. A local radio station was talking to listeners about their average Thanksgiving caloric intake (fast fact: did you know the average American will have a 3,000 calorie meal on Thanksgiving?), and I heard a student today tell a friend she always wears sweat pants to her family dinner to accomodate the bulge she will develop throughout the course of the day. It's actually fascinating to listen to people prepare for the traditional holiday face-stuffing as though it were an Olympic sport.

I, like most others, find the American tradition of gluttonous Thanksgiving feasts to be humorous. We can never do anything in moderation, now can we?

The Mr. and I handle the food piece of major holidays differently. He, like many others, skips breakfast and intends to eat one and only one meal: a massive, balls-to-the-walls, stuff-me-until-I-explode plate of food. He then skips dinner and probably breakfast the next day, too. He somehow draws energy from that one meal for days before his metabolism finally limps back to normalcy and becomes ready for processing yet again.

In my previous life (pre-eating disorder), I approached the meal as just that: a meal. I still ate my regular breakfast, kept the holiday feast to a slightly larger version of a normal meal, and ate another dinner later on to round out the day. I never really stuffed myself into a food coma, rather, kept to a regular schedule. I'm not sure why I took that approach, exactly, except that I have never liked the feeling of being extremely full, even before the onset of my eating disorder.

I left LA's office about an hour ago, where she prepped me for my first recovery Thanksgiving as though I will be going off to war. A "high-risk situation" she called it...I would have to agree. I've been thinking about how to approach the day and the meal all week, and was thankful to see her the night before so we could talk it through. Plus, thanks to a work commitment on Monday morning (when I usually meet with LA), I hadn't seen her for ten days and told her I had forgotten what she looked like. It was definitely time to check in.

LA started off by asking me where my anxiety about tomorrow's meal comes from, and I started to list off the usual fears:

• Social pressure to eat more than usual (this time would be from family who are not aware of my eating disorder), or be subjected to the "you don't eat enough and are far too skinny" comments.
• Not knowing the ingredient list behind every food on the table, therefore wondering whether or not I'm eating something that breaks my completely irrational set of self-imposed "rules".
• Eating too much and wanting to purge, therefore probably inducing the pain and additional vomiting I've been experiencing (oh yeah, we're finding there is a link between the two...did I mention that?).

Just after I listed these usual fears (all of which she has heard from me before), the real reason for the fear hit me. While the fears listed above are always present, I realized my anxiety about managing Thanksgiving is slightly different...

It used to be my favorite meal. It's stacked with my favorite foods...all of which I now avoid. I realized that Thanksgiving is different than other celebrations, parties, and holidays. I really want to enjoy it, given that mashed potatoes, stuffing, and any dessert involving pumpkin would all be included in my hypothetical "last meal" request.

Okay, so you are thinking You love all these foods and are running a 5-mile race a few hours before the meal...what is the problem here? Go ahead and enjoy for once...

The problem is that I still carry the black and white thinking that helped me to eat as little as possible during my sickest period. When in starvation/restriction mode, I stayed the hell away from any foods that I loved because they presented a risk of overeating. As someone in the throes of anorexia, I had trained myself to ignore hunger and cravings. Food, when actually consumed, was kept to a minimal amount and only used to keep me from passing out. That was it. Given how hungry I was back then, I knew that even just one bite of something I had previously loved would have led to an out of control "binge" (again...relative term...I was never one to actually "binge" by most people's standards). Back then, I viewed a binge as a failure, given that my ultimate goal was to exist on as little food as possible. Overeating was the ultimate sign of weakness.

So now I'm eating again, quite regularly in fact. But when dealing with an eating disorder, the brain is a little slower to catch up. It's one thing to treat the physical symptoms, to rebuild metabolism and restore weight. It's another, more difficult challenge to retrain the mindset that drove the eating disorder in the first place.

What I realized with LA tonight is that my biggest fear about Thanksgiving is this:

• I love the foods involved.
• If I eat just a little of each, I will want more- especially since I have deprived myself.
• If I take more, I will not be able to stop.
• If I am not able to stop, I will binge.
• If I sense that I have binged, I will purge.
• Conclusion (and reason for the fear) = Staying away from the foods I once loved ensures this cycle will never begin in the first place.

I am convinced that if I eat it at all, I will not be able to stop. All or nothing. Black or white.

So LA and I developed a game plan, which I intend to stick to because, well, I am not one to back down when faced with a challenge. The game plan is this:

1. Take a regular sized plate and fill it will small amounts of what I want.
2. Sit with The Mr. and eat slowly while engaging in conversation (this will require The Mr.'s cooperation).
3. Sip wine while eating (uh, yeah, that is not usually a problem).
4. Make sure The Mr. is on board with "running interference" (LA's exact words), which includes making sure I do not go back for more than what is on the plate (therefore leading to guilt about "bingeing" later on).
5. Immediately distract after eating...watching football, going for a quick walk, go talk to a relative are all acceptable options.
6. Try as best I can to move on, forget about the meal, and continue with the rest of my life.
7. Use the workouts, runs, and training I have planned for the long weekend as motivation to continue to fuel and resist purging. (The exercise bulimia part of my eating disorder is much more under control, and these now act as the "carrots" dangling in front of me to keep me eating properly and maintaining strength. The professionals know this approach works for me, as long as I do not exceed Dr. Joe's "hours per week" exercise limit).

So we have a Thanksgiving game plan, LA and I. I'll stick to it and make us both proud.

As for Dr. Joe, he has also jumped on the "game plan" bandwagon this week with another one of his ever-amusing treatment approaches. True to his Psychologist-Slash-Athlete swagger, Dr. Joe has somehow mashed two very unrelated topics together to create a new therapy approach: body image and...football.

Yes, football. And body image. You read that correctly.

I thought Dr. Joe's eyes lit up when he used to drop the "Just Do It" Nike reference back in the day...but that was nothing compared to the sheer joy the man seemed to experience while relating my poor body image to gridiron plays. I sensed that he had been saving this therapy approach for years, just waiting for the perfect eating disordered female football fan to walk through the door and soak up his blitz approach to body image. I made his day by being that patient.

Body Image According to Dr. Joe:

The setting: Imagine Dr. Joe sitting on the edge of his seat like my old volleyball coach used to, excited beyond belief to share this with me.

Dr. Joe: "Ok, M. All the messages that run through your head related to your body and eating are like the blitz. What happens when the quarterback doesn't properly read the blitz?"

Me: "He is sacked."

Dr. Joe (beaming with pride that I can follow along with this game reference): "Right! It means the quarterback didn't see what was coming, and didn't pick the right play. He should have dumped the ball, ran for the first down, or switched direction. Instead, he is left picking himself off the ground and wondering what signs he missed. Your eating disorder voice is like the blitz. If you start to starve or purge, you just got sacked. You misread the blitz or used the wrong play."

Me: "Okay. I get it."

Dr. Joe: "And you can't scramble! Just avoid the quarterback scramble...because sometimes it will work, but other times it won't and you'll be dusting off the dirt wondering how the hell you just got sacked. Reading the blitz and applying the right play is the best way to stay on your feet."

In that moment, I stopped thinking about my eating disorder and really just wanted to talk to Dr. Joe about the NFL. But I tried to refocus. Blitz = negative messages. Sack = reverting to eating disorder. Read the blitz, don't scramble, pick the right play. Got it.

Our "talk" stuck with me. But I laughed the whole way home imagining Dr. Joe trying to use his passionate football approach with a room full of female adolescent eating disorder patients staring at him blankly wondering why the hell the man is talking in a foreign language.

This Thanksgiving, I'm thankful for the therapist and dietitian who have gotten to know me so well that they can tap into what makes me tick and use it to help me get better. Game plans, sports, running, blitzes, quarterback references, sacks...hey, I don't know of anybody else on the planet who could bring this eating disorder therapy down to my level quite like these two.

Happy Thanksgiving, all.