Why we should NOT use BMI to diagnose eating disorders

Today’s post is a bit different from my usual content but I saw a story on BBC news yesterday which really stirred up emotion in me and inspired me to write. It was a young woman sharing her experience with disordered eating and being told by doctors that her BMI “wasn’t low enough to be anorexic” when she went to seek help. Here is the short video clip:

For those of you who haven’t read my previous posts about my struggles with disordered eating, I had an undiagnosed eating disorder throughout my teens and early twenties and lost my period for nearly 10 years due to being underweight for my body type. During this time I too was told by doctors that I was healthy because my weight was within the normal range and was led down the road of more and more tests to figure out why I wasn’t menstruating. This definitely prevented me from getting the help I needed and delayed my recovery by several years as I was able to keep kidding myself that I was healthy and continue with my unhealthy behaviours around food and exercise.

I still have anger inside me towards the medical system for failing to help me and I think it’s so important to share stories like these in the hope that they can help someone else who might be going through something similar. Disordered eating is something that so many women go through at some point during their life and often it is brushed under the carpet because obsession over our bodies, chronic dieting and exercising to lose weight is seen as just part of being a woman in today’s world. Using the BMI scale as a measure of disordered eating is so outdated and only continues this issue. Women and girls, like me in the past, who do become aware that perhaps they have a problem around food are often made to believe we “aren’t sick enough” to seek or receive support.

The BMI scale was developed around 200 years ago by a mathematician as a quick way of determining whether an individual is at a healthy weight for their height. It is usually seen as a chart of height vs. weight like the one below with marked ranges for underweight, normal weight, overweight and obese. However, it was never intended to be used as a formal diagnosis of health. It wasn’t developed by doctors but for some reason it has been adopted by the medical system and is still used, often without question, to this day.

According to most doctors, a BMI within the range 18.5-25 is considered “normal” but there are several major problems with using the BMI scale. The main one I want to highlight is that it doesn’t take into account the percentage of lean mass which consists of bones, organs and muscle tissue. So someone with a larger bone structure or more muscle mass can quite easily be considered overweight or even obese. Think football players or figure skaters who are often lean but extremely athletic and muscular, according to the the BMI scale many would probably need to lose weight to be considered healthy.. really?! How can a basic mathematical formula know what it healthy for your body type. All it is is statistics. On average, humans have less than 2 arms but does that mean that the typical human has less than 2 arms? Of course not!

What is healthy for our bodies depends on so many factors, including our genetics, the environment we are currently living in and what stressors we have in our lives. At certain times it’s healthier for us to hold more fat and at others it might be more advantageous to be leaner. Our bodies are smarter than we give them credit for. I look at photos of myself at my lowest weight when I was around a BMI of 18.5 and I wonder how any doctor could have thought I looked healthy. I was 20 years old but I looked like a child. There was nothing womanly or fertile about how my body looked at that time. I had hardly a scrap fat on my body, no breasts at all without a padded bra and my knees stood out a mile on my stick legs.

Of course, I didn’t look like the completely skeletal anorexic figures that you see, but I was clearly not at a healthy weight for my frame. It’s obvious to me now why I didn’t have my period. As women we need fat on our bodies to support a healthy pregnancy and to nourish a growing baby. I definitely was not eating enough to support my activity level and I was restricting food groups and specific “unhealthy” foods. I had a high level of cognitive dietary restraint meaning that I thought a lot about food and I was constantly controlling and denying my cravings. My body was sending me all the signals that it wanted to be at a higher weight, I would have crazy binge eating episodes because my body was starving for calories but I saw this as a lack of motivation or as emotional eating. I wasn’t underweight for my height so I didn’t see the problem.

This is the issue with the BMI scale, it lumps everyone in the same category and doesn’t account well enough for our bio-individuality or our bodies’ natural intelligence. Personally, I had to workout excessively and restrict my diet in order to maintain this weight which should have been a major red flag that it wasn’t my natural set point. Perhaps another woman could maintain this same weight naturally with little effort and could be healthy but that is not how my body was designed to be. But because I was so attached to the BMI scale and trusted doctors when they told me I was healthy, I carried on this delusion for too long. I’m sure there are so many other women (and men) stuck in this same false narrative, believing that their behaviours around food are healthy when in reality it is causing more harm than good.

When it comes to eating disorder diagnosis, I think using the BMI scale can be extremely dangerous. Especially today as the trend online is not just to be skinny but also to be fit and lean. There must be so many girls and women out there who are suffering in order to achieve a “perfect body” either by being overly rigid and restrictive around food or by over-exercising but they are at a normal BMI so they must be healthy, right? Wrong. Eating disorders are about so much more than physical appearance, they are mental disorders. Diagnosis should be based on thought patterns and behaviours and not on weight alone. If someone is focused on food to the point it is affecting their life, if they are afraid of certain foods or obsessed with losing weight, it doesn’t matter what BMI they are, they deserve help.

I understand that the NHS has limited resources and that they have to prioritise those who are at the highest risk. Being dangerously underweight can cause so much damage to the body and of course these people need to be under medical care, but for those who fall into the grey area of not being sick enough to receive support this can be a real problem. Disordered eating develops over time and generally the earlier it is diagnosed, the easier it is to recover. Eating disorder thoughts are like a fungus that enters your brain, sets down roots and spreads a network across your psyche. Rooting out all of the false beliefs, stories around food and your body and replacing them with healthy, helpful thoughts takes a lot of time and effort.

Putting off treatment because your weight isn’t low enough yet means falling further down a slippery slope and it can become harder if not impossible to achieve a full recovery. Eating disorders are already such a secretive disorder, drenched in shame and denial. Even when part of your mind realises there is a problem and wants to seek help, the disordered part wants things to stay as they are and will hold tightly onto any excuse to stay stuck. A healthy BMI is exactly that, a lifeline of denial for the eating disorder voice. I still have to deal with these thoughts today, even though I can recognise them and not act on them. I think this is partly because of my disordered eating being hidden and allowed free reign of my sub-conscious mind for so long.

I do believe that full physical and mental recovery is possible but it’s much more likely when these things are caught early and don’t go as deep. I definitely consider myself fully recovered now and have for many years but I don’t think that quiet voice will ever completely go away. As a nutritionist and yoga teacher, healthy and wellness is still a big part of my life but I am fully aware that I have to stay vigilant as it can be a fine line between looking after your health and obsessing over your health. It’s not like recovering from alcohol or drugs where you can completely abstain, you can’t recover from obsession with healthy eating by avoiding healthy foods.. that’s a recipe for disaster! However, my motto now is be healthy to live, don’t live to be healthy. Eat vegetables but also eat chocolate cake. Move your body but know when to rest. It might be cliche but balance is the way!

Over to you

Please like and share this post and help to spread awareness of this issue. Follow my blog for more posts on balanced health, yoga and nutrition for healthy hormones.

If you feel like you or someone you know is suffering with disordered eating, please please reach out for support. Don’t let having a healthy BMI get in the way of getting the help you need.

YOU DESERVE TO HAVE A HEALTHY, ACCEPTING RELATIONSHIP TO FOOD AND YOUR BODY NO MATTER WHAT!

BEAT: https://www.beateatingdisorders.org.uk/support-services/helplines

NHS: https://www.nhs.uk/conditions/eating-disorders/

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Why and how I include treats as part of a healthy diet

The last couple of weeks we have had lots of celebrations! Valentines’ day, pancake day, my birthday and my boyfriends’ mums’ birthday all within the space of ten days. Considering the three of us have been in lockdown together for nearly four months now we are making the most of every opportunity to be festive. And with everywhere closed that has pretty much meant one thing.. FOOD. Here’s a sample of the tasty treats we have been making. We have crepes, carrot cake, kourou (Greek feta pastries) and lemon drizzle cake curtesy of the one and only Mary Berry. Yum!

I think it’s such a gift to be able to enjoy tasty foods and share the experience with loved ones. Food can be such a sensual experience and a way for us to connect with ourselves and other beings. As humans we are designed to enjoy food as it is essential for our survival and preparing and eating delicious food can be a ritual that brings us a lot of pleasure. Of course we can survive on simple foods and that is great too but there is something about biting into a delicious homemade cake or warm pastry that gives us such satisfaction. Cooking for or with our friends and family is often a way that we show our love and memorable mealtimes are moments that we remember many years later. Passing on recipes down generations is a way to keep cultural traditions going and remember generations before.

It’s such a shame to reduce food to only fuel. Especially now the world is closed it is even more important to take enjoyment from our food. And by that I don’t mean we should be eating emotionally and using food to numb out. Or that we should be indulging in artificial junk foods that harm our bodies. I mean that we should take the time to buy and prepare delicious, nourishing food for our bodies and souls. And that includes sweet and savoury treats! There is a huge difference between baking some cookies at home and eating a few round the table with loved ones vs. buying a packet of cheap biscuits from the supermarket and eating ten in one sitting whilst watching TV alone. One bring genuine pleasure and enjoyment and the other is just a mindless habit. I think that part of including treats in a healthy diet is really to take the time to eat them mindfully and savour every bite.

I remember the days when I used to be afraid of celebrations because I was so anxious around food. If I was invited to a party I’d be worried about what food would be there and if I’d be tempted to eat foods that were unhealthy or off my diet. I’d be so focused on food that I’d forget to enjoy myself or I’d get really drunk to make the food anxiety go away for a few hours and then not remember the party the next day. If I went to a restaurant I’d have to triple check the menu beforehand to make sure there was something I could eat otherwise I’d freak out at the table and not be able to decide at all or I’d end up over eating to the point of feeling sick and spend the next week trying to burn it all off. It sounds so crazy now I look back but I know this is a reality for many others too. It’s so freeing now to be able to eat whatever I want and know that it all fits within a healthy diet. I am allowed to enjoy food without feeling guilty about it.

But I’m still a nutritionist and I still want to remain fit and healthy so how do I balance the two? The key is that I base my diet on whole plant foods. This means that most of what I eat is unprocessed and comes from the earth. I’m not vegetarian (I was vegan for nearly 3 years but that’s a story for another day) but lots of my meals are plant-based and this makes up the foundation of my diet. I don’t restrict the amount of these foods that I eat and try to “save calories for later”, I just eat until I am satisfied at each meal and move on. I follow “balanced plate method” which is something I teach to my health coaching clients, a way to create filling, satisfying meals every time. I eat lots of fruits and vegetables, grains, beans, nuts and seeds and on a day to day basis I try to keep processed foods to a minimum. When I want to eat a treat I just do it and because I’ve already met my needs for calories and nutrients I don’t have a need to go overboard.

I think an important thing to note here is that I also don’t allow myself to eat emotionally anymore. By that I mean that if I am feeling sad, stressed or angry, I focus on understanding and processing that emotion rather than stuffing it down with food. If I have a craving for a food I will ask myself first if it is because I am trying to avoid feeling a certain way. If it is then I will turn to other self-care tools rather than food which will help me to soothe myself and actually feel better rather than distracting myself and pushing the feeling down until later. But if the craving is not emotional but just a natural desire to eat something tasty for whatever reason then I’m ok with giving my body what it is asking for. I’ve learnt to trust my body around food and listen to it’s hunger and fullness cues and in return it has learnt to trust me and no longer sends out urges to eat insane amounts of food.

Something I realised is that the thing driving my fear of over eating was the fact that I was constantly hungry. I was always on a diet an maintaining a body weight that was below my body’s natural set point which meant that I was always fighting against my body’s hunger signals. When I did give in and eat what I was craving I wouldn’t be able to stop. I thought that this was just a normal part of being healthy and that giving in to it showed my lack of willpower. It was only after I went through a period of extreme binge eating, when I could no longer fight my hunger and decided to just surrender to it that I realised that this was genuinely my body telling me it needed more fuel. And once the hunger was satisfied and my body reached it’s set point weight the food obsession gradually went away.

Whatever we resist persists and I think that putting food into categories of good and bad only makes us go more crazy around the “bad” foods. As soon as I let myself eat whatever I wanted, the cravings went from mountains to molehills. After years of trying to figure out why my binge eating was happening, I was shocked! So now I am maintaining a healthy weight that my body likes, but not necessarily what my mind wants and I’ve learned to be ok with that. It’s so worth it to be a few lbs heavier and not have the constant fear of gaining weight. I’ve learned that I don’t have to be perfect to be healthy and that health is about way more than what you eat or how much exercise you do. Holistic health includes mental wellbeing and in my opinion, eating treats and not depriving myself means I feel so much better psychologically and emotionally. Living an overly controlled, restricted life is not fun and definitely does not lead to long term happiness. Balance is always the way!

Over to you…

I hope you enjoyed this post and it gives you the confidence to allow yourself treats as part of your healthy diet. Let me know your thoughts and experiences in the comments below.

  • If like this post, hit the like button and follow my blog for regular posts on health, nutrition and yoga. And please share with anyone you think might be interested.
  • If you are looking for guidance, support and accountability on you health journey, please contact me for information on the nutrition and holistic health coaching packages I offer. I would love to work together with you to get you feeling your best again.

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hypothalamic amenorrhea

Real health #20 Why your period is so important for your health

It’s been a while since I talked about my favourite topic.. the menstrual cycle aka your period. Specifically why your period is important for your overall health and the problems associated with not having a regular menstrual cycle. Any guys out there, maybe this isn’t the article for you but feel free to read on and you could just learn something to help the ladies in your life!

We usually think of our menstrual cycle as two phases: bleeding and not bleeding. In reality it is a menstrual cycle with levels of several reproductive hormones shifting throughout the month. The amount of these hormones your body produces is sensitive to stress, including both physical stress from under-eating and over-exercising and mental and emotional stress. When you lose your period because something is off in your lifestyle is it called Hypothalamic Amenorrhea (HA). I wrote all about this in a previous post so you can check that out if you are interested in learning more. But here I want to focus on the problems that come with not having your period.

The problems with not having a period

The most obvious reason to have a regular, healthy period is of course your fertility. The whole point of your menstrual cycle is to prepare your body for pregnancy and allow you to have a baby. If you don’t have your period, it’s very unlikely you are going to be able to get pregnant. But what if you have decided you don’t want children or you’ve already had children? It’s still important for you to have your period too! I spent many years believing it was “fine” that I didn’t have my period and it was actually pretty convenient to be honest, not to have to buy tampons, worry about getting pregnant or have my period ruining my plans but once I found out what it means to not have a period and how unhealthy it is for your body I was shocked and I wished I’d been told sooner.

One of the key hormones that drives your menstrual cycle is estrogen. Apart from it’s role in your menstrual cycle, did you know that estrogen also helps to build your bones? When women enter the menopause and stop producing estrogen they start to lose bone mineral density and are at an increased risk of developing osteoporosis or brittle bones. Not having a regular period is a sign that your hormone balance is off and estrogen levels could be low. Girls who don’t have their period due to hypothalamic amenorrhea during their teenage years are at risk of developing early onset osteopenia which can lead to osteoporosis if not treated. This might not mean much when you are young but trust me, you want to make sure you are building strong bones while you can! And don’t forget that your if your bones are losing minerals then it’s highly likely that your teeth are suffering too putting you at increased risk of cavities and teeth sensitivity. Who thought that periods and teeth were related??

Another surprising link is between hypothalamic amenorrhea and heart disease. Estrogen has an anti-oxidative, anti-inflammatory effect in the body and also acts as a vasodilator meaning it causes your blood vessels to expand and low levels of estrogen have been linked with an increased risk of developing heart disease. Even though most of the research is in post-menopausal women, there have also been studies linking low estrogen levels in younger women with build up of plaque in the arteries and increased risk of heart disease in later life. And yes this is even for those who exercise! You might think you are being super healthy and boosting your cardio-vascular system but if you are exercising excessively and you have lost your period then you are undoing all of that hard work. Another thing I wish I’d known about sooner..

Other problems with hypothalamic amenorrhea

Not only does hypothalamic amenorrhea put you at risk for issues later in life, it can also cause problems in the here and now. Low estrogen can also be the explanation for fatigue, headaches, low sex drive, vaginal dryness, anxiety, depression and insomnia just to name a few. And as well as your reproductive hormones, not having your period could be a sign that other things are off in your body. We often think of our body systems acting in isolation but in reality, all of these things are connected and if one falls down it can have a domino effect throughout your body.

Often women with hypothalamic amenorrhea have higher levels of the stress hormone cortisol which also has been associated with bone loss as well as anxiety, insomnia and lower thyroid hormones. In hypothalamic amenorrhea, your metabolism is suppressed which could explain symptoms of hypo-thyroidism such as feeling cold all of the time, hair loss and low energy levels. Many women who develop hypothalamic amenorrhea due to restricting their food intake also experience digestive problems like bloating, stomach pain, constipation and food intolerances. If you don’t have your period and you feel like you are constantly struggling with digestive issues, then maybe the two could be related.

What should you do if you’ve lost your period?

So if you have made it to the end of this post, well done and I hope I didn’t scare you too much. If this is you, don’t worry, now you know you can do something about it! First you can read my blog posts about hypothalamic amenorrhea, how to recover and my recovery story. I’d also recommend buying the book No Period Now What by Nicola Rinaldi if you want an in depth explanation of all things hypothalamic amenorrhea related. If you need that final push to commit to getting your period back, definitely buy her book. If you think you have hypothalamic amenorrhea, visit your GP to get your hormone levels checked and Nicola also offers blood test results analysis through her website if you’re unsure. Three steps you can take right now:

  1. Eat more food and let go of any dietary rules and restrictions
  2. Take a break from intense exercise for at least a month
  3. Reduce the stress in your life and add more stress relieving activities

Easier said than done I know, but I believe in you! It’s never too late to recover your period and undo at least some of the damage to your body from hypothalamic amenorrhea. Recovery is challenging but so worth it.

References

Emma O’Donnell, Jack M. Goodman, Paula J. Harvey, Cardiovascular Consequences of Ovarian Disruption: A Focus on Functional Hypothalamic Amenorrhea in Physically Active Women, The Journal of Clinical Endocrinology & Metabolism, Volume 96, Issue 12, 1 December 2011, Pages 3638–3648, https://doi.org/10.1210/jc.2011-1223

Over to you…

I hope you enjoyed this article on why it’s important to have your period and the series so far. Let me know in the comments below your thoughts and experiences, I’d love to hear from you.

  • If you want to follow along with this Real Health January blog series, like this post and follow my blog for daily updates. And please share with anyone you think might be interested!
  • If you are looking for guidance, support and accountability on you health journey, please contact me for information on the nutrition and holistic health coaching packages I offer. I would love to work together with you to get you feeling your best again.

Other posts you might like

Shufelt, C. L., Torbati, T., & Dutra, E. (2017). Hypothalamic Amenorrhea and the Long-Term Health Consequences. Seminars in reproductive medicine35(3), 256–262. https://doi.org/10.1055/s-0037-1603581

the problem with fitspo

Real health #16 The problem with fitspo and fitness influencers

I actually wrote this post about 5 years ago for my first ever blog site! This was before fitness influencers were a huge thing, or at least they weren’t really on my radar, but I think it is more relevant than ever today. I’ve updated it a little but the core message is still the same. Enjoy!

This morning a friend posted this image on Facebook..

fitspo

I know she had the best intentions behind the post but it really got me thinking about the “fitspo” trend, fitness influencers and their effects on viewers’ body image.  The Urban Dictionary definition of the word fitspo is:

“Images of active, strong, and fit women that promote proper exercise and diet. May also include images healthy foods. Much like thinspo (images of dangerously thin women used by people with eating disorders to motivate) but healthier.”

From the definition it sounds like a great thing. Replacing the horrible trend of “thinspo” and encouraging women to be healthy and active.. both of those things get a great big TICK from me. However, what can’t be escaped is the fact that images like this still encourage women to focus on their body shape and size. They still provide a body ideal, a goal for women to aim for. They still encourage women to base their self-worth on their appearance and attach morality to food and exercise. And this results in the same feelings of unworthiness and disappointment for those women who don’t follow the rules and don’t look like the picture-perfect Instagram fitness models.

The image above does an amazing job at showing us that the number on the scale is, well only that really. A number. The point here is that body weight and BMI are pretty meaningless and bodies of the same weight can have completely different body shape and composition. That’s all well and good, but what does the image imply? That we should be focusing on getting lean and toned instead of skinny? That it’s much better to be heavier and look like the photo on the right? Yes it may be successful in shifting the focus away from the scale and obsessing over how much you weigh but to what… the way your body looks in the mirror or a photo?

Lots of women (myself in the past included) have fallen into the trap of shifting their health and fitness goals from trying to weigh as little as possible to eating clean and looking lean and muscular. Maybe it’s getting abs or building a booty. But what the fitspo images like the one above don’t show is how the woman is feeling in each photo and what her life really looks like. What kind of behaviours is she engaging in to maintain her body? What is her overall health like? How are her relationships and social life? Is she following her passions or is she spending every waking minute obsessing over eating healthy food, exercising and comparing her body to others online?

There could be a whole range of things going on behind the scenes. We often assume that just because someone looks “normal” that they are not suffering and this is not always the case. Disordered eating can take on so many shapes and sizes. Bulimia and exercise bulimia, orthorexia, food fears, laxative abuse, binge eating, compulsive exercise. All of these can often go unnoticed as people can maintain a normal BMI and not end up looking like the skeletal eating disorder stereotype. I am not saying by any means that the girl in the photos is suffering from any of these issues but what I am trying to say is not to take photos like this at face value. Images mean nothing unless we know the full story behind them.

For me personally, looking extremely lean and fit came at a great cost. I did all of the healthy things. I worked out daily. I ate clean. I drank plenty of water. But I didn’t feel good and I didn’t know why. I wasn’t healthy. My periods were totally absent. I started to wake up in the early hours of the morning for no reason. I felt fatigued all of the time and had to rely on more and more caffeine to get through the day. I know not everybody will have the same experience but I am sure I am not the only one. It took a lot of effort to unlearn all of the so-called healthy habits I had developed and get back to focusing on feeling good. Finally after going back to university to study public health nutrition, diving into my yoga practice and becoming a qualified teacher I found a balance where I could feel good and maintain a slim, healthy body without taking it to the extreme or letting it take over my life.

For those of us in the health and fitness world, food and exercise and shaping our body can easily become the focus of our life. Yes it is fun to experiment with food and of course moving your body feels great. But it doesn’t have to be your sole purpose. It is very easy to get caught up in the social media bubble and forget that there is an outside world. Real life connections and meaningful relationships where you can be yourself can do so much more for your health and wellbeing than following some online fitness guru and feeling connected to others by the restraints of whatever lifestyle they preach. My point in this article is to let you know that you don’t need to idolize anyone and your body is perfect whether you feel more like the “before” photo or the “after”. Remember to focus on the things that keep you feeling happy and healthy above all!

Over to you…

I hope you enjoyed this article from 5 years ago Amy. I would say my opinions haven’t changed much since then. Let me know in the comments below your thoughts on fitspo and fitness influencers, do you find watching them uplifting and motivating or does it make you feel bad about yourself and like you need to change?

  • If you want to follow along with this Real Health January series, like this post, check out the recommended posts below and follow my blog for daily updates. And please share with anyone you think might be interested!
  • If you are looking for guidance, support and accountability on your health journey, please contact me for information on the nutrition and holistic health coaching packages I offer. I would love to work together with you to get you feeling your best again.

Other posts you might like

heart opening yoga - wild thing

Yoga and body image / Yoga for women

I’m really enjoying teaching my online Yoga for Women classes on Sunday evenings, it’s a really cosy way to end the weekend and to connect with other women whilst we are in lockdown here in Greece. If you’re interested in joining the class contact me and I will send you the joining details. This week the class theme was about how yoga can help to develop a healthy body image. Especially nowadays with social media, so many of us have a distorted view of our bodies and waste our precious energy critisising ourselves for the way we look. We hold ourselves to such high standards, often comparing ourselves to images we see in the media which have been carefully crafted and edited to the point where even the person in the photo doesn’t look like that in real life (if you don’t believe me try following Beauty.False on Instagram!).

In my experience, yoga can be an amazing tool in our self-care kit on our journey to overcoming body shame and developing a healthier relationship with the way that we look. Yoga is one of the things that helped me the most in recovering from disordered eating and developing self-acceptance and a more positive body image. However there are also some pitfalls along the yoga path that can make us feel worse about ourselves. In this article I want to share 5 ways yoga can help to improve your body image and 5 body image traps to avoid.

How can yoga help with body image?

  1. Yoga teaches us to be still and to turn our attention inwards. Even if it is only for the short time of the practice, we can shut out the outside world and let our true inner voice become louder. This means tuning out the external voices of societies’ beauty standards, other peoples opinions of us and our own interpretation of how we should be and instead letting the inner knowing that we are fine just as we are come through.

  2. Yoga is a great way to get your body moving and improve your strength and flexibility. Heart opening postures such as back bends and cleansing twists can really help to get energy moving through your body making you feel more alive and good in your body. Standing postures help to improve your posture so you can stand tall and confident and feel good about yourself as you move through your day.

  3. Unlike other types of exercise, yoga is not focused on weight loss or burning calories but on uniting movement and breath to create a more calm, positive mindset and a strong, agile body. During my eating disorder recovery, switching out my gym and running sessions for walking and yoga did wonders to change my relationship to exercise. I started to move my body in a way that felt good, pay attention to how I felt and rest when I felt tired instead of pushing through in an attempt to achieve “results”.

  4. Practice of yoga asana (postures) gets us very acquainted with our bodies in all sorts of weird positions! We are forced to look at our belly rolls in forward folds, our thighs in downward dog, our double chin in shoulder stand.. any part that we might feel shame about we are going to come up close and personal with through yoga. And that’s a good thing! Yoga helps us to become used to seeing our bodies and to normalise the things we might not like and cultivate acceptance over time.

  5. Yoga is a personal journey. Yoga encourages not to compare our progress to others but to arrive on the mat each practice ready to try again and observe what our body can do on that day. We realise over time that nothing is constant and progress is not linear. Our bodies change from day to day depending on what is going on in our lives, how much stress we feel, how much sleep we got and also the with the seasons. We learn to accept these fluctuations and even come to love watching things unfold.

5 body image traps in yoga

  1. Beating ourselves up or negative self-talk. As I said, yoga helps us to turn inwards and let our inner voice become louder. But what happens when your mind is ruled by your inner critic? Sometimes we can let this critical voice seep into our practice and tell us we are not good enough, we are weak or our bodies aren’t flexible enough instead of just accepting what is and feeling grateful for the progress we are making. If you catch yourself spiraling down into self-criticism, pause for a moment to ask yourself why things should be different.

  2. Comparison with others. Although yoga encourage us to focus on our own practice, it can be tempting to compare our bodies or progress in yoga with others around us. This is the worst possible thing we can do when we are trying to develop a healthy body image, especially if those others are people we see online and not in real life. I have definitely fallen into this trap, comparing myself to other yoga teachers online and feeling shame for not being as flexible or as beautiful as them, as if this made me any less of a teacher. Simply not true! A home practice can be a great way to explore yoga without the temptation to compare with others around you. There are plenty of diverse teachers offering free online classes that you can try out.

  3. The perfectionist mind-set. If we have a tendency towards perfectionism we can also bring this attitude into our practice having very high expectations of our selves and holding ourselves to extreme standards. Whether that is how our bodies look or being able to achieve the perfect yoga pose, perfectionism harms us more than helping us. It can cause us to injure ourselves because we are being driven by an external ideal rather than focusing on what’s going on inside. I encourage you to let go of the idea of creating a shape with your body and instead focus on lines of energy and sensations within your body.

  4. Feeling shame about our bodies. Again this is the other side of the coin of becoming aware of our bodies, we can also become more aware of the things we don’t like about our bodies. If we are not careful we can bring our body shame onto the mat and instead of accepting what we see we can magnify the things we don’t like and start to pick ourselves apart. If you catch yourself doing this during your practice, take a big deep breath in and as you exhale imagine you are breathing out the toxic belief that is making you feel something about your body is wrong.

  5. Pushing ourselves too hard. There are many different types of yoga, from relaxing yin and restorative practices to more intense ashtanga and vinyasa practice. For anyone with a history of excessive exercise or body image worries, it can be tempting to use the more active, physically challenging practices as a way to continue to try to lose weight or change your body. If you fall into this trap, work on expanding your mind by bringing more pranayama and meditation into your practice as well as challenging your body through asana practice. Set the intention of awareness with every practice and listen to your energy levels and emotions

Over to you…

I hope you enjoyed this article on yoga and body image, please share with anyone else who this could help!

  • Like this post and follow my blog for more on yoga and holistic health. My next post will be a short yoga sequence you can practice at home to help boost your confidence and improve your body image.
  • If you are interested in joining my yoga class or you are looking for a nutritionist and health coach, contact me and we can work together to help you achieve your health goals!

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cycling exercise during period recovery

Can exercise stop your period coming back? 5 ways exercise can slow recovery

A common question from women trying to recover from Hypothalamic Amenorrhea is “can I exercise while trying to get my period back?”. I wrote about my tips for exercising during HA recovery but if you are thinking about taking a break and need some motivation, here are 5 ways exercise can work against your recovery.

1.Exercise burns calories which could otherwise be directed towards healing and repair of damage caused by dieting. The point of eating a lot more food during recovery is to flood the body with energy and nutrients to use for healing and repair. Exercise burns up some of these precious resources which will only prolong the healing process. Often women find it hard to meet the minimum recommended calorie intake for recovery and if you choose to exercise you should eat even more to compensate which can be a challenge.

2. Many women use exercise as a way to compensate for “over-eating” and it can be temping to start to move more when we allow ourselves to eat in abundance. We don’t want to exchange one control mechanism for another, we want to be completely free of all restrictions and compensations around food. We want to get to a place where we let go of any toxic beliefs around exercise and let go of guilt for resting. Exercising to make up for eating more is just another form of disordered eating behaviour.

3. Intense exercise is perceived as a stress by our hypothalamus, the brain master control centre. This means it can continue to feel it is unsafe to reproduce and not send the signal to restart our cycles. Although exercise is a good way to relieve mental stress, it is a physical stress on the body as it depletes glycogen reserves, increases the heart rate and damages muscle tissue. Exercise is healthy for a healthy body but if you don’t have your period you are not healthy right now and rest and recuperation will be your medicine.

4. For many women with HA, exercise has long been used as a way to manipulate their body and separating exercise from weight loss is difficult. We want to get to the point were we can exercise for fun and well being, regardless of the impact that it has on our physical appearance. If we continue to exercise during recovery, we might not do some of the mental work that is needed to fully break free of the weight loss mindset. It’s likely that you need to gain weight if you have lost your period and exercising could make this more difficult.

5. Exercise can be used as an appetite suppressant or a distraction from hunger. Exercise puts our nervous system in “fight or flight” mode when our body is stimulated and running on adrenaline which decreases hunger. You might find that you are more hungry on rest days because your body has calmed down and this is exactly what we want for healing. If you are hungry on a physical or mental level you should eat. Don’t fall into the trap of being “too busy to eat” as this will only delay your recovery.

Once you have recovered your period and have accepted your healed body, you might want to start exercising again from a much better headspace but at least it will be a conscious choice rather than because you feel you have to control your body in some way.

Over to you…

I hope this article gave you something to think about! It’s a personal choice whether you decide to stop exercising all together during your recovery. Women have recovered successfully from HA whilst still exercising but it is my opinion that we recover faster and more completely if we give our bodies chance to rest and fully repair.

  • Let me know in the comments, how do you feel about taking a break from exercise? Does it feel scary or a relief? For those in recovery, are you still exercising or taking a break?
  • If you are looking for support, guidance and accountability on your period recovery journey, please contact me for further information on the health coaching packages I offer. Together we will set you up with a plan to get your hormones balanced and you feeing your best mentally and physically.

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Why am I so interested in hormones? Part 3 – recovery, relapse, repeat

Continuing from my last post.. I started working with an online coach to heal my PCOS. Through working with her I started to uncover all sorts of ideas around my relationship to food and exercise and how it had impacted my body. Even though I was still very restrictive in my food choices I was eating a lot more and really cut down on my exercise routine. Over time, I started to doubt my diagnosis. I didn’t have any of the symptoms of high “male hormones” and just didn’t seem to fit the profile for PCOS. Eventually, I had the confidence to go and see another doctor and ask for further tests. I had some blood tests which confirmed my testosterone levels were normal and a second ultrasound scan which showed my ovaries were totally normal too. So I was “undiagnosed” from PCOS!

But I still didn’t have a period..

I continued researching trying to figure out what was going on and eventually I came across something called Hypothalamic Amenorrhea (HA). This is basically the loss of menstrual cycle due to physical or emotional stress. Finally something that seemed to make sense! It pointed at 4 basic causes:

  1. Under-eating
  2. Over- exercising
  3. Maintaining a low body weight
  4. Stress/anxiety

Over the next few months I found various people speaking about this online who I can’t thank enough for opening up this world to me. Especially Nicola Rinaldi and This Girl Audra whose books No Period Now What and Get Your Period Handbook really helped me to figure out a path out of this mess i’d got myself into. And this is where my relationship with my hormones started to shift from one of fear, panic and confusion to a softer, kinder understanding. I finally accepted that I needed a complete lifestyle overhaul if I wanted to heal and that my idea of healthy was totally warped and influenced by the diet and fitness industry.

I took an “all in” approach to healing my hormones where for a few months I did zero exercise, ate as much as I wanted (which was a lot!) and tried to reduce stress as much as possible. And in March 2016, at age 23, I finally got my period back. It wasn’t an easy journey, I had to gain weight which was something that terrified me and I had to totally rewire my brain and tackle disordered eating thoughts that had become so automatic that I didn’t even notice them anymore and just thought they were part of me. I had many fear foods and food rules to overcome and constantly doubted that what I was doing.

But I continued and since then I have been so aware of my cycle and grateful each month that I get my period. I was so amazed by the female body that I continued to read and learn about how to maintain balance and work with my hormonal cycle. I read Woman Code by Alicia Vritti and Wild Power by Alexandra Pope and Sjanie Wurlizter and these became my handbooks for life. I started to experiment with cycle tracking and cycle syncing and I have been doing this now for a couple of years. I am still learning but honestly I am completely fascinated and in awe by the magic of our hormones. I realised just how powerful they are in affecting the way we feel and show up in the world and the importance of working with our cyclic rhythm rather than against it.

It hasn’t all been plain sailing, I have relapsed several times in the last 3 years. Stressful periods at work and in life have triggered my “eating disorder brain” and resulted in me restricting food groups, creating food rules, tracking my calories and falling back into obsessive exercise in an attempt to change my body. These things help me feel in control and give me something to focus on when life gets too much to handle. But now I have my period as my “fifth vital sign” and any time it goes awry I know I need to re-evaluate and get myself back on track. I think it is something that I will always have to be mindful of, like many others who have struggled with disordered eating. However, I will never go back to the destructive habits that used to be my life.

During this time cycle tracking and syncing has been a key spiritual practice for me, helping me to learn more about my self and get closer to nature. I am still working on putting things I am learning into practice, especially as cycle syncing is not easy in the world we live in. But I keep going and I am excited to share my experiences on this blog. I hope this answers the question of why I am so interested in hormones, after the last 10 years I feel like its impossible for me not to be!

Why am I so interested in hormones? Part 2 – veganism, PCOS and orthorexia

Unfortunately after I graduated I slipped back to some of my old ways. I was still struggling with gastritis and other digestive issues and doing endless research online to find the “perfect healing diet”. This is where I found veganism, specifically the high-carb low-fat vegan diet. I started following all of these Youtube channels with skinny, shiny women promoting this diet where you can eat as much as you want and as long as it is vegan and low fat you won’t gain weight. I dived straight into this whole-foods based diet. I was convinced I was doing the right thing for myself as well as the planet and the animals. My diet took on this new moral value instead of simply being a way to control my body.

On one hand it was great as after years of calorie counting and restriction I finally let go and allowed myself t eat as much as my body wanted. This meant loads of fruit, potatoes, grains etc. At first I felt amazing with this new found freedom and I genuinely believed I had found the golden ticket. However, in reality my eating disorder had just morphed into something new that I didn’t recognise: orthorexia nervosa. This is an obsession with eating healthy food to the point where it controls your life. I might have been allowing myself to eat more but food was still taking centre stage in my life. I spent so much time reading and watching videos/ documentaries on the vegan diet, talking about veganism, writing about veganism, taking photos of my food for instagram etc..

At the time it was fun and I genuinely enjoyed it. It’s crazy how eating disorders can shift and manipulate you. I know my parents were worried about me at this time thinking that I had switched from one restrictive disorder to another but I couldn’t see it. I was in denial and so defensive if they ever brought it up. I gained this self-righteousness that I was following the way and they just didn’t understand. I tried not to be preachy and annoying but I definitely was! I was always the odd one out at social events and had to bring my own special food. I pretended that it didn’t bother me but of course it did. I started to feel so isolated and dived into the online world and groups of vegans where I could feel like I belong. This only pushed me away from my real life friends and left me feeling insecure and lonely.

Around this time I also got back into exercise as a way to control the stress from my new graduate job. Again I thought that this time was different because I was weight lifting instead of spending hours on cardio machines. But I was still using exercise as a way to manipulate my body, following fitness influencers and trying their workout programs to look like them. I was still choosing to go to the gym instead of socialising and still pushing myself to exercise when my body was crying out for rest. By this time I was struggling with insomnia and feeling exhausted ALL of the time but instead of letting go and allowing my body to heal I continued to exercise on a daily basis using pre-workout and coffee to drag myself through.

So it won’t come as a surprise when I tell you that my periods disappeared again (if you could count the couple of feeble periods I had as them returning). After a year I was back in the doctors office and this time something showed up on an ultra-sound scan that I hadn’t seen before. Small cysts over both of my ovaries. With this and blood test results which showed low estrogen and elevated testosterone, I was diagnosed with PCOS and the doctor told me I might never be able to conceive naturally. This was such a bombshell I literally cried for days afterwards. I was angry at myself thinking that my behaviours had caused this and I was screwed for life.

My doctor recommended that I took birth control pills to regulate my cycle but I knew straight away that this wasn’t something I wanted. It just didn’t seem to make sense to add extra synthetic hormones into my already imbalanced system. Plus I knew that it would be a fake period and was really only masking the problem. Once I’d calmed down I (again) turned to the internet. This time looking for natural ways to heal PCOS. I found an amazing community where omen were healing PCOS naturally via a plant-based diet. As I was vegan already I was like bring it on and jumped straight in to the 8 week program. 

This was only fuel for the fire of my eating disorder. Of course in the mindset I was in this was exactly what I wanted to hear and I carried on down my orthorexia path with my food choices getting stricter and stricter over time. I spent months trying to do various detoxes and cleanses – raw food, fruit diets, smoothie cleanses.. Foods that I had previously thought were healthy under the high-carb low-fat diet banner such as bread and pasta now moved into the “unhealthy” category. I became more and more attached to my healthy food choices so that it became part of my identity to be the “health nut”. I rewired my brain to think that ordinary foods were toxic for my body and I became afraid of them.

Am I saying that veganism is unhealthy or “orthorexic”? No!! Am I saying that exercising and wanting to tone up is unhealthy? Again, no!! What I am saying is that the mindset I had at the time was unhealthy. I was over-controlling and the reasons behind my choices were out of fear and anxiety about what would happen if I chose otherwise. Maybe you’re reading this and you think well I do these things and I’m perfectly healthy. Maybe that’s true and if it is then good for you. However, I know that there a a whole bunch of girls out there (guys too but this is aimed at women) who are trapped in this cycle of obsessive thoughts. The easy access to information that the internet brings only makes this worse. You only have to look at the number of “what I ate today” and body transformation videos on Youtube to see this collective pre-occupation with food and fitness.

In Part 3 I will talk about what finally motivated me to recover and what this process has been like for the last 5 years.

Why am I so interested in hormones? Part 1 – my battle with disordered eating

My journey with my hormones has been up and down to say the least. I started my period at age 12 with no major celebration.. my mum explained what to expect and how to use pads and tampons and that was that for a few years. I don’t really remember much from that time but I think my cycles were pretty “normal” coming each month with some pain and emotional ups and downs but it was no big deal. I was a happy, active kid. I played hockey in school and had competed in judo competitions since I was 10 years old.

I don’t remember ever being a fussy eater as a child but once I got to my final years of high school, I became pretty self conscious (like many teenage girls do) and started to manipulate my diet in the quest of “the perfect body”. It started off pretty innocently with me trying to eat more healthy foods and cut down on snacks (especially the buttery doorstop toast we used to have daily in the school canteen- yum!). But over time things spiralled and I became obsessive with my eating habits, trying to eat as little calories as possible and joining a gym to burn off anything I did eat. This carried on for a couple of years, all through my final exams and the summer before college. I some weight but I was still in the normal BMI range so no one was too worried.

High school2   High school   sophs

Looking back there were a few personal issues that most likely played a big part in me falling into this black hole of anorexia. At the time I wouldn’t have even called it anorexia as I was eating, just not a lot. But the official definition of anorexia is “an emotional disorder characterised by an obsessive desire to lose weight by refusing to eat” which is exactly what I was doing. I was so focused on dieting and weight loss and it never even crossed my mind that what I was doing could be impacting my hormones. Then at age 16 I decided to go on the birth control pill and that set off a cascade of events for the next decade.

I was having a regular period but I didn’t realise at the time but the periods you have on the birth control pill are not real, they are simply a reaction to the drop in synthetic hormones when you take a week break from the pill each month. I didn’t react well to the pill – like many women it made me anxious and emotional so after a year I decided to come off it.  And that’s when my periods went MIA. I saw a doctor after 6 months and was told that my body just needed to rebalance after the pill and that it would take a while for my body to settle out. But 12 months later.. still no period.

Back in the doctors’s office, after asking some questions and finding out that I was very active I was diagnosed with the “female athlete triad”.  I was told that losing your menstrual cycle  is common amongst women who exercise a lot and that it was nothing to worry about if I wasn’t trying to get pregnant. I felt something in my gut right there, my intuition telling me that is WAS something to worry about. I hadn’t been totally honest about my restrictive eating but I was in denial so I ignored the voice inside, accepted the doctor’s advice and carried on with my life. I tried to keep up my diet and exercise regime but after a while my body started to fight back with EXTREME HUNGER.

I still had my goal in mind though so I carried on working out and restricting my calories. But I would keep having these full on crazy binge eating episodes. I didn’t understand what was going on. Seriously I felt like something was invading my mind and forcing me to eat everything in sight! Then afterwards I would feel panicked and confused, guilty about everything I had eating and would vow to eat less and exercise more the next day. Always frustrated, angry at my body for not conforming to the size and shape I had decided it should be. Every time I binged I thought there was something wrong with me and I worked hard to make my body pay for its mistake. I spent hours researching how to stop binge eating, trying all sorts of tips to distracting myself from taking a shower or painting my nails to going for a walk or calling a friend but none of them could help me past the strong compulsion to eat when it came.

So my weight would fluctuate by up to 20lbs as I yo-yo dieted and the cycle continued until I was about 22..

Montpellier   bbq   Leaves   World challenge

croatia   cheer   euro   10616617_10154543788405654_85327801458386665_n

Don’t get me wrong I had some amazing times whilst all of this was going on. I made amazing friends, travelled Europe, volunteered in South America, got a job as a waitress, joined the university cheerleading team, had boyfriends, worked a year in industry and was on track to get a first in my engineering degree. But there was this underlying current of worry and anxiety and I was hiding the anorexia part of my brain leading me to go through periods of isolating myself from my friends and leaving me stuck in these mental patterns of criticising my body and myself, never believing I was good enough. I did seek help a couple of times with support from my mum but because I could go through periods of feeling ok again and because part of me was still in denial, I would discharge myself from therapy.

By my final year at university, my over-exercising and under-eating had spiralled into some pretty disordered eating patterns. I had been battling this whilst studying for my final exams and keeping up an active social life and eventually my body crashed hard. I was still in denial that I had a problem, believing that I “wasn’t sick enough” to need help (which I now know is a common symptom in disordered eating). So I carried on dieting and exercising until I was hit with chronic gastritis. This totally wiped me out and I wasn’t able to work out at all other than walking and some yoga. I put on some weight and funnily enough I got a period! It was only light and lasted a couple of days but after nothing for 5 years I was over the moon.

pub   chem eng ball  laos

I graduated from university and went travelling in South Eat Asia for 6 weeks before I started my new graduate job. Things were looking pretty good, I was exercising again but much more relaxed around food. I was maintaining a slightly higher weight that my body seemed happy with. But the story didn’t end there…

To be continued