MyNetDiary Blog

What Helps Adults Lose Weight & Maintain Weight Loss?

Did you watch HBO’s “Weight of the Nation” earlier this week?  It is a four-part film series made for the general public – it combines compelling personal accounts along with accurate, evidence-based information about weight control.  Everyone would benefit from watching this documentary, including health care providers who do not already work in the area of weight control.

Adults & Weight Control

In “Part 2: Choices,” the focus was adult weight control.  Although the film covered many important topics, I want to share a few summary points that I found particularly helpful in regard to weight control.

1.  Journaling food intake and exercise helps us be accountable for our eating and exercise behaviors.  Consider using a mobile app to make journaling simple and at your fingertips.

2.  Fad diets might succeed at weight loss, but they fail at weight maintenance since they are not sustainable eating plans.  These diets typically exclude entire food groups – this leads to a big drop in calories intake which then causes dramatic weight loss.  But once people go off these plans, they simply regain the weight that they lost.

3.  Mindful eating helps us pay attention to the “what, why, where, and when” of eating.  It is particularly helpful to tease apart eating to relieve hunger vs. eating to relieve stress or boredom.  

4.  Avoid drinking your calories since those calories are just added on top of food calories.  Caloric beverages to be especially careful to limit given their sugar content:  soda pop, sweet tea, energy drinks, juice drinks, and juice.

5.  Regular physical activity is important for weight loss maintenance.  Exercise will increase total calories burned, supports strength and balance, and helps control blood pressure, blood glucose, and stress.  About 1 hour of moderate exercise per day works appears to be most effective for weight maintenance.

6.  Social support helps people stick to their weight loss and maintenance goals.  The documentary shows how three women, who lost about 100 lbs each, lost and now maintain their weight using social support.  If you are isolated, considering using an online forum to help connect with others.

7.  Losing weight is easier than maintaining weight loss.  Researchers have found that a person who has lost a significant amount of weight and is maintaining at that weight will require about 20% fewer calories than another person of the same height, weight, sex, and age.  That is, the “weight loss maintainer” might need 1600 calories to maintain her weight whereas the “never-lost-weight” friend might need 2000 calories.  Long term calories tracking can help you become an expert on how many calories you need to maintain your weight.

8.  Lifestyle always matters.  Eating fewer calories from a variety of healthful foods from all food groups and regular physical activity are basic behaviors that are harder to master initially, but result in weight control success over the long term.  Lifestyle factors are also critical to reducing the risk of progressing to Type 2 diabetes.  

9. Your genes are not your destiny.   Your health is a result of the interaction between your genetic make-up and your lifestyle choices.  A great example of this is comes from the story of Tim and Paul, middle-aged identical twins featured in the documentary.  Tim controlled his weight and exercised regularly, which prevented him from progressing to Type 2 diabetes.  Paul did not pay attention to those lifestyle changes and found himself struggling to control Type 2 diabetes.

10. First, aim to lose 5-10% of your body weight.  Significant health benefits are seen with losing 5-10% of body weight when an individual is overweight.  That would be 10-20 lbs for a 200 lb person.  See my MyNetDiary blog post for more information on setting SMART goals.  

Have questions or comments about this post?  Please feel free to comment on MyNetDiary’s Forum or Facebook page.  I would love to hear from you!

Best,
Kathy Isacks, MPS, RD
Consulting Dietitian for MyNetDiary

More Resources

Academy of Nutrition & Dietetics.  Consumer Diet Lifestyle and Book Reviews.  

Dietitians-Online.  Health Choices:  How to Spot a Fad Diet.  

MyNetDiary Blog.  

WebMD.  Weight Loss & Diet Plans.  This is a website devoted to reviewing all eating plans, including fad diets.  

Disclaimer: Please note that we cannot provide personalized advice and that the information provided does not constitute medical advice. If you are seeking medical advice, please visit a medical professional.

What Helps Us Make the Better Food Choice? 

What motivates you to make the better food choice – the one that supports your health, your weight, or even your mental health – despite the huge number of tasty, less healthy options?  Is it willpower - a form of mindful eating that allows you to pause and reflect upon the choice you are about to make before you actually commit to the choice?  Are you willing to consider the consequences of making the less healthful choice every time you decide to eat a meal or snack?  

I need food decision making to be easier than that.  Sure, I’m willing to use willpower for some decisions, but I don’t want to be challenged continuously to make the best choice all of the time.  That sounds exhausting to my doughnut-, french-fry, cookie-loving brain.  I want the better choices to be my range of options in the first place, so that it is actually easier to make the better choice, and harder to make less healthful choice.   To do this, I use a combination of tactics. 

Mindless Portion Control

I am a big fan of Brian Wansink’s approach to skimming off calories - controlling portion size without cognitive effort.  For instance, I use smaller plates and bowls, skinny vs. wide glasses, high contrast place settings so that my food stands out on the plate, keep used plates or chicken wing bones on the table so that I remain accountable for food eaten, store trigger foods out of sight, and serve food out of smaller containers.  These simple tactics work well for me.

Environmental Control

I decide where I am willing to get my food and then don’t consider other places as options.  This refers to all food venues - grocery stores, farms, markets, restaurants, fast food places, convenience stores, etc.  When I limit my food venues to those that offer nutritious, calories-controlled, and affordable selections, then I create an “easier” healthful food environment in which to make choices. 

I won’t blame the obesity crisis on fast food or the restaurant industry, but folks should know that if they want to control calories, limit harmful food ingredients, and maximize nutrients, then they have a tough road ahead of them if they insist on eating most of their food away from home.  I find that the more I cook at home, the easier it is for me to maximize nutrients while minimizing calories, sodium, saturated fat, and trans fat content of my meals and snacks.

I negotiate with family or household members regarding what gets brought into the home.  If my husband wants to eat one of my trigger foods (e.g. cookies), then he has agreed to do so outside of our home.  There is no reason why we “need” to buy or bake cookies. 

Are you the only person who needs to create a more healthful eating environment at home?  I bet not.  When one family member has a weight problem, typically other family members do too.  So have that important discussion with family members to get your trigger foods out of the house. 

Willpower

In a recent conversation with MyNetDiary’s marketing director and fellow blogger, Ryan Newhouse, I started out with a simple question: “What does willpower meant to you?” In response, Ryan writes:

I think of willpower as the power to put things into perspective - with food, it’s about that moment right before we open the ice cream container (or the freezer for that matter) and admit to ourselves that we don’t “need” this. Willpower can be what keeps us from filling our plates with food or feeling like we need to finish everything in front of us. It could simply be the power to put more veggies on our plates instead of extra meats and carbs (as I often do).

Willpower, for a while, made me think of restraint, control, etc., but when we lose those things it can be hard to bounce back; this is why I believe thinking of willpower as a “big picture” perspective is more helpful. Willpower can certainly include the power to rebound when we “fail” at a meal - when we overeat or sneak treats – but instead of the downward spiral into guilt and feeling “it’s just too hard,” we can think of a reasonable plan to succeed that includes the “why” of what we’re doing – better health for ourselves and our family, a more active lifestyle, gaining more self-confidence, etc. 

Have questions or comments about this post or Ryan’s definition of willpower?  Please feel free to comment on MyNetDiary’s Forum or Facebook page.  I would love to hear from you!

Best,

Kathy Isacks, MPS, RD
Consulting Dietitian for MyNetDiary

Disclaimer: Please note that we cannot provide personalized advice and that the information provided does not constitute medical advice. If you are seeking medical advice, please visit a medical professional.

The Weight of the Nation - HBO Documentary Premiers May 14-15

HBO and the Institute of Medicine have joined forces to create a new documentary about America’s obesity epidemic. Airing in four parts over May 14 and 15, “The Weight of the Nation” considers everything from how we got here, what the experts say about obesity, what our children face and what are the driving forces behind this epidemic. 

Here’s the complete description about the project, as listed on the website:

Bringing together the nation’s leading research institutions, THE WEIGHT OF THE NATION is a presentation of HBO and the Institute of Medicine (IOM), in association with the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH), and in partnership with the Michael & Susan Dell Foundation and Kaiser Permanente.

The centerpiece of THE WEIGHT OF THE NATION campaign is the four-part documentary series, each featuring case studies, interviews with our nation’s leading experts, and individuals and their families struggling with obesity. The first film, CONSEQUENCES, examines the scope of the obesity epidemic and explores the serious health consequences of being overweight or obese. The second, CHOICES, offers viewers the skinny on fat, revealing what science has shown about how to lose weight, maintain weight loss and prevent weight gain. The third, CHILDREN IN CRISIS, documents the damage obesity is doing to our nation’s children. Through individual stories, this film describes how the strong forces at work in our society are causing children to consume too many calories and expend too little energy; tackling subjects from school lunches to the decline of physical education, the demise of school recess and the marketing of unhealthy food to children. The fourth film, CHALLENGES, examines the major driving forces causing the obesity epidemic, including agriculture, economics, evolutionary biology, food marketing, racial and socioeconomic disparities, physical inactivity, American food culture, and the strong influence of the food and beverage industry.

Currently, researchers are predicting that 42% of Americans will be obese by 2030, and yet it seems that Americans can’t go a day without reading or seeing on TV an advertisement for quick and big weight loss pills, tactics and diets, as if it’s normal to drop 20 pounds in two weeks or was easy to lose 100 pounds. 

The health of those who are obese can be improved just by losing 5-10% of one’s starting weight, according to several studies. But we don’t see that touted as the “answer” to losing weight in those flashy ads, right? 

Tell us, will you be tuning in? What would you like to see happen from this? Chime in on our MyNetDiary Facebook page or in our Community Forum. 

Click here to watch the “Weight of the Nation” trailer. 

Eating Gluten-Free & Struggling to Get Enough Fiber?

Many folks in the U.S. rely on wheat for meeting their fiber need but that is not an option for folks who must avoid gluten.  Wheat, rye, and barley all contain gluten.  So how do you get enough fiber (25 grams for women, 38 grams for men) from gluten-free sources?  There are many processed gluten-free foods available now but they are often low in fiber and very expensive.  This post is just to get you started thinking about less expensive gluten-free fiber options.  For a food to really work in your eating plan, it needs to provide an acceptable taste, texture, and cost.

Dried Beans & Peas

The easiest and least expensive way to get a lot of fiber without gluten is to eat dried beans and peas (legumes).  Legumes are high in protein, vitamins, minerals, complex carbohydrates, and fiber.  One-half cup provides between 6-8 grams fiber – and much of that is soluble, the type that is so beneficial for heart health and Type 2 diabetes.  Examples include chick peas (garbanzo beans), kidney, white, fava, pinto, black, and navy, lentils, and split peas.

If you hate beans because they give you gas, then try different types and limit portion size.  Lentils seem to be less gassy than other legumes.  Try ½ cup cooked lentils if you are just starting to eat legumes.  They also cook very quickly.  If you like Alton Brown’s recipes, then try his delicious Lentil Soup (if you don’t have grains of paradise, you can substitute it with black pepper, shansho, or cardamom).

FYI:  Using packaged bean flour for baked goods is a much more expensive way to get your fiber from beans.

Ground Flax

Although not as inexpensive as beans and peas, ground flax is affordable if you simply stick with the standard portion size of 2 tablespoons (13 cents - 27 cents depending upon brand).  Two tablespoons will give you 4 grams of fiber along with 6 grams of healthy fats, fiber, magnesium, and iron.  It is also very low in digestible carbs – only 1 g per serving.

Brown Rice

For pennies a serving, 1 cup of cooked brown rice provides about 4 grams fiber and about 25% DV for magnesium.  In my opinion, the best taste and texture comes from cooking long grain brown rice from scratch.  If you plan to cook rice often, invest in a good rice cooker.  Or, if you cook it on your stovetop, bring to a boil and then turn down to low/simmer for 50 minutes – 1 hour.  Extra rice freezes just fine.  If you live at altitude or in a dry climate, try adding more water than what the recipe calls for to avoid undercooking.   Note that wild rice also provides fiber but it costs about four times as much as brown rice.

For those who suffer from constipation, do not be fooled by the relatively modest fiber content of brown rice.  Try it – you’ll be surprised at how effective brown rice is at moving your bowels.

Fruits & Veggies

All fruits and veggies contain fiber, but some are especially great sources:  blackberries and raspberries (8g/cup), and acorn squash and green peas (9g/cup cooked).  To keep cost in check, buy fresh berries only in season but consider frozen berries during other times of the year.  If you live in the Pacific Northwest, then feast on those delicious blackberries that grow wild everywhere.  Can’t beat free!  

Have questions or comments about this post?  Please feel free to comment on MyNetDiary’s Forum or Facebook page.  I would love to hear from you!

Best,
Kathy Isacks, MPS, RD
Consulting Dietitian for MyNetDiary

Additional Resources

Gluten-Free Goddess Recipes.

The Gluten-Free Mall.  

Shelley Case, RD.  Gluten-Free Diet:  A Comprehensive Resource Guide.  

Tricia Thompson, MS, RD.  The Gluten-Free Dietitian.

Disclaimer: Please note that we cannot provide personalized advice and that the information provided does not constitute medical advice. If you are seeking medical advice, please visit a medical professional.

What the Belly Really Holds

Excess body fat doesn’t always distribute itself evenly over our bodies. Sometimes we see a concentration of it around our midsections, including our belly, hips and thighs. Unfortunately, when this happens it can signal that our excess weight can lead to more serious health issues. Carrying extra weight in these areas have been associated with increased risk for heart disease, stroke, dementia, high blood pressure, Alzheimer’s disease and type 2 diabetes. And though genes may play a role in this, it can also be triggered by our lifestyles and eating habits. 

While it would be nice to point to high-fat foods as the culprit behind a bulging belly, any kind of excess calories lead to weight gain in our midsections. However, there is one exception to this. High calorie drinks, especially ones with alcohol, have been shown to be linked specifically to belly fat. Our livers are so busy burning off the alcohol it can’t get to burning fat, so the excess is stored in the midsection. 

We can guard ourselves against excess calories by keeping a food diary, but we can also be aware that certain fats can actually redistribute existing fat in our bodies to our bellies. Trans fats, according to research by Wake Forest University, have been shown to redistribute fat tissue to the stomach area. 

In addition to avoiding trans fats, we can also eat foods high in fiber. The American Journal of Clinical Nutrition has shown that diets high in whole grains can trim extra fat from our waistlines. 

And when it comes to the differences between men and women, it’s men who tend to collect more belly fat than women. However, once a women hits age 40, estrogen levels drop and body fat can get redistributed to the belly. 

All is not lost though if you have belly fat. If you are actively losing weight through diet and exercise, belly fat is often the first to come off. Spot exercising, such as doing crunches and sit-ups to get rid of belly bulge, do not work quite in the way we hope them too. They can have some benefit, but not a lot. Aerobic exercise is the best for burning fat. 

Tell us, what has helped trim your waistline? You can share your tips on our MyNetDiary Facebook page or in our Community Forum!

Portion Distortion

Guest post provided by Martha Henze, MS, RD, Traveling Taste Buds, LLC; marthahenze@gmail.com

How many inches in diameter was a bagel 20 years ago? How many ounces were in an average soda 20 years ago?  A bagel 20 years ago was 3 inches in diameter and had 140 calories.  A bagel today is 6 inches in diameter and has 350 calories.  More than double the calories!

To learn the answer to the soda question and about French fries and spaghetti and meatballs, try this fun Portion Distortion Quiz: You will be surprised!

When people regard excessive portions as normal amounts then we have portion distortion.  As meal sizes have increased so has our waist sizes and our risk for various chronic diseases such as cardiovascular disease and type two diabetes.

How do we prevent portion distortion?

At home:

*  Buy smaller plates, bowls and beverage glasses.

One client of mine noted that her new Christmas plates were too big to fit into her 1950‘s dishwasher.  Wow, what a great visual example of portion distortion!  Fill half of your plate with fruits and vegetables and the rest of your plate with other foods, such as lean meat and whole grain foods. Only place the serving dishes with the fruits and vegetables on the table for seconds.  Leave the entree in the kitchen so you have to get up for it!

*  Track your food using MyNetDiary at http://www.mynetdiary.com/

Often clients I work with, lose weight just by writing down everything they eat and drink.  I joke with them saying that I did not know that “writing” was an aerobic  activity.  Study after study demonstrates that the greater number of days per week that a person tracks his or her food and beverage intake, the greater the weight loss.  Keep tracking!

Enjoy nuts but do not “go nuts”.

If you enjoy snacking on cashews or peanuts while watching the Colorado Rockies baseball team, enjoy them, but limit your portion size to 1/4 cup of nuts (about 23 almonds).  One-fourth of a cup of nuts (1 oz.) has about 200 calories.  Thus, if you nibble on 1 cup of nuts this would be about 800 calories.  If your daily caloric need was 1600 calories, the nuts would provide 50% of your caloric intake in just one sitting.

At restaurants:

Don’t think that restaurants serve you the appropriate amount of food! 

*  Share entrees. 

We are a family of four and generally order three meals.  We do not leave the restaurant hungry!

*  Pack a “to go” package when you get your meal. 

Studies show that the more food is put in front of people, the more people eat!

If you pack it immediately, your lunch will be ready for tomorrow! Better on the budget and better on the waistline.

Beverages - Order water.  Add a squeezed lime or lemon.

Cheryl Forbes, registered dietitian for contestants from the Biggest Loser, noted that most contestants BEFORE joining the Ranch were meeting their daily caloric needs through beverages alone (e.g. caloric sodas, juices and fruit punch)  Many consumed very little water.

Going back to portion distortion.  A soda 20 year ago was 6.5 oz. (that’s less than 1 cup) and had 85 calories.  A soda today has 16 oz and has 220 calories.  To burn these extra 135 calories, you would need to lift weights for about 1 hour.

Step one to preventing portion distortion, is awareness.  Remember that the bottom line to healthy eating habits is variety and moderation.  Moderation is the key to preventing portion distortion.

Alles Gute,

Martha    

MyNetDiary Integrates with Withings Devices

Popular calorie counter and diet tracker now works wirelessly with Withings body scale and blood pressure monitor

MyNetDiary, a comprehensive food diary and calorie counter with online and mobile app services, announced its integration with two popular Withings products, the Wi-Fi Body Scale and Blood Pressure Monitor, allowing members to automatically send data from both devices to their MyNetDiary account to aid with monitoring their health and diet.

“This integration with Withings makes it even easier for people to keep track of their diet, weight changes and health,” says Sergey Oreshko, CEO of MyNetDiary. “We have always strived to make calorie and exercise tracking as fast and simple as possible, and now with the speed and technology Withings offers through its dynamic products members can focus more on achieving their goals and less on manually entering data.”

For MyNetDiary members who own a Withings Wi-Fi Body Scale, data from each weigh-in, including body weight, fat and lean body mass and BMI, can be downloaded automatically to their MyNetDiary account. And for members who have the MyNetDiary Auto-Pilot feature enabled, the new data will automatically adjust target calorie intake in conjunction with the recorded changes and the user’s weight loss goal and target date.

MyNetDiary members can also automatically link data from the Withings Blood Pressure Monitor and an iOS device. The Withings Blood Pressure monitor can measure systolic, diastolic blood pressure and BPM. Many MyNetDiary members already record their calorie intake and exercise through the iPhone and iPad apps MyNetDiary offers.

“We are a leader in tracking for diet and health,” says Oreshko. “Our service allows a user to track up to 45 different macro- and micro-nutrients, and record up to 20 different body measurements, more than any other calorie tracker on the market. Blood pressure and heart rate data play obvious and important roles in one’s overall health, and they should be monitored when dieting and exercising for weight loss.”

“Weighing yourself and keeping track of your diet are obviously two major components of weight control, and MyNetDiary makes it very easy and seamless to do both” said Cedric Hutchings, Withings General Manager.  “Through this partnership, we will make it a seamless process to keep track of your weight and your nutrition on MyNetDiary to help people reach their fitness goals more smoothly.” 

Why Smart Eating, Exercise and MyNetDiary Work for Weight Loss

Fad diets are so out of the loop, at least according to a new study published online in the American Journal of Preventative Medicine. Researchers at Beth Israel Deaconess Medical Center analyzed data from over 4,000 obese people who participated in a survey by the Center for Disease Control and Prevention between 2001 - 2006. 

The study looked at how these individuals tried and succeeded at losing weight. Those who were most successful did two very simple things: ate less fat and exercised. A significant number of people also lost weight when they joined a structured weight loss plan, crediting the importance of guidance. 

However, those who didn’t lose weight were the ones who participated in a variety of fad diets (liquid diets, nonprescription weight loss pills, diet foods/products, etc.). 

More than a third of Americans are obese, and 50-70 percent of them are trying to lose weight. And just a 5 percent reduction in weight can improve one’s health. 

MyNetDiary members benefit from having support and structure through the RD-moderated Community Forum and many articles published here on the blog and through the MyNetDiary website. We encourage simple, healthy eating and active lifestyles, all tracked through our web or mobile apps. We don’t encourage fad diets or “lose weight fast” mentalities. 

We hope you’ve had great success using MyNetDiary. Please keep sharing with us your success stories. And if haven’t yet done so, we always appreciate a review of our mobile applications. They really do help us make them as useful as we can! 

Bulimia: the other eating disorder



Guest post by Donna P. Feldman MS, RD, Nutrition journalist and consultant, Radio Nutrition

Usually when we think ‘eating disorder’, we imagine an emaciated-looking young woman, possibly a celebrity. Anorexia is typically what comes to mind. But there are other eating disorders that are just as serious, even if they don’t fit that extreme physical image. People suffering from bulimia — out-of-control bingeing followed by purging — can be normal weight or overweight. But they definitely have an eating disorder, one that can have serious consequences.

Why would anyone engage in this behavior: eating thousands of calories at one time, then vomiting? Bulimics themselves ask this question, yet they feel completely out of control and helpless to stop themselves. Binge eating is a learned reaction to stress, anxiety, depression and other emotional conflict. It’s actually a coping behavior, like self-medicating with food, especially sugary, high-carb foods. If you ask a bulimic person what their preferred binge foods are, the answer is typically ice cream, cookies, cake, candy, pastries, pretzels, crackers, chips and bread. No one binges on stuff like apples, broccoli, cheese, salad or steak.

Bulimia can have serious health consequences. Binge-purge cycles can lead to chemical imbalances in the body. Dehydration and electrolyte imbalances caused by vomiting can lead to irregular heart rate and even heart failure. Vomiting can cause inflammation or injury to the esophagus, as well as tooth decay. Purging and laxative abuse can lead to chronic digestive disturbance, including constipation. In addition to those physical problems, the secretive binge-purge behaviors make bulimia a very isolating experience. Bulimics are usually suffering from symptoms of depression, but whether that is a cause or effect is not well understood.

While some people may secretly envy an anorexic’s ability to resist eating, few people would find bulimia attractive. It’s embarrassing and distressing to the afflicted person. This makes it hard for a bulimic to seek help, which is unfortunate, because treating bulimia isn’t just a matter of using self-discipline to quit the behavior. Bulimia is not just dieting behavior that spiraled out of control. It’s driven by a very complex set of emotional triggers. Psychotherapy can be a very effective treatment, if the psychotherapist is experienced in treating bulimia and the bulimic person is committed to working on change.

Here are some common signs of bulimic behavior:

• Feeling out of control about your eating behavior
• Bingeing to the point of physical discomfort and pain
• Binges done in secret
• Eating far more food in a binge that you would ever eat at a normal meal
• Preoccupation with weight and body shape
• Forced vomiting or exercise, or laxative abuse to purge the food. 
• Fear of gaining weight
• Rigid compensatory exercise routines in response to eating, in an effort to burn off calories

In fact, the term “exercise bulimic” is now recognized as a disorder. Instead of, or in addition to, purging, exercise is used to deliberately burn off excess calories. The person may jump on a treadmill or stationary bicycle after eating, until a certain number of calories are burned, or run very long distances for the same purpose. Exercise schedules can take over the bulimic’s life.

If you’re bulimic and want to change, the first step is finding a therapist to work with. Unless your situation is so severe that you need inpatient treatment, weekly sessions with a local therapist should be sufficient. The therapist should have experience dealing with eating disordered clients. While one particular therapist may be highly recommended and very experienced, this may not be the right person for you. You should feel comfortable working with your therapist, even if the therapist expects you to work on issues that feel uncomfortable. The next step is showing up for your therapy sessions and following through.

It’s also a very good idea to work with a registered dietitian on food and nutrition-related issues. An RD experienced with eating disorders can help you understand what balanced meals look like and help you work through changes. If you’ve been engaged in severe bouts of bingeing and purging, you should probably be checked by a physician to be sure your health hasn’t been compromised.

What if you suspect a friend or family member is bulimic? This can get tricky, since you don’t want to be confrontational and lose that person’s trust. But if you see signs of bulimic behaviors, you need to have a frank and supportive discussion.  Signs may include:

• Frequent smell of vomiting (on the person, in the bathroom)
• Empty food packages or wrappers stuffed into the trash
• Food missing from the pantry or refrigerator — a new half-gallon of ice cream or a new package of cookies simply disappears
• The person frequently disappears into the bathroom after dinner for prolonged periods.
• A rigid routine of excessive exercise, especially after eating

You can find more information about signs and symptoms, as well as advice on helping friends or loved ones navigate through treatment options, at the Eating Disorder Referral and Information Center website. This national organization also has searchable information on treatment options in your area. In addition, you may find referral and information centers in your own locality.

-Donna P. Feldman MS, RD

Nutrition journalist and consultant

http://RadioNutrition.com