: The problems with nutritional science

Anorexia Recovery as an Adult: Letting go of nutritional science 9


I have a nutrition qualification, but I don’t use it. In fact, what I was taught about nutrition on that course set me back a good couple of years in recovery. I was taught that fat was bad, calories should be minimized, meals should be planned as to balance macronutrients, and all sorts of balderdash that was very unhelpful to me. I had been suffering from Anorexia for over 8 years by the time I took that nutrition course, and it was evident on the course that the professors had nothing to teach me. Anorexia loves nutritional science, and I could already look at a plate of food and break it down into calories and macronutrients; tell you the vitamin and mineral content; and quote the research verbatim to support my criticisms of it’s value to health.

What my nutrition degree gave me was validation for my Anorexia behaviors. That piece of paper meant that whenever I was told by my family, my doctor or anyone else that I was too thin I could ambush them with not only science to support my actions but a qualification and a scathingly supercilious attitude to boot.

For me, Anorexia recovery was about exposing, calling bullshit on, and disobeying everything that I knew about nutrition. Doing that was both painful and powerful. Painful because it meant rejecting the foundations of what my entire identity had been built on — I had a successful personal training and nutrition business  — yet powerful because it allowed me to jump out of the shackles. It brought me closer to my body and taught me to trust my body. It was a critical aspect of my recovery and I highly recommend it.


The problem as I see it is that nutritional science is taken as fact when it should be taken as theory at best. When we take a laboratory-tested theory and apply it as fact to our living bodies it doesn’t seem to work out too well.

Macronutrients were not discovered until somewhere in the middle of the 1800s. Vitamins even later in the 1900s. As far as I am aware, humans have been eating food for a good while longer than that. Arguably we did a better job of doing so when we knew less …

This blog post about the problems with nutritional science is coming from the viewpoint of Anorexia. That is, a very black and white thinking (malnutrition causes this sort of thinking) and tendency to latch onto concepts that suit the Anorexia’s agenda and take them as gospel. For a person with a very open and flexible mind, nutritional science will be considered as it should be: interesting and theoretical. But malnutrition stiffens the mind and for this reason, nutritional science do us a lot more harm then good when we are sick.

If public health research functioned like some of the harder sciences — high energy physics being the one I know best — then researchers would be ridiculed and perhaps even run out of the field for over-interpreting their evidence or publicly presenting the results of sloppy experiments or basing claims on premature evidence and none of this would have happened.

You can think of this kind of brutal response to bad science as an immune system that serves to protect reliable knowledge from infection by the infinite number of bogus but compelling ideas that are out there. The last place you want a science to find itself is where obesity research is today, with hypotheses of causation that can explain none of the pertinent observations, but yet are believed so fervently that no one can challenge them without being ostracized or declared a quack.

— Gary Taubes, author of Good Calories, Bad Calories


When I was 16 I knew how to eat.

I ate whenever I was hungry. I ate what I felt like eating.

I ate regardless of the time of day, or what other people were eating.

I ate what tasted good, not what nutritional science, my friends, or the media told me was good for me.

I ate without having the foggiest of the nutritional value of the food I was eating.

I ate lunch without thinking about what I had already eaten for breakfast that day, and what was planned for dinner, and what would mean that my day was nutritionally “balanced.”

I didn’t have these weird OCD-like 24-hour bracketed food rules on the amount of times one type of food could be eaten in a day. For example, I could have eggs on toast for breakfast, a cheese baguette at lunch, and pizza in the evening without thinking “I’m eating too much bread.” I could eat Honey Nut Clusters for breakfast and a chocolate bar and and apple an hour later without thinking “I have a sugar addiction and have to not eat anything sweet for the rest of the day.”

I could eat a burger and fries without thinking “Are you crazy? That is two carb servings!”

I could eat what I wanted, when I wanted, completely oblivious to what nutritional science/health gurus would say about it. Oblivious to “balance.” Oblivious to “right” and “wrong.”

That was the healthiest time of my life in terms of physical and mental wellbeing.

Right now, in terms of physical and mental health I am closer to where I was when I was 16 than I have been my entire adult life. Any health problems that I have are a consequence of over 10 years malnutrition from Anorexia. Other than that, I am back where I was. I eat what I want when I want. I eat for taste and hunger. But it took me a long, long time to get back to where I was. And mostly I can attribute my re-found attitude to one simple, lightbulb moment I had when I was 29:

Fuck nutritional science. 

Fuck nutritional science because I have Anorexia. I have a mental illness that tries to kill me if I follow food rules.

Okay, I know, I know … there will be a lot of people reading this aghast because saying “fuck nutritional science” feels like blasphemy. I am also a lover of science, which makes this statement seem bizarre. But if you take it in the context of a person who was once bombarded with a hundred conflicting thoughts about what the “right” thing to eat was in any one moment … someone who was mentally hounded by hunger/desire versus sensible/correct/scientifically proven concepts of good and bad. Well, then you will probably understand why “fuck nutritional science” was an very healthy and healing concept for me.

Remember, I am coming at this with the viewpoint of a person in recovery from Anorexia. To be able to let nutritional science go … to let it all go. The power of deciding I wasn’t going to care about any of that any more. Never, ever would I choose a meal based on what science told me to eat. Never ever was I going to read some pop-science article on why I should eat more kale. This felt like freedom indeed.

A vital part of my recovery from Anorexia was discrediting the nutritional science that the eating disorder loved so dearly to lob into every food choice. In order to let it go, I had to disempower it. Disempowering nutritional science was far far easier than I had expected. Egregiously, nutritional science is a bit of a rotten apple.

 

Nutritional science is a baby

(And a precocious one at that!)

It is only very recently that we have been looking to nutritional science to answer questions of what is healthy or not outside of the realms of problems like famine-caused malnutrition. This industry is really just a baby, and until it grows up, everything that comes out of it needs to be considered with a pinch of salt (is that even allowed anymore, or is salt considered a bad food again?)

Scurvy was first treated in 1747 after a bloke called James Lind who was a surgeon on a ship played around with administering different tonics to sailors with the illness. In 1902 the caloric values of the macronutrients were first theorized. In the early 1900s the vitamins A,B,C,D and folate were discovered. In the 1970s Ancel Keys concluded that CHD is linked to cholesterol. (This is the first real example of how wrong we can get things.) Keys’ research started this whole movement against the macronutrient fat which people are still caught up in today despite our understanding now that Keys was wrong in his conclusion.

Additionally, nutritional science for optimal nutrition is underfunded. NIH research spending amounts shows nutrition receives only a quarter of about what cancer research gets. Now, the larger problem here is that the research into nutritional questions are often funded by interested parties. For example, research looking into the question “can sugary drinks lead to weight gain” (who cares anyway) is majority funded by parties with a financial conflict of interest. The field of nutrition is not as advanced as the field of medicine when it comes to building in the safeguards to address these conflicts of interest. Incidentally, it was sugar-company funded research that pointed the blame for CHD onto fat and cholesterol in the 1960s. For some reason this makes me even more annoyed that I spend a good 10 years believing all that tripe. I feel into that marketing trap. Bah.

Another interesting problem with nutritional science is that of confounding variables. Even in the best controlled trial one cannot isolate the effects of nutrition from all the other aspects of your life that have and are currently influencing your health. Even actually taking part in a study can alter your health. For example in one study where scientists asked people who eat breakfast to stop and people who don’t eat breakfast to start, both groups lost weight! It was the change that sparked the weight loss, not the intake! This study pretty much sums up everything I think about nutritional science. (That makes me a hypocrite, as I am writing a post discrediting nutritional science and validating it with a nutritional science study — I’ll take it!)

Most nutritional science is generally observational (and retrospective) I don’t need to list the problems with that, do I? Okay well let’s just say that if I asked my hubby what he had for dinner last night he’d get it wrong. Anyway, an observational study cannot account for the variables so it can’t answer the question “do apples make people go to the Dr less or do people who go to the Dr less happen to eat more apples.”


No one likes to admit that his or her best efforts at understanding and solving a problem have actually made the problem worse, but that’s exactly what has happened in the case of nutritionism. Scientists operating with the best of intentions, using the best tools at their disposal, have taught us to look at food in a way that has diminished our pleasure in eating it while doing little or nothing to improve our health.  — Michael Pollan


And the problem with calories …

Calorie counts on labels can be off by a large amount. Suck on that, Anorexia! All those years you made me diligently tot up the calories I was eating as based on the labels of my food and all this time they were wrong anyway.  They can be out by around 25% according to some sources. The good news here, is that if you are reading this and struggling with calorie counting, you can use this information to your advantage. Even if you have been treating your body as if it were a calculator and neatly putting in the same amount of calories each day based on nutritional labels you can stop. It is futile.

Furthermore, we don’t absorb all the energy that we consume, and there is no current understanding or why or how because all individuals are unique. Calories in doesn’t equal calories out! As Susan Jebb from the Medical Research Council’s Unit of Human Nutrition Research in Cambridge puts it, not all the calories that we consume will be available for the body to use. Also, the nutrition labels only measure calories that present in the forms of the macronutritents as presented by Wilber Atwater over a hundred years ago! Macronutrients are based on a system of averages and no food is “average.”

Even the exact same food can vary one day from the next as to how it is absorbed. Some foods are also good at escaping digestion. As demonstrated by a study done by Janet Novotny and colleagues that found that certain foods are not digested in a way that makes all the calories available. Additionally, some foods mean that the immune system has to get involved in digesting them. There don’t seem to be many conclusive studies on how many calories this takes for the body to deploy minor immune system responses (ones that you don’t even know are happening), but it is some. Additionally, some foods will require more of an immune system response in some people and less in others. We are not machines, our bodies don’t all work identically. More reasons why caloric values are whack and you can tell your eating disorder to give up trying to make you believe that calorie counting matters.

It irks me something chronic that people in recovery from Anorexia are often put on low caloric intakes (under 3000 calories) but even more so if one considers how unconsciously incompetent we are in our knowledge of how the body uses calories. All the more reason to err on the side of caution and encourage people in recovery to eat a lot more food, not cap it out at a low intake.

In short, the best use of caloric information in Anorexia recovery is using it to set non-negotiable, high minimum intakes. 

 

Individuals process food differently 

In one study not so long ago in Israel, scientists tracked 800 people to see how blood sugar levels responded to the same foods — they did this for 46,898 meals. The results were wildly different for each person even when eating the exact same meal. Now tell me, how can we possible conclude that any one type of food is good or bad for every person?

From the study’s Rafael Perez-Excamilla: “It’s now clear that the impact of nutrition on health cannot be simply understood by assessing what people eat as this is strongly influenced by how the nutrients and other bioactive compounds derived from foods interact with the genes and the extensive gut microbiota that individuals have.”

That feels like common sense, does it not? Yet we are still prescribing meal plans to people in recovery from Anorexia based on the theory of a balanced diet. Doing so increases our levels of stress and reinforces the eating disorder’s OCD around food and eating.


“Even with things that we can all intellectually agree is unhealthy, such as a meal at McDonald’s, there will be literally thousands of people that read this book who are freezing cold or haven’t slept through the night in years, or who are suffering from anxiety..And most of those health-conscious people wouldn’t DARE eat at McDonald’s. But to their surprise, they might find almost immediate relief from their health condition(s) if they were to go pig out of 2-3 double Cheeseburgers, an apple pie or two, and an ice cold Coke form none other than the infamous Mickey D’s. Why? Because the calorie-density, digestibility, and salt and sugar-healthy load of a McDonald’s meal is unparalleled. And for someone in a really low metabolic state, this can literally be the most therapeutic of all combinations. You might heal faster eating at McDonald’s than trying to do it on organic, unrefined, wholesome, and nutritious food because such food is not as calorie-dense, has higher water content, has more fiber, and is just too filling and unexciting to foster the same level of calorie consumption. So the unknowns about what is and isn’t healthy for an individual at any given moment are so vast that they are beyond our ability to neatly file into categories of “good” and “bad.” — Matt Stone, Diet Recovery 2


Here’s the thing: We don’t know shit!

Nutritional science is an infant, a baby. We are taking what we know from a couple of pieces of the million-piece jigsaw and making guesses about the complete picture. Is it a house or a tree? A landscape or a cityscape? We have no idea, so the conclusion can only be drawn from whatever the looker wants it to be. i.e. conformation bias. You want to think fat is bad because you are a billion dollar sugar company? You’ve got it. You want to condone sugar in your research because you are a diet food company? You can. You want to prove that raw diets mean humans live longer because you want to sell books? Just say the word.

And yet everyone jumps on the bandwagon. Why is that? I think it is human nature to want to think that one is doing the “right” thing — eating the “right” things. When something labelled “science” comes along and tells us that “this is right and this is wrong” we bow to authority. Surely the men and women in white coats know so much more than we do? Surely those laboratories know are far more knowledgable than our own bodies?

No actually. The human body — your human body — is an organism. A living, growing, changing organism. Not a machine. Not a calculator. Not a petri dish in a controlled environment. Not even a lab rat.

It’s actually almost laughable, that people and their petri dishes think that they know better when it comes to what one should eat than the human body itself does. I mean, talk about teaching Grandma to suck eggs.

Who the hell do we think we are? These bodies we live in have evolved over thousands of years. Survived drought, famine, changing environments, wars, disease … and suddenly somewhere in the 20th century we decided that actually we cannot trust them to know what to eat anymore and that we need to dictate to the body what it can have for breakfast, lunch, dinner and all the spaces in between.

What a pretentious, arrogant proposal.

What’s Next? Are We To Control Breathing Too?

If our bodies cannot be trusted to know what and when to eat, then surely they cannot be trusted with air either! How do I know if my lungs are doing the right thing with the whole breathing gig? What if they are getting the ratios wrong? What if they are intaking too much air in the morning and not enough at night. What if they are getting the balance wrong?

I know, I’ll start to measure it out. And then, if I am breathing in too much air in the morning and not enough at night I’ll limit the air I can have in the morning and wake myself up at midnight to do some controlled breathing. That must be the better option than leaving breathing all to my body to decide about on it’s own. 

In the meantime I had better start reading a lot of articles about breathing so that I can work out if I am doing it right. I bet there are some “Healthy Breathing” bloggers out there whom I can learn from. Maybe there are some “Healthy Breathing” Instagram accounts I can follow to give me daily motivation on how to breath right. 

It probably won’t be easy, to breathe correctly. But I think it will be worth persisting with. Maybe if I can learn better breathing control people will like me more, and maybe it will also make my hair shinier.

Or maybe I should just stick to what I am good at and mind my own business when it comes to meddling with processes that my body already takes care of for me?

Even if you disagree with my take on the state of the nutritional science industry at this current time, you have to agree with this: it is not working for us.

If it were working for us, we wouldn’t be in such a mess as a society over food and eating. Food is a minefield for most people and it wasn’t like that 100 years ago. We were better off when we knew less. Now we only have enough information about how the body uses food to be dangerous.

If you trust your body to know what to do with the air you intake and to know how much it needs to breathe, you can trust it knows what to do with the food you intake.

 

What’s my point?

What is the point of me writing about all this? I’ll tell you. Among various other factors, Anorexia recovery is dependent on a) weight restoration and b) eliminating all OCD-like eating disordered behaviors. One very common such OCD-like behaviour is counting calories, and there are many others that revolve around “healthy” eating and nutrition and doing the “right” thing in terms of eating. It is very helpful in recovery — when one is trying to ignore the calorie counting and other nutrition-related anxieties — to come to the realisation that it is not as accurate and meaningful as the Anorexia tells one it is. In other words, this enables us to call our Anorexia thoughts on their bullshit more effectively.

It is incredibly hard to try and convince yourself to “just ignore the calories on the labels from now on,” when the rest of the world is telling you they are important. In recovery from Anorexia, many people find that they crave certain types of food. I went though stages when I only wanted to eat sweets for example. Days when I only wanted bread and bagels. Some days when I woke up thinking about steak and knew that day was going to feature heavily in red meat. For me, not restricting meant allowing myself to eat chocolate cake with pop tarts for breakfast if that is what I was craving. Or steak and cheese if that was the food of my thoughts that day.  Of course that was incredibly hard for me to do mentally as Anorexia was screaming at me that I was not eating a balanced diet etc. However, I believe that when a body has been deprived of certain food groups for years, it is out of balance, and in order to get back into balance it may need to go buck-wild on certain food groups at a time. I ate my way through many food phases in recovery and the end result was that I naturally shifted into eating what would now be considered a balanced diet. But to get there, I had to be brave enough to trust that if I let go of restriction and ate the foods I was secretly obsessing about in large quantities that it would all circle around in the end. And it did.

It hard enough to to allow oneself to eat without restriction. Imagine how a person trying hard to recover from Anorexia feels when they are told to eat a balanced diet. In some stages in recovery, eating a balanced diet can be restricting i.e. not eating what one really wants to eat!

So the point is, if you are in Anorexia recovery developing a “fuck it” attitude to eating might just be the healthiest choice you ever make. 

 

 

Please follow and like me :):

About Tabitha Farrar

I work as Head of Marketing for a software startup in Boulder. As a recovered Anorexia sufferer, I advocate for proper understanding of eating disorders in my spare time. On that note, I wrote a book about my own journey into eating again called Love Fat.


Leave a comment

Your email address will not be published.

9 thoughts on “Anorexia Recovery as an Adult: Letting go of nutritional science

  • Lawrence

    Dear Tabitha,
    once again your post is a beacon of hope for me.

    After reaching my pre-ED weight I tried to follow a “healthy diet” because I thought that was the best way to completely recover and regularize my behaviours about food – at least that’s what I had been told by everyone, including society and my dietitian. I tried so hard to make him believe that I was eating “healthy”. In the end though I only began restricting again and again started having weird obsessive rules about food. Today I ate bread and fruit jam for breakfast and I immediately panicked because I thought OMG THAT’S LIKE CARBS WITH OTHER CARBS PURE SUGAR NO PROTEINS AND NO FIBERS IT’S SO UNHEALTHY AND I WILL GET DIABETES IN NO TIME.

    And I ate it. I ate it because my goal is to eat intuitively and freely just like I used to. I ate junk food at weird hours. I missed meals. I hated veggies. I ate pasta with potatoes or pure white bread alone because I liked it. I had white chocolate or a croissant as an afternoon break. I ate heavy whipped sweetened cream directly from the jar. I exercised sometimes, but rarely, and didn’t enjoy it.

    And in the end I was happy, healthy and carefree. And also skinny.

    Why can’t I just go back to that life? Is it even possible to go back to that life?

      • Lawrence

        Dear Tabitha,

        thank you so much, this is so refreshing to hear.

        Let me ask you a question. I got the ED one year ago when I was already 24 years old (I know, I am a “late bloomer”). Previously I had just mantained a naturally low weight since puberty. In your opinion, should I just expect to get back to that weight and naturally stay there? Because I am already at that weight but still am hungry as hell. I don’t understand why. Can the “body set point” change in so little time after it has been stable for years?

        • Tabitha Farrar Post author

          Hi Lawerence

          I have a number of blogs under the overshoot category that might help answer your question on this. The short answer, is that many of us experience a temporary weight increase in recovery which naturally returns to set point when the body is good and ready

  • Kim Hupp

    As I am sitting here reading this blog, my AN 27 yr old daughter is anxiously stressing over our 6 oz cuts of grilled salmon we are having for dinner. A serving is 3.5 oz, Mom! I tell her she may have to rethink portions during this refeeding FBT. I get an eye roll. We have a long way to go!
    Your blogs ate very inspiring. I just finished Love Fat last night. Trying to get my daughter to read the last fewchapters. The first half of the book, sadlycould be her story too!
    Thank you, Tabitha

  • Karen

    Hi Tabitha,
    First I want to say how happy I am I’ve found your blog! I’m in my 40s, (British!) and was anorexic in my teens that was never properly treated, morphed into bulimia, then back to anorexia, then over-excercising, same old story and whilst I am now pretty good thanks to finding Your Eatopia a few years ago which opened my eyes to the chronic nature of eating disorders and explained a lot of what I had gone through, I do still suffer from reading nutritional info so this post was very timely for me.

    The problem I have is that I discovered traditional foods websites (and your mention of Matt Stone etc and other things you’ve written, plus I’ve read your book, makes me think you’ve also read these) which in many ways were incredibly helpful as they made me eat fat, see the importance of fat etc but then of course I started slipping into paleo which my body pretty much rejected and now the media is full of sugar fears so I have to MAKE myself eat cake, biscuits, processed foods regularly, within my now mostly ‘balanced’ (whatever the hell that means!) diet so that I don’t slip into only allowing myself ‘real’ foods which soon descends into restriction etc. It really is so insidious, I’m glad I love fat now, and genuinely realise it is super-important, but it can be a ‘safe food’ for me so I need to realise that actually sugar (or whatever the media’s latest food villain is) can be good too. I’ve learned to repeat to myself the mantra, when reading nutrition articles, which I mostly avoid tbh ‘This doesn’t apply to me’ because any restriction of any kind put those of us with EDs at risk of relapse. Anyway, bit of a rant, but thanks for all your hard work 🙂

  • Maria

    Hi Karen,

    I am 31 years old and was on the restricted diet for more than 10 years, before that I was skinny kid too.
    I was on wholefood diet(vegan, low fat) too and eating proccessed foods it’s scary I didn’t eat bread for more than 10 years and other forbidden foods.

  • James

    Hey Tabitha,

    Really great blog! I’ve been recovering from anorexia for a few years now. I don’t avoid foods like I used to and don’t compulsively excercise like I used to.

    My weight is still lower than my pre-ED weight though. I’m a male and I got anorexia at the age of 17 and now I’m 21. I never used to get acne when I was a teen and now suddenly I’m getting acne. My skin isn’t the oily type but is quite sensitive. I find that most my spots are inflammation based and are thus more hormonally driven. In addition to that my hair has thinned out considerably and all my other brothers don’t have hair as thin as me.

    I’m guessing the eating disorder has something to do with both of my problems. Have you ever had/heard of people having these problems with an ED? Do you happen to know something I can do to help resolve it?