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Is Calorie Counting an Eating Disorder?

Jessica awakes to the gentle vibration of her wristband fitness monitor.  She looks at the time—5:30 AM—as she throws her gym bag into the car, listening to her favorite calorie-and-step-counting podcast on the way.   At the gym, she hits the treadmill for an hour while watching the morning talk shows. On the way to the shower, steps on the scale for her “low weight” of the day.  Dang—184 pounds—a pound up from yesterday!

With a sense of defeat, she gets dressed for work, frowns at her image in the mirror, loads up her gym bag, pulls out her 200 calorie meal replacement shake to sip on the way to work, dutifully entering the calories into her phone app before she starts the car.   She notes with satisfaction that her fitness monitor shows she burned 345 calories on the treadmill—so, she’s going to have a 145-calorie deficit by the time she gets to work!  But the same time she’s wondering, “What’s wrong with me? Why am I not losing weight? I must still be eating too many calories!”

We know why Jessica is not losing weight.  It’s because the body doesn’t work according mathematical equations. It works according to a beautifully complex set of biological principles.(1)

Meantime, as 10 AM rolls around, Jessica is barely functioning.  Her hands and feet are freezing, and she can hardly keep her eyes open.  She takes a break and gets a grande skim-milk cafe latte— 170 calories into the phone app.   That perks her up a bit, but by lunchtime she’s famished and has a bottle of pomegranate juice (180 calories), and half of a “healthy” tuna sandwich on whole wheat bread (211 calories).  Back to work, and by 3 PM Jessica is cold, tired, and starving!  She pulls out a 100-calorie diet snack bar from her purse and eats it slowly.  She’s still hungry, but the hunger is at least a little “rewarding.”  It makes her feel that she’s “being good” and makes her think that at least maybe she won’t gain any more weight.

So Jessica continues overweight despite exercising obsessively and eating very little.  She is trying as hard as she can to be healthy, yet she feels tired, sad, and ashamed.   Is she suffering from an eating disorder?   If we list some of the characteristics of people who suffer from eating disorders (2,3), she might recognize a few:

  • They think constantly about whether food is healthy and whether it will make them fat
  • They are very concerned about their weight and body size and shape
  • They have a terrible fear of gaining weight
  • They are rewarded by feeling hungry
  • They will eat only controlled portions of “low-calorie” food
  • They feel driven to exercise an hour or more every day
  • They are not happy with the size and shape of their body
  • They are often sensitive to cold
  • They are ashamed and feel guilty

Indeed, people who are overweight and people who have eating disorders whether overweight or not, share number of characteristics:

  • Genetic factors play a significant role in the nature of these conditions. (4,5)
  • There is evidence of generalized inflammation in the body as well as in the central nervous system. (6,7)
  • One or more of the hormones that regulate appetite, fat storage and metabolism are altered. (8,9)
  • Neurotransmitters that control mood and energy are altered.  (10,11)

How can Jessica turn this situation around?   Recent research show that people like Jessica can effectively normalize their hormones and body composition and increase their physical and emotional health by doing the following:

Stop doing long hours of medium intensity “aerobic” exercise.  Jessica needs to free herself from monitoring her weight, steps, and calories burned through exercise.  She needs instead to exercise safely, intensely, and infrequently to develop lean muscle tissue and improve her hormonal and neurochemical environment.

Stop counting calories!  If Jessica focuses on eating so many non-starchy vegetables, nutrient dense proteins, whole food fats, and low-fructose fruits that she’s too full for nutrient poor starches and sweets, she will lose fat while feeling comfortable, full and satisfied.  She will no longer be cold, her hair and complexion will glow, her mood will improve, and she’ll have a lot more time and energy for fun.

Eating that is actually healthy is all about a positive relationship with food.  It’s about celebrating our ability to enjoy an abundance of healthy, delicious foods while we gain strength, glowing good health, energy, and increased feelings of well-being.

So the key to a slim and healthy body and a clear and empowered mind is eating PLENTY of the RIGHT KIND OF FOOD. We are not defective by default nor are we required to perform mathematical calculations to avoid being overweight.  Chronic starvation and disordered eating induced by feelings of inadequacy, misinformation and insane societal pressures should neither be celebrated nor encouraged.  Jessica and everyone like her deserve better!

The rates of obesity and related illnesses were dramatically lower before anyone knew what a calorie is let alone counted them. It’s time to heal our relationship with food and with ourselves. Out with calorie-counting disordered and degrading eating and in with an abundance of the foods that kept us slim, healthy, and happy long before anybody knew what a calorie was.
This post was co-written by Jonathan Bailor and Catherine Britell, M.D.

(1) Bailor, Jonathan :  The Calorie Myth: How to Eat More, Exercise Less, Lose Weight, and Live Better. HarperWave, 2014.

Table of Contents

(2)  Pritts, SD, Sussman,J: Diagnosis of Eating Disorders in Primary Care, Ohio Am Fam Physician. 2003 Jan 15;67(2):297-304.
(3)  Amin R, Strauss C, Waller G. Body-related behaviours and cognitions in the eating disorders. Behav Cogn Psychother. 2014 Jan;42(1):65-73
(4)  Herrera V,  Keildson, S: Genetics and epigenetics of obesity. Maturitas. 2011 May; 69(1): 41–49.
(5)  Scherag S, Hebebrand J, Hinney A. Eating disorders: the current status of molecular genetic research. Eur Child Adolesc Psychiatry. 2010 Mar;19(3):211-26.
(6)  Wen X, Pekkala S, Wang R, Wiklund P, Feng G, Mei Cheng S, Tan X, Liu Y, Chen P, Eriksson JG, Alen M, Cheng S. Does systemic low-grade inflammation associate with fat accumulation and distribution? – A 7-year follow-up study with peripubertal girls. J Clin Endocrinol Metab. 2014 Jan 13
(7) Wisse BE. The inflammatory syndrome: the role of adipose tissue cytokines in metabolic disorders linked to obesity. J Am Soc Nephrol. 2004 Nov;15(11):2792-800
(8)  Housova J, Anderlova K, Krizová J, Haluzikova D, Kremen J, Kumstyrová T, Papezová H, Haluzik M. Serum adiponectin and resistin concentrations in patients  with restrictive and binge/purge form of anorexia nervosa and bulimia nervosa. J  Clin Endocrinol Metab. 2005 Mar;90(3):1366-70
(9)  Prakash J, Mittal B, Awasthi S, Agarwal CG, Srivastava N. Hypoadiponectinemia  in obesity: association with insulin resistance. Indian J Clin Biochem. 2013 Apr;28(2):158-63
(10)  Avena NM, Bocarsly ME. Dysregulation of brain reward systems in eating disorders: neurochemical information from animal models of binge eating, bulimia  nervosa, and anorexia nervosa. Neuropharmacology. 2012 Jul;63(1):87-96
(11)  Haley AP, Gonzales MM, Tarumi T, Tanaka H. Dyslipidemia links obesity to early cerebral neurochemical alterations. Obesity (Silver Spring). 2013 Oct;21(10):2007-13

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