Saturday, 16 March 2013

Portion Distortion

Have you heard of the term 'portion distortion' before? It is often used to describe the 'fact' that many people do not know how to eat appropriate portions; mainly, that they eat too much because they do not know how much food is 'enough'. But recent studies are showing that the TRUE portion distortion occurs in people with ED. (See
http://www.sciencedirect.com/science/article/pii/S0195666312005120 for details)

Basically, this study compared anorexic patients with those who did not have any ED. The results are pretty consistent: people with ED (specifically anorexia) are more likely to overestimate food amounts. For example, take a person with anorexia and a person without anorexia. Now give them a plate with one cup of pasta, a piece of chicken, and a cup of vegetables. The person with anorexia is much more likely to estimate that the plate has (for example) double the portion it really has; the other person without ED is more likely to estimate the food correctly.

What does this tell us? To someone with ED like myself, it shows me that what I am doing in recovery is probably the best for me right now - eat by the clock and eat the amounts of food that I have been prescribed. I cannot depend on my intuition to estimate how much food I need to eat; I need to measure it because I KNOW that if I just 'eyeball' it, I will take too little.

Note that for some people with ED, measuring like this is obsessive; it is part of their disorder. For me, I NEED to measure because when I do not, I take simply too little food. If you have an ED and measuring is obsessive for you, it is a different case.

If you struggle with 'portion distortion' in anorexia (in that you always think you are eating more than you really are or always take too little food), a good idea is for you to see someone who can help you. I have heard people learning portions by using their palms instead of measuring cups, or 'eyeballing'. Whatever works for you is fine, as long as you are taking enough food.

I would be really interested in learning from others WITHOUT ED how you 'portion control'. Do you use your hunger cues and stop when you are full? Do you measure your food? Do you even KNOW how much food you are eating (ex. a cup of rice) or do you just take what you want and simply eat it? I am interested because I would like to get an idea of what 'nromal' people do when eating; I know that I personally cannot depend on my hunger cues or eyes to estimate foods.

So for now, I have to depend on measuring my food. And that is okay. As long as I am eating what I need to, that is fine. Maybe one day I will learn to eat without measuring - and eat enough. But for now, I am doing what I need to do to recover. My portion distortion is something that I have learned to deal with. Thank God.

23 comments:

  1. Talking about portions distortion is innovative .It is one of the early signs of ED or DE .
    I am glad you are addressing this Marina.
    That is why your blog is the msot helpful for those who struggle with ED or DE .
    My regards

    Kelly W
    Therapsit To

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  2. I always make sure I eat my meals and snacks on time .I do not have ED but I like to be healthy.I use Canadian food guide as my guide for portions and servings.
    When I do not feel hungry as when I am under stress,I eat same as you by hour and use Canadain guide for what a healthy meal and sncak contains
    It works for me and protects me for fatigue

    Sorina

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  3. I use my plate as a guide .I make sure my plate is full with the 3 main food items ,carb,protein and some fat along with veg and grains and fruits.
    One has to be watchful of nutrition as this keep us away from doctors and I do not like doctors

    Gerald

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  4. I eat morning,noon,dinner and supper till I feel full and ususally my stomack takes what is enough for good nutrition .I am healthy active and well.

    Sasha

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  5. I always consult my dietitian to tell me the advise on what and how much.Frequently I have little appetite and so I want make sure I am eating well.Prevention is way and a lot better than medicine .

    Yara

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  6. Good point Marina.
    I am 6 years complete recovery without relapse and I think the one thing that is preventing me from relapse is I am protecting my meal scheddule and my portion size so that ED will not sneak on me when I feel full or no appetite.
    I am glad that you recognize from the begining that keeping your schedule and portion size pre set is the best for now.

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    Replies
    1. That is true .
      As you know Marina,I am still in my treatment program as out patient.I learnt lots about ED and developped many skills now to control my emotions and to challnge my thoughts knowing and be aware that those are only thoughts and not facts
      I still have to challnge my meals and portion sizes when I eat with my family .
      I am geeting a recipe from my dietitian but some times I try to eat normal food with family and I feel that I am eating much more than all of them .
      I know ED disguise in my thoughts and make my plate much more than really is and also make me feel that my body is fatter and my stomach is very full.
      I am moving a head to overcome the last obstcale of ED.
      I agree with you ,the best way to avoid faultering in my recovery when I am home or eat alone or with friends is stick to my schedduled meals and my portion size ,at least for now.
      No way I will return to be under the mercy of ED.
      I was abused by this monster enough Marina .
      Once again I credit you for motivating me to get help

      Anne A

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  7. I am glad that Satan no longer has a hold on you. I will continue to pray for you

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    Replies
    1. I am also glad too
      ED is the biggest,worst,most evil Satan.
      To be free from this is a big win and big blessing from the All MIGHTY.
      May God bless you .
      I will continue to pray for you and all who suffer.

      Mary
      Mississauga

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  8. I have difficulty with estimation of sizes myself
    When it comes to foods and my body ,I always overestimate but when it comes to self esteem ,my achievements and my skills I tend to underestimate.
    I am better since I started reading your blog that encouraged me to ask my doctor who does not any thing I was talking about(idiot!!) and so he refered me to Psychiatrist and to a dietian.
    Dietitian is helpful but her instruction is harsh to follow but I will try and continue
    Thanks for having me in your blog and you sharing your experience and your support.

    Nanaraj

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  9. I had ED and I recovered long ago but still I feel I need to be careful about this and I always making sure I am taking enough food .I still see my portion look bigger relative to my husband who in fact his portion 5 times as big.

    Ivanka

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  10. My mom knows exactly what portion size is enough for me and I respect her hunch as well as her education.

    Mays

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  11. My Dear Marina
    I am doing my neuro elective and was just reading about micropsia and macropsia.
    Basically when our brain understress,it misinterprets the image we see.
    I think ED put victims under severe stress ,so that their brain misinterprets real images and so see their portion sizes much bigger and also see their body fat when it is really a skelton.
    Also they do not see their real accomplishments and always underestimate their success.
    During recovery ,as you said Marina ,one may face even more stress as from the ED as well from the hard work of recovery till they completely recovered and then they enjoy the freedom and have all the control.

    As I said before I like your blog as it is for me educational and evidence based .
    My regards

    Penny

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    Replies
    1. I am really impressed with this talk and also explaination of micro and macropsia.
      Yes I had ED when I was a teenager and I had trouble seeing my real body image and I used to see myself as fat when I was really dying and I used to look at my meals and comapre them my father who eats 5 times as much and I will argue with my mom that my food is larger.
      Thank Goddness I am recovred now and I am enjoying my meals and I am eating all my portion as enough and little more than enough to be on the safe side .
      I also want to tell you my self esteem has gone way up with my recovery and I am very successful sales manager now

      Blanchette

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    2. Since my alcohol abuse and depression.I really like this and I am still struggling with same feeling that is making me feel down sizing my success and my participation and my self confidence and maximizing others's skills ,beauty,achievements etc.

      Good newa I am much better and I still need to be aware and I am taking steps to ward off any relapse.
      God bless


      Carlos

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  12. That is very helpful blog
    I think we all need to watch our self and make sure We have enough.

    Leila

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  13. I like the blog as it is well searched and credible information


    Hesham

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  14. Your blog is the first thing I scan when I go on my web

    Hamza

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  15. I've never had a proper ED but have always had a picky relationship to food. When I'm alone I use the same bowl every time I eat (around 1/2 liter capacity) to know how much I need. For lunch I like to pack a bento (see http://justbento.com/handbook/bento-boxes-perfect-tools-combat-portion-distortion-and-idea ). If I'm eating socially I simply pay attention to my level of hunger and allow myself to eat more than usual.

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    Replies
    1. Welcome! There is no such thing as a 'proper' ED.
      It sounds to me (and I might be wrong) that you eat too little when alone. Why? Are you afraid of your weight? Or is it something about being alone that makes you cut back your intake?
      I dont know how much you eat, but all I can say is that if something tells you to eat less when you are alone, think about why that it. Maybe it is not ED, but it could be disordered eating that can get dangerous. Please let me know if I can support you!

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    2. I don't exactly know, it's really a mixture of things. I do want to stay lean and, at 29, naturally tend to put on weight more easily. This sometimes causes anxiety since I fear losing something that would be hard to come back to. I also feel better at a lighter weight and more lethargic when I put on a couple of kilos. Using portion control does two things: it ensures that I do not overeat, but also that I keep eating sufficiently at least three times a day (and eating more with company means social eating won't become as issue). Lastly, I have IBS and experience fewer syptoms when I keep my portions small.This being said, I periodically identify thought patterns that could lead to an ED if I let them take over, I suspect.

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  16. To add a few precisions, I'm not underweight, but with a BMI of just over 19, I'm not that far from the limit. As a teenager I was a few kilos too light and had trouble reaching the weight which my doctor had set as a minimum. Which is why I'm being careful even now: I've never had an ED, but I may well be a little borderline on disordered eating.

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    Replies
    1. Hi, can you please start posting on the newest post? This helps me see your comments right away and I can respond in a timely manner.
      I understand what you mean about not wanting to gain more, especially if you feel this way. I know about the portion contrl because I need to do that as well. However, is it portion controlling the reasonable amount? For example, the bento boxes you spoke of are meant to be one meal - not half of one. So I am concerned that you eating half is not enough, and this is why you portion control.
      IBS is a major discomfort, I am sorry that you go through this. However, you can keep portions small and still eat enough, like multiple times a day but small meals or snacks. I am glad that you can catch ED before you fights you, but sometimes it is really hard. It is great that you can do this, but it might not always be clear. Just be careful. While I cannot tell yo uwhat to do, I can say that your eating half during lunch when alone sounds to me like it might be ED.
      Let us know how can help, and stay strong!

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