MinnieMaud Guidelines For Recovery From A Restrictive Eating Disorder v.s. Islamic Eating Guidelines

Dear Readers,

A reader asked me a question about Gwyneth Olwyn’s Minnie Maude Eating Guidelines and whether they were compatible with Islamic Eating Guidelines or not? I have never come across these guidelines before, so I thank this reader for sharing this Eating Disorder Recovery Resource with me. If you suffer from Binge Eating Disorder (BED), Bulimia Nervosa, Anorexia Nervosa, or even EDNOS then please take out few minutes to read this information. It may prove useful in your recovery. I was also asked to present an example of my reactive eating, which I now have.

Islam is very strict when it comes to seeking treatment for your illness. As a Muslim you are forbidden to live with an Eating Disorder or any other illness that is detrimental to your well-being. No simple cure exists for eating disorders, but treatment is available, and recovery is possible. Through a combination of  therapy, spiritual healing,  nutritional education and medical treatment, the symptoms of an eating disorder can be managed or eliminated. Early diagnosis and treatment significantly increase your chances of recovery. As a Muslim, seek treatment for your illness wherever it’s available and consult your practitioner . Please do not sit-around and wait for a miraculous cure from your ED. ED is a silent killer.

Read the story of Prophet Moses below where He had to seek treatment for his illness:

Once, Prophet Musa/Moses (as) became ill. The Bani Israel (Children of Israel) came to him and realizing what his illness was, advised him: “If you consume such and such medicine you will recover from your sickness.” “I shall not seek any cure but will instead wait till Allah (SWT) cures me without the help of any medicine,” said Prophet Musa/Moses (as) to them. His illness became prolonged whereupon Allah (SWT) revealed to him: “By My Majesty and Glory! I shall never cure you till you have consumed the medicine which they had recommended to you.”
Prophet Musa/Moses (as) asked the Bani Israel to treat him with the medicine that they had previously suggested. They treated him and shortly after that, Prophet Musa/Moses (as) regained his health. However, this incident left Prophet Musa/Moses (as) with a feeling of complaint and dejection but Allah (SWT) revealed to him: “You desired to annul My Wisdom by means of your trust in Me! Is there one, other than Me, who has placed the medicinal and beneficial effects in plants and various things?”
Say: “Nothing will happen to us except what Allah has decreed for us: He is our protector. In Allah let the Believers put their trust.” (Noble Qur’an, 9:51)

In MinnieMaud Recovery Program, You have to Eat minimum of 2500 calories every single day to break free from the confines of disordered eating, (No Exercise and no weighing and measuring yourself). Gwyneth Olwyn’s guidelines are unproven. I don’t see a backing up from NHS or any other Eating Disorder Org. It’s not supported by BEAT or NEDA. But her guidelines do make sense. Her calorie recommendation is right, this was my calorie intake during my recovery from low weight. But I started off with 1500 calories and this was then increased to 2000 and then to 3500 calories per day. My re-feeding took place in inpatient settings with controlled monitoring and regular blood tests.

After getting to a healthy BMI, you have to continue with eating these much calories and if extreme hunger kicks in, then you have to up your calorie intake.  It’s important to do that, if you want your body to get to its natural set-point and if you want to set yourself free from the binge-eating/restrictive eating cycle. Once your body reaches its set-point, you will be able to respond to the physical feelings of hunger and fullness.

Gwyneth Olwyn justifies overeating/binge eating as a ‘reactive eating.’

It is this extreme hunger that leads to binge eating/over eating etc. This craving for food is immediate and urgent. If you continue to ignore this hunger, you will forever be stuck in the cycle of disordered eating, why? Because this craving, extreme hunger is a signal that your body requires fuel, energy to get to its set-point.

Her message is very clear that resistance to emotional eating is futile.  She doesn’t tell you what you should or shouldn’t eat, in fact she even places emphasis on eating processed food.

We all know that getting to a normal weight does not mean that you are recovered from your ED. Once the weight is restored the real hard work begins where we have to work on our mind and unearth what lead to our ED. I believe that if we want to recover from our ED, we have to try each and every method, you never know what may work for you.

Islamic Eating Guidelines apply to who?

Prophet Muhammad (pbuh) advised people not to be extreme in the act of eating and said “No person can fill a dish that is worse than his stomach“. Islamic guidelines on Eating apply to those who are not suffering from Eating Disorders and other illnesses. Eating Disorder is an illness and in order to restore your body to its natural balance, you need to consume set-number of calories (depending on your age, height and BMI). This is simply to replenish your body and to reverse the damage that ED has caused. Take an example of a Cancer patient, after a chemo therapy, their recommended calorie intake maybe higher to repair their immune system. In this case, the Islamic guidelines on eating in moderation do not apply to them, as food is needed for nourishment, healing and to rebuild the tissues and muscles. People with cancer who are well nourished and able to maintain a healthy body weight often have a better prognosis. Each stage of the cancer healing process brings with it increased nutritional demands.  In recovery from an Eating Disorder,  a patient may need to be fed every two-three hours, depending on their condition. In this case, food is simply acting as a medicine for healing and not something of an indulgence. Eating well during ED recovery helps to improve your strength and energy, decrease the risk of infection and assist your body in healing.

In Eating Disorder recovery, often lower calorie diets contribute to underfeeding syndrome. Minnie Maud Eating Guidelines promote higher calorie diet and if you are suffering from ED, then it’s appropriate to increase your calorie intake to promote recovery.

More Calories = Better Results

My Reactive Eating

As you lower calories to lose weight, you starve your brain first and that depletes serotonin (a neurotransmitter which helps you feel calm, peaceful, and contented, and has a pivotal role in regulating appetite). This leads to increasing cravings for different foods, depression, anxiety, lethargy, feelings of hopelessness or rage all increase. Typical dieting means an immediate cutback on the production of chemicals that support health of your mind, your psyche, and your spirit.

My recovery and stability of disordered mind would not have happened, if I had continued to follow the anorexic no-food diet. I was forced to gain weight at the Eating Disorder Unit and though I was eating, I was so resentful of weight gain that I simply blocked out everything except one single thought ‘I hate eating’.

I would not even engage with the food I was eating, forget about savouring every bite as if it was my last bite and eating mindfully. I would chew my food very thoroughly so it was digested properly but I would not acknowledge the flavours or what I was eating.

Let me Tell you one thing, nature laughs when we cheat our body. Our body is cleverer than us and there is no-way we can cheat our body. Our body was not created to live on no-fat, no protein, and no-carb diets. Our body gets confused by all these weird diets and the longer we abuse our body, the direr the consequences.

When you diet, your body senses a food shortage. As a result, you feel deprived, preoccupied with food and more sensitive to food around you and that’s why so many people fall into the cycle of binge eating, self-loathing and shame.

This happened to me several years ago, when I had my first binge in Pakistan. What I binged on was fresh bread and fresh butter, and I was simply horrified. If I had binged on anything sweet, I would have justified it, because I always had a very sweet tooth, but bingeing on bread and butter was completely out of character for me. After that first binge, I vowed never to touch bread and butter again.  Next Day, same thing happened, I craved bread and butter. After bread and butter I wanted French Fries that were being sold by the street vendor carts in Islamabad.

We went to a doctor and she said to my mother, ‘give her whatever she wants to eat’.

Next it was grilled chicken cucumber sandwich or plain pasta with chicken/fish and lemon parsley mint dressing. For 10 years, I had excluded bread, butter, dairy, protein, vegetables and fruit from my diet and now I was confused by all these signals. What was shocking for me was just how specific these cravings were and I was powerless.

As soon as I came back to UK, I relapsed and I started controlling my food intake again. In 2011, I went to Eating Disorder Unit and I had no choice but to eat (sniff sniff).

In 2012, after discharging myself from the unit and a relapse, I made a very conscious decision (just like Gwyneth Paltrow did with ‘conscious uncoupling’) and I thought God, I can’t spend hours dreaming about food and agonizing over food. My body at that stage was rejecting all my favourite anorexic foods. I was getting sicker and sicker by the day. So I simply gave in and made a brave decision to eat for my mind. I just wanted a mind with no thoughts of food.

Of course I could not do it by myself- So I asked my Friend Eileen Nicholson to help me. In the winter of 2012 till the winter of 2013, we got together once a week for lunch. Eileen cooked and I ate without a Question. We discussed portion sizes and we agreed after 4 weeks, she’ll increase my portion sizes bit by bit. Eileen is a wellness coach, so there was no-way; she was going to put anything that was devoid of nutritional value in front of me. So I ate with Eileen and the more I ate with her, the more familiar I became with food.

I then started implementing the same thing at home. Why? The Horror of Skipping Meals:

If you skip meals, this will lead to your blood sugar levels going abnormally low and intense cravings start. This also this causes an increase in ghrelin (a neurotransmitter that sets up an irresistible urge to eat) and also lowers neuropeptide Y, which increases carbohydrate cravings. This will lead to an unstoppable desire to eat lots of food and increases your eating frequency, which leads to binging on extra foods. Oops, not what you wanted to happen!**

My Reactive Eating (I ate other Foods as well, but this is what I intensely craved for)

2010: Bread with Butter, French Fries, plain Pasta, grilled lemon chicken sandwiches etc. What was a horror was developing craving for this specific food- Paratha (buttered chappati). I had this like -3 times a week for breakfast.

 

2011:  Milk with Horlicks, Banana Dates Milk Almonds Smoothie, almond cake, pistachio cake etc. I didn’t crave bread that much, but if I saw bread and butter, then I would go for it.

2012: Fish with vegetables, avocados, plain pasta with butter, Irish Soda bread with Walnut butter and Jam and Lentils with Rice.

2013: Hearty soups with bread, Full Fat Yogurt with Mint and anything with Eggs and Prawns, Squid and Scallops. (I only had Scallops twice) and Chicken with Vegetables

Did I freak out about calories? The first lunch I had with Eileen, I was shaking so much that it took me 90 minutes to finish my meal. But they say try try try and week after week I ate and the fear started to evaporate.

Over the period of next few months, I stopped focusing on calories. I just knew one thing that what I was eating was required by my body, it was needed to repair my brain cells and rebuild the fatty tissues in my brain, so I could become strong again. I also made sure that my diet had all the vitamins, especially B6. B6 plays a vital role in regulating the metabolism and beating depression. After five months, I could see the difference good nutrition was making to my mind and body. This reactive eating became a medicine and gave my body much needed energy, helped build and repair organ tissue, and strengthened the immune system. It made me powerful and in-charge of my life and gave me power to defeat the demon of Eating Disorder (How dare anyone belittle me, mock me and control my life and my mind?)and Alhamdulilah (Thank God) I did, because today, I am strong mentally. I never want to compromise on my mind and I never want a malnourished dying brain again, so I eat for a healthy brain. The state of Mind influences your moods and your life. Now in 2014, I eat anything and everything, but all in moderation, and I don’t have intense cravings or an urge to binge.

What I Eat now is what my Family Eats- Its a fusion of Pakistani, continental, Italian Mix.

 

Information below is taken from Your Eatopia.com.

 

What are MinnieMaud Guidelines?

“Science-based guidelines for recovery from restrictive eating disorders. Restrictive eating disorders include: anorexia, cycles of restriction and reactive eating, bulimia, orthorexia and anorexia athletica (also known as exercise bulimia). The “Minnie” refers to the Minnesota Starvation Experiment and the “Maud” refers to the only evidence-based treatment program for eating disorders out there at the moment: Family Based Treatment, also known as the Maudsley protocol.”

The Troika-

1. Eat the minimum intake for your height, age and sex every single day. It’s a minimum intake and you are both encouraged and expected to eat more. Never restrict food intake.

2. No weighing yourself or measuring yourself. Get forgiving stretchy clothing. Relapse is common if you watch the needle on the scale.

3. No exercise.

In addition to these simple, yet hard to apply, necessities there is also a need to recognize that restrictive eating disorders are neurobiological conditions. You are not cured by restoring weight. The condition can be active or in remission, but it is never cured.

To get to a robust and permanent remission, you have to incorporate, along with weight restoration and physical repair efforts, the fact that the anxiety you feel welling up when you eat unrestrictedly has to be addressed as part of your treatment.

You have practiced maladaptive responses to that anxiety (dieting, exercising, cycling through restriction with reactive eating, etc.) and it helps to have a guide and teacher to help you learn the well-adapted techniques for responding to the anxiety. Cognitive behavioral therapy, dialectical behavioral therapy, exposure/response prevention therapy—all are suitable options to investigate with a counsellor or therapist of your choosing. Over time, it not only gets easier to automatically apply well-adapted responses, but you will find the underlying anxieties ease as well.

The Food Intake Guidelines

Here are the guidelines for when 2500 calories applies as a minimum daily intake for recovery:

1. You are a 25+ year old female between 5’0” and 5’8” (152.4 to 173 cm) and,
2. The regular menstrual cycle has stopped and/or,
3. You have other symptoms of starvation: feeling the cold, fatigued, foggy headed, hair loss, brittle nails, dull skin and/or,
4. Even if you were only underweight/dieted for a very short space of time (a few months) these guidelines apply. And remember “underweight” is relative to your body’s optimal weight and is not a clinical measurement. 

Here are the guidelines for when 3000 calories applies as a minimum daily intake for recovery:

1. You are an under 25 year old female between 5’0” and 5’8” (152.4 to 173 cm) or an over 25 year old male between 5’4” and 6’0” (162.5 and 183 cm) and,
2. The regular menstrual cycle has stopped and/or,
3. You have other symptoms of starvation: feeling the cold, fatigued, foggy headed, hair loss, brittle nails, dull skin and/or,
4. Even if you were only underweight/dieted for a very short space of time (a few months) these guidelines apply. And remember “underweight” is relative to your body’s optimal weight and is not a clinical measurement.

Here are the guidelines for when 3500 calories applies as a minimum daily intake for recovery:

1. You are an under 25 year old male between 5’4” and 6’0” (162.5 and 183 cm) or female with young children or an equivalent and unavoidable level of activity.
2. The regular menstrual cycle has stopped and/or,
3. You have other symptoms of starvation: feeling the cold, fatigued, foggy headed, hair loss, brittle nails, dull skin and/or,
4. Even if you were only underweight/dieted for a very short space of time (a few months) these guidelines apply. And remember “underweight” is relative to your body’s optimal weight and is not a clinical measurement.

If you are taller than the guidelines listed above, then add 200 calories to the guidelines that match your age and sex. If you are shorter than the guidelines listed above, then you may eat 200 calories less than what is suggested for your age and sex, however these are all minimum guidelines and everyone is expected to eat well above them for a good portion of the recovery process in any case.

Disclaimer: The content of this website is provided for general informational purposes only and should not be considered a substitute for professional medical advice. Do not use the information on this website for diagnosing or treating any medical or health condition. If you have or suspect you have a medical problem, promptly contact your healthcare provider.

Source: http://www.youreatopia.com/

If you want to follow the recovery guidelines above then please speak to your doctor and a dietitian. Your doctor can help you maintain nutrition through your treatment and any side effects. A dietitian is a key member of the healthcare team who can provide counselling about proper nutrition just for you during your recovery experience. Ask your doctor for a referral to a registered dietitian if you have questions or concerns about nutrition.