Putting Together the Puzzle Pieces of Full Eating Disorder (PDF)

Journal of Critical Dietetics ISSN 1923-1237 Vol 4, Issue 2 Copyright 2019 Toronto, ON 84 Gillespie, C. – Putting Together the Puzzle Pieces of Full Eating Disorder Recovery. Self published, ISBN: 9781980815280 Review by Kori Kostka, RD BOOK REVIEW In Catherine Gillespie’s Putting Together the Puzzle Pieces of Full Eating Disorder Recovery, a hybrid mix of her personal story recovering from an eating disorder, her research in eating disorder recovery and a review of the research around the recommendations for a full recovery from an eating disorder is delivered. Helpful resources for professionals working within eating disorder recovery are shared, as well is written for clients and loved ones to have an understanding of what elements help one’s process of full recovery. This book is a highly suitable companion to medical treatment for recovery from disordered eating, bulimia, anorexia, binge eating disorder or eating disorders not otherwise specified, but is not a replacement for medical treatment. Although written for eating disorder recovery, anyone living with or working with body dissatisfaction or disordered eating would benefit from reading this book. Full recovery from an eating disorder is not a clear- cut process, but this resource is laid out to help the reader understand elements that may be helpful to an individual’s recovery. This book focuses on filling in the gap of resources for the “middle stages of recovery all the way to a place of full recovery”. The first two chapters establish what it takes for a solid recovery through a discussion of eating regularly and satisfaction. The following chapters focus on progressing to a full recovery by believing full recovery is possible; practicing body appreciation and acceptance; practice body-led eating; stop thinking so much about food, eating, or weight; getting in the zone; reviewing maintaining factors and what it takes to continue moving on. Gillespie walks through the difficulties someone living with an eating disorder may have with eating regularly. We are given an understanding of what eating regularly means, the power of regularity and how to make the transition with a mix of how the author’s personal approach to recovery. A month of journal recovery prompts are provided in this chapter to help navigate through challenges and struggle. An exploration of how Gillespie came to realize “diets are part of the problem, not part of the solution to eating disorders” is shared and how that led to finding, “If I am satisfied, then I have the energy to deal with the rest of my life.” This book renews the possibility of recovery and what full recovery can look like, by also highlighting how it may differ between individuals, thus using tools like the EDE-Q as a guide for partial and full recovery provides some parameters. Gillespie recommends focusing on eating disorder behaviours first before dealing with the problem of body dissatisfaction through body appreciation and body acceptance. In Isomaa & Isomaa’s research, poor interoceptive awareness was predictive of a chronic course of illness, yet Augustus-Horvath & Tylka and Avalos & Tylka’s research, showed how body appreciation aids in intuitive eating with the shift to caring for bodies using internal needs. Social media, theoretical models, demographics and dissociations are all described factors contributing to body dissatisfaction, which allows the reader to view which could be contributing as a process to body appreciation and body acceptance.  85 Practice body-Led Eating, describes an all-encompassing approach of intuitive eating, mindful eating, Health At Every Size®, as well as other approaches described through the book that use internal cues for guiding an eating experience. Anyone exploring these approaches, or blending in their practice, will appreciate the time spent not only on the research but the practicality shared of these approaches. Using Tribole & Resch’s 10 principles of intuitive eating, Gillespie distinguishes that intuitive eating is not the opposite of eating disorders, but is a positive approach that one can practice and embrace through recovery. The author also shares here her journey through learning to listen and honour senses using mindful eating, as well as an alternative approach to numerical hunger scales. Weight inclusive approaches such as Health at Every Size®, now registered trademark of the Association for Size Diversity and Health, are outlined with research from highly respected colleagues in the field that provides the theoretical framework to body-led eating practices. This quote highlights what many often misunderstand about Health At Every Size®, failing to recognize and understand the health risks associated with cultural oppression that comes with living in a higher-weight body, “higher body weights do predict health problems over time, the cause of these health problems may not be the actual weight, but other factors linked to higher body weights, including lower socio-economic status, physical activity and fitness, and social determinants of health including rejection, stress, and lack of social support”. Changing behaviours in eating disorder, and disordered eating, is not sufficient if self-evaluation continues around weight and shape, this predicts higher rates of relapse. Gillespie provides a helpful guide of the behaviours and thoughts in recovery that need to change to prevent this. Also provided, is 30 days of journaling through an experiment of not weighing, showcasing the struggles, thought process and evolution of recovery through using an approach that utilizes lapses as learnings and embodies weight-inclusive approaches. The discussion of self-compassion is a lovely finish, showing the difference from self-esteem, which many have been conditioned to focus on. We are left with an exploratory ending, with suggested weekly prompts based on the chapters of the book, reminding we are worthy and capable of full recovery. This book gives restored faith and reassurance of everyone’s role and the impact of full eating disorder recovery is possible, perhaps more so when these approaches are embraced. This book may be critiqued for not offering thorough discussions of oppression through intersections of gender, race, age, etc. within eating disorders, but to be commended on the surmountable focus on the resources, research and story for bridging the gap from partial to full recovery for those living with an eating disorder, colleagues working with clients or family members trying to gain perspective and understanding so they may be even more supportive. References Augustus-Horvath, C.L., & Tylka, T.L. (2011). The acceptance model of intuitive eating: A comparison of women in emerging adulthood, early adulthood, and middle adulthood, Journal of Counseling Psychology, 58(1) 110-125. Avalos, L.C., & Tylka, T.L. (2006). Exploring a model of intuitive eating with college women, Journal of Counseling and Psychology, 53(4), 486-497. Isomaa, R., & Isomaa, A-L. (2014). And then what happened? A 5-year follow-up of eating disorder patients. Nordic Journal of Psychiatry, 68(8), 567-572. Tribole, E. & Resch, E. (2012). Intuitive Eating: A Revolutionary Program that Works, 3rd. ed. St Martin’s Press: NY. Author Bio Kori Kostka is a mindful-at-heart, Registered Dietitian for over 11 years. She started off her career working in inpatient acute care medicine, quickly realizing her passion in nutrition therapy. Kori shifted into primary care where she fell in love with counseling. She later started her business, coaching mindful eating to clients and other healthcare professionals. Kori is also one of the creator and hosts for the Weight Neutral 4 Diabetes Care online symposium and the co-host of the Nourished Circle Podcast. Kori will be starting her MHSc this fall at Ontario Tech University.