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control one's exact body weight or body image, and the constant weighing of both food and self, is part of the obsession of an eating disorder, often handing emotional power over to what the scales say that day - or even several times a day. As long as we are abstinent, there should be no real need to weigh ourselves more than once a month - at most - as an occasional check. Actuarial tables for normal height and weight (for life insurance purposes) give a range of five to ten pounds for each height and frame. It is important to get away from the concept of an'excess five pounds which 'makes all the difference to how we feel about ourselves. Initially it may be an excellent idea for us to throw out the bathmorn scales and possibly hand over the occasional check on our weight to a trusted friend or partner who can then tell us whether we are still within the healthy range, even though not telling us our exact weight. This practice should not need to be continued in the long teen. As a general principle, if our clothes still fit in the same way that they did when we reached our goal weight, then there is no need for us to weigh ourselves any more. Body image is an exceedingly complex subject. Naturally we want to look and feel good, but this is often a decision on what we feel we ought to look like in terms of body shape, clothing and fashion. These are emotional concepts rather than physical absolutes. Patients with eating disorders tend to have a distorted body image so that a sufferer from anorexia will perceive himself or herself as being fatter than anyone else would perceive. Correspondingly, a compulsive overeater might see himself or herself as much thinner than reality and a sufferer from bulimia may have a very narrow range of body weight or shape that he or she would perceive as "normal".
Perhaps the most difficult aspect of receiving help for an eating disorder is, as with any other addiction, coming to see that one's own concepts may be passionately held but may nonetheless be deluded.
Sufferers from eating disorders have particular sensitivity to refined carbohydrates. For them, sugar and white flour of any kind, where the fibre roughage has been purified away, lead to a chemical reaction within the brain, producing an emotional lift and setting up a physical and emotional craving. This is one of the reasons that, in these people, eating one chocolate leads on to devouring the whole box, and why we often crave for things such as pastries, cakes or sweets. This craving is exactly similar to the craving for alcohol set up by the first use in any day of alcohol in sufferers from alcoholism, or the cravings set up by the first use in any day of any other mood-altering substance or process. In each case it is the first use in any day that does the damage. This is the origin of the saying in Alcoholics Anonymous that one glass is too much and a barrel too little, or for the warning in Overeaters Anonymous that we should beware of the first compulsive bite. It also explains the humorous new word "ufluation": checking in the refrigerator to see if something has mysteriously appeared in the ten minutes since we last looked.
Appropriate physical abstinence, which avoids all sugar, including honey and syrups and all refined carbohydrates of any kind, dramatically reduces the likelihood of craving or bingeing. On the whole, other foods should be confronted just as an alcoholic would confront milk or orange juice: with no problem whatever.