The 5:2 Fast Diet: a disordered eating revolution

Every man and his intermittently fasting dog is doing the 5:2 diet at the moment.  While periodic fasting is hardly a new method of dieting, this particular form caught the public imagination in late 2012 after the airing of a BBC documentary “Eat, Fast and Live Longer”. Hosted by medical journalist Michael Mosley, and followed up by his best-selling book, the show convincingly demonstrated the many benefits of eating normally for 5 days a week and severely restricting calories for the other 2: not just weight loss, but increased longevity, reduction in susceptibility to forms of dementia such as Alzheimer’s, decreased insulin sensitivity, lowered cholesterol, the list goes on. And weight loss. Did I mention weight loss? Because let’s be honest, that’s the main attraction. The book’s a bestseller, and every second person is talking about their 5:2 journey, from Kate Langbroek to Kate Middleton’s uncle. Even Benedict Cumerbatch is on board. The appeal is pretty undeniable. You eat what you usually do for 5 days of the week, and for the other 2 you restrict your calorie intake to 500 (for women) or 600 (for men). And you lose weight. These ‘fast’ days are non-consecutive, so you can always have that biscuit tomorrow. For those who struggle to maintain a consistent healthy eating and exercise regime (ie. most people), the 5:2 diet is quite the dream discovery. After all, anyone can manage to diet 2 days a week, right? You’ll have to ditch alcohol on those days too (unless you choose to use up your 500 calories on a couple of glasses of wine), so there’s the added virtue in that. Of course, the weight loss depends on you not eating the entire fridge on your ‘non-fast’ days,  but most testimonies in the 5:2 book say the need to overcompensate fades quickly, once your body realises you’re not going to be surviving on 500 calories every day.

Looked at in this way, the 5:2 diet seems like a sustainable “way of life”. But filtered through an eating disordered perspective, it suddenly seems much more unhealthy. There has been very little medical research done on the long-term effects of the 5:2 diet, and rigorous valid studies are as yet absent. The claim that only restricting caloric intake for 24 hours at a time does not suppress metabolism is unsupported. But even if we just consider the wealth of anecdotal evidence flooding the internet, a trend of thoughts and behaviours emerges. While dieters report additional perks such as clear-headedness, increased energy and better digestion (along with easy weight loss), many like Lucy Cavendish also report dizziness, obsessive thoughts about food, irritability, tiredness, headaches, and on their ‘non-fast’ days, eating everything in sight. They advise drinking lots of water when you’re hungry, and loading up boring meals with low-calorie, high-flavour condiments such as salsa and mustard. To anyone familiar with restrictive or binge/purge eating disorders, this sounds like a roll call of warning signs. In 1944, the Minnesota Starvation Experiment took 36 men and reduced their caloric intake from 3200 to 1560 per day (more than 2.5 times what the 5:2 diet allows on fast days – but this was every day) over a period of 6 months. The men quickly developed symptoms similar to those displayed by those with eating disorders: an obsessive preoccupation with food, irritability, difficulty concentrating/sleeping, and demonstrated binge eating on re-feeding. Sound familiar?

While the 5:2 diet is touted as a sustainable health miracle, if I turned up to a therapist  and described this as my personal eating regimen, and my accompanying thoughts/feelings – but left out the 5:2 brand name - I'd most likely be told that my eating was disordered, and probably offered psychological and practical strategies to try to help correct this. This is not to say that the 5:2 diet will cause someone to develop an eating disorder (though, as the book mentions all too briefly, the diet should be avoided by those with these illnesses). But the diet does normalise thoughts, feelings and behaviours that mimic those of eating disorders. In a society already so consumed by food and weight concerns, we are edging ever closer to explicitly encouraging pathology, clothed in seductive marketing and masquerading under the name of health.

If life gives you lemons, don't eat them

 Late last year I had an article published in The King's Tribune about my 10 years of following pro-ana sites online. If you're interested, head on over for a read.

If Life Gives You Lemons, Don't Eat Them

(This post in lieu of me having released any poems because slack! I'll get my act together.)

My Brain on a Plate

(Triggery warning: this post contains writing related to eating disorders and ED recovery. I don't think it's particularly triggery, but you know if you need to be careful.)

Still getting my weekly dose of self-inflicted rage from The Age's Sunday Life column: 'My Day on a Plate'. Occasionally there is the pleasure of reading someone like Sandra Reynold's frankly reassuring day (except for the Marmite. Outrageous! Love the Milo bit.)


But more often than not, it dishes up for us things like last Sunday's, which began:

5am: I have a coffee, a litre of naturally flavoured water, then I go to work.

9am: I enjoy some Chia seeds...

You get the idea.

Now, it may be that I'm just filled with naturally flavoured bitterness, and would like to deliver a kick to the Chia-seeds to these sorts of columns that try to normalise whatever the unrealistic eating-trend-of-the-moment is (not to mention implying that human eating habits are entirely uninfluenced by mood/tiredness/menstrual cycles/what you ate yesterday/weather/hangovers/toddler tantrums/stress/inclination).

I know space is an issue, but I really wish these sorts of columns could present some kind of brief note of the thoughts that go along with these lists of eats, like: "I've just got back from a relaxing weekend away, so I didn't end Monday with an entire box of BBQ Shapes on the bus like I usually do, instead I waited til I got home and had grilled salmon with quinoa." Because if I picked and chose my meals out of, say, a fortnight's worth of eating, I'd probably be able to piece together a pretty perfect My Day on a Plate too*. My rage-on-a-plate about this column stems from wanting to see more of a 'My Brain on a Plate' than 'My Day on a Plate'. (That was too many 'on-a-plate's for one sentence. Please accept my apologies on a plate.)

Even now at an (undisclosed yet respectably) healthy weight, for me every day with food is a struggle with anxiety and overthinking and second-guessing myself. Obviously, I can't be sure people who haven't ever been diagnosed with an eating disorder don't sometimes/often think like this too. It just goes round and round and round:

6am: 1.2 litres of tea. I love tea. Tea is the one thing I've never worried about. Tea tea tea tea tea.

8:30am: I bought some full-fat strawberry Jalna yoghurt for my 3 year old Luka, but he doesn't like it, so I've put 2 big spoonfuls on half a cup of raw oats in a container for myself to eat on the bus for breakfast. How much is a 200g serving of yoghurt? Like, a whole tub? Maybe these 2 spoonfuls are 200g. I'll have to look that up.

11am: Stupid oats and yoghurt, they've got more calories than my usual toast breakfast, and yet they've lasted only a couple of hours, whereas the toast usually keeps me sorted til 1pm. It's nowhere near lunch time. I'm hungry. Am I hungry? Maybe I'm just thirsty. How much water have I had this morning? 1.5 litres. Plus the tea. I'm probably not thirsty. I eat 2 big squares of Saladas. It makes my hands shake afterwards, I hate snacking, it always just feels like the prelude to a binge. What if now I'm not hungry for lunch, or I do get hungry for lunch, but too late to be hungry for dinner? Perhaps the Saladas should just count for lunch.

12pm: Birthday celebration at work. I refuse the cake on offer, saying I'm not a big fan of cake (which is true), but it's mainly because if I eat when I'm definitely not hungry, my anxiety levels will shoot through the fucking roof, and I won't get any work done for the rest of the day. Let alone lunch. I wonder if they all think I'm refusing because I'm relapsing. I'm not. Am I? I don't think I am.

3pm: Great, now I'm hungry for lunch. And I don't want the lunch I've brought from home, I want laksa. Laksa is enormous though, it's like treble what I'd normally eat for lunch, and then I won't be hungry for dinner. Maybe I just won't have dinner. People do that, right? They have a big late lunch and then don't have dinner because they're not hungry? That's not disordered, is it, if I'm truly not hungry? Oh for fuck's sake. This is ridiculous. I buy a laksa. I don't finish it all, but I still worry that I ate it too fast and as a result ate more of the noodle part than I would normally do. I'm clenching my teeth a lot. I have a lie down for the rest of my lunch break so that my breathing calms down a bit.

7pm: I get home from work, and assess my physical hunger as objectively as I can, about twenty times. Nope, I'm definitely not hungry. I feel guilty by default just saying this to my Newly-Corporeal Boyfriend, because the words are the same as when I was starving and lying to everyone: "I'm not hungry". Now they're true. I think. I hope he believes me. I've certainly gone over it enough times in my head to make sure I'm not lying. I think. Have I? Oh fucking hell, can I have a glass of wine now?

6am: Wake up. Absolutely ravenous because my last meal was now 15 hours ago. So today will be out of whack too. Should I start with a bigger breakfast? How long should it last me? Sigh...

And on it goes. Recovery is very tiring and very boring. I could be thinking about way better things, like buses that are also ATMs and have vending machines and mini-bars in them.

Still, my brain is much less plate-heavy than it was even a six months ago. And as tedious and anxiety-inducing as attempting recovery is, that's got to be a good thing.

*Aside: this is why overly rigid meal plans that eating disordered people are often given to follow (especially on hospital discharge) can be problematic - because when you look around in the real world it's obviously bullshit: not many 'normal' people eat exactly 3-meals-plus-2-snacks every single day. But this is rant for another time.

My Day on a Plate

Every weekend in The Age Sunday Life magazine, I read the ‘My Day on a Plate’ section. I read it first, and I make self-conscious scoffing noises every week. Apparently, every human being on the planet follows this daily routine:

1. We start the day with lemon juice in hot water. (I look forward to future columns about our dentist bills)
2. We adore untoasted muesli with natural yoghurt and ($8 a punnet) blueberries. Go you antioxidants go
3. Occasionally (we should capitalise that, really) OCCASIONALLY we indulge in a skim-milk latte mid-morning.
4. Somehow we have lunch prepared for us by a professional chef because it’s always lightly seared tuna steak with quinoa, raw grated beetroot and and light dusting of fear. Dressing on the side.
5. Whereas most people I know have four dim sims from downstairs and three chocolate coated teddy bear biscuits and fifteen tomato salsa rice crackers and some of that slice from Emma’s going-away-afternoon-tea last week and a bottle of Diet Coke.
6. Sorry about that. Ignore point 5. We’re back on track for afternoon tea, where we have a cup of sencha tea and a handful of raw almonds. No more than ten almonds. Usually five or six. No more than ten. Definitely not the whole bag. Because raw almonds aren’t very nice so why would we eat the whole bag anyway? Unless we were a bit bored.
7. Right. So, at 7pm, when we were supposed to finish work at 6, we catch a train and get home by 8 and instantly prepare a perky combination of grilled chicken, more fucking quinoa, and some kind of colourful combo of vegetables (steamed) and a delightful squeeze of lemon if we’re feeling crazy. After all, it’ll be in our morning teeth-eroding drink so we may as well kick on.
8. In no way after this virtuous day will we crack open the block of Fruit ‘n’ Nut our in-laws left behind and nip down to the bottle-o for another bottle-o.

***

So I wrote the above based on what I think normal people might be like. I don’t eat like ‘My day on a plate’, but I don’t eat like the above version either. I eat like a person who has an eating disorder. And I wanted to write a version of it based on me, at my worst, though I suspect it’s at the blacker end of black.

But what the fuck. My day on a plate has just as much right to be out in the world as green tea and quinoa.

First, a disclaimer: I do eat at relatively sustaining levels at the moment. However, this was my average day back in January.

4am: I wake up early because I’m pretty hungry; I haven’t eaten for 24 hours. I set my tea to brew and take off all my clothes (including my watch, rings and glasses), go to the toilet and then weigh myself naked. I note the number, but also note that I haven’t taken a dump yet today, so I am probably 200-300 grams heavier that I would be otherwise. Having an eating disorder means you know the weight of everything, including your average shit.

6am: I inhale a litre of tea while reading. My child wakes up and demands Rice Bubbles followed by Vegemite toast. Afterwards I stare at his buttery crusts and milky cereal. I place a single piece of bread in the toaster, look at it for a bit, and then abandon it to have a shower.

7am-12pm: 1.5 litres of water. I do a lot of shelving and counter work. I try to be as active as I can in the morning, because I’m less likely to pass out at that time of day, and it stimulates my metabolism.

12pm: I’ve been at work since 8:30am and when I stand up things are starting to swirl a bit. I chuck back four Tic-Tacs to attempt to kick up my blood sugar levels while I get the pickled cucumbers out of the work fridge. Pickled cucumbers contain 15kj per 30 gram serve. A piece of bread (also 30 grams) by comparison contains 305kj. If there was an anorexic supermarket it would have entire aisles devoted to pickled cucumbers, mustard and salt. Somewhere between the laxative aisle and the toothbrush aisle.

12:30pm: I’ve finished my allotted amount of pickled cucumbers. I usually have to sit down as much as I can for the rest of the day.

1pm-5pm: 1.5 litres of water. Everything gets a bit blurry. I won’t remember if you come to see me at the library or if I see that cat that looks like the cat I sort of adopted when we lived in Carlton that you hated because he woke you up at night howling outside your window and annoyed you and I didn’t know. Oh right, sorry, you’re not my old housemate, you just want to borrow a book.

5:30pm: End of the day. I’m tired and dizzy and I have to double-check before I cross roads. I take the train home, plough up the hills toward home. At some point I lurch sideways into a fence and it’s just another bruise.

7:30pm: My child is asleep. I don’t want dinner. I never want dinner. I have four glasses of wine (because alcohol doesn’t count as calories) and I type words onto a screen until my fingers hit all the wrong places and all the songs I listen to are too meaningful.

11pm: I fall asleep on the couch, wake around 2am and drag myself to bed.

***

I’ve struggled about how to end this. Flippant, caustic, matter of fact?

Matter of fact wins.

4am: I wake up. My limbs feel like they’re filled with sand. My heart is beating like a hammer inside my chest. I have to sit up slowly, stand up even slower. I hold onto the door frame. And the whole day, the same as every single day, begins again. I feel like I’ve been alive forever.

Reading 'Wasted': Yes. Fucking yes.

Reading Wasted is like being belted over the head.

Marya Hornbacher's 1998 memoir of her anorexia and bulimia (written when she was just 23) has been much criticised for its triggering nature and unresolved, bleak ending. Which is fair enough, on one hand. It does have huge triggering potential. There are startling amounts of research and theory pulsing through Hornbacher's writing, along with descriptions of her personal experiences that are magnetic, raw and deranged. It's a seductive and mesmerising combination of factors - the academic and the mad, and she was obviously still unwell when she wrote it. Reading Wasted draws you in so close to Marya that it does make you feel pretty nuts, so if you're already a bit nuts, proceed with care.

But I'm not intending to enter the debate about whether Wasted 'should' ever have been published. It was published, it still is being published. People can choose what they read, choose to stop reading. People in recovery know what triggers they need to avoid. And not every book has to have a happy ending.

Moving on.

Wasted veers between vicious honesty, articulate introspection and self-indulgent ranting. The belted-over-the-head factor for me in this book comes from many things Hornbacher says that I haven't had the words to express, or that I haven't even thought of. Things you don't read in the Standard Government-Issue Pamphlets On Eating Disorders, and things that struck with with their truth (their truth for me, personally).

Sometimes it doesn't occur to me that the DSM-IV-TR might not be a comprehensive account of these conditions (although the very inclusion of EDNOS should be a tip-off that eating disorders are that easily defined, yeah?). The value of this book for me is pointing at a paragraph and just thinking "Yes. Fucking yes."

I've folded so many corners down in this book it's starting to fan out at the bottom. Rather than ramble on, I'm going to share a few corners. I don't think they're particularly triggery passages, but that's only going on my subjective appraisal.

"The bragging was the worst. I hear this in schools all over the country, in cafes and resaturants, in bars, on the internet, for Pete's sake, on buses, on sidewalks: Women yammering about how little they eat. Oh, I've starving, I haven't eaten all day, I think I'll have a great big piece of lettuce, I'm not hungry, I don't like to eat in the morning (in the afternoon, in the evening, on Tuesdays, when my nails aren't painted when my shin hurts, when it's raining, when it's sunny, on national holidays, after or before 2am). I heard it in the hospital, that terrible ironic whine from the chapped lips of women starving to death. But I'm not hun-greeeee. To hear women tell it, we're never hungry. We live on little Ms. Pac-Man power pellets. Food makes us queasy, food makes us itchy, food is too messy, all I really like to eat is celery. To hear women tell it, we're ethereal beings who eat with the greatest distaste scraping scraps of food between out teeth with our upper lips curled.

For your edification, it's bullshit.

Starving is the feminine thing to do these days, the way swooning was in Victorian times...My generation and the last one feign disinterest in food. We are 'too busy' to eat, 'too stressed' to eat. Not eating, in some way, signifies that you have a life so full, that your busy-ness is so important, that food would be an imposition on your precious time. We claim a loss of appetite, a most-sacred aphysicality, superwomen who have conquered the feminine realm of the material and finally gained access to the masculine realm of the mind."

Yes.

"This is the very boring part of eating disorders, the aftermath. When you eat and you hate that you eat. And yet of course you must eat. You don't really entertain the notion of going back. You, with some startling new level of clarity, realize that going back would be far worse than simply being as you are. This is obvious to anyone without an eating disorder. This is not always obvious to you. But at this stage, when it is effectively Over, is haunting in its own way...This is the pitiful stage where you do not qualify as an eating-disordered person. And you feel bad about this. You feel as if you really ought to count, you ought to still merit worry, still have the power to summon a flurry of nurses, their disdain ill hidden, your skeletal smirk.

But you are in the present tense. Your husband sips his coffee, saying, But dear, I don't really care if you've gained weight. And you, triumphant, logical as the Red Queen, shriek, You see? I have gained weight! I knew it! And he sighs. You ask again, Do I look fat? No. Plump? No. Round? Well you're a woman. What do you mean? I mean - I mean -

I picture husbands all over the world, hovering in doorways, caught in a terrible tangle of language, feet and hands bound by these slippery words glossy and meaningless as the pages of a magazine."

Yes.

"I should've known better, I should've called myself on all the lies I was telling myself - I'm eating enough, I'm doing all right, I'm healthy. I was happy. I had learned, or thought that I'd learned, that I was a valuable person. I understood that I needed to eat to live, and I wanted to live. I said to myself: It takes time, it's not that easy, you can't expect yourself to be perfect this soon. There are altogether too many 'empowering' things that professionals tell you that can be twisted around and turned against yourself. I had heard a few too many times that if I threw up, it was just a 'slip', if I stopped eating for a little while it didn't really mean I was relapsing. How long is a little while? It stretches out, one week, two weeks, three, and you're back where you started. Professionals give anorectics and bulimics way too much credit for having their brains in order: You have to be patient with yourself, they said, you have to be nurturing to yourself, be nice to yourself. And so, as I went through another day without food...I said to myself: I have to be patient, I'm being nurturing to myself by not expecting too much of myself, I will not push myself too hard today, so I guess we'll just have some coffee for lunch...
We all do this. I've never met an eating-disordered person who could not come up with an astonishing battalion of solid-sounding, intellectualized reasons why they can't eat."

Yes.

"Did my family set it off again? Did my father's neediness and my fear of it spark relapse? My mother's distance? An article I read? A woman I saw? Not likely. What happened is that, faced with a number of things in my life that I didn't like, I turned to my eating disorder because I had never, ever figured out how to fucking deal."

Yes.

"I have a remarkable ability to delete all better judgement from my brain when I get my head set on something. Everything is done at all costs. I have no sense of moderation, no sense of caution. I have no sense, pretty much. People with eating disorders tend to be very diametrical thinkers - everything is the end of the world, everything rides on this one thing, and everyone tells you you're very dramatic, very intense, and they see it as an affectation, but it's actually just how you think. And it isn't that you ignore the potential repercussions of your actions. You don't think there are any."

Yes.

It was also very pleasing to hear my opinion on the therapist-worshipping 1980s YA novel The Best Little Girl in the World echoed: "It is in fact a rather romanticized account, written by a doctor intent upon demonstrating not the experience of having an eating disorder but rather his own genius in curing them."

Yes. Fucking yes.