The Year Of Babies, But Not For Us (At Least, Yet)

Writing is like therapy for me, it helps when I need it, so here it goes.

These past six-plus months have been straight up emotional, challenging and personally transformative. In many ways, the old adage holds true: “What doesn’t kill you makes you stronger.”

So let me back up.

Ready To Try

When we were in Hawaii this past October (2016) John and I had a lot of good times, enjoyed the big race, went on scuba dives, hikes, and had our share of date nights and cocktails, but in particular one thing came from the trip that would potentially change our lives forever. We decided we wanted to start trying to get pregnant! Even though we’re still newlyweds, we’ve been together for a long time and we’re at a point in our lives where we’re just ready. When you know you know.

So me being me, I got all ready for this baby-making process by becoming an expert on it and following concepts of the Fertility Awareness Method (FAM). Actually, I had already been measuring BBT and tracking cycles on Kindara so that was nothing new. But I started doing everything else from OPKs (to watch for the LH surge) to timing our sex—all new territory for sure. I also did a lot of other little things that I felt would help make my body baby-ready—got acupuncture, gained a little weight (which I’ve discussed here; the changes took some getting used to but now I really enjoy my body), kept exercise to moderation, ditched intensity (most the time), ate more carbs*, weaned off coffee, abstained from alcohol for a month, ramped up the supplements, etc.

*In fall 2016 I logged on MyFitnessPal for a week just to see what I was eating intuitively these days, and I was averaging 90-130 grams of carbs most days, and on exercise days usually eating anywhere from 150 to over 250 grams of carbs a day. I figured that now trying to conceive I shouldn’t be going chronically less than 130 grams a day even if that was working fine for maintaining a regular monthly menstrual cycle and normal bodyweight/BMI, hence the increase. 

That first month of trying, October, totally messed with my head. I was obsessed over it… I was excited… I was nervous… I was tripping out over the idea of getting pregnant… I wanted it really bad… I was over-thinking every little thing. Looking back I went totally over board and let that ol' control freak take over.

Worst of all, I expected it to happen just like that. A lot of my friends shared their stories of getting pregnant on the first try and said "watch out what you wish for!" Then I look and John and I and think, “I’m the healthiest I’ve ever been, John’s a very healthy dude, we take care of ourselves, we’re not too uptight or stressed, I’m an expert on healthy living… not to mention, I’m no longer too lean, not training too hard, and all my tests show that my hormones and biomarkers kick ass so I should be 100% ready to build a baby!” (PS studies show that there’s no reason to believe a woman who had amenorrhea in the past will face infertility as long as her hormones and cycles are back to normal, which mine have been for years now, thus this has never been a concern for me).

The First Negative

That first month we did not get pregnant—and it’s not surprising looking back. I was pretty sad the afternoon I started my period, and there were tears, but also something else happened: I immediately felt myself relax and loosen up. Right then I learned a couple huge lessons. 1) I had been so worked up over how to do everything perfectly for trying to conceive (TTC) that I forgot the most important thing to just relax and let nature take its course. I knew I’d never get pregnant if I kept up like this. And of all people, I should have known better than being in a state of stress like that does not usually lead to desirable outcomes. And 2) the negative result was also humbling. You can be the healthiest in the world, but that doesn’t guarantee anything with getting pregnant, apparently. The more I learn the more I realize pregnancy is a giant mystery in many ways.

November and December continued to be active months of trying, but I was working on changing my attitude and approach. December I especially let go of trying so hard, and poured myself some wine over the holidays. All the while I was still tracking and timing “stuff” (because at the end of the day things like timing sex do matter), but I was truly making an effort to be more relaxed and less obsessed about it. I wasn’t perfect, but I was managing it better. Here’s the thing: When I set my mind on a new goal it’s hard for me to just to be casual about it, and if I’m not reaching the goal, I tend to get even more intense about the effort I put in. But in this case that had to change, and that’s been part of my transformation…

Finley The Vizsla

Thankfully on Dec. 9 a new little member to our family arrived to our home, the fur baby kind. We had committed to getting a vizsla puppy (my dream dog for the past decade) way back in summer—even before the decision to TTC—so I had been eagerly waiting his arrival and the timing was absolutely ideal. I had no idea how quickly I’d fall in love with our boy, Finley, and also had no idea I’d need this little guy in my life so badly during this time. Finley’s filled our hearts with so much love and happiness, and no matter what he is and always will be our first baby. Lucky for him, since he’s our only child as of now, he has one hell of a good life with a mom and dad who both work from home and give him lots of love, attention, walks and treats.

As far as TTC goes…

More disappointing outcomes for us in the final months of 2016.

The Baby Boom

Meanwhile, a handful of my girlfriends and best friends from various circles in my personal life were announcing their pregnancies, had recently become pregnant or about to pop. It was crazy. Apparently everyone else was trying too. I’m sure my age has something to do with it, but still, the pregnancies seemed way more than normal. In February alone I went to three freakin' baby showers ha!

I started seeing the same thing happen in the triathlon/endurance world and everywhere else I looked—it felt like every damn day for months someone else was announcing a pregnancy. There are people even claiming it’s the “year of babies.” It was a bit overwhelming for me to stomach…

I never expected I’d react this way, but the flood of announcements started breaking me down emotionally and really fucking with my head. I wasn’t jealous of anyone, but the situation just made me really sad and confused. I couldn’t help but compare and wonder—why them and why not us? Of all times for this to happen, why the hell does this pregnancy boom have to happen now—right when it’s become a very sensitive subject in my life?! These mom- and dads-to-be are feeling the most happiness ever while I’m over here crying at the start of my period and feeling like a failure.

Pity party. I know. I’m not saying I’m proud of it… I’m just telling the truth. I'm sure many women can relate.

Thankfully I got over that shit with time; it was making me bitter, anti-social and even more resentful at social media, which I didn’t like. Meanwhile, the baby boom is still going strong. No matter where I look it’s “baby this,” “baby that.” Baby bumps galore. To this day I’m seeing new announcements once a week or more on average. But now, I react with laughter. Literally. Whenever I see or hear of a new gal who’s knocked up, I laugh to myself and say, “Of course she’s pregnant!” (And then I remind myself that I have a pretty good life and the freedom to do lots of things pregnant women can’t do.)

Let me also say, I am certainly not ignorant to the fact that there are, no doubt, plenty of women like me out there right now who so badly want to get pregnant but aren’t, month after month, and these women probably also have a hard time hearing about all the baby talk from their friends and social connections… We’re more of a silent group; when you’re going through it it’s harder to talk about it publically. Personally, I never knew it would be so hard to talk openly about trying to get pregnant. I consider myself an open book these days, but this is tough stuff and it even took me months to build the courage to write this blog post. So to all you women TTC and having a hard time, my heart is right there with you.

Now Into 2017

January… February… March…

Half a year of trying.

Not pregnant.

Gradually, it’s gotten back to life as usual, I definitely think about it less, and am doing way less. I’m not so emotional about it. When I look at my friends and acquaintances who are pregnant I don’t get a lump in my throat anymore. At some point you realize you just have to live your life, be in the moment each day, be grateful for what you DO have, don’t fret over the things you DON’T have, and not be obsessed over that which you cannot control. Oh, and let go of all expectations.

And, hey, after all it's only been six rounds so far. It certainly feels like forever, but in reality it's not that long to be trying!

However, the one time of month that sucks no matter what is when I start my period. Aunt Flow (AF) now comes with a different type of emotional response (i.e. not PMS)—and it’s when I get all choked up. I can tell when AF is coming days before, and for those few days, it’s just a hard time of month for me.

I’ve also let up on how much I was doing to TTC. I’m not trying to be perfect during the two-week wait anymore (if I workout a bit harder or have some wine, so be it). I'm not trying to "hack" this one. Less is more. Keep it real. Until I see a positive pregnancy test with my own two eyes I have to live life normally, not cautiously thinking “what if.” I still keep up with a few things I find valuable—mostly things I’d be going even if we weren’t TTC—such as acupuncture, taking certain supplements, using Kindara, clean eating, etc.

Meanwhile, I’ve gradually been putting in more effort on myself in other ways and have searched for underlying stress that could be plaguing me (more on that below). The transformation has been real!

What About My Guy?

We did get John’s sperm tested because every expert with whom I speak always says, “Keep in mind it’s 50% the guy when it comes to getting pregnant, not just the girl.”

The results show his “stuff” was about average and/or potentially borderline low in one or two areas depending on whom you ask (the standards for what constitutes good, healthy sperm are somewhat vague and inconsistent in what we researched and resources we were given). So what we know is that John’s stuff could be better, but it’s certainly not problematic at a clinical level and nowhere near infertile. (PS - John gave me permission to disclose this tidbit).

Given his results, we built out a plan to aid in his fertility and he was very willing and open-minded to it despite not being the type of guy who likes supplements and health plans (go figure). It’s funny because we've each had to take a somewhat opposite approach in this: I relax more; he puts in a bit more effort. I’m very proud of the man he is, the efforts he’s making and most of all how he’s been incredibly relaxed about the whole process. He sets a good example around here.

So at the end of the day, thankfully there’s zero reason at this point to believe that he or I are infertile in any way, which means we’ll just keep on trying and this a practice in patience. If I find the need or desire to do more testing and investigating down the line, then we’ll discuss it, but again, it still has only been six months of trying, which is not that long all things considered!

Love & Life

Meanwhile, all this has brought John and I closer together (not just talking all the sex we get to have, which of course is another big bonus lol). We’re taking more time as a couple, having fun date nights and little adventures (Finley’s always included too) and we’re in a great groove. I’ve never felt so in love with my man.

A good friend and mentor told me about her efforts on trying to get pregnant (it’s not been easy for her either), “Truly, I live an amazing life, and am wanting for nothing. So I give thanks for that daily, and trust that the rest will fall into place for reasons that I may never understand the details of!”

This spoke to me. I couldn’t ask for a better life with John. Wanting a baby is just that: Want. It’s not about needing one. We don’t need a baby. Once you understand that it really puts things in perspective and I’ve learned to not let myself take for granted the good things that are happening right now.

Uncovering and Eliminating More Underlying Stress

I knew I was stressed in the beginning, but over time I know in my heart of hearts I’m not like that about it anymore! It really is life as usual for the most part. I really don't feel stressed. HRV is fine (if I get around to measuring). My body feels healthy and robust. I feel like I've learned to handle this pretty well. So I've despised it and still despise it every time someone says, “Oh you just need to relax and it’ll happen.” I’ll admit to having stress when it’s clear I have stress—I’m not ashamed—so how could there be stress and lack of relaxation if I really truly don’t think that’s the case? Even John is amazed at how chill I've become—a lot of it thanks to him and his naturally chill demeanor.

But maybe there was something I was missing? I was willing to dig deep and figure it out. And actually, I discovered something…

My work. Being self-employed.

Therein lies the hidden underlying stress.

So I had the chance to do something about it, and long story short: I’ve temporarily and purposefully cut back on work despite that being a terrifying concept in my world. Turns out this is something I’ve needed for a while but was too scared to ever do. Thank goodness I have the support of my amazing husband in this.

The longer version:

For a while I’ve been having some feeling like work was taking a bigger toll on me and that perhaps I was starting to experience burnout, but then I’d have a bunch of shit to do so I’d have to ignore it. I was also confused because I love what I do so damn much—how could I be burnt out?

What it comes down to is being self-employed and fearing a plateau or decline. When you’re self-employed it can be intense and stressful in different ways than a traditional job. I put a ton of pressure on myself that I always need to be growing, building, expanding, making more money, figuring out new ways to stay fresh and relevant, and that each month and each year needs to be better than the last. Granted, it’s not so bad that I’m back to being frazzled and dealing with work-stress insomnia like I have year’s past. These days I certainly take better take care of myself, I know when to say NO, and I don’t get completely overwhelmed at my workload (getting organized has helped a ton). But even if I’m mindful of my wellbeing and time management, I’m always of the mindset that as a small business owner I need to do better each year, make enough money to cover all my costs and still have enough save, invest in my future, pay for health insurance, be on top of my game as an expert in the field (thus find extra time to do research and continuing education), and so on—while god-forbid I stay status quo, plateau or experience a decrease in business; that would make this Type A gal an anxious mess. I discovered that this mindset has been a huge source of underlying stress.

So I pondered, “What if I challenged myself to cut back on work, live a bit more simply, be a bit more of a hermit, and see what happens?” The timing seemed right given the main subject of this blog post you're reading. The idea of a sabbatical also floated around for a bit, but the more I thought about that the more it didn’t seem realistic, desirable or necessary for several reasons. So instead, we decided (John of course has been very much involved in this) that I’d cut back on work for a month or so. Of course, I’d keep all my current full-time coaching clients and the regular work I do for them, but not take on anyone new, and cut back in other areas, e.g. podcast once a week instead of twice, scheduling fewer consults per day, blocking off certain days of the week as “personal development” days and so on. Last year I decided to do more consulting and less full-time coaching (thus I scaled back on how many full-timers I accepted) so that actually made this shift in workload easy.

Once I pulled the trigger I immediately felt the difference. Holy shit did I need this extra room to unwind a bit, reconnect with my whole self and feel the work pressure lift away. For once it’s ok that I’m not striving for more or worrying about how much money is in my accounts. I can’t emphasize enough that this would not have been possible without my John, he’s simply incredible and couldn’t be more supportive.

By now, you probably know as well as I do that I can be a serious put-your-head-down-and-do-the-work kind of person and have unwavering commitment to my schedule, work and goals; I take things like health, wellness, performance very seriously—my own and that of my clients—all to the point where sometimes I get so wrapped up in the work and chasing optimal, that I forget to lighten up and realize I’m just human; we’re all just human. So this transition/break has allowed me the opportunity to be more of the carefree person that lives within me (thankfully she's alive and well); to spend my days moving at a slower pace and take more of a ultra-chill happy-go-lucky approach; to laugh off shit that happens rather than turn on the “flight or fight” mode. 

This little self-discovery project has also taught me to truly live in the moment and not get worked up over what the future may hold; to find some space and just be comfortable with “what is;” to be more process oriented than outcome oriented. I’m good at that mindset when I’m on vacation or out backpacking, but I’ve had to learn how to be this way at home during regular day-to-day life.

“When we practice ‘being here’ during less stressful times, we'll be more equipped to respond mindfully when dealing with strong obsessions.” – Tara Brach

So That’s Where TTC Has Led Me…

It’s funny how this journey has taken me down paths that I never expected. I’ve realized that in life, no matter what it’s been, nothing has ever come easy to me; I feel like I’ve always had to work a bit harder, go through some shit and overcome tough times, and go a step further to peel back layers and discover more. If I had gotten pregnant the first try none of these good things would have happened, and I wouldn’t have learned these lessons or have taken the time to explore more on how I want to live my life. So maybe we didn’t “get lucky” and conceive on the first or second try like so many I know, but in a way I feel just as lucky if not luckier on this journey because it’s making me a better person, making my husband a better person, it’s making our relationship and love for each other better than ever … and it’s making me more compassionate to all those out there who face tough times—whatever their definition of “tough times” may be; it doesn’t matter, it’s all relative.

So that’s it for now! I wish I could say this post was ending on a happier note and something like, “Surprise, we’re finally pregnant,” but I’m not. We’re not pregnant. Who knows what’ll happen. 

Someone asked me if I’m worried about that yet, i.e. what will happen, and the honest truth is no, I’m not worried about it. I’m really not. Have I worried about different variables as it relates to getting pregnant? Yes. But I’ve let go of that. Overall I have no worries about the future. There is only the now to focus on—and enjoy the hell out of my little family and this life we have built.

~~~ BONUS ~~~

Helping My Hormones

Last tidbit because it's relevant and may also be helpful to other women out there if they’re experiencing something similar; it's when all the tracking and investigating pays off. Just please do me a favor and work with a practitioner when starting any new supplements or health plan.

Backing up a bit to those early months of trying (last fall)… I did discover that my hormones potentially could use some balancing. My cycles were regular but there were little things that were “off,” all of which I discovered thanks to the tracking I’ve done on Kindara dating back to 2015. Before we were TTC and even the first couple months of TTC, I saw that I had been ovulating relatively late in my cycle and having short-ish luteal phases, as well as inconsistent cycle lengths during a lot of last year (I’d cycle every month, but it’d bounce around a lot). I also have suffered from PMDD for over a year, which is not normal! (And yes, I’ve tried managing diet and carbs to alleviate the symptoms, which is another topic for another day.) I wondered if the short luteal phases were due to not enough progesterone sticking around and if this was causing a luteal phase defect that can have a negative effect on getting pregnant.

To fix things, I decided to start on vitex back in early December (specifically I’m taking Chastetree Berry Extract by Vitanica) and this had an immediate beneficial effect. Within a month, I started ovulating at a normal time (Day 14), luteal phases improved to 13-14 days and cycles stayed consistently 27-29 days. It’s been like that since.

Meanwhile, I consulted with my amazing functional practitioner/fertility expert, Brie, about my health, hormones and fertility in general, she eased a lot of worries and gave some great insight and thoughts. In particular, I asked about the idea of taking progesterone just to see if that would help and we decided it wasn’t absolutely necessary (my progesterone looked fine on my most recent DUTCH) but she also said it wouldn’t hurt trying it. So I’ve been on sublingual progesterone the past two cycles—haven’t really noticed a difference nor did it magically lead to a pregnancy; not that I was expecting that. (Note: do not start taking progesterone on your own, please only do so under the guidance of a qualified practitioner.)

All this work I’ve done to aid my fertility—from the acupuncture and herbs to vitex and lifestyle—has greatly relieved my PMDD symptoms, to the point where I don’t have to hide away that time of month, lol. So that’s a bonus!

Part 1: Keto vs. LCHF, and My Experience

Last week we published an Endurance Planet podcast on the potential risks of very low carb (VLC) and ketogenic diets for endurance athletes. This was especially geared toward female endurance athletes, and even non-athletes for that matter.

Keto/VLC is defined as roughly 50 grams of carbs a day or fewer, on most days. Furthermore, it's a very high-fat diet, often 50-70 percent of calories coming from fat! That's a lot of fat. It's also not a low-calorie diet, which should be clear if you know a bit about macros: 1 gram of fat has 9 calories, whereas 1 gram of carb or protein has 4 calories... if you have 50-70 percent of calories from fat, and you're eating enough, that's going to be a lot of calories. That said, it's not always pounding a ton of calories because keto-adapted people can go long periods with less or no food because they're so efficient at burning fat for fuel. Often the keto folk do intermittent fasting. And other times they're taking down "fat bombs." Endurance athletes are finding more interest in this diet lately because you can be a mega fat-burning machine and go forever on very little fueling needs--efficiency like none other.

To read more on what keto even means and its role for athletes, check this out. You'll see, it's extreme diet with extreme considerations. It doesn't just cut you off from cookies and junk, it goes way deeper. As do potential risky side effects if not executed carefully.

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Keto Does Not = A Moderate Low-Carb High-Fat Diet

I had some folks email me and thanking me for the podcast, which makes me happy. And in Part 2 I'm going to talk more about why I thought that podcast was needed, along with more that we'll be doing.

But first, I think some people might have mistaken that the potential risks/side effects of keto also apply to a more moderate low-carb high-fat diet. It's important to point out that keto and VLC is not synonymous with a moderate low-carb high-fat diet. The moderate approach is something one would generally take on to promote better fat oxidation (fat adaptation), metabolic efficiency, "cleaner" eating, and overall better health (i.e. avoiding refined carbs, refined sugars and junk). Moderate low-carb diets are much more flexible, "friendly" and doable in most lifestyles, and have many many benefits. And for the record, if you see me hashtag #LCHF, in my world I use this acronym for a moderate low-carb high fat diet, NOT keto or VLC. Maybe it should become MLCHF lol.

Tailored LCHF kick ass diets for health and sports performance, and I truly feel like most people should go this route instead of traditional high-carb fueling. I don't promote high-carb diets for males or females, nor even females needing better hormonal health. I won't say never, though, because I also believe our diet needs are unique to our situations and I can think of a few cases where I can see high-carb diets working really well. For me? High-carb/low-fat makes me batty, erratic, foggy, flat and sluggish, gut in shambles, and I feel like crap. On the flip side, I cannot sustain keto (at this point in my journey). I do well somewhere in between, moderate low-carb, high fat, adequate calories. I've learned through trial and error; scroll down for more of my story.

For females who who need to regain hormonal health, there may be a bit higher need for carbs--but you don't have to go off the deep end--while allowing tons of good fat and calories in general. In regaining hormonal health and a menstrual cycle, I allowed more carbs when my body craved them*, but I did not need to binge on tons of carbs in an unhealthy way--it was more about ensuring adequate and nourishing energy was present in my regular diet (including the fat that had been missing!), that stress remained low, and that body fat/body composition remained in a good spot. It's as simple as that. Ok, I know it's not that simple, but it also doesn't have to be overly complicated if you're dedicated to the cause as I was/am.

*If you are currently a carb-addicted human you will always be craving carbs all the time, so first you must break this addiction--it's a mental exercise. Sugar and carbs are a drug, and you have to break the addiction. There's also usually an emotional and psychological component at play here too. And, no, you are not that special exception, sorry. I know what it's like to crave refined and processed carbs/sugar, and I know what it's like to get off that cycle. So when I say above that my body craved carbs these cravings were genuine--my body was asking for things it needed to rebuild. You have to respect that. Likewise, I also crave fat now--fatty meats, avocados, butter--and always crave the greens and veggies and so on. 

More reading on sugar addiction.

And ya, I'll say it again: I love LCHF and I'm willing to align myself with a diet style at risk of being called out for joining a LCHF cult, or whatever. But I don't mind because I really truly believe this carb- and sugar-addicted world in which we live is making us obese, the root of so many diseases, killing us, and hurting athletes' performances and health. (It's not the dietary fat that's to blame). Managing carbs and sugar so that it doesn't spiral out of control and lead to bad outcomes just makes sense--and it doesn't doom you to a life without carbs either.

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Should You Cut Back the Carbs, Add the Fat?

How do you know if you should give this moderate LCHF stuff a try? If you can't go more than 2-3 hours without food in general, if your energy is constantly fluctuating (when you're empty you're a jerk/b*tch), and if you can't do a workout without fuel--even a 60-minute session--this is bad. I'd suggest weaning of the carb and sugar dependence and introducing more healthy fats into your routine. End that vicious cycle, end the carb and sugar addiction/dependence, and you will go far as athlete and human. The carbs, while enjoyable, can wreak havoc in you.

"Thanks to generations of people over-consuming sugar and other refined carbohydrates, many people suffer from a condition known as carbohydrate intolerance, or (CI). This is perhaps the most well-hidden epidemic of our time... CI then progresses to a functional disorder producing symptoms that negatively affect quality of life, such as fatigue. Gradually, this process generates serious illnesses such as diabetes and heart disease." --Dr. Phil Maffetone

That said, if you find you are having trouble getting off the carbs and shit is going haywire in the process, a few things:

1) First I would make sure your carbs haven't dipped below 100g/day--i.e. don't start with extremes like keto. Even though I personally hate counting and calculating calories and macros, sometimes it is needed, and even I've done it to check in.

2) Ensure you're getting enough calories and fat. Too low calorie is a common mistake when making diet switches and eliminating things--if you eliminate foods, you gotta replace the calories with something else nourishing. It could be as simple as adding more cooking fat (oils) to your meals; an extra handful or raw nuts, some avocado, or sipping on bone broth daily. Or google "fat bomb recipes" and take a stab. Again, food logging can help.

3) If it's still a problem and say you're 100-200ish grams of carbs a day and still struggling for whatever reason then I would look at the bigger picture: Are there other underlying problems that need solving first? Are you severely addicted to sugar/carbs and it needs time to break the addiction? Are you "fit but unhealthy" i.e. maybe overtrained and burnout. Is your lifestyle so high-strung and stressful that you can't survive without carbs? Or could it be another issue ranging from adrenal fatigue to gut disorders, and so on. Not that you need to be LCHF forever, or else, but a healthy person should be able to handle a moderate LCHF diet without it crashing their world.

We as humans simply don't need to be carbed up to survive and quite frankly it's really healthy to develop "fat-burning" with LCHF-ness whether you're an athlete or not. Like Maffetone's Two-Week Test, a test to see how you handle moderate LCHF (not keto) can be telling. It's good to be able to slip into LCHF with ease, and slip out if you feel like it. This concept is also closely related to what my friend Peter Defty is doing with OFM.

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How I'm Dialing It In

As much as I now love LCHF, at first it was my enemy. LCHF did not work for me until I stepped back and fixed my health first--it was too much stress at the time. I also made the mistake of starting out too low carb, and too restrictive too often. In fact I remember blaming LCHF saying, "It ruined me."

But really, LCHF in itself was not the only problem. I was.

First off, I was likely doing something closer to keto and possibly too low-cal while 70.3 & Ironman training, so that did me no good. Yup, I made the mistake of mixing up keto and LCHF and it was mainly because I didn't carefully monitor what I was doing. Meanwhile, I was too deep into being "fit but unhealthy" at the time, overtrained, gut wrecked, and in need of lifestyle changes. I needed to get my training and stress under control. I needed rest. I needed nourishment of all kinds.

I still actually did achieve and maintain a level of fat-adaptation though. The fat-adaptedness was clear in my training, a few races, and even a metabolic efficiency test. But that didn't even matter at the time because my hormonal status and overall health needed mending if I wanted that fat-adaptation thing to do me any real good.

On my road to regaining health and recovering, I was able to still keep a healthy lowered carb/high fat/Paleo-ish approach as a general theme, and did so because I know at the end of the day this is a healthy way to live and thrive (and also knowing that high-carb diet hadn't done me any good either). But I also did not define how I ate by a specific diet and became open to anything that would charge my body back up. So I tweaked my approach to carbs, allowing more but not going off the deep end. I also got comfortable with eating a lot more dietary fat that had been missing for so long, and overall dug into more calories too--which really wasn't scary for me if you can believe it. It wasn't scary because when I put my mind to something--in this case the goal of regaining health--nothing can stop me. Overall, this combo/approach was when I found my sweet spot. It wasn't just carbs for female health.

But it's so important to underscore that I had bigger fish to fry than just a diet protocol. I had to create an environment--mind and body--that allowed for hormonal balance, a regular menstrual cycle, among other things. This made me reevaluate my training, racing and how I executed my days. Diligently making the necessary lifestyle changes was the ticket to start moving up the ladder toward optimization.

When it synced up finally--a healthy thriving body, good mindset, my macro's working for me not against me--man did that feel awesome!

And that's also when I could start playing around with LCHF how it's supposed to be--slip into lower carb times for fat-burning endurance sport purposes, and then cycle in the higher carb times for refueling, female health, and whatnot. Again, not to the extremes of keto but rather building a diet that would promote health, performance, and relief from gut woes--another benefit of LCHF.

~~~

Intuitive LCHF

My ticket to maintaining health and LCHF these days entails intuitive eating and living (so MAF!). I know "intuitive" is hard to define, but for me being intuitive means some days that are quite frankly very low carb/high fat, and that feels fine and I'm not depriving myself whatsoever. Then there are other days where I eat as many carbs as I want because my body says so: including but not limited to sourdough bread, sweet potatoes, gluten-free crackers/stuff, honey, oatmeal, rice, kabocha squash, healthy cereals, bars when on the go, even quality sweet treats (yes, I like to bake things like banana bread, healthy-ish cookies; yes, I love chocolate). And then days that are somewhere in between. It fluctuates with the training/adventures I'm doing, life demands and also my female cycle.

I've learned to really deeply listen to what my body's asking for, and answer its wishes. As such I don't find myself mindlessly snacking or chowing down at all hours of the day. Ya, maybe sometimes I eat beyond satiation when I cook a good meal, but that's because I also love food. And if you're good at balance and/or 80-20 you can be flexible.

But there's a catch:

Intuition only works when you don't overrule it with your brain by doing something other than what your body is asking for. 

...That said, there have been times when I've overruled my intuition--because I still get stubborn--and that's when I get in trouble. This usually happens when I let my old tendencies get the best of me--overly stressful kinda stuff--and there are times when I get this crazy idea that I can go even lower carb and keep it going even with more training added on... As such, my body may look great and I may even feel revved up (sympathetic state overload), but it's not healthy for me. I think that's what happened this last time--I was doing things that didn't align with what my body needed to thrive. So I stepped in and fixed it--fast. I'm totally back on track. Dodged a bullet. Learned more lessons. I think now I have even a better feeling of when my body is teetering on the fine line of wanting to "shut down" and go haywire vs. when it's wanting to thrive. It is literally is a feeling, and when I am thriving I just feel strong and sturdy like I can take on the world; when I'm about to shut down I feel weak, fragile, and emotional.

~~~

Ok let me tie this up.

I'd try not to lump keto and LCHF into one. They're not synonymous. There are many reasons why I'd recommend avoiding and/or being very cautious with keto (like the podcast covers) but LCHF tweaked to your needs can be a secret weapon. If you're trying and having trouble getting off the high-carb life there's a reason. Get to the bottom of it. We need to be in control of what we're eating instead of it controlling us. Climb that ladder of optimization.

On MAF Tests, Preparation and Progress

It was time for me to do another MAF Test. I hadn't done one since the beginning of the year, and even though it's a straight forward format (warmup; 3-7 miles at strict MAF; cooldown) every time you learn a bunch, not just about splits and HR. After this last round, I'm making it a monthly thing. Because, why not? It's good data collection, an MAF Tests are obviously not aggressively intense like an LT/FTP test, either, so this kind of frequency is ok. Personally I got an really good lesson on the importance of preparation and some--take note for your own tests.

So, in this post, I'll use my own data and experiences, complete with fresh input from Dr. Phil Maffetone, to give insight on how to:

- avoid mistakes before your test begins;
- use a MAF test to assess progress (or lack thereof);
- further develop the ability to be an intuitive athlete (whether coached or self-coached);
- use MAF results to structure/tweak training going forward;
- use these tests to avoid accumulating too much fatigue, overtraining or plateaus;
- correlate the tie in's with health, stress and lifestyle.

For a refresher on MAF Tests or if you're new to the concept click here. And to make sense of the heart rate (HR) info I discuss and why 150 is my number, click here.

~~~

Lead-up Preparation

So let's start here. You can examine exactly what I did exercise-wise in the week leading up to MAF testing, starting 11/14/15. Note that when I was doing the 30k I wasn't even thinking about a MAF Test coming up in the near future.

Sa- 30k trail race
Su- IMAZ spectating/sherpa'ing
M- Off, rest, travel day
T- 60' weighted hike (mostly flat)
W- AM: 8 mile ez trail run (sub MAF); PM: 60' strength (functional + weights/KB circuit)
Th- Incredibly ez activity (aka day of movement). AM: 40' fasted spin on bike trainer; NOON: 15' non-wetsuit ocean swim/flop; PM: 40' easy walk no vest
F- 15' slow weights (inc. KB swings); 75' SUP- 1mi ez/1mi hard/1mi ez + "SUP farmer carry;" it counts ;)
Sa- MAF test, round 1
Su- MAF test, round 2, yes, you will see....

Food factor: Friday pre-test I felt fresh and like I could have done more, but I didn't. Then dinner happened. I got creative, making some grain-free pizzas, experimenting with a few "clean" crusts and topping combos. That's fine, but there was cheese. Quality cheese, and all variations that I've been ok with in the past, but cheese. Lots of it. I ate too much of it. Not wise for a gal who's essentially dairy-free and still in recovery from severe gut issues.

~~~

MAF Test Round 1: Ugh

The next morning I felt the cheese effect. I woke up as usual about 5:45 but my gut was in knots. I went to the bathroom 3 times, not good news there. Damn dairy. I decided to wait it out a bit instead of starting the test right away. I had some breakfast and cold brew. Headed out around 9:30 en route to the track, and--in typical crazy SoCal style--it was a fall heat wave with dry, santa ana wind conditions.

I was not feeling well at all (and now I was slightly dehydrated from the bathroom situation), legs heavy, breakfast not fully digested. I thought, "maybe it was the weights and SUP this week; maybe it's still the 30k in the legs; maybe it's the f*$&ing dairy... maybe it's all that... maybe I should shut up and just try." I ended up prolonging the warmup to 40 minutes (!), which consisted of walking, sub-MAF jogging, and eventually settling into some MAF intervals on the track. It was hot by the time I started. I was trying not to chug my water, but I was thirsty--a red flag.

The Saturday test went like this:

Mile 1- 8:40
Mile 2- 8:53
Mile 3- 9:06
yup only 3 miles

Avg: 8:53

HR was wanting to be high-ish around mid-150s instead of steadier MAF ~150, and by mile 3 it was already creeping to 160 forcing me into a couple walk intervals. I'm sure the caffeine played into this.

I may not do a ton of MAF tests, but I've run MAF enough, and I knew this was not normal data for me at all. Body was dragging, and HR was wanting to be way too high for the pace/effort. Intuition clicking in...

During that third mile I could see the writing on the wall and decided to pull the plug because I had an idea brewing: Instead of forcing this shitty test, I would stop there, recover like a rockstar for the rest of the day, eat like a champ, and re-do the test the next morning. Since it's a MAF test, aka aerobic and moderate, doing a repeat test that soon is fine; I would not recommend the same for LT, FTP and VO2max tests though!!

Dr. Phil Maffetone agrees: "The back to back MAF Tests are OK. Normally, when healthy, you should be able to run at MAF regularly. Many people can train daily at MAF."

I was frustrated that I perhaps sabotaged the test, but I made my peace with it. I was actually motivated and fired up to give it another go and do better--I knew I had a better performance in me. The rest of Saturday I laid low, did a little cold therapy in the ocean, ate a "safe" dinner (no trigger foods), and got to bed early around 9.

~~~

MAF Test Round 2: Not giving up so easy

Sunday I woke up without an alarm around 5:15. Lately I'm sleeping like a rock again, uninterrupted sleeping bliss almost every night. I woke up feeling ready to dominate. Preparation success this time.

For the second MAF test I opted to do it even earlier and fasted, no coffee nor breakfast before (not hungry), beat the heat. I had a glass of water with lemon juice; typical morning ritual. Had a good/normal poop (sorry, TMI, but yay) and got going. My fat-adaptation is great so I don't need food or caffeine in order to function, and my body is used to fasted workouts; however, I'm certainly not training fasted all the time, too risky.

I wore the same shoes, did the same warmup route, and got to the same place--the high school track--well before sunrise, at about 6am. This time it was cooler in the 60-70s, not 80-90F hot pounding sun. I wasn't feeling 100 percent fresh and springy, but I was certainly feeling better than Saturday. I needed less warmup, about 25-30 min of the same protocol: walk, sub-MAF jog, finishing at MAF for a couple laps. I like to make sure I get in just a bit at MAF before I start the test so my body easily slips into and stays that mode once the test starts.

The Sunday test went like this:

Mile 1- 8:16
Mile 2- 8:22
Mile 3- 8:36
Mile 4- 8:41
Mile 5- 8:44

Avg: 8:32

Overall avg HR was 152, and I was able to much better control it around 150. I don't have an alarm on my watch, and I also don't stare at my watch the whole time I run, so I know it bounces around a tiny bit, but generally it was on target for MAF (sometimes even sub 150). Hydration on Sunday was so much better/normal. I only "needed" about 100ml of water for this workout, vs. saturday when I drank 700+ ml.

Decent splits, and nothing earth-shattering but a stark improvement from the day prior, even in just how I felt. (That day I had great energy--saw a client at the gym, tooled around on the SUP, and went to a friend's party. No soreness/fatigue from the tests.)

Lessons learned on preparation:

1. Don't eat potentially sketchy and/or trigger foods in the 24-48 hours before a test.

2. No caffeine before a MAF Test.

3. If metabolically efficient (fat-adapted) consider doing the MAF test fasted, or at least on an empty stomach.

4. Don't discount weather and its effect of performance.

5. Try to avoid anything overly strenuous (i.e. a race, hard strength training) in the week before a MAF Test.

~~~

Analyzing Results 
Ok so there's that. Fun right? Now, what to make of these numbers?! Because what's testing without geeking out over results and data ;)

Comparing Tests
These recent splits are all slower than the MAF test I did in January. Not a ton slower (still within 30 seconds of the average then), but still slower. Hmmmm. So then I start to question all the things like any coach and athlete should do:

My specific questions, and ones you can ask yourself!

1. Was I simply too fatigued when I tested? (That 30k! Re-test?)

2. Is slower ultra training making me slower? 

3. Is my overall training "not specific" enough for a better MAF Test result?
(Not enough time training at MAF?)

4. Other factors: Could it be an underlying health issue or stress? 

5. What to do going forward?

6. Do MAF Test results even matter, especially if I feel good and am happy?!?!?

Fresh vs. fatigue factor
January: I was arguably more fresh/rested overall coming off an extended 5-month rest break July-Nov 2014. I had transitioned to moderate MAF-based marathon training, 6 weeks later tested.

Currently: The 30k race/travel happened, and I guarantee I didn't do a 30k right before the January test, lol. Plus other potential variables may have skewed results. As for overall training fatigue? Ya, we've been actively building volume and time on our feet. No, I am not exhibiting signs of burnout/overtraining.

Specificity of training
January: I was at about ~6 weeks into a MAF-specific running (20-30 miles per week (mpw)) program. It was all about training for a marathon at MAF!

Currently: I'm not running exclusively MAF anymore. Instead, my running/hiking is majority sub-MAF (under 150 HR) and slower paces, but more mpw. I do occasional but inconsistent longish runs at all MAF, plus sprinkled in hill repeats or strides. The rest of my training is crosstraining, which varies in intensity.

Training Breakdown, Aug-Nov:

42% - running

35% - hiking and walking*

12.5% - strength training

10.5% - other (bike, sup, swim)

11:30 - average weekly volume 

(15hr/wk at most)

*this includes strenuous hiking, some backpacking, weighted vest hikes, 

and recovery walks--all types of intensity.

Health
I feel fine, but who knows. So, this is why you test. I'm getting blood and hormones re-tested soon, and also a gut/stool re-test to check status of the nasty infections I've fought: H. Pylori, SIBO, and candida.

Dr. Phil Maffetone chimes in!!
Summary of what Phil had to say in response to my questions: 

Feedback: "Of course, you were a bit trashed the first test on Saturday. No surprise that stress raises the HR and slows the pace. Only part of this was due to the previous week's race (then add travel stress, food stress, etc.). The second test was much better... What would the results be after another week or two when you were fresh? Maybe even better, with appropriate recovery! I don't think the slower training is make you slower, but rather the stress [this includes life stress too; see below]."

Going forward: "Maintain once- or two-a-week MAF runs when your body is feeling like it can do that well, and for as long and as often as your brain dictates. Re-do a MAF in a week or two, and hopefully it will be faster than 8:16 on the first mile. There's no reason to reduce training leading up to a MAF Test. Just make sure you're recovering really well (especially sleep, and no muscle soreness). Might be good to reduce or eliminate any strength training until your MAF test improves. The primary need is to remain healthy."

Takeaways from Phil:

1. Be an intuitive athlete and exercise the brain not just the muscles.

2. Health comes first. And there is a way to be healthy, get faster and have success in ultra. (Phil did NOT say it's probably a good idea to pull the plug on ultra training.)

3. Be honest about your overall stress, and manage it.

4. Recovery is paramount.

5. Less is more.

~~~

The Plan Going Forward
With this one little weekend of MAF Testing, I have so much more clarity and a plan:

Train smarter not harder
My recent training is making me a better long-slow-distance (LSD) athlete who physically and mentally has no problem being on foot for 3-6 hours now, which is good because that was always lacking in my years doing triathlon (my long runs were traditionally 90 minutes). But I believe I'm starting to plateau and/or am being too random with training--random just like I was before the marathon this year before buckling down. So, I'm going to experiment by laying out a bit more structure in the form of a "MAF-based polarized training approach" rather than just winging it. Polarized training is proving to be safe and very effective, and I'm intrigued by it which I'll discuss more in an upcoming post. Basically for me it means I'll avoid the "gray zone" in all of my training, work the aerobic (sub-MAF+MAF) and also work the high-end anaerobic (over threshold). The goal here is to train smarter not harder and always adhere to smart recovery.

It's fine to have a generalized (random) approach to get a good base level of fitness and athleticism, but then the plan must come together with specificity for the sport--these are the basics of periodzation (and you can periodize whatever style of training you want whether a traditional threshold-based program or the MAF Method or in my case a hybrid of MAF+polarized). Meanwhile, it's always important for athletes to be flexible with the plan, intuitive and go-with-the-flow (i.e. bail on a workout if fatigued; add volume if feeling phenomenal; add recovery when needed even if the plan says workout; etc.), and not be a mindless robot executing a pre-set schedule. Don't disconnect from listening to the body.

On more recovery
Generally, I don't think too much training stress + not enough recovery is my problem these days. I even re-checked on TP, and I'm very good at taking one day off a week on average, sometimes two days off if I feel it's needed, plus having very easy recovery days. I'm not afraid to rest from training (or life) anymore. My weekly training volume is clearly not insane. I don't get wrapped up in needing to be like other runners who are doing 100-200 mpw; I do what's right for me. I think the slower MAF Test was just more acute fatigue, not me blowing up again. I'll plan MAF Tests better so they're consistent with reliable results. Reliable, meaning I do generally the same things in the week-ish leading up to a test.

Better focus on stress management
Putting the training/race fatigue factor aside, I got to thinking more deeply about my overall stress and non-training stressors, realizing it was time to touch base with these things again. I got really good in 2014 and into 2015 of finding a peaceful, low stress and more chill approach to life that works for me, and I consciously eased up on my aggressive Type A tendencies with tremendous success. But I can see in recent months how I've slipped up here and there and am tending to push myself hard again, in more ways than one. I recognize it. I will reel myself back in. It's funny, on a recent NBT podcast with Dr. Tommy Wood and Chris Kelly, they discussed that even as health practitioners who know the tools for optimal health, they still struggle because they have sh*t to do, big goals, and often crazy demanding schedules. People like us have chosen these lifestyles, and I think they're admirable ways to live, but we often need to step back and take a dose of our own medicine...

John and I are always on the go and living it up, I love our crazy life, but I know I have a hard time just relaxing especially when I feel good. I just like to be doing things. I love my work, so I work a lot even work on weekends. I love adventure, so I hate just sitting around at home. August/September had something "big" (often requiring travel) nearly every weekend--backpacking trips, music festivals, weddings, vegas and even food poisoning for me. Then October was a tough month--don't hate but for real, Kona/Ironman week was (as always) very demanding and I burn myself out, while drinking way too much coffee (my poor adrenals). Even our few days in hawaii post-Ironman are all about adventuring (probably not enough R&R). Then after kona, I had a hard time emotionally revisiting some past life things, aka the anorexia, which had been shoved down in me and needed to come out to get more closure and peace. Letting things out like that are great, but they still take a toll and are a stress. I have also been clearing out that H. Pylori infection and my gut/digestion issues have been a roller coaster. November has been starkly different in that I've back to better balance, fewer stressors and breakthroughs with gut issues (as such, I'm sleeping better as mentioned earlier). But I know the calm periods don't last forever. I fly out of town next week and will be pulling close to an all-nighter at John's 25-hour endurance car race, then the holidays, and most of all: Our 2016 is going to be a huge year for us. It's on me to work harder than ever at stress management, self-management and prioritizing. If we're going to race ultras and get married next year, among all the other plans, I need to manage my life so that I remain healthy and perform optimally. There's no negotiating this. It means everything to me to put health first.

Do MAF Tests matter?
Yes. But I also want to emphasize that it is not my goal to become an elite ultrarunner or the fastest chick around. I just want to be healthy and continue to be able to put one foot in front of the other for a long time. So the MAF Tests for me are check-in's to make sure I'm in a good state of health, managing stress, not overtraining and not undertraining either. My training is also a constant ongoing experiment in how to further understand endurance athletes in order to be a better coach. Learn by doing.

Strength Training?
Lastly, where I might actually disagree a bit with Phil is in his opinion that I eliminate strength training (ST). "That will give your body a change to focus more on re-building the aerobic system--something that's most important right now for health and a great fat burning foundation, and before building more miles and more strength," he says.

Valid point, and I agree that I shouldn't be doing ST that wrecks me, compromises my running and leaves me with ridiculous DOMS, especially the week before a MAF Test. However, I think that some ST--whether an easy functional routine or an occasional heavier weight session or slow weights--is important for health and balance so it's not simply chronic endurance. The ST keeps healthy muscle mass on my body; I don't like getting too lean from just aerobic running nor is that healthy IMO especially given my history. I don't personally think my approach to ST is overdoing it--I rarely break a sweat during sessions outside the occasional day of sledgehammer swings ;) And most of all, I love ST. I don't want to stop. It's fun, it keeps me functional (mobility and stability), strong and injury-free. But I won't completely rule out his advice.

...ok, your turn to MAF Test!

Analyzing Healthy Eating vs. Eating Disorders (including Orthorexia), and The Need to Get Out

Whoa long title... but lot's to follow up on in regard to my last post.

Among all the lovely comments, emails and replies to the anorexia post (btw, thank you!), a couple stood out, which makes me want to dive deeper into this very important conversation. Basically the jist of those comments was, "But, Tawnee, it is OK to 'fear' today's food, ingredients and restaurants!"

The folks who said this, folks whom I highly respect for the record, suggested that it's better to prepare your own food (aka cook at home), be seriously skeptical of the restaurant industry and what really goes on in their kitchens (especially in the U.S.), and find ways to socialize or go on dates that don't center around food and dining out.

Valid points.

However, I said, "Yeah, but it's different if you've had an eating disorder (ED). In fact, it's really complicated...."

Letting Go of Control and Loneliness
For one, I've had to work my ass off to overcome some serious fears over food, control issues with food, body dysmorphia, and self-imposed social isolation. When you're suffering from an ED, you are lonely--extremely lonely no matter how many people love you and how many friends you have. And loneliness is not fun. In fact, the latest NBT podcast with Dr. Bryan Walsh explains how loneliness has very negative impact on gut health and overall health. I had to step up and stop isolating myself. There where times where I'd go hide in my car at SDSU (while it was parked in a hot parking structure) to eat my "lunch" for fear of people seeing what I actually ate, and what they may think of me. Those were sad times. I've had to overcome anxiety eating in groups (even with family!), anxiety over dining out, and anxiety over what my body looks like to the world. Thus, it is incredibly important that I continue to GET OUT and make sure I don't get "stuck" in my safe place at home, eating my "safe" meals. Not only physically get out the door to sit at a restaurant but also build up the comfort and confidence to enjoy the company of others--and not feel isolated but rather feel engaged, connected and truly part of a group. (And this isn't just specific to those with ED's either; think about how often we're lonely when we're around others; in or cubicle or social media are good examples too....)

Not to mention I love the experiences and life-lasting memories that often come from dining out--even at the risk of a few less-than-perfect ingredients. John and I have had some amazing times, amazing meals, and guess what? I survived, and he and I thrive as a couple. Plus, since 80 to 90 percent of the time I am cooking at home and eat an incredibly clean diet (even when we travel we do VRBO to get places with kitchens so that we can home-cook some of our meals) I think that extra 10 to 20 percent of the time I'm perfectly ok stepping outside into the world and take risks--and so are you.

My risks don't include "extreme eating" like sketchy hole-in-the-wall buffets, questionable hot dog stands, Outback Steakhouse-type fare or fast-food joints, etc. Hell no! I'll sit out on eating truly bad stuff, and/or go there to be social but not eat--then before (or after) eat something better quality. When we dine out, I am usually very conscious of choosing good restaurants, for health reasons above all--not for the need to control/restrict calories or lose weight. Ok maybe I am too conscious at times of searching for "the perfect" restaurants (getting a little obsessed with Yelp), but I truly care about fueling my body with the best quality foods possible--organic produce, free-range/grass-fed meats, wild fish, healthy fats, locally sourced fare, etc. Especially since I have knowledge (maybe too much knowledge) on nutrition and today's food supply--it is a scary world out there if you're not careful--and because I want to fuel for performance in sport and life. I'm the first to agree, and recommend, that we should give a lot of thought and concern into the the quality of food we eat, the restaurants we choose, and the meals we cook at home.

Happy times at a random restaurant in DC...

...trying creamy, buttery escargot--worry free!

New-Age Eating Disorders
This begs the question.... what's the healthiest approach? Does it always have to be about adhering to the best-quality ingredients, or should we let go more often--let go of the associated stress that comes with seeking perfect food--and be more free and go-with-the-flow. If you get too wrapped up in always trying to eat a perfect, pure, healthy diet, you go down a scary road--one that's lonely and isolated--and risk developing a new-age eating disorder known as orthorexia, the obsession with eating healthy food to the point where it disrupts your life, behavior and happiness.

I've thought about it in my own case: Has my ED past manifested into some form of orthorexia? Are my aforementioned friends who told me I should fear the food and only cook at home also orthorexics? (They both work in the functional health field, after all.) There's plenty of reason to believe, as you'll see below, why a former anorexic could easily fall become orthorexic. I don't want to think that's the case with me... and I'll argue why I don't think I'm orthorexic. But at the same time I don't think you'll ever catch me eating McDonald's or even the salad at Chuck E Cheese's, ever.

So now to the meat of the post. I've got some 'splaining to do. 

Breaking it Down
Gets confusing though, right? You're telling me. There are multiple situations going on, and they can't be lumped together. What the former anorexic feels--often irrational fears--is very different than what a non-pathological human feels when going to a restaurant with intent to eat healthy--which is different but similar to the orthorexic. Thus, my friends who promote cooking at home have a fair, valid point, but they have to understand there are reasons why I choose to eat out that are more important to me than ingredients alone. Below I'll attempt to distinguish the differences among the types of people we're talking about:

Person 1: 

Those who strive to eat quality/healthy food but are flexible with no disorder

Person 2: 

Those who've suffered from an eating disorder such as 

anorexia nervosa ("AN") and/or bulimia nervosa ("BN")

Person 3: 

Those who've developed Orthorexia Nervosa ("ON") by taking healthy eating too far

Person 4: 

Those who are all or some of the above

It could be a good practice to find out where you fall on the spectrum in your quest to develop a healthy relationship with food, your body, your mind, and stress levels--and to avoid any loneliness or isolation caused by fear over food.

Person 1: Health-Conscious but Non-Pathological 
This is the person who seeks healthy food and clean ingredients for smart reasons, with no underlying pathology. Their reasoning to eat healthy may include achieving and maintaining good health status, avoiding harmful substances (i.e. pesticides, GMOs, chemicals, additives, hormones, etc), disease prevention, and building a well-functioning body that's not overloaded with sugar, gluten and other disruptive forms of food. Or it's the person who wants to eat healthy and clean as part of their health and fitness routine--perhaps they're in high training mode and need/want to feel their best, or they achieved great weight loss and don't want a setback. Or it's the person who's doing it for more ethical and moral reasons. With the increase of documentaries, books and articles exposing what really goes on behind the scenes in the food industry--from poor treatment of animals to GMO crops--some folks will not support these poor practices and avoid conventional foods for better alternatives--they consciously seek labels that say "organic" or "free range" or "grass-fed" (hint: labeling something "natural" doesn't count--that term is total BS with no governing regulations). Person 1 may develop a sense of pride in choosing quality over the "evil"' stuff, as well as realize how much better quality food in terms of its nutrient density, nourishing properties and superior taste*. Or maybe Person 1 doesn't even care so much about health-food per se, but simply realizes that junk food and empty calories make her feel like crap--and she chooses not to feel like crap.

That said, Person 1 is not overly obsessed with only eating healthy, quality, pure food. She likely has no pathological condition surrounding food or her body and its size/shape. She allows for balance--realizing we can't all be perfect--and sometimes living life means the occasional situation where the food may not be the best, so she adapts, doesn't freak out and understands that the 80-20 rule (or some variation) will ensure she'll be okay. For example, she's flexible and willing to eat most things at holiday gatherings or parties, she can find something to eat at most restaurants or during travel without any food-related stress, she's okay having the occasional "conventional" piece of birthday cake or pizza. Person 1 has good intentions to eat well, but realizes we can't be perfect so we can just do our best, and the idea or reality of a "bad" meal or "bad" day of eating won't shatter her world or have lasting psychological implications like anxiety, fear, doubt, and obsessive thoughts.

Bottom line, she's not eating the Standard America Diet ("SAD") by any means, and rather is much healthier and making conscious decisions for clean, quality food the majority of the time, but she is flexible and doesn't see food, or control over food, as a source of stress.

Btw: I think my fiance, John, is person 1, and I admire him. He definitely makes efforts to eat as healthy as possible but realizes it'll never be perfect, so he doesn't stress it and instead lives a balanced, happy life and goes with the flow. Could he be healthier in his meal choices at times, sure. Does he know that? Yes. But at what price? Maybe more stress that then makes him less healthy?

~~~

Person 2: Healthy-Eating-Turned-Orthorexia
For argument sake, let's assume Person 2 does not have a history of an eating disorder nor a per-existing condition. It started out innocently enough: She got on a health kick, liked how it felt, saw results, and even liked how it felt to be part of an "elite" community of fellow healthy-eaters. She spent free time reading/following blogs and websites on nutrition, clean eating and healthy recipes. She started obsessing more over "pure" eating, eliminating anything that was not deemed healthy, and even letting her obsession with healthy food cut into her social life by declining invites if she knew there's be unhealthy options. She'd get angry if she couldn't stick to her healthy routine, fussy if ingredients weren't up to par. It snowballed, and healthy eating went too far turning into the latest of eating disorders: orthorexia.

Orthorexia was coined by Steven Bratman, MD, in 1996 and literally means "the fixation on righteous eating." Although it's not listed as a disorder in the DSM-5, it is an increasingly growing REAL eating disorder in today's population, and happens when people who let a once-innocent desire to eat clean, quality, and pure go too far. The quest for quality food dominates their life. How does it differ from healthy eating? According to Dr. Bratman, "healthy eating is a conscious choice. Orthorexia is an obsession with healthy food that involves other emotional factors and has become psychologically and perhaps even physically unhealthy. It is an eating disorder."

I can certainly see this being the case for many athletes, especially endurance athletes, who are very in tune with their bodies and very particular about the food they allow in order to look and perform a certain way. In fact it took two seconds to find research validating that theory. On one hand, I think it's fair for an athlete to be strict with diet--or any human, it doesn't have to be athlete--but how do you know that strict approach has gone too far?

When it invades your life and "creates psychological distress and impairs various life dimensions, but does not present a physical danger," says Dr. Bratman (who recovered from orthorexia). Dr. Bratman was also quoted on nationaleatingdisorders.org saying, “I pursued wellness through healthy eating for years, but gradually I began to sense that something was going wrong. The poetry of my life was disappearing. My ability to carry on normal conversations was hindered by intrusive thoughts of food. The need to obtain meals free of meat, fat, and artificial chemicals had put nearly all social forms of eating beyond my reach. I was lonely and obsessed. … I found it terribly difficult to free myself. I had been seduced by righteous eating. The problem of my life's meaning had been transferred inexorably to food, and I could not reclaim it.”

Still, there are some who think it's silly that healthy eating could be considered a terrible thing, but in my eyes--as someone who's lived through an ED--I don't think it's too silly at all. Those addictions and obsessions can go too far, I think. However, I would NOT consider ON on the level of AN or BN.... I just wouldn't...

More on healthy eating vs. ON - and don't be a "wannabe orthorexic."
Here's a test used to assess ON. 
Here's a critical look at ON.

~~~

Person 3: The Recovered ED
I don't want to take the space here to define an ED other than they are mental disorders, often life-threatening; read more here. What I do want to distinguish is the difference between ON and other EDs: AN/BN are more related more to the quantity of food, while ON is more about quality. AN/BN patients seek an ideal body image, while ONs seek a pure body. Usually there are strong biological roots in AN/BN cases (my story supports this), whereas I would argue that ON may be more of a phenomenon of our modern world (and the person with the "right" traits falls victim). ON often has roots in obsession to look good and fit in, including on social media--AN/BN not so much. Not too many ANs want to post full-body selfies. Instead, AN/BN often reach a level where they knowingly don't take care of their bodies--they realize the harm but still continue on. TO complicate it further, as you will read in Person 4, it seems that these days the lines are often blurred between ON and AN/BN.

So for the Recovered ED (aka Recovered AN/BN), it's complicated... there are stages to get through. Let's assume we're talking about someone in a maintenance and relapse-prevention stage, or beyond. Whether you finished rehab yesterday or 20 years ago, it doesn't just shrivel up and die as soon as treatment is over. If you've never experienced an ED don't assume that this illness can be expelled from the mind and body once and for all.

There's a lot of shit that can still surface, those unwelcome inner "demons" that rear their ugly heads:

1) Sometimes food choices may or may not not have pure intentions about healthy, clean eating. Perhaps eating healthy is just another manifestation of restriction or quantity control. Research supports that some Recovered ED's still have a strong urge to control food, ingredients and/or weight even in the management post-ED phases, and healthy eating or having dietary restrictions (i.e. vegan, gluten free) is the perfect excuse; for more see Person 4.

2) Maybe exercise addiction is still present along with body dysmorphia and the need to control weight. The Recovered ED may be a normal weight but inside feels strong impulses to keep strict control over bodyweight, fears getting fat, and maybe even feels fat or obese even if that's not the case. An "easy solution" is to take up a sport that requires a lot of training, or some highly-regimented fitness routine. There's a bit of comfort found in the calories-in, calories-out equation.

3) Speaking of punishment, it's hard for the Recovered ED  to let go of feelings of guilt and self-hate. For example, say she over-indulged--not binged--but simply enjoyed eating whatever food was present and let go of that damn voice telling her to control. It felt so good for a second--free and liberating--but then... then the guilt set in. The desire for self-punishment and future restrictions started brewing... 

4) Or, there is some presence of obsessions, the need for control, and anxiety issues. There are still "pizza stories" that pop up. Perhaps these obsessions manifest into a new issue. Enter Person 4.

I could go on... keep in mind I'm highlighting the problematic behavior for a Recovered ED (for the purpose of this post) not the positive gains they've made. Whatever the problem is, it's all about self-management and belief in one's self that they are better than the ED.

~~~

Person 4: The Recovered-ED-Turned-Othrorexic
Yikes. Person 4 is not just someone I made up, there is strong evidence in the research of this being and actual person. This study, for example, had a small sample size, but it showed how "easy" it is to develop ON if there's a history of AN or BN. ON symptoms are highly prevalent among patients with, or recovering from, AN and BN. ON tends to increase after treatment of and improvement from AN/BN--it's migration toward a "less severe" form of an ED.

I see how this can be. Coming off AN/BN it seems very logical that one would develop a new obsession for eating healthy--the obsession for quality, to some degree, replaces an obsession over quantity. Let's assume that she even lets go of obsessing over weight loss and calorie control. Now the obsessions are about organic, gluten-free, chemical-free, etc--all those distinguishing variables I listed with Person 1 (oh, Person 1, it was so simple then lol). Again, seems innocent enough, right? But not so fast...

Since there are biological roots in someone who develops AN/BN, the new ON obsessions may trigger the same old anxiety or irrational fears over food, and bring back the same old habits, rituals and tricks. More and more food is "off the table" for being considered edible, dining out once again becomes a problem (god forbid eating non-organic), there's more secrecy and seclusion surrounding food. The fun is taking out of food, anxiety comes back, and the quest for healthy food is no longer pure. All of a sudden it appears a worse relapse may be occurring: social isolation, psychological disturbance and even treating the body maliciously again.

Perhaps even the desire to control weight and calories comes back. Dr. Bratman says there are "covert anorexics" who use healthy food as an excuse for low calorie. Even the diagnosis of "anorexia" now includes one's desire to eat healthy food--not just restriction. Equally confusing, there's research to support that some orthorexics start to take on AN/BN behaviors like binge/purge or severe restriction and weight loss obsessions. It gets to a point where you have to question what really is going on here? What's the diagnosis?! It's complicated!

"Today, the majority of people with orthorexia may best described as having orthorexia with anorexic features, and a large percentage of those with anorexia as having anorexia with orthorexic features," says Bratman.

~~~

Final Thoughts
I can't help but think about where I fall.... I wish I was Person 1. I'm not quite there. I'm likely some hybrid of a Recovered ED with ON tendencies--but I certainly don't consider myself to be ON. If I weren't careful, I probably could go down that road. I won't go down that road. I don't want to be lonely and isolated due to food ever again. So I have to be proactive. How so? Keep it real. Go outside my comfort zone. Face situations that will allow me to toughen up and manage it. I don't like going out of my way to introduce stress (like the pizza episode), but sometimes risking a little potential stress up front ends up saving a lot of big stress down the line--and could even promote better health going back to the Bryan Walsh/NBT podcast. It's the same with sport, the podcast, entrepreneurship, even backpacking--none of these things are "easy" and there are definitely associated stresses and fears at times, but that doesn't mean I hide from them by quitting or getting a "safe" desk job instead. I step up to the challenge--and I also become a part of some great communities as a result, making life-long friends and lasting relationships in the process. Just look at lucho and I--he's my BFF! All because I got over myself and public speaking fear to do the podcast AND bring on a co-host who at first intimidated me due to his amazing race resume/reputation.

So with food, hell yea, I will proudly eat healthy and clean, and hell yea, there are still certain unhealthy foods that I'll absolutely refuse to eat for health reasons. But I'm equally set on branching out and maintaining balance and quality relationships--let me say that again QUALITY RELATIONSHIPS. I do my best to maintain an open mind and a flexible approach and attitude. I don't want to go down a path of stress, isolation, loneliness and misery just because of food... 
Sometimes that means facing those very stressors to stand up to them, and sometimes I have to fight really hard to overcome the old demons. But I got it. I can and will stay strong. Attitude prevails.

ED or not, maybe we can all take this as a lesson to ease up a bit... don't always stress... think deeply if you are feeling lonely or isolated (for food reasons or otherwise), and know that we won't be perfect, but there are tools to have a damn fulfilling, fun life--pizza included.

What do you think: 

How far should we take our healthy habits? How far is too far?

Have you ever felt lonely or isolated because of your eating habits/dietary needs?

Anorexia Nervosa

John and I grabbed a table after ordering our dinner where we proceeded to make small talk, sip our drinks, and take in the ambiance as we waited.

Then, for about the billionth time, my mind started freaking out. Here we go. I didn't let him on to the inner turmoil and nervousness bubbling up inside of me. Anxiety-filled thoughts about the food, the ingredients and the impending meal clouded my brain. I was fidgety. I practically began chugging my glass of wine as an attempt to chill out. I felt my heart beating faster. Flushed. Brain on overload. Obsessive thoughts about food overwhelmed me. More wine....

I was second-guessing the order we just made. What were the ingredients? Was it the healthiest, best choice? Does this place really use quality ingredients or are they BS-ing? Should I have found a "better" restaurant for us? I had spent an hour on Yelp researching what was nearby, deciding that this one restaurant--an artisan pizza place with quality ingredients--would meet our needs for a healthy yet somewhat indulgent delicious Friday night dinner date. But now I wasn't so sure (for no reason). Shit.

C'mon wine, set in, I thought. It was the first time in a long time that I was "using" wine for this reason again.

The anxiety was real. I had control over the choice of restaurant, but now I had no more control over the situation. All I could do was wait. The meal was in the hands of someone else. I had to let go... but... ugh. John hadn't caught on to anything being wrong with me. I was pretending to be as cool and casual as ever. I've gotten pretty damn good at that over the years.

Finally pizza No. 1 came. A "personal size" gourmet pizza. It looked good--great actually. I wondered if they remembered to use the gluten-free crust. I hoped the GF crust didn't have too much starch or gum-type ingredients, which upset my GI system. They brought pizza No. 2, but it was the wrong one! Shit. We sent it back, hoping they'd remake it the right.

Ugh...

SHUT UP AND ENJOY THIS! ENJOY YOUR MAN! ENJOY THE FOOD!

I dove in for a slice.

My heart was pounding. John was already halfway through his first slice at this point. He had no idea.

I tried to take a moment before that first bite to calm down and ease my mind. Telling myself the same old, "You're fine. What's the worst that can happen? Just enjoy.... Don't scarf it down. Don't turn this into something ridiculous." I know from past experience that I'm more likely to get an upset stomach and digestive issues if I eat while overly anxious.

I found some peace after a little self-talk, breathing and positive thinking.

Those first couple bites settled well. I was feeling better. I was over the hurdle. The anxiety left. Relaxed. No longer feeling threatened. It was no longer Tawnee vs. Food. Flight or fight over; transitioned into rest and digest mode. And thankfully the wine pour was meager so I never even got a buzz—I was clear-headed. I laid off the wine... I enjoy the taste, but I didn't "need" it nor a buzz.

The second pizza came, the right order this time, along with a side of veggies. We enjoyed the evening. I was able to recover from that little episode and have a happy fun date with my man. I didn't make a dramatic scene about it... although, the next day I did tell him what had happened. He understood. He knows.

Stress and anxiety over food is nothing new for me. There's a history. And in this post I want to open up about a battle I've fought that I've never shared publicly.

~~~

Anorexia Nervosa: Overview

In 2003 I developed anorexia nervosa (AN), an eating disorder (ED) characterized by self-starvation and excessive weight loss. It's been more than 10 years since I battled this disease, but it changed me forever. When it happened it was a like an all-consuming force that took over nearly instantly and it became my everything. The ED felt safe like being wrapped up in a warm blanket. But that blanket was suffocating me and leading me down a very scary path. The "why"—as in why did I develop AN?—actually makes a lot of sense if you look at the variables, my personality and the situation I was in when it started. ED's are something I've explored deeply in research, books and case studies, and my situation makes sense. Normally the stories don't always have such a bright ending and relapse is common. That's where I differ. I recovered. I got back on my feet and was able to look at myself, see the damage I was doing, where my life was going and put an end to it. I could have given in and stayed on a path of self-destruction; it would have either left me helpless needing care 24/7, or worse, it would have killed me. But I knew better. I wanted a thriving life.

In this past decade post-ED I've learned how to fight a vicious addiction and use all my might to build back health and performance. I don't feel like an ED defines me in any way, but I think it's important to have it be known that it's part of my history and I'm not afraid to admit it.

One one hand I consider myself incredibly lucky for the fast recovery I made; however, unfortunately, I've since battled with periods of disordered eating behaviors, disordered thoughts and episodes of inner turmoil. Each year since '03 I know the ED tendencies have haunted me, but each year the issues fade away more and more. I think 2013 was a huge turning point; I started to pursue true health and more self-love, and in the process learned how seriously harmful any level of an ED can be. I realized I allowed years of those disordered behaviors to manifest in sport and daily life—I certainly had the female athlete triad even back then though I would have never admitted it. My ongoing issues were not enough to be considered a relapse, but enough to be unhealthy. As of this year, 2015, I know the worst is behind me; I don't sneakily allow disordered behaviors, and I certainly don't restrict. Instead, I'm continuing to work on me and my so-called weaknesses—things like fostering more self-love, which was lacking for so long, and trying not to be so damn hard on myself, nor push my body to extremes like I know how to do all too well. I can be very disciplined and live very extreme in a way that few could sustain, and while sometimes this works toward my benefit, I know it's equally self-destructive when it gets out of hand.

The one area where it still gets sticky in all the years since, even currently, is when that old "ED stress" blindsides me and takes over. The closest thing I can relate it to a form of PTSD for a former anorexic, and it varies in severity, but I have these "ED flashbacks" where the stress and anxiety are sometimes too much to handle and I shut down. Triggers may be: Having no knowledge or control over food ingredients and prep; if the food being served might be iffy but I know I'm going to be asked to eat it; too many food choices and decisions to make; if I fear that others might judge or question my healthy choices (i.e. "no bread please," "dressing or sauce on the side," or "no thanks, I don't want to eat at Denny's." These things sometimes may lead me to internally (or externally) freak out, worry like crazy and go into fight or flight mode. Thanksgiving is tough—I've been known to worry about that meal for days in advance. Going to shitty restaurants is no fun. Social gatherings can be a high-alert situation. I can even get overwhelmed at a place like Whole Foods trying to decide the healthiest things to eat and scrutinizing all the choices. I also have deeply worries about others judging my food choices, and I fear having to explain myself and why I eat how I do. I can't stay at home and cook every meal forever, I won't avoid social connections, I have to branch out and live my life, and actually later on in this post I'll talk about why I think it's good "therapy" to go outside one's comfort zone and face reality (it doesn't mean being forced to eat the bad stuff, either).

First, let's back up to the beginnings of this ED...

How It Happened

My anorexia began when I was in college at SDSU, during Winter Break of my freshman year, and it accelerated quickly. It triggered due to many variables—I had gained the freshman 15 and 15+ more, I so much desired to be skinnier like the other girls around me, I was a perfectionist to the max degree, Type A and easily obsessed, and I was also subconsciously having separation issues being "all alone" away from home for the first time. The final nail in the coffin that triggered a full-blown eating disorder was after I got my tonsils out over Winter Break and couldn't eat much for a period of time; it happened to be a long, delayed recovery due to the wound re-opening and needed a second round of treatment. That kick-started weight loss and the light bulb went on in my head that restricting calories could get me the leaner body I so deeply wanted, and I could have the ultimate control in the process. This was very attractive to my 18-year-old self. At the time I was far from my normal, healthy weight and sick of what I saw in the mirror; I was insecure and vulnerable; I needed something to grasp onto.

The ED just exploded from there, looking back it makes perfect sense. My restrictive behavior was further validated when I got comments from college friends noticing the weight loss and new bod, and saying how good I looked. Guys were paying attention to me finally, and I was the one being chased for once. Little did they know they were fueling the fire...  I loved the attention, and I went even more extreme. My behavior toward food clearly became odd, and I know my close girl friends probably noticed but just didn't know what to say. I became more distant and closed off. I would spend all my extra effort thinking about food, analyzing my body and figuring out how little I could eat to still function but lose more weight. It was a complete obsession. Before I knew it I was a shadow of my former self. I couldn't even surf anymore because I was too cold. I wouldn't even eat with my friends because my behaviors were too odd, I had to eat alone. If I did go out with friends or on weekend trips I'd make excuses as to why I wouldn't eat—or I'd have a salad with no dressing, no meat, no fat, as low of calories as possible. I was definitely terrified of any dietary fat, but meanwhile "safe carbs" i.e. those with lots of fiber, were my friend, as were all the diet/low calorie products... and gum.

Meanwhile, I was running and exercising daily, walking miles and miles around campus, and going to the gym—the exercise was part of the formula.

I never completely stopped eating, I just ate as little as possible to still function, and I'd only eat the same handful of foods that were deemed safe. It was easy for me to turn down invites to eat out or offers to share someone's food. I had impeccable discipline and control. Every day was a victory when I got away with barely eating and becoming leaner. Meanwhile, I was still getting straight A's and appearing as if I were "perfect" or so I thought. I was partying a lot too, burning the candle on both ends, and at parties I'd get a bunch of attention unlike I ever had before. I was also drinking with reckless abandon, which brought out a confidence I didn't have when I was sober. I'd be sure to eat less on days I knew we would drink to balance out my calories.

It was all ridiculously unhealthy and a serious problem.

By spring '04 I had withered away into nothing. My parents didn't know how bad it had gotten until they saw me, and they quickly intervened. After my freshman year wrapped up, I moved home for the summer for rehab. I never was hospitalized (thank god, because I hear horror stories about treatment in hospital), but my case did require treatment and therapy, which detoured my life for a period of time. Namely we did family-based therapy; regular appointments with a nutritionist, psychologist, psychiatrist; and straight-up one-on-one time with myself to figure shit out.

Recovering

I recovered within a year from the worst of it because I was able to adopt the right mindset and attitude. I would have self-talk that entailed something like, "I will not let this bring me down, I have to much to do, too many goals, and an awesome life to live."

There were several keys to my recovery: 1) admitting it out loud to myself and everyone else; 2) an incredibly supportive family who didn't judge, but just loved me and gave me the loving attention I needed; 3) family-based therapy which gave me the freedom to reconnect with food and exercise in a healthy way (nothing forced); and 4) my own mind telling me to rise above to live a healthy, fun, fulfilling life and to develop a strong, capable body—which is how it once was when I was a varsity volleyball player, surfer girl, snowboarder, and mountain biker back in high school. (I finally realized that it doesn't feel good to be so weak that you can't do anything fun with your body.)

Meanwhile, the "doctors" tried to tell me I was depressed and all that. I call bullshit. I wasn't depressed. They prescribed me anti-depressants, I reluctantly tried them, nothing happened other than feeling even worse and actually feeling for a moment that maybe I was more fucked up than I thought, and that I was not worthy of happiness. My brain started to convince myself that I was depressed. That is scary shit. I threw out those meds and never looked back.

It's like that phrase from Dirty Dancing, "No one puts Baby in the corner." In my case, it was like, "No one tells Tawnee she's depressed and has to be on drugs." Screw you and your medical degree, Mr. Psychiatrist, you don't know me!

Many anorexics get to the point where it's not even really about being stick thin anymore—instead, the disorder takes over and it's the obsessions, need for control and restrictive nature from which they can't break free, so they continue down that path even if they understand the harm they're doing. But somehow I was able to avoid this path with a strong mindset. I saw the harm I was doing and was said, "Shit, this has to end."

Those same traits that led to developing anorexia (the perfectionist, over-achiever, Type A, obsessive personality) were also the same ones that helped me recover, move on, and now thrive. I became obsessed with recovering as fast as possible and my goal was to make it back to SDSU for sophomore year and not have to take a leave of absence. Maybe it was not totally healthy to force it so quickly, but I was determined and it worked. I proved to my parents, counselors, and friends that I was back on my feet.

It could have been way worse. I could have given in and lived labeled as "anorexic"—and I won't lie, there were days where it sounded attractive to just give into the disease and let that be it forever. But I said fuck that. I was determined not to let anorexia define me, control me, nor ruin me. Not me! I was/am lucky to be a tough chick.

I never relapsed to that really "bad" place. I can assume it's because I was not going to let my zest for life and potential go to waste with a disease like AN. And being weak is seriously not fun.

But It Doesn't Disappear That Easily

The psychology of the eating disorder, the ability to become anxious over food on the drop of a dime, the body-images issues, and issues with weight.... All of that didn't just disappear. It takes time and so much effort to truly heal. My healing is 10+ years in the making.

First of all, even though I was at an ok weight by 2005 and able to eat more normally, I think I allowed some level of an eating disorder for the rest of my time at SDSU (i.e. through 2007) and the disordered behaviors continued thereafter, but I kept it at bay. I truly didn't want to go back to that horrible state, yet I was still often defaulting to those odd behaviors and/or ED tricks. For example, I would stress out and "run away" from food situations that were too risky (i.e. a pizza party at work); and instead I'd hide in my car and eat my safe foods all alone instead—where no one would judge my food choices. I was still often very worried about my body and size, and deeply feared getting chubby again, so I did everything to control my weight so I wasn't fat but also not too skinny where it would be a red flag. I had a boyfriend whose family loved gourmet food and eating out, and of course I was always invited along. I'd often freak out internally over the chosen restaurants and would research menus for hours, figuring out what was a safe dish to order, and I'd make sure to exercise heavily prior to the dinner. At the restaurant I'd battle stressful moments until realizing the food was not going to kill me and that not everyone was going to scrutinize my choices nor corner me and drill me on anorexia. Despite the stress and odd behavior, I didn't avoid dining out like I once had. I stepped up to to the plate and participated in life. In fact, I went a step further and became somewhat of a foodie once I realized 80-20ish living is ok, and that trying a variety of foods can be fun. The older I got, the more I loosened up and enjoyed dining out and having fun experiences, allowing more variety and formerly "unsafe foods" were allowed back in.

Then there are the triathlon years.

Triathlon was a blessing but a challenge at the same time as it related to my ED history. On one hand, triathlon allowed me to see food as fuel and my ally to build a strong, capable body. Food was no longer the enemy and I embraced eating well to become a better athlete (granted, like most endurance athletes I I thought eating well meant high-carb, and I had my sugar-addiction phase while still fearing dietary fat, but eventually I wised up and that changed). On the other hand, for many years as a hardcore endurance athlete I think I very much allowed disordered eating and disordered exercise behaviors to win. Triathlon was an easy way to mask continued disordered behaviors, namely training to eat and training to earn my calories. I could keep the lean frame and eat lots as long as I maintained my rigid exercise routine. I was clearly out of energy balance having no period and probably other hormonal and health issues (though, I didn't start testing until '13). Bottom line: I was totally suffering from the female athlete triad, but I didn't recognize it let alone admit it. Even in grad school I read about the triad but literally thought, "That's not me. I had an ED, and I don't know. I'm ok." What I didn't realize is that you don't need a full-blown ED to suffer from the triad.

Earning calories and staying lean are certainly not the only reasons I did triathlon—I truly love the sport, love competing, love the challenge of swim-bike-run, love the process, love physiology and sports nutrition, and I especially love that it is all on me (not a team) to make it to improve and race to the finish line as fast as possible. Triathlon came into my life in '07 and made me feel alive unlike anything I've ever felt! Sadly, though, those old ED tricks were sabotaging me. I was still lacking self-love and respect for my body, thus allowing destructive, stressful behaviors that longterm I'd find weren't sustainable. I now see that I would underfuel during training and even racing sometimes, and train way too hard (where was Maffetone?!). I still maintained a rigid control over my food, eating what I thought was healthy and avoiding dietary fats, and and the only times I'd "go big" with food were after a huge training days or a race—and in those cases I'd "binge" on things like burgers, booze and desserts letting all inhibitions down. I hadn't grasped the art of fueling for true health and performance. Meanwhile, I lived on the stress train; I was fueled by high-stress living, and asking so much of my body. This went on for years before tanking and taking a stand to change my ways.

Many of us, especially athletes, have some issues with food and body image—questioning what to eat, what will be best for our bodies, what foods to avoid (especially challenging in this day and age), how we can control food and exercise to get the body we want, how training/racing validates gluttonous behavior, or how sport literally is masking an eating disorder. None of that is healthy. But I don't blame you or me so much. We've created a society that's obsessed with image, looks and performance. Athletes, especially female athletes, are subject to scrutiny on so many levels, we're asked to be lean, fast, hot, sexy, successful and meanwhile work, cook, have babies and do it all. The "requirements" of the modern woman are pathetic and it's no wonder women like I take it to an extreme. Guys have it almost as bad. As such, it seems like many of us are constantly in a battle with our selves, never totally satisfied with appearance, always worrying about calories, and in the process developing severe body-image issues and ED-like behaviors. It's tough. I get it.

But let's get real. Take a step back, face it, own it, and don't pretend it's not happening. I finally did that (the same way when I first recovered from an ED), and it's helped more than I can describe.

Moving On & Striving for True Healthy

All in all, I've been able to regain a level of health and fitness that's quite incredible if you think about where I've been. I've built myself back up from nothing—built back my muscles, my endurance, my hormones and health, and all of it! I've never lost my zest for life, and I've always held on to happiness. Today the idea of restricting or even being wrapped up in the female athlete triad sounds awful to me. The idea of being too skinny sounds so painfully cruel to do to my body. I strive to be strong, healthy and thrive, using food as fuel to nourish a healthy body and life. It makes me sad when I see women and men clearly suffering, and letting ED behaviors rule their life and sport—I can spot it from a mile away.

In the 10-plus years since my ED, my relationship with food and body has evolved. It started as a destructive disease of restriction and dangerously low body weight, then active recovery and re-gaining my life, then it manifested into the female athlete triad while I relentlessly pursued triathlon, then I started figuring it out and tried to avoid destruction, and now I'm into the phase of pursuing honest true health, nourishment, self-love and peace. Healthy eating and a healthy body have always been important to me, but for a long time my definition of healthy was skewed. Not any more. I understand the truth and through practice, I've learned how real healthy eating makes me feel great, whereas crappy food or dieting or restricting or "fake healthy" or living off sugar and stress does not bode well for me. And I've learned that with the right food and treatment my body maintains a healthy state. With all I've been through, why at this point would I want to put crap in me and feel like crap? My body has suffered enough.

So the last piece I'm working on is the stress and worry as it relates to food and body. As mentioned earlier, the closest thing I can relate it to is someone with PTSD. I can easily snap and go off the deep end worrying about food and my body. I know I can't let it be this much of a stressor nor send me off the deep end anymore.

Going back to the pizza episode. Here's what I think. I think it's fair that I concern myself with ingredients in these situations especially considering the world in which we live and that food quality in the US is sketchy at best if you're not careful. However, I'm not like your casual human who just wants to make an innocent healthy choice. I'm dealing with this history, my brain is too familiar with extreme stress over food. Irrational anxiety will take over, and I just have to manage it and use my tools to calm down. I don't want to avoid eating out either. Some of you may suggest to just always cook at home or only go to the trusted healthy restaurants. I don't want to have to confine myself to that, so I haven't. I believe it's good for me—and all of us—to avoid getting stuck at familiar and safe restaurants or with home-cooking. It builds strength to branch out, take risks, face potentially challenging situations, figure out solutions, and understand that it'll work out. I think the more I fight, the more likely I'll be able to win and break free for good. And this doesn't mean I'm going to go off the deep end and adopt an unhealthy diet akin to the SAD, c'mon we all know that won't happen ;)

Hold up. There is actually one more final component of this that makes it complicated these days, and that would be my gut issues, which are not just pretend in my head. My gut problems are very real and have been quite severe since my ED, but only since 2014 did I start connecting the dots, wake up to the fact that what I'm experiencing is NOT normal, and what I eat or don't eat makes a huge difference—so I choose wisely trying not to make it about a mental disorder. Interestingly, there is research stating that those with a history of an eating disorder are very likely to develop some level of gut issues within 10 years of the ED. This was a huge finding for me. Turns out, there's a very high correlation between those with ED's and gut disorders. I know there are other variables that contributed to my sensitive gut (from being a C-section baby to stress and overtraining), but there's no denying the ED played a role too. I guess I just have to work harder at fixing my gut :)

So that's where I'm at. Some who've had an ED say that the issues with food/body never go away but you just get better at managing. I'm not sure if that's true. I've dealt with this now for more than 10 years and every year I'm getting so much better, the issues are fewer and far between and certainly don't rule my life. These past fews years have been some of the best yet, and I've been feeling more and more freed up. I'm in much better balance and a much better headspace overall. In fact, I think the act of writing this blog is major progress because I no longer feel ashamed of this secret, and it's ok to lay it all out there.

I have faith that there can be peace and closure.

Lastly...

Why didn't I bring it up before?

As you might guess: Fear.

Fear of what you may think of me. I held back for years out of fear of the opinion and judgements of others, and fear of losing credibility as an athlete, coach and expert in my field. But I will not go forward in fear because this is a journey that needs to be told—I know it can help someone else who's struggling and inspire many others. It's time. I think it's extremely important to tell the whole story.

I'm not afraid anymore. I am so incredibly confident in who I am, what I do, and my knowledge base, and anorexia does not take away any of that. I am not defined by that piece of my history, but it is part of who I am and what I've become.

Meanwhile, I see many athletes out there silently suffering. No more! I feel it's my duty to open up about my history and let you know there's hope. You can recover and get back your zest for life! Consider me your go-to girl on how to break free from an ED and build back health and performance!

What's next for me? Lots. I started writing about my journey on this blog in fact (a separate post from this one), and about how the anorexia came to be, with intentions of describing in detail my post-anorexia days in triathlon, building a better relationship with food and my body, and all that. The blog started getting long, really long, like thousands of words. Not to mention all the research I started uncovering and citing in addition to my own story. I realized this is--and needs to be--much more than a blog post. This will be the biggest project of my life so far.

Whew.

Go hug someone, for me... thanks xo


Please note that I am not a doctor nor counselor. If you or someone you love has an eating disorder, or you suspect someone you know might have an ED, the right treatment plan is in your grasp. Here are some resources. Don't wait another second. There is life beyond this dark place.