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Lighten Up: Chewing over the troublesome world of those with eating disorders

Paula Mekkelsen, a local licensed clinical social worker, specializes in eating disorders, a topic often buried in as our fast-paced world of fads and trends.

Mekkelsen is no rookie in the field: she has been an individual counselor and therapist since 1983, currently running a private practice.

Mekkelsen’s main focus is on eating disorder recovery, which can be a broad spectrum and ranges from anorexia to bulimia and disorders involving overeating.

“Bulimia, a lot of times, parents don’t even see it happening,” Mekkelsen explained.

When treated, bulimics need to see gastrointestinal doctors or dentists, the latter because persistent vomiting erodes the enamel of the teeth.

“That is really important because in bulimics, they could rupture their esophagus,” Mekkelsen added. “It could be cancer or tooth decay... so, a lot of times, dentists will say, ‘why is this girl’s tooth decaying so quickly?’”

It’s the same thing with the GI levels, she added.

“If they use a laxative, there is dehydration or even overuse of laxatives and their intestines won’t work anymore,” she said. “Their intestines become dependent on the laxative.”

Bulimia is also known as a “secretive” disorder, as most people can look normal in height and weight, but they are good at hiding the disorder itself.

“Bulimics will eat like a horse and compulsively exercise, which is counterproductive,” Mekkelsen said. “Sometimes they are edgy and bitter or angry and stuff their feelings to get rid of it.”

In order for a bulimic to get on track nutrition-wise, Mekkelsen said portion control is essential, and working with a dietitian helps in finding the right kind of nutrients.

Some have trigger foods, like ice cream or yogurt, which are easier to throw up, so the first plan of action is to take those types of foods off their meal plan. Working with a therapist, and even having family therapy helps, as the entire family is encouraged to be involved in the healing process.

On the other side of the spectrum, anorexics can have a much more difficult time in adjusting to a meal plan, as they need to be able to eat. According to Mekkelsen, southeastern Connecticut has very limited resources in regards to outpatient treatment centers for eating disorders and, thus, some clients have to go to another state to seek help.

“As a therapist, although I can give some suggestions, I know that nutritionally their bodies are so shut down that they have to go into re-feeding again,” Mekkelsen said about recovering anorexics who have come home post-treatment. “It’s really learning about certain foods to get some enzymes going in the stomach and to help them not blow up like a balloon.”

Anorexics tend to start off slowly on a bland diet such as the BRAT (Bananas, Rice, Applesauce, Toast) diet.

“Clinically, the anorexic typically lacks nurturing,” Mekkelsen added. “It’s self-esteem... they’re missing nurturing care and they want to be invisible.”

That brings us to disorders involving overeating. Mekkelsen tries to break down the triggers of what makes a person overeat as well as what they are eating.

“I’m looking at proteins and what they’re getting in,” Mekkelsen said. “Are they eating some foods that stimulate their appetites? The first shift person needs protein in the morning, for lunch, and snack, and then you go into your carbs. Carbs come in and we look at what triggers their eating. Are there cultural aspects, or is it [just] pleasurable? We try to find other rewards — watching a movie, reading a book, taking a walk – and really be mindful about eating when you’re hungry.”

Portion control is important.

“When we go out for all-you-can-eat, you think, ‘I’m eating everything because I paid for it,’” she said. “These ‘non-fat diets’ aren’t helping us either and doesn’t really hold. Don’t be afraid of the healthy fats, avocadoes, etc.”

All in all, Mekkelsen said that when working with clients, she focuses on “really building your self-esteem”.

“They’re not anorexic, they’re not bulimic...they’re human and should not live behind their diagnosis,” she said. “They can develop and embrace their own identity. With an addiction, you can never fully recover and you have to really take care of it on a regular basis. You don’t have to be so hard on yourself. Pause and re-group and get back on track!”

And, with that note, I open it up to you, readers. What kinds of weight loss methods have you tried? Have you been successful? I’d love to hear your story!

Erika Y. Gradecki operates Food For Your Soul, LLC. She can be reached at


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