The Kahm Clinic

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Why I Quit The Kahm Clinic, Twice.

Well, I don’t know where you want to start. I just want to hear your story and experience. The story of diving into disordered eating happened when my mom died, about seven years ago. When coping with that loss, I got into a pattern of extreme dieting and overeating, binging, and then extreme dieting and binging. About four years into that pattern I had an accident. I went into anaphylactic shock after doing allergy shots. I had left the doctor’s office with my daughter, and I was fine, and then about an hour later in the parking lot of Hannafords, I had to call 9-1-1 on myself because I knew what was happening. 

This was the result of the shots that the doctor gave you? Yep, allergy shots. My daughter and I were actually both getting them and we had been doing really well for a while, but then that happened and for some reason it catapulted me into stopping my eating pattern. I stopped exercising, I stopped doing a lot. I was eating a lot and I ended up gaining a bunch of weight. I started graduate school and I was working full time, and I realized that I needed help because I couldn’t figure out how to get back to a normal way of relating to food.

I reached out to The Kahm Clinic and Elaina was amazing … and it was really difficult, I’ll be honest with you. It’s still not the easiest thing, but I’m definitely used to it. I’ve been going there on-and-off for almost two years, and I quit two times. I thought, “I don’t want to do it anymore” or “I think I’m doing alright,” and then I would inevitably reach out to her months later and say, “hmmm...no, it’s not working and I’m not feeling great and things aren’t going well.” Of course, I was also dealing with depression and anxiety. 

Basically, I just really worked the program and stayed consistent. I kept checking in with her and things slowly got better. 

I don’t know how to explain it - my thinking had changed around food. 

The idea of restricting to be healthy was really embedded in my brain and that finally went away. The yo-yo dieting definitely stopped. My overall feeling, mentally and physically, really improved. My energy has increased. I guess ‘more stable’ is how I would say it: I feel more stable. 

It doesn’t mean that I don’t have a day where I’m eating ice cream all day or something like that, but there’s no weird feelings around it or the thought that, “Oh, I did something bad.” There’s no good or bad, it’s just food. Food is fuel to help my body feel good, and I work out and exercise, but I’m not doing anything extreme. We’re in a rhythm now, and we know exactly what I’m supposed to be doing to make sure my body is losing some of the fat that I’ve gained and maintaining the muscle - or even adding muscle. 

Elaina called it disordered eating, or a disordered way of looking at it, and I definitely understand that. I think that now, because I’m fueling my body the way I should be, my brain is working better and so I’m able to navigate my emotions and my life a little bit better - I mean, a lot better. [Laughs]

How do you feel now, versus before you came in? Oh my god. So definitely, I’m a different person. [Laughs]

It’s also work that I’ve done in other areas, like therapy. I feel really good, I feel healthy. I feel more stable with eating and with my body. Some negative self-talk still comes in my brain about my body, and I’m still working on that and letting go of thoughts and expectations related to disordered eating.

I had two weeks where I was sick and stressed, and I had medical stuff and my eating was weird - I didn’t eat enough sometimes - and when I went to my appointment with Elaina, I found that my body is trusting me enough so that whatever my numbers are, they may fluctuate a little bit, but it’s not so extreme. 

The goal when I originally came in was just to lose weight. I knew I was unstable, but I didn’t really have an idea of the disordered eating part, it was just about losing weight. And that was the least of my problems.

How did you come to change your goal? I think I realized that the yo-yo dieting wasn’t working; not long-term. I couldn’t sustain it. Not only would my body yo-yo, but my emotional wellbeing would, too. I would feel really great and skinny for a while, but then inevitably the stress of life happened and I would gain weight and then my self-esteem would be connected to that. 

I think what happened was that Elaina informed me of how it’s all connected: the mind, the body, and how really eating what your body needs will help the mind and the depression. 

It wasn’t a lightbulb moment. I slowly started changing my eating and then I realized how it was affecting other things. I realized the bigger goal was really health. When I first came in, my resting metabolic rate was in the tank and, yes, that affects how I can burn fat, but it also affects everything else: my energy, my sleep, my mental outlook. It just took time to realize that. 

(Note: this person’s first metabolic test results predicted resting energy expenditure for someone this age and size was 1760kcal; her actual resting energy expenditure was 1336kcal. In the most recent metabolic test results, her actual resting energy expenditure came up to 1770kcal, which is an increase of 434 calories/day! This means that her body is functioning more efficiently with more energy and that's excellent!)

Now the goal is to lose the weight and also to have a healthy life.

Tell me about the first time you quit. Well, I thought I was doing great. Things were going well, I thought it was all working. But then when things weren’t going well, I wasn’t able to have a relevant reaction to it. I would get really down. If I had a “bad” day of eating, I would catapult into the old thinking about food and disordered eating. 

The first time I quit I was feeling really great. But inevitably, life isn’t always easy, and when things got harder I had trouble managing it. I was like, “I need your help.” 

Why did you quit the second time? The second time I was like, “is this even working?” At that time, although I was feeling better, I wasn’t really showing any signs of weight loss quite yet. Maybe a little, but I was like, “maybe this isn’t working, and I’m feeling okay,” so I quit again and then went back to restricting. Not as badly as I used to, but I went back to restricting and then I started feeling like crap again. 

I was improving, but I was still stuck in a cycle. When I came back after the second time there was progress, it was just that I had previously quit in the middle of that progress. 

How would you describe the progress? As far as numbers, I have a notebook where I keep track, but my fat percentage is continually coming down. My muscle has gone up a pound in the past four months, which is a lot for a 45-year-old. 

My fat is going down, my muscle is going up, and my phase angle, which is the health of the cells, has remained stable. That has become important to me because it shows my overall health, and it’s been pretty good. My resting metabolic rate, last time we tested it, was at a rate that it should be for my age. The numbers are always moving in the direction we want them to. 

The scale is bullshit, so I’ve completely stopped using that. Two appointments ago, Elaina said that my fat is coming down, my muscle is coming up, but my weight has pretty much stayed stable. So weight is not really an indicator of health. It can be, but I want myself to be healthy. I want my fat to come down and I want my muscle to go up. That’s the goal now; not the weight anymore. 

I thought I was healthy before: 120 lbs and a size 4, but my body was probably eating my muscles. Now, I think I’m around 165 pounds, but my muscle is up, my fat is down, and it’s just a completely different way of thinking. I could stay 165 pounds and be where I really, really want to be. 

Do you mind if I ask … prior to your mother’s death, did you diet? Was there a hard line where that started? Or were you dieting a little bit and then it just got out of control after that? Exactly! I don’t know if I would consider it dieting. I would think, “oh, I’m eating healthy.”  I don’t think I ever restricted. Maybe a little bit, but not really. I think there might have been some percolating disordered thought process somewhere, but I was able to be okay. Then a large stressor happened and it catapulted me in the direction I ended up going with it.

People deal with that kind of stuff all different ways, and I guess food ended up being the way that I tried to cope.

Is there anything else you want to add to this? I really appreciate all the work The Kahm Clinic does. It’s hard. I try to tell my husband about it because he has some disordered eating, and now I can recognize it in other people [laughs]. It’s really been a part of changing my life. I really believe in the awesome work that they’re doing. At this point, Elaina is going to have to say to me, “you’re good, you can leave now!” [Laughs] And I’ll be like, “no, I don’t want to go!” 

(This interview was recorded on Friday, September 20, 2019 at 10:00 a.m., the interviewee wishes to remain anonymous.)