This is a whopper of a question and I'm excited to jump in. I'm also already noticing that I get a lot of questions regarding not quite weight loss, but body-neutral or body-positive ways to improve health, often when a doctor wants someone to lose weight. I LOVE that I'm your go-to for this. Sharing my own ED recovery journey has helped me process so much over the past 5+ years and it's obviously helping you as well.

Here's the Q:

How do you work around the ODD tendencies to make positive changes? I would like to increase my fruits/veggies and start exercising. My Doc has suggested that I lose weight and so my immediate response is to refuse to even consider any "lifestyle changes" because fuck him. I've been trying to reframe to positive changes (eating 3 veggies, drink xx amount of water, remember my damn meds, etc) but even that makes me crave sugar and potatoes.

First I want to break this down into several parts.

Part one: Defying Your Doctor

Your doctor suggested you lose weight. You have PDA (persistent drive for autonomy) and/or ODD (oppositional defiant disorder), which means when your doctor tells you a thing, you say "FUCK YOU NO THANKS."

We're used to this part of PDA/ODD. Defying the "authority" is easy to understand. But the call is also coming from inside the house...

Part two: Defying Yourself

You WANT to increase fresh produce and exercise. But you still can't make yourself do it. You obviously know how to reframe things into overall positive changes rather than a prescriptive weight loss just because the doctor said so, BUT your brain still doesn't want to make change even if you know it feels better to stretch every day, you're more energized if you take an afternoon walk and eat a green thing, etc.

Part three: The Motivational Triad

Your brain operates on three main drivers: To seek pleasure, to avoid pain, and to conserve energy. This triad will be important as I work through the rest of my answer, but that's the basics.

Part four: Shame

You are not a bad person, a worse person than that guy over there, or a bad role model for your loved ones because you do not currently work out and eat veggies. You are inherently lovable exactly as you are right now. So if shame is part of this, no matter how small, get to noticing it when it pops up and ask it to be more specific. What does shame think you "should" be doing? Hopefully the rest of my response can help you argue with it.

PS. Sugar and potatoes are rad. You are still allowed to eat them. Unless you have a health condition that is specifically endangering you by eating these foods, there's no need to fear.

Here's the A:

The thing about brains is... they don't like new things. They are CAPABLE of new things, but the brain's function is to keep you alive. Not even happy. Not even having a good time. Simply alive. If your heart is beating, your brain thinks its work is done today.

The motivational triad I mentioned above is affecting you in the following ways:

Seeking Pleasure

Resting and doing cozy activities, eating tasty foods, and anything else that you're enjoying in your current lifestyle is A-OK with the brain. It likes it when you enjoy things. It likes it when you play and have fun and do your hobbies.

It does not care that you "want" to exercise more. The brain has zero motivation to do this thing called exercise. This is not a you problem, it is a brain problem. That little bit of distance can help you see your brain's patterns as separate from your humanity, so keep it in mind.

Make It Fun & Rewarding

Once you can attach a dopamine-releasing activity with your exercise, water, fruit and veg, etc., your brain will start to get at least a little interested. The brain wants enjoyment, so do everything you can to have fun.

Some ideas for eating:

• Try a new recipe each week that has a fresh veggie you don't normally eat.

• Plan your meal with the rainbow, and choose fruits and veg in red, orange, yellow, green, blue, purple, brown, and white throughout the week.

• Include the kids in the rainbow and new recipe stuff - encouraging them to try new foods will also encourage you.

• Pretend you're hosting a cooking show. Record yourself cooking (even if you never share the video) or get on a video call with someone who will appreciate the whimsy of your fake accent as you peel carrots.

• Do a veggie competition and try out different ways of preparing the same vegetable, making them compete until you have a list of finalists and champions that you know you and your family LOVE to eat.

• Get a chocolate protein mix and put your greens in a smoothie that tastes (a little bit) like a milkshake. Frozen banana cuts the grassy green taste and adds a milkshakey texture.

Some ideas for moving:

• Go on a Weird Walk. Walk around your neighborhood until you see something weird and whimsical. Take a photo and share it online. Bask in the fun feedback you get from your weird walks.

• Listen or watch something fun. Pop in your headphones and listen to romance novels while you walk around your neighborhood. The thrill!!!

• Become a volunteer with your local animal shelter and take the dogs for a walk once or twice a week.

• Try the classes at your local Y. Maybe you love kickboxing or Zumba and it's more fun than going for a run. Alternately, maybe you love running and group classes aren't for you. Experiment and challenge yourself to try X number of new things each month, with a celebration or reward planned for each one.

• Stack exercise with a fun hobby. At each save point in your video game, do sixty seconds of squats or jumping jacks. After an episode of Netflix, walk around the block. Each time you laugh, do three reps of something.

• Help charity. Download the Charity Miles app and find a cause that's important to you. Use the app when you get your steps in and each mile you walk will mean funding for your charity.

Avoiding Pain

Your brain also wants to avoid pain - and exercise will feel like pain and danger at first, to the brain that's used to a more sedentary vibe. There's also real actual pain involved! Tired muscles, inflamed past injuries, fatigue... exercise releases a lot of endorphins but let's not pretend it doesn't also suck a lot of the time.

To work with this element of the motivational triad, you will need to reduce the pain of the changes you're making while also increasing the pleasure. Doing both together is more effective than just touching one corner of the triad on its own.

You can reduce the EMOTIONAL/MENTAL pain as well as the PHYSICAL pain. My recommendation for both is to approach any changes with a bare minimum, baby steps approach.

Ideas for eating:

• Commit to the three-bite rule. Try a new food in three bites and really let yourself experience all of the flavors and textures before deciding if you like it or not. We need repetition. And taking multiple bites will communicate to your brain and body that even though this is an unfamiliar food, it's not dangerous or painful.

• Start small. Your question said you want to work up to 3 veggies a day. If that makes your brain FREAK OUT, then start with one. (Then, going back to the pleasure side of things, what about a challenge to eat one veggie a day for 30 days? What can you win? What makes it fun?)

• Build on things you already like. If you know you love carrots, try vegetables similar to carrots, or a different color variety of carrot, or a different preparation of carrot. Your brain will already be primed to like the new food if it's familiar with it.

• Add, don't subtract. You don't need to deny yourself any food (unless there is a medical reason - beyond "you're fat," which is not a medical reason). If you're feeling down on yourself for having a sweet treat, don't beat yourself up over it. Simply ADD another veggie on top. You still get the fun of the treat with the nutrients of the veggie, and you're allowed to have both.

Ideas for moving:

• Reduce your expectations. You don't need 10K steps a day - 4400 is the minimum amount of daily steps to start seeing improvement in heart health. Your brain is going to say a hearty "No thanks" to a sudden increase to 10K steps a day just because Big Fitbit said so. Give it a break and reduce the pain. And if 4400 is too much to aim for at first, start smaller. 1000 steps. 2000 steps. 3000 steps. Do the smallest possible amount until it's so easy and ingrained you are BORED OF IT. (At which point we go back in with the dopamine!)

• Count stuff you're already doing as exercise. Cleaning the bathroom is literally exercise. Reframing it as such will teach your brain that you already do exercise and it's not so bad after all.

• Have a self-care routine. If you know you'll be able to soak your sore muscles in an epsom salt bath or ask your partner for a massage after a workout, it might not seem so painful anymore.

• Go low-impact. I beg you, do not go from couch to crossfit. It's too much. We are fat and tired and disabled. Stick to low-impact exercise if you have chronic illnesses that cause fatigue and pain. Yoga. Swimming. Elliptical. Slow body-weight exercises. ALL MOVEMENT COUNTS.

• Journal before and after a workout to talk out all your fears and hesitations, and then how you felt during and after. You'll start to see patterns and teach yourself that even though it always starts off annoying, you end up feeling great.

Conserving Energy

Oh, motivational triad. This one looks like it wants you to maintain all your physical energy, but the brain is more concerned with its own processing power. How your brain conserves energy is by forming habituated responses. Any pattern repeated over time becomes habituated in the brain, from exercise and eating your greens to your self-talk as you're mad at yourself for not exercising and eating your greens.

The brain itself doesn't have to stick around for the emotional fallout of that judgment call. It just says "Oh, the body did not exercise today? I have a shitty shame spiral for that." Boom. Suddenly you feel like crap and you're convinced that you are actually the worst person ever. And your brain gives itself an A+ for not wasting any time on that thought process. It doesn't need to - it has the pattern for this ready to go. Next problem, please!

You have to approach this entire thing with mindfulness and a willingness to notice your thoughts and emotions. Because those thoughts and emotions are how the brain decides to press the Shame Spiral button rather than the Resilience button.

Try these practices:

• Notice your thoughts. Check in with yourself as you navigate your meals and snacks all day. Did you listen to your hunger cues or try to talk yourself out of them? Are you comparing your eating speed or portion size to others around you? Why? Do the same for exercise - how are you considering your body's needs and are you expecting too much from it? Why or why not?

• Meal prep. Having pre-portioned smoothie ingredients or lunches ready to go will reduce the mental load of preparing these more labor-intensive foods, which means the brain will think you're being A+ efficient! (Bonus: Get some cute containers to up the dopamine).

• Journal. Not a food journal with calorie counts and stuff, but journal about your thoughts and walk them all the way through. Let the worst-case scenarios play out in your mind and ask yourself if they're likely or just your brain worried about potential pain points. Practicing different outcomes, even in your imagination, teaches your brain that there isn't just one habituated response to choose from and you can start to choose new reactions.

• Turn yourself into a Tamagotchi. Download the Finch App and set yourself some BARE MINIMUM self care goals. As you check off your goals, you strengthen your little bird friend and help them have adventures! It's cute and it's helped me get more of my self-care, creative, and domestic tasks done in the past three months. For some reason, doing it for the tiny bird is more acceptable than doing it for myself, so my brain thinks we're playing a game or something instead of doing (GASP) a task.

Other Things to Consider

If you have a history of ED and hyperfixate on weight loss, it's a good idea to set up a care team - friends/family who can check in with you and who know your triggers and signs that you're going down the rabbit hole. As you develop these habits, you can expect your blood work to improve but you might not necessarily lose weight. Be prepared for your doctor to be a dick about this. If you do happen to lose weight, your doctor will probably praise you, which might feel weird but just let it roll off your back. Doctors don't get it.

• Do not make yourself go long periods hungry. If your stomach is growling, put something in it.

• Fed is best. We're not doing diet culture hierarchy of "good foods" and "bad foods." If the choice is between a food and no food, choose food.

• Exercise will likely make your muscles feel tight/strained, but if you feel PAIN, stop and see a doctor to get cleared for exercise.

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