This article is written by

Accredited psychotherapist and psychoanalyst
Specialist in eating disorders

Telephone: 02 97 64 63 65



Cara's page is HERE on Counselling In France


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Eating problems



Eating Problems and Expat Life, Maintaining Recovery Abroad.

When I first came to France as a young student, I thought I’d outrun and outsmarted my eating disorder. Well, whoops.

About two weeks after my arrival, the obsessional thoughts about food, eating, and my weight returned with a vengeance. I’d really thought they were gone. Gone with the charm of Paris, the new person I’d thought I’d become, and the excellent food that I thought I’d have in moderation.

It can be so disheartening to discover that your problems with food (or alcohol, depression, anxiety, etc.) have followed you to your new home. It’s all the worse when trying to get assistance means struggling in a new language and a completely different system. Moreover the stressors that come with expat life may exacerbate your eating problem.

Food and Familiarity
Many people who struggle with eating like routine, especially in their choices of food. In your home country, the food is familiar -  you know how many calories in this or that, you know where to find your favourite things, and people eat at times that make sense. In a new country, all of this will change.
I remember my shock at closed grocery stores during lunch hour, or the unavailability of sugar-substitutes (at the time). This made me anxious and irritable. It also led to binges.

The question of eating – simple for those who are “normal” with food - becomes fraught and frightening if the parameters are upended. Here in France, the meals seemed huge and endless. How was it that no one was fat? Not only that, no one seemed to be obsessed with eating low-calorie food (except me), and no one was upset about eating at crazy hours (dinner at 8PM!). How much to eat, when to eat, and what to eat was my main preoccupation; taking up so much space in my head that I was never really present, but in a worried cloud of shame and calorie-counting. In retrospect, this is obviously a sad way to live; I won’t get that time back. Many sufferers feel the same sense of imprisonment in their minds, and yet feel powerless to change.

It may seem paradoxical but thinking about food and eating may be easier than dealing with the strangeness of your surroundings. Thoughts about the ED can be more tolerable than loneliness – almost like a familiar “friend” in a foreign land, a way to recognize yourself and get your bearings through a well-known filter.
Finally, learning what “healthy” looks like in a new country may take some time and effort, even in a country where people tend to eat better in general. This will also require tolerating the discomfort of adapting to the unfamiliar – that is to say, of allowing yourself to loosen up and lose your way, in order to find it again.

Loneliness, Depression, Anxiety
Sometimes a sufferer is aware that the issue isn’t really food, it’s something else. An eating disorder is only “kind of sort of” about food. Biologically speaking, bingeing and fasting are going to have an effect on brain function. Psychologically speaking, the eating problem is a “short circuit” for another issue. In other words, ED’s can replace the psychological by the biological, turning the initial emotional problem into a physical one about food and eating. Once this happens, it’s very hard to get at the psychological issues, because the brain can’t function optimally.

Being an expat in and of itself creates loneliness, which leads to depression and anxiety. Loneliness is also inherent in an eating disorder, where living in one’s obsessional head complicates any genuine social connection. Isolation can create a distorted view of yourself and others – you feel too “different” or “strange” to have close friends. This can be a vicious circle.

What can I do?
All of this is not to discourage someone with an eating problem from taking the plunge and living abroad. However, it’s better to come prepared for a possible relapse, and know how to take care of yourself if the need arises.

Here are some ideas:

  • Know where to find an English-speaking eating disorders specialist, or center. The Academy for Eating Disorders  can provide you with centers around the world.
  • If you have a therapist in your home country, find a way to keep in touch through Skype or the internet. Or, try to find a therapist familiar with eating disorders in your new country.
  • Make sure that you have regular medical care. Even if the doctor doesn’t speak English well, he or she can monitor your health and make sure you stay at a healthy weight.
  • Try to enjoy your expat time and adapt as best you can. Learn the language but also join English-speaking social groups. Try to see this time as another period in your recovery, even if it’s a bumpy one. Don’t be hard on yourself and try to stay in the present moment. It’s not because you had a bad day (or week or month) that your whole trip is a failure, or that you won’t adapt to your new life. Move on and get more help if you need it.
  • I have worked with eating problems for over twenty-five years; twelve of them in France. If you would like help finding help in your area of France, or would like to consult with me, don’t hesitate to contact me.














DOA! (Depression On Arrival)
Along with the suitcases and the jetlag, you may discover another thing upon arrival in your new country: depression. It may not be immediately apparent. It’s not the rule. But it is very frequent in people adjusting to a tremendous change, especially when they have high expectations. Did you imagine that changing your scenery, language and culture would transform everything, from the obvious externals to (possibly) your disposition? This is pretty normal; a lot of expats make the move because they hope for something much better, even amazing.

Nothing about that is in itself problematic. Initially a lot of people feel “high” from the adrenaline and excitement of a move. I’m sorry to say that for most of us this wears off once things settle in. We find a place to live, it’s finally furnished well enough, the electricity works, and all the various administrative papers are sent out. Life becomes everyday again, and any psychological baggage from the past can (and most likely will) catch up with us from this point on.

This is not to be too pessimistic about the adjustment process, au contraire. Fluctuating moods are normal, and understanding will help you gain perspective.

If in your home country you had issues with depression, anxiety or addictions, these may reappear – subtly or obviously- after settling in. We may hope that moving will change our inner world as much as the outer one, but eventually, we catch up to ourselves. What seemed behind us is still inside, no matter how far we’ve travelled. A geographical change can work temporarily (like getting a sunny vacation in February), but moving is often a superficial coat of paint over deeper issues.

Even if you’ve never had problems with depression before, you may discover intense feelings of loss and sadness. Again, if you aren’t expecting this, it can take you by surprise. It’s important to know that this is perfectly normal. The new home isn’t really home yet, and your old home is gone. While this is true of any move, expats have the obvious added stress of a strange language and different culture. Moodiness – ups and downs, irritability, and a longing for “home” with nostalgia - can become the new normal.

The reasons for depressed feelings are related to ordinary adjustment issues…
1. Loneliness

We were used to chatting with the neighbor, the cashier, whomever… these small exchanges that broke up our day might be impossible in another language. We may have never experienced loneliness quite in this way before. If we speak, we have an accent, and it’s exhausting to make the effort. We can end up living mostly in our heads, or on a computer screen. This creates a quality of life that can feel a bit unreal or filtered – we are “here” but “not here” - with a sense of distance from the world around us.

If you feel too lonely (only you know your threshold for tolerating loneliness), treat it as an urgent matter. Find someone you can speak to, face-to-face. This doesn’t mean over a computer screen (ideally), but if there’s no one around, it’s better than nothing. Speaking to someone in your language, ASAP, can get you over the hump. Luckily in most cities there are anglophone groups that meet. Find one.

2. Disappointment, Rage…
You saw the pictures: languorous chateaux with rolling green hills and vineyards, peaceable rustic villages, weathered ocean vistas. You imagined yourself in the village market, placing ripe fruit in your straw basket, while the sun warms your back through the leafy shadows of old oak trees, accordion music in the background.

Yes, it was a cliché, and part of you knew it. But to go from that image to standing in line at a French version of Walmart (if you’re from the States) can be a shock to the system. It can still be disenchanting to realize that life is still life, even in a new country. Cultural differences might mean you find your doctor too abrupt, everyone too formal, or too cold. You may miss your mushy peas more than you enjoy escargot.

We can underestimate how losing one’s bearings linguistically and culturally feels infantilizing. That is to say, in a foreign country we can be reduced to feeling childlike in our perceptions of the world, and our ability to move in it with confidence. “Natives” are also likely to treat us with condescension; speaking slowly, seeming impatient with our misunderstandings, or speaking to our partners (or children) to get their point across. Not only is this infuriating, but it will take two hours to think of the perfect rebuttal in French!

That being said, adults can and do actually regress, just like children, in new situations.
Children confronted with new and unsettling conditions can temporarily lose the skills they had mastered. For example, they want to sleep with the lights on again, have trouble with separations (school or daycare), or even wet the bed. “Grown-up” symptoms of regression include needing comfort (with food, alcohol, or screen time), feeling more anxious, or having trouble being organized and concentrating.

All of this can take a toll on physical health. Stress will augment the level of certain hormones in your system (cortisol and adrenaline). This has potential cardio-vascular effects and can set you up for other stress-related and auto-immune difficulties.

No one is trying to scare you away from your move or be overly pessimistic about your adjustment. There are many ways to be an expat, and many ways to cope with all of the above. The more you can find specific, subjective responses to help you get through – be it with exercise, clubs and associations, language classes, etc. – the more quickly you will feel better, day by day.

If you are having a hard time, there are many psychotherapists who are also English speakers available to help you. It is not “weak” to ask for help; it is actually very brave to recognize your vulnerability.

How will your move affect your relationship with your partner? How will your children react? What if I suffer from an addiction, or an eating disorder, and I start to slip up? More to come in future articles.