Naomi appeared lean and fit, although a bit pale, when she arrived for her appointment in the Nutrition Clinic at Massachusetts General Hospital. At first glance, before taking her history, I thought she might be a long-distance runner, an ice skater, or a gymnast. I had counseled many elite athletes over the years. They usually wanted to know what kind of foods would enhance their performance and if it was true that some nutrients or supplements made it easier to build muscle. Sometimes they had an eating disorder brought on by the constant competition to be strong, but look thin. As soon as Naomi began to speak, I realized that her nutritional challenge was completely different.

“My mother thought I should see someone,” she said, her eyes welling up with tears. “I can’t eat – I have no desire to eat – in fact I feel full all the time – but also empty.”

She described a feeling of heaviness in her chest, lack of concentration, restlessness, difficulty sleeping and frequent tears. Further conversation revealed the source of her emotional and physical state: Three months before, her fiancé had been killed in Iraq. Many people don’t realize that learning terrible news – being suddenly and powerfully aggrieved – triggers an automatic physical response. It’s not a sign of weakness or inability to handle emotion, it is the body’s way of trying to stay safe.

Both the physical stress of athletic training and the emotional stress of a sudden tragedy can create the same reaction in the body. As we battle to survive, stress hormones are released from the adrenal glands located just above the kidneys. As these hormones surge throughout the body, they enable us to feel as if we can run, fight or overcome an obstacle. These important and natural substances might enable a runner to complete a torturous marathon, but for someone experiencing grief following the sudden death of a loved one, the result of the same hormonal out-pouring can be different and longer lasting.

Adrenalin, the “fight or flight” hormone, increases metabolic rate making the heart beat faster and raising blood pressure. It also takes away appetite, giving us the impression that we don’t need food. The physical effects of adrenalin are felt in the area of the heart and chest; the same place where the heart feels broken.

Cortisol, another hormone secreted during reaction to stress, facilitates the use of carbohydrates stored in the body for quick energy. This first immediate source of energy (glycogen) is packed in the muscles like tiny firecrackers. When glycogen is gone, the body starts to use its’ supplies of fat and muscle, and weight loss begins if calories are not taken in. Without adequate nutrition, a body working fast and hard in reaction to either physical or emotional stress eventually begins to show other signs of stress such as sleeplessness, depression, panic disorder, malnutrition and weakened immunity.

Naomi described that she had eaten very little since she had received the news of her fiancé’s death; she suffered with the normal reaction that it wasn’t real, it didn’t actually happen. She was forgetful and preoccupied. She kept expecting to receive a letter, a package or an e-mail from her beloved. She had lost fifteen pounds.

Can we help our body and mind deal with an unpreventable stress reaction caused by the overwhelming crush of incomprehensible and shocking news that we have no power to change? Sharing thoughts about the tragedy with a trusted listener is the first step, accompanied by baby steps to replenish the nutrients, energy stores and fluids lost during the body’s hard work to cope and survive.

The best approach is to eat wholesome foods in small quantities; whatever is appealing. Choose fresh vegetables and fruits, whole grains, easily digestible proteins like eggs, fish and poultry, nuts and seeds, low-fat dairy products and water. It’s okay in the beginning to imagine that you are eating for the one you have lost. You might even begin with the foods that you know they liked. It’s not unusual to assume the mannerisms or traits of the loved one. The goal is to regain the pleasure of eating and restore a healthy appetite.

I asked Naomi to treat herself with kindness; to remember that her fiancé would want her to take care of herself and become whole and healthy again.

“Think of your body as a temple that needs maintenance in order to hold the memory of him,” I suggested. “Imagine that you are an athlete embarking on a challenging journey. Nourish your body with good food and loving thoughts, and you will gain the strength to travel to a different place. He’ll still be in your heart and soul, even if you get better.”

Having been in her shoes many years ago during the Vietnam War when my husband was killed, I understood the terrible pit of her grief. There is no real solace or cure except the offer of enough nurturance for her to decide to survive this moment and the next. Perhaps someday she will become a nutritionist and counselor, too.
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