In the last few weeks I’ve been doing a short series of posts about the weight gain phase of eating disorder recovery. In many programs, this is the first stage of recovery: you have to restore to a weight range that’s healthy for you before you can work on learning to eat intuitively, recovering psychologically, and finding a new, ED-free identity.
First, I posted a rough approximation of what I ate in the weight gain stage of recovery. What you will need to eat in recovery may be very different from what I needed to, but you, too, will likely be assigned a meal plan by the dietitian or nutritionist with whom you’re working. He or she may ask you to track exchanges, macros, or even count calories. (My dietitian at the time had me count calories, which I now regret, but that’s another post for another day.)
Second, I posted about unlearning what you have likely learned about eating “healthy” and challenging yourself to eat fear foods.
Today, I’d like to share some thoughts about something that was particularly a challenge for me in this phase: how often my body hit the extremes of intense, uncomfortable hunger and intense, uncomfortable fullness.
I’m not a dietitian, but the professionals with whom I was working taught me that in the weight gain phase of recovery from a restrictive eating disorder like anorexia or bulimia, you really don’t have the luxury of stopping when you’re full. You’re not ready for intuitive eating yet. You need to eat to your minimum, whether that’s measured as a meal plan, exchanges, macros, or calories, every single day. Often, you won’t actually feel hungry. In fact, you’ll often end up in the zone of really uncomfortably stuffed…even before you’ve met your minimum for the day. And you still need to keep eating.
First of all, you need to do this because restrictive eating disorders like anorexia and bulimia really distort your sense of fullness. I’m all about trusting your body, but if you’re coming off of a period of starvation, you really can’t trust your body for a while. It’s too screwed up.
Second, you need to eat at least your minimum every day, even though it will sometimes be stupid uncomfortable, because that’s what’s needed for weight gain. Eating until you’re overfull once in a while is not enough to gain weight even for a healthy person, let alone someone who is extremely malnourished. Significant weight gain means eating until you’re overfull frequently, sometimes at every single meal.
To be totally honest, this aspect of recovery was hard for me, but it wasn’t the hardest part. Yes, I really dislike feeling uncomfortably full. But I also like following rules. And eating to a minimum every day with no additional exercise was oddly comforting to me in that it offered structure: there was no questioning when to eat or how much.
What was honestly even harder for me was the other extreme: feeling intensely, overwhelmingly hungry.
See, while the meal plan provided me the structure I needed to force myself to eat enough to gain weight and recover, I was very perfectionist about it. I didn’t want to ever exceed my allotted daily total. I was afraid of…what? Was I afraid I’d gain weight too quickly? I don’t remember thinking that consciously, but perhaps I was. I’m inclined to say it had more to do with my perfectionist tendencies; I was going to follow the law, by the letter of the law, and any deviation was a screw up, a mistake.
And the intense hunger was scary, overwhelming. Sometimes I had to get up in the middle of the night to feed myself–sometimes several times a night. Sometimes I ate a big meal and was extremely hungry within an hour. Sometimes I’d get so hungry the edges of my vision would go fuzzy and I’d get dizzy.
Still to this day, it makes me anxious to respond to hunger when it comes at an unexpected time, when I feel like I’ve already eaten “enough,” when I feel I haven’t exercised enough to warrant eating more, etc.
But that’s an anxiety I have to learn to tune out. Because eating when you’re hungry is not eating to gain weight. Eating when you’re hungry is eating to maintain: maintain your weight, yes, but also to maintain your health, your skin, organs, bones, blood, and your body’s many complex functions. When you’re coming off a period of starvation, your body has to work extra hard not only to maintain but also to restore and repair these many functions. And that takes a ton of energy–even while you sleep!
Again, I’m not a dietitian, but resources I have read about the science of recovery, as well as information I’ve received from professionals I worked with, suggest that someone recovering from starvation sometimes needs as much as two to four times as much energy as a healthy person of similar height and build.
Sometimes I wonder if part of the reason I still don’t have my period back, even two years after I’ve been “weight restored,” is because during this weight gain phase, I was frequently unwilling to exceed my daily “allotment” of calories, even on days when I was really, intensely hungry. My body put as many of its Legos back together as it could–I regained weight, stopped feeling so cold all the time etc.–but maybe it didn’t quite have enough energy to put all the Legos back together. I still have a few abandoned Legos rattling around in there.
Is that a weird metaphor?
My point in all this is, following your meal plan or exchanges plan is important, yes, but it is the minimum. Equally important, perhaps more important, is learning to respond to your hunger, no matter what. I’m still working on that.
You’re hungry for a reason. That reason is you need more food.
To readers who have gone through eating disorder recovery: did you experience the extremes of intense, uncomfortable fullness and intense, uncomfortable hunger?
Were you, or are you ever still, afraid of eating beyond what you planned?