Category Archives: eating disorders

Calories: Why You Need More Than They Tell You

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I’ve written about this before, but it’s so important that I decided that it is time for a refresher. It’s important because if you are following the recommended daily allowance of calories, or advice you’ve read on the internet, or used a calorie calculator to try and work out how much your body needs, then you are almost certainly not getting enough energy for your body.

So we all know that currently the RDA is 2000 calories for women, and 2500 for men, but what most people don’t know is that number is too low. Especially if you are under 25. For people in recovery from restrictive eating disorders, it’s wayyyyyy too low. Under-eating is damaging to our bodies and to our minds. People who do not diet and eat by listening to their hunger and fullness cues do not eat the RDA when it comes to calorie intake.

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So let me tell you a story.

In 2009 the calorie guidelines were reconsidered when a study found that energy requirements had been underestimated by 16% (around 400cals). What is telling is how the guidelines weren’t changed to accommodate these new findings. On the NHS website is written

“This news does not mean that everyone can, or should, now eat an extra cheeseburger or its equivalent in calories a day. The advisory committee makes it clear that the revised energy intake recommendations do not mean that people should increase the amount they eat and that, if people do eat more, they will need to do more exercise to avoid being overweight or obese.”

What we have here is science telling us that the current calorie guidelines underestimate the energy REQUIREMENTS, yet we are being told by our medical community and our government to not eat the amount that our bodies need. Regardless of the fact that studies found that we need more energy, the government put this on its website in 2017:

“The new campaign, due to launch in the spring of 2018, aims to help people be more aware of and reduce how many calories they consume from the 3 main meals of the day, in particular when eating on the go. There will be a simple rule of thumb to help them do this: 400:600:600 – people should aim for 400 calories from breakfast and 600 each from lunch and dinner.”

There the government are advising 1600 calories as a rule of thumb, and cited obesity as the reason for this. “As we are the sixth most overweight nation on the planet, we believe it is a sensible thing to do.” A sensible thing to do? To deny scientific findings, which have, by the way, repeatedly shown that the calorie guidelines are inadequate? To me that sounds like irrational fatphobia, and a complete misunderstanding about health, which is a pretty scary thought since this information comes from the government itself, not to mention our health physicians. It shows very clearly how our entire society including the medical community and our government is indoctrinated in diet culture and fatphobia, so much so that they will dismiss actual science in favour of advising that people restrict to stay thin. Even when this is unhealthy. Even when it harms us. How can we accept this?

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So what do we do about providing our bodies with enough energy? As stated above, evidence shows that adult women need around 2400 calories and adult men 2900 calories. This is extremely similar to the calorie guidelines shown on The ED Institute website run by Gwyneth Olwyn, who developed the Homeodynamic Recovery Method (formerly known as the MinneMaud Guidelines). Olwyn has always promoted 3000 calories for men over 25 and 2500 calories for women over 25. Under 25 the recommendations are 3500 and 3000 calories respectively, due to the fact that our bodies continue to grow and develop until around that age. Those who exercise or have children need more energy to cover this. On her website you can read an extremely detailed blog post on why the government approved calories guidelines are entirely inadequate, with far more scientific evidence than this simple refresher.

In remission you will have learnt how to listen and respond to hunger and fullness cues and your body will give you signals in order for you to provide it with the right amount of energy, without counting calories. Until then, it is advised that you keep track of calories in order to ensure that you are getting enough energy for your body (I wrote an entire post on this here). I urge you with all my heart to take note of the science, and take care of your body accordingly. Nourish your body. Respect it. Listen to it. Provide it with what it needs.

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On that note, it is also totally normal for someone in recovery from a restrictive eating disorder to eat far more than the calorie guidelines. This has been coined “extreme hunger” in restrictive eating disorder recovery. Extreme hunger is where you are eating above and beyond the calorie guidelines by quite a bit (e.g. over 4,000 calories). Eating between your guidelines and 4,000 calories is additional hunger but not classed as “extreme”, however the following explanation also applies. The reason you might find yourself eating an extreme amount of calories is because your body has acquired significant damages during your restriction and engagement with disordered and harmful behaviours. Your body needs energy for the day (actual daily guideline amounts – NOT the inaccurate government approved guidelines) but it also needs energy on top of that in order to heal the internal damage done to your body. Some people need more, and some people need less. Some people will find their bodies are calling for a more extreme amount for a shorter period, and some people may find that their bodies are calling for a less extreme amount but over a shorter period. This is something that will taper down in time to settle more around the guidelines, but whilst your body is damaged, it often will need more, and whilst it can be terrifying, it is normal. I always compare it to when burns victims are in hospital and put on a high-calorie diet in order to give the body enough energy to heal the damaged skin and flesh. It is a similar concept in that your body will need more energy on top of daily energy expenditure to restore itself to good health internally. You can read several of my blog posts about extreme hunger that include much more detail here and here. also I have my very own YouTube video on the subject, which you can watch here.

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It is a sad, and frankly terrifying fact that we can not always trust our own government or medical communities to ensure our good health. It is frightening how diet culture and fatphobia are so prevalent in every single area of our society, so much so that we can’t even escape it even when we turn to those whose responsibility is to provide us with accurate information in order for us to be as healthy as possible. What we must do is look for ourselves. Research for ourselves. Critical review the information that is given to us, and then take care of ourselves, and if we can, take care of others by enabling the science to be available to others. And most of all, heal the relationship between ourselves and our bodies, and then listen to them – our bodies have the most reliable information on how much we need to eat, and they share that information with us via hunger and fullness cues. Listen.

You can read my original and more detailed blog post on why we need more calories here.

Repel the Relapse: 8 Tips for Staying on Track in Recovery from an Eating Disorder

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It happens to us all at some point in our journey from sickness to health: we hear a comment, see a magazine article, or wake up with rose-tinted glasses that throw us back into a tirade of insidious thoughts, ideas, and what if I just‘s.
What if I just exercise more?
What if I just restrict a little bit?
What if I lose just ten pounds?
What if I just cut out xyz?
What if I just…?
And of course: I’d feel so much better if I was thinner.

STOP.
The answer is you won’t. You’ll feel worse. You will always feel worse.

Engaging in eating disordered habits will mean spiralling down right back into the hellish Pit of Misery. You can convince yourself that you won’t end up there, but you will. And even if you don’t, engaging in any kind of eating disordered habits isn’t exactly taking a vacation to Disney World. It’s dark and dangerous, and it is joyless.

Here are some things to think about when you can feel the pull of a relapse:

  1. Ask yourself this: what did your eating disorder give you? How did you benefit from it? Okay, I know it made you thin, but what did you actually gain from being thin? Did it give you stable, healthy relationships with friends, family, and romantic partners? Did it find you a fulfilling job? Did it buy you a nice home? Did it contribute towards your education? Did it make you feel better about yourself? Did it bring you happiness? I imagine the answer is no. Eating disorders help us feel in control (which is only an illusion), but beyond that, they don’t give us anything real.
  2. Think about your own personal reasons for recovery. Write them down and think about them. Is it worth abandoning those goals for the sake of losing weight? Your reasons might include the things mentioned in number 1. They might also include decreased anxiety, trips out with friends, being present in your day to day experiences, keeping your body healthy in order to have children, being involved in your hobbies and passions, being able to enjoy social events, being able to enjoy food, improved sleep, having time to do the things you want to do, dedicating your energy towards enjoying life, being productive and fulfilled by doing things that matter to you and are important, physically feeling a million times better, and regaining your identity.
  3. Use your support network. Friends, family, partners, doctors, therapists, helplines, online support forums – USE THEM! They are there to help you and are often crucial in remaining strong and continuing on in your journey. You may feel ashamed or like you have failed, but that isn’t the case – we all slip backwards at one point or another. It’s all part of the journey. Don’t suffer in silence: seek support.
  4. Eliminate negative influences. Get rid of those triggering gossip/women’s magazines that spout diet culture bullshit. Unfollow those accounts on social media that make you feel like you are doing recovery wrong. Stop looking at that vegan paleo raw blogger who survives off smashed avocado and vegetable juice and works out 7 days a week because it makes her SO HAPPPPPPY (it doesn’t). Follow people who are crushing their eating disorder, eating fear foods, and resting. Follow people who are body positive and food positive. Follow people don’t set rules for what health looks like – because it is different for everyone. Cut toxic people out of your life. Assert your boundaries with your loved ones who comment on your body/food choices/lifestyle/exercise habits or who won’t stop talking about the diet that they are on. Motivate yourself to move forwards by using the positive influence of those who truly push you onward.
  5. If you find yourself missing food here and there, make yourself a schedule. Ensure you eat regularly and consistently. If you find yourself making excuses not to eat, then you may just have to put yourself on a more rigid plan until you are able to go back to eating intuitively. Three meals, three snacks. Adequate amounts, and no excuses not to eat them.
  6. Know your warning signs! If you find you are:
    – Finding reasons not to eat/avoiding situations involving food
    – Increasing your exercise
    – Weighing yourself again/more regularly
    – Worrying about food/weight/exercise
    – Changing the way you dress/hiding your body
    – Body checking/spending time scrutinising your body in the mirror
    – Cutting out certain foods or thinking about cutting out certain foods
    – Desiring control
    – Withdrawing
    – Hiding disordered behaviour from others
    – Feeling like you NEED to change how your body looks
    – Feeling guilt after eating/resting
    then any of these could mean that you are approaching a relapse or in a relapse. If you know what your own warning signs are, and are able to recognise if you find yourself doing/thinking those things, then you will be able to address and resolve the problem a lot quicker. This will enable you to bring yourself out of a relapse/prevent a relapse before it snowballs into something more ingrained. It may also be a good idea to tell your partner, friends, and family what these red flags are so that if you are unable to see them in yourself when they happen, they can point them out and support you in getting back on track.
  7. Remember that recovery isn’t linear, and every setback is an opportunity to learn and take bigger steps forwards. Some of my most important lessons learnt were during the slip ups that I made during my recovery. Pick yourself up, dust yourself off, and don’t let the tide sweep you up and carry you back. Keep wading upstream, and take the knowledge with you for next time.
  8. Keep busy and use distraction techniques. This list is not exclusive but here are some ideas of what to do when you are sitting with anxiety/guilt/relapse temptations:
    – Watch a movie
    – Read a book
    – Write
    – Paint or draw
    – Blog
    – Collage
    – Knit or sew
    – Research something you are interested in
    – Play XBOX
    – Play games on your phone
    – Do fun internet quizzes
    – Play computer games
    – Call a friend or family member
    – Meet up with someone
    – Watch a documentary
    – Play a musical instrument
    – Do homework
    – Tidy your room
    – Do some internet shopping
    – Take photographs
    – Do puzzles

Write these tips down. Save this article to your bookmarks if it helps. Make a reasons to recover/reasons not to relapse poster or screensaver. Watch my YouTube video on that topic here. Remind yourself how strong and brave and beautiful you are. You’re gonna be okay. You’re gonna make it through. Keep on trekking on, and you can and WILL beat your eating disorder.

Coping At Christmas: A Rough Guide For Those With Eating Disorders (Take 2)

I have pretty much copied and pasted my article from last year on this topic, except for some tweaks, so if you recognise this article, that’s why!

Christmas is looming (how is it tomorrow already?), and people are preparing for Christmas with food, wine, presents, decorations, and of course, advent calenders. This time of year is always filled with trepidation for those of you with eating disorders. It’s a holiday focused around alcohol, food, and family, and at least two of the former bring on that familiar rising panic for lots of people suffering with or recovering from eating disorders.

If you are someone who is living with an eating disorder, and you are approaching Christmas Day with dread, you are not alone, and you can get through it. It is probably going to be a tough day, but there are steps you can take to make the most of it, and to protect yourself from at least some of the stress and anxiety that the day might hold.

Here are my suggestions on how to get through the day:

Focus on Family

Food is a big part of Christmas for most people, but you don’t have to let that be your main focus. Prioritise your family and/or friends and/or partner and enjoy their company. Catch up on the gossip, take part in the board games, and sing along to the carols with grandma. Spend time doing what is enjoyable for you. If your family can make this easier for you, let them know how. Maybe it means trying to keep the topic of conversation away from food. Maybe it means keeping food in the dining room and having the lounge as a food-free zone. Maybe it means going out for a walk with your siblings to get a bit of fresh air and space. Whatever you do, try to keep the focus on the company of those you love, and enjoying the time spent with them.

Set Boundaries with Loved Ones

This is a day that everyone should be able to enjoy to their very best, so do take the time to talk to the people that you will be spending your time with and set your boundaries for the day. This could mean asking them to refrain from talking about New Year’s diets, making food-moralising remarks, or reminding them not to comment on any of your eating habits or your weight. Do not be afraid to voice your needs, and do not be afraid to emphasise how crucial it is that they respect your boundaries. It is important to make clear what you need from them in order for you – and everyone else – to enjoy the day.

Use A Helping Hand

Have a chat with family and identify one or two people who you could use as a “safe person” during Christmas day. It might be good to have two people so that they can share the responsibility (one in the  morning, one in the afternoon for example). These family members can look out for warning signs that you are not coping (or you could devise a signal), and are people you can take aside for reassurance and support. If you don’t have a family member that can help you get through the day, then make sure you have a helpline phone number available on your phone that you can call if any situation gets too overwhelming and you need someone to talk to in order to get through it. 

Challenge Yourself…But Not Too Much

A huge part of the anxiety of the day is that there will be a lot of delicious food around that you will want to eat but also will not want to eat, and that’s the fight between you and your eating disorder. For a lot of people, this battle is going to go on all day, and that can make the day extremely stressful and anxiety-provoking (see Focus on Family for ways to minimise this). This is also a great time to challenge yourself, but a time to not push it too far: you don’t want to make the day even more stressful by pushing yourself to the limit. One way to go about using this day as a manageable challenge is to make rough plan of what you might eat that day. This will give you a guideline that might help you feel a little more contained, but could involve trying something new or facing a fear food. Try not to restrict yourself as much a you can, but it’s okay if you need to feel safe for a day that is so difficult already. Remember that you deserve to enjoy yourself and you deserve to be able to eat the foods that you like.

Take Care of Yourself

You may be around people this Christmas that will not respect your boundaries or may be insensitive or ignorant to your recovery. They may talk about the triggering topics which I mentioned in the “Set Boundaries With Loved Ones” section above, such as complaining that they have put on weight/are going to put on weight, lamenting that they have eaten “too much”, are being “naughty” or “bad” because they are “indulging”, or moaning that they need to go on a diet because of that. Please ignore them. They are battling their own insecurities and are looking for reassurance that what they are doing is okay and that other people feel the same and that they are not alone. This is really, really sad, and something that no one should have to feel. Enjoying the Christmas food is part of the festivity, and no one should have to feel guilty for it. Know that other people’s worries are not a reflection on you, and you should keep in mind that it is not something positive that they are experiencing, but guilt, anxiety, and insecurity. So instead of letting their negativity impact on you, empathise with them, as guilt, anxiety, and insecurity are emotions that you are likely experiencing also (albeit on a much grander scale to those who do not have eating disorders). Then turn your thoughts to yourself and keep moving forwards towards your goals. Keep moving forward on your journey towards health and happiness. Keep in mind your motivations, and remember that the way you respond to others affects you primarily.

Leave the room for a bit if you need to. Take yourself off for a relaxing bath or a nap or to read a book. Go for a stroll. Have a quiet word with that relative who keeps calling the chocolate yule log “bad”. Just take care of yourself and do what you need to do, for you, to have the best day that you can. Do not be afraid to speak up. You need this. You deserve this.

If you are someone who has an un-supportive, highly triggering family, do know that it is okay to decide not to see them at all. If you want to spend Christmas with yourself, your partner, your partner’s family, your friends, or your pets, do it. Do what is best for you. Do what you need to do to continue moving forwards. Do what you need and you deserve to continue working towards health and happiness. Make positive choices, and don’t feel guilty about them. This is what you need. This is what you deserve.

Move On

Christmas is unfortunately never going to be an easy time for those with eating disorders, and it often means that those people go into it with anxiety, and leave it with guilt. It is okay to experience those feelings: you are not alone and those feelings are not your fault. However, you have to keep remembering that these negative emotions are caused by your eating disorder and the control that it has over your life. Keep fighting the war against it, and don’t respond to those negative feelings. You are going to be okay and you can get through this. Christmas will be over in a blink of an eye, and then it is time to put it behind you and move on from that day. Don’t carry the stress from it with you. Let the day go. Remember that it is absolutely, 110%, super okay to eat more than usual, go outside your meal plan, eat “normally”, or respond to extreme hunger (this applies for always, of course). It is okay to put on weight. It is okay to enjoy yourself. The guilt of going against those eating disorder rules can be overwhelming, but it is important to remember that this is part of recovery. Going against your eating disorder and doing what you deserve is part of fighting the battle inside your head. Eating whatever you want, whenever you want, is the goal, and so if you were able to do that for a day, or two, or more, or even if you were able to eat a little more than normal, you are making small steps towards achieving that outcome. That is a wonderful thing.

If the anxiety is becoming overwhelming, check out my article on anxiety management here.

Original article can be read here.

 

A Balanced Diet: What Do Those Words Really Mean?

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We hear it everywhere: in order to be healthy, you need to eat a balanced diet. But what does that really mean? I’m scrolling through Google images right now trying to find an appropriate picture to go with this article, and at least half of the images only show “healthy” foods. You know what I mean: your greens; your grains; your fish; your eggs; your cheese; your meats (the latter four tiny splodges at the top compared to the large array of fruits and breads). A large percentage of the pictures are only of fruit and veg. I mean, come on: I have my own “cheese corner” in my fridge, and no one is ever taking that away from me. Especially not a food chart.

For the most part, the food triangle often used to demonstrate balanced eating is a fairly accurate rough guide, and looks something like this:
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It is a rough guide to the way our diet will look if we listen to our bodies (when energy-balanced and healthy in themselves – not in a state of recovery or beforehand) and follow its cues – and we do not have to do any counting or checking or weighing or recording to trust that this is what our bodies will naturally lead us to do. Our bodies are extremely intelligent and I urge you to listen to them over most external influences.

I also like this pie chart, apart from the wording of “treats”, as these types of foods should just be another part of the pie chart rather than being labelled with a word that holds so many negative connotations.

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What I do like about this pie chart is that it shows that 10% of your diet in a day should include foods deemed “unhealthy” by society. Foods like cookies, sweets, chocolate, cake, biscuits etc. Now this chart shows a representation of your daily diet. If you start to think about it, that means that you can eat these foods every day – something that I have seen demonised in countless magazines and online articles. I have often seen or heard advice that you should only eat “treats” a few times a week, and no way am I giving up my daily dose of baked goods, however much you tell me it’s not good for me, Karen.

The thing is, a lot of us believe the words “balanced diet ” to exclude those yummy foods that are so often seen as the devil. The thing is, these foods are an important part of a varied, balanced diet. They are part of our mental health – because we should not deprive ourselves of anything. They are a good, quick energy source for our bodies, and they are especially helpful to our bodies in recovery because of this. Eating a balanced diet means eating bits of everything. It means not restricting any food types or specific food items, unless you have a food allergy, food intolerance, or you have an illness that requires you to cut out certain foods or monitor them. It means varying what you eat and not eating the exact same thing every day (yeah, I’m talking to you, ED). It means eating foods and consuming liquids that you enjoy. It means getting in those nutrient dense fruit and vegetables. It means providing yourself with an adequate amount of carbohydrates so that you have enough energy for the day. It means having that coffee and cake with Ann, and getting takeaway with Heather, and digging into ice cream and popcorn in front of a movie with Sam. It means changing up your routine. It means being flexible. It means trying out new things. It means going back to old favourites. It means hearty meals, light bites, snacks, and puddings. It means not overthinking it and letting your body lead the way.

So often these wonderful foods like crisps, pizza, and cake are associated with feelings of shame, greed, and overindulgence, and there can be judgement from others when eating them. However, this is only because they also have been made to feel those negative emotions when eating those foods themselves. The thing is, food is not a moral issue (and you can read my article on that here). You are free to eat what you want, when you want. You are free to be as healthy or unhealthy as you want – and that is not anyone’s business. And if you want to be healthy, follow the lead of your body (yes, I will repeat that until my death). If you want to check that you are eating a varied, balanced diet, do a quick valuation of what you eat on an average day or an average week, but don’t overthink it, as this can very quickly descend into a spiral of obsession. As long as every food group is incorporated into your diet, that’s a good sign. And when you’re uhmming and aahing in the cafe with Susan, just get the damn cake.

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To The Bone: Yes, Another Review

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To The Bone is the hot topic right now in the eating disorder community: amongst those who are suffering, those in remission, and professionals who work with people with eating disorders. There are reviews being written about it left, right, and centre, and unfortunately I am here to throw my unoriginal opinion into the mix. I know that what I am about to write has been said already, but I wanted to join the conversation. Here are my thoughts on To The Bone below.

(GIANT SPOILERS ALERT FOR THE CONTENT BELOW)

What was wrong with it:

It shows an overly represented narrative

Eli is a straight, white young woman from a wealthy family, which is totally great, because I’ve just never seen that narrative be explored before. Not. How many times have we seen this in the media? Over and over and over and over again. Quite frankly, I’m bored of seeing emaciated white women counting their ribs in the mirror as their white panties hang off their hipbones. Not that their suffering is invalid, but because the suffering of others is just as valid and I’m not seeing them represented anywhere. Where are the black girls with anorexia? Where are the average weight women? Where are the men (I know, a man was included in To The Bone, but he was not the main character – it was not his story)? Where are the girls with bulimia (the one girl with bulimia got about a minute and a half of screen time) and the men with anorexia athletica, and the elderly? Or just anyone who isn’t white having any other eating disorder than binge eating disorder? We don’t see these people in leading roles, or talked about in magazines, or depicted pretty much anywhere, and they are a huge portion of people with eating disorders. The straight white wealthy female narrative is overdone. It is cliche, it perpetuates myths and stereotypes, and it is damaging for a large portion of those with eating disorders who do not see themselves represented anywhere, and therefore, feel that their pain is invisible, and that they are not sick enough to be noticed.

The lead actress – a recovered anorexic – starved herself for the role and then gave ridiculously problematic interviews about it

Lily Collins said that it was a “scary process,” but “I knew that, this time, I would be held accountable for it. I would be [losing weight] under the supervision of a nutritionist and surrounded by all these amazing women on set. So, I knew that I would be in a safe environment to explore this.” Do you know what is not safe in any environment? BECOMING EMACIATED. Do you know what is especially not safe in any environment? BECOMING EMACIATED WHEN YOU ARE IN REMISSION FROM ANOREXIA NERVOSA. The genetic predisposition for an eating disorder is triggered by energy deficit. A recovered anorexic cannot just lose weight and be safe. You cannot say that it is alright just because you are supervised by a nutritionist. Becoming emaciated always comes with risks, and becoming emaciated as a recovered anorexic opens the gateway as wide as you possibly can for the eating disorder to stroll right on through. Immersing herself into the role is also another huge risk factor for relapse. The point of this is not that I care about her health in particular, because after all she is an adult and she has the choice over what she does with her life. The point is that she is responsible for the way in which she takes care of herself and for the messages she gives out when she knows that a movie like this is going to attract a huge number of vulnerable people, most of them young. Saying that she lost weight in a healthy way to become incredibly underweight sends out the message to people with eating disorders that they can starve themselves and this is totally okay as long as they do it in a certain way – the “healthy” way. This is not helpful. It is damaging, and she should have been way more aware of the position she is in and how what she says will be heard by others. There is no way to starve yourself in a healthy way. Ever. She also said that she didn’t think she would fall back into it because she is “more mature”, as if that makes any difference whatsoever to the development and maintenance of eating disorders, or of the relapse into them. Eating disorders don’t just leave you alone because you grew up. Honestly, for someone who has had an eating disorder, she sure is giving interviews like she is entirely ignorant of them.

The director also said to PEOPLE that Lily Collins losing weight for the role was a conversation that they had and that part of it was “how do we keep you safe, and not at a dangerous weight that’s going to be triggering for you.” In what world was the weight she was at not dangerous for anyone? In what world was it not triggering for anyone with anorexia, let alone herself? I don’t know what planet these guys are living on, but it’s not the same one as the audience of this film.

The psychiatrist is an idiot

He is meant to come off as cool and modern with all the dramatic swearing (how scandalously hip of him!), “revelations”, “wise” and “meaningful” words, and trips to rain installations, but to me he just looks like he sucks at his job. For example, the first time is meets Ellen, he tells her that he is not going to treat her if she is not interested in living. Sorry, what?! Many people with eating disorders struggle to find reasons to live for and part of treatment can be helping someone to find them. He also dismisses family therapy after one session. Therapy is difficult. Family therapy can be a nightmare. But it is through this that many things can be explored and sometimes resolved. You don’t just give up on it in one session, and to me, it looked like that session brought up a number of issues that needed to be addressed. He also tells her that he doesn’t like her name and that it doesn’t suit her and tells her to change it. Maybe this was some sort of point about making a new identity for herself, but it came off as rude and inappropriate. And since we are on the topic of inappropriate, it is highly unlikely that a professional in his position, as a male, would be in her room alone with her at night. Just saying.

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The love story overshadowed the whole thing and was incredibly unhealthy

“I need you, Eli,” Luke, the love interests, says as Ellen leaves the unit after feeling completely overwhelmed. Luke puts Ellen on a pedestal and then continuously pushes responsibility onto Ellen for his wellbeing. He spends the entire time demanding things of her: things that often she feels she cannot do, and when he gets pushy and she snaps, he gets all upset and butthurt. This is not romantic, and this is not what should be portrayed as a good relationship. As their relationship grows, he insensitively (and that is putting it lightly) brings up the topic of sexual abuse and asks if she has been sexually abused, saying that it’s a thing amongst “us rexies” (seriously, rexies?!). He then proceeds to tell her that she needs to be touched by someone who cares about her. That’s right: needs. Nothing like a bit of sexual coercion to set a really good example to an audience of predominantly vulnerable young women. And don’t get me started on the idea that women just need to fall in love with a “great guy” in order to find a reason to recover…

There was a weird, psychoanalytical scene that came out of nowhere

Near the end of the film, when Ellen is coming to the end of her tether – or her life – Ellen stays in her mother’s yurt. Her mother starts to talk to her about her experience of postnatal depression after Ellen was born, and how she did not hold her enough and how her pastor suggested feeding Ellen like a baby in order for Ellen to heal from the neglect she had experienced in the past from her mother. Ellen wants to think about the idea, but as her mother leaves says “mom, please feed me.” Her mother then sits Ellen in her lap like a baby and proceeds to feed her from a baby bottle. The scene to me was uncomfortable and totally out of context. If more was explored and developed from this angle, I don’t think it would have come off as such a strange scene, but it was totally out of the blue. It also directly proceeded Ellen’s “revelation” scene, as if being fed by her mother was so healing that it led directly onto a pathway to recovery. It was completely oversimplified, as was the next scene which leads me onto…

Ellen’s revelation moment was ridiculous

Ellen has a dream about being a healthy weight in a tree. She looks down and see herself, curled up in a foetal position, on the ground, naked and emaciated. “Is that me?!” she asks, shocked. When she wakes, she has the drive to recover, and returns to the unit in order to get better. I know that this was an interpretation of the director’s experience, but as a director you must know that you are not just sharing your version of events but also sending a message to the world. This airy-fairy scene is, to me, undermining, and made the transition from wanting to stay sick to wanting to recover look as easy as switching on a light in a dark room, when for many it is months and months of indecision and struggle before they are finally able to give themselves permission to make the arduous but invaluable journey towards freedom.

It glamorises eating disorders

They did not seem to do too well in their quest for awareness with eating disorders let’s be honest, and just like nearly all media, it has also successfully glamourised eating disorders. Beautiful Ellen, with her smoky make up, cool clothes, and sarky attitude, who doesn’t give a shit and eye rolls at every given opportunity. She just doesn’t seem to make eating disorders seem all that bad, does she? Then there are the discussions of behaviours and weight loss strategies within the eating disorder unit that she stays in. There’s the quirky boy that she falls in love with, and the handsome psychiatrist, and almost no discussion about what actually goes on inside the head of someone with an eating disorder. All we see is Ellen pushing food around her plate; Ellen doing sit ups in bed; Ellen fainting; Ellen rejecting food; Ellen getting thinner thinner thinner. All we are seeing here are the physical symptoms and behaviours of eating disorders, and when you don’t see the torture going on in someone’s minds; when there is barely a conversation about it, then how is it going to look like the hell it is to vulnerable people watching it? How does it dissuade people from carrying on into darkness; how does it help people to seek help; how does it educate those who don’t have eating disorders themselves? The truth is, it doesn’t. Not in any shape or form.

It isn’t even interesting

To The Bone is – to put it bluntly – boring. It doesn’t change anything. It doesn’t challenge any myths or stereotypes. People who are knowledgeable about eating disorders haven’t learnt anything new, and neither have those who aren’t. It is a non-film: at best, people will watch it and come away with nothing new. But at worst, as discussed above, it sends out damaging messages to those susceptible to them.

So what’s right with it?

It acknowledges the effect that eating disorders have on loved ones 

During family therapy, and at other points in the film,  the affect that this pervasive and deadly illness has on everyone around them was depicted. This was a positive aspect of this movie, as often stories about people with eating disorders are very much focused on how the main character is affected and does not show the way in which it disrupts the lives of loved ones and the immense pain it causes them.

It acknowledges the hunger

“I’m really fucking hungry. Like two years worth of hungry,” says Luke at one point. I practically whooped at this small but important acknowledgement of the intense hunger that people in recovery often experience, and how this is quite clearly obvious. It is hunger from years worth of damages, and it is there for a reason. The body wants to heal!

It shows a tragic consequence of having an eating disorder

One of the women in the house is pregnant, but she goes on to have a miscarriage. I thought that this was the most moving scene in the film, and shows what eating disorders can do to eating disorder sufferers, outside of the usual symptoms that are often shown.

It did depict one male character with anorexia

Which is great. (But he was still an asshole).

So in conclusion…

Overall, this film to me wasn’t worth making. The only real positive that I can see from the making of this film is that it has provoked conversation across all social media sites. People are naming what is wrong with this film and that sparks debate: debate that will hopefully be educating people. Unfortunately, those involved with reading these sorts of articles will nearly always be those who are already well-versed in eating disorders, whereas the film will have a widespread audience and was a chance to educate people who would not otherwise engage on eating disorder topics. Whilst for many it will be a fleeting moment in their lives, for others it could have a negative impact that could be a factor in propelling them towards unhealthy habits with devastating consequences. Let’s just hope not.

Are You Listening? How We Hear the Things that People Say About Our Bodies When We Have An Eating Disorder

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My partner and I are lying in bed. He’s got his arms around me and we are a tangle of limbs beneath the sheets. Then he speaks.
“You’re so soft,” he says.
He says this a lot. He also says things like “you’re so huggable” and “you’re so squeezable”.

I wonder what your reaction was reading those words. Imagine hearing them said to you. How would you feel? What would you hear? I know what my reaction would have been a few years ago. I know that I would have heard “you’re fat”.

The thing is, we listen to what people are saying and then we apply our own filters to the words; filters which have been created from a whole myriad of experiences. That is what our minds do, and when it is someone with an eating disorder, that filter is especially pervasive, vehement, and antagonistic in the most negative of ways when it comes to comments about our bodies. People’s words go through this filter and it gets translated, so that what we hear is not necessarily what was said.

In this instance, I did a little laugh as I realised that his words went through my “ED translator”, and then carried on through my “recovered translator”, meaning that it went through two stages: “you’re so soft” turned into “you’re fat” and then into “he means your skin is soft or maybe he does mean your body is soft and so what Sarah, a lot of it is, and that’s nice, and it is nice to hug soft things that’s fine stop acting like he told you that you look like a naked mole rat that went through a blender.”

Sometimes my partner even puts his hand on my stomach and gently squeezes the squishy bit. Yeah, you can see my face now:

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If it was me three years ago I would have had a meltdown and engaged in some drastic and incredibly harmful behaviours, and it would be something I would probably remember forever as a trigger point for self-loathing. However, I am not that person anymore and I am – thankfully – now not in that torturous place. Instead I asked (slightly incredulously):
“Are you squeezing my fat?!” to which he replied: “Yeah, sorry.” Again, three years ago I would have heard that answer as “yes you remind me of a beached whale and I am poking fun at your fatness and reminding you that you should probably do something about it because it is gross.”  But instead the translation that finally came out of my little two-staged system was “You have fat on your body and he squished it because he had his hand there and it is a part of you and it it something that squishes and that’s okay; he still finds you attractive and wants you to be naked 100% of the time.” Because I suffered from an eating disorder for ten years, and because I live in a society that highly values diet culture and thinness, my brain will always automatically put the words through a negative filter. But because I was able to fight tooth and nail for my life and succeed in claiming it back from my powerful and evil mental illness, and because I then went on to reject diet culture and embrace body positivity, I have a wonderful second filter in place that allows me to pause, rationalise, and try to really hear what people are saying when it comes to my body (and everything else).

The important thing in these situations is that the outcome is totally different depending on where your head is at and on your ability to hear what is really being said rather than putting it through your own personal filter. You want to be able to really hear what the speaker of the words means rather than ending up reflecting back your own insecurities as a response. If we hear things through a negative filter of our own, it can then lead to negative situations with that person or people, because we think that they are insulting or hurting us. It also leads to a spiral of negative thoughts and possibly subsequent harmful behaviours. It is important not to hear the words that people say as confirmation of our own insecurities. Your eating disorder is always looking out for ways in which to validate itself. Don’t let it cause distance and destruction towards others or yourself.

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If you are struggling with something someone is repeatedly saying, or even a one-off comment that affected you, then talk about it. Be calm; be open; be honest; and try not to use accusatory language. Instead use “I feel” or “my eating disorder hears it like x” as opposed to “you are doing x/you are making me feel x”. People’s defensive barriers go up when they feel that they are being attacked. Often what is being said is actually okay to say and is not intended harmfully, but it is the eating disorder that translates it into something else and then causes harm. Because of this it is more productive to talk about how the eating disorder is at fault rather than them, or you. Of course I am perfectly well aware that there are those who are disrespectful, insensitive, and malicious and do intend to cause damage or do not care enough not to, but I am for now talking about those who we assume are not saying the wrong thing per se, but are saying things that are triggers for the eating disorder, which then rears it’s ugly head and translates for us.

It is not an easy thing to change the patterns within our brains, but it is possible. It takes time, and patience, and perseverance. It takes determination. It takes persistence. It means having to challenge negative thoughts every damn minute of every damn day. It means working towards liking and respecting yourself as a person. It means taking steps towards accepting your body as it is at its individual natural and healthy weight. It means screaming “NO” to the eating disorder and fighting for your health and happiness. It means recognising that the people who love you are not out to hurt you. It means remembering that you might at this point in your life feel hatred towards your body and self-loathing towards who you are, but that that is not how other people feel about you. It means recovery, and it means going on a journey to the place you want to be; to the life you want to live; to being the person that has been suppressed by the eating disorder. It means taking the path that leads to being free.

Recovery Does Not Mean Compromise

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Recovery from an eating disorder is a fantastic thing. A long, arduous, torturous, fantastic thing. It is painful and it is terrifying and it is tedious, but it is the most rewarding thing anyone with an eating disorder will ever do, because it gives you your life back. It gives you back your freedom, and it gives you back your health. However, all too frequently I am seeing what looks like compromise in those who claim to be recovered from an eating disorder.

I want to state right now that the recovery journey in itself does often entail some compromise as we navigate our way from disordered to healthy. It does frequently mean swapping things in and out, finding that with challenging one behaviour another pops up more strongly, transferring fixations and focus from one thing to the next, and other such struggles as we learn how to overcome our sickness. That is perfectly okay. That is part of the journey. It is part of managing the initial trauma of recovery. But there comes a certain point where you have to challenge how you are recovering, and you have to move on from compromising with your eating disorder. There comes a certain point where you have to be aware of all those things listed above, and start to do something about it, because although at the start recovery may include it, recovery cannot be about compromise. Recovery has to be about getting rid of the disordered habits, not switching them up for more socially acceptable ones and calling it healthy.

I get it: it is easy to fool the world and it is easy to fool yourself that eating “clean”/detoxing/eating only “healthy” foods/being vegan/going Paleo/etc and going hard at the gym/training for marathons/attending multiple aerobics classes/etc is living a recovered life, but those sneaking eating disorder lies and manipulations only prevent you from living the life that you deserve to live: one free from the shackles of your eating disorder. We as a society can praise the woman who “recovered” from anorexia nervosa and became a bodybuilder all we like, but it doesn’t change the fact that she still has an eating disorder. We can applaud that man who went from having bulimia nervosa to being a fitness instructor whose muscles ripple and glisten in the sunlight, but that doesn’t alter the fact that he has just switched up one eating disorder for another. We can use the woman who “beat” her eating disorder and now stocks her kitchen with protein shakes, quinoa, and lentils, and exercises an hour every day as inspiration, but that doesn’t change the fact that her life is still dominated by rules and routines and fear.

Recovery means breaking free of that suffocating cage. It means tearing down the walls that keep you from dedicating your time and energy to your passions, hobbies, interests, and relationships. It means not worrying about your calorie or macro intake. It means engaging in physical activity that you actually enjoy when you want, not in a fixed, rigid routine. It means resting whenever, but especially when you are sick, tired, or having any intrusive eating disorder thoughts, however small (because being recovered does not mean being cured). It means throwing off the shackles of guilt and anxiety by challenging and overcoming every negative, controlling eating disordered thought and behaviour. You know what they are. Push away the convincing eating disorder voice, and listen to your gut. Do you feel free? Think about the life that you want to lead. Is this it?

How To Cope At Christmas: A Rough Guide For Those With Eating Disorders

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We are just two days away from Christmas, and people are stocking up on food, wine, and last minute presents. This time of year is always filled with trepidation for those of you with eating disorders. It’s a holiday focused around alcohol, food, and family, and at least two of the former bring on that familiar rising panic for lots of people suffering or recovering from eating disorders, whereas for the rest of us, it’s generally just the one (family; I’m talking about family).

If you are someone with an eating disorder, and you are approaching Christmas Day with dread, you are not alone, and you can get through it. It is probably going to be a tough day, but there are steps you can take to make the most of it. Here are my suggestions on how to get through the day:

Focus on Family

Food is a big part of Christmas for most people, but you don’t have to let that be your main focus. Prioritise your family and/or friends and/or partner and enjoy their company. Catch up on the gossip, take part in the board games, and sing along to the carols with grandma. Spend time doing what is enjoyable for you. If your family can make this easier for you, let them know how. Maybe it means trying to keep the topic of conversation away from food. Maybe it means keeping food in the dining room and having the lounge as a food-free zone. Maybe it means going out for a walk with your siblings to get a bit of fresh air and space. Whatever you do, try to keep the focus on the company of those you love, and enjoying the time spent with them.

Set Boundaries with Loved Ones

This is a day that everyone should be able to enjoy to their very best, so do take the time to talk to the people that you will be spending your time with and set your boundaries for the day. This could mean asking them to refrain from talking about New Year’s diets, making food-moralising remarks, or reminding them not to comment on any of your eating habits. Do not be afraid to voice your needs. It is important to make clear what you need from them in order for you to enjoy the day.

Challenge Yourself…But Not Too Much

A huge part of the anxiety of the day is that there will be a lot of delicious food around that you will want to eat but also will not want to eat, and that’s the fight between you and your eating disorder. For a lot of people, this battle is going to go on all day, and that can make the day extremely stressful and anxiety-provoking (see Focus on Family for ways to minimise this). This is also a great time to challenge yourself, but a time to not push it too far: you don’t want to make the day even more stressful by pushing yourself to the limit. One way to go about using this day as a manageable challenge is to make rough plan of what you might eat that day. This will give you a guideline that might help you feel a little more contained, but could involve trying something new or facing a fear food. Try not to restrict yourself as much a you can, but it’s okay if you need to feel safe for a day that is so difficult already.

Take Care of Yourself 

You may be around people this Christmas that will not respect your boundaries or may be insensitive or ignorant to your recovery. They may talk about the triggering topics which I mentioned in the “Set Boundaries With Loved Ones” section above, such as complaining that they have put on weight/are going to put on weight, lamenting that they have eaten “too much”, are being “naughty” or “bad” because they are “indulging”, or moaning that they need to go on a diet because of that. Please ignore them. They are battling their own insecurities and are looking for reassurance that what they are doing is okay and that other people feel the same and that they are not alone. This is really, really sad, and something that no one should have to feel. Enjoying the Christmas food is part of the festivity, and no one should have to feel guilty for it. Know that other people’s worries are not a reflection on you, and you should keep in mind that it is not something positive that they are experiencing, but guilt, anxiety, and insecurity. So instead of letting their negativity impact on you, empathise with them, as guilt, anxiety, and insecurity are emotions that you are likely experiencing also (albeit on a much grander scale to those who do not have eating disorders). Keep moving forwards towards your goals. Keep moving forward on your journey towards health and happiness. Keep in mind your motivations, and remember that the way you respond to others affects you primarily.

Leave the room for a bit if you need to. Take yourself off for a relaxing bath or a nap or to read a book. Go for a stroll. Have a quiet word with that relative who keeps calling the chocolate yule log “bad”. Just take care of yourself and do what you need to do, for you, to have the best day that you can. Do not be afraid to speak up. You need this. You deserve this.

If you are someone who has an un-supportive, highly triggering family, do know that it is okay to decide not to see them at all. If you want to spend Christmas with yourself, your partner, your partner’s family, your friends, or your pets, do it. Do what is best for you. Do what you need to do to continue moving forwards. Do what you need and you deserve to continue working towards health and happiness. Make positive choices, and don’t feel guilty about them. This is what you need. This is what you deserve.

Move On

Christmas is unfortunately never going to be an easy time for those with eating disorders, and it often means that those people go into it with anxiety, and leave it with guilt. It is okay to experience those feelings: you are not alone and those feelings are not your fault. However, you have to keep remembering that these negative emotions are caused by your eating disorder and the control that it has over your life. Keep fighting the war against it, and don’t respond to those negative feelings. You are going to be okay and you can get through this. Christmas will be over in a blink of an eye, and then it is time to put it behind you and move on from that day. Don’t carry the stress from it with you. Let the day go. Remember that it is absolutely, 110%, super okay to eat more than usual, go outside your meal plan, eat “normally”, or respond to extreme hunger (this applies for always, of course). It is okay to put on weight. It is okay to enjoy yourself. The guilt of going against those eating disorder rules can be overwhelming, but it is important to remember that this is part of recovery. Going against your eating disorder and doing what you deserve is part of fighting the battle inside your head. Eating whatever you want, whenever you want, is the goal, and so if you were able to do that for a day, or two, or more, or even if you were able to eat a little more than normal, you are making small steps towards achieving that outcome. That is a wonderful thing.

If the anxiety is becoming overwhelming, check out my article on anxiety management here.

Extreme Hunger in Eating Disorder Recovery: Why You Are Not Binging and Other Fears Explained

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Recently I have been inundated with questions about extreme hunger. This is not unexpected, as extreme hunger is one of the most terrifying aspects of recovery, and one that the eating disorder will latch onto; screaming all of your/its fears into your brain and how they have/are about to come true. Extreme hunger is probably the most common topic that comes up in messages to me asking for information and advice, alongside digestive issues. Recently though, the questions have become even more unrelenting: I could answer five questions in a row about extreme hunger and then within hours receive five more, even though their question was answered in the previous messages. Either the senders of these messages did not take the time to read them (or my FAQ), or, as is understandable, they see themselves as the exception to the recovery process (the “I am a magical unicorn” thinking process).

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Our anxieties and our eating disorders tell us that what we are experiencing isn’t the normal symptoms of recovery; that we are different; that our experiences with an eating disorder do not warrant the symptoms of recovery; that we were not sick enough for this; that somehow we need less food; that somehow our weight gain is not normal; that unlike everyone else the numbers on the scale will increase forever more and we will gain into infinity. And I get this entirely, because I was the same, but there is only so many times that I can repeat the same things over and over again, especially when they are in messages that come directly after one another. And so I decided to create this article to address the fears and doubts that are the most common: the ones that come up in those messages time and time again. The first part of this issue is to talk about the main fears of those with extreme hunger. The second part is a collection of experiences from those who have gone through extreme hunger and come out the other side.

Without further ado:

You can experience extreme hunger regardless of what weight you are or how much weight you lost.
If you restricted your intake, your body experienced an energy deficit. This energy deficit causes damage. This can result in extreme hunger.

Extreme hunger varies in severity and length of time.
It often lasts longer, or is more extreme, in those who have restricted for long periods of time, or those who have restricted very severely. Combining the two is therefore likely to double the chances of this. However, everyone is different, and the severity of extreme hunger is down to how much the damage the body has to repair. If you have extreme hunger, you have it for a reason.

Extreme hunger can come at any time.
Extreme hunger can come and go, be constant, start on Day 1 of recovery (or even during your ED, hence “binging” episodes), come during the middle of the recovery, or the end, or not at all, and it can last for varying periods of time.

It is totally normal to crave what you may call “unhealthy” or “junk” food.
High carb, high fat, and high sugar foods are foods that you are likely to have restricted during your eating disorder, which is why your body craves them now. It is deficient in those things and also in energy, and these foods tend to be high in energy and are easier to process by the body. Basically, this food is easy energy for a starved body. Your cravings for these types of foods will calm down in time as your body gets healthier and your mind recognises that you will not deprive it of these foods again. As a side note, just remember, that there is no “healthy” and “unhealthy” foods; “good” or “bad”, there are just foods that have different nutritional and energy values. Food is food, and also food is not a moral issue.

Extreme hunger is normal, natural, and expected.
If you starve your body, it is going to need more calories than a healthy, energy-balanced body, in order to get back to its balanced state. You can read more information about extreme hunger, why it happens, and how to cope with it here. I also have a video on the topic here. You are not alone in this experience.

Extreme hunger will not lead you to gain forever.
If you starve and lose weight, you will gain that weight back when you start eating more (and possibly more if your body is still growing and developing as your natural weight is not static until around 25ish when you have grown fully  into your adult body). However, extreme hunger is more about internal repairs. So yes, some energy will go towards gaining weight, but lots of energy also goes into healing the damage done to your insides, which means it is used up doing this and is not part of weight gain. When your body is not so severely damaged, your appetite will taper down.

Extreme hunger will stop.
Extreme hunger is there for a very good reason: because your body is severely damaged and needs energy in order to repair this damage. When the body is healthier and not in need of so much energy, it will stop giving you signals for so much energy. Trust the body. It wants to heal you. It wants you to be happy and healthy. Your eating disorder wants to kill you. Put your faith in the right one, even though handing over control feels so scary. Remember that the illusion of control is scarier, and that with your ED you were never in control at all. You were controlled by something that wanted you as miserable and as sick as possible. It’s ultimate goal is your death. Take back control by working with your body, not against it. By giving over control to your body, you will be more in control than you ever have been, because you are reclaiming your health and happiness.

Your eating disorder will try and tell you that you are using extreme hunger as an excuse to eat, but that you were “not sick enough”, “didn’t restrict enough”, “didn’t lose enough weight” to warrant experiencing extreme hunger in recovery.
This is manipulation and bullying by your eating disorder. It can feel that it is losing, and it will try anything to have total control over you again. P.s. you never need an excuse to eat whatever you want, and if you can eat amounts that are “extreme hunger amounts”, then there’s a very good reason for it, and that reason is that the body needs it.

What you think is extreme hunger might not be extreme hunger.
2,500-3,500 calories is a very normal appetite. 3,500-4,000ish is more of a grey area. It is a larger appetite than most people with a healthy, energy-balanced body (although can be reached by energy-balanced people, usually by eating lots at a restaurant, or a buffet, or a night out drinking lots of alcohol and mixers), but it is not exactly extreme. 4,000-4,500+ is when it would start to be more in the extreme hunger range. All of these ranges can be experienced by a person in recovery from a restrictive eating disorder.

You are not binging and you do not have BED.
It feels very very much like binging, but it is not BED, and here we can look at the criteria for Binge Eating Disorder:

DSM-5 Diagnostic Criteria
  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • eating, in a discrete period of time (for example, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances
    • a sense of lack of control over eating during the episode (for example, a feeling that one cannot stop eating or control what or how much one is eating)
  • The binge-eating episodes are associated with three (or more) of the following:
    • eating much more rapidly than normal
    • eating until feeling uncomfortably full
    • eating large amounts of food when not feeling physically hungry
    • eating alone because of feeling embarrassed by how much one is eating
    • feeling disgusted with oneself, depressed, or very guilty afterwards
  • Marked distress regarding binge eating is present.
  • The binge eating occurs, on average, at least once a week for three months.
  • The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (for example, purging) and does not occur exclusively during the course Anorexia Nervosa, Bulimia Nervosa, or Avoidant/Restrictive Food Intake Disorder.

You will probably read these and think but this is what I am experiencing! Let’s go through it point by point:

  • Yes, you will eat food that is larger than most people would eat in that time because you have a starved body that needs loads more energy than most people.
    You will absolutely feel a lack of control because your eating disorder (which gives you the illusion of being in control) is not driving this: your body is, and therefore your ED will feel out of control.
  • Yes, you will probably eat rapidly because your body wants to get energy is as fast as it can because it is desperate for it.
  • Yes, you will feel uncomfortably full because a) your stomach is shrunken and b) this is an amount of food that your stomach is not used to at all.
  • You may not feel physically hungry because extreme hunger can be experienced in many different ways. Extreme hunger can be the feeling of hunger and tummy rumblings etc, but for the most part, from talking to people and experiencing it myself, it comes in the form of feeling empty and/or intense urges to eat/mental hunger.
  • Feeling embarrassed, disgusted, depressed, and guilt, along with marked distress, whilst and/or after eating a large amount of food, is quite obviously going to be experienced by someone with a restrictive eating disorder.
  • Again, it can be experienced every day, or on and off on some days and some not, or once a week, or not for a week and then constantly for weeks, etc etc.
  • Now if we take a look at the last in that category, I want to draw your attention to “does not occur exclusively during the course Anorexia Nervosa, Bulimia Nervosa, or Avoidant/Restrictive Food Intake Disorder“. You are in recovery from one of these eating disorders (or OSFED/EDNOS). This means that you still have that eating disorder, because even though you are moving forwards from it, it is still active for you, until it is inactive and you are in remission. Meaning that you do not have BED. You have anorexia, bulimia, OSFED, or ARFID, and your body is trying to recover from the physical effects that this has had on you.

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Personal Experiences With Extreme Hunger : Those Who Have Come Out The Other Side

Extreme hunger was definitely the most daunting part of the recovery process for me. Mine began about 1 week into recovery and lasted non stop for approximately 3 months and then fairly regularly for the next 9 months with only the odd day here and there after that. It was emotionally traumatic and I was, like many people who go through it, certain that I had developed a binge eating food addiction. I had not… it was exactly what my body was screaming out for and all I had to do was listen to it and respond appropriately without compensating through exercise or attempts to restrict afterwards. I would eat thousands of calories in single sittings, often after a meal is when it would hit me. For example I’d have a normal lunch and would then suddenly feel like a bottomless pit, like my insides were desperate for more. I’d eat several family packs of biscuits, boxes of cereal, whole boxes of magnum ice-creams, share bags of salted nuts, loaves of bread, you name it. It was terrifying but I battled through the fear and the hatred my ED would scream at me and allowed my body to do the healing it so desperately needed to do. Over time the episodes of EH would become fewer and further between and now I simply couldn’t eat as much food as that in a single sitting- now I look back on it and know with confidence and experience that it was essential for my recovery and pivotal in my battle of overcoming my eating disorder. – Emily, 22

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I developed an eating disorder when I began restricting calories in order to lose weight. It got out of hand and I then developed bulimia. I wish I had known that my binging (extreme hunger) was a normal reaction to the restriction. Eventually I realised the only way to end the bulimia cycle was to just go all in and let my extreme hunger run its course. It was really really REALLY hard, and scary, with many slip ups, and I recommend building a good support system around yourself. I didn’t count my calories at the time, but I’m sure they went to at least 4000-5000 most days. I think on average I would have hit 4000 calories a day. But there were definite days where it could have easily been 8000 calories. What I remember most is eating entire loafs of bread with butter in one sitting. Definitely entire large icecream tubs were in there. Just complete freedom. It was the best decision I have ever made. It meant I could enrol into university and study. It took the better part of a year for the extreme hunger to completely subside, and then another year for me to be completely rid of disordered thoughts around food. I know I’m so lucky to have gotten through it. I’ve tapered down to a weight that has stayed stable for months without any effort. I now have the brain space to focus on things I actually love doing. I wouldn’t have gotten here if I didn’t let extreme hunger run its course. – Ira, 24

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Before I experienced extreme hunger, I had tricked myself into thinking I wasn’t sick anymore, because while I was eating the minimum amount of calories recommended for me for my body weight (which turns out is less than half what I should have been eating to live a normal life) and experiencing extreme orthorexia, I was still, in my mind, eating. I thought that I was well enough to go back to work as a chef. In the six months that followed the years and years of starving myself overwhelmed me and extreme hunger kicked in. I had no idea what it was and was terrified I had developed BED. I would eat cake until I felt sick, throw it away in tears, and then feel the need to eat it so badly that I’d get it out of the bin again. I would eat entire loaves of bread and cheese and all of the food I’d told myself I wasn’t allowed to eat, and panic until I had anxiety attacks. I was terrified and felt so wildly out of control that I started making myself sick again. After months of this, although it was incredibly difficult, I stopped being sick, I stopped counting calories, and I tried really hard to eat what my body was telling me to eat. I threw away my scales. I didn’t look in a mirror for months. I just told myself that it was going to be okay, and that I had to let my body do this so that I could live my life without spending every waking moment thinking about fat and weight and diet plans. I just wanted to be able to live like normal people lived. Obviously I put on weight, because my body was starved and was desperate to hold on to the calories I was putting in to it, but after a few months of extreme hunger, my body began to calm down. My appetite lessened, and my weight evened out. I learned how to eat normal food again, how to eat without calorie counting, and how to eat meals like normal people at normal times. Extreme hunger terrified me because I didn’t know what it was, but I needed to go through it not only to let my body recover from all of the awful things I’d put it through, but also to learn how to eat again.  Anonymous, 24

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My experience with extreme hunger was a scary one. Going from eating so little to so much in such little time was a shock both mentally and physically… and was actually kind of terrifying at times. My extreme hunger began very soon after embarking on a ‘3000 calories a day’ meal plan. After a few days of this plan, it was as if my body completely took over my mind and wouldn’t rest unless it was well fed. For the first few days of extreme hunger, there was actually very little fear or hesitation involved when it came to eating. I felt FREE. I ate pretty much everything I’d been restricting by the bucket load. If an award could be won for the most chocolate consumption in one sitting I’d definitely win them all (are these awards a thing? I hope so). I’d say that my consumption started at around 5000-6000 at the beginning for around 2 weeks and then crept up to around 10,000 calories a day which I’d say lasted for around 4-5 weeks. Can I just add that it sounds WAY more terrifying than it actually is. Yes – it is scary, but it is also the most freeing thing you could ever experience. After eating around 10,000 calories a day for 4-5 weeks, my hunger began to taper a little; week by week my intake lessened slightly until I was eating 3000-4000 calories naturally and comfortably a day.
Body wise, I gained weight quickly. I had the whole puffy face, slightly pregnant belly thing going on. At the time, I honestly didn’t concentrate much on how I was looking. The feeling of freedom was completely overwhelming and overshadowed the physical effects of what I was going through. That being said, extreme hunger didn’t come without its discomfort. My body was obviously not accustomed to digesting this volume of food, which meant that I experienced fairly severe stomach cramps. I ensured that I stuck to easily digestible food at this time and after a couple of weeks, they passed.
My extreme hunger diminished completely at around 7 months into recovery and I am now 3 years in! Extreme hunger helped me break down so many barriers in recovery and it has enabled me to build a far healthier relationship with food. – Emmy, 22

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I was meeting with a nutritionist about once a week at the beginning of my recovery. She would give me a meal plan, calorie goal, etc. It was extremely difficult at first because I had to not only eat, but keep in, the calories I was consuming. Once I was on this meal plan for a few weeks the extreme hunger started to kick in. The biggest issue I had with extreme hunger is that in the beginning you don’t trust your body or think that it’s accurately telling you the things that you want. But one day I just said “fuck it” and tried a different approach. Whatever I was craving I ate, no matter the amount I wanted. The extreme hunger lasted for six months, and was one of the more difficult parts of the recovery process but it is so, so worth it, and is exactly why I can be typing this right now while enjoying ramen with my roommates and knowing that yes, this can be overcome. – Natalia, 21

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Last year, I used MinnieMaud to recover from anorexia. Extreme hunger hit me like a truck, and I was a ravenous beast for a solid 4 months. I went from about 90 lbs to 150 lbs, and once I hit that weight, my appetite normalized, which was pretty awesome and relieving. It was a rough and scary road, but having confidence in the principles of MM, and especially the Minnesota starvation study, and TRUSTING my body, helped immensely. – Anonymous, 30

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During the early parts of recovery my hunger was huge. I was CONSTANTLY hungry/craving large amounts of food. I would eat blocks of cheese, chips, sandwich after sandwich and still feel hungry even though my stomach felt so full and bloated. It was scary to think the hunger would never end and I’d just keep on eating and eating. BUT, I trusted the process and resigned myself to allowing myself grace during this period knowing many other people had experienced the exact same thing with good results in the end. I knew the key was to not limit myself when it came to food and cravings. It took awhile but slowly I started noticing myself eating and craving smaller portions and feeling satisfied with those portions. The body just needs all those calories and nutrients after being in the negatives for so long. Give yourself time to make up some of the deficits without freaking out too much! You can do it! – Shannon, 34

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My extreme hunger started before I even chose to recover. My body eventually decided that after seven years of restriction that varied from minor to severe during that time span, and one year of severe, unrelenting starvation, it was going to have to do something about it. My body would put me in what I can only call “trances”, where I would go to the kitchen and eat loads of porridge oats, then “wake up”, and chaos would ensue, both in my mind and my reactions to what I had eaten. A month or so of this ensued: with my body taking over, and then my eating disorder reacting to it and making me compensate. Then I chose recovery, and tentatively gave myself permission to respond to the hunger and cravings that I was experiencing. During extreme hunger I would eat whole cheesecakes; pints of Ben and Jerry’s; bowls of cereal; whole big Thornton’s chocolate boxes…I was terrified that I had developed BED; that I was using recovery as an excuse to binge; that I would never stop eating so much…but it did. It stopped when I was healthier. My appetite tapered down. It stopped demanding so many high carb and high fat foods. My days of experiencing extreme hunger lessened and grew farther apart. During the second year of my recovery, my appetite was generally normal, with a couple of days of eat around 4,000 calories (in the grey area between normal appetite and extreme hunger, but then again some days I probably didn’t eat enough for my body and therefore ate more on other days). Now my weight is stable, my appetite has normalised, and I haven’t experienced extreme hunger for years. It was terrifying to go through, but it is not endless. It does stop. And it is so important to trust that your body is that hungry for a reason. – Myself (Sarah Young), 25

I hope that this article answers most of the questions related to extreme hunger and gives some reassurance that this is normal and does end.

 

Hidden Behind A Healthy Weight: The Eating Disorders You Can’t See

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Eating disorders are complex illnesses. They are a mental illness that often result in the deterioration of physical health, and there is not one recovery method that has a high success rate as of yet. They have a complicated entanglement of genetic and environmental causation that is entirely individual to each person. There are many different types of eating disorders (anorexia, bulimia, EDNOS/OSFED, ARFID, BED, purging disorder, rumination disorder, pica), and people of all ages, genders, weights, ethnicity, sexual orientation (etc, etc) can develop one. And yet we are bombarded only with images of eating disorders in the form of extreme anorexia: the emaciated, skeletal bodies of those walking the fine line between life and death. The media blasts out the headlines that often scream something like “I WAS 4ST AND ONLY ATE A LETTUCE LEAF A DAY”. They plaster photos of bones protruding across the articles and present to us an “after” photo of the recovered victim: nearly always a slim, beautiful, white young woman.

And there we have it: the damaging stereotype of what an eating disorder looks like and who develops one. This stereotype harms everyone who deviates from the narrative of pretty young white girl who starves herself to within an inch of her life. I’ve never seen an article about anyone black with an eating disorder. Ever. I’m sure that there are one or two articles out there, but the media all but erases the existence of black men and women with eating disorders. It erases the existence of older adults with eating disorders. It erases the existence of men with eating disorders. In fact, the media erases nearly all eating disorders in themselves – the minority of people with eating disorders experience anorexia nervosa, and an even smaller amount have the chronic anorexia that the magazines depict. “Before the latest change in diagnostic criteria, it was estimated that of those with eating disorders, 10% were anorexic, 40% were bulimic and the rest fall into the EDNOS category” (from here). Most of the 90% of people with eating disorders that are not diagnosed as anorexic will be fit into the “healthy”, “overweight”, or “obese” BMI categories. That’s not to mention all the undiagnosed people who are not seeking help and are invisible because of their weight, who are not getting the help and support that they need and deserve.

There are also different types of “invisible people” with eating disorders at a “healthy” weight. Those who have lost lots of weight but come from a higher weight are one set of people. These people are often congratulated for their weight loss, even though it has been lost in exactly the same way  that someone going from a “healthy” BMI to an “underweight” one has – someone who would be diagnosed with anorexia rather than praised for their efforts. We offer treatment to those that lose weight and fall into the weight criteria for an anorexia diagnosis, and pat those on the back that lose the same amount of weight but come from a weight perceived as socially unacceptable (or a weight perceived as “acceptable” but not “desirable”). And what many people do not know, or forget, is that we all have our own natural healthy weights (that can be pretty much any weight, shape, or size), and if people are well below those weights, they are underweight for their own individual body. So if someone is naturally a BMI of 27 and they starve themselves to a BMI of 20, they are severely underweight for themselves, but their eating disorder are often dismissed as “healthy weight loss efforts”. Their illness can be not only hidden, but recognised as something positive, and therefore encouraged and reinforced. Included in this category are those who will never dip below a “healthy” BMI and could remain invisible for any amount of time, and those who will continue to lose weight. At this point society will go “woah, lose weight but not too much weight!” This is when their weight loss will be recognised as an issue, but as it was never noticed before, by now the person will likely be entrenched with their eating disorder.

Another group are people who have eating disorders but find that their weight doesn’t change much, or there are those that gain weight during their eating disorder. Weight is only a secondary symptom of some eating disorders, and it is important to understand that not everyone experiences a change in weight when suffering from an eating disorder. They are primarily mental illnesses.

Another group of “invisible people” at a “healthy” weight are those who are recovering from a low or lower weight and have gained weight to a weight that society deems “fine”. Peoples see them in the street and don’t suspect a thing. Friends stop worrying and family heave a sigh of relief. Those close to the person show less concern and more frustration: they think that the journey is over. You look fine therefore you must be fine. It’s important to remember that this is a mental illness, and that the physical symptoms are secondary. It is also important to remember that the person may still be at an unhealthy weight for their own personal body, and though they may be an acceptable size in terms of society’s standards, they may be underweight still regardless of BMI. Just because you can’t see their pain doesn’t mean that they are not experiencing it. The mental anguish that led them to rock bottom is still there and still needs to be addressed.

People who look fine but have expressed that they are not need to be taken seriously. They need to be supported, and they need to be encouraged to move towards being healthy and happy: whatever that looks like for them. It might not look like your idea of healthy and happy, but you have to put aside your biases, your judgements, and your prejudices in order to help that person achieve the best life that they can for them.

If you are someone who is living at what society says is a “healthy” weight, but you have engaged in disordered habits to get there, or you are regaining weight and are still unwell but people think you “look fine”, then sit those people down that are important to you and tell them. Set your boundaries, let them know what you need, and ask them to support you to get better. Be open and honest. Don’t downplay your struggles. Be assertive when telling them what is helpful and what is unhelpful.  Print off information on eating disorders to support what you are saying and to give them something to read later to help them to understand how pervasive and powerful an eating disorder is mentally. Write a letter if that is easier. Whatever you do, talk. Your voice needs to be heard.