Tag Archives: anorexia

Health At Every Size and Big Is Beautiful/Fat Acceptance: What These Movements Stand For and Why They Are Important

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Health at Every Size and the Fat Acceptance Movement started as small, barely recognised movements. Due to the hard work of those involved and the (very) gradual shift in views around weight, shape, and size, these movements are now beginning to get the acknowledgement and publicity that they deserve. The more exposure these movements get, the more people will start to be enlightened to the real facts, figures, and evidence around size, health, and weight set point theory. Hopefully with time weight-based myths, discrimination, and stigma will be something that we as a society look back on and cringe with shock and humiliation that we got something so wrong and treated millions of people so badly. However, we still have a really long way to go until then.

You might be new to these movements, or you might not be, but either way, you may be unsure about what they stand for and why these things are so important. So let’s have a look at each movement and discuss a little bit about them.haes-4

Health At Every Size (or HAES) was first developed by American psychotherapist and nutritionist Linda Bacon, who wrote the book Health at Every Size (first published in 2008), and the sequel, Body Respect. Health At Every Size is a movement that is promoted by those who believe that health and fitness can be achieved regardless of weight, shape, and size, and that weight-loss is not a requirement for those deemed “overweight” or “obese” by BMI in order to live a healthy and happy life. HAES encourages people to accept their weight as it is, and promotes mental and physical well-being without weight loss as a goal. HAES cites studies that have shown that weight loss often leads to worse health regardless of the starting weight, and presents evidence that suggests that obesity is not the cause of health issues or premature mortality. It provides strong arguments for the idea that correlation does not equal causation, and picks apart flaws in studies that apparently connect obesity to poor health. HAES supports self love, self care, and body positivity, as well as healthy physical lifestyle choices such as being active and eating a balanced diet. HAES promotes this in a way that is conductive to mental health: it urges people to engage in activity that is enjoyable first and foremost, and not gruelling and repetitive work-out routines, and it supports the idea that food is not just for survival but also for pleasure. It maintains that weight loss should never be a goal, and that weight loss is frequently damaging, and encourages people to follow intuitive and instinctive eating and activity. It also supports weight set point theory.

The Health At Every Size® Principles are:

  1. Weight Inclusivity: Accept and respect the inherent diversity of body shapes and sizes and reject the idealizing or pathologizing of specific weights.
  2. Health Enhancement: Support health policies that improve and equalize access to information and services, and personal practices that improve human well-being, including attention to individual physical, economic, social, spiritual, emotional, and other needs.
  3. Respectful Care: Acknowledge our biases, and work to end weight discrimination, weight stigma, and weight bias. Provide information and services from an understanding that socio-economic status, race, gender, sexual orientation, age, and other identities impact weight stigma, and support environments that address these inequities.
  4. Eating for Well-being: Promote flexible, individualized eating based on hunger, satiety, nutritional needs, and pleasure, rather than any externally regulated eating plan focused on weight control.
  5. Life-Enhancing Movement: Support physical activities that allow people of all sizes, abilities, and interests to engage in enjoyable movement, to the degree that they choose.

Health At Every Size is a movement that I strongly agree with. Its main principles on exercise, food, weight, and body positivity are ones that I advocate with every fibre of my being. It’s incredibly important because we live in a culture obsessed with dieting and weight loss; a culture preoccupied with attaining the “perfect body – a body that is not achievable for the majority of people without sacrificing their mental and/or physical health. Even if you are someone who naturally has society’s idea of the “perfect” body, the dieting and weight loss industry will find ways to make you feel inadequate and flaw-ridden in a bid for you to buy their products to “fix” yourself with. The diet and weight loss industry controls much of our research into food and weight, and sweeps any evidence that contradicts their interests under the rug and publicises in a selective and biased way research that has questionable study methods or sample sizes, contentious results, and tenuous correlations. So do I have any criticism of the HAES movement?

Firstly, I think that although HAES is absolutely correct in that we should intuitively eat and listen to hunger and fullness cues, it underestimates how difficult that can be to relearn, especially if you are someone who has suffered with an eating disorder or severe dieting. In our society, feelings of guilt, self-loathing, shame, anxiety, and, on the other hand, superiority and control, have become inextricably linked with food and weight, and so it can be incredibly difficult (and perhaps even impossible) to entirely disentangle our emotions from our biological signals. That’s not to say that it cannot be done, but we need to address the context in which we live in our bodies  before we can start to challenge and relearn the way that we feed and view our bodies. Being presented with the principles of the Health At Every Size movement can feel like ordering flat-pack furniture and taking it home, only to open it up, lay out the pieces of the floor, and realise that the instructions aren’t there. You’re left with all the parts, but with no idea how to assemble it. And in reality that’s not exactly a flaw of the HAES movement itself, as HAES aims to educate and promote a mentally and physically healthy and positive way of living, but it is an area it sometimes fails to recognise and address.

Secondly, I’m not really a fan of the name. Heath At Every Size is misleading. Although I absolutely 110% agree that the what we view as “healthy” should be a much much much broader range of weights, it is undeniable that there are certain weights at which you just cannot be healthy at. You cannot be a healthy adult at 50lbs, just like you cannot be a healthy adult at 500lbs, and so the name of the movement leaves it open to criticism from the onset. Prader-Willi syndrome, hypothyroidism, cancer, depression, anxiety, or eating disorders are a few examples which can cause a person’s weight to plummet or skyrocket, and there are weights that are too low or too high for anyone to be healthy at. So for me, I believe in Health At (Pretty Much) Every Size, and whilst Health At Every Size is much more catchy, it’s technically incorrect, allowing those against the movement an easy starting point on which to discredit it.

Last but not least, HAES aims to provide people with the information to start working towards accepting their bodies whatever their weight, shape, and size in order to improve both physical and mental health. However, it also has to be addressed that we live in a society where fat people are constantly subjected to prejudice, body-shaming, weight stigma, and discrimination. Fat people who agree with HAES may still struggle to accept their body size in a culture so cruel to them, and their inability to find peace with their bodies may well become yet another source of shame. Again, this isn’t a flaw in the principles of HAES, but a topic that may need more recognition.

So what is the difference between Health At Every Size and the Fat Acceptance Movement? Let’s take a look at the latter:
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The Fat Acceptance movement (also known as the size acceptance, fat liberation, fat activism, fativism, or fat power movement) is a social movement seeking to change anti-fat bias in social attitudes. Those involved seek to change attitudes towards fat people in areas of life including the aesthetic, legal, and medical approaches to people whose bodies are fatter than the social norm. The Fat Acceptance movement focuses more on the way fat people are perceived and judged due to their weight, shape, or size, and although it does address physical health and the research to back up the same principles as the Health At Every Size movement, it is more focused around changing the way fat people are treated and discriminated against. Fat people are often dehumanised and shown far less respect than those that are at a socially “acceptable” weight. One of the main examples is medical care. Fat people’s medical issues are often inaccurately dismissed as being caused by their weight, are shown less respect, and are often shamed for their body size.

The Big Is Beautiful movement is a smaller movement that comes under the Fat Acceptance movement, and focuses more on aesthetics. Its message is that people whose bodies are bigger than what is considered socially “acceptable” are beautiful too, and that you don’t have to be a certain weight, shape, or size to be attractive. Its aim is to help people find beauty in their bodies regardless of any contributing factors that make them look a certain way: health is besides the point.

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Both movements are focused around respect, and also talk about health as irrelevant. The ideas is that even if you believe that someone IS unhealthy due to their weight, its not your business what lifestyle choices they make, and they should be treated with respect regardless of those choices. For example, we all know people who smoke or binge drink, but we do not treat them as less human on an everyday basis because those choices lead to poor health. We do not assume their personality, or directly link their personal lifestyle choices with their moral character. This is why these movements are so important: they address the way society perceives and treats people who are fat.

My only criticism of these two movements (Fat Acceptance and Big Is Beautiful) is that there are some people involved in this movement who look down on those who diet as betrayers of the movement, when they should be seen as victims of a diet and weight loss obsessed society. As I stated above with HAES, it can be forgotten how powerful and pervasive “thin ideals” are, and all of us are affected by it in some way, even if we do constantly work to disentangle ourselves from it and rise above it. We should all be working together to support one another and help to lift each other up not put anyone down. We should aim to educate, not shun; support, not vilify.

Health At Every Size, the Fat Acceptance movement, and Big Is Beautiful, are all extremely important in terms of physical health, mental health, feminism, and education around food, weight, and health, amongst other things. They are powerful and uplifting; inspiring and motivational; enlightening and passionate. They can give us the information and confidence to live in a better way; a way that makes the aspirations of health and happiness more achievable.

To find out more about weight set point theory, and to read discussions around and evidence to support Health At Every Size, you can visit the resources section on this website. There is a drop-down menu that displays many sub-sections, including one for each of these topics.

And as a last little titbit of information, check the photo out below:

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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

5 Replies

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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.

Extreme Hunger – What Is It, Why Is It Happening, and How Do I Handle It?

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It has come to my attention that I have not yet addressed one of the biggest topics of recovery from a restrictive eating disorder in any of my articles on this website (shame on me!). I’m not sure how I managed to miss it but it may be because I have a comprehensive video on the subject, and also refer to Your Eatopia’s articles about it. It was, after all, Gwyneth Olwyn who did coin the term “extreme hunger” (as far as I am aware). But let’s get started.

Extreme hunger is a rather controversial subject in the recovery world. It is rarely recognised by professionals regardless of the clear logic that shows us that it is totally normal and expected to experience a surge in hunger after a period of starvation, not to mention the sheer amount of people that talk about extreme hunger being part of their recovery (or “binging”, which is actually the same thing, but we will get to that later).

Extreme hunger is a very rational experience when you look at the facts. A body that has been starved has a large energy deficit, and therefore calories that are needed for daily expenditure are not going to be enough to get an energy-deficient body back to its energy-balanced state. This is because it will need calories for daily expenditure and calories to make up for the energy deficit. This energy deficit in itself will have resulted in damages to the body, and it can also result in weight loss which also causes harm to the body – and frequently the more extreme the weight loss the more severe the damage. Damages like that require energy to heal, and that has to be energy on top of daily energy needs, as that is expended in – you guessed it – the energy that you use up in your daily life.

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So if you imagine that energy-balanced is the number 0 – a neutral place with a healthy body, and let’s say you need around 2,750 calories to stay in this energy-balanced place. Then starvation brings you to -10 on that scale, which means that you are in an energy-deficient place. Let’s say you now enter recovery and bring your calories up to 2,750 again (after increasing gradually because of the risk of refeeding syndrome). Your metabolism is probably very suppressed, so for a while, 2,750 may cause weight gain either slowly or rapidly as your body will store as much energy as it can rather than burning it, to get you to a healthier weight. The metabolism will then speed up and you might a) experience hypermetabolism and end up dropping weight or maintaining a fairly low to low BMI (or a BMI too low for your personal body), which will mean that you will need to increase your calories until you are gaining again or you may b) find that you maintain a certain weight or that your weight gain slows down. This does not mean that you need fewer calories. This means that your body is now able to maintain its weight on those calories. It does not mean that it is done healing the many internal damages done through starvation, so if you experience hunger or cravings for more than the 2,750 your body (theoretically) needs, then it is really important to respond to those signals and eat. Your body is your team mate; your best friend; your rescuer. Listen to it. It if it telling you that it is hungry, then it is hungry. I know – this is ridiculously difficult, and I will talk about that in a moment.

Now let’s say you are recovering on a sub-optimal amount of calories and have stopped gaining weight. My body must be recovered! I hear you say. It must only need this amount of calories! Wrong. Let’s say that you are recovering on 1500 calories. Your body is maintaining a weight that is not its natural or healthy weight because it needs more energy to repair and gain weight. In order for it to gain to its set point and heal the internal damages done to your body, it needs adequate and consistent energy, and that is much more than 1,500 calories (or whatever your sub-optimal is). Let’s say you are recovering on a sub-optimal amount of calories and are gaining weight. Well clearly I don’t need any more calories if I am gaining weight on this! I hear you shout. Wrong. Giving your body an inadequate amount of energy means that it is extremely likely to keep your metabolism suppressed and therefore will continue to store more energy as fat rather than burning it like it would if it had a normal-speed metabolism. To find out how many calories you need (base level, without extreme hunger), check out my recovery guidelines here. Remember that activity level also factors into being energy-balanced, and that if you are engaging in excessive exercise, this will put you in an energy-deficient state too. It is also important to note that whilst your body is healing, any energy put into exercise will put a strain on a body that is desperately trying to heal a multitude of damages, and exercise will eat into much-needed energy for repairs. This is why it is important to rest during recovery (and for more on that  here, here, and here are my videos on exercise).

You may be experiencing extreme hunger right now. It may be something that you will experience in the future. It is something that most likely makes you feel terrified beforehand, and extremely guilty after. It is something that may be heavily weighing on your mind (excuse the pun). You may think that you have lost control; that you are spiralling into a different eating disorder; that this is binging and you are never going to eat like a normal person ever again! You are not alone in those fears. I had them too. Extreme hunger is utterly anxiety-provoking. It feels as if it will never end, and it evokes a multitude of negative emotions and thoughts, including shame, terror, and disgust. The eating disorder will scream and scream and scream at you inside your head. It will do anything to stop you eating what you need to eat, and the more you eat, the louder it will usually scream.

This is an extremely chaotic time inside the mind of someone recovering, and you are not alone if you feel completely overwhelmed by your hunger and your eating disorder’s reaction to it. The eating disorder hates anything that goes against its cruel, life-threatening rules, so for something like extreme hunger to hit and be responded to is something that will enrage it. People also have fears that it is binge eating disorder – and these fears are understandable, given the volume of food that might be consumed. Yes, you will be consuming a large amount of energy. You might eat anywhere from 4,000 calories to 10,000+ (although the latter seems to be quite rare – but again, not unheard of and if you are experiencing this you are not the only one). This would be a lot of food for an energy-balanced body. But you do not have an energy-balanced body. You have a starved, damaged, energy-deficient, nutrient-deficient body that needs far more energy than a healthy, energy-balanced body, to get it back to that state of equilibrium again. This is okay. This is necessary for your body. You are not alone.

You may experience extreme hunger at the beginning of your recovery. You may experience it in the middle, or near the end. You may find that it comes and goes throughout your recovery. You may never experience it at all – and that is okay too. This could be because you may need less energy to repair internally – this does not negate your need to recover. It may be that you may have repressed hunger cues and find that you struggle to even eat your calorie guidelines let alone have any desire for more. Extreme hunger may come to you later, or it may not come at all. It may be that you are someone that finds that you eat a little more than what your body needs as an energy-balanced body for a long time and your healing is done more slowly.

It can also be that during extreme hunger you find that you are eating a certain type of food: sugar, carbs, and fats are generally the types of foods that are most highly restricted, and because of that, the body needs and craves foods high in these things. It is also easier for the body to quickly process and get energy from these types of foods. Those who are highly lacking in fats may find themselves eating jars of peanut butter – this seems to be quite common so don’t freak out if you are eating whole jars of peanut butter, nutella etc, and strange combinations also seem quite frequent during extreme hunger or recovery in general. You may find yourself chomping on lots of meat or iron rich foods. You may find yourself digging into ice cream, milk, cream, and cheese because you are deficient in fats or calcium. There is a reason for the foods you crave. Listen to your body and respond to it.

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The message that I want to get across is that if you have been through a period of restriction, experiencing a raging hunger is totally, absolutely, 100% normal. I want you to know that it is not forever, even though it feels like it could be, and even though that is your greatest fear. Your body will become energy-balanced (or close to energy-balanced) and the intense hunger will dissipate as your body gets healthier. Your extreme hunger may taper down, or it may vanish from one day to the next, but you will not have extreme hunger forever. Everyone I know who has gone through the entire recovery process has experienced extreme hunger, and they have come through it and out the other side. They have eaten whole cakes for breakfast, or pints and pints of ice cream, or whole cheesecakes, or whole large Thortons chocolate boxes (that one was me), and they have all been horrified; ashamed; fearful. They have all been scared witless that it would never end. They have all questioned whether they had gone from one extreme to the other and developed Binge Eating Disorder. And they have all, in one way or another, either come across information on the topic and been a little soothed until the hunger calmed down, or have freaked out and then, in time, found that the hunger normalised. If you (unsurprisingly) need help with anxiety management, check out my article on it here.

Why more research has not been done into this topic, I don’t know. I have talked to thousands of people in recovery since I began my journey over four years ago; on the Your Eatopia forums, on my blog, on this website, on my Youtube channel, and on my Instagram account, and one of the most frequent topics is extreme hunger. I don’t know why it has not been researched or recognised by many health professionals, and it is one of the most frustrating and saddening things for me when people are told not to respond to these very natural, obvious signals from the body. But I can say with conviction that if you are experiencing this, you are far from alone. You are okay. You are healing. Work with your body, not against it. Be strong, and patient, and kind to your body and your soul. What you are experiencing is normal, and expected, and you can get through this.

Fat Girls Can Wear Crop Tops Too

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Yep, you heard me. Fat girls can wear crop tops too. Let me say it again for the people in the back:

Fat

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girls

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can

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wear

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crop tops

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too.

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But this article isn’t just about crop tops.

I understand that we live in a society that has brainwashed many of us into believing that fat bodies are worth less than thin bodies; that fat is synonymous with ugly; that there is nothing worse than being fat; that we cannot be fat AND happy (these are all lies by the way) but I still do not understand why anyone would feel that it is acceptable to attempt to police the clothing choices of any other human being, regardless of their weight, shape, or size.

Fat girls are told implicitly and explicitly that they should not wear leggings, or crop tops, or bikinis (or even go on the beach at all), or bear their legs in dresses, or wear mini shorts, or…the list goes on. There is even a hierarchy of privilege amongst fat bodies, depending on how fat you are or where your fat is stored or whether you have big enough boobs to even out your thick thighs and hips. And frankly, I find it all disgusting.

We are all people. We all lead different lives and have different values and passions and hobbies. And we all have different bodies. And the weight, shape, or size of our bodies does not alter our self worth or how beautiful we are. It also does not give anyone the right to dictate what we wear. Fat, slim, curvy, thin, chubby, muscular, pear-shaped, apple-shaped…you can be star-shaped for all I care and wear the same clothes as anyone else. Certain clothes are not reserved for certain body sizes or shapes, and whether you are a size 6 or a size 26, you are the only one who gets to choose what you wear. Don’t let ignorance get in the way of your clothing preference. If you want to rock a crop top, a mini skirt, and nine-inch heels, you do that. If you want to wear a cute summery dress to the beach and then whip it off to reveal an itsy, bitsy bikini, you do that. If you want to wear leggings and a bralet, you do that. And if you feel more comfortable in jeans and a t-shirt, you do that too. Because you should be able to wear whatever it is that you feel the most confident in. And if our fatphobic, asshole of a society has made you feel too uncomfortable to wear a crop-top even if you really like them, it doesn’t make you any less badass if you save the crop tops for another time, or even never.

You do not have to wear whatever society thinks is most “flattering”. I only recently took a real long hard look at this word, and saw it from a totally different angle to what I previously saw. People use it as a compliment towards each other all of the time, and it seems like a genuinely nice thing to say someone until you examine what it wearing something “flattering” really means. The word “flattering” in itself is oppressive: it implies that we should be aiming to look a certain way – and that certain way is “as thin as possible”. No one should feel that they have to disguise their hip fat or accentuate their waist or push up their breasts or flatten down their bellies. You do not have to hide any part of your body as if it is shameful. Not one part of your body is shameful, and you have the right to wear whatever you want, at all times. Everyone deserves to embrace the body that they have and everyone deserves to love it for what it does for them and for what it looks like.

It is summer time, and it is hot outside, and fat girls are entitled to dress in the clothes that make them feel coolest – both in temperature and in style. Don’t ever shame anyone for wearing what they want to wear. It is their right to do so and to feel confident in doing so. Respect everyone’s clothing choice. Respect everyone’s bodies. Respect everyone.

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(Here’s me and my crop top)

Celebrating the Day that I Chose to Live

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TRIGGER WARNING.

This article contains before and after photographs of someone who has previously suffered with an active eating disorder, and also names eating disordered behaviours that they previously engaged in. This article could be triggering for vulnerable people, those with eating disorders, and those recovering from eating disorders.

Today holds an extortionate amount of significance for me: four years ago today I made the decision to make the first steps towards recovery from my mentally and physically destructive and severe mental illness: atypical anorexia. It didn’t feel like much would come from the vague, half-hearted decision, but it was a monumental moment that put me on the road to recovery. That moment has gotten me to where I am now: a healthy, happy woman who has been in remission from an eating disorder for over one and a half years, after an intense two and a half year battle in which I emerged victorious.

I’m well aware that I wrote a post last year which will probably be very similar to this one, but the topic isn’t an insignificant one: this day four years ago saved my life in many ways, and celebrating it is, in reality, celebrating the day I decided not to die slowly, and to fight tooth and nail for my health, my happiness, and ultimately, my life.

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Four years ago today I was entirely, unequivocally, weary of being sick and miserable. I was weary of being in a living hell. I was weary with the despair and the darkness and the anger and the devastation. I was weary of watching my hair fall out in clumps in the shower; of watching it become thin and dry and brittle; of being dizzy; of living in a grey world where my senses were dulled as if my brain was smothered in cotton wool. I was fed up of the insomnia; of the nightmares; of the calories circling around my head all day and all night, leaving little space in my mind for much else. I was tired of counting down the minutes until I was “allowed” to eat; of the starving and compulsive exercising, and eventually, the purging; of the intense fear I felt at going anywhere near food; of the absolute and utter desolation of my mind and body that meant that I lived in a starving shell that could not function, and a mind controlled by  a single focus: lose weight lose weight lose weight. A focus that meant I could not think about anything else; could not deal with anything else. A focus that meant that I did not have to confront the emotions and experiences that had caused my eating disorder in the first place. A severe mental illness caused by a combination of genetics and my environment was my way of handling the world and myself, but finally, after 8 years, I had decided that this could not go on. At first, I viewed death as the only escape from the torment my eating disorder wreaked upon me, but moments of clarity started to push their way to the forefront of my mind, until the possibility of recovery developed from rejected thoughts to cautious actions. And over time my strength grew, and grew, and grew.

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I know: you’ve heard it all before. You’ve read my posts or the posts of others, you’ve watched a loved one battle an eating disorder, or you’ve experienced it first hand. But today I also want to talk about where my recovery took me and how it might differ from that of others.

I have come across a lot of people who live under the title of “recovered”. It may be a title they have given themselves or a title a professional has given them. It doesn’t matter. What I see are a lot of very slim people who use the word “recovered”. Some of those people will be naturally slim – people whose natural, healthy weights are down the lower end of that “healthy” BMI category. And that’s great! All weights, shapes, and sizes are fab, as long as the person is at their natural, healthy weight and is healthy and happy. However, I tentatively would suggest that there are those that maintain a certain weight by closely monitoring and restricting their intake and controlling their exercise. And if that is where you end up at in recovery because you are unable at that point in time to go any further or feel that that is all you can manage, then I applaud your progress and your strength and bravery in getting to that point – you are amazing and strong and wonderful. Some people will manage their eating disorders and live with it in a state halfway between being free of their eating disorder, and being utterly consumed by it. That is absolutely okay, and if you want to call that full recovery, who am I to decide that it is not by your own personal definition? But I also want to stress that that is not where you have to be if you want to choose differently. You can push further. Whether that is now, or in the future, there is the option to press on forwards to a life where you live pretty much entirely free of your eating disorders influence. I know, because I decided to take the path to that place.

This is a killer top I couldn’t decide between these two photos so I went with both.

I decided to reject the idea of an “ideal” body. This took me a very long time. It took years of research into health at every size and weight set point theory. It took getting involved with feminism and the body positivity movement. It took learning about the impact of diet culture and how the diet and weight loss industry intentionally make us hate ourselves for profit. It took deciding to be as healthy and happy as I could possibly be in both body and mind. It took deciding to let go of the importance that I had placed on being a certain weight.

I turned out to be one of those people who naturally have a higher body weight than others. It can mean dealing with increased stigma around weight and size, and comes with knowing that I am at a weight where some people will look at me and decide that I am unhealthy/lazy/greedy, whilst knowing nothing about my lifestyle, or indeed myself as a person. Some people will look at me and see me as a weight/shape/size. I am also aware of my own weight privileges in that there are people at far higher weights than me that suffer a hell of a lot more stigma and discrimination. I am aware that although I am far from society’s “ideal” body weight, shape, or size, I still wear “acceptable” clothes sizes (as in, the clothes stores that I shop in cater for my size, even if it is a size some feel shameful about). It is also a size that I maintain effortlessly eating a balanced diet (and by that I mean I eat what I want, when I want, which leads me to eat a wide variety of foods from all food groups), and with physical activity that I do for enjoyment rather than to alter my weight, shape, or size, or any other disordered reasons. It is the size that I can live my life as a healthy and happy person. If I wanted to be smaller, I would have to focus on calorie restriction and possibly an excessive amount of exercise, and we all know where that would lead. Don’t misunderstand me: I’m not going to lie and say that if I had to option to do all this at a smaller size, then I would choose not to. Because of the importance society places on our bodies, being at a smaller size would mean not having to think about or deal with the discrimination of being at a higher weight, and I would rather choose not to deal with that. But my body and its weight/shape/size is not at fault for those stigmas, and nor am I. I accept my body. It is everyone else accepting my body as happy and healthy and beautiful that is the problem, because not everyone does. But that’s okay, because I choose my health and happiness over the approval of others. I choose me.

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To get to where I am now, I chose to reject the ideas and ideals that are so entrenched in our culture and our society. I chose my actual health over the idea that you have to be a certain weight, shape, or size to be healthy. I chose my happiness over the absolute lie that you have to be a certain weight, shape, or size to be happy. Those lies are fed to us all day, every day, everywhere we look, but I just don’t buy it any more. I’ve seen enough evidence of all kinds to call bullshit. And I have decided to live my life in a way that means working with my body and letting it be whatever weight, shape, or size it needs to be to enable me to be healthy and happy. I will not change that for anyone. I choose me.

Is Intuitive Eating a Good Idea in Eating Disorder or Dieting Recovery?

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Intuitive eating is a concept that really resonates with me. In a society entrenched with diet culture, a huge percentage of people have lost the ability to trust their bodies, and instead opt for counting calories or macros, or eliminating food groups, or trying out various juice fasts, veggie cleanses, cabbage soup diets…the list of restrictive diets and ways to self starve is endless. The fact that we do not ignore other bodily signals: emptying our bladders or bowels; sneezing; coughing; itching; removing our fingers from a burning surface; blinking; but ignore our body’s signal for hunger and then call it a good thing is absurd. We have decided to stop trusting our biological body; a body built for survival, and instead listen to the multi-billion dollar diet and weight loss industry, our unhealthy thin-obsessed culture, and the media which panders to both (again, to make money). It is nonsensical. It is ridiculous. It is madness. And yet nearly all of us are guilty of listening and responding to it.

Intuitive eating is a nutrition philosophy based on the premise that becoming more attuned to the body’s natural hunger signals is a more effective way to attain a healthy weight, rather than keeping track of the amounts of energy and fats in foods.

This is why I love the idea of intuitive eating (although do remember when reading the above that a “healthy weight” is whatever your body needs to be at naturally, and has nothing to do with BMI). Reconnecting with your body; listening to it; honouring its cues and signals; respecting it and giving it the treatment it needs and deserves…this is exactly the right attitude to have, and exactly the right action to take. However, when it comes to recovering from the effects of dieting, or even more serious, an eating disorder, intuitive eating becomes a little trickier to throw yourself into.

Months or years of damages done to the body through restriction can cause huge issues with the way the body communicates with you, especially when it comes to hunger. Your hunger cues may have become suppressed, and therefore will be unreliable during the recovery process. When this is the case, it means that both hunger for the correct amount of energy and cravings for the right types of foods that the body needs won’t be felt by the person experiencing this, and so intuitive eating would be a disaster for them. It would mean that they would not get the energy that their body needs for daily energy requirements, and would not get the types of food that the body needs and nutrients that the body is lacking in. For these people, intuitive eating would not be something that they could jump into straight away, and would have to be a goal for later on in the recovery process. Those without reliable hunger cues would need to count calories to ensure that they are eating enough (I wrote about calorie counting in recovery here), and also keep an eye on the types of foods that they are eating to make sure that they are getting enough of each food group.

Those with reliable hunger cues will find that they are able to move to intuitive eating sooner, although I would always suggest counting at first whilst you establish if you have reliable hunger cues or not (and I have a video on when to know when you are able to eat intuitively here). Those with reliable hunger cues may find themselves ravenously hungry, or may be hungry for the amount that they need day to day, and then find themselves absolutely starving most of the time. This is normal and expected and in recovery is called “extreme hunger” (I have a video on this here). This is something those in recovery often experience, but not always. Those with reliable hunger cues find that they are hungry for the amount of energy that their body needs each day.

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Some people in recovery go through periods of both reliable and unreliable hunger cues, and during this time it is best to keep counting calories and keeping an eye on what you are eating until you are receiving consistently reliable hunger cues.

For both those who have reliable and unreliable hunger cues it is important to make sure that you are eating all food groups, as they are all important for health. It is important to note for both those with reliable hunger cues and those with unreliable hunger cues that it is normal in recovery from restrictive eating disorders or dieting to crave foods that are high in energy, especially foods with a high fat, sugar, or carbohydrate content. This is because processed food can be one of the best things for recovery, especially during the initial stages. Foods high in energy  help to fill the calorie deficit and repair the extensive damage done through starvation, as well as providing energy for the day. Foods high in fat help with regaining your period, aid bowel movements, and most importantly, the brain is made of at least 60% fat which requires eating fat in order to heal and maintain its health. Fat is also most easily processed by the body, which is quite essential to your damaged digestive system. Usually in recovery people crave “junk” food because this is just what their bodies need, and that is okay. If you are eating far more carbs than any other food group, that is okay. If you are eating far more sugary foods than any other food groups, that is okay. What is not okay is if you are only responding to these cravings and not having any other food group. Responding to the cravings is really important, but it is also important that you don’t go without an entire food group. Some people find that whilst their bodies are busy craving foods high in energy, it can end up not sending signals for fruit and vegetables. It is quite common for those with eating disorders or even dieting to have issues with filling up on fruit and veggies, and for these people, cutting down and thinking about it less is the goal, but for others, they can find that in recovery they can have reliable hunger cues for the energy that their body needs, but do not have the cravings for all the food types that it needs. The body, in this way, is being reliable in letting you know exactly what it needs in order to become energy-balanced (by craving foods high in energy), but has made this a priority and is not giving the right signals in order for the body to get all the nutrients that it needs. So if you realise that you are going days without fruit or veggies, make sure to incorporate some into your diet. Don’t become rigid or fixed upon a certain number, but just make sure you are having some throughout your day. The same applies to any other food group that you might find yourself not eating through lack of cravings.

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Whilst many people crave “junk” food, you may also experience cravings for dairy, cereal, and meat/fish. You can have cravings for anything! You may also find that you have cravings for odd combinations of food, and that is perfectly normal too. Just respond to what your body is asking for.

If you are experiencing extreme hunger and/or having intense cravings for only one food group or particular type on food – don’t panic. Appetite settles down when the body is healthier to include cravings for a massive variety of foods: chocolate, milk, fruit, cereal, doughnuts, pizza, pasta, vegetables, fish, steak, cake….EVERYTHING. No foods should ever be off limits, and your body will start giving you more and more reliable hunger cues as your body gets healthier and healthier, until you are able to really connect with it and trust it. Throw out your magazines. Forget the media. Forget diet culture and societies unhealthy obsession with thinness. Trust your body and work with it. There is no wrong way to have a body (and please please please check out weight set point theory, and health at every size under my resources section).

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For some people, intuitive eating can be something that they start doing fairly early on in recovery from an eating disorder or dieting, but for others, it can take time for their bodies to adjust and be able to communicate correctly. Whichever is the case, intuitive eating is a fantastic goal to work towards, but it is important to recognise that it can take time, patience, and perseverance. I would always suggest it be the goal, and would never want anyone to have to return to listening to diet culture – it’s what got a lot of people into a terrible place emotionally and physically in the first place (particularly those recovering from dieting as eating disorders are nearly always a lot more complex . However, recovery is certainly not helped along by diet culture). Listening to your natural, biological, earth-given body is the best thing to do for your mental and physical health when it comes to eating. Not concepts created by society. And always know that food is not just about nurture and nourishment, but about pleasure and enjoyment too. Do what makes you happy and healthy, both physically and mentally. You deserve it.

 

Orthorexia Nervosa: The Invisible Eating Disorder

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Orthorexia Nervosa. Have you heard the term before? Many haven’t. “Orthorexia” is a word that is not yet an official eating disorder diagnosis, but is used to describe a particular set of eating disorder behaviours that are distinguishable from other eating disorders, although can be experienced in conjunction with other eating disorders (usually anorexia nervosa). It is also an eating disorder that is easily overlooked in a society obsessed with “healthy eating” and exercise.

Those suffering from orthorexia have an unhealthy obsession with healthy eating and healthy lifestyle, so much so that it becomes extremely rigid and restrictive in regards to food, and can also include compulsive and excessive exercise. Orthorexics can be obsessed with feeling “clean” or being “pure”, and generally fixate more on this than on body weight as a motivation for behaviours. Orthorexics can also feel morally superior for the choices that they make in regards to their lifestyle, and the way they view themselves becomes entangled with the way they live their lives and what they put into their bodies or do with them. Orthorexics can find that their diet becomes so restrictive in both calories and food variety that it can become extremely physically unhealthy as well as mentally. This can also be the case in regards to excessive exercise. Like other eating disorders, it will end up becoming a top priority for the sufferer, and they can end up isolated.

In a culture that celebrates weight loss, calorie and food group restriction, and exercise, it is easy to go unnoticed if you have an eating disorder at a “normal” weight, but even easier if you have orthorexia. In a society that focuses so much on health, those with orthorexia will more likely than not be congratulated for their “healthy” life choices, determination, perseverance, and motivation. Others may aspire to be like them because they appear to work so hard at being healthy, whilst in reality they are driven by a relentless and miserable force that has nothing to do with being healthy and more to do with being mentally ill. That mental illness will be driving that person into the ground both mentally and physically with its extreme rules and restrictions, and that may go unnoticed in amongst the admiration of others.

Eating disorders are terrifyingly common, let alone the phenomenal amount of people living with disordered eating (issues with food, weight, etc, that are not a mental illness but are a problem). Our preoccupation with a “healthy” lifestyle and our celebration of “healthy choices” is misplaced. Living a healthy lifestyle is great, but we are missing the bigger picture: so many people are utterly miserable trying to achieve goals that are usually more about being thin than being healthy, or are driven by guilt and shame about not being “healthy” enough. In trying so hard to be physically healthy, we are sacrificing mental health, which is just as important – if not more so. With our food/weight/exercise/health obsession, and the equation of “health” with morality, no wonder so many eating disorders go undetected. It is a culture for eating disorders to thrive in, and that horrifying truth is something that we need to recognise and address.

So could you recognise orthorexia? Do you think you may have it yourself? The Timberline Knolls website talks about orthorexia and how to recognise it particularly articulately, so I have put it below. If you want to read more information on it, just click the link above.

Orthorexia is the term for a condition that includes symptoms of obsessive behavior in pursuit of a healthy diet. Orthorexia sufferers often display signs and symptoms of anxiety disorders that frequently co-occur with anorexia nervosa or other eating disorders.

A person with orthorexia will be obsessed with defining and maintaining the perfect diet, rather than an ideal weight. She will fixate on eating foods that give her a feeling of being pure and healthy. An orthorexic may avoid numerous foods, including those made with:

  • Artificial colors, flavors or preservatives
  • Pesticides or genetic modification
  • Fat, sugar or salt
  • Animal or dairy products
  • Other ingredients considered to be unhealthy

Common behavior changes that may be signs of orthorexia may include:

  • Obsessive concern over the relationship between food choices and health concerns such as asthma, digestive problems, low mood, anxiety or allergies
  • Increasing avoidance of foods because of food allergies, without medical advice
  • Noticeable increase in consumption of supplements, herbal remedies or probiotics
  • Drastic reduction in opinions of acceptable food choices, such that the sufferer may eventually consume fewer than 10 foods
  • Irrational concern over food preparation techniques, especially washing of food or sterilization of utensils

Similar to a woman suffering with bulimia or anorexia, a woman with orthorexia may find that her food obsessions begin to hinder everyday activities. Her strict rules and beliefs about food may lead her to become socially isolated, and result in anxiety or panic attacks in extreme cases. Worsening emotional symptoms can indicate the disease may be progressing into a serious eating disorder:

  • Feelings of guilt when deviating from strict diet guidelines
  • Increase in amount of time spent thinking about food
  • Regular advance planning of meals for the next day
  • Feelings of satisfaction, esteem, or spiritual fulfilment from eating “healthy”
  • Thinking critical thoughts about others who do not adhere to rigorous diets
  • Fear that eating away from home will make it impossible to comply with diet
  • Distancing from friends or family members who do not share similar views about food
  • Avoiding eating food bought or prepared by others
  • Worsening depression, mood swings or anxiety

You can also read my article ‘Food Is Not A Moral Issue’ here.

 

MinnieMaud: Is It the Only Way to Recover from a Restrictive Eating Disorder? (Take Two)

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It has been over a year since I wrote my first article on this topic, and I am still somewhat inextricably linked to the MinnieMaud method of recovery, however much I try to disentangle myself from it. I thought I would talk about this topic again because my views have continued to change as I grow and develop as a person, and also learn new things in the recovery community. Being in remission has given me the motivation to celebrate my own recovery and give opinions and advice based upon my own journey, but it has also given me the ability to recognise that we all take different paths to get to a full recovery. Even the concept of “full recovery” in itself is individual for each person, and the goals we wish to reach can be quite different. Some people in recovery are not able to yet reach for a full recovery. Others take different routes to reach the same destination. What people define as “remission” or “full recovery” varies, and that’s okay. We are all allowed space to determine what it is that we believe, and what we want for ourselves. We are allowed space to express what we want for others, but we have to respect what people want for themselves over our own views of what would be best for them. The only decisions we can really make are for ourselves.

As I have progressed and developed in my remission, my advice has been less “Gwyneth Olwyn” (creator of MinnieMaud) and more personalised to my own individual views and experiences. In a nutshell, my views on MinnieMaud are that it is an invaluable recovery method for many people during the early to middle stages of recovery and can help inform the rest of the recovery process whilst you learn to navigate your own path leading into remission. Eventually you will find your own version of remission and start living your recovered life in the way that works for you. MinnieMaud can still be useful then, but your recovery/remission will now be tailored to you as an individual. I think that the black and white approach to information and advice is apt for the unwell; for the people who need firm, unflinching boundaries between them and their eating disorder (and boy, did that help me when I needed it). It gives permission to do the things that society forbids – things that profoundly help so many people in their recoveries (e.g. freedom around food, encouraging the idea that all food is good food, resting and repairing, breaking unhealthy relationships with exercise by total cessation of activity, eating enough, always responding to any hunger however much that means eating, accepting your body at any weight, shape, or size etc). It outright rejects any and all unhealthy societal views in order to promote a healthy relationship with food, exercise, and the body. Is Gwyneth Olwyn the only person to encourage all these viewpoints? No, not by a long shot. There are a huge amount of people in the recovery community, body positivity community, and health at every size community (all of which overlap quite frequently) that share and promote these views and give advice accordingly. However, Gwyneth Olwyn is, as far as I know, the only person who has taken these viewpoints and created a structured, research-informed recovery method for those with restrictive eating disorders. The fundamental difference that people see is that Olwyn has created a set of guidelines, and given these views a name; made them into a method of recovery. She has solidified a huge amount of people’s views into “rules for recovery”. Now this irks some people because they don’t like the black and white; they don’t like the “you need to/must do this in order to recover”, and I entirely understand that. As I spend more time in remission and grow and develop as a person and as a member of the ED recovery community, I have become aware that this way of thinking and dishing out advice becomes problematic especially as people come out of the initial stages of recovery and start to make their own way towards remission. People start coming out of the very necessary and standardised initial parts of recovery and start to develop personal goals and targets and outcomes and values and opinions and moral standpoints and….and and and. I could go on. I think that to reach remission there are fundamental aspects of recovery that need to happen – but again, these are my own individual views on what remission is – and those are:

  1. Regaining normalised and reliable hunger cues in order to eat intuitively and respond to the body’s request for energy, always.
  2.  Being able to eat any and all food without anxiety, fear, or guilt (seeing food as food, seeing it as nourishment, enjoyment, and just another part of life rather than immediately worrying about weight gain, compensation, exercise, or seeing certain foods as “bad” or “unhealthy” etc).
  3. Being able to eat when not hungry (for example, in social situations) without anxiety, fear, or guilt.
  4. Being able to eat without compensation.
  5. Building a healthy relationship with exercise (moving the body primarily for enjoyment not for burning calories or altering the body).
  6. Managing or resolving underlying issues that contributed to the cause of the eating disorder.
  7. Working towards body acceptance and acknowledging that your body’s natural weight is outside of your control and to obsessively focus on controlling it is to be disordered.
  8. Being able to manage stressful situations without lapsing,  and using healthy coping mechanisms in response to stress and anxiety or being able to pull yourself out of a lapse very quickly because you are perceptive about your behavioural reactions and then use healthy coping mechanisms.

Outside of that are a wealth of details within recovery that are different for every single person. For example, whilst I feel assured in giving out the advice that someone in recovery should not make drastic decisions around their diet (such as becoming vegan or vegetarian), when that person is in remission, I am unable to say whether that person would become triggered into relapse by making that choice. I have a fully recovered friend who has become vegan. I myself am now a pescatarian. But I have also known people who have made changes to their diet and spiralled back down into illness as the elimination of certain foods opened the door for the eating disorder to slip in through. For some people it triggers those restrictive thoughts, and for others, opens up new doors to try new foods. Since I have had to become gluten free for medical reasons, I have tried and discovered a wealth of new wonderful foods (although I do mourn my loss in the bread department), and find joy in doing so. Others might find this a slippery slope into restriction without the right mindset and support. Another example might be yoga. Yoga might help one person relax and fight anxiety, whereas for someone else it might be another form of burning calories or subscribing to an obsession with “health”. There are a million examples of things that affect different people in different ways in recovery, and I do think that MinnieMaud forgets this. Its rigid blanket statements and black and white style are appropriate for most people in the initial stages of recovery, and even for some further on, but are not so relevant to those moving towards their own individual destinations, and for those in remission itself.

I reference the site so frequently because many people that I talk to are in the initial stages of recovery, and I think that everyone, whatever stage they are at in their journey, could benefit from the views expressed there in regards to body positivity, health at every size, freedom around food, and a no bullshit approach to exercise. I think MinnieMaud is fantastic, but that doesn’t mean that I don’t think that it is flawed. Because the MinnieMaud site (Your Eatopia) informed so much of my recovery and started me off on my journey towards discovering body positivity and health at every size, I wrote a lot about it, and at first when my blog turned into an advice blog, I was regurgitating everything Olwyn said. Because of that, I have struggled to separate myself from it in the eyes of my audience. I have attempted to distance myself as being seen as a “minion of MinnieMaud” and be viewed instead as a standalone person who references MinnieMaud and its recommendations, but is not solely about MinnieMaud. Like The Fuck It Diet, I want MinnieMaud to just be another site that I reference – albeit it is the site I reference the most as it is so concise and informative and is the one site aimed so specifically at restrictive eating disorders and the recovery process. Hopefully one day, the association between myself and MinnieMaud won’t be so strong, and I will be able to promote the MinnieMaud method alongside my own indvidual views and that of many other people.

I advocate freedom around food, health at every size, the rejection of diet culture, moving your body in a mentally and physically healthy way in remission, body acceptance and positivity, self love, eating what you want when you want, personal growth and development, resolutions or management of toxic situations, relationships, internal beliefs, and/or experiences with the help of professional support, and building and living a full, rich life outside of your eating disorder. Does MinnieMaud advocate this too? Yes. But it is only one website amongst many that does so. Olwyn is one person amongst millions holding these beliefs. I am advocating all of them, not just MinnieMaud. I am advocating all of the incredible women and men fighting for these views to be the norm; for diet culture to be destroyed; for people of all weights, shapes, and sizes to be accepted as equally beautiful and equally potentially healthy; for a recovery from restrictive eating disorders not informed by our unhealthy, toxic societal views on food and exercise and weight. I advocate Caroline of The Fuck It Diet, Amelielee of LetsRecover, Bodyposipanda, Nourishandeat, and Goofy_ginger of Instagram, Harriet Brown of Brave Girl Eating, Ragen Chastain of Dances With Fat, Kate of FYourED, Michelle of The Fat Nutritionist, Sandy of Junk Food Science, Tetyana and Andrea of Science of Eating Disorders, Summer Innanen of Rebelle Radio, Rachel W. Cole of her website of that name, and those who run Big Fat Science. I also advocate Gwyneth Olwyn of Your Eatopia, and I agree with the method of recovery that she promotes, as I also agree with the way of eating that Caroline and Rachel W. Cole promote. They are slightly different, as are my own views, but we all agree on some basic fundamentals.

I am not here to say that MinnieMaud in and of itself is the only way to recover, but I do think that its basic principles are needed for a full recovery: basic principles that are supported in many other places, not just Your Eatopia. Am I here to say that MinnieMaud is the only method of recovery that works? No, but it does work. It may not work for everyone, but as recovery methods go, its success rate looks pretty good when you look at the multitude of anecdotal evidence. There is no one recovery method that works for everyone. Success rates for any treatment for eating disorders are mediocre at best, so let’s not slam a recovery method that so many people (including myself) have used successfully to help them in their journey, whether that is using it fully or taking bits from it that inform their own personal path to becoming well.

This will be the last time focusing solely on MinnieMaud, because I am not a spokesperson for that method of recovery. I am someone who used MinnieMaud to help my recovery. I am someone who agrees with its main principles, and I am someone who refers to it and uses information from it in order to try and help other people.

MinnieMaud is, in my opinion, a good way to recover. It is not the only way to recover. However, I believe that its underlying principles are needed for a full recovery. Those underlying principles are not exclusive to MinnieMaud. They are not the entirety of MinnieMaud. They are basic principles that underlie the method and are shared by many other people. MinnieMaud was built on top of those principles, and the nitty gritty details of MinnieMaud are not things that I think are always necessary to recovery – I think that is individual. I think that is as clear as I can make it.

If you have any questions, don’t hesitate to contact me through the contact section above, or leave a comment on this article.

Our Bodies and Us: The Disconnect.

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Our bodies are wonderfully constructed, complex, ingenious natural creations. They are fantastically clever, and work to keep us in the best of health. But we have been working against them. We have stopped listening to them. We have decided that they are the enemy and we have been treating them as such.

Our bodies are natural but our culture is man-made, and our culture has decided to wage war on women’s bodies (and to a lesser extent, men’s too). We are bombarded from every direction with the message that our bodies are not enough; that we are not enough; that we must mould and warp and change our bodies into something else to be satisfactory women. We are told that our bodies are not good enough as they were born to be; that they are not good enough in their natural forms. We are told that we must alter them, no matter what pain that means putting our minds and our bodies through. Low carb diets, low fat diets, high protein diets, Paleo diets, Atkins diet, cabbage soup diet (?!), 5:2 diet, raw till 4, weight watchers, slimming world, eating “clean” (because other foods must therefore be “dirty” right?)…it makes me want to scream. Instilling fear of sugar and fats and carbohydrates until there is nothing else that is “safe” to eat creates more and more anxiety around food and makes us try to restrict further and further. Equating certain foods with morality and superiority and “making the right choices” makes us turn on one another as if eating a certain way can make us better than someone else who chooses to eat differently. Food has become about being “good” and being “bad”. Food has become about being worthless or worthwhile. Food has become our means of exerting control over our bodies and our lives.

All the while, our bodies are being ignored. They give us a pang of hunger, and we focus on something else. We pass a bakery and saliva pools in our mouths, and we swallow and walk on. Our brains direct thoughts of food to our brains over and over, and we shut them down. Our bodies keep sending us signals, and we pretend that they are not there, and instead, we listen to the magazines and other media telling us to ignore our hunger…drink a glass of water instead…eat a celery stick. We have become so far removed from our bodies that we listen to an unnatural ideal rather than the natural being of our bodies. We are so disconnected that we read information on what we should do with our bodies in regards to food and exercise, instead of actually listening to them. Our society has made us so focused on our bodies: how they look, what we do with them, and what we put into them, that we are panicked by it, and in turn, it has become an obsession. Health; fitness; food…we follow other people’s advice on what to do with our bodies and pay no heed to what our bodies are communicating to us. We are out of touch with what we really need.

Breaking away from that is hard, but freeing. Your body will thank you, and so will your mind once you learn to reject dieting culture and embrace your natural weight, shape, and size. If you develop a healthy relationship with food and your body, eating intuitively will come effortless as you follow your hunger and cravings. Healing, and repairing that relationship between you and your body will allow you to reconnect and work with your body, rather than against it. This will, in time, lead you to naturally eating a balanced diet – this includes “junk” food too. We need to start viewing food as food, rather than something that is “good” or “bad”, “healthy” or “unhealthy”. Food is fuel, and food is also part of our enjoyment in life. It has no place alongside morality. None of it should be demonised. None of it should be feared. None of it should be restricted. When you stop listening to outside noise, and start turning your focus inwards, that is when you will be able to be your healthiest. When you get back in touch with your body and start to really listen to it, that’s when you will start getting healthy again, both mentally and physically. If you fancy a fruit salad, eat a fruit salad. If you fancy a doughnut, eat a doughnut. No rules, no restriction, no foods that are off limits, and no foods that you “should” or “should not” eat. Shut out our dieting culture and embrace your body’s signals.

As a side note, it’s important to understand that if you have been dieting or restricting, that your hunger may be powerful and insistent, and your cravings may be strong for the foods that you have restricted (and therefore have fear and anxiety around). This is normal. If you don’t give your body enough energy, it will have an energy deficit, and will need more energy than usual until it is energy-balanced again. If you restrict certain things, your body will want them more, as it is often low on carbs and/or sugars and/or fats, and “forbidden” foods will also always be the ones you want most. If you respond to your body and work with it by providing it with the energy that it is asking for and the foods it is craving, it will settle down. It will become energy-balanced, and it will not be lacking in any food types, and when you stop viewing certain foods as forbidden, it will not want them as much. When all food is available to you, you don’t feel the need to eat certain foods as if it is the last time you will ever eat them (which you may have felt before when you let yourself have a “cheat” (I shudder at this word) snack/meal/day). When your body is energy and nutrient balanced, your eating will be balanced. When you are lacking in something, your body will give you signals in the form of hunger or cravings.

Listen to your body. It is cleverer than you, and it certainly cleverer than dieting culture and the media. Listen to your body, and embrace it.