Tag Archives: eating disorder recovery

Exercise (pt 2): Exercise and Eating Disorders

exercise addiction

This is the second part to the article I wrote last time, which talked about exercise in general and the way that an unhealthy mindset around exercise has infiltrated our society as a whole.

Today I want to talk about exercise and eating disorders.

Like I spoke about two weeks ago, nearly everyone views exercise as something that is healthy, regardless of how it is used. During my recovery from my eating disorder, I told a friend about my compulsive exercise and about how I was trying to challenge it because I was doing x amount of exercise a week because I felt that I had to, and hadn’t been able to stop myself from doing it even when I didn’t want to. She genuinely replied with “Yeah but that’s fine because exercise is good!” Because we have such a warped view about exercise, many people don’t seem to understand how detrimental it is to those with eating disorders, especially when it doesn’t appear to be severe.

Some people with eating disorders push themselves to the extreme when it comes to exercise. Some people exercise for five hours a day, and some more. Some people never let themselves sit down – ever – except when sleeping (and I’ve even known someone to sleep standing up). It is easier for people without eating disorders to understand why this might be a problem, but when you are someone with an eating disorder who exercises in a way that people might perceive as inspiring and healthy; in a way that people might see as #goals; in a way that people aspire to, you may end up with congratulations rather than concern.

For those who have exercise addiction, you can’t just stop when you want to, or give yourself a day off (unless you already have a “scheduled” day/time, and then it must be that day/time and none other). You will miss social events if it coincides with your sessions. You will feel incredibly anxious before exercising, and after the exhilaration of finishing a workout has subsided, you will feel the dread of knowing that in less than 24 hours you will be repeating the same monotonous and exhausting work out. You will continue with your exercise routine however much you don’t want to do it, however tired you feel, or however sick you are. It is not enjoyment that drives someone with exercise addiction: it is the perceived need to do so.

As well as being mentally draining, compulsive exercise (also known an obligatory exercise or in extreme cases, anorexia athletica) can have a negative effect on the body. Firstly, by working out intensely every day, the body is being put under a lot of strain, and is not being given any time to recover, which is needed. Those addicted to exercise will work out even if they are ill or injured, which could have serious consequences to their health, including damage to tendons, ligaments, bones, cartilage, and joints. When injuries happen and are not given enough rest to heal, this can result in long-term damage. If the body is not getting the nutrition that it needs, muscle can be broken down for energy instead of building muscle. Girls and women could disrupt the balance of hormones in their bodies, which can change menstrual cycles and even lead to the absence of them altogether. It can also increase the risk of premature bone loss, which is known as osteoporosis. The most serious risk is the stress that excessively exercising can place on the heart, particularly when someone is also restricting their intake, or using self-induced vomiting to control their weight. Using diet pills or supplements can also increase the risk for heart complications. In worst case scenarios, restrictive eating disorders and compulsive exercise can result in death.

The reasons behind exercise addiction can be complicated when it comes to eating disorders. For many people it is an additional means of furthering and/or quickening weight loss, or it could be the main part of someone’s eating disorder, in order to get “fit” or muscular (anorexia athletica). It could be about control. It could be, like the rest of the eating disorder, a form of distraction from feeling or thinking certain things. It could be part of orthorexia (an obsession with eating “healthy” or “pure” foods and leading “healthy” or “pure” lifestyle). Athletes, dancers, wrestlers, gymnasts, and other people who are fixated with keeping in shape and keeping their weight down for their careers are also susceptible to developing exercise addiction.

Although it is not listed in the Diagnostic and Statistical Manual of Mental Disorders, exercise addiction is a serious and potentially life-threatening obsession, and needs to be taken extremely seriously. It is not just a strain on the body but a strain on the mind. It is absolutely exhausting, and completely miserable to experience. It can take up a huge amount of your life and a huge amount of your thoughts, and is extremely unhealthy for your physical and mental health. Whether it  is the main part of an eating disorder, a lesser part of an eating disorder, or a disorder on its own, compulsive exercise is serious. It is something that must be challenged and overcome as part of recovery from an eating disorder, and must be ceased until the unhealthy relationship with exercise is broken and remade into something healthy. Only in remission can someone make an informed and healthy decision about whether to restart exercise and how much/what to do in regards to moving their body. Even then, it’s a fine line.

I talk more about a healthy relationship with exercise in part 1.

If you think you may be developing/have developed an addiction to exercise, seek medical help from your GP.

Signs that you or someone you know may be suffering from compulsive exercise include (but are not limited to) the following:

  • Not enjoying exercise sessions, but feeling obligated to do them
  • Seeming (or being) anxious or guilty when missing even one workout
  • Not missing a single workout and possibly exercising twice as long if one is missed
  • Seeming (or being) constantly preoccupied with his or her (or your) weight and exercise routine
  • Not being able to sit still or relax because of worry that not enough calories are being burnt
  • A significant amount of weightloss
  • Increase in exercise after eating more
  • Not skipping a workout, even if tired, sick, or injured
  • Skipping seeing friends, or giving up activities/hobbies to make more time for exercise
  • Basing self-worth on the number of workouts completed and the effort put into training
  • Never being satisfied with his or her (or your) own physical achievements
  • Working out alone, isolated from others, or so that other people are not aware of how much exercise is being done
  • Following the same rigid exercise pattern.
  • Exercising for more than two hours daily, repeatedly

(sites used for reference and more information: 

http://www.brainphysics.com/exercise-addiction.php
http://addictions.about.com/od/lesserknownaddictions/a/exerciseadd.htm
http://kidshealth.org/parent/emotions/behavior/compulsive_exercise.html
http://en.wikipedia.org/wiki/Exercise_addiction )

Exercise (pt 1): Is it Part of Your Healthy Lifestyle, or Are You Waging War on Your Body?

personal-exercise

My first ever blog post was on the dangers of exercise addiction, but I wanted to reboot this topic and do it over in two parts, focusing more on exercise in recovery from an eating disorder (in part 2), as well as exercise in the general community (part 1 right here), and the effects it can have on both sets of people.

Exercise is something that those with eating disorders use and abuse to lose weight, change their bodies, and deal with negative thoughts and feelings in a negative and unhealthy way, but it is also something that has become a toxic part of many people’s lives in the community at large. It has become something that is unhealthy for many people who are engaging in it.

“Exercise…unhealthy?!” you gasp in disbelief, “How can something that is clearly part of a healthy lifestyle be a problem?”

The issue with exercise in our society now is the way people exercise. The issue is why people exercise. The issues are the mentality: the thoughts and feelings behind what is driving someone to exercise, and the outcome that they are looking for.

If you look around at the media, at health food blogs, at doctors recommendations, at magazines, books, and website articles, then you will see that women primarily, but also men too, are constantly being told that they should be exercising in order to lose weight or become toned, or in some way alter the way that their bodies look. I frequently see my friends updating their Facebook statuses letting us all know they have had an intense session at the gym, or tweeting about how they don’t want to go out for a run because it’s cold but that they need to. I see “healthy” lifestyles which include clean eating (eliminating all processed foods and extra additives from your diet, and only eating whole, unrefined foods) and regular exercise all over blogging sites. I can’t seem to avoid fitspo. Society has become obsessed with it.

There are people who genuinely enjoy the physical activities that they pursue as hobbies. There are people who don’t like the physical activities that they choose to do but feel that the results are worth it.  There are people who cannot stand to do the physical activity that they force themselves to do but feel like they have to do it because of whatever the driving force behind their exercise is – which is usually body hatred.

In my opinion, only the first of the three types of active people that I mentioned should be exercising. The others should cease exercise and heal their relationships with their bodies and themselves before resuming any physical activity. They should find physical activities that they genuinely enjoy that are primarily focused on having fun and/or socialising rather than changing the way their bodies look.

Don’t get me wrong, I am not condoning a lifestyle of sitting on the couch eating Chinese takeaways and playing videogames forever after (but if that’s what makes you happy, by all means, go for it! No judgements made), as I believe movement is part of a healthy lifestyle, but I do not think that anyone should be forcing themselves to do a workout that they don’t find any enjoyment in. I do not think that anyone should be wasting time engaging in activities that they do want to do purely because they are driven by a society telling them that their bodies are not good enough as they are and/or that they are lazy and unhealthy if they do not engage in x amount of physical activity doing certain types of exercise.

“I really don’t want to go the gym today, but I know I need to/have to/should,” is a common comment that I hear from colleagues, friends, and strangers, and this is a result of the insidious and toxic system that is diet culture. Nobody has an obligation to engage in physical activities that they don’t enjoy. Nobody should.  These days we see exercise as something we don’t want to do, but something that we have to do. Doctor’s orders. Exercise has become something we associate with gyms and aerobics and gruelling runs, which most people don’t really enjoy. We’ve lost touch of recreational activity: doing things that we enjoy that involves physical activity. The enjoyment part is primary, and the activity secondary.

Being active is great, but only when you have found something that you actually enjoy. This could just be leisurely strolls through the countryside, or hikes in the hills. This could be swimming with your kids, or challenging a friend to a few badminton games. This could be finding a team sport that makes your heart race and your grin wide. It could be practising mindfulness through yoga, or getting competitive with a colleague whilst playing squash. This could be once a week or once a day. Whatever makes you happy. Not whatever makes you lose weight, or whatever gives you abs. Not whatever gives you a tiny waist or bulging arm muscles. Not whatever burns the most calories. Whatever makes you happy.

Physical activity should be done only if it adding to your life, not something that comes at a cost. Not something that you dread. Not something that you have to make yourself do. Exercise is something that is pushed on us as categorically healthy, but it’s just not when it comes at the expense of someone’s mental or physical health, and it’s not when the drive behind it is body dissatisfaction, or downright body hatred. On the extreme end of the spectrum, exercise can also turn into a dangerous addiction, and in the case where exercise becomes the focus of someone’s life it needs to be taken very seriously, and this is something that I will talk about in my next article in the coming weeks (part 2).

If you are exercising not because you want to, but because you feel that you should, or have to, then I would highly suggest that you take time out, stop the exercise that you have been engaging in, and take the time to evaluate if what you are doing is actually benefiting you. Assess your reasons for exercising, and start building a positive and healthy relationship between you and your body. Because you need it, and you deserve it. Your body is perfect just as it is. Learn to love it, not to wage war on it. Then find movement in your life that makes you smile. Find movement in your life that you look forward to. Find movement that brings you positivity, and never expend energy in the name of diet culture ever again. You are beautiful, and this is what you deserve.

 

Counting Calories and Recovery

numbers

It seems like something that would be counter-productive to suggest, but counting calories is a really important part of recovery – especially during the initial stages. Counting calories is very likely a large part of you or your child’s (or partner’s/sibling’s/friend’s et) eating disorder, so it can seem like madness to say ‘continue doing this’, but hear me out.

Whilst counting calories was used as a way to restrict, it now needs to be used as a way to heal. So we are turning around a negative habit and using it to make sure that the person recovering gets enough energy into their body. Getting enough energy is essential for recovery, and it is likely to be something that proves impossible to do unless someone is counting the calories of the person recovering.

For most people it will be you; the recoverer, that counts. Sometimes it will be parents or partners. Either way, those calories need to be counted because after an eating disorder, people have unreliable hunger cues. The body has gone so long without food that it has repressed the signals, and so it can take a long time for reliable hunger cues to return again and for the body to learn to expect food and give signs as to when it needs it. This can mean that eating can feel like a chore to some. It could mean that you will have no appetite and feel too full, but it is important to ensure that you continue eating adequately regardless. It could mean that you feel really hungry sometimes, but other times have no appetite. Respond to any hunger or cravings that you have, and continue eating enough even when you don’t have an appetite. You may have reliable hunger cues straight away, which would be great and would lead you to eat what you need to eat in order to recover. Responding to mental hunger is also really important. Mental hunger is just another signal from the brain to tell you that you are hungry. All signals come from the brain, and it is crucial to listen. So if you don’t feel the physical signs of hunger but are wanting or craving food, then it is necessary to listen to that signal and respond to it – always.

So how are you going to count calories? I would advise staying away from apps such as MyFitnessPal, as they can be incredibly triggering due to the fact that they try to suggest restrictive amounts to eat, and they are an app focused on weight loss. You could just use a ‘notes’ app and count it up yourself and keep the number on record for the day there, or you could write ‘500’ as many times as adds up to how much you need to eat on a sheet of paper or on a notes app on your phone, and just cross it off every time you reach 500 calories. This can mean that you know you are getting closer to your goal but don’t need to count the number if not thinking of the number helps. If your parents or partner are very involved in your recovery, they could do the counting for you if this is possible and more beneficial for your recovery.

Calorie counting can be triggering for many people, but the alternative of under-eating is much more harmful. Under-eating – which many people in recovery will do due to unreliable hunger cues if they do not count calories or have them counted for them – will mean that the body cannot heal. Mental and physical recovery are interconnected, so if the body is not getting enough energy, this will also impact on mental recovery also. Under-eating means that neither mental nor physical recovery will be able to take place, so counting calories until your hunger is reliable is a necessity. This is one habit that will have to be saved until a bit later to break – which is okay, because there are many habits and thought processes to manage, change, and break, and there has to be something that is saved until last (or later on)!

So you’ve been counting calories for a while and making sure you that you get the energy that your body needs. How do you know when you can stop counting and start going by hunger? When you start feeling like your hunger is happening in a reliable way which is consistent with when you should be eating and how much you should be eating, you can start thinking about testing out that hunger to make sure that it is naturally bringing you to the amount you need. A good way to test how reliable your hunger is, is to write out everything you eat for a week (or two weeks), and then count it up for each day, add it all up to get the total amount, and divide it by seven (or fourteen). The average figure should come to around the amount that is suggested as the minimum for you to eat during your recovery (this is around the amount that you should need forever). If it is three hundred to four hundred calories below that total, then I would really suggest that you continue to count calories as your hunger signals are likely to be unreliable. Most people will naturally and intuitively eat the amount recommended for them, or close to it, as this is the amount that an energy-balanced body needs each and every day. Some people do have hunger that is below or above the average (for example, someone who is expected to need 3000 calories for their age, gender, height, and activity levels could find that they naturally eat 2400, or 3600), and that is absolutely okay. However, if you are eating more than three hundred to four hundred less than what is recommended as adequate, it is more than likely that it is your hunger cues that are unreliable and you still have a little way to go before they are back to normal. If, say, 2400 calories is your normal hunger, eating 3000 for while longer will not have a negative effect on your recovery process, and will not have an impact on your weight. Your body will adapt to deal with the excess energy by putting it to good use (e.g. to continue repairing your body) or the metabolism will speed up to burn it off. (As a side note, when you are adding up your calories for those tester seven days, if one day has a really low amount, and another a higher amount, for example, 1000 calories one day and 4500 the next, this is a sign of unreliable hunger cues, even if the average does come to around the amount suggested for you. As a second side note, if you are consistently eating well above and beyond the minimum you require for recovery, your hunger cues are working and you are experiencing extreme hunger or higher energy needs still, which is totally normal for recovery).

So let’s say your hunger cues seemed reliable, and testing this out has shown that they are, now what? You can start trying to eat intuitively, but you will need to keep reassessing yourself to make sure your eating disorder is not sneaking in and manipulating the situation. It is important that you eat what you want, when you want, and don’t let the anxiety of stopping calorie counting come out in other ways, such as restricting certain foods types or resisting eating something you want because you are worried you are eating more now you have stopped counting. It is going to make you feel more out of control, but it is important to continue onwards, and not use any other behaviours.

But how do you go about stopping counting calories? Calorie counting is a hard habit to break. It can become so ingrained in you that it can happen even without consciously thinking. There will be different things that work for different people, but here is a list I put together with some suggestions about how to stop counting:

  1. Get yourself and your family to put labels over the calorie amounts on packets etc. This can deter you from looking and also remind you when out of habit you try to check that your goal is to not look and not to count.
  2. Get your family to serve you at dinner time, to challenge skewed perceptions of portion sizes, and to learn to relinquish control over amounts.
  3. Stop measuring foods or liquids.
  4. Eat intuitively for one day (or even one meal). In a week or so, try doing it for two days (or meals). Work your way up until you can ditch the habit altogether.
  5. Visit cafes, restaurants, cinemas, and other places that are uncaloried to get you used to eating meals where you don’t know the calories to face that anxiety and start to overcome it. You can then start trying to do this at home and challenging yourself there.
  6. Listen to your body and its signals (this is also something you should start doing as soon as you get into recovery, even when you are counting calories). Follow your body and tune in to what it is telling you, rather than going by calories you’ve already eaten today or any other calorie “rules” you are sticking by. Start learning to listen to mental and physical hunger, and also learn that you can also eat when you are not hungry if you fancy it.

There are only six suggestions here, and there will be countless other things that can help. If you have any tips that helped you or someone you know, write them in the comments below so that others can benefit from it too!

Counting calories and not counting calories are both big parts of the recovery process, and both relevant at different stages in your journey. Again, make sure that you are not using compensatory behaviours when you start trying to eat intuitively and stop counting calories, such as eating smaller portions, cutting out calorie dense foods, or not drinking liquid calories, out of anxiety. Learning to eat intuitively without compensating due to anxiety is a big part of recovery. You need to learn to eat what you want, when you want, without letting your ED get on the stage with you. Make sure it is not running the show, or even making compromises with you. It doesn’t have a place in the life that you are creating for yourself. This life is yours, and yours only.

Celebrating Three Years Since Choosing Recovery

3 years 5

TRIGGER WARNING – this post shows images of my body during my eating disorder, as well as images of my recovered body*. Please do not look at this article if these are images that are likely to trigger you.

In the last three years (and a bit), I have come further than I ever thought I would. Just over three years ago I was a suicidal, starved, insane mess of a human being. I was throwing glasses across the room in anger because my partner at the time had turned around my horrible self-reminders not to eat that I had plastered around the house, and had instead written lovely messages on the backs on them. Just over three years ago I was screaming at him because he put a dash of milk in the scrambled eggs. I had intense urges to eat food off the ground because my body was so hungry. Each day was all about filling out the time until I was “allowed” my next measly portion of food. My life revolved around the number on the scales. Everything I did was for that number to decrease. I walked around with my brain feeling foggy, my body weak, and put it through intense and draining physical exercise anyway. I was a walking corpse. I wasn’t alive. I was merely existing.

It took me a couple of months of uhmming and aahing to really choose recovery. I was uncertain. I was scared. I was in denial about having to gain weight in order to be healthy and happy. But eventually I got there. Gradually I solidified my decision, and I although I had ups and downs (understatement of the year), I never really looked back. I had many, many, many moments where I said to myself “I’m done! I’m going to relapse!” but I would cry it out and keep on going anyway.

tumblr_mztsy5ii2G1qcy3b7o1_500

A year into my recovery, I made the photo above. If you know me and my blog, you’ve probably seen it before (and I posted it on another post on this website too). The hollow, unfocused, red-ringed eyes had been replaced by bright, shiny ones. My grey, matte skin now glowed. My smile didn’t seem stretched, and the happiness showed upon my whole face, rather than looking tired and empty. I love the comparisons. It always shocks me, and it always reminds me how terrible I looked then and how healthy I look now. It always reminds me of how far I have come.

3 years 3

My hair is shiny and soft now, not falling out, and not desert dry. After two or so years in recovery, it suddenly grew really fast and is now really long and I love it. I now engage in the world: my senses aren’t dulled due to starvation, and I take in what is around me. I am fully present when conversing with friends and thoughts of my body don’t cross my mind when I am with them, when before I was utterly distracted by how my body looked in that moment. I feel strong, rather than feeling like I am going to pass out at any moment. I feel like I am really in the world, rather than miserable and alone in my own harrowing personal nightmare.
dani and sarah
During recovery, my personality that had been smothered by my eating disorder emerged, stronger than before. During the first two years of my two and a half years in recovery, I grew more than I had ever done in my life. I established who I was and what was important to me. I developed hobbies and interests that I had never had before, whilst regaining my love of old ones. With help from feminism and the body positivity movement, I felt empowered and impassioned. I found my drive and my purpose, and I established my worth as a person inside my own head. In simple words, I now feel solid. I feel strong.

3 years 2

My eating disorder starved me. I lost myself, not just my weight. My relationship disintegrated. I couldn’t concentrate around my friends (although, unlike a lot of others with eating disorders, I managed to maintain my friendships). I didn’t do anything without thinking about losing weight. Recovery gave me back my sanity, and my ability to function within the world and within relationships. I regained weight, and I regained myself. Unfortunately, my relationship came to an end six months into recovery, but I now know I will be able to have a healthy, happy relationships without my eating disorder destroying me, and in turn, destroying my relationship.

3 years 4

For me, sleep was first an escape from the pain of the life I was living when my eating disorder was active, but after a while, as my body became more and more starved, it became impossible to sleep. I would be thinking over and over about my “meal plan” for the next day, and would find it really difficult to fall asleep. When I did, it was food that I dreamed of – that, or gaining weight – and I would wake up in fits of anxiety, or stroking my hipbones; a bizarre habit that occurred in the worst period of my eating disorder. One of my favourite things about being healthy is being able to sleep properly. Resting is so important to me now, and such a relief.

3 years 13

Giving up exercise was something that I really struggled with during recovery, and was something that I relapsed with two or three times. Once I’d started eating and my survival instincts took over, restriction wasn’t something I wanted to engage in again (even though my eating disorder kicked and screamed against that thought), but exercise was something I could do without having to feel hungry all of the time but could still burn calories and feel “healthy”. Even though my weight didn’t change whether I exercised or not, I still had the severe compulsion to work out because I felt so anxious and guilty if I did not. But even though I didn’t have to deal with being hungry all the time, exercise made me so utterly exhausted that I could not even sit up in bed with my laptop on some days. I had to lie down instead. Eventually, I was able to cease exercise until I was healthy enough both mentally and physically to be able to do what I now like to call “recreational activity”. I walk a fine line in choosing to be active in remission, but I have my “red”, “amber”, and “green” types of exercise so I know where I am with it, and I’m constantly evaluating how I feel and how much I’m doing. I see the activity I do as enjoyment rather than doing it for my body – the health benefits are secondary for me. Having fun comes first and foremost in the choice to do physical activity, and I think it should be that way for everyone.

bralet 3

The picture above is me today. I am now over 8 months into remission (full recovery). I feel strong and healthy and confident. I have bad and good days with my body, but I more or less accept it for what it is now. Today was a good day, and I feel powerful as a person. I’m about to have a delicious dinner with my family, on holiday, with a view of the sea. This evening I am going to a bar to have cocktails with my brother. And it won’t even matter to me how many calories any of what I have consumed today has.

I am enjoying being me.
3 years 6

*The reason I have included photographs of myself when I was ill is because for me, it’s an amazing transformation. Recovery should be equally about mental and physical recovery – you can’t have one without the other – and I wanted to show both, because for me, my experience with weight gain was a huge part of my recovery. I can only show my physical recovery through photographs, and my mental recovery through expressing it in writing. This article is not about the process but about the comparison as to how I was then to how I am now. I also wanted to show that it is possible to gain a significant amount of weight and look very different and be able to accept that. My body and the changes it made throughout recovery were hugely significant to me, so to be able to show that comparison and say that I made those changes to my body and I got through all the self-loathing, guilt, and anxiety, and found my way to accepting my body as how it looks now is incredibly important to my journey. Some people may not agree with my choice to include photographs, but that is why there is a trigger warning. That was my body, and this was my journey, and I want to express it in the way that is significant to me.