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Men with Eating Disorders: Suffering in Silence

men and eating disorders

Eating disorders amongst men: we are not talking about it enough. We are not doing enough to end the stigma against eating disorders in general, let alone for the male population that suffer with them. We need to raise awareness. We need to be having conversations about it. We need to be educating the general public about it. We need men on TV, in magazines, on the internet, on every social media platform, to speak out about their struggles and help others do the same so that they can get the help and the support that they need. The thing is, many men don’t feel comfortable talking about it with their closest friends and family members, let alone the public. In fact, they aren’t just uncomfortable: they are terrified, and this is because of the incredibly detrimental stigma wrapped around eating disorders that is magnified tenfold when it comes to the male population. And when people don’t get help, there’s an increased risk of them dying from complications due to their eating disorders.

Out of those with eating disorders, it is reported around 10% of sufferers are male, although these statistics are unreliable due to the fact that so many men do not come forward for treatment and so are not recorded as part of the statistics. A recent study on a large university campus found that the female-to-male ratio of positive screens for eating disorder symptoms was 3-to-1 (you can read more statistics with references in my article Men Get Eating Disorders Too).

For this article, I talked to two men with eating disorders, a friend of mine, Leo*, who is a man in his mid-twenties from the UK, and Joshua*, an Italian-American, who got in touch with me via this website to talk about his experiences with his eating disorder and the stigma surrounding men with eating disorders.

Leo talked to me about how his eating disorder affects him in day-to-day life, and about the one and only time he sought help from a professional.

“I wake up every morning and the first thing I do is check the mirror and look at myself and think I’m fat. I will do it again after a shower and again once I’m dressed. I will do this throughout the day while at work if I go to the toilet as well. I try not to eat to much because in the back of my head is someone saying you’re fat, you’re fat, don’t do it. People at work have joked about me being fat, and I cannot get rid of them saying it over and over again in my head. I want to be perfect, I want to feel normal, and it probably started with the bullying at school and has always sat with me. I went to the doctors and explained that I didn’t feel normal and I hated eating food and I wanted to make myself sick and all I got was the doctor telling me that I need to eat to be healthy and we need food to survive, and that was pretty much it.”

Leo experienced disordered eating for three years, before developing a full blown eating disorder which he has now suffered with for seven years. He struggles with restriction, self-induced vomiting, and compulsive exercise. As you read, when he opened up about it to a doctor, he was met with dismissal. After describing his fear of weight gain, and sustained body hatred, his doctor chose not to explore this further and just told him to eat. I asked him about whether he would consider going back again to see if his experience could be different if he saw another doctor.

“I don’t go back to the doctors because it is embarrassing. I’m a guy and I have to not show weakness. I tried to cry for help and no one cared and so I shut all my emotion off towards it.”

Unfortunately, this is all too common an experience for men, and because of these negative experiences, men don’t seek help in the first place, or don’t go back again after being met with invalidation. Doctors are reportedly less likely to make a diagnosis of eating disorders in males than females (again, you can read my article “Men Get Eating Disorders Too” for references and more information). Not only is there limited training in eating disorders for medical professionals, but the stereotype of eating disorders being an illness exclusively suffered by white, young, females still lingers, and professionals are not exempt from absorbing the myths and stigma that surround eating disorders. Coupled with the damaging pressures from society telling men what they apparently should be like, people seem to have a really hard time accepting that men can suffer from such a debilitating illness as an eating disorder. These societal pressures, which include not showing emotion (or not too much, whatever that means), not crying, not needing help or support, are aspects of being a woman, and they are also supposedly aspects of being weak (because, just in case you are unaware of this entirely ludicrous concept, in our patriarchal society, being like a woman – and therefore being a woman – means that you are weak). On top of that, eating disorders are seen by some as obsessional vanity, whereas they run much deeper than that, and can stem from a variety of things (bullying, abuse of any kind, sense of worthlessness, deep insecurity, trauma, to name a tiny proportion of triggers). They are also a biological illness with genetic links. Your genetics play a part in determining whether you are someone who will develop an eating disorder or not. Those who understand eating disorders already know that developing one is not a choice, but this provides further and solid evidence for those who may not be able to fully comprehend the fact that there is no choice when it comes to mental illness. Still, so many people are still ignorant about mental health. Leo says,

“People look at it as a female disorder. I have mentioned it in conversation with friends and family, and I always get the same opinion – that it’s a woman’s disorder because they are weak or have issues because of how society sees them.”

Leo feels like he can’t talk to anyone about his eating disorder, because they won’t understand. He is terrified of the reaction that he could get.

“I can’t talk to people because they won’t understand. They won’t understand waking up every day feeling the way I do about myself and how I want to fit in and for people not to say I’m fat or chubby. I can’t talk to them or even want to talk to them because my step-dad, my brother-in-law, and I are always in competition in everything we do and I wouldn’t let them know I am weak. I don’t know how they would react. They will see it as a weakness and will think less of me. Even my mum wouldn’t understand.”

I ask if he thinks his mum would view him as weak. “I’m not sure, but I don’t want to risk it.” The concept of men (and women) with eating disorders being weak is so persuasive that Leo sees his own eating disorders as a weakness in him, but says that he doesn’t make the same judgement about anyone else.

Another issue we have to look at is the “ideal” male body that our society has created. Women face a huge amount of pressure to look a certain way thanks to our society, our diet culture, and the media continuously shaming women, telling us to lose weight, giving us diet tips, banging on about “health” 24/7, and showing us a disproportionate amount of slim, beautiful women who have been photoshopped to the nth degree, but whilst we do receive the majority of this pressure, we forget that there’s so much pressure going around that there’s plenty left over for the guys too. Men are being exposed to an increasing amount of images and messages pertaining to what a man “should” look like, and this is extremely harmful. Leo has been affected by this.

“Having 0% body fat and all the muscle in the world is the only way to fit in society for men. Women are seen as having to be skinny but men have to be both skinny and muscular.”

Whilst this is not a reality, and in general only men who are fat or very thin experience stigma around weight, the message has become so strong from the media that for some men, this is how they feel – that they and their bodies will not be accepted unless they look a certain way. The expectations that this is driving some men to have for themselves are unrealistic and unhealthy, and is having a dangerous impact on the mental and physical health of men.

Eating disorders can also be harder to spot in some men because it is more likely for women to have dramatic weight loss, whereas in men their eating disorders can expressed through “bulking up” and hitting the gym, which is not seen as particularly suspect in a society so keen on advocating exercise and showing male body “ideals” as lean and muscular. It is important to note that if an individual is taking performance-enhancing supplements in their attempt to become more muscular and then engages in weight lifting, they are at increased risk of suffering a heart attack or stroke (this paragraph has been taken from my article “Men Get Eating Disorders Too”).

Joshua also talked to me about his experience with an eating disorder.

“My situation largely stems from my cultural love affair with food and how the outside world placed such an unnecessary stigma on what are “good” or “bad” modes of eating. I am an Italian-American, and as such, our lifestyle revolves heavily on cooking and family gatherings that centre on delicious dishes. It is a tradition and rite of passage to learn how to cook for many of us. This is an overwhelmingly positive facet of our heritage, but the media’s obsession with “thin” and “perfection” have demonized any sort of fascination with food beyond what they deem “healthy or fit.” Admittedly, I was heavy as a child and into my teen years – but with changes in my daily lifestyle and just growing, I evened out to what was my normal weight (which was apparently still slightly “larger” than the projected ideal). I still enjoyed any type of food that I wanted and never did I have to restrict. Naturally, as I got older, I became interested in finding a meaningful relationship with a girl. This was when the pressure of having to achieve that outrageous image of “true masculinity” began to weigh heavily on my mind, and my interactions with women in my age group reinforced these damaging gender stereotypes.”

Joshua was also influenced by the media.

“The problem is that “having abs” and looking like an actor/model is so much more than losing weight – it is about obsession to the point of illness.”

Joshua was shamed for his appearance when he became very ill during his eating disorder.

“Ironically, I never did achieve the appearance I aspired to even when I was dangerously skinny. I merely became an emaciated mess, which ended up working against me as I was told it “feminized” my looks and made many girls lose interest.”

Although no one should ever reach any weight, shape, or size by unhealthy means, this shows again the idea of an “ideal” body shape and size for men that has pervaded our society. Whilst no one is naturally emaciated, many men are naturally slim and can feel ashamed of being so. In fact, within a couple of weeks of being with one of my partners, he asked me, “Is my body okay? Am I too skinny?” because he was naturally slim. I had never even considered that this might be an insecurity of his, but it is more common than we think. Insecurity is rife amongst both men and women, and whilst this is damaging in itself, this can also contribute towards the development of eating disorders, which are severe and life-threatening. Anorexia has the highest mortality rate of any mental illness, and other restrictive eating disorders follow close behind.

“I find it so difficult to explain to anyone I meet (especially potential dates/prospects) that I am trying to heal from this battle. It is such a strange position to be put in – knowing that double standard of men not expecting to be concerned with weight or appearance (to be outwardly cavalier/macho) but still having to hide their true feelings when exercising themselves into oblivion for muscles/being defined. Gender roles and expectations for men are just as serious [as they are for women] – yet they fly under the radar as something that doesn’t happen and are laughed at by those from older generations.”

These myths, stereotypes, and stigmas need to become a thing of the past. We need to be talking about eating disorders more in general, but we also need to start prioritising the inclusion of men in every conversation that we have about it. We need people to stand up and talk about their experiences, but this should never have to be their responsibility in the first place. We need to educate ourselves and each other about the realities of eating disorders and how they affect men as well as women. We need to dispel the untruths and we need to be more proactive in challenging hyper-masculinity in our society. We need to help our men, and we need to help them to ask for support. If we don’t, we are going to lose them. If you are someone who looks down on men with eating disorders; if you are someone who sees them as weak, put that aside now, and take the time to research eating disorders. Keeping your mind shut to their suffering is costing them their health, their happiness, and sometimes even their lives. These are your sons, your brothers, your husbands, your friends. Each minute we continue to treat our men with eating disorders as weak; each minute we continue to dismiss them, we put their lives in danger.

*Names have been changed for confidentiality

Digestive Distress in Eating Disorder Recovery

tummy troubles 3

So you’ve started recovery from a restrictive eating disorder, and suddenly you’re experiencing tummy troubles: troubles you may or may not have been expecting. I know that when I started recovery, I was unprepared for the physical symptoms and did not attribute some of them to recovery process. I wish I’d known more: my mum and I were baffled when I started sweating so profusely at night that I was soaking the sheets through, and I thought I had Chronic Fatigue Syndrome at one point when I was unable to even sit up in bed I was so tired. Both of these are normal recovery symptoms (sweating lots indicates your metabolism speeding up, and exhaustion is your body telling you to rest and repair).

The first set of symptoms to normally occur, however, are those related to your digestive system: gas, bloating, constipation, diarrhoea, acid reflux, indigestion, partly digested food, abdominal pain, and having very frequent bowel movements. These symptoms are not fun, and they are certainly not comfortable. However, recovery is about persistence.

tummy troubles 2

Restriction has a huge affect on the body, and with the digestive system, if it the body isn’t processing food regularly and consistently, it will stop wasting energy on working so efficiently. The digestive system slows down: a healthy person’s digestion rate is about 1.5 hours, whereas someone who has been starving themselves can have a digestion rate of 4 or 5 hours. This means that when you start to nourish your body with adequate and consistent energy, the digestive system will need a while to catch up. During the beginning of your recovery, because your digestive system will be working slower, food will sit in the stomach or bowel longer than it should do, which can result in abdominal distension, gas, and constipation. Or the body can go I’VE FORGOTTEN HOW TO PROCESS THAT, which can result in diarrhoea.

Restriction also can result in critical bacteria in the gut being reduced, and digestive enzyme levels being not as they should be, which also contributes towards digestive issues.

Wastage of muscles in the abdominal area can also cause distension as the muscles are not strong enough to hold things in more firmly when food is eaten. Do remember though that your stomach will distend slightly throughout the day naturally – the more food, the more your stomach will distend, and this normal and healthy. Those in recovery though will often find that the bloating and distension is far more extreme than that of a healthy person -and that is normal for the recovery process. Remember that your stomach has most likely shrunken during starvation, and will need to be stretched back to a normal size with refeeding. This is not going to be a great feeling, and it is likely to cause pain and tenderness.

The other thing to talk about is IBS and food sensitivities. During your eating disorder, your body can become unused to processing certain foods, for example, carbohydrates could be one. Dairy products could be another. This could lead you to think that you have a gluten or lactose intolerance if in recovery you start to reintroduce foods like bread, pasta, biscuits, cakes, and pastries, and/or ice cream, cheese, chocolate, and milk back into your diet and you get adverse digestive effects. However, this is generally not the case. If your body has become unused to processing foods that you have restricted for a long time, it is logical that it will now have to work up a tolerance again (like babies have to). It does not mean that you will be permanently intolerant. Abstaining from these foods that you are sensitive to will only mean that the body never gets used to processing it again. Refeeding and reintroducing these foods slowly into your diet – with the help of a doctor if the results are severe – will help your body develop a tolerance to them again and heal the gut. The same is true of IBS. Your doctor may have diagnosed you with IBS if tests for other conditions came back negative. Most of the time, sensitivities and IBS are resolved with refeeding, so give it time. Recovery requires patience and perseverance, so bear with the discomfort and keep on going. If after years, certain symptoms have not resolved themselves, then it is time to look for other causes, but this is fairly uncommon. Obviously if you have diagnosed food allergies or diseases/conditions such as Celiac disease, Crohn’s or ulcerative colitis, neuropathy disease, or have any obstruction in the GI tract, or have any other diagnosed medical condition that would be dangerous and cause damage to you if you were to increase certain foods/types of foods into your diet, then the paragraph above does not apply to you.

So, onto gas. This is probably the most awkward of the recovery symptoms. Smelly gas; loud gas; persistent gas; gas that wakes both you and your partner up with a start when you trump in the night (yes, that happened to me). It can feel embarrassing, but it’s one of the most common symptoms in recovery. If it happens in front of someone (which it probably will) just giggle about it. It may even help to pre-warn them if you are happy to let that person know that you are in recovery from a restrictive eating disorder. It means that they will be expecting it and you can laugh about it (which you can do even if it is a surprise). Everyone farts- you’re just going to be letting off wind a hell of a lot more than the average person for a while.

Frequent bowel movements are also normal. This can be a sign of your digestive system speeding up. I went to the toilet to poop up to seven times in a day for a while (yup, really). If your bowel movements are loose, this could be the I’VE FORGOTTEN HOW TO PROCESS THAT from above.

It is important to continue to eat, even when it is the last thing that you want to do. If you are experiencing a lot of pain, then it is okay to give yourself a break and eat when it feels more tolerable, but discomfort and slight pain is normal and it is important to eat adequately and consistently. However, if you are worried about any symptoms that you are experiencing, please see a doctor to determine if there is anything other than the normal recovery process going on in your body.

So how do you deal with these recovery symptoms?

tummy troubles

Firstly, if you are experiencing constipation, eating fats can help move things along. Getting some fibre never goes amiss to prevent it from happening, but this is recovery, so doing healthy people things won’t necessarily work. Warm water is also extremely helpful for constipation – I’d never heard of it before but it has saved me a couple of times. If your stomach is not feeling so great, herbal teas can help settle it, and a hot water bottle can help ease pain or discomfort. For acid reflux and indigestion, there are over the counter medications that you could use, or you can visit your doctor for other options.

I know it sucks, but don’t give up – these symptoms do not last forever. Be patient, and stay on course. Keep moving forwards. As Churchill once said “If you’re going through hell, keep going.” You will come out the other side.

New Year’s Resolutions vs Eating Disorder Recovery

Happy-New-Year-Banner-2016-15

So New Year’s Eve has come and gone, and people are scribbling their new year’s resolutions all over social media and bringing them up in conversation. And if truth be told, it’s boring. It’s boring and it’s pointless, because most people jump simultaneously on the resolutions and diet culture band wagon and publicise their diet/weightloss/health/exercise #goals for 2016, which predictably (and thankfully) are forgotten about a month or so into the year.

For some people, it’s not just boring, it’s anxiety-provoking, and those people are those recovering from a restrictive eating disorder. After knuckling down and recognising and accepting that weight gain is part of the process, as is eating much more, ceasing exercise during recovery and cutting it down in general for life, and eating and regaining a healthy relationship with “fear foods” which generally consist of high fat, high carb, or high sugar foods/food groups, they then have to watch everyone pledge to lose weight, exercise more, and cut down on “unhealthy” foods.

If you are one of those people, it’s going to be hard seeing and hearing about all these new years resolutions that trigger negative thoughts and emotions, and tempt you to engage in the same behaviours that for most would end in the cessation of them, but for you would end in the spiral back down to misery and sickness, and could end in death. It could be an obvious impulse to just say “fuck it” and relapse, or it could come under the manipulative guise of “health” – that eating disorder voice whispering in your ear that going paleo, cutting down on carbs, or hitting the gym would not be a behaviour but just a way to get healthier (Nope. It’s a behaviour. It would be many steps backwards and the path to full relapse). If you are experiencing any of the above difficulties, you need to remember to focus on yourself. Other people’s behaviours should not impact on your own. You know where it would lead you, and it is important to make it your utmost priority to do what is best for you, your recovery, your happiness, and your health. Don’t allow other people’s insecurities and anxieties about their weight and shape influence your own actions. Instead, empathise with them. Know that they are not feeling happy with themselves and hope for their sake that they find a way to accept their bodies as they are naturally and celebrate themselves as beautiful people with beautiful bodies.

Remove toxic relationships or negative people from your life if you are finding a certain person consistently triggering. Unfollow people on social media who are likely to post/continue posting about weightloss, dieting, exercising, or anything else that triggers you as an individual. Talk to the people in your life who try to have conversation with you about their diet or exercise routines or similar, and let them know that it is unhelpful for you. Those who love you and care about you will cease pushing these topics on you. Those that don’t are the toxic, negative people in your life that I mentioned above.

Finally, know that your recovery is mandatory. You need to do what is best for you and your recovery, and that means fighting the negative thoughts and getting rid of any constantly triggering people. You deserve to live a happy and healthy life. Keep working for that, and keep moving forwards. You can do this.

Christmas and New Year: Anxiety Aftermath

anxiety

So Christmas and New Year are finally over. Most people with eating disorders approached the Christmas period with intense fear and have probably left it with intense guilt. And that’s okay and that’s not okay. By that I mean that it is okay to experience those feelings. You are not alone and those feelings are not your fault. What’s not okay is that your eating disorder has control over your life, so keep fighting the war against it, and don’t respond to those negative feelings. You are going to be okay and you can get through this.

If you ate more than you usually would this Christmas, went outside your meal plan, or ate what a normal person would eat over the Christmas period, I can imagine that right now you are feeling extremely stressed, and terrified that you have put on weight or that your body composition will change. And if you have put on weight or your body composition has changed, that’s okay. If you have stayed the same, that’s okay too, but remember that part of recovery is about gaining weight, and along with that does come a changing body.

The guilt of going against those eating disorder rules can be overwhelming, but it is important to remember that this is part of recovery. Going against your eating disorder and doing what you deserve is part of fighting the battle inside your head. Eating whatever you want, whenever you want, is the goal, and so if you were able to do that for a day, or two, or more, or even if you were able to eat a little more than normal, you are making small steps towards achieving that outcome. That is a wonderful thing, however terrible it might feel right now.

Unfortunately, feeling negative feelings and thinking negative thoughts are part of recovery. If it wasn’t, recovery would be pretty easy-going. It’s important to push past that and sit with the feeling of anxiety (and other negative feelings) rather than respond to them. The feeling will pass if you give it time to. You can read my post on anxiety management that may help you sit with anxiety and other negative emotions and thoughts.

You may also be feeling triggered by the people around you, complaining that they have put on weight or have eaten “too much” this Christmas, or need to go on a diet because of that. Please ignore them. They are battling their own insecurities and are looking for reassurance that this is okay and that other people feel the same and that they are not alone. This is really, really sad, and something that no one should have to feel. Enjoying the Christmas food is part of the festivity, and no one should have to feel guilty for it. Know that other people’s worries are not a reflection on you, and you should keep in mind that it is not something positive that they are experiencing, but guilt and anxiety and insecurity. So instead of letting their negativity impact on you, empathise with them, as guilt, anxiety, and insecurity are emotions that you are likely experiencing also (albeit on a much grander scale to those who do not have eating disorders). Keep moving forwards towards your goals. Keep moving forward on your journey towards health and happiness. Keep in mind your motivations, and remember that the way you respond to others only affects you primarily. You can do this. Keep moving forwards.

 

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.

 

Recovered Does Not Mean Cured

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I like to write positive posts about recovery and what it means to be recovered and all the fantastic things about it. I like to illustrate how amazing it is to go from being very mentally and physically sick to being a functioning human being with passions and interests. I like to talk about going from empty to fulfilled; suicidal to content. But I also want to talk about the realities of recovery, and talk about where the eating disorder goes once you reach remission.

In an ideal world, reaching full recovery would mean that the eating disorder was banished from our brains for good. It would mean that the war, once won, was never to be fought again. In a way, that can be the case. You don’t have to fight that war ever again if you remain stable and strong in your remission, but there will be a few riots to deal with, and the odd battle here and there. The war will be won, but the eating disorder will always try and rebel where it can.

The eating disorder will always be there, in each and every one of us who have been a victim of this deadly disease. It is part of our genetic make up, and worse than that, it’s a part that has been triggered. It cannot be un-triggered, and it cannot be un-learnt. But that’s okay: people who have suffered from an eating disorder and fought it are some of the bravest and strongest people. If you’ve never had an eating disorder you will never know how exhausting and gruelling it is to fight it, but take my word on it: it’s one of the toughest (if not the toughest) that we will ever have to do. With all that strength we have, after beating the eating disorder, keeping it in check is a hell of a lot easier than what we have already been through.But it is important to know that it will be there, and you have to make sure that you are the one that stays in control at all times.

It is a mistake that those who haven’t had an eating disorder can easily make: that once it has been defeated, then it is gone. Sometimes people don’t understand that once a day, or once a week, or once a month, there will be a little battle that we have to fight. And it is fairly easy to win it, but if we give in due to not being vigilant, or feeling too tired to resist it that day, it is something that can quickly spiral out of control.

Take my last 24 hours, for instance. I had to go home from work with a severely upset stomach. My mum told me not to eat for 24 hours (a sensible thing to do in this situation), so I geared up for that challenge. After eight hours, I was starving, so I ate a cracker and smoked a cigarette, and my hunger pretty much vanished. That reared the head of the beast, and a little voice said see how easy it is to make your appetite disappear. I also kept stroking my stomach to see if it felt flatter, because when I was sick and would have an upset stomach, my stomach always felt super flat and I liked that. After 20 hours with only 3 crackers, I tentatively made some toast to test out my stomach. The little voice told me that I could just go longer without eating, and that I’m too sick to eat at all, and I felt resistance to wanting to start eating again. I will fight that small battle every time I get a stomach bug and can’t eat for a while, because for me, once I stop eating, I find it a small challenge to start again. I know that I can fight that, but there is always the possibility that I could give in to it and that the eating disorder would take the wheel and I would fall into the back seat. It is so important to recognise when the eating disorder is trying to worm its way into your thoughts and influence your actions, so that you can roar at it to get back in its place (metaphorically, of course – I’m not sure how those around you would react to that kind of outburst).

Another example is exercise. I enjoy some types of physical activity like badminton, swimming, and walking. I love doing it, but so does my eating disorder. That means that I have to constantly assess how I am feeling towards it. It means that when I can’t do exercise (like now, being ill), I feel anxiety. It means that I have to consistently challenge myself to make sure that I am in control, not my eating disorder. This means that I take rest days where I don’t exercise whatsoever. If ever I told myself to take a rest day or two, and couldn’t do it, there would be a problem. It would not be me taking charge in that situation, and I’d then have to work through that and fight a bigger fight. I think anyone who chooses to be active in their remission and has had exercise addiction will always walk a line with it. If I ever exercise when I am ill or injured, or when I have challenged myself not to, or because I feel I have to even though I am not enjoying it, that is when there will be an issue. I have to watch out for that, and so does everyone else in my position.

There are also bad body image days. In our society this is – tragically – normal, but for those with an eating disorder it can be accentuated, or a trigger and therefore more dangerous. It means accepting the bad day, or week, or month, and not responding to it, which can be incredibly hard as someone without an eating disorder, let alone someone with one.

There are many different things that will trigger different people, and although a lot of triggers become null and void, most people have one or two (or more) that remain with them. Having those triggers, and having the eating disorder itself, means that we are always at risk of relapse. It means that we do still have to fight battles that other people do not have to fight. It means that we have to be vigilant and careful and assess our thoughts and behaviours towards things like food, exercise, and our bodies on a regular basis.

Recovered does not mean cured. Recovered means in remission. It means that it can come back, and it means that we will always be fighting, even if the fight is a million times easier to win.

Counting Calories and Recovery

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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

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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.

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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.
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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.

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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. 

Distinguishing Your Voice From that of Your Eating Disorder

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Recovery can be really hard when you are unable to distinguish the eating disorders “voice” from your own. Making decisions becomes an uncertain task that can end up taking up far too much of your time because you are anxiously torn between what you want and what your eating disorder wants, and not being able to tell which is which. Because the voice actually sounds like your own thoughts, this can make it really difficult for someone to tell what thoughts are really theirs, and what are those of the eating disorder.

When it comes to telling your voice and the eating disorder’s “voice” apart, the first thing to think is “do I really want this?” Some people are able to quite easily separate the two with just that first question, and others are still unable to do so.

When it comes to food, and choosing to eat a certain food or comparing between two choices, the easiest way to tell what it is you want is to ask yourself; if it had no calories, would you really want to eat it? Or would you prefer something else? If the two you are comparing to had no calories, which one would you actually want to eat more? Another thing to do is think, if I walked away with this one and bought it, would it give me more anxiety than the other option? The one that you have more anxiety over is the one your eating disorder wants you not to choose, and is therefore the one you should choose to confront and overcome that anxiety. I would bet that the other one is something your ED picked to get you to choose that “safer” option rather than the one you really want to eat.

When it comes to negative thoughts about yourself – that’s not you. Hands down anything negative that comes into your head will be your eating disorder. I say this because now, in remission, I rarely have negative thoughts about myself or my body. When I do, they are quite mild and I can tell that they come more from a “normal” brain and have developed because of the society we live in. Negative thoughts caused by an eating disorder are usually very forceful, very malicious, and very hateful. They are cruel comments, not just “hmmm I’m not sure I’m loving those back rolls but meh okay what was I doing let’s carry on with that.” They are hurtful, vindictive, venomous comments like “you are disgusting” or “you are worthless” or “you are a worthless fat bitch”. When you experience thoughts like that, they are the lying, bullying voice of the eating disorder and you need to recognise that that voice does not carry truth. It just wants to hurt you. I would place my bets on saying that 99.999% of negative thoughts going on in the head of someone with an eating disorder are eating disorder thoughts.

When you are eating, or buying things for yourself, or doing something you enjoy, etc etc, and a thought comes into your head about not deserving to eat it, or buy it, or do it, then that is not your own thought. That again, is a bully inside your head that should not be there. Kick it out. Tell it that it is wrong. You deserve all the things that you want and you should be able to have all of the things that are within your reach.

When it comes to negative thoughts or thoughts that you don’t deserve something, ask yourself “is that something I would say to someone else?” If it isn’t, chances are it’s your eating disorder speaking. The things that eating disorder says to us, we would not find it acceptable to say to others, or let others say it to us, but we let that internal voice say it to us and submit to it. Start changing that and fight back. Recognise that the “voice” is just playing on your insecurities and is making unacceptable and vile comments towards you. Tell it to f*** off.

When it comes to other habits or behaviours, for example using certain items of cutlery, using certain plates or using only bowls to eat out of, challenge that. If you feel like using a bowl, use a plate. If that invokes anxiety in you, then using the bowl is a disordered habit. Use  a different fork/knife or spoon. If that invokes anxiety in you, then using certain items of cutlery is a disordered habit. The same goes for every habit or behaviour. Test out if they are disordered by switching things up. If you find it hard to sit still or sit down, but are pretty sure you’re just an active person, have a duvet day. If you eat at certain times because, you know, that’s just how it is, make it earlier or later. If you avoid white carbs because you just never really have the urge to eat them, make up a nice crusty roll or a bowl of pasta or some egg fried rice using white products. If you are eating low fat yoghurt but are pretty sure you just love it, buy some full fat yoghurt. Stop making excuses and just do it. It won’t be a problem if it is not a disordered habit. If the change freaks you out, the habit or behaviour is disordered.

These are some ways for you to tell apart yourself from your eating disorder when it comes to decision making and making the choices for you instead of your eating disorder. These tactics, of course, are not exclusive. I would welcome any comments to this post suggesting other ways for people to distinguish between their eating disorder “voice” and themselves. The more the better.

Why You Need More Calories than the Government Approved Recommended Daily Allowance

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We all know the recommended daily allowance of calories that the government has handed us, but do you know where those amounts originate from? Do you know enough about it to trust that those are your energy needs? Because I’m telling you now, you shouldn’t.

I would recommend reading Gwyneth Olwyn’s ‘MinnieMaud Method and Temperament Based Treatment‘ and ‘I Need How Many Calories?!!‘ for an extensive and in-depth analysis of how the RDA guidelines came about, and why they are so inaccurate – complete with references. However, I understand that, although sound in science and reason, many people do show doubt in Your Eatopia and want more evidence: to which I would say, look up the references! Regardless, I am going to write this shorter article in less detail to illustrate why we all need more than that magic RDA.

The recommended daily allowance set by the government came about by using surveys that relied on self-reporting. This means, in short, that members of the population filled out the survey and the results were averaged out. The actual results were above what the RDA is now:

The FDA wanted consumers to be able to compare the amounts of saturated fat and sodium to the maximum amounts recommended for a day’s intake–the Daily Values. Because the allowable limits would vary according to the number of calories consumed, the FDA needed benchmarks for average calorie consumption, even though calorie requirements vary according to body size and other individual characteristics.

From USDA food consumption surveys of that era, the FDA knew that women typically reported consuming 1,600 to 2,200 calories a day, men 2,000 to 3,000, and children 1,800 to 2,500. But stating ranges on food labels would take up too much space and did not seem particularly helpful. The FDA proposed using a single standard of daily calorie intake–2,350 calories per day, based on USDA survey data. The agency requested public comments on this proposal and on alternative figures: 2,000, 2,300, and 2,400 calories per day.

Despite the observable fact that 2,350 calories per day is below the average requirements for either men or women obtained from doubly labeled water experiments, most of the people who responded to the comments judged the proposed benchmark too high. Nutrition educators worried that it would encourage overconsumption, be irrelevant to women who consume fewer calories, and permit overstatement of acceptable levels of “eat less” nutrients such as saturated fat and sodium. – Marion Nestle (from here)

In short, the results came up as an average of 2,350 calories, and even though that has been shown to not be enough for the average man or woman, they still went and lowered it to 2000. We also know that people under-report what they eat for numerous reasons: not knowing the accurate calorie count of food, missing out liquids and condiments, and reporting what they think they should be eating, rather than what they are eating. Even without mentioning that information on the subject of under-reporting, the NHS has written that the calorie guidelines have been underestimate by 16% due to revaluation of people’s average physical activity, including walking, breathing, and even sleeping.

To put it even more into perspective, the RDA for children aged 5-10 years old is 1800 calories. That’s for small children. When you look at that logically, growing teenagers and fully developed adults are clearly going to need significantly more than that.

Although it does not say what the calorie intake was for either groups, in one interesting study, where they studied the eating of healthy, everyday women, they found that those that were eating in an unrestrained way were eating 410 calories on average more than those who ate in a restrained way, and had a relatively lower weight, which feeds into the relatively well-researched theory that eating less actually can cause you to gain more weight due to a decreased metabolism.

When we talk about teenagers, researchers conducted a study involving more than 200 children between the ages of 8 and 17, and used a lunch buffet to give them access to unlimited food. They found that boys routinely eat more compared to girls of the same age, but the amounts that both parties ate do not fit with the RDA that they are supposed to follow. They found that boys in their mid-teens ate an average of 2,000 calories during the lunch hour, which they thought made most sense due to the age that puberty hits most boys. Their calorie requirements appear to shoot up drastically in late puberty (between the ages of 14 and 17). They found that with prepubescent children, the boys averaged nearly 1,300 lunchtime calories, compared to 900 among girls. Girls consumed the most calories during early- to mid-puberty (between the ages of 10 and 13), as they tend to have their most significant growth spurts during that time. Girls consumed an average of 1,300 lunchtime calories.

A study of teenage girls between 16 and 17, where 204 were dieters, and 226 were not, showed that “the mean reported energy intake of the dieters was 1604 kcals/day compared to 2460 kcals/day amongst non-dieters”, and that “more than twice as many dieters as non-dieters failed to achieve the reference nutrient intake (RNI) for retinol equivalents, thiamin, riboflavin, folates, vitamin B12, vitamin B6, zinc, copper and selenium,” which is obviously not healthy at all and suggests that consuming a low intake results in not being able to get enough of what the body needs, both in energy and in nutrients, because the body requires a much higher level of both. There was a similar study conducted on teenage boys.

Now you might say: yes but these studies show that on average unrestricted eating then leads women to need around 2500 calories on average and men to need 3000. Well, yes, those over 25, whose bodies have stopped growing and developing and so no longer need so much energy, do. But those below 25 still need 3000 and 3500 respectively, as their bodies need additional energy to grow and develop. Do remember here that the two studies above on teenage boys and girls are again, self-reported studies where the unrestricted eaters ate 2460 (females) and 3064 (males) – and as Gwyneth Olwyn points out, under-reporting can range from 2% to 58%, and that “if we average the studies reviewed by JR Hebert and his colleagues, then people eat on average 25% more than they think they do (or report that they do).” Also keep i mind that normal, healthy, energy-balanced people do not know the accurate calories in foods, which is why under-reporting can occur in healthy people, and the healthy intake can then be reported as lower than it is because they are going by what they perceive to be a healthy amount, which is constructed by our society in the form of the daily recommended allowance.

And there we have come full circle.

These intakes (2500 for women under 25, 3000 for women under 25 and men over 25, and 3500 for men under 25) are guidelines but best seen as absolutes during the recovery process due to the nature of the eating disorder and the way it will use grey areas to eat less than needed. If your own individual body requires, as a 30 year old woman, 2300 calories, then a extra few hundred calories will not mean that you gain a significant amount of weight more, if any at all, due to the fact that our bodies are able to get rid of energy by burning it off when it is not an excessive amount more than it needs (which would only be consumed by force feeding when you had reliable hunger cues – this does not include making yourself eat when you have unreliable hunger cues), and when you did eat intuitively when fully recovered, any excess weight would be lost again. Any small increase in weight past set point for a small period of time would be far more desirable than under-eating and remaining both physically and mentally ill.

As a p.s. I just want to put a study in about pregnant women and their energy requirements, as this is sometimes a question I receive on my blog. It reports that “in the normal-BMI group, energy requirements increased negligibly in the first trimester, by 350 kcal/d in the second trimester, and by 500 kcal/d in the third trimester.

I would also like to refer you to Wikipedia’s list of how many calories on average people consume in each country.