Tag Archives: health at every size

5 Tips For Coping With January’s Diet and Weight Loss Talk

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It’s January, and we all know what that means: a total inundation of diet talk. It’s EVERYWHERE. TV advertising is filled with diet promotions, “healthy” eating, exercise equipment, gym memberships, and low fat yogurts (although hell, when do those NOT appear in the ad breaks?!). Friends, family, and colleagues are on a mission to lose weight, tone up, or get super heallllltthhyyyyyyy (god, pleeeeeease make it stop). “Lifestyle changes” are being broadcast from the rooftops (it’s still a diet, Susan, don’t kid yourself). It’s really difficult trying to deal with all this talk when you are trying to recover from an eating disorder or dieting, and/or are on a journey towards body acceptance. It can be downright triggering. So here are some tips on how to deal with the diet culture disaster that is January:

1. Set boundaries

I know that this can be really tough for a lot of people, but it is so important. If someone is talking to you about their diet/lifestyle change/new workout routine/how many pounds they’ve lost since only eating lettuce for the past two weeks, or god forbid are trying to offer you “advice”, tell them that it is making you uncomfortable. Hell, tell them that it downright harms you when you are trying so hard to explore a different path. Let them know that diet and exercise talk is not appropriate or helpful for you and that you would appreciate if you engaged in conversation about other topics instead. If they are commenting on your own body or eating habits, let them know it’s entirely not their business.

2. Use facts as a weapon against disordered thoughts

When you are feeling the insidious pull of temptation leading you towards to some sort of restriction, consider the facts:
* Diets don’t work. 95-97% of people who lose weight on diets regain the weight within 2-5 years (if not sooner). They also often end up gaining more weight due to the body trying to protect itself against “famine”.
* Chronic restriction can push people’s set points (their natural, healthy weight that is individual to each person) higher, because the body becomes damaged by getting less energy that it need, and can alter its set point in order to protect itself from harm.
* The metabolism slows as a response to not getting enough energy, and this makes it harder and harder to lose weight – which if you have an eating disorder or have ever been on a diet, you know already.  Leptin levels also drop when our fat levels decrease. Leptin is a hormone produced by the fat cells in our bodies. It exists in the body in proportionate amounts to our weight. Our bodies want to compensate for this loss in leptin and respond by increasing hunger urges, which makes not eating enough super unpleasant – as you know already. Your body does not want to lose weight, and it is going to fight to keep it at its set point.
* Studies show that weight cycling (losing/gaining/losing/gaining) is much more unhealthy than just staying at a higher weight. It increases the risk of developing major illnesses such as cardiovascular disease.
* Restricting often leads to binging, and that’s a signal from your body that you are not getting enough energy on a regular basis. Binging also leads to emotions that are really not fun to experience, and can lead to even more unhealthy behaviours as compensation.  Restriction also leads to obsessing over food, and that means less time for doing things that are important, productive, and enjoyable. In addition, restriction leads to increased cravings – again, not fun to feel, and again, often leads to binging.
* Any type of restriction is a slippery slope. It could easily turn into a full-blown relapse. Don’t risk it.
* Losing weight won’t make you happier. It won’t. We’ve all been there before, ladies and gentlemen. Who’s life was super awesome with an eating disorder/chronic dieting? I’m betting no one at all.
* Did I mention diets don’t work?

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3. Unfollow or mute people on social media who are triggering you

This is advice for anytime of the year, but if people are going on about losing weight, cutting out certain foods, restricting their intake, or exercising then unfollow them. If anyone is making you feel bad about yourself, triggered, or is causing you to compare yourself to them, then unfollow them. If they are a friend or family member that you want to keep on your social media, you can mute their posts, or you can let the know that their posts are negatively impacting on your wellbeing (see tip number 1).

4. Fill your social media feeds with body positive and food positive people

This has helped me so much in the past few years, and is definitely one of the things that gives me ongoing support and a sense of community, hope, and positivity. Start following people who are body positive. Start following people who love food and have a healthy relationship with it. Start following people who are fat, trans, disabled, of other races than your own, etc. Fill your feed with people who are diverse. Fill your feed with people who look like YOU, and people who don’t. Just stop filling it with thin white women (or if you are a guy, muscly white men). Stop looking at people who you want to look like or be like, just because our diet culture told you that’s who you should look like or be like, and start looking at people who celebrate who they are. Start celebrating who you are.

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5. Write down reminders of why you made the choice to try something other than dieting/restricting

There’s a reason that you are in recovery for an eating disorder or chronic dieting. There’s a reason you chose to try going down a new pathway; why you decided to give another option a try. I bet there are quite a few reasons. Write them down somewhere where you can always see them if you need to. If you need any help with thinking of reasons not to relapse, you can check out my blog post ‘Repel the Relapse: 8 Tips for Staying on Track in Recovery from an Eating Disorder‘ or watch my video ‘Reasons to Recover and Reasons Not To Relapse‘ on YouTube.

I know that it sucks to hear the constant chatter about diets, weightloss, exercise, and the body-shaming that comes with it, but you know it’s all for nothing. You know that diets don’t work. You know that it is extremely bad for your physical and mental health. You know it won’t improve your life, or make you happier. Remember remember remember. Grit your teeth, and do your best. You can do this.

So Now We Have to Lose Weight to Get Surgery

On Sunday I read the news that obese NHS patients will not get non-urgent surgery until they lose weight.

It made me want to cry. I’m a recovered anorexic who is very active and eats a varied and balanced diet and because of that I am both fit and healthy. I also happen to fall into the “obese” BMI category. In order to lose weight I would have to restrict my food and exercise to the extreme, leaving me both hungry and exhausted; pushing my body below the weight that it sits naturally at. This is unhealthy, and it would mean that my physical and mental health would be in decline. I would also end up spiralling back down into a very dark and dangerous place, with even more devastating and continual effects to my physical and mental health. If I required non-urgent surgery, I would therefore have to force my body into a place where it is not at its healthiest, experience distressing physical symptoms, and in the process would be triggered into a life-threatening mental illness that could leave my physical health in such a bad way that it could kill me – if the torture of living with an active and consuming eating disorder didn’t tempt me to end my life first. In short, I would be put in a life-threatening situation in order to get non-urgent surgery. For me, it wouldn’t be worth the risk.

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Artwork by Francis Cannon

BMI is bullshit. All health professionals know this. And if they don’t, then they should: there’s been so much indisputable evidence that shows us that using a basic BMI chart to tell us whether we are healthy or not is ridiculously primitive, simplistic, and inaccurate. To think that I might not have access to the same healthcare as someone thinner than me after working so incredibly hard to get to this healthy and happy point in my life both physically and mentally makes me feel sick.

We all have individual natural and healthy weight ranges that our bodies choose and we maintain when we have a healthy lifestyle. We don’t get to choose that weight. No one else gets to choose that weight. Our bodies determine it. And those people who don’t fit into the “socially ideal” weight category (that literally wasn’t EVER intended as a way to measure health) get punished for it (whilst those who push the “obesity epidemic” and reinforce the stigma and myths around “obesity” profit from it). There is so much overwhelming evidence that it is possible to be healthy at most weights, shapes, or sizes (depending on yourself as an individual and what your own personal healthy weight is), and it is nauseating to think that people will be forced to make a choice that could cause them both physical and mental distress. 

Even regardless of health, “singling out patients in this way goes against the principles of the NHS,” says Mr Ian Eardley, senior vice-president at the Royal College of Surgeons in The Independent.

The article also reports on more details:

Patients with a Body Mass Index (BMI) of over 40 will not be referred for routine surgery unless they are able to reduce it to under that number over a nine-month period.

Alternatively they will be required to shed 15 per cent of their weight, according NHS Herts Valley Clinical Commissioning Group (CCG) and NHS East and North Hertfordshire CCG. 

Whichever achieves the greater weight loss will then allow them to be considered for surgery.

Patients with a BMI over 30 but under 40 will also be required to reduce that figure to under 30 or lose 10 per cent of their weight before they are considered for surgery.

This decision is yet another discriminatory act against people in larger bodies in the UK, and I’m so tired of it. I’m tired of being told everywhere I look that my body is “wrong”. I’m tired of watching my category of bodies represented by images of men and women with protruding stomachs and their heads cut out of the shots as if they are nothing but  their size (for example right now I typed in “obese patients will not get non-urgent surgery until they lose weight” into Google and the majority of the images are fat people with their heads chopped off – seriously, I’m so done). I’m tired of things like having a “World Obesity day” following the National Mental Health day – which if it wasn’t so revoltingly ironic, would be laughable, without even addressing the fact that there is literally a day to tell us all how bad and unhealthy our bodies are if we are over a BMI of 30.

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Artwork by Frances Cannon

Despite that, I’m someone who exists in a body that is fairly “average”. Even as an “obese” person, I have an amount of thin privilege. I can fit into clothing at regular stores. My friends laugh as if it is absurd when I say that my body fits into the “obese” category. My booty is the UK’s “average” size (although this booty is anything but average, just saying), and my top half is below the UK’s “average” size (and just so you know the average clothing size for women in the UK is a size 16, which is a US size 12, and in the U.S. the average size is between a 12-14, which is a UK size 16-18). I have only had one health professional (physiotherapist) mention my weight in a negative way (AFTER I had told him all about my previous experience with an eating disorder and described to him my active lifestyle and balanced diet. And boy, did he receive an educational six-page feedback letter on eating disorders and health at every size? Yes he most certainly did). The discrimination that I face is significantly less than those who live in bigger bodies than I do, and it can have devastating effects on mental health.

I don’t want to be fighting to be seen as equal to other people because of my BMI. I don’t want to fight for those bigger and smaller than me to be treated the same. I don’t want to fight to get rid of negative associations with certain body sizes. I just want it to BE like that. Right now. I will, of course, keep fighting this fight, but man, am I exhausted of having to argue with at least one person every time I say that to be obese is okay and that someone who is obese can be just as healthy as someone who is not. And now we have our healthcare to fight for, too.

Hopefully, one day, we will all be at peace with our own bodies, and each other’s, and regardless of our weight, shape, or size, we will be treated equally and our health considered individually. Until then, let’s keep being angry, let’s keep speaking up, let’s keep pointing out the evidence, and let’s never give up.

Artwork by Francis Cannon

It’s Summer Soon and Surprisingly, Fat People Get Hot Too

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Art by Jovanna Radic Eriksson

The summer is fast approaching and that means that the weather is cranking up and sweat patches are about to become a lot more common. It also is the season of self-consciousness as those with bodies that do not fit societal ideals feel unable to wear less clothes and therefore sweat in silence as their smaller counterparts breathe a little easier in mini shorts and tank tops.

There are many reasons someone who has more fat on their body than is deemed socially acceptable (or is only deemed acceptable when wearing less revealing clothes) will feel uncomfortable wearing less clothes. It could be the cellulite on their legs; the way their thighs rub together; the way parts of their body jiggle; the belly folds when they sit down; the softness around the tops of their arms; the back fat creasing around their bra strap; the curves of their hips…and the judgement they might receive for having a body that does those normal, natural, absolutely okay things.

This is a perfect time to point out that everyone of any weight, shape, or size, is allowed to feel physically and mentally comfortable in their bodies and in whatever clothing they choose to wear this summer (and any other season). Everyone deserves to feel safe from humiliation and judgement, and everyone deserves respect and consideration, regardless of what their body looks like. If you feel uncomfortable looking at someone else’s body, then you may want to have a good hard think about what makes you feel a certain aspect of someone’s natural body is unacceptable and why it is affecting you personally. If you are someone who makes comments about or towards other people in regards to their weight, shape, or size, you might want to take a moment to reflect on why you think that someone else’s physical appearance is any of your business and why you are treating that person with less respect just because of how their body looks.

If you are someone who does not fit society’s idea of the “perfect” body, and are struggling to know what to do this summer in regards to clothing, then I urge you strongly to…do whatever the fuck you want. If that means that you want to rock a short little number or feel more comfortable covering your curves in a floaty summer dress, then you do what feels good for you. If you want to strut your stuff in a crop top and leggings, or if you prefer to don a baggy t-shirt and harem pants, then you dress yourself in what feels right. If you want to strip down but aren’t at the stage where you feel confident doing so, then it is perfectly okay to cover yourself up, but please start/continue to work towards accepting and loving your (beautiful) body, because you deserve to feel comfortable in your own skin. Whether you want to get your body out or keep the layers on, you deserve to feel good about yourself.

Top tip: if you’re getting your legs out this summer and have issues with chub rub (those gorgeous thighs loving each other so much that it gives you friction burns), then pop some baby oil on your inner thighs before you stride down the street.

Enjoy your summer. It’s going to be beautiful, and you are too.

 

An Open Letter to the Girl I Saw at the Pool

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Dear girl that I saw at the pool,

I went to the pool a few weeks ago to mindlessly bang out some lengths and think about nothing as the water swirled around me. I got into a cubicle and changed into my swimming costume, and then emerged; towel slung around my hips, with my belongings gathered in my arms. As I stepped out from the cubicle, I saw you looking into the huge mirror at the end of the aisle with sad eyes.

“I hate how i look,” you said. The woman next to you – presumably your mother – said “don’t look then.”
I sighed.
You still looked sad.
“You’re doing something about it though,” the woman said.

I wanted to say something, but I hadn’t worked up the courage or formed the appropriate response in my head quick enough. I watched you walk past to the pool, and I went and found a locker. Then I got in the pool and swam. I decided that I would say something if I saw you after. However, you were long gone before I got the chance to say what I wanted you to hear.

I wanted to say that you deserve to love yourself whatever your body looks like; whatever your journey is. I wanted to tell you that you don’t need to not look into the mirror: you need your reflection not to define your worth. I wanted to tell you that you are inherently beautiful and that you worth is not determined by your weight. I wanted to tell you that I don’t know your story, but that you don’t have to lose weight to be happy.

I wanted to tell you not to use self-hatred as a motivation for weight loss. I wanted to tell you that I’ve been there and I’ve done that and it didn’t make me any happier. I wanted to tell you that it’s your choice what you do with your body but that weight loss is not necessary for self-love. I wanted to tell you that I wish your mum (if that was your mum) could say these things to you instead of telling you to hide from your own reflection. I wanted to tell you that you are worthy and you are beautiful and you are loved.

And to everyone ever – the same message applies. Your weight, shape, or size does not negative your self worth. It does not negate your strength. It does not negate your beauty. Never let anyone tell you otherwise, and know that you do not need to change your body in order to be happy.

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

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

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

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

The Health At Every Size® Principles are:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Without further ado:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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

invisible

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

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

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

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

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

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

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