Eating disorder recovery
March 12, 2013 8:51 AM   Subscribe

Around 2 weeks ago I decided to actually properly recover from my eating disorder. And I am hoping that some people here with relevant medical knowledge or personal experience might be able to give me some advice on how to proceed and information on what I can physically expect, as the information given online is often very contradictory. I live in a rural area (UK) and have had very negative experiences with the local medical professionals/counselling services (I also get the impression that most GPs will not be very well informed anyway) so I am attempting to do this very much on my own.

I've had an eating disorder of some kind/degree for about 5 years now (since I was 14 and I am currently 19). It has never been quite bad enough to warrant any intervention beyond forced doctor's visits and weighing, where I was able to hide quite how ill, I guess, I was.

But for the past year or so I have been in control of my own diet and have been attempting to 'eat healthily' i.e. a very restricted and low calorie diet of foods, which I can trust myself not to throw up - except all to often I do, or I eat something slightly unhealthy and so 'have' to binge and be sick or I eat too much healthy food so my stomach hurts and I have to be sick. Basically, being pretty obsessed with what I'm eating, using food and being sick as both a form of self-harm and coping mechanism and, even when I'm feeling good and want to concentrate on other things, feeling permanently hungry. I called that 'getting better'. And I have gained weight - enough not to be underweight and to get my period back and to feel that I am fat, and to be very self-concious about my appearance and never wear nice clothes, particularly close-fitting ones! But I still feel both hungry and full/bloated, and have acid/heartburn and digestive problems as well as general fatigue, weakness and poor health. So my body is obviously not healthy, even if my BMI apparently is.

So I have decided to really get better and to accept that this will involve gaining weight (and it feels so liberating and terrifying) but I really don't know how to go about it....
I have spent far too much time researching healthy eating but I am unsure how much any of the different varieties of ordinary advice for a healthy diet apply or whether I ought to attempt to eat a normal (not optimally healthy) diet, or even what that is, or whether I need to eat a high calorie diet in order for my body to repair itself....
I also permanently incredibly hungry and I think it is a genuine signal from my body - but how much should I respond to it? because however much I eat it doesn't seem to stop, will it go away eventually and how long will that take?
And my stomach seems so fat and bloated and protruding - that will change, wont it?
I obviously want to try and gain muscle rather than more fat but I am very bad at sport (and embarrassed about the whole business) and I am always so tired so I don't really do much exercise beyond going for walks - should I increase that? Or would that be bad for me? (some advice seems to say that it would hold up recovery)
I know that it is different for different people but generally what can I expect to happen to my body? And how long will it take? What was it like for you?

This is mainly a question about the physical process as I think I am working through the psychological aspects by myself; I have stubbornly refused to explicitly admit that anything was wrong to all except my closest friends and I really don't want to change that - and I think I can do it myself. However I am seeing a councillor regarding other issues (mainly social, self-confidence, very minor child sexual abuse) and if I find I have to I will bring it up there. I think I probably do have some kind of depression also and I am unsure of the relation between feelings of isolation and despondency and the eating disorder. I am familiar with the Minnesota starvation experiment etc. but I am pretty sure the depression and social withdrawal is a separate issue in itself, however I think in order to tackle that I need to deal with the eating disorder first.
I KNOW that however much as, if I am honest with myself, I like being messed up and having an excuse to be a failure in everything and I want to be ill and interesting and perversely beautiful and special like I used to be (I despise myself for wanting it so much) and childlike and for people to feel sorry for me and protective towards me, it is be better to be grown-up and capable and fun and clever and engaged with life and others so they admire and respect me and like being around me. I can't continue to sabotage my chances of having friends and my university degree and basically waste my life with this.

So I have made my decision and if anyone has any advise on how to go about it and what I can expect, I think that would be really helpful, thank you.

(Throwaway email:
posted by anonymous to Health & Fitness (13 answers total) 5 users marked this as a favorite
Yeah, you really can't do this alone, and you have to be honest with your therapist about what's going on.

You have medical, mental and nutritional stuff going on and you need help with all of it.

I have an eating disorder as well, and everyday it's a struggle for me.

Here is a resource in the UK.

Call them, tell them everything you've said here. Ask them how to approach with your therapist, how to deal with your GP and how to get the help you need.

Also, know this, your disorder is a lying, bitch who deliberately plants these terrible ideas in your head. You are strong, beautiful and capable. That voice in your head is wrong.
posted by Ruthless Bunny at 9:19 AM on March 12, 2013 [6 favorites]

Oh, baby. No, your body isn't healthy. But the most important part is that your MIND isn't healthy right now. An eating disorder is a serious mental illness; I don't say that just to scare you, but doing this alone is basically impossible.

PLEASE clue your therapist in; he or she can probably refer you to a specialist and maybe get you started on an outpatient program. I did one, and it was the best decision I ever made for myself. It took weeks (maybe months!) before I started to realize how deeply my self hatred ran (all ED based!). But it does get better! I love myself now, and even though I have so many flaws, I wouldn't change my body if I could. There is help for you; please reach out and take it!!
posted by fireandthud at 9:27 AM on March 12, 2013 [2 favorites]

Good for you. Reaching out to others is an incredibly important first step. Your honesty, especially with wanting to stay sick, is especially awesome and will be incredibly helpful.

I'm going to tell you something you don't want to hear. You need to be in recovery and you can't do it on your own.

I've been in recovery for 10 years. 3 therapists - 2 of them eating disorders specialists. I've relapsed about a billion times. In the last 3 months, after so much work I can barely believe it, I think I might be actually "in recovery" rather than searching for recovery.

If you've lost your period for any length of time you may need to seek intensive outpatient treatment (or even in-patient).

Your eating disorder is going to tell you what it needs to keep itself alive. It's your best and most trusted coping mechanism and it wants to survive. You need someone outside of yourself to be watching you and being a sounding board and that can't be a friend. It has to be someone trained in this.

This isn't about following a meal plan and the food is not the problem, nor is the obsessing or the throwing up. It's what is under all of that that is the problem. Those are just the symptoms. If you had lung cancer, would you think you just needed to stop smoking and that would take care of it? If you decide to skip the idea of therapy now, you'll be back asking the same question in a matter of months.

Please take care of yourself. Be gentle and get help.
posted by Sophie1 at 9:27 AM on March 12, 2013 [4 favorites]

Eating disorders are a tough tough thing to overcome. They require that you take in nutritional counseling, therapy, and medical support. You need to talk to a doctor because re-feeding is an extremely dangerous time for people in recovery. During re-feeding you can experience any number of things. Hot flashes, heightened blood pressure, hair falling out, bloating and swelling. THIS STUFF GOES AWAY. It's very hard to get through this part of recovery because you start feeling and seeing dramatic changes in your body but I promise promise double promise it is temporary. You need to see both a therapist and a GP to get your head caught up with your body. Even if you physically recover, if you are mentally still hurting, relapses become more common and dangerous. You sound fairly self aware and ready to start recovery and that's the hardest step. I know it sound scary. But I promise it's worth it. I'm 6 years fully recovered (after suffering for 15 years) and it was the best thing I ever did for myself.
posted by picklesthezombie at 9:51 AM on March 12, 2013 [1 favorite]

(I posted this in a previous AskMe, but I keep returning to it for myself and thought it might be helpful for you)

Bulimia, or any eating disorder, is not about the food. Food is the enemy, the friend, the confidante, etc., but it's still not about the food.

You are going to have to get underneath the food to figure out why bulimia works so well as a coping mechanism. Changing your diet might stop some behaviors temporarily, but I've binged and purged on every diet and every food plan there is. Eventually, the thing under the food needs to be confronted. You'll do that when you're ready and not a day before. In the meantime, do what you can to reduce your risk. Eat soft foods if you're going to binge and you know you have to purge. Make yourself wait if you can.
posted by Sophie1 at 9:56 AM on March 12, 2013 [1 favorite]

The desire to get better is awesome! But you have a real health issue, and i'd really encourage you to seek out a mental health specialist, even if you have to ride a bus/train for an hour each time you go see them.

Eating disorders are a mental health disorder, please ask for the help that it sounds like you want and need.
posted by Kololo at 9:56 AM on March 12, 2013

I agree, good for you! This is not something I have personal experience with, so hopefully there are some others who will be able to describe what the recovery process is like or provide resources.

A couple of years ago this great comic, I Do Not Have an Eating Disorder (index of all comics)was linked on Metafilter, and it gave me a lot of insight into what it feels like (at least for this one woman, I'm sure it's unique for everyone) to realize something is up, and to start forcing yourself to accept a different "you" as the real "you". She clearly had a lot of help from friends and professionals, and even then it was not easy. I also have to admit I forgot about the comic until today, so I don't know if she's still updating.
posted by Secretariat at 9:58 AM on March 12, 2013

I think you need to address your emotional relationship with food with a therapist. The physical part of an eating disorder is like the tip of an iceberg. The binging and purging and other behaviors and physical ailments are the part that's visible above the surface. The bulk of the iceberg is your psyche and your emotional health. That's what you really need to address.
posted by ablazingsaddle at 10:28 AM on March 12, 2013

If you are currently at uni the university should also have resources for you. I'd expect there to be a GP practice associated with the university, as well as a student counselling and mental health service. Even if your family's GP is not well versed in this area the university services should be much more familiar - you are not the only student at your university with an eating disorder. So please do not be disheartened, if your family doctor is not sympathetic or well informed. Help is out there.
posted by koahiatamadl at 11:07 AM on March 12, 2013 [1 favorite]

I'd also like to offer my hand to you if you ever need someone to talk to. As a fellow sufferer, I know how *hard* it is. I am so proud of you for seeking out recovery. I *know* all of the things you are feeling, because I have thought them and still battle with it every day. Sometimes I do okay, sometimes I don't. It's a battle, but I know you can do it. ::hugs:: We all deserve our lives back.

As obnoxious as it sounds, get to a nutritionist as soon as you can, especially if you can't go inpatient. Your body needs more calories than you'll think it will, and having a plan helps, but you have to surrender to it, and THAT's the hard part.

I was/am never been so low as to require refeeding, but I do have some things to suggest from my experience about the physical stuff.

Don't jump into your "fear foods"(the word sounds so dumb, but yeah) right away. Eat protein in any way you can manage it. Take a multivitamin. The bloating will go away in time. Do move your body, but gentle gentle stuff, like yoga, stretching, or casual walking. If you're having trouble pooping, take a stool softener(no laxatives, just something that makes the stool have more water in it, in America Colace is the brand name, docusate sodium is the drug name).

Again, if you ever need someone who knows what is going on to blab at, please feel free to me-mail me.
posted by lettuchi at 11:26 AM on March 12, 2013 [1 favorite]

Mod note: From the OP:
Thanks for the responses, just to clarify that I am currently at university but I have 5/6 weeks vacation at the moment and while I guess you are convincing me to try to access the resources available there when I return, I don't think there is very much I could access during the time I'm home - so if I amend it to simply getting by (and not freaking out) until then?
posted by taz (staff) at 2:56 AM on March 13, 2013

OK - Promise yourself, no matter what, that you will see the Uni healthcare once you're back in school.

Then, first: Eat every day. You don't have to be perfect. You're not going for perfection, you're going for fuel.

You can have a heart attack at any moment when you're purging.

Wait 5 minutes before you purge. It's going to feel like hell. You're not going to want to do this. Sometimes you won't and sometimes you will. Sometimes, it will stop you from purging at all. If you can during those 5 minutes, journal about what it feels like to want to purge and you can't, or journal about what it feels like to have a full belly, or what it feels like to be changing.

Minimize your risk. If you feel like you are definitely going to purge, eat soft foods. Seriously.

Journal some more. Ask yourself how being sick helps you. What do you get out of it? We all get something out of it and you seem to have more insight than many do when starting recovery. I would go get The Anorexia Workbook. Start it.

If you're really into reading, read Appetites by Caroline Knapp and When Food is Love by Geneen Roth.

Women who have recovered from eating disorders are badass. We have fought the devil within and we won.

Please feel free to memail me.

Be kind to yourself.
posted by Sophie1 at 6:47 AM on March 13, 2013 [1 favorite]

My advice comes from personal experience, from when I was thirteen, hiding my eating disorder, cold all the time, hair falling out, ...but finally approaching THIN. I wanted to be so thin so bad, and it was a frame of mind I couldn't let go until I was about nineteen years old. What got me to let go of my obsession and scary eating habits was a combination of a few things. One day in college, I realized that I was happiest when I was hanging out with friends and finally coming out of my shell. I wasn't happiest when I was dieting, and by that point, I gained or stayed the same weight when I attempted dieting--so essentially I got absolutely nothing from my weight attitudes, except for constant, pointless food obsession.

Dieting stopped working for me less than a year into my eating disorder. By then I had already lost my period for about six months, and was about 95 lbs. I had been losing weight so well, and then suddenly I started walking into the kitchen and compulsively stuffing food into my mouth, like I was possessed by a demon. That happened every single day, made me balloon past even my pre-ed weight, and hate myself a lot for the lack of control. But it probably saved me, forced me to nourish myself, didn't allow myself to ignore my body etc.

So after I started being able to have a social life in university (in high school, living in my parents' house with their restrictive standards, was not conducive to a full social life), I had a series of feelings and experiences with which to contrast my food habits. From meeting a guy I actually liked and gelled with, to having a consistent social life, pursuing interests, I saw that what I had always assumed was the key to being happy when I looked at it objectively, actually never made me feel truly good. It was just a (poor) way to escape feelings of inadequacy, an attempt to escape my pervasive unhappiness.

It sounds like your story is a little different. You seem to have a lot more control over what you eat/don't eat, and it was an intentional choice to start eating more, instead of an uncontrollable compulsion. Good for you, indeed! It's a great step, and shows how strong you definitely are compared to your ed. You also already have a social life haha, which you're trying to preserve. One thing I read about eating disorders that might be more applicable and helpful, is how a lack of emotional awareness is often linked to developing eating disorders. In Daniel Goleman's "Emotional Intelligence", it cites a study where a group of junior high school girls are observed for a few years to see which ones develop eating disorders. Taking record of different factors, scientists look at the characteristics that the girls with eating disorders share in common, which weren't shared in common with the girls who didn't develop eating disorders. The conclusions according to the book (paraphrasing; don't have the book in front of me): the girls who (1)had a difficult time identifying their feelings; (2)had difficulty responding/soothing distressful emotions; (3) had dissatisfaction with their bodies, all were good predictors that they would later be anorexic, bulimic, etc. If you don't have access to the book, here's a resource online that seems to corroborate with these conclusions:

A lack of understanding emotions definitely played into my ed. I know that when I dieted, I was extremely dissatisfied with my life--believing my parents when they told me I was useless, too fat, not good enough, etc. I didn't know why I had those feelings or from where they sprung. So, assuming my unhappiness was due to being too fat, I decided to tackle the "fatness", instead of saying, "I'm fine as I am and my parents are the ones with issues."

Anyway. If you feel like this is relevant, getting in touch with your emotions, really getting to the root of them and understanding where they're truly coming from, would probably be a smart thing to do, and really help you let go of harmful eating habits.

Also, don't hang out with girls who complain endlessly about their bodies etc. That's a major trigger for me.
posted by tenlives at 7:28 PM on May 26, 2013 [1 favorite]

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