Part of recovering from my ED was learning that it is OK to listen to my body and eat intuitively.
First I learned about mindful eating where distractions from the task of eating are eliminated and meal times are a date between just you and food. This means no lap dinners, or TV dinners, or social media dinners.
Book dinners are also out of the equation. Social dinners with others are OK though.
I sit at a table to eat as mindfully as I can, putting my cutlery down between mouthfuls if I feel myself eating fast. This is now partially habit, but it took a lot of being very mindful to do this initially.
Then by measuring portions came a lesson in what portions roughly look like, and I learned to listen to the faint cues of satiety.
Not, I should be full or still hungry, but am I full or not? Because satiety isn’t always instantaneous and those signals can be a subtle feeling that grows as the body realizes it has had enough.
Additionally, learning to listen to slight cues after years of blatantly ignoring them is a very difficult skill to acquire.
Following lessons included
- Having reasonable amounts of treats per sitting, i.e., 2-3 biscuits instead of the whole pack.
- Recognising what I fancied or craved and learning to respond instead of consulting my short list of ‘safe foods’ or trying to suppress these signals from my body.
- How to recognize true hunger vs. mental/emotional hunger.
- How sugar affected my mood and stability (and to stop living off chocolate)
- How to eat out and enjoy it, without knowing the calorie count came later.
- How to eat something without knowing the nutritional information, mainly, calories.
- That it is ok to eat and we need to for survival.
- Eating isn’t a failure and eating when you don’t want to is strength.
And finally, that I can trust my body to regulate my weight in a healthy range if I just eat relatively healthily and intuitively. This includes responding to cravings for treats and allowing that.
In time, after bulimia, then after anorexia my weight stabilized and remained in the same region of weight restoration. I lost during my bulimia recovery and gained during my anorexia recovery.
Ironically, my settled weight was where I had been before either eating disorder, exactly almost to the last pound. I was the same height the whole time within an inch range.
My body knew where it wanted to be and I had to learn to accept that.
I grew to like my body at this weight. My constant remaining the same gave me trust in my body – it knew what it was doing.
It knew how to maintain homeostasis, and more importantly, it knew when to let me know I was hungry and full in response to my needs. The whole concept was new to me.
Eating what and when I wanted was new to me, and trusting myself around food, to not overeat and then sneak off to vomit, to eat and not to think and analyze it to great lengths was also new.
During my recovery, I had started exercising. At first, it was swimming, then running, then rock climbing as well.
I wasn’t trying to lose weight by doing these activities, nor was I trying to change my body or count the calories burned – it started as a method to try and help manage my mental health because you know how much they bang on about the positive effect exercise has for mental health gains: that.
This time, exercising was about more than calories and weights, and from this, I gained a whole new perspective and insight into my body, my mind, and movement. There was now a profound reason to exercise other than hating myself, or trying to lose weight.
When I stopped using exercise to punish myself for essentially being human and eating, when I stopped engaging with self-deprecating internal monologues about how disgusting I was, and when I stopped viewing my relationship with exercise as a sum to keep myself in the negative numbers of existence I started to really experience movement, and what movement was about.
By focusing on movement in a new light, for doing it to feel better, to have fun and enjoy myself, I started to enjoy exercising.
The enjoyment became so great and the benefits to my mental health so obvious that it became a solid part of my lifestyle. I made friends, attended races and signed up for more and more challenges – as the race bug goes.
It seemed that finally, I had hit the holy grail of eating intuitively and enjoying leading a healthy lifestyle – that was genuinely healthy and not restriction disguised as ‘healthy’ – as I had spent many years perfecting until the effects showed so much that I couldn’t deny it anymore.
My final challenge is to obtain the same lucrative balance of self with my mental health.
This is a challenge I’ve faced for as long as I can remember, even though I didn’t always know it.
It’s been over a decade, and I’m still working on it. I’ve been through numerous therapy programs with more currently in the pipeline; I’ve made behavior change after behavior change; I’ve lost count of how many psychiatrists and psychologists I’ve met and worked with along the way.
Each of them suggesting explanation after explanation, diagnosis after diagnosis and enough treatment plans to write a book of indexed treatment plans over the years.
Bulimia, depression, anorexia, borderline personality disorder, dissociative identity disorder, emotionally unstable personality disorder with dissociative disorder NOS, Bipolar affective, anxiety, psychotic depression… the list reads like an introduction to a module on learning to recite the DSM.
Some of these diagnoses require a medication regime as part of their treatment plan to try and help rebalance neurotransmitters to stay out of crisis and hopefully maintain the dream of functioning well again. Citalopram, olanzapine, quetiapine, risperidone, aripiprazole, lurasidone, clonazepam… medication after medications, pill after pill.
It doesn’t stop. I’ve been on many of these medications multiple times in varying dose strengths and combinations.
Amongst this list are most of the a-typical second generation anti-psychotics. Each medication has their own side effect profile, and each person is affected differently, but one consistent side effect amongst the a-typical anti-psychotics is weight gain and the general slaughtering of your metabolism.
The extent can vary between people, so you never know how much it will or won’t affect you until you try it, and maybe you gain 10 lb., maybe you gain just 5 lb., and maybe it stops and you maintain after a while, but suppose maybe you don’t.
It’s extremely frustrating that the only way to find out is to try it and if you gain weight, and your metabolism grinds to an almost halt you then have the repercussions of that: you need to try and rectify it, come off your medications and risk being crazy again, or however you may respond to this situation. It’s a difficult one.
Additionally, gaining so much weight and the biochemical reactions these medications cause greatly heighten your disposition to gain type 2 diabetes, cardiovascular disease, high blood triglycerides, and blood sugar dysregulation – all in a previously perfectly healthy individual.
This is a hard process for anyone. Imagine though, having spent the most part of a decade with an eating disorder, recovering then dealing with this. The trigger potential goes through the roof for a potentially vicious and toxic cycle to restart with your relationship with food.
It is very difficult to tolerate such a rapid and non-sensical rate of weight gain and feel completely out of control. Especially when the mechanisms by which these medications make you gain weight are not fully understood.
Currently, interventions in this area for weight gained due to side effects are largely non existent within the NHS. Your appetite increases, coupled with moderate-heavy sedation; it’s a recipe for a homeostatic nightmare.
The body loses balance and once you start falling it’s difficult to stop it from snowballing. even if a medication is effective and helpful for it’s intended purpose, it can be difficult to rationalize the rate of weight gain and rate at which you consume high carb, high-fat foods in an urgent frenzy 24/7.
Olanzapine, for example, was a very good medication for my symptoms but I gained stones of weight despite still having and engaging in anorexia related behaviors at the time. It was very distressing for me, and I would cry in the evening of each day because I had hit a reasonable calorie limit and remained starving so much it hurt.
I was in a constant battle between one illness and the cure for another. I bought ‘fat pants’ in the hope it was a temporary effect, and soon they became too small, along with everything else in my wardrobe.
I am currently on Quetiapine. I have gained weight very easily again, however; this time I have managed to at least stabilize in a weight range without signs of metabolic related illnesses if I manage my diet well.
My hunger and satiety signals, however are now unreliable. My blood sugar feels unreliable with hypoglycemia symptoms occurring easily despite having eaten. I get fatigued sometimes – and when I am feeling better emotionally, mentally it is quite frustrating.
I want to be doing stuff and making the most of each day and to find yourself easily physically fatigued due to your medication. I overheat and dehydrate easily.
Yet this medication feels like it has the potential to save my life and enable me to live a fuller life overall. It’s a tug of war between pros, cons and which way sways to outweigh in favor of the greater good.
One difference between this time and last time I was on quetiapine is that I have greater acceptance of my body and have learned to focus on what it can do rather than how it looks.
This means that despite my weight gain and the fact that I again opt for slightly baggy clothes in order to feel comfortable with myself this helps me to deal with it, and learn to love and accept my body for everything it is capable of other than looking how I want it to, or losing weight at any normal rate if at all, and for gaining weight at an abnormal rate if I am not careful with my diet, nutrition and exercise.
I have learned through this process that I can no longer trust my body to tell me when and what I’m hungry for whilst I am taking this medication. I can’t eat intuitively because I am capable of eating vast amounts of food without realizing it.
If I am guided by my craving at the moment, I make poor nutritional choices which make the blood sugar regulation more difficult as well as affecting my mood for the worse.
In order to problem solve I have started measuring portions to make sure I eat enough without overeating at each sitting. I have started keeping a food diary and dare I say it, counting calories.
I am technically overweight at the moment, with my waist-hip ratio putting me in the medium risk zone. I am learning to stop focusing on this, however, and focus on my holistic physical health: blood pressure, cardiovascular ability, and ability to fight infection or illness.
My body is pretty neat at all of these things. This put me not at my peak health status, and at a good enough fitness level that my weight is falling outside of the prescribed BMI chart isn’t a health concern at the moment.
Oddly enough, I don’t hate myself. Eating disorder history aside, and as a training nutritionist, I feel under particular scrutiny to look a certain way. This is something I need to own and challenge.
It doesn’t sit well with me however in my own mind to be eating a nutritionally poor diet and allowing my cravings for chocolate croissants to override my need for fuller nutritional quality from my diet. As a result, I am unable to eat intuitively.
I am at ease with this fact. It is something I have accepted however the intuitive eating movement on social media at the moment makes me feel like I should hide the fact that I calorie count.
How can I be recovered if I calorie count? How can I be a nutritionist if I have metabolic issues that make me look very non-typical of a nutritionist? How can I advocate a healthy relationship with yourself, your body and your nutrition whilst I weight myself, calorie count, and manage my nutrition in this way? Intuitive eating has a place for a large proportion of the population, however, in pushing this message whilst demonising other ways of managing diet and nutrition is unhelpful.
I get the anti-diet movement, and a part of that is that calorie counting is deemed as a negative and unhealthy behavior. I understand the movement is in response to the extreme diets pushed in the ‘clean eating’ movement: however, there is a balance to be observed, obtained and where different ways of eating and exercising work for different people.
For some people counting calories is helpful and not necessarily pathological or unhealthy. For some people, letting go of numbers and calories in order to listen to your body is a healthier option.
Not everyone is blessed with perfect physical health enough to be able to listen to their bodies. There are exceptions, and these aren’t being discussed in the open discussion and backlash towards diet culture.
The rise of orthorexia and gym obsessives on Instagram has spiked the level of a surge of the intuitive eating and body positivity movements. Again we have swung on the ride of the pendulum. Where is the middle ground? And what may be the middle ground for me may not be the middle ground for you or the next person.
We all have our own middle ground, we all have our own personal relationship with food and a blanket message without acknowledging that may not be the way for everyone isn’t quite achieving balance in the health message being pushed on social media at the moment.
This doesn’t undermine the importance of intuitive eating and learning how to eat intuitively for some population groups. It is incredibly liberating to be able to eat intuitively.
If you are recovering from an eating disorder at any place on the spectrum, learning to eat intuitively is definitely be a helpful skill.
Learning to trust your body and yourself with food is an important step for those in recovery due to the nature and level of micromanaging that goes into the practice of eating disorder behaviors, or the complete emotional takeover of eating behaviors that may be in place for some eating disorders. The specificity of this tool in obtaining a healthy relationship with food has been missed.
Just as one weight gain plan doesn’t work for everyone in need of weight restoration and no single diet works for those trying to lose weight doesn’t work for everyone, and one plan for restoring less chaotic eating patterns in bulimia work for everyone, nor does intuitive eating.
I feel as if it is being pushed as a one size fits all, and that is so far from the truth, and once again perpetuating the pendulum of trends of the ‘how we should eat this year/decade’ on social media. Balance is different for everyone, and balance is the ultimate goal.
Balance in managing your diet without it interfering with your life in a negative or pathological way.
A balance in eating intuitively in order to learn to listen to your body rather than your mind. These goals can also be achieved away from the plate; learning to rest when you need to rather than denying yourself rest because of everything you ‘need’ to do for example is an area of health that can be addressed in order to achieve some form of balance.
For me, this means calorie counting. That doesn’t mean I am obsessed with my diet and food in a pathological sense. I am taking responsibility and trying to maintain a level of balance in my life beyond the plate alone: this includes meal planning sometimes, cooking, sometimes eating on the go, reading labels, and exercising.
It means sleeping when my body is tired, and resting my mind when it’s getting too fast or is too sluggish to achieve what I want. It means exercising as a means of aiding the recovery of my metabolism, as well as for my mental health and managing my mood swings, fatigue, tearfulness, stress and to zen out.
The core difference in my relationship with movement this time is that it is a multifaceted relationship where I exercise out of self-care and love for myself – as well as hoping my metabolism will return to a more reasonable rate as a side effect.
Things happen in life. Poor health happens, and good health happens. Sometimes we need to take medications and endure treatments, and sometimes they can impact on our relationship with health, food, and exercise.
As tempting as it is to come off my medication in order to achieve intuitive eating again, and lose weight as I do so – this just isn’t an option for me. I am finally well mentally, and in order to manage that, I need to calorie count. I’m not ashamed.
I’m aware of my triggers and signs of eating disorder problems so I can nip them in the bud quickly. If I start to get anxious about cake, I’ll just go right out there and eat a cake to prove a piece of cake isn’t going to make me gain exponentially forever.
However, my form of balance is different to yours, and intuitive eating isn’t necessarily the best way to achieve balance for everyone. I think it is important that we remember and acknowledge this.
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In-Post Image: shutterstock.com & pinterest.com/