Why recovery isn’t just about weight restoration

eating disorder recovery

Three reasons why recovery is beyond merely physical

 

Weight restoration can be a crucial indicator of recovery on one’s healing journey from an eating disorder. When weight restored, you might feel stronger and may have reversed your symptoms related to starvation syndrome – which is already a significant and remarkable achievement!

While reaching your restored weight can positively affect your pathway to food freedom, it is also a hugely uncomfortable challenge to face eating what feels like vast amounts of food and experience rapid weight change. We empathise with you!

Studies have shown that eating disorder recovery heavily involves biological and neuropsychological factors, where those who are on the recovery journey report hope, support from others, and self-acceptance as integral in the process. (1)

Recovery is non-linear, and there is a need for more complex and flexible measures to understand the endpoints, timelines and processes of recovery. (2) It is necessary to recognise why it may not be too helpful to make weight our sole focus of recovery – and why it’s vital to think much further outside the box.

Below are three reasons why eating disorder recovery goes beyond the return to a ‘normal’ weight and other factors to consider on your healing journey, too. 

 

ONE: Health goes beyond physical measures.

We know that our whole health, particularly in eating disorder recovery, comprises far more than just weight. Mental, social, environmental, occupational, spiritual and emotional health are all relevant and valid facets when it comes to our health, too.

For example, if someone was injured in a potentially fatal car accident, but their fractures had now recovered, we wouldn’t assume that all of the trauma and fear that may have surfaced from this singular event has magically disappeared. 

It could take this person years before they feel comfortable travelling by car again. This could cause restriction in other areas of their life – such as in their occupation or social life – perhaps even evoking feelings of guilt or isolation. From this sole experience, we can see the consequential impacts on multiple forms of our health.

In the same way, although a stable weight may be reached, this doesn’t mean that we are in the best mental or emotional state that we would be considered ‘recovered.’  The weight gain itself could stir up inner conflicts too, so it is important to learn about how to cope with this.

These additional pillars of health cannot be defined or measured by a number on a scale or a portion size. So, putting weight as the threshold by which one is recovered can be seen as reductionist – losing sight of the broader picture.

You must also consider your emotional resilience, the relationship with have with your body and how you interact with the world around you.

 

TWO: Remembering the power of cognition.

Only looking at weight restoration as a measure of healing from an eating disorder assumes that this objective measure is the only indicator of recovery – and that our personal experiences and cognition is also healed through weight restoration.

Thought and behaviour play a massive role in our recovery. Although our weight may have normalised, this doesn’t mean that our mindset is positively aligned with achieving a complete and sustainable recovery. It is also beneficial to identify and detach our recovery ‘self’ from our eating disorder ‘self.’

Reaching a place of freedom, intuitive eating, and body compassion is no easy feat, and particularly for someone with an eating disorder, this may still feel like a lifetime away. They may still experience body shame and have a massive fear of gaining weight or continue to feel extreme hunger throughout the day. All of these can be signs that they may still be a long way off recovery. (3)

Those healing from an eating disorder may feel guilt for any weight changes or uncomfortable eating large amounts of food and limiting their heavy exercise routines.

Although recovery may be visible from a weight perspective, we do not know the whole story of someone’s mental state and any silent disordered thinking that they may experience. 

A big part of healing from an eating disorder is our mental health and self-talk – so again, ignoring this misses out a significant factor of one’s recovery path.

 

THREE: There is no such thing as a ‘normal’ weight.

It is important to remember that weight is an individual and relative term and that there is no one-size-fits-all approach when it comes to our bodies. 

You may have reached what is considered a ‘normal range BMI,’ but this is a social construct and one that has been criticised in the media time and time again for its potential inaccuracy. Weight is not a highly accurate measure of health – read why here.

Weight is personal to you – it goes beyond a number on a scale and involves how you feel and perceive yourself at that weight. It also doesn’t account for our unique build and other health conditions or situations that may shift our set point weight or what feels ‘normal’ for us. (4)

Focusing on weight implies that people are recovered through reaching a number on a chart and may further reinforce the visual stereotype of an eating disorder – being thin, emaciated, and usually female. 

We know this stereotype is often inaccurate, and eating disorders can manifest in any body shape, gender or race. The idea that all eating disorders look the same on the surface is simply not true. 

This may lead people to believe that they are not ‘sick enough’ due to their now-restored weight, and they may not feel an urgency to continue to recover or may feel they no longer need to. Being unwell is not a ‘look’ – and so it’s important to consider health from a more holistic viewpoint. (4)

We hope you enjoyed this article and are sending you plenty of strength and positive energy, no matter where you are right now. This kind of self-work takes immense courage, and we are here to support you along each step of the journey. 

Reach out to us at hello@embodyhealthlondon.com to chat with one of our specialist dietitians and book a discovery call today!

 

Priya Chotai, BSc ANutr

EHL Team x 

 

 

 

 

 

 

References

  1. Bardone-Cone AM, Hunt RA, Watson HJ. An Overview of Conceptualisations of Eating Disorder Recovery, Recent Findings, and Future Directions. Curr Psychiatry Rep. 2018 Aug 9;20(9):79. DOI: 10.1007/s11920-018-0932-9. PMID: 30094740.
  2. LaMarre A, Rice C. Recovering Uncertainty: Exploring Eating Disorder Recovery in Context. Cult Med Psychiatry. 2021 Dec;45(4):706-726. doi: 10.1007/s11013-020-09700-7. Epub 2021 Jan 2. PMID: 33389444.
  3. Bardone-Cone AM, Johnson S, Raney TJ, Zucker N, Watson HJ, Bulik CM. Eating disorder recovery in men: A pilot study. Int J Eat Disord. 2019 Dec;52(12):1370-1379. DOI: 10.1002/eat.23153. Epub 2019 Aug 16. PMID: 31418898.
  4. Hayden, M. Why ‘Weight Restoration’ Isn’t Recovery — ThoughtsbyKenz. 2021 Jan; Retrieved Nov 26 2021, from https://thoughtsbykenz.com/posts/2021/7/11/why-weight-restoration-isnt-recovery

Beliefs holding you back from full recovery

limiting beliefs

Three limiting beliefs your eating disorder has you believe

 

Recovery is hard enough as it is, not to mention when we hold unhelpful limiting beliefs that prevent us from reaching our full potential.

A limiting belief is a state of mind, conviction, or belief that you think to be true that limits you in some way.

We work with hundreds of clients who feel limited in their recovery due to these beliefs. Whilst, of course, we are all unique, there are some common limiting beliefs that many of our client’s experience. 

In today’s blog we are going to explore a handful of these beliefs and hopefully shed some light on why they are worth reframing. Because after all, beliefs are ever-evolving – not static.  

 

#1 FULL RECOVERY ISN’T POSSIBLE

Let’s start by saying… full recovery IS possible and it’s never too late to begin!

Why do we feel so strongly about this? Because we witness this possibility every day and research says it is, too.

With the right support and willingness to make change, you CAN recover.

What is full recovery?

It could be defined as an improved quality of life due to being free of all eating disorder symptoms and returning to a healthier body weight (if underweight). Beliefs and attitudes about body image, food and exercise are also normalised and healthy.

Factors that make it more challenging:

  • Not being aware of the eating disorder or of having a problem: If you’re here reading this, this likely isn’t you! Therefore, the world is your oyster! For those that are not aware, the right medical support is needed to ensure they are stabilised and then there is scope for engaging in recovery. 
  • Severity and duration of the eating disorder: The longer and more severely you have lived with your eating disorder the longer it may take to recover. But don’t let that put you off. Think about how much your life is impacted by the eating disorder – do you really want that to continue into your future? How much longer can this go on? You’ve got a life to live!
  • Anxiety or depression: Eating disorders often present with anxiety, depression, or obsessive-compulsive disorder (OCD)1,2,3. Therefore, to recover fully it can be helpful to have the right therapeutic interventions to deal with the anxiety and/or depression alongside the eating disorder.
  • Low self-esteem and perfectionism: It have been shown that some of the maintaining factors of an eating disorder are underlying clinical perfectionism and low-self-esteem4. This tells us how engaging in a therapy is helpful to address underlying causes. 

 

#2 I WANT TO RECOVER IN A “HEALTHY” WAY

You want to have a go at recovery, but don’t want to eat that because it’s “not healthy”, right?

Holding onto “healthy” or “clean” eating is keeping you trapped. Healthy/clean eating in the context of eating disorder recovery is likely just a restriction dressed up with a halo.

We have to be very careful of this, because we also run the risk of recovering from one eating disorder into another – for example, from anorexia into orthorexia. This is NOT a good thing. It can be just as harmful and is not freedom!

Healthy eating has many definitions. It is perceived as a “good thing to do” in society and therefore if we suggest that our choices are based on “healthy eating” then it can be a get out of jail card for the eating disorder, and it can continue to go under the radar.

What do we know about the eating disorder staying under the radar?

Eating disorders THRIVE in isolation. If you are not allowing yourself to be honest with your intentions for healthy or clean eating, you are not allowing yourself to find food freedom.

It’s immensely important to challenge ALL foods as part of your recovery – including “fun foods”. If this doesn’t happen, food fears will continue to creep in and limit you from living a full life.

 

#3 I WANT TO RECOVER, BUT STILL BE IN CONTROL OF MY WEIGHT

In order to fully recover, we need to be able to accept that our body will change. Our body’s weight will change across our life. If we are still gripping onto the idea that we can “stay skinny” or “not gain any more weight” then we are letting our eating disorder control us.

The desire to still be in control of weight is driven by FEAR. We are scared. We fear what weight gain might look like, people’s opinions, what it might feel like, and what it may mean about us.

In order to overcome the fear of weight gain, we have to stop and move away from any weight-controlling behaviours. This is absolutely necessary. Every time we engage in weight control behaviour, we teach our brain that it needs to be afraid of weight change and that keeps us trapped in a negative loop of other unhelpful eating disorder behaviours such as the restriction-binge cycle or purging and over-exercise.

When we learn to let go of the control of our weight, we make room for SO MUCH more in our life. How much time a day do you spend thinking about your weight or ways to control it? Yes, too much. What else could you do with that time? Imagine the possibilities!

Your weight is the least interesting thing about you. Don’t give it so much of your energy. You are a whole person, you have so much to give to the world – the world needs that.

To learn more about how our dietitians can support you in your eating disorder recovery, book a free discovery call.

Zoe Light, RD

EHL Team x

 

 

 

References

  1. Godart N.T., Flament M.F., Perdereau F., Jeammet P. Comorbidity between eating disorders and anxiety disorders: A review. Int. J. Eat. Disord. 2002;32:253–270. doi: 10.1002/eat.10096.
  2. Godart N.T., Perdereau F., Rein Z., Berthoz S., Wallier J., Jeammet P., Flament M.F. Comorbidity studies of eating disorders and mood disorders. Critical review of the literature. J. Affect. Disord. 2007;97:37–49. doi: 10.1016/j.jad.2006.06.023
  3. Garcia S.C., Mikhail M.E., Keel P.K., Burt S.A., Neale M.C., Boker S., Klump K.L. Increased rates of eating disorders and their symptoms in women with major depressive disorder and anxiety disorders. Int. J. Eat. Disord. 2020;53:1844–1854. doi: 10.1002/eat.23366
  4. Fairburn C.G., Cooper Z., Shafran R. Cognitive behaviour therapy for eating disorders: A “transdiagnostic” theory and treatment. Behav. Res. Ther. 2003;41:509–528. doi: 10.1016/S0005-7967(02)00088-8

 

Three steps to challenging your food rules

anti diet food rules challenge recovery

How to move away from the shackles of diet culture by challenging your food rules 

 

If you’ve ever felt guilty or anxious around food and eating, you’re probably be influenced by your food rules.

Food rules are beliefs about foods that are collected over time and form the basis of our food choices when we are not eating intuitively. They dictate things like the types of food you’re allowed to have, how much you should eat, and the timing of your meals and snacks. You may not even realise how many food rules you have until you start your journey towards intuitive eating and begin to question the reasoning behind your eating habits!

This article will give you three simple steps to help you get to the bottom of your food rules and overcome them, in order to learn to eat based on your internal body cues.

 

ONE: Renourish your brain

In order to do the difficult work of changing your thinking patterns and belief systems, you must first ensure that your brain is functioning to the best of its ability. We know that the brain needs a tonne of energy to do its job properly; this means that getting adequate nutrition is one of the most important steps you can take if you want to change your cognitions.

One of the most well-known studies showing the effects of inadequate nutrition on the brain is the Minnesota Starvation Study. Amongst other ground-breaking discoveries, the study found that the restriction of calories causes impaired concentration, reduced alertness, poor comprehension and problem solving, and reduced motivation. Learn more about the effects of starvation on the brain and body here.

Ensuring you are eating regularly and adequately to give your brain the fuel it needs will make the next two steps that much easier.

 

TWO: Unpack the rule

It can be helpful to understand the origin of your food rules and what exactly they mean to you. This can allow you to develop a deeper understanding of you thought processes, making it easier to challenge them.

Some questions you can ask yourself to begin this process are:

  • Where did this rule come from?
  • When did I first begin following this rule? What triggered this?
  • What do I believe this rule will achieve? Is this belief logical?
  • What are my specific fears around breaking this rule?
  • How is my life affected by this rule?

 

THREE: Conduct an experiment

The most effective strategy for breaking down food rules is experimentation. Put your scientific hat on and approach your beliefs with curiosity and a methodical mindset.

The first step of this is to select a rule to challenge. Begin with the more flexible and less fear-inducing rules – there’s no need to throw yourself in the deep end!

Next, form a hypothesis about what you think (or what you fear) might happen. This might be structured like “If I do X, then Y will occur”.

Here comes the scary part – testing your hypothesis out. You might like to ask a friend or family member to support you through this if you’re expecting it to be particularly difficult. Keep in mind that you may need to test your hypothesis several times in order to come to a conclusion.

The last step is to evaluate the results. What actually happened? How did this compare to what you expected to happen? If it was different, can you come up with an alternative belief that might be more accurate?

Continue to repeat this process with all your food rules, gradually progressing to the more challenging ones. With patience and practice, you’ll be eating according to your body cues in no time!

If you believe you would benefit from individual support with your journey towards intuitive eating, our expert dietitians are here to help! Get in touch at hello@embodyhealthlondon.com to learn more about how we can work with you to achieve your goals.

 

Karli Battaglia, APD

EHL Team x

 

How to distinguish your healthy self from your eating disorder self

two minds eating disorder recovery

Recognising and challenging your eating disorder thoughts

 

At the beginning of the recovery process, many of our clients worry about who they’ll be without their eating disorder. Oftentimes, the eating disorder has ruled over their thoughts, emotions and behaviours for so long that they fear it has permanently taken over their identity.

However, through the privilege of seeing many people recover, we know that this is not the case. Instead, as the person progresses through their recovery journey, what we actually see is their true identity becoming stronger as the eating disorder retreats.

This is where the idea of having a healthy self and an eating disorder self comes from. In this article, we’ll talk you through how to tell them apart and how doing so can help you in your recovery.

 

What is the concept of the healthy self and the eating disorder self all about?

The concept of the healthy self and the eating disorder self is based on the work of Carolyn Costin, a renowned eating disorder clinician, founder of the first eating disorder residential treatment program, and author of ‘8 Keys to Recovery from an Eating Disorder’. You can learn more about Carolyn’s incredible work here.

When we explain the idea of the two selves, many people resonate with it right away, clearly seeing it reflected in their own thoughts and behaviours.

The healthy self is the part of you that was in control before your thoughts and behaviours became warped by diet culture, trauma, fear and so on.

It is the rational, kind and non-critical part of you that, over time, has been hijacked by your eating disorder self. This is the part of you that is harsh, fearful and has a distorted view of the world and yourself.

To make sense of this concept, you might like to think of an angel on one shoulder and a devil on the other, battling to be the dominant voice. This is similar to how your healthy self and your eating disorder self interact.

Ambivalence is incredibly common in eating disorder recovery. It would be very unusual to have a client whose commitment to recovery is steadfast throughout the entire process! This phenomenon a representation of the conflict between the healthy self and the eating disorder self.

When part of you wants to recover and part of you is terrified to get better, that is the two selves at work. When part of you knows that the eating disorder behaviours are irrational and part of you feels compelled to engage in them, that too is the two selves.  As you become more aware of the two voices, they will become more distinct.

The ultimate goal isn’t to eradicate your eating disorder self – this is the part of you that alerts you when something is wrong, when you’re struggling to cope or when you’re feeling afraid.

Instead, the goal is to strengthen your healthy self and reintegrate the eating disorder self to form one single embodiment, where the latter continues to do its job of alerting you to problems. When prior you may have used eating disorder behaviours to silence these alarm bells, once the two selves are integrated, you will be able to use more constructive strategies to address the issues you are being alerted to.

 

How can I strengthen my healthy self?

There are several ways you can get more in touch with your health self, in order to strengthen this part of you over your eating disorder self.

One of the simplest ways is to consider what you would say to friend or a small child in a similar situation. For example, while your eating disorder self might tell you to engage in restriction to compensate for a large meal, we’re sure that’s not what you would recommend to your little sister! Your healthy self tends to emerge more strongly in your compassion for others.

Once you have identified the voice of your healthy self, you can use it to dialogue with your eating disorder self. In other words, you can come up with “healthy” responses to your eating disorder thoughts, either in your head or on paper. You might like to utilities this worksheet from EDIT™

As an example, if your eating disorder self says “If I gain more than x amount of weight, I’ll be miserable”, you may come up with a response like “The number on the scale does not define me and it won’t change the way I feel unless I allow it to”.

This can assist you in your recovery by helping you to turn up the volume of your health self and strengthen it over your eating disorder self.

Saying all this, be sure not demonise your eating disorder self. As we mentioned above, it has been acting as a coping strategy during a difficult time in your life. However, through the process of recovery, we can support you to find new, healthier behaviours to replace your eating disorder.

Remember that your eating disorder cannot be stronger than you are, because you give it all of its power.

The idea of the healthy self and the eating disorder self is, of course, just one way to look at and understand eating disorders. It may resonate with you and it may not!

If you take only one thing away from this article, let it be this: you are not your eating disorder and recovery is possible.

Reach out to us at hello@embodyhealthlondon.com to find out how we can support you on your recovery journey.

 

Karli Battaglia MDiet, APD

EHL Team x