#bingeing

Extreme hunger- exactly what it says. Extreme

Extreme hunger in #EDrecovery Because it needs to be when you’ve been starving

When will my extreme hunger end, is my extreme hunger normal? Should I trust this hunger? How do I get rid of this extreme hunger? Why can’t I eat like a normal person? Am I mad? Are these questions you’ve asked?

You’re not alone.

Hunger is normal. Most people wouldn’t give it a second thought, they experience hunger, they eat and move on with their day. It is a normal human function.

For those of us who have been through an eating disorder or any form of disordered eating we have tried to avoid hunger. Lost touch with it, broken our trust and relationship with it.

Almost as a sick joke, when you start recovery, it is very likely you will experience the well recognised phenomenon that is hyerphagia, a.k.a ‘extreme hunger’, though not everyone does. Realistically you are unlikely to be able to go from heavy restriction to eating ‘normally’ straight away.

What is extreme hunger?

It is essentially a biological reaction to a period of restricted intake, this can be through disordered eating such as dieting or an eating disorder. It is the body’s mechanism to heal, there are physiological aspects to do with hunger hormones such as ghrelin as well as psychological mechanisms. It is a means of repaying the deficit of energy the body has undergone to repair itself. So whilst we are here, let’s emphasise that although it feels ‘excessive/extreme’ it isn’t under the circumstances is it?

When you restrict, even in short periods your body begins to utilise energy from all parts of your body. This basically means your body has started digesting its own organs etc. Now imagine if that was for a very long time, the damage done, eating normal quantities of food would be a drop in the ocean, it’s not enough.

As someone who has ignored hunger, restricted their intake of food, this feeling of intense hunger is terrifying but makes complete sense if you break it down logically. I wanted to wait a while before writing this, I wanted to write my experience from the other side to reassure you IT REALLY does get better.

Not everyone will experience it, it will look different for everyone, it may show up right from the offset of recovery, or like me later after a relapse.

I remember trawling the internet for hours, reading scientific papers, watching YouTube videos to try and predict when my ‘extreme hunger’ might subside and if it was normal asking all of the above questions, hoping for an answer.

The truth is, no one can tell you when it will happen, if it will happen or when it will go. The only thing you can be reassured in, IT IS NORMAL, IT WILL GO AWAY when your body is ready for it too. And yes, there may be times it returns, for instance if you enter a period of inadvertent restriction i.e. after a small illness.

I didn’t experience this “extreme hunger” when I first started recovery in 2019, it showed up for me when I truly let go of all restriction and got back on track from my last relapse in August 2020. It manifested in many ways which I’ll elaborate on.

When I was seeking comfort from online sources, article after article would reassure me that what I was experiencing was in fact a completely normal response mechanism to restriction and that if I honoured this hunger it WOULD dissipate. I did not believe any of this at the time. It felt so wrong, like I was doing something wrong (I was in terms of my ED brain, which is a good thing), I felt like it would never end.

But now, if you have found this by searching “will my extreme hunger ever go away, how do I get rid of extreme hunger” I promise you as someone who has come out the other side IT WILL GO AWAY if you obey and don’t judge the hunger. I know you’re probably laughing at me now, “how can I not judge this hunger, I am never going to be able to get through it” YOU WILL.

What does it feel like...

It feels like bingeing. It’s not. It is eating what you need for the deficit. The key difference is restriction and the behaviours associated such as compensation etc. Although- I personally believe BED (Binge Eating Disorder) patients are often in a difficult position- where many treatment providers inadvertently promote restriction, by trying to limit intake, which in my opinion can set the sufferers up to binge more, which makes their recovery journey difficult. But that’s just my opinion. This is why health at every size aligned treatment is so important.

Your mind and body tells you to eat ALL foods ALL the fucking time.

You’ll think you can control it, “I won’t eat as much as that tomorrow, I’ll be normal” but you won’t, you can’t win that, so settle into the discomfort.

You will likely feel full to the point of pain but hungry all at the same time. Your stomach may feel bloated because it’s not yet well rehearsed at digesting and it’s like your stomach can’t keep up with your brain. Or you’ll think your full and done only to then feel as if you haven’t eaten just 15 minutes later. This is completely normal. (I mean nothing about restricting, starving is normal, but this response to that is)

I could eat my dinner & pudding then 30 mins later repeat this and still feel un-satisfied. I felt like a bottomless pit. It was like a survival drive.

I also experienced mental hunger. Mental hunger is a form of hunger, where you are constantly thinking about food, it often occurs when we haven’t 100% connected with our physical hunger cues or satiety.

For me this included dreaming of food, often nightmares of my fear foods, thinking about what my next meal would be, worrying about what it would be, when I would eat, if it was enough/too much, if it was ok to eat XYZ, if I was hungry, am I eating out of boredom, emotions, would I like it, would it be horrible, It was probably more distressing than the physical hunger because it was relentless and totally unimportant. If you experience mental hunger, it’s hunger. It will get better with eating.

For someone who has not experienced this, it’s hard to actually express how intrusive this is. It makes thinking about ANYTHING else really hard. My rule of thumb during this time was, if I thought about it, I ate it.

THIS is highly traumatic to a person who has restricted their intake for so long. I would advise you to enlist support during this phase. Distraction can work a treat when you are eating. Watch a show that holds your attention, eat with someone you trust, take up puzzling, anything to shift focus from the anxiety of eating. (I don’t personally believe mindful eating is very helpful at this stage as it just increases anxiety and our ridiculously critical brains, mindful eating is for WAY further down the track, intuitive eating is the goal. Just not now.

Hot water bottles become your best friend as do things like peppermint tea, they help soothe some of the gastric symptoms (I.e. unbearable gas – having a pet helps for blaming purposes!).

Yoga not only helps with the anxiety side of things, it can help with the bloating.

This is not a time to be wearing things that make you uncomfortable. Wear elasticated pants, those comfy sweat pants, flowy dresses, loose clothing, nothing that makes you feel constricted.

One thing I did, which is probably really weird but it helped me, was to name my belly “Bob”. This wasn’t a particularly conscious effort. But I like to use humour for many things, my distended belly ‘Bob” became a running joke between my partner and I. When I reflect now, I can also see it made the process easier, I separated myself from ‘Bob’, which meant I could seperate myself from my ED. If ‘Bob’ was hungry it was easier to feed ‘Bob’ than it was myself. If ‘Bob’ wanted something my ED was utterly disgusted by, ‘Bob’ got what they wanted, it was ‘Bob’ not me. When Bob was bloated I could laugh and show them compassion rather than receive the barrage of abuse and contempt my ED voice would show me.

I HAVE NO IDEA if this is something that ANYONE else would do. But it worked for me and I wanted to share.

I haven’t fed ‘Bob’ for ages, I feed myself now. But when it was really difficult to do, responding to ‘Bob’ was easier. As a thirty something year old there’s nothing less de-humanising than not being able to feed yourself, and until I could, I enlisted this tool.

Will my extreme hunger ever go? Yes, when? no clue.

Eventually over months my appetite “normalised” I use this term very loosely. There’s no such thing as a ‘normal’ appetite but what I mean is I now have a pretty reasonable relationship with my hunger cues and desires. I am leaning into intuitive eating. This extreme hunger fixed itself with time. I would find it very difficult now to eat large quantities of food (outside of what I was desiring).

One thing I had to accept was, during this time and possibly for the foreseeable future my requirements are not the same as someone who has not waged war against their body. I had a lot of damage to repair, to pay back and so comparisons to your peers will NEVER be helpful. It is not a normal situation to be in, recovering from an eating disorder and so your requirements will not likely be the same as someone who has not experienced this. So leave the judgement behind. YOU do YOU, stay in your own lane. For example there have been times where I have been able to demolish double what my husband can eat, I do not believe in the “his and hers” portions. Or portion sizes full stop for that matter.

Eventually your body will start to heal, it will start to trust you and your hunger and satiety cues will return without any intervention. Just hang in there.

‘Portion sizes’, re-learning to eat like a ‘normal human-being’, anorexia recovery..

Re-learning ‘normal eating’ ED Recovery

I say normal, loosely. Because the majority of the population has some form of low grade restriction going on. Whether they realize it or not, any diet behavior is restriction. This is not normal eating. But it is ‘societies normal’ This is not an option for us.

When we restrict, our body adapts, by lowering metabolism and a whole heap of other changes like disrupting hunger cues. (This is partly why diets don’t work, restriction leads to a response known as ‘hyperphagia’ (increased hunger) to counteract this unnatural behaviour. Our bodies function in equilibrium and so will adapt or correct the perceived famine. For anyone who is interested like me, in evidence or scientific explanations, the ‘Minnesota Starvation experiment, led by Ancel Keys’ is the closest we will ever get to depicting what happens to humans when starved, both physiologically and psychologically. It would never pass an ethics committee today but the evidence still stands. This was a practice changing study from the forties that still helps to shape nutritional rehabilitation. It provides explanation for experiences such as hyperphagia.

In early recovery most of us experience “extreme hunger”, hyperphagia. For me this wasn’t so much physical hunger, for the most part, but it translated more as mental hunger or feeling off. Regardless it’s still hunger, if we are obsessing about food it’s because our bodies are needing fuel. I was constantly thinking about food, when I was next going to eat, what I could eat, worrying about whether it was ok/ not enough, even dreaming about food, obsessing about food, reading recipes the list goes on. It felt relentless and really intrusive. It was hard to think about anything else. During this period, I would also find it hard to leave food on my plate, even if I felt full, I guess it was my brain freaking out, fearing that I was going to return to a state of famine again. I’d feel almost a compulsion to finish everything. I never felt satisfied early on, I would be painfully full but still thinking about food. This has gotten better with time. I don’t feel the need to finish everything in front of me. This obsession with food was different to that in the depths of my eating disorder, where I would obsess over food then. When under the grip of ‘HH’ I would control everything around it, I’d cook for others, but never eat what I’d made. I’d bake a lot at this point, now I bake if it’s someone’s birthday, I’m just not interested or obsessed like I was. This is common I think, now we have a rule in my house if I make it, I eat it. Some days, if I haven’t eaten quite enough, I find my extreme hunger can return the next day, but this is getting less and less.

This is terrifying when it first happens. If it is happening to you, or someone you know, extreme hunger is normal, it’s a healthy response to energy deficit and reintroducing nutrition. It showed up for me months later in recovery, after I got back on track from a relapse. I didn’t experience it prior. Bingeing is normal in this setting. It’s distressing, it feels it’s going against everything the eating disorder believes. But the only way I found it improved was to listen and respond to it. Restriction remains the enemy for this.

Some-thing I still find difficult, is what’s normal. I also think, there probably isn’t actually a normal, because what’s normal for one person is not for another. However serving sizes is a tricky one, I can under-eat some times because I have done so for so long and my perception of what a ‘normal portion’ is warped.

I have found asking for help with this, although humiliating as an adult and at time unbearably uncomfortable, I often run my lunches past my husband and if he tells me it’s not enough, I don’t argue, I add more. I am trying to re-learn normal eating.

Another thing that helped me, although at the time I hated it and argued until I was blue in the face was relinquishing control around food. By this I mean, I was lucky my partner took complete control of what I ate, when I could not make healthy decisions geared towards recovery without ‘HH’ sabotaging. I was not allowed to cook, prepare meals, or enter the kitchen when meals were being prepared. It was one of the most humiliating experiences of my life and there were times when I would argue, shout, cry, throw, he would force me to eat what was in front of me. I was like a child. But worse, I was an adult having a meltdown. But this role was necessary for a short time, because if left alone, I would skip ingredients, make smaller meals, substitute ingredients ‘for healthier’ alternatives etc.

But it was important for me to regain independence quickly (for me and my partner) and the only way I could was to suck it up.

I cannot express the grattitude I have for my partner, I think people who support a person through eating disorder recovery are saints, they see the worst side of a person imaginable, because a caged animal will always lash out. I have apologised more times than I wish I’d ever have to in a life time. I think this is where it’s useful to seperate the person from their eating disorder. We are not our eating disorders, and the non-negotiations are with the eating disorder, not the person being over shadowed by it. This does not give a free pass to be a dick, it’s just to help understand why you have to keep fighting for recovery. Thankfully this wasn’t needed for long.

For a short while, I followed the principles from Gwyneth Olwyns, homeodynamic recovery. I like evidence and this is evidence based. I will link this below. I do not count calories and find doing so to be detrimental, however this principle sets minimums and it helped me for a short period when trying to become independent again.

One thing I’ve accepted is, comparing what we need to eat in recovery to someone who has not just waged war on there body is never going to be helpful. We need more than most people to heal. Healing doesn’t end at ‘weight restoration’, we still have a nutritional rehabilitation, inner repair, mental healing beyond this. Who knows how long this will take. This, Is hard for someone with a restrictive eating disorder, but I believe it’s true and giving yourself permission to eat whatever, whenever and often ‘more’ than people around you is an important step. Letting go of the judgment. I’ve only recently gotten to this point, I used to find it really really hard to eat in front of, or with others. That’s isolating and something a lot of us have to overcome. So ignoring comments about food is important, hard but totally achievable.

1. The Minnesota Starvation experiment: https://archive.wphna.org/wp-content/uploads/2016/01/2005-Mad-Science-Museum-Ancel-Keys-Starvation.pdf

2. Gwyneth Olwyn, Homeodynamic Recovery Method: https://edinstitute.org/blog/2013/3/31/homeodynamic-recovery-method-guidelines-overview