Recovering from an Eating Disorder doesn’t Automatically Guarantee Life Will be Perfect..

But when life is challenging , you won’t have an eating disorder to contend with as well.

Rather naively, I think many of us hold this notion of “if I could just fix my ED, my life will be perfect”. So let me get in there early and save you the “aha” in months/years to come, set your expectations now, be realistic .

This is something I have come to realise throughout my recovery. The many times I’ve contemplated what recovery means, how I define it, what life will look like beyond my ED.

As I’ve gotten further into recovery and shifting away from my eating disorder, it’s become increasingly apparent that recovering from an eating disorder does not mean life will ultimately be all rainbows and flowers once the ED is conquered. No. That’s just not possible. But, life’s so much better, just putting this out there early.

But, the big thing here, the “aha” moment for me, was recognizing recovering from an eating disorder means we have tools to help us when life throws us a curve ball and returning to the eating disorder does NOT have to be an option.

Additionally when something in life happens out of our control, not having to contend with an eating disorder simultaneously, means we are better equipped to handle the stress.

An eating disorder is a big problem, not a solution. It may feel like it gives you control and comfort around times of difficulty but I promise you, that is the mask of the ED. It is definitely an added problem that you do not need.

Recovery will not mean that when you have a stressful time in your life, a loss or lots of change you won’t experience human reactions such as anxiety, low mood or whatever else we all feel according to life events. Recovery doesn’t make you some kind of super hero that doesn’t feel or get rocked by anything- but it does mean you don’t resort to dangerous/ maladaptive coping mechanisms that you have relied upon until this point. Learning to feel has been a skill I’ve developed in recovery and how to respond to these feelings.

It would be unrealistic to believe you will never have a day of insecurities, or god forbid a bad body image day. Because even people who have never experienced an eating disorder experience these human emotions. But if you’re recovered you won’t obsess over them, you will be able to deal with them and it won’t “ruin your day your week or even your year”! Yes I did just do that.

Recovery is a beautiful thing and it means something different to everyone. The recovery process is not the same for any of us, but I do believe it is important to consider your expectations of what it will mean for your life.

Personally, it has led me to an understanding that beyond ED Recovery work, in order to remain in recovery, l will need to put work into ongoing stress management, imposter syndrome and work anxiety. For me they are interlinked.

It is highly likely this will mean continuing with therapy of some kind to help me work with these issues, because I want to protect my health legacy.

One thing I know, life stressors are not something that are going away because it’s part of life, everyone has problems. BUT don’t let having an ED be one of them or believe that once you have recovered you will be a unicorn and NEVER have another issue.

“Weigh days” in ED recovery

Your worth can never be defined by a number

Weigh day in recovery This used to instil dread and fear into me and so I want discuss this further as I’m willing to bet it’s a common experience in recovery.

I’ve already talked about my tenuous relationship with the scales. However in early recovery when we are “ nutritionally rehabilitating” the scales can be important in therapy. Weight restoration can be an integral part of ones recovery.

I was doing my usual re-reading old journal entries and so many were about “weigh days”.

For me, I used to experience extreme anxiety leading up to weigh day and then days following.

Why is “weigh day”so traumatic for someone in recovery?

People with eating disorders tend to obsess over numbers, whether it’s calories, clothes sizes, or the frigging number on the scale. The numbers torment us. We live by them, we fear them. Therefore on the days I had managed to gain weight my eating disorder voice would throw a full on wobbly, if I’d lost it would throw a full on wobbly. You cannot appease an eating disorder.

For my family the “weigh days” were important to them, they were afraid it was one of the only ways the could tell if I was “doing ok” or slipping because of the secretive nature of ED. This reinforced the anxiety as-well, the concern of feeling like a failure or the threat of more focus being placed on me. But, I had lied before, many times and so I respected the validation they needed whilst I rebuilt trust.

The “target weight” issue

I personally don’t feel that “target weights” are helpful to most of us with EDs. I completely get why health professionals use them, but I personally feel that they have the potential to perpetuate trepidation and internal judgements that exceeding that target weight is to be feared or avoided.

Realistically most of us go way over. We go over because we need to, it’s called overshoot and it’s natural. It’s your bodies way of protecting you in case another famine arises. It’s why when people continually diet end up heavier because their bodies no longer trust them. However eventually when you let go of the diet BS, your body figures it’s shit out. But try rationalizing that with someone fighting an ED voice and going against an entire society who shares the ideology weight gain is a negative.

I believe holding on to my target weight kept me stuck, every time I got close to I’d bail on my recovery efforts, if I surpassed this arbitrary number I slipped. Until I let go of weighing and ate unrestricted. For some I imagine having a rough idea of a target may help them but for many like myself it can be a sticking point.

I know that, eating disorders love to hold on to numbers, to manipulate our thoughts and behaviors. Mine convinced me I needed to know my weight in early recovery to “monitor progress to “check”. Let’s cut through the crap, my eating disorder wanted to know the number as a “form of control” to ensure I wasn’t “gaining too much, too fast” it colluded with the numbers and therefore my behavior. This was continual until I was willing to accept my motives to know the number was not healthy.

Additionally certain values held specific connotations to previous relapses, or behaviors. For example the “target weight” hurdle was a huge trigger. I found it almost impossible to reach or pass when I knew the value because my eating disorder voice would get so much louder.

Recovery is hard enough, why make it harder for yourself by observing the scales? If you follow the recovery process, eating enough, not engaging in behaviors your body will recover and reach its natural weight without your eating disorder trying to complicate/ control things along the way.

For a while, I couldn’t know my weight, or (when agreed with my therapist) we reduced the weigh days.

There are pros and cons to this. Weight provides teams with anthropological information about recovery.

Regardless of whether it’s vital you are weighed you do not need to know your weight, you have the right when you attend a medical appointment to be blind weighed.

Fast forward to now, I’ve been in recovery for a while, there are days where I feel a draw to the scales. I know it’s never about the scale and I return to my recovery tool box to find what I need. I do not weigh myself. If I have to be weighed I would like to think it would cause little more than an internal stir.

If I have the situation where I have to be weighed:

I will likely follow my own healthy voice’s advice and ask for the number not to be made known to myself. Because, weight has no value to who we are. We do not need to know. It’s not worth giving the unhealthy part of my brain ammunition.

Arrested State of Development

Last week I was setting my intentions for the New moon. Whilst beginning to manifest and set in place the foundations of those intentions, I had a realisation.

When we are experiencing an eating disorder we are living in a state of “arrested development”. Loosely this is defined as a cessation of growth, this can be both psychological and physical. Initially ALL of our focus and energy is used in sustaining our eating disorder, then it becomes recovery orientated, both requiring substantial energy and attention.

I’m in the process of some major life changes and upheavals over the coming months with a ton of uncertainty. I’d been ruminating over the fact I wasn’t where I wanted to be, in terms of the standards I’d set myself for my career, my life. I was feeling resentful to the time lost to my eating disorder and to some extent recovery.

It dawned on me, for the last two years I have been fighting for my recovery, fighting to have a life not dominated by and eating disorder and before that I was expending all of my energy on the disorder itself, leaving room for very little else. I was feeling frustrated that I was now “no longer considered the best doctor of my cohort”. This is an egocentric attitude I need to work on anyways, but I have always been a perfectionist and through uni I had never settled for second place. Now, academically I am viewed as “capable”, but not excelling. There is nothing wrong with this, it’s how my brain processes this that is the problem. Now, I’m the doctor who has the good rapport but hasn’t necessarily recalled every hazard ratio from every journal ever written, but this was me, a long time ago. Before my life priorities had to change.

I realised some of the standards I’d set myself had become external expectations and now I don’t match those either. Again, this is not a problem, it’s how you react to this. The thing is I have been trying to be “that standard”, but I’m not, I can’t be right now. I essentially took two years out. If I was a professional athlete I couldn’t expect to compete at the same level after two years out, it’s the same here. The difference is, the people with those expectations don’t necessarily know I have been trying to survive and recover again, this was because I kept my eating disorder hidden through fear of stigma and so why would they? It was only recently I felt able to be open about my journey.

It’s only now that I was beginning to feel “bored of having to be recovery orientated” and have so much more mental capacity I could see unmasked I had been living this state of arrest. It’s releasing, I’m ok with who I am. I’m proud of what I have overcome and where I am. Letting go of unrealistic standards and expectations is what’s helping me in my health legacy and provide my patients with care. I think it would be unhealthy and unrealistic to want to be the same person we were before recovery.

How can we develop and grow when our worlds are so minute and focused on such specific details such as weight or that grade. I didn’t have the energy or time to be reading the journals I now am, when I was merely trying to survive.

I worry about my colleagues, the pandemic will fuel burnout, but unless the healers have a place to heal themselves this won’t go away. I wish for the unforgiving environment that is the healthcare profession to become a more open and compassionate one. One that does not depict personal struggle as failure. I shared my struggle not so long ago, because this unrealistic image of what a doctor should be is harming those that look after you, the more we normalise the narrative the healthier the healers.

I do think recovery burnout is a thing, it’s emotionally, physically draining, it becomes tedious but for the days where recovery is not boring it’s important to keep recovery orientated.

Hypothalamic amenorrhea #1

This post is not intended as medical advice and I am not an expert. I write this with lived experience, the intention of raising awareness and promoting self advocacy.

Have you lost your period?

Losing your period is never something that should be taken lightly, it can be a serious indicator that your body is functioning suboptimally.

What is Hypothalamic Amenorrhea?

The absence of a period for 3 or more months related to an problem with the hypothalamus. The hypothalamus is situated in the brain it connects our endocrine system to our central nervous system. It has many roles- it basically acts as a regulator for many of our bodies systems. It is the main regulator of the pituitary gland which is the where central regulating hormones are released. Some of those hormones include reproductive hormones, needed for menstruation.

Hypothalamic amenorrhea- When the control centre of the brain that regulates hormone secretion– is turned off.

Why does this happen?

There are several factors that can lead to disruption to the hypothalamic signalling. This post is focusing on the reproductive aspects- hypothalamic amenorrhea. My intention is to give a brief outline to help you understand 1.why it happens, 2. Why doctors don’t necessarily consider it when they see someone in front of them.

Factors that lead to HA:

Energy deficit, this is the biggest factor and can occur due to a plethora of reasons. One of those is dieting. Whether this is through intermittent fasting- where the regular signals are not being maintained, caloric deficit, or excluding specific food groups such as cutting carbs/ fats, they all disrupt the signalling from the hypothalamus.

◦ If your hypothalamus perceives energy deficit it shuts down non vital functions of the body. It keeps you alive, it’s like a book balancer. What you don’t “need” it cuts. Menstruation is a function of reproductive health. Therefore, it is not a vital component to staying alive. Therefore it shuts off this non vital function, in order to preserve other functions including keeping your heart beating. This is another reason why we tend to feel COLD ALL the time when we are in energy deficit or have HA- the generator shuts off the heater to conserve other functions.

Weight loss regardless of your size. You can have HA at any BMI. Firstly, If you lose weight it’s likely related to energy deficit, however when you lose weight you lose important regulating hormones (leptin) which are in fat cells and this is part of the feedback system to the hypothalamus.

Stress. Something that puts stress on your body can disrupt periods. This may be through emotional or physical stress. Cortisol turns off the hypothalamus. Therefore it can cause you to lose your period.

◦ For similar reasons to above- exercise especially high intensity exercise can raise your cortisol by placing stress on your body. Additionally it can lead to energy deficit and weight loss and so it’s continues the issue. This is part of “female athlete triad”

Unfortunately HA is a common issue, however it’s not always recognized. Partly because it’s not understood and there are many misconceptions around HA. For instance people inhabiting in larger bodies are often rewarded for their weight loss efforts and exercising, but we know that HA can occur at any size. But often we are not as open with healthcare professionals about our lifestyle and they often don’t enquire.

When women lose their periods they are sometimes then commenced on the contraceptive pill to “restart” their cycle, or in some instances diagnosed with Polycystic ovarian syndrome (PCOS).

Unfortunately this is a problem because the management of PCOS- is often the complete opposite of HA. The contraceptive pill does not address the underlying issue, energy deficit. A bleed induced by the oral contraceptive pill is not a real period. If you took the pill away likely the person would not bleed.

I lost my period for a long time, thankfully I have healed from HA personally.

When in the depths of my eating disorder I did not advocate for myself or share my situation with healthcare professionals. I was advised at times to take hormones, I was not advised to stop/ reduce my exercise or eat more for instance. Getting a diagnosis is challenging because one, we don’t share and two it’s not always on the healthcare professionals radar.

However sharing knowledge with health professionals can help raise awareness.

I am no expert, I write this purely from personal experience and getting to know people within the recovery community.

I encourage anyone who has lost their period to seek medical advice, there are many reasons for this not just HA. But if you are someone who could be at risk of this you may need to advocate for yourself here.

I’ll write a separate post about some of the myths and issues associated to HA.

Diet pills, we don’t talk about this in ED recovery enough

Diet pills/ appetite suppressants… another side of eating disorders we don’t readily talk about. We should.

Over the years I have used many forms of products that were labeled as either “diet pills”, appetite suppressants, detoxing or laxatives .

I probably started using them well before I developed a full blown eating disorder. Raising the question for me, are they a gate way drugs to eating disorders?

Taking diet pills is disordered in itself. I trialed all sorts , I bought them without really knowing what the active ingredients were. Which for me, is completely against my personal values. I’m a scientist and to be so driven to take something purely for the goal of weight loss is baffling. I’m the kinda gal that has to know the how, why and the risk/ benefit of anything. However diet pills were different.

I remember buying my first diet pills in secondary school. I thought it would be a “quick fix”. They are addictive.

Soon diet pills became a part of my ever expanding routine and rituals.

I would hide this behaviour from others, which means I knew what I was doing wasn’t normal. I was incredibly secretive about this behaviour. It eventually expanded to other drugs including laxative abuse.

Neither diet pills or laxatives result in weight loss. The weight loss associated with laxatives is water weight. It’s purging and extremely dangerous.

I felt cleanest when I was emptiest and high from ignoring hunger pangs, and even more euphoric if the hunger was suppressed. Sometimes I felt superhuman. But I wasn’t. Looking back now, I only felt happy if I was empty. I wasn’t happy outside of this. I was numb.

I’m fortunate I don’t have lasting effects from the laxative abuse. Many are not so lucky. Laxative abuse is not something to be scoffed at or ignored people can be rendered incontinent or dependent on laxatives for life in order to be able to poop.

Diet pills are also dangerous. Not only do I believe they encourage disordered eating and other behaviors they can be harmful in themselves. Many of the diet pills or appetite suppressants are widely available without prescription or worse over the internet without any safety regulation. That means many of the products have not been approved for use in humans let alone approved as safe. You do not know what is in many of them. The drugs that are rigorously tested and checked require approval from the Food and Drug Agency (FDA). Anything without out this approval stepping into completely uncharted waters and potentially very dangerous. I had signs of liver inflammation when I started recovery and signs my liver was struggling. When we don’t know what we are putting into our body we really are playing with fire. Thankfully my liver recovered.

Social media is rife with adverts selling these hazardous products. Companies that sell them are also cunning and as soon as a drug is labeled as dangerous, they rebrand the same product. I bet you have seen celebrity’s used as promotions for such pills, claiming celeb X had a miraculous result to their product without any ill affects. When in reality I am willing to bet, the celebrity NEVER takes them. But people who engage in disordered eating or want to fit into the societal norms are easy targets. I was. You name it I tried it. I have intentionally omitted the product names of anything I took, as I do not wish to trigger or promote disordered actions. Frankly I know that when I was in the depths of my eating disorder if I heard about a new product, I was onto it as soon as I read about it, and so I know what goes through some of our eating disorder brains.

I want you to see that it’s something we don’t talk about enough in the eating disorder community. However, I am confident it’s a hell of a lot more common than we think.

I’m not going to pretend stopping this behavior wasn’t difficult. It was but it is completely possible. I can’t imagine putting something I had no idea the content or safety of into my mouth now (unless it is food).

I went cold turkey- I flushed my pills and binned all the detox teas. It was one of the first behaviors I tackled in recovery ( that and the Fitbit, which is a post enough in itself) Fitbit aka handcuff.

Now when the adverts appear on my social media I either report them or remove them.

Diet pills are an odd one, but if you want to recover they have to go. They don’t work and who know’s what damage they’ll do.

Let’s make this discussion part of eating disorder recovery and bring it out in the open.

Your Weight Is Not Your Personal Responsibility…

Photo by Brett Jordan on Pexels.com

Some things are not supposed to be controlled. They are not our personal responsibility. Weight is one of them. I repeat, your weight is not your personal responsibility or choice.

This may sound controversial because we have been taught that our weight is inversely correlated with health. But this is oversimplified and largely untrue.

We cannot “healthily” manipulate what’s not supposed to be manipulated.

Your weight, much like your height or eye color is predetermined, by genetics. But it’s influenced by environment, your health, your diet history, & both diet and exercise. The latter two are only small contributors. With all the other factors that you have no influence over, it’s futile trying to micromanage. If you go too far in one direction, your body will fight it to live in homeostasis.
If you are genetically built to live in a larger body you will never have a “healthy” smaller body regardless of all the exercise or dieting you do. It just won’t work, the body will fight it and you will see all of the negative effects of this.
The larger body you were born into was healthy.

What’s prompted this post is following announcements from the UK governement they may financially reward weight loss in a campaign to “fight obesity”. They talk about providing incentives with subscriptions to restrictive diets such as weight watchers and slimmers world. This is such a harmful campaign. Further more, this announcement was released in the middle of national eating disorder awareness week, the theme of this was Binge Eating Disorder (BED) (1). Binge eating disorder sufferers are already statistically less likely to seek help than any other eating disorder, despite it being the most prevalent eating disorder. 1 in 50 people in the UK are expected to be affected by BED. A staggering 40% of people in the US following weight loss programmes meet the criteria for BED (2). BED is a serious mental disorder with physical side effects. People with BED, consume large quantities of food quickly without feeling in control, it is NOT the same as “over indulging”. Patients often restrict heavily between binges which fuels the cycle. Often patients with BED do live in larger bodies, they are “obese” by societies definition. The UK government’s message is damaging and harmful to those with BED. Weight stigma is a huge problem in society and in healthcare. Patients with BED are stigmatised, invalidated and often do not seek help. They are too commonly prescribed restrictive diets as an answer. However evidence has proven time after time, binges follow restriction.

Campaigns like this, will have a ripple effect, making access to treatment all the more difficult. More patients are likely to develop eating disorders such as BED, following restrictive diets will not end well.

I anticipate- the “obesity crisis” will increase after everyone regains the weight they lose and more, furthermore it is encouraging disordered eating, which will raise the incidences of eating disorders. Without tackling the core issue of weight stigma, many of those eating disorders will go undetected. “Atypical anorexia” is another diagnosis used by the DSM-V ( diagnostic, statistic manual psychiatric disorders) to diagnose patients with anorexia but are not underweight according to BMI. However Anorexia can manifest in any body shape or size. The difference is the weight stigma those suffering with anorexia in a larger body experience. They are often congratulated for their disordered behaviours, not taken seriously making access to help more difficult.

Let’s discuss BMI. The BMI was invented by a Belgian mathematician in the early 19th century. Lambert Adolfe Quetelet was a mathematician, statistician, sociologist with an interest in anthropometric sciences (3). Anthropometric study is essentially is body measurement study. He had no medical training. He has since been heavily criticised for his population studies of BIPOC and labelling people of colour as “separate species”. One of Quetelet’s areas of interest was in the “average man”, he used data including height and weights to help him determine this.
His studies were largely population based, cohort studies, mostly including white European males. He developed a formula to calculate a ratio of body weight to height squared, after an observation that there were weight and height variations within populations. More specifically that weight did not appear to be directly proportional to height, he discovered weight varied in proportion to height squared. This became known as the Quetelet index, before Ancel Keys renamed it the BMI in 1972. Ancel keys a famous physiologist, attempted to prove correlation with obesity, BMI and poor health. He did not succeed.
The BMI was not used to determine health it was to show “population averages”. It was designed to track population’s weights. It did not measure adipose tissue, or account for muscle. Once again it primarily referenced white European men.

It can therefore not be used as a predictor of individual health status, at best it’s a population screening tool, particularly if that population is white, male and European.
It identifies potential “population risk” of certain diseases such as diabetes, coronary artery disease. However an individual’s BMI, in isolation is not helpful, as a person can have a high BMI but very little visceral fat which has been associated as a greater risk factor. Muscle mass contributes significantly to weight and therefore BMI.

Interestingly, the optimal BMI for mortality is actually within the “overweight” category on the BMI scale. The most optimal BMI statistically from latest studies is actually 27 (4). Yet the BMI scale has not been updated to reflect the definition or risk stratification. Go figure.

The more I learn the less I know, but the more I want to know. Nutritional science is an incredibly complex field of science. It’s also a very difficult area to interpret. I am relatively confident in my ability of interpreting scientific papers coming from an oncology background, but I do not feel equipped to interpret and advise patients on nutritional science. The studies I tend to go to as my default for information and decision making in my career comes form the “gold standard” of evidence, which is data from meta-analysis of randomised control trials.

Meta-analysis analyses data from big randomised trials. (For anyone non medical or non scientific, randomised control trials (RCT) are the holy grail of investigating an intervention. It involves studying two groups, randomised to receive the intervention or a placebo. The difference in the two groups is studied. For example a group of patients with diabetes are randomised to receive a new blood sugar lowering drug. One group gets the drug, the other does not. The changes in their blood sugars are observed. You can control for variables because people are selected based upon specific characteristics, such as age, starting blood sugar levels for example.

Nutritional science is difficult to interpret, because, the studies are largely cohort studies (population based), i.e. you cannot ethically conduct randomised control trials in this field (i.e. you couldn’t restrict a particular nutrient from a group). You cannot control the variables that vary like you can in an RCT (you have no idea how much carbohydrate someone eats compared to the next or how their body actually uses it). Interpreting them is difficult. Therefore I feel uncomfortable ever promoting something I have little or no understanding in. Examples that have come from nutritional science are: the “carbs are bad”, high fibre diet and colorectal cancer risk reduction, ketogenic diet, vitamin E and reduced risk of developing alzheimers. But, unlike medical studies, we cannot control variables in the studies and then apply them to individuals or draw cause and effect. Vitamin E, has been shown to reduce the risk of Alzheimers, but when you look at how, it is not actually understood. Therefore taking a supplement that is not that same as the vitamin E absorbed from a persons diet is just not generalisable.

At medical school we get minimal training on nutrition, yet we are asked important questions that I feel we are ill equipped to provide. I find it concerning when people advocate things such as low carb diets as a one size fits all, pun intended. It’s an issue, there are so many shades of grey. However I am confident in my knowledge and the evidence surrounding BMI, and weight bias. Weight bias is dangerous and our lack of understanding or inappropriate use of nutritional science is concerning. Nutrition is also a luxury and we do not acknowledge this. I am a white middle class female, I acknowledge my privilege, what this means is I am fortunate to be able to choose what I eat. Many people are not as fortunate and they eat what they can, therefore prescriptive diets by nature are also not available to a large population, and yet they are stigmatised for choices that are actually not really a choice.

The BMI was never intended to be used as the measure of individual health, that is is used for today. It is also not applicable to a wider population as it included a narrow cohort. Yet we base such importance on a number that never had any intention for medical use.

For anyone who has received weight stigma or bias, please understand you are not alone. Binge eating disorder is serious and everyone should be able to access help. We can be healthy at any size.

References:
  1. BEAT Eating disorder Awareness Week: https://www.beateatingdisorders.org.uk/edaw
  2. BEAT information page BED: https://www.beateatingdisorders.org.uk/types/binge-eating-disorder
  3. Quetelet index: https://pubmed.ncbi.nlm.nih.gov/17890752/
  4. BMI associations and mortality: Change in Body Mass Index Associated With Lowest Mortality in Denmark, 1976-2013 Afzal, S., Tybjærg-Hansen, A., Jensen, G. and Nordestgaard, B., 2021. Change in Body Mass Index Associated With Lowest Mortality in Denmark, 1976-2013. https://jamanetwork.com/journals/jama/fullarticle/2520627?resultClick=1

Recovery isn’t about never making mistakes

Setbacks will happen, because life happens.

Whether you are just starting recovery or have been on the the path for some time setbacks are inevitable.

It’s okay. It doesn’t mean you can’t recover, I absolutely believe recovery is possible.

But not preparing for setbacks is setting yourself up to fall. After all perfectionism is part of the issue right?!

I am happy that I will one day consider “succeeding at anorexia” as my biggest failure. A setback or relapse does not mean you have failed at recovery.

Setbacks teach you things and pave the way for what might be ahead. They prepare you for a fulfilled life without your eating disorder.

I’m hoping my latest setback will help you.

I’m not ashamed I momentarily took my foot off the recovery pedal. It happened, I’m back in control and wiser for it.

Why did it happen?

Well if you’ve read any of my previous posts you will know I am a firm believer that eating disorders have a strong neurobiological component fueled by energy deficit. Energy deficit being the match to the flame if you like. The physical and psychological symptoms that follow being the fire that is contributed by everything else such as environment, stress etc. The important thing is the match in the genetically vulnerable.

I have just finished a set of night shifts. Night shifts to the average person without a history of an eating disorder can reap havoc on health, both physically and mentally. They disrupt your natural circadian rhythms, they can be socially isolating and routine can become difficult.

I’ve worked shifts for years. I know it’s a time where previously I have allowed my eating disorder to thrive. Therefore, armed with this knowledge I planned to avoid falling into the trap of my eating disorder.

Knowing I cannot allow myself to slip into energy deficit I made preparations to attempt to combat this. I ate more before work and before I slept, I planned out snacks to take with me.

But life happened. I missed some breaks and a few snacks. I was lacking sleep and so my appetite was lacking, I hadn’t made self care and routine a priority.

I didn’t think much of it in the craziness of the shifts, but when I found myself unable to eat 3 meals a day when I came off my shifts I knew I had slipped.

I haven’t had “fear foods” for sometime.

I haven’t thought about engaging in disordered behaviors such as concealing what I was/ or wasn’t eating, for months.

I haven’t listened to the voice tearing me to shreds in the mirror for the longest time ever.

But suddenly it was all there I was right back in it. I found myself wanting to control my intake, to compensate for every “ unhealthy” choice I was making. I recognised a familiar welcome feeling of emptiness that in truth I had actually forgotten. The emptiness euphoria made me contemplate giving up on recovery. After all if I’ve fallen so easily after so long, what’s the point in continuing? The intense draw to the scales returned, I had to fight to not give in to the temptation. I know that no number on that scale would have had any importance, but to my eating disorder it would have been used as firewood.

I danced with the temptation of a full blown relapse. However, I reminded myself it was all lies. If I didn’t put this match out I’d be amidst a wild fire that only wants to destroy.

I needed help. I needed support. I’m not ashamed of that.

My eating disorder tried to make me carry the weight of shame. But that’s another reason I knew I needed to put the match out.

I enlisted support from my support network. I chose to let them in. For the few days following, making decisions around eating felt like an impossible task. The thoughts were so loud. I have now reinforced routine, I challenged the “fear foods” that re-emerged and I prioritised taking care of myself by resting, talking and eating. Instead of pulling myself apart and focusing on “failure” I’ve chosen to treat myself with compassion.

I feel back on track. Ive bounced back. With more knowledge and information for my next set of nights- I need to prepare further. I will carry more snacks on my person. I will increase my intake. Self care, such as yoga, journalling and talking each day will be a priority and not an after thought.

My tool kit is more substantial.

Recognising a slip is vital to enable you to seek help and the support you need.

Recognising it early can help you get out quickly.

It’s obvious to me these slips came from:

Skipping meals (no matter how innocent)

Eating in isolation.

Blasè attitude “no big deal”

These are known triggers for me. Knowing your triggers can help you prevent and identify potential setbacks/ relapses.

Preventing setbacks is not always possible.

But planning what to do in the event is key.

Make your relapse prevention plan. Update it with each learning experience.

Seek help.

Most of all- choose to get back on track. Choose to put the match out, don’t start the fire. A moment of struggle doesn’t mean failure. Be kind to yourself and keep going

Check these out:

Relapse prevention plan mirror-mirror: https://mirror-mirror.org/recovery/607-2

Relapse prevention/ recovery maintenance sheets from cci: https://www.cci.health.wa.gov.au/-/media/CCI/Consumer-Modules/Overcoming-Disordered-Eating—Part-B/Overcoming-disordered-eating—09—Relapse-Prevention.pdf

Two years in recovery..WAKE UP CALL

TW and this may be difficult to read.

Yesterday a memory came up on my Facebook feed.

A trip we made to Sri Lanka in March 2019. My final wake up call before seeking help for my eating disorder.

It was not the wonderful experience that it should have been, or our pictures from our travels captured. They say “a picture paints a thousand words’, but most of what you see is what my eating disorder did for years, fake an exterior. It was this trip that I for the first time in 15+years, began to see how much of an issue my eating disorder really was.

For years my eating disorder had concealed the negative impact it was having on me.

My eating disorder was slowly killing me. If you are starving, you’re slowly dying. My friend if you need this sobering reminder, people die from eating disorders. We forget this when we are dancing with the devil. Or perhaps, we no longer care, when it’s painful to sit, or our body is covered in fine hair because we can no longer keep ourselves warm. We ignore message after message from our bodies until, if we are lucky we WAKE the FUCK up. It’s not just us that our eating disorders impact upon. Truthfully when engaging in behaviours and driven by the numbers, I didn’t worry about the effect each action could have on my partner, parents, brother, friends. But our actions do matter, If I had have continued I would have likely ended up as a stark statistic. Remember, YOU matter, your life matters and you affect many people’s lives. Please wake up.

That trip I felt completely lost and trapped in my relentless behaviours that had been by my side for years. I had no idea how I was ever going to step outside of the grips my eating disorder held on me. But I knew something needed to change or I would slowly but surely die.

What made me wake-up?

I realised I wasn’t living. If I wasn’t living, what was I? It became so obvious to me on this trip because Sri Lanka is full of beauty, but I felt nothing but cold.

I was done with the comments from peers and concerned looks. I hated it.

I was done with feeling nothing but bone cold, ALL OF THE TIME. Even in 30 degrees heat. I wanted to see past the brain fog and constant chatter.

I didn’t want to live like that anymore. I couldn’t live like it anymore.

This was not the first time I had had a moment of clarity, a few years prior I knew things were far from in control, but I didn’t seek help. I thought I could fix myself by eating a little more. Things got better for a time, but without support things soon descended back to the familiar chaos and calm of my eating disorder.

But this trip was different. Something needed to alter. I had reached “rock bottom” and I had to crawl out.

I wanted to be present, to share the experience but my eating disorder bled into everything. It was all encompassing. I was afraid for the first time. I was scared this was either going to be my life, or it would take my life.

It was the first time I realised how much stronger the eating disorder voice had become and how buried I was. I feared I had lost myself forever, I couldn’t recall when I was last in the driver’s seat of my thoughts. This was a sobering moment, at the same time I felt powerless to do anything about it.

These moments of clarity would pass again, and my eating disorder would begin to fool me once more that I was in fact fine, convinced me I wasn’t “sick enough” or that I even had an issue. However my healthy thoughts, were desperate to be heard and me listen. And so, it was this trip, I shared with my partner some of my story, although by this time it was hardly a secret.

Even though this trip was incredibly painful, I remain grateful for it, because it was like a wake up call and it kickstarted my true recovery process. Seeing pictures of the trip makes me sad for memories and experiences my eating disorder stole from me but I’m so thankful to be where I am now. Writing this.

If you’re in this dark place, THERE is always hope, It is never too late to seek help. And, you don’t have to go at it alone. You don’t have to have answers. Choosing to reach out of help is the biggest step, the rest will follow if you trust in the process and take that massive leap of faith.

There are stages we go through prior to starting recovery and then during recovery itself. I think we flip flop between them whilst we go to war with the two voices in our head. But we can all win, it is possible.

To me the stages look something like this:

◦ The “I’m fine. I’m just super healthy. I’m totally in control” stage.

◦ “Something’s not quite right with what I’m doing, but it’s ok right? I know I can stop if I want to. But I don’t want to” stage.

◦ The “Shit, I can’t stop. Well better just keep going. It will pass. It’s not that big a deal?” Stage

◦ The, “Ok, I think this is probably a problem. Not sure I want to do anything about it. But not sure how long I can keep going on like this” stage

◦ “Ok, I’m so done with this, I can’t keep living this way. But I don’t feel I have any control. I’m not sure I can stop” stage. This is the point I got to when I sought recovery. It’s one of the scariest decisions I’ve ever made.

◦ “Let’s try this recovery malarkey out. What do I have to lose? But I’m so scared of the thought of change”. Stage

◦ The, “Oh my god, this is way too hard. I’m never going to recover. Why even bother trying” stage. I think it’s common here, we often resort to old behaviours intermittently whilst making small changes in recovery. But the small changes matter and count.

Then something clicks/ it’s like a switch. Recovery becomes easier. It’s still bloody hard but it’s less of a monster than the one that’s been dictating your life. This stage, you start to question your eating disorder thoughts, your own thoughts start to become clearer and in the foreground more frequently.

It doesn’t take much for your ED to lure you back, a slip or relapse happens. But you learn from them and each slip you get wiser. Recovery gets stronger, you get stronger.

◦ Now you really want this, recovery feels achievable . You begin to see who you really are, what your life can be without this hitchhiker. You remain vigilant and know how recovery can look and you make it your mission to not go back. You’ve got this. Your actions and thoughts are all protective of your recovery, you have worked harder than anyone will ever know to be here.

Recovery is always possible, no matter how deeply trapped, lost or afraid you feel. Wake up, and rejoin the world, you deserve a full life and the world deserves to have you in it.

Check out the links below for seeking support/ starting the conversation:

  1. https://www.beateatingdisorders.org.uk/recovery-information/tell-someone
  2. https://www.nationaleatingdisorders.org/toolkit/parent-toolkit/how-to-talk-to-a-loved-one
  3. https://www.ed.org.nz/getting-help/what-to-do/

Strength in vulnerability.

“Strength in vulnerability” Sound like opposites to you?

I have lived my entire life holding this belief. With the sense that showing vulnerability was demonstrating weakness. How incorrect this belief is.

From the wise words of Brenè Brown:

“Vulnerability is the birthplace of love, belonging, joy,courage, empathy, and creativity. It is the source of hope, empathy, accountability and authenticity. If we want greater clarity in our purpose or deeper more meaningful spiritual lives, vulnerability is the path.” (1)

This concept is a difficult one, when we have spent our entire lives believing weakness and vulnerability are one of the same.

But for me, I didn’t truly understand the meaning of vulnerability. Why is it such a difficult emotion for us to experience, why do we numb it?

Brenè Brown defines vulnerability as “uncertainty, risk and emotional exposure”.(1) I feel this depicts eating disorder recovery in one sentence, it’s beautiful; and it’s true.

People in recovery are anything but weak, I am yet to meet or speak to someone with an eating disorder who I consider weak. The people I have come across are some of the strongest, kindest, most resilient people I’ve encountered on all parts of my life.

Eating disorders are encompassed by guilt, shame and fear of being vulnerable. Feelings and emotions are viewed as weakness. During recovery, emotions that had been buried, lost or numbed are reclaimed and owned. Sometimes, all at once!! Some days in early recovery it’s a cluster fuck of emotions. Recovery is learning to tolerate these emotions and not numb out. This is embracing vulnerability.

Vulnerability for me has been, fear of being perceived as weak, judged, failure or a disappointment.

My eating disorder numbed everything,including these feelings but at the cost of all my positive emotions.

Exploring vulnerability has opened up my authentic self. I have never felt so vulnerable than these past 18 months, admitting my imperfections, my shadows.

I don’t see vulnerability as a negative now. It’s neither positive or negative, it’s just part of what makes us all human.

“Imperfections are not inadequacies; they are reminders that we’re all in this together.”(2)

Why shouldn’t we show vulnerability if it’s the foundations of how connections are made, creativity and passion is discovered? Connection can overshadow shame.

Yesterday I did something I would have never imagined myself doing, even a few months ago.

I shared my experience with anorexia publicly on my personal facebook account. It’s National Eating Disorder Awareness (NEDA) week in the US, which will be followed by the UK and Australasia next week. And So I decided, why not share my most “feared” secret with the hope of encouraging others to seek help, de-bunk myths and stigma and challenge attitudes.

I’m not going to pretend it was easy. It was more terrifying than either of the bungee jumps, sky dives I’ve done. Not nearly as scary as starting recovery, which is why I felt so compelled to do this . I know I am not alone but I am lucky, so lucky I have had help and support. It took nearly 2 decades to seek the help, which is sad, because this is not uncommon.

If my share changes one attitude, helps one person reach out for help then a little bit of fear is nothing. I’m fortunate I have found my voice. Many people remain struggling in silence. I’m not advising everyone to share their stories. It’s taken a long time for me to reach a place of acceptance and resilience. I know there will be some negativity from sharing such. It will come from ignorance. I feel equipped to deal with these because the majority of responses have been positive and most importantly I didn’t do it for the external validation. I am happy enough with who I am, I did it for those who are not. Those battling stigma and shame everyday.

There’s tons of ways to raise awareness for a subject, not everyone will comfortable with sharing personal accounts and that is ok. Have a look at some of the links below, NEDA and BEAT of how we can raise awareness and fight stigma.

For a deeper look at vulnerability, shame and guilt I recommend checking out:

1. Brenè Brown: TED-Ed https://youtu.be/iCvmsMzlF7o

2. Brenè Brown: Book; https://www.amazon.com/Daring-Greatly-Courage-Vulnerable-Transforms/dp/1592408419

3. NEDA awareness week: https://www.integratedeating.com/blog/2021/2/22/national-eating-disorders-awareness-week-2021

https://www.nationaleatingdisorders.org

4. BEAT: https://www.beateatingdisorders.org.uk/edaw

References:

1. Brene Brown (2017). Daring Greatly : How the Courage to Be Vulnerable Transforms the Way We Live, Love, Parent, and Lead. Penguin Random House Audio Publishing Group.

2. Brenè Brown: The Gifts of imperfections.

You are NOT your Eating Disorder…

You are not “anorexic, or insert ED

It’s never been you.

You have experienced anorexia/ bulimia, BED

It has been with you.

I recently shared a post on instagram after hearing a person with an eating disorder referred to as their disorder. “They’re bulimic”

It infuriated me. I wanted to remind that individual “they are not their eating disorder” It’s hard enough for the person to seperate themselves from this idea without it being fuelled externally. It continues the shame and stigma attached to these complex disorders.

I see this identity as the sufferer playing underdog to their eating disorder, but that does not mean they are that disorder. Most times the underdog prevails eventually.

This notion was something really important for me to hear when I first started the recovery process. From day one my therapist repeated this mantra, that I was not my eating disorder. Even when I didn’t see it or believe it.

We often attach our identities to the the eating disorder, because we have lost touch with who we truly are. That does not make the identity true or real.

Still not convinced? Picture this. You would not call a person suffering from cancer, “cancer”. The principle is the same for us experiencing an eating disorder. A person is not “cancer” anymore than a person is “anorexia, bulimia or Binge eating disorder” You have an eating disorder, it is not you.

When we embark on recovery, there maybe times where it is easier for the person to hold on to that identity whilst discovering who they are without that disorder. REGARDLESS, It is still helpful to be reminded that they are not their disorder. The disorder is acting as their safety blanket. Of course, early in recovery you will return to the safety of that blanket. But it’s a blanket, it is not part of you. Eventually you don’t need the warmth the blanket offers.

During recovery I think it’s important to explore who you want to become? Who is that identity?

Picturing who I want to be, what I want my life to look like helps me stay in recovery from anorexia. It helped me to see myself separately to the disorder I was fighting. Our values are completely incongruous. I don’t have all the answers and I’m still learning. That’s recovery and growth.

When we are amidst the throws of an eating disorder, for most of us our world becomes very small. There’s very little room for anything beyond- food, exercise and concerns with these. It’s all consuming and incredibly isolating. But- it’s not really what most people want from life.

Eating disorders restrict EVERYTHING.

Who wants to be 80 years old and look back on their life, and all it’s filled with is fear and anxiety over eating, body image, exercise. None of it matters. If we are lucky to reach an old age I want to look back on what my life was filled with, not an eating disorder. It is never too late to make this change. I don’t care if you have been the underdog to your eating disorder for 50 years, there is always hope you can recover.

My journal has been my haven for my recovery but also exploring who this recovered person is, what her goals, aspirations, values and worth are.

I promise you, my recovered self is not fixated on dietary restraint, exercise or control over shape. My recovered self is loud, doesn’t care for other people’s judgements, grateful for the process of getting from A-B and not just being at B.

That brings me onto my next point. G. R. A. T. I. T. U. D. E…

It is easy when we are having a tough time to focus on the negatives. But one thing I have learnt from recovery is there is always something to be grateful for. Even in the darkest of times when you don’t feel there is anything to be grateful about. There will be. Start small on those days. Gratitude, has really helped me ground myself and shift from the “all or nothing” thinking we so often experience with eating disorders. Black and white thinking is a prominent trait we share. I promise you, if you give gratitude practice a go, it’s very hard to stay in a negative space. I make it a daily practice now. I get it, you think I’m full of crap. I thought the person who suggested it to me was too. I thought it was hippy bull crap and I’d be making daisy chains. No.

Try this…

Everyday for a week, think of at least 2 things you are grateful for. It can be as big as you want or small as you want. Aim to build up to more than 2. Some days this will feel harder than others. It’s these days you need to find things. The way you see yourself and the world around you will improve.

You will discover your life beyond they eating disorder even if you don’t see it now.

But for those who need to hear it again… “You are not your eating disorder”

Please people stop it with the before and after pictures.

Before and after pictures are harmful on so many levels.

Firstly you see the diet industry, so called “wellness” industry’s using pictures to market their false products.

The premise of the so called before and after picture in this setting, suggests that image and weight is the marker of health. Which people, if you have read any of my blogs or IG posts you know this is bullshit. Like the Bullshit Mass Index (BMI).

None of these elements reflect a persons health and the idea that manipulating your body, or image is a way to get healthy in most instances is simply ludicrous.

Before and after pictures in the eating disorder community are extremely dangerous. They are often posted on social media. Without a trigger warning, monitoring and to the most vulnerable of audiences. They serve no place in recovery. Why?

1. It promotes the unhelpful myth that eating disorders affect only the emaciated. Sadly this is still the image the media portrays of someone struggling with an eating disorder. Which is not helping to raise awareness, reduce stigma or educate about Health At Every Size.

2. They inadvertently promote ‘thinspiration’. For those of you not familiar with this colloquialism it’s a term well recognized in the eating disorder community that encourages thinness and can lead to very unhealthy comparisons and behaviors. For this reason alone no matter how well intentioned before and after pictures are dangerous.

3. Just because someone has gained some weight, or lost it’s not reflection of health status. You have no idea of the physical or mental state behind the picture.

4. The can invalidate a person’s recovery. Seeing someone’s pictures may make an individual question their recovery and why they haven’t “recovered” like the post. The pictures do not portray the enormous effort, energy and mental struggle involved in recovery. They are not true depictions.

I have written on previous posts, mentally I was at my most screwed up, difficult place when I first weight restored. To show a before and after picture at this point declaring my “recovery” would have been incredibly inaccurate. This is not helping to raise awareness that weight restoration is only part of the recovery process. Mental recovery takes far longer.

When all consumed by my eating disorder there was barely a day went by that I didn’t take a photo to “check” my progress. It was almost a big of an issue as the scales and weighing. People with eating disorders use the camera as a form of body checking. Body checking is not a healthy behavior and does not help in recovery.

Photos-are personal. For some people keeping photos of themself at their sickest can maybe act as a reality check, or reminder of why they recovered. For others I can imagine it would be detrimental, like holding on to “sick clothes” regardless the photos should never be shared to show ‘before and after’.

Social media is a mind field for ‘before and after photos’ and it’s feeding the fat shaming, stigmatizing society we live in. So please if you’re thinking of posting a before and after pic, think before you do.

Why and who are you really doing it for, what message are you really trying to convey? If in doubt don’t share.

What we want to tell you about our eating disorders, but find hard…

Eating disorders are secretive, preoccupying and feel extremely shameful. They are rarely openly discussed and stigmatised.

Below are things I would have never felt able to share with others before I found my voice in recovery. However I wish I had said them sooner to help you understand. Hopefully this might give voice to other’s experiencing recovery and wish they could share some of the things going on in their heads.

1. Weight restoration does not equate to recovered. In fact, this part is probably the toughest, most brittle part of recovery. On the surface I may appear “well, healthy or recovered” but I am just about holding it together. You have no idea based on my appearance how I am. Likely I am fighting strong thoughts and urges to undo this courageous work. Mental recovery takes so much longer than the physical recovery.

My eating disorder was at its loudest when I reached my “target weight” and then exceeded. Regaining weight, gaining weight is harder than you will ever know for someone who is recovering from an eating disorder. They are fighting every thought, every second, every minute of every day waiting for a moment of inner peace. Weight gain is a small part of recovery, but possibly the toughest part. Once we regain weight, (weight we should never have lost) often people assume we are recovered and support lessens. This is arguably the point we need your support the most, please help to encourage us to keep going. And so I implore you, please do not comment on my appearance. Well placed comments can fuel this cruel deceptive eating disorder voice that I am trying so hard to move away from.

Statements, however true and well meaning, such as “you look healthy or better” can really harm someone’s recovery. Comments such as have you lost weight? Can ignite the path to destruction or send my brain into a frenzy that I have failed at recovery. I cannot win when it comes to body shape comments. So please keep them to yourself.

2. Recovery is a choice I have to make, every minute of every day. You cannot make me recover or do it for me, but I value your support. My recovery is my responsibility. My choices, my decisions are what keep me on the path to recovery. It is a full time job. One incorrect decision can set me back. BUT….. If I do slip, please do not give up on me. Recovery is not linear. Hope is a very important value of my recovery. I will very likely get back up again and continue on my journey to recovery. Please help me to see that a small slip does not mean I have failed at recovery but if I need reminding how far I have come, help me to see past this lapse. Hold hope.

3. Things you do not pay any thought to such as trying something new to eat, eating out at restaurants may be very hard for me. People with eating disorders are ridiculously good at hiding what’s going on beneath the surface, but know that just because I appear cool calm and collected there is likely a tornado rushing around in my brain. Sometimes I just want a distraction, I always want to hear you and not what’s going on in my brain and being present with you.

4. Never, ever comment on my food choices, volume or timing of food. You do not know how hard it is for me to eat 5-6 times a day or alongside others. Likely if I am eating with you, I trust you. Comments like, are you really going to eat that?, congratulating me for eating, Don’t you like XYZ?, are only going to feed unhelpful thoughts and make eating and decision making more uncomfortable than it likely already is.

5. I do not ever want to hear about your “weight loss attempt, diet”. If you are someone close to me, know that sharing this with me is insensitive, unhelpful and extremely triggering. I have worked incredibly hard to reframe my implicit biases and unlearn this detrimental cognition.

6. I do not want my eating disorder to be an elephant in the room. I want to be able to be open with you. Talking about it as you would any other medical problem will help break the shame cycle. I do not wish to be defined by my eating disorder, there is so much more to me than this, however my recovery is an important part of my life. I want you to be part of my life, my authentic life.

7. Shame is something I feel very deeply, it fuels my problem. I feel frustrated and angry I am in this position and it makes it hard for me to ask for help and talk openly as much as I wish I could. I am grateful that you show up for me especially when I am finding it hard to show up for myself.

8. I do not think everyone else is fat. I do not see myself how you see me. Regardless of how much weight I lose I will never feel satisfied. But it is not about weight and food. The sicker I became the more warped my view of myself became, making it really hard to see myself and the crazier and more lost I felt. We are fully aware of the self destruction but that makes it harder to think rationally because we do not understand why we cannot stop. The impossible standards my eating disorder held for me, are not the same standards I hold for everyone else, so no I do not see everyone else as “overweight, or fat” I just simply cannot see myself.

9. No one would choose to have an eating disorder, Choosing a life of rules, unhappiness, isolation and emptiness is not a choice anyone would make. I did not choose to develop an eating disorder, I didn’t wake up one day and decide to have anorexia it’s not how it works.

10. It’s not as simple as eating and that being the end of the story. I have many neural pathways and thought processes I have to unlearn. I believe in full recovery. I need to believe in full recovery. But I do not know how long it will take. Right now I see myself in recovery, meaning for me I have “disordered thoughts” which can disappear for days and then return out of the blue. In certain situations, I can still feel extremely distressed at times.

I’m not sure that recovery is a destination, I think it’s a process where these thoughts and associated emotions do disappear with time and effort. But likely remaining “recovered” and preventing the cognitions from returning will require much less energy. I believe this effort becomes like second nature, similar to riding a bike. Once you’ve learned you don’t forget, its more like protecting yourself from falling off at times of risk.

See a post I recently wrote for recovery warriors magazine: https://www.recoverywarriors.com/how-i-broke-the-rules-by-ordering-movie-popcorn/

If you find this helpful, feel free to share!

Fullness. Is not the enemy.

During recovery from an eating disorder you require at times “abnormally” large amounts of food.

Makes sense when we have deprived ourselves for so long. When you start to eat again and repair the damage it requires energy. Food is that energy.

I’m writing this because fullness was something I avoided at all cost in my eating disorder. I feared it. I felt “cleanest, euphoric” when I was empty. But that’s not clean and it’s not healthy.

I’ve talked about extreme hunger on previous posts. But I think it’s something that is really feared because as a society that breeds “clean eating or orthorexia” as normal eating it makes the process of nutritional rehabilitation even more frightening and shameful. It’s harder to learn to eat intuitively when “wellness blogs”, magazines, platforms are subtly promoting orthorexia. Orthorexia is not healthy. It’s a disorder in itself. Obsessing about eating cleanly and healthily will not help you to recover from a restrictive eating disorder.

I am wary of any social media platform or magazine that calls itself “wellness or healthy living” because they focus on eating and exercise as if they are the only things that factor into a person’s health. I feel anyone from an eating disorder background should steer clear of the information from these types of platforms because it’s 1. Not helpful to our recovery, 2. Feeds the obsession with numbers, 3. Reinforces false beliefs that you have to micromanage your body and lastly they promote the societal stigma around shape.

Rant over.

I have just come off a set of nights. Nights have always been a playground for my eating disorder behaviors. The altered routine, long hours and busyness has allowed my “HH” to justify restriction, skipping meals, compulsive movement. This set of nights I was adamant “HH” would not get to dictate.

Knowing that old situations tend to stir up old pathways I wasn’t surprised I suddenly felt I was wading upstream and the “HH” voice became louder. But I was better equipped to deal with the bullshit.

The old voices of “walk the long way, count your steps, you don’t need to eat, are you seriously gonna eat that?, that’s disgusting” played like a broken record.

I made myself a contingency plan: I took in lots and lots of snacks meaning I could not be in a place without food.

I ate between walking to cases.

I knew the days after nights would be a bit trickier because of the old neural pathways. Therefore I enlisted support early. I told my husband. We planned out our meals, my snacks. I think this is helpful because in the midst of my ED, I wouldn’t have shared, I would have struggled on and likely engaged in the behaviors ending up deeper.

Therefore identifying potential triggers is a big thing in recovery. Something that deserves a post in itself. It’s unsurprising old memories, situations activate entrenched pathways. We are creatures of habit. Most of recovery is unlearning old habits. Exposure to old situations, places that are tied to unhealthy behaviours has been an integral part of my recovery.

My nights finished yesterday and last night we had takeout. I felt full, uncomfortably full. This caused a few moments of turmoil. However I know having eaten “a lot” of food in the early stages of recovery, fullness settles on its own. You do not need to do anything, it passes. It is normal. My fullness last night was just because I had eaten a little extra. Big deal. Don’t judge your fullness. In the early phases of recovery, fullness can be excruciating because of the gastroparesis. Gastroparesis is basically where your gut is so out of practice at digesting and undernourished the emptying is really slow. Often your gut can’t keep up with your mouth and brain, but like all things in recovery it gets better. Eating is the medicine.

You eat, repeat and move on.

Normal eating is sometimes over eating, sometimes eating slightly less. Fullness is not something to fear or avoid.

Things to remember on a bad day in recovery..

Iv’e been in recovery some time now, I can’t have a bad day right? Sound like a familiar thought? Bad days happen, shit happens.

Today, I was caught off guard. So I wanted to share for anyone else who had found themselves, feeling they “should be further than they are in recovery or should not have a bad day”

It was at a colleague’s farewell lunch which was a buffet to celebrate and wish her well.

But as I sat amongst my peers, the familiar thoughts and noise returned to, how am I back here again? How can it be so hard to put a piece of damn food in my mouth.

Panic swept over me, as the noise got louder and louder. The harder it became for me to pick up the single piece of sushi I had put in front of myself. Why couldn’t I just eat? “Seriously are we really back here after all this time? You should not be finding it this hard.”

Willing myself to pick it up and take a freaking bite. It became a battle. A battle I was all too familiar with but had felt very distant. I had almost forgotten what this absolute feeling of being overwhelmed and petrified of food was like. It was a battle.

The thoughts, “how are you suddenly paralyzed by a simple buffet? You look crazy, people are going to notice, you can’t eat that now it will look even weirder, pick something up, hide something”. JUST NOISE.

Everyone else had finished.

I realized if I was going to win this battle I needed to find and-listen to my healthy voice, the kind voice that was thinking about our future, where my life won’t be defined by moments like these, but what I will gain from listening to this voice. Not this “HH”.

Through the time in recovery, my voice is much stronger now than the noise of “HH” and can be found if I listen.

Another thing that has helped me move through today has been, accepting ok, I’m here today. It’s not where I want to be but it’s not where I was either. Before that I was criticizing myself for having “a moment of weakness”, feeling overwhelmed, but I realised, that’s not helpful or what got me moving forward and in tune with my healthy voice. This has taken practice and perseverance but it’s why I am here, now.

Finally, as we were clearing up I took some deep soothing breaths and I shoved the piece of sushi into my mouth. I picked up another piece and I repeated.

Beating myself up blaming myself for “not being further than I should” in recovery, is not serving my recovery. Some of life’s greatest lessons come from experiences and slips like this. So I am grateful for constant learning and growth.

Struggling is a standard part of recovery. I felt crushed when I was in that moment, it felt too acute and raw. I was terrified I was back to square one. Experiencing challenging moments doesn’t mean my recovery is “failing”. When we look past a particularly difficult experience, we can see actually how far we have come. We tend to focus on the negatives, what we do “wrong” and often get swept away in our unrealistic expectations. But if we take a step back and show ourselves kindness there’s something positive to be taken from every experience good or bad.

I have felt like I have been running along, but when we are running we often trip/ stumble at some point and that is normal. Recovery is no different.

I am grateful for this reminder how far I have come, but also that recovery really is a process of ups and downs.

So for anyone feeling they are failing at recovery for having a bad day, or should be further along, give yourself a break and see how far you have come. It’s ok to not be where you want to be yet.

Not playing the blame game is a game changer.

It’s been a shit day. I haven’t failed because tomorrow I get back up and carry on with recovery having gotten through a bad day, that much stronger.

Relationships in eating disorder recovery..

For anyone in a relationship with someone with or recovering from an eating disorder it can feel like there’s a third wheel in the relationship.

This is hard. Quite often the person you fell in love with disappears before your eyes. Quite literally at times. Eating disorders change our personality’s. Often we are very good at putting on a facade and this means intimacy and connection can suffer. It’s difficult to let people in.

My eating disorder had a huge impact on the relationship with my husband. I will expand a little on how shortly. However, navigating recovery together has strengthened our relationship.

Relationships are based on trust. They need honesty, vulnerability, availability and intimacy. But eating disorders chip away at each one of these values.

Honesty is important to us both. But eating disorders thrive on secrecy and shame. The longer time went on the more secretive it became and more shame I felt. As I fell deeper, vulnerability was replaced with a false exterior.

For pretty much the entire time my partner has known me, I have had some form of disordered eating. For a very long time I kept it secret. Which is preoccupying in itself. Navigating how to hide this part of me, prevent it being part of our relationship, inevitably meant with time it became the third person in it.

Why do we keep our eating disorder from you?

I hid my disorder, firstly because I thought I was in control and it “wasn’t a big deal” and secondly because I was afraid of his reaction. We often talk about our “disordered eating” to friends or colleagues by that I mean dieting, but it’s boring and so it was also something I didn’t think should be discussed at home. Diet talk is boring, so we probably spare our partners from this, until it escalates. I guess there was a part of me that did not feel open to the kindness he later showed me when I did share. It felt incredibly shameful. The longer it went on, the more shameful it felt and impossible to admit. Externally like many, I felt like I was doing ok until I wasn’t and so to admit “the failure” I was experiencing was too much. I saw myself as a high achiever, my relationship was part of this achievement. And so part of the secrecy is fear, which is complex and deep routed. But he has been patient. So so patient. Like saint status in terms of patience and that has given me space and time to be vulnerable again.

I count myself as incredibly fortunate, that once I shared what was going on with my partner he worked really hard to educate himself about eating disorders . He was so understanding and not once did he use unhelpful terms or statements such as “why can’t you just eat” This helped so much.

Obviously I can’t share his side but I can share what he did that really helped me with the hope it helps others finding themselves in a similar situation.

I think it’s important to know, it was not ever about trying to look good for him.

It is rarely about that, if you are a partner reading this. We are not starving ourselves, or whatever dysfunctional behaviour for anyone else. The never ending strive for perfection is for our own sense of control. If you’ve read my about page you’ll know it was a perfect storm that started my eating disorder and really about ‘control’.

I would compare myself relentlessly to others, colleagues, celebrities, public figures on tv, people in the street, friends or family members and ask him to assess (this was a big telltale of my body dysmorphia and preoccupation). It was infuriating to him, because even when he told me I was perfect, I never measured up to that image internally.

Now comparison is something we do not engage in. He does not entertain it if I ask a stupid question. He has responded with very helpful challenges such as “who am I speaking to, you or HH, what’s driving that” which often diffuses the thought. Helping me to see it’s disordered.

Even at my most resistant times towards treatment or moments where anosagnosia were prevalent, he never judged me. He saw me for me, and that I was being overshadowed. He separated me from my eating disorder which I reckon is hard at times. Not feeling judged is huge fear this. He probably did judge me at times internally but externally he never did.

Living with a partner with an eating disorder, poses many challenges. If I were a child, living with my parents, I would have likely been force fed. This dynamic is very different in an adult setting. Instead I had to be my own parent and he was my biggest support when I was literally shaking putting fork to mouth. He was brilliant at distraction. Distraction is a great tool. He would sit and chat rubbish, or make me watch something to grab my attention. Or just hold my hand.

We have navigated the challenges as a team. So I wanted to share the things that have helped me, because there is a paucity or resources or information for people living with someone as an adult with an eating disorder.

I know, I am lucky with my husband but if you’re reading this as a someone wanting to support someone there are things you can do to help. But also if you are that person, good luck and don’t lose hope.