EDAW, Infertility, Pregnancy Loss

** ***I’m going to discuss eating disorders, infertility & pregnancy loss & so feel free to skip this post if you think this might be unhelpful for you. Reader discretion advised.*** ****

Standing perusing the new born baby clothes in a department store to pick a gift for my expectant friend. I feel my eyes welling up and a lump in my throat. This week would be the week my husband and I would have been expecting to welcome our own rainbow baby. Instead I’m choosing a gift for our friend’s baby, and the enormity of our grief hits me like a freight train once more. In the middle of a busy store. No warning.

My husband takes the present from me and hugs me.

I say to myself; “ It’s just a piece of clothing, ridiculous. Pull yourself together, I shouldn’t react like this”. I was not prepared for moments like this. I was done with this, right? moved on?

This moment felt so permanent, so raw. I wiped the tears from my face. Paid for the onesie and the next day went to visit my friends and pass on the gift.

No one talks about how many emotions one can feel all in the space of a few minutes when you have experienced either pregnancy loss, infertility and are surrounded by either pregnant friends or those with children. You can feel immensely happy for someone and consumed by sadness at the same time and a deep sense of no longer belonging in circles. So much confusion.

Pregnancy loss, miscarriage, ectopic and infertility are all difficult words to speak. People avoid the subject, skirt around the topic or mutter under their voices as if it’s a dirty word. Some people avoid you completely too. I’m sorry if this is your experience, you’re not alone, despite how it feels.

It’s Eating Disorder Awareness week. This weighs heavy on me, one of the topics I rarely see discussed in the ED community/ space is exactly this subject. Infertility, pregnancy loss or navigating pregnancy/postpartum in recovery. The latter I do not feel equipped to discuss because, I have not been there.

However, I have lived through the wrath of infertility and pregnancy loss with an eating disorder. Both, I believe should be spoken about more openly/freely in the space because eating disorders, infertility and loss all have isolation & grief in common. Sadly we are also not immune to these problems. There’s enough shame already and I feel called to open the discussion.

On top of the isolation these issues bring, & speaking from my own experience, they perpetuate the common hallmarks of guilt, shame, loneliness & body dissatisfaction eating disorders feed off. Another difficult and common denominator of these, is that society shies away from & stigmatises them. There’s not a safe space to openly discuss the experience of an eating disorder let alone the often complex complications such as infertility or loss that can be more common amongst our population. Considering 1 in 4 pregnancies end in miscarriage, that’s a lot of people even outside the ED community that are affected by loss and emotional distress.

Throughout the entire process I experienced intense body loathing. Every cycle failure this intensified. Every pregnancy announcement around me I felt more and more disconnected from myself and my peers.

This, I imagine for a person without an eating disorder is also a common experience. However for someone with an eating disorder, familiar with, the all encompassing viscous eating disorder voice, it was incapacitating. Infertility treatment in itself was incredibly hard, my body changed over night, my hormones reaped havoc with my mood, appetite.

The lack of control. Your body is not your own. Things change in an instant. One minute you’re pregnant, then you are not. The feelings of shortcomings were unbearable. “Why can’t you do this” “It’s your fault”, “you’re a failure” “You’re so broken” We’re all things I repeatedly said to myself.

Infertility, pregnancy loss are not a form of grief readily recognised or accepted by society. I found myself not knowing “what the process was”. How I “should” be. If I was “allowed” to feel what I felt.

Infertility, treatment, pregnancy losses all stirred up feelings of alienation from my body. It didn’t feel like a safe place to reside. I believe this is a common experience with many who go through this, however, personally with the history of an eating disorder it allowed a space to slip into a familiar self-deprecating/punishing state.

For me, a family, being a mum was a strong motivator for my eating disorder recovery. You hear the term “ remember your why” banded about in the recovery space a lot.

For me, the post-pregnancy loss, this term especially, alienated me from my own community for a time. I didn’t feel I belonged in any community and I’d temporarily lost my ‘why’, until, like always happens with recovery, I found new reasons to recover. But for a while, body positivity spaces, neutrality spaces really infuriated me. I needed to know this was okay, but there’s no one who talks about this! I’ve never seen it anyway. It’s ok to feel whatever you feel, there is no right or wrong. What you feel is worthy of compassion. COMPASSION is what I lacked for myself. Compassion is what society lacks at times. And so you need to learn to be compassionate to yourself and to find where it’s safe for you to get the support you need. For me it’s been talking to my husband and my therapist. A lot. It’s been in writing.

Connection is the other thing that humans need. Yet, experiences like this, where you not only feel disconnected from yourself but also with everyone around you, finding a way to remain connected is imperative to healing. Whether it’s online communities, podcasts, blogs, friends, family, therapy or whatever.

Eating disorders are complex entities. Whilst I can only speak from my own experience, I know there are certain themes many of us share. Numbing painful emotions can be one thing an eating disorder promises, at the expense of losing any emotion. However, in a body that no longer feels home and with such grief it’s hardly surprising many of us believe the false promises. Again connection, having people that remind us of our values and show us compassion is so helpful.

I wish, we lived in a society that recognised this grief and there was a space to acknowledge a persons loss and pain. No one should have to suffer the self loathing and loss in silence. Expecting these feelings as a given, and allowing room for them how we heal. Creating a safe space for discussions and environments for healing.

Your grief is real and you are worthy of help and support.

The way your experience affects your body matters, you matter.

Thinking of anyone experiencing complex body related grief especially during this EDAW.

These are my own experiences and opinions and whilst I want to make my posts relevant to as many people as possible it is impossible to do this in a single post.

Smoke ‘N’ Mirrors

I’ve never written a post whilst “in the thick of it” before. But one of my values is authenticity. We often forget our struggles when we come out the other side and often some of the biggest lessons are lost if not shared when we are truly at our most vulnerable. I’m out of alignment and stuck. That’s basically an eating disorder summed up.

The last few months have been hard. I let small ED things creep back in and before I knew I was back under anorexia’s grip. I didn’t think they were a big deal. Individually they probably weren’t but if like me, you have a history of an eating disorder, we have to be vigilant of these things because one slip can become a landslide before we even realise. It’s a lot easier to deal with when it’s small and early. My aim of this is to reach someone, perhaps you’ve noticed a couple of things slipping, shut this down before it becomes an uphill battle.

The best way I can truly describe being amidst a relapse of an eating disorder is “Smoke and Mirrors”. I could kind of see it happening, but the smoke just kept coming.

The eating disorder serves as an obscurer. It’s made it near impossible for me to accept/ see I am in a relapse, I have a problem, I need help or that I’m not making my eating disorder up. It confuses my brain on a daily basis. It will have me believe I’m fine when everything and everyone I care about tells me the contrary.

All of this is the smoke that has kept me in the grips of anorexia, it’s made me hard to “reach”. How do you solve a problem when someone doesn’t believe there’s one to be solved? It’s taking me time to figure this out. It can’t be unless I decided to trust the people telling me I’m on fire. Some days I believe it, other days I can’t see past the smoke.

This is the main reason for wanting to share this, because I forget this feeling when I get back on track and yet it’s a feeling I can guarantee anyone who’s lived an eating disorder has or will feel at some point. When this started a few months back, I didn’t talk about how things were slipping, instead I isolated and went to anorexia’s open arms. Anorexia and eating disorders thrive on this secrecy, isolation and vulnerability.

Talking might have pulled me out of this faster and so I urge you, if you can feel things slipping, don’t wait for it to get worse before you ask for help. “It’s no big deal” may well be a big deal. It gets harder to ask for help the longer you wait and the eating disorder will do anything to trick you into believing you have this “shit in control”.

It’s a scary and lonely place to sit in. When your brain doesn’t allow you to see through the smoke. Everyone around you might be trying to pour water over the fire, but you struggle to even feel the burn. Occasionally the smoke clears for a moment and you might get glimpses of the situation and it’s suffocating. Realistically it comes back to putting one foot in front of the other to pull yourself back out. Because I only I can pull myself out, just like only YOU can pull yourself out. BUT*** We don’t have to do it alone. Which is something I’m yet again grappling with.

My goals are to go back to basics.

What does that mean?

– Attempting acceptance and when it’s not there trying, to trust my support team because I sure can’t trust my brain right now. If people are telling you they are worried, try to listen to them even if the eating disorder doesn’t believe it. It may never believe it, but one thing I do know is, I can trust people that care about me.

– Try and be honest. There’s no point saying you ‘want’ to recover when you don’t, but that doesn’t mean we can’t commit to recovering or at least trying. It’s a very strange concept to explain to someone who has never lived an eating disorder, why on earth wouldn’t someone want to recover from something that was harming them. For me the work here is coming from “unpacking what my beliefs around what the eating disorder does for me“ It’s hard for me to say I want to recover when in the short term recovery makes me feel shit but I know that long term it’s short term pain for freedom.

Again being honest about what’s realistic for you to challenge now. Only you can really know this. Recovery is meant to feel hard. But I know if I over commit and I can’t meet that goal it only fuels the critical voice of anorexia. Everyone’s recovery is different. Your goals will be not be the same as the next person. Whilst we are at it, releasing comparison full stop.

– Going back to basics. Trying to re-establish the healthy routines.

– Trying to re-establish things like regular eating.

– Using tools that I have learned in treatment or that have helped me in the past- such as dialoguing (as much as I dislike this exercise) because I know it helps to bring my healthy self to the foreground. Dialoguing is something I have let slip, yet it’s a tool that has always helped me see my eating disorder thoughts and healthy self more clearly and allowed me to reinforce that healthy side of me in moments of difficulty. (For anyone who is unaware; dialoguing is an exercise where you write out eating disordered thoughts and counter them with your healthy self (non disordered brain) to try and separate yourself from your disordered thoughts and strengthen your healthy self, you should always end on a healthy self point)

– Connecting not isolating or withdrawing. For me this looks like: keeping appointments with my team, talking to friends and family and even writing this blog because it’s connecting with my authenticity. This is something that I’m finding hard right now because the eating disorder wants me to be quiet an secretive. I’m also having a tough time saying eating disorder or anorexia and so I’m being deliberate in using it. Calling it what it is. Connecting with reality, truth and people. All the things the eating disorder tries to stop me from doing.

So where am I going with this…

Am I motivated to recover at every waking minute at the moment HELL no, But I am COMMITTED to keep trying every day. You don’t have to want to recover. But first step is to meet yourself where you are and work with that.

Eating disorders will distort and hide the truth of your suffering from you. Making it hard to accept or see your reality.

But no matter where you find yourself, even in times of relapse it’s important to remind yourself you’re never starting at square one, even if you feel like you’re starting again. You’re starting with more knowledge and resilience than you did at the beginning. Recovery is not linear. It’s ok to not be ok.

https://www.eatingdisorderhope.com/recovery/self-help-tools-skills-tips

Three Years in Eating Disorder Recovery

Sat in the car with Ben driving me to my first ED therapy session was the scariest day of my life, but it was also the beginning of my life. Sounds dramatic, well it was.

I sobbed the entire way, I yelled at him when we got stuck in traffic and the prospect of missing this appointment. The extreme reaction came from utter terror that if I missed this appointment I might never be able to re-find the courage that was leading me there and fear of starting the hardest battle of my life.

I had been to therapy before, when I was 7 and struggling with OCD and again a couple of times as an adult but I’d never talked about the eating disorder.

I remember the room and the welcoming demeanour of my then therapist who went about my intake assessment, I recall the paper questionnaire she had me fill, (EDE-Q) exploring my relationship with food body and mood. Distinctly I remember the battle in my head about how honest to be.

The room was cold and it was pitch black outside and I’d rushed from work, because I didn’t feel I could attend this appointment in work hours. At the end of the session I remember telling the therapist “please don’t label me”

She replied with a sentence that changed my life. “You have anorexia, restrictive type”

I felt a rush of complex feelings, Shame, disgust, denial and most prominent RELIEF. Relief I might not have to do this anymore.

Relief that now it was out in the open I couldn’t completely deny it anymore. Although at that very moment in time there was no part of me that felt “ready to give this part of me up” I also knew I couldn’t keep it up either.

The weigh in, which would become a regular feature of our sessions following, made the ED scream. I wanted to leave and not return for my second session but the present but quiet healthy voice would make me show up.

And three years on, that quiet healthy voice is now the predominant voice and I’m grateful to her.

I went back 3 weeks later and started CBT-E. It was the toughest and still remains the hardest thing I’ve ever done, hands down. I affirm it saved my life, in every sense. But 3 years on from that first meeting I wanted to share some hard truths.

1. Recovery isn’t a quick process. When I wrote a blog last “year- two years in recovery”, a large part of me hoped and thought by now I’d be saying I was fully recovered. In some ways this black and white all or nothing thinking kept me stuck. It was putting an unnecessary pressure on myself. There’s not magic crossing line.

2. You don’t always have to want to recover in order to do it. I mean when I reflect on that first appointment I certainly didn’t, but I started it anyway. There are days now, where the constant of my eating disorder feels like an easier option than recovering. But when it comes down to it, I hated my life with an ED far more than in recovery. Recovery will also not be forever, whereas an ED would be or a race for death. I don’t want to die and so even on the days where the ED comes knocking it no longer has as much power.

3. My definition/expectations of recovery have changed with time. Like I said, I no longer have a self determined end date for recovery. Instead it’s a commitment I make to myself over and over, with the hope and expectation that one day I will confidently exclaim I am free.

4. Slips, lapses happen. I’d be completely disingenuous if I pretended recovery has been linear. I’ve probably had more slips in the last 12 months than the 12 months prior to that, but each slip/ lapse has given me much needed information and education. I’ve gotten to learn so much about myself and it’s been generally easier to pull myself out of each one. It’s shown me areas of recovery that require my attention and focus to move forward and prevent the same slips later.

5. Self compassion. As a typical ‘all or nothing’ thinker and perfectionist tendencies it’s been one of my biggest challenges to learn to be self forgiving, to show myself kindness and compassion particularly in moments of struggle. But eating disorders feed on this inability to be kind to ourselves and practicing these have been by far one of the most powerful tools I’ve found in my recovery. This includes learning to talk back to the negative critic with kinder & gentler affirmations. Often, accepting what the eating disorder tells me and countering those thoughts with a healthy alternative. This continues to be something I work on. My journal is full of dialogues between my healthy self and the eating disorder voice and I gain insights to recurring themes or things that are keeping me stuck.

6. There are many beautiful things in recovery. My husband recently sent me a text “do you know what I really love? That the real Nikki is almost fully back, despite the shit that goes on in your head, the goofy girl that’s always been there is coming back more and more”

I screen shot that text and in moments where the ED is screaming at me, I read it and use it to motivate me to make the right decision. Finding something that can help motivate you in tough moments can really help, whether it’s a post card or somewhere you want to visit, an affirmation or a text from a relative can often empower you to fight back.

Now here’s where I highlight once more, I don’t always like recovery but if I want to stay that “goofball” my husband, family and friends love, I have to fight that voice, sometimes many times in a day. And this lends me on to another recovery tid bit.

Connection. Connecting with others in recovery, connecting with those that have trodden the path before you and connecting to your why’s is like an eating disorder recovery essential survival kit.

Connecting with people who ‘get it’ has helped me more than I can express in a simple blog. But if it’s something you’ve been reluctant or afraid to do, please consider it. Talking to people who ‘get it’ often without having to say what “it” is, really helps in several fronts; feeling seen, not alone or crazy. Not to mention the unwritten support and etiquette that most people in recovery show each other (I.e automatically knowing what Info is harmful, like numbers etc) without having to ask someone not to share things likes diets etc that is normalised outside of the ED recovery community. This can also lead to a level of accountability the “wanting to set an good example or help others” can inadvertently push you forward.

7. Connecting to my why. If I was to share what my why was three years ago, it would be very different today. The only thing I knew then was I couldn’t live that way any longer. Now, my why remains dynamic but is also much broader. I’m no longer a one dimensional figure where my life revolves around food and exercise.

What has recovery taught you?

That’s it my reflections on the last three years in recovery, who knows what I’ll find in the next 12 months, but I know one thing I’m letting go of the pressure of setting myself a recovery deadline and I’m just going with it.

Is That “Before” Recovery Photo Actually Thinspiration? Don’t Be Fooled!

What is thinsporation? And how does it play into eating disorders? And is that “before” photo helpful, or actually harmful?
— Read on www.recoverywarriors.com/is-that-before-recovery-photo-actually-thinspiration-dont-be-fooled/

Trigger Warnings…

What are trigger warnings and do they work?

These are often at the beginning of an article or social media post, either labelled as; trigger warning “TW’, or content warning ‘CW’. Triggers have many different definitions. The discussion regarding their use is not straightforward or easy.

I’m keen to start a discussion about how we perceive them, use them or alternatives that we could implement.

This is a heavily nuanced subject and I do not claim to have all of the answers, in fact my experience and knowledge is finite.

However I wanted to explore this topic further after an Instagram post I shared about them sparked a few interesting DM’s. https://www.instagram.com/p/CUYQe2Mhae4/?utm_medium=copy_link

Before I get into my own views, lets discuss the origins of where “trigger warnings” for content originated.

Trigger warnings originate from trauma, PTSD content. They were specifically attached to protect people with a history of PTSD/ trauma from experiencing the negative effects of reliving the traumatic exposure and secondary response. “Being triggered” in any other setting is different to this. People with PTSD often cannot regulate their response to the trigger.

I do not have experience with PTSD and so I’m not equipped to be able to talk about all of the nuances associated with this. I can however talk about the use of “TW” outside of trauma & PTSD and the potential harm they cause.

Multiple studies have demonstrated TW used in any other context at best do not work and at worst can cause harm. Yet almost every post I come across in the eating disorder community comes with a “TW”. It’s almost as if a trigger warning absolves a person from any responsibility of what they are posting.

If you are consuming, participating and engaging with particular content on social media you have a level of personal responsibility.

What do I mean by this?

It is your choice to visit certain pages, hashtags and communities. You have the same choice to avoid or unfollow content that does not help you.

Additionally you have a degree of responsibility regarding content you share. If you feel it may be harmful, caveating it with a TW is not solving a problem. Before I share anything, I consider a few things; does this post have the possibility to harm, does it serve the community I want to be an ally to and how would I have perceived this when I was unwell?

There is also a big difference between being “triggered” and discomfort.

Unlike people with PTSD, most of us with eating disorders whether you like it or not can choose to be triggered by something.

People with PTSD find it difficult to self regulate/soothe when they come across a trigger and reminder of the traumatic event. It can have many physical, somatic effects such as dissociation, soiling, hyperventilation and these are not in their immediate control. Therefore trigger warnings applied to topics/scenes depicting graphic violence/ sexual assault may help. There’s also debate that avoidance of such can do harm to some people’s recovery but again I am not equipped to go into the nuances regarding these.

I know when I was deep in anorexia, I would seek content with “TW’s, my eating disorder wanted me to be triggered. A trigger warning did not deter my unwell brain. If anything they helped keep me stuck in the cycle. I chose to be triggered by them. Why?

Eating disorders by nature a incredibly competitive. When the eating disorder voice is the dominant voice it will go looking for anything that validates it and makes it “more successful”. I could have controlled my response to them, I could have avoided them all together, but I chose not too.

Trigger warnings do not prevent this. They are the problem.

Now I’m solid in recovery, if I see an post with ‘TW” I can view content without allowing myself to become “activated”. I will often choose not to open such posts depending on how I am feeling in myself. I take responsibility in what I engage with. This is self regulation. But let me lay this out there…the “TW’s” on content I used to seek when I was ill with anorexia would reinforce intrusive thoughts. Labelling content with a “TW” would often lead me to engage in things I wouldn’t other wise. It’s like when someone says “don’t think about the colour red” all you can think about is the colour red. TW’s don’t tell you to avoid the content but they may increase the intrusive thoughts too. There’s increasing literature to show that “TW’s” do not work and can result in increased anxiety (I’ll share some links below).

As I have referred to already there is a difference between “being triggered” and feeling uncomfortable (feeling our feelings). I can feel uncomfortable about something but still remain within my parasympathetic nervous system and not enter the fight or flight mode invoked by the sympathetic nervous system. Commonly posts will elicit feelings of grief because I resonate with them to a time when I was unwell. These feelings are healthy and transitory- they do not keep me stuck in a state of “activation or triggered into a trauma state”.

Again I’m not knowledgeable in all of the nuances regarding this. I wanted to start the discussion about how blanketly these warnings are being used and whether they are causing more harm than intended.

I’m not saying there is no role for TW’s, I am encouraging you to reflect on why you use them, is it truly to prepare an individual or to remove responsibility from what you share or engage with?

Do trigger warnings help you are they as useful as we think? Do they cause you more intrusive thoughts? I’d love to hear your opinions, either via the comments or email me.

A few published studies:

Lived Experience..in ED Recovery.

Lived experience is one of the most valuable assets to recovery.

You can read about eating disorders in as many text books as you like and on some level you will understand them. Cognitively you may get it, but unless you’ve walked in the path it’s difficult to “really get it”

When you have lived that experience, You get it on a whole other level. People in recovery “get it’ on a level that reaches them to their core.

This makes people with lived experience such important allies in a person’s recovery journey and can be crucial alongside treatment.

I will never be able to express the gratitude I feel for my therapist, I know she saved my life, literally. Therapy was huge in my starting recovery and breaking free from the ED. But the most transformative part in my own recovery has been through connecting with those who have lived it.

At all stages of my recovery lived experience has been influential and important in my own growth.

Reading blogs, listening to podcasts/vlogs and following pro-recovery accounts on social media has really assisted me in the process.

There’s a deep level of trust that develops, knowing that others who have fully recovered, or are in a strong place in recovery helps us to feel connected, validated and most importantly gives us HOPE.

I reflect on the times I listened to people like Jessica Flint, Tabitha Farrar, Mia Findley and Millie Thomas sharing their stories, their wisdom and experience and aspiring to reach many of the milestones in recovery. Believing through sheer faith in their stories that recovery IS POSSIBLE for everyone. Even in some of my darkest moments in the throes of the ED or difficult moments in recovery, trusting what those who have lived and come through the other side has felt comforting and at most motivating.

Connecting with others in recovery seemed terrifying to me when I first started. If I had have been offered group therapy or any form of treatment that meant connecting to others, I would have ran a mile. In fact, I did. I was so ashamed of my eating disorder and terrified my “sordid secret” would become common knowledge. But through listening to others, joining platforms or groups a lot of this shame began to disappear, because there was nothing in this community that was judged, hadn’t been felt, said or done before. I started to see I was NOT ALONE, that there were millions of us who have experienced eating disorders.

A common theme I began to understand was the level of shame we all suffered. The more I read stories, listened and talked the more the shame began to dissipate.

Things I felt I could never share with another living person, suddenly felt like no big deal in the recovery community. The nuances that we believe are so shameful and not to be brought out into the light of day, are everyday struggles we share and is part of non-judgemental wonderful conversations. They say shame is fuelled by secrecy, I believe this is so true.

Following other’s journeys enabled me to find my own voice. I refuse to be ashamed of something that has made me who I am and helping me to connect with my true self.

I used to say I wanted to recover to the person I was before the eating disorder. I no longer wish this, because recovery has made me someone else, someone bigger than I was ( pun intended), but the level of growth that comes from choosing to recover & surviving an eating disorder is such that I wouldn’t trade it for the world. I’m becoming more connected with myself with every recovery orientated decision and becoming aligned with who I want to be. I’m grateful to those who were brave enough to share their experiences, that motivated my own recovery and helped me keep faith.

People recovering from eating disorders have to do this in a world that still challenges many of the beliefs we have to unlearn and to be able to recover in this society is so hard. For some this society can be incredibly cruel and the more people who share their struggle, experience the better this will be one day, especially for those who cannot find their voice. Lived experience is becoming a much bigger part of recovery, with the ever increasing resources available, recovery coaches becoming mainstream and peer mentorships, this can only be a good thing alongside traditional recovery. These people have experienced the struggles, the up’s downs and navigated their way out and are so valuable in helping others do the same, with compassion and sensitivity that is as authentic as it can get.

I’ll share some resources that have been so imperative to my own recovery below.

https://www.recoverywarriors.com/ From blogs, to podcasts and online community platforms such as the “Courage Club” this has been huge in my recovery. Jessica Flint is fully recovered from her eating disorder and has now founded a recovery community that has reached thousands of people in recovery. This has introduced me to some of the most incredible people I’ve ever met.
https://www.instagram.com/lindseyhallwrites/?hl=en Lindsey Hall has herself recovered from anorexia and she shares incredible insights
https://tabithafarrar.com/ Tabitha is a recovery coach, who has fully recovered from her eating disorder. She’s very direct in what she believes recovery is, but she has shared some amazing blogs, podcasts and now mostly posts video content on youtube. I followed her avidly when I first started recovery. She posts about things from “extreme hunger, weight gain, and neural rewiring”
https://www.instagram.com/millietnz/?hl=en & https://podcasts.apple.com/au/podcast/end-eating-disorders/id1534539219 End Eating disorder recovery Podcast.
https://www.beyondbodycoach.com/ Mia Findley- is an Australia based recovery coach, who has fully recovered. She posts videos and podcasts with her experiences.
http://maintenancephase.com/ This is a great podcast that promotes HAES, diversity and is anti-diet
https://www.instagram.com/drheatherirobundamd/?hl=en

Recovery Super Powers

Protecting your recovery can be like developing a super power. It’s also incredibly important when we are surrounded by potential triggers every where.

If we are in recovery from an eating disorder, we need to learn to reject diet culture, which is really difficult when it infiltrates every part of our society.

I recently came across a blog, where the author was promoting a weight loss regimen, whilst sharing their own ED Recovery.

That tells me two things, firstly it is not something helpful to my recovery, secondly the writer very likely still holds a lot of internalised implicit biases around weight and fear of weight gain and unlikely recovered.

The intention of this post is to highlight the importance of being aware of the content you chose to follow and your motives behind it.

People have the right to write/ talk about whatever they like. However, it can be really damaging to a person who is trying to heal from an eating disorder to follow accounts like that. You have a choice regarding the content you chose to follow or not.

My thoughts are and they may be unpopular, YOU CANNOT recover from a restrictive eating disorder whilst still actively attempting to pursue a smaller body. Believe me you cannot. It took me long enough to come to terms with this. You might get the idea of “I could go on x diet, lose this much and I would be ok”. Take it from me you will not. It is a relapse waiting to happen. That is how my last real relapse happened. All it really tells you, if you get those thoughts there’s still work to be done on neural re-wiring. It gets easier. I get these thought from time to time, “If I could just lose X amount I will be happy” this is my eating disorder voice and one that I know cannot be trusted. A size, or shape will never change how I value myself, I am so much more than a measurement but this is not what my eating disorder believes, it will make me buy into the notion that my worth is solely based on a number. This is not happiness.

I cannot diet ever. ever. ever. Choosing to go on a diet when you have a history of an eating disorder is like saying a person who has recovered from substance or alcohol abuse can have the occasional drink. You would not say this. Dieting is our drug. We cannot safely dabble.

In recovery the focus should be on challenging our fear of weight gain, body image, learning about the health at every size movement. Dieting becomes less appealing. I’m not saying you won’t get those thoughts. However your brain will learn that you don’t place all of your value on a number and it’s not something we’re interested in. If the concept of Health at Every Size (HAES) is new to you, I encourage you to explore some of the resources I’ve shared at the bottom. However, a very brief summary of HAES; the basic premise supports people in implementing health practices for the purpose of overall well being rather than the focus on weight control. There are some key values to HAES, it encourages people to eat intuitively, accepting of body diversity shape and sizes and that health is about much more than weight. This is a very simplified explanation.

I do not believe a person can endorse weight loss and be fully recovered themselves, because the aim of eating disorder recovery is to unlearn your fear of weight gain, to rewire implicit fat bias/ fat phobia. Therefore by promoting weight-loss on an eating disorder recovery site is an oxymoron. It does not have a place in recovery. I personally do not follow accounts whereby the premise is promoting weight loss or any form of diet culture based content.

If you are trying to recover from dieting, disordered eating or an eating disorder it is your responsibility to not allow this to trigger you. Therefore avoiding unhelpful information such as “losing weight” in eating disorder recovery might be the easiest way.

My last real relapse came from thinking “I can safely diet”

How I deal with these thoughts now; I challenge myself with the following questions:

Why do you want to diet, what are you actually trying to do? What are you lacking in an area. (It’s usually self care and self compassion for me).

Why do you feel the need to change your body- can you learn to accept your body at any shape size and understand a number on the scale has no bearing to who you are as a person or your health?

But, I find sites like this are dangerous in the ED recovery community, they do not realise the potential harm they could have. This particular individual has a large following. Many of the followers suffer with binge eating and the blog is the last thing a person experiencing such should be taking notes from. Dieting no matter how you look at it is restriction. Restriction is no friend to bingeing in fact restriction causes bingeing.

I recently shared this checklist on my social media- it serves as a way to protect myself and maintain healthy boundaries.

Resources:

Health at every size: NEDA: https://www.nationaleatingdisorders.org/sites/default/files/ResourceHandouts/WhatisHealthAtEverySize.pdf
The amazing works of Lindo bacon: https://lindobacon.com/HAESbook/pdf_files/HAES_Introduction.pdf

For the days where you are feeling nostalgic towards your eating disorder…

During the recovery process, I believe it’s common, even normal that many of us feel some kind of nostalgia towards our eating disorder.

The times in recovery where our ED comes knocking and tries to lure us back, nostalgia is a tactic it uses.

I found this crazy, why would I ever want to return to something so destructive, yet I experienced a sense of wistfulness for it at times.

Your ED will not remind you of your darkest days in the depths of it, it will tell you mistruths, altered memories- such as, “it wasn’t that bad, you didn’t really have an eating disorder, not every day sucked, you still ate xyz, you didn’t miss” bla bla. But it will not be reminiscent of the rules you had to allow yourself to do that, the guilt and shame you felt and the resentment from others when their concern fell on deaf ears. No, it will not remind you of any of this.

It will recollect and romanticize the euphoria you felt on occasion, but not the crashing low points that always followed and were the majority. It is deceptive and the memories are modifications.

Your eating disorder has been a maladaptive coping strategy. It’s not surprising it tries to draw you in, at a point in your recovery where you are experiencing so many challenging emotions, new experiences, loosening of support, why wouldn’t your eating disorder try and lure you back, romanticize its role in your life?

It might be on a bad body image day; the voice whispers a reminder of old compliments you used to get. It will not remind you of the days where you missed out on happy events in order to follow the ED demands or how the compliments left you feeling conflicted and confused.

Nostalgia is natural in recovery, but do not dwell in it and do not believe the romanticized picture your ED paints, your ED was not a happy place.

On the days where your ED tries to convince you otherwise:

I find reminding myself of the many things I DO NOT miss about my eating disorder helps snap me out of it. Here are some of those things I do not miss…

My entire brain being consumed by nothing but thoughts of food and numbers.

Being “bone cold” all the damn time no matter what the temperature was.

The deception, the constant lies and shame that accompanied.

The isolation, the missed social events and memories

Not being able to eat with company, not being able to eat alone.

Not having a period

Feeling lightheaded most of the time

The pain, and many injuries through not allowing my body to rest.

The inability to laugh the inability to cry real tears.
The crippling fear when faced with a “fear food.”
The incapacitating supermarket, menu, choice “blindness.”
The brain fog and difficulty to concentrate and apply most of my brain.
The sore throat
The bloating and constipation
Never getting a full night’s sleep, sleep being haunted by fear foods.
Not being able to eat out without planning a year in advance.
Having to move 24/7. The unbearable discomfort of being still.
Being boring because I had nothing to talk about
Feeling like a constant failure no matter what. No number, image or achievement was ever enough.
Feeling like I wanted to crawl out of my skin all the time.

The list is not endless. I could continue.

However, I feel it is important to remember a few things:

Nostalgia towards your eating disorder is nothing to feel ashamed about, it makes a lot of sense in recovery. We should normalize it.

Nostalgia is natural in recovery, but do not dwell in it and do not believe the romanticized picture your ED paints. Bit by bit this nostalgia will dissipate and become replaced with the truth so long as you keep addressing it.

Orthorexia

Orthorexia- the “socially acceptable” eating disorder

My eating disorder like many, has been a shape shifter over the years, meaning at various times I would have met criteria for more than one diagnosis besides anorexia nervosa.

We are all human beings. Fitting into criteria or a neat little box isn’t congruent with being human. And so whilst diagnostic criteria can be useful to help identify or guide which treatments may or may not work for you, I think that’s where their relevance ends.

What is Orthorexia?

The Diagnostic & statistical Manual of Mental Disorders (DSM-V) does not currently hold a separate diagnosis for Orthorexia. Instead it technically fits under the diagnosis Avoidant Restrictive Food Intake Disorder (ARFID) , although not perfectly, we return to my point about us being humans and not fitting neatly under one set of criteria.

This is a disorder characterized by an obsession with eating “healthily” or “clean” foods. A person becomes fixated on eating only foods they deem to be “pure”, meaning they can adopt strict rules and restrictions around foods and how they are consumed. I called it the “socially acceptable” eating disorder because it can be hard to detect in a society that praises restriction and demonizes anything else. People often reward people for eating “cleanly”. No eating disorder is ok. Orthorexia is when a persons focus on eating healthily actually becomes detrimental to their health, as a result of the obsessions, restriction, nutritional deficiencies and effect on the body.

It wasn’t until I started recovery for anorexia I realised I needed to challenge this too.

Orthorexia complicated my recovery, as I mentioned eating disorders are shape shifters, my way of “coping” with recovery became focusing on nutrition for a short while. If you are trying to recover by eating only “healthy” foods, you need to challenge this.

You cannot recover from a restrictive eating disorder holding on to ANY rules around foods. My obsession with eating healthily also preceded my development of anorexia and at some points other ED symptoms.

It is generally accepted that people experiencing orthorexia are not always driven by a fear of weight gain or drive to be thin, unlike anorexia. It can result in body dissatisfaction but weight loss it is not the driving factor (usually). It is about feeling clean and pure. I have no doubt that it could lead to anorexia in those of us with the genetic susceptibility because it can result in energy deficit.

Some of the warning signs of Orthorexia may include:

Unhealthy obsession with checking ingredients or contents of food (not driven by a fear of weight gain)
Cutting food groups because they are deemed “unhealthy”
Rigidity, not being able to eat foods not prepared by themselves or consume foods they do not know the ingredients (again not as a form of intentional energy deficit)
Distress, obsession impairing well being

If you think you have a problem, any concern with disordered eating, it is always good to seek help. Talking to a GP, a health at every size aligned dietician or therapist would be a good place to start. You deserve to have mental freedom.

Helplines/websites:

USA: National Eating Disorder Association (NEDA) https://www.nationaleatingdisorders.org/
UK: BEAT: https://www.beateatingdisorders.org.uk/support-services/helplines
Australia: https://butterfly.org.au/who-we-are/contact-us/
NZ:https://www.ed.org.nz/
International: https://www.eatingdisorderhope.com/treatment-for-eating-disorders/international/india
A really good Instagram account:https://www.instagram.com/OrthorexiaBites/

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.

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.

Eating disorders, Stigma and Labelling..

Stigma has many definitions and layers.

But from my A-level psychology days the works of a psychologist Goffman defined it as an attribute that is “deeply discrediting’and reduces the bearer from “whole, to a tainted version” of themselves. Though much of his theory has been disputed most still accept this part of the definition.Goffman definition

“n. Stigma; the negative social attitude attached to a characteristic of an individual that may be regarded as a mental, physical, or social deficiency. A stigma implies social disapproval and can lead unfairly to discrimination against and exclusion of the individual’. Definition

Stigma is not a new concept, dating back to Ancient Greek and Latin, where it’s common meaning “a mark, or “sign of” as well as ‘to brand undesirable”, hence the origin of the word.

Labelling has been an area of great debate for decades. Various psychologists and sociologists have attempted to argue in favour of labelling and it’s impact upon stigma or refute it. Each arguing different consequences of labelling.

Regardless, one thing I have witnessed as someone with an eating disorder is a fear of attaching a label and the stigma associated with it. The reason I am writing this was prompted by a discussion with someone within the ED recovery community this week. They themselves were struggling with the label they had just been given at diagnosis. I recall vividly feeling this way, it served as a barrier to me seeking help.

It reminded me of my very first appointment with my then therapist. After completing the EDE-Q questionnaire and the weigh in, she said with conviction “You have anorexia nervosa”

I remember practically begging her to not attach “the label”, it meant everything to me, to not have this “blemish the tarnish” on my record. It felt dirty, shameful. Even though, I had know myself, in the moments free of the anasognosia I had had Anorexia for many years but NO one had formally named it, labelled it, discriminated against me for it. Suddenly this would be the first thing doctors saw on my record. It mattered.

This fear appears to be a common amongst many fellow eating disorder sufferers. I expect, though I cannot blanketly say so, for many other mental health issues.

Labelling has been attached to concepts including, self-fulfilling prophecy, stereotyping and stigma. Suggesting close interconnection. Labelling theory broadly states people behave or identify in ways that society or people have labelled them. This can also work on a societal level that people develop stereotypes attached to a label and expect specific behavioural patterns attached to those with a label. This can have positive or negative consequences.

Lending itself to the self-fufilling prophecy whereby an expectation results in fulfillment of embodying the label.

As these roles tend to be “deviant” from the societal norm stigmas can develop. These are derived from negative stereotypes and thus resulting prejudices and discrimination result.

The structure of stigma can then be further categorised into self stigma, label avoidance, public stigma, social and structural stigmas: ( this is by no way comprehensive and just my simpleton understanding). For this post I’m focussing on stigma within mental health.

There’s a breadth of information available pertaining to the many types, mechanisms and structures of stigma.

1. Self stigma: Self stigma impacts upon how you see yourself and your interpersonal relationships. Self stigma can be a barrier in recovery, in seeking help. It can distort perceptions of how you believe other people view you. An example in the case of anorexia might be: “ I am not worthy of help, seeking help makes me weak” self prejudices– “having an eating disorder is my fault, Why would anyone want to employ me, be friends with me”. Self-stigma and resulting discrimination: self-imposed isolation, the person cuts off from world and opportunities, including help)

2. Label avoidance: An individual may be aware of stigma surrounding a particular diagnosis and thus engages in behaviours to avoid the label. With respect to eating disorders this might look like: “having a diagnosis will mean I am vain, or I chose this “lifestyle” so they avoid seeing a heath professional. Prejudices that result- ‘I am ashamed to have an eating disorder, to be seen as someone with anorexia’. Discrimination: Concealing the “label” from my family or employer and therefore not being able to attend important appointments, because I am afraid I will lose respect and my career. The best way to combat this is through finding your voice, self-disclosure. This may be through sharing your diagnosis with a small circle or friends, family or being open to talking more broadly. (This is very personal)

3. Public stigma: Where general beliefs and prejudices are affirmed to a marginalised group ultimately leading to discrimination towards them. ‘People with eating disorders are vain, People choose to have eating disorders’. Prejudices may manifest as; employers are worried to employ the person, as they may fear their mental health makes them unreliable. Discrimination may result in a person not being employed.

4. Societal/ Structural stigma: this refers to policies invoked by large organisations or systems such as governments, health facilities that lay down restrictions on opportunities and rights of those with mental illness. An excellent example of this is weight stigma. The DSM-V label of atypical anorexia. Where this diagnosis is exactly the same in terms of criteria as anorexia with one difference the sufferer is not of a low BMI. The prejudice- fat people cannot experience as severe symptoms or implications as those who are underweight. Which is not the case. The discrimination that may result; many people living in larger bodies are denied access to health care or resources because of their size. This is a big one. Structural stigma is the one that affects marginalised communities. It’s interconnected to societal stigma. How we address this is through education, challenging the narrative. But it takes time.

There are MANY types of stigma and I have barely touched the surface. My aim was merely to shed light on how public, structural and self stigma are closely interlinked and can serve as a barrier to those with mental health problems from seeking help. Understanding the origins of stigma means we can continue to break down the cross links within it. My hope is that one day, no one will fear seeking help or a diagnosis because the label will not hold power.

Permission to Eat, Eating Disorder Recovery..

Answer this question honestly, do you ALWAYS, without fault give YOURSELF full permission to eat exactly what you want, when you want?

If you are some one like myself recovering from an eating disorder it is an essential skill we must master.

For a person who has never endured an eating disorder, you have still been subject to the messages from society that eating xyz is bad, eating after x o’clock is unhealthy. It’s all bollocks but it’s been ingrained into us and so I reckon if you really answered this question truthfully the answer would be no, for the majority.

What does permission mean in eating disorder recovery?

There were times/ are times where I have required external permission to eat. Questions like, is it okay to eat XYZ, is this too much, are you sure I need to eat XYZ? These are all utterances that have left my lips. Obviously, like any human being, I do actually know the answers to these questions. But giving myself that permission to eat is something the eating disorder makes very difficult. The eating disorder tells us there are many things we cannot/ should not do. Permission to eat intuitively, unconditionally is not something the ED permits.

This is something we have to master for ourselves.

There were times early in recovery, where I just couldn’t give myself that permission. At this point, I think it’s often helpful to have support, where permission can be granted, whether it’s from friends, family, therapists, dieticians or coaches, until you are strong enough to start permitting yourself. Ultimately that is the goal. Full unconditional self permission. It doesn’t happen over night. I have given myself permission slips before. If I couldn’t do it mentally then having a permission slip physically was helpful.

Intuitive eating is the goal, but it’s not something we can just start doing. Particularly in early recovery, when you are re-kindling hunger cues, trying to restore weight because realistically left to our own devices in this phase we would likely not eat enough. My ED would not allow me permission to eat more than I intuitively felt in early recovery. This is where external permission was really helpful until I could do this. I would set an alarm every 3 hours, my snacks, meals all non negotiable. Until I started getting hunger signals and cravings.

Even now, there are occasions where if I’m having a stressful time where this self permission can be difficult. I can walk through the process in my mind but then following through is the issue. So permission slips or external permission can be helpful.

The following are some common permission pitfalls/ situations I’ve come across- I don’t think they just apply to eating disorders but I do believe they are very important for us not to fall into.

1. I ate a lot of food already/ I ate so much for dinner I can’t possibly be hungry or eat now. If you are hungry you are hungry. What you ate before is old news and irrelevant. Your ED won’t like it, but so what.

2. I haven’t exercised. You do not need to move to eat.

3. I’m not hungry now so I’ll just have a little bit. Then 30 minutes later or just before bed you’re hungry. It’s normal. Respond. You’re bodies not on a timer.

4. It’s after X O’clock I can’t eat now because “it’s unhealthy”….Your body does not tell the time, it doesn’t work to a schedule, this is a diet industry myth that is not substantiated by evidence.

5. But I’m going out for dinner in an hour so I’ll wait. Nope if you’re hungry, you’re hungry.

6. No one else around me is eating but I’m hungry. This is a tough one for those of us in ED recovery. Eating in front of others can be challenging as can eating when no one else is. But YOU have to be able to give yourself permission to eat whenever, wherever.

7. You don’t know what the nutritional value of something. (You don’t need to). Your body is not a calculator, again this comes from diet culture.

8. You gained weight. Giving yourself permission to eat when you have gained weight- whether you’re in recovery from an eating disorder or just rejecting diet culture is courageous.

9. Don’t feel hungry. Eating when you don’t feel hungry but are not sure when you will next eat etc is smart eating. In ED recovery there will be times where you don’t feel hungry as your hunger signals are not working. Eating mechanically here is important, giving yourself to eat even when you’re not hungry is essential. Set an alarm, reminder if you have to.

10. Eating when other’s around you are dieting. Giving yourself permission to eat unconditionally- this is definitely a hard one. With or without disordered eating.

11. Permission to eat, just because. Because it’s nice- something our weird ED brains can have a hard time with. My brain often questions why. There does not have to be a reason.

12. When you don’t feel you deserve to eat. Food has no moral value. You always deserve to eat. Find that permission.

You always have full permission to eat what you want, whenever you want no matter what. We all need to be able to grant ourselves unconditional permission.

Identifying Core Values, in Eating Disorder Recovery

Finding life/ meaning beyond an eating disorder

Recovery involves a great deal of self exploration and a deep development of self -awareness, a level that most people will not their entire lives. This is something to be grateful for.

When I first started treatment for anorexia, I remember my therapist drawing out two pie charts. She asked me to fill in the blank circles with what was important to me in life and as a person. Her point was to show me how warped our thinking becomes when we are living with an eating disorder.

My pie at the time is a world apart from the one I would draw today.

The original pie was occupied by over valued pre-occupations with food, fear of weight gain and then tiny snippets of other aspects such as family, friends, career, “hobbies’ (at the time it was labelled as hobbies rather than individual interests because I didn’t have many besides controlling my food and shape) now this would include things like, creativity, art, writing, yoga, running, being outdoors, travelling, my veggie patch, puzzles, learning and discovery. My point being it’s a lot bigger and I have reconnected with individual interests and no longer struggle to think of what my “hobbies” actually are. Recovery involves increasing self awareness and discovery.

I wrote a blog on “you are not your eating disorder” some months back. Whilst I still believe this to be true, it is somewhat simplified because much of our identity is unveiled to us as we move through recovery.

When I was first asked, “what are your values?’, by my therapist I had the default answers, but they weren’t the core. I’d long lost touch with what they were. I suppose I identified as my eating disorder.

I had my values I would spurt as if off of a script because I felt they were what they “should be” I had my values that came from my eating disorder, but truthfully at the time I had no clue what my “true” values were.

Personally discovering and reconnecting with “my” virtues and traits has been instrumental in my recovery. There’s a sparcity in research pertaining to the use of connecting with values and eating disorder recovery but I believe for many of us it could be the missing link.

We know that eating disorders can be ego-syntonic ( we believe our actions, beliefs to be appropriate and congruent with our central personality, in contrast to ego-dystonic). Meaning many of us “value our eating disorder, see nothing wrong with it” and it helps to explain the resistance to give it up. This is where the whole rhetoric “you are not your eating disorder comes in, but to begin with we often view this as synchronous with our identity. Through the self exploration we bring the ego-syntonic values into question, essentially resulting in dissonance between the contradicting values.

I’ll use my own example, when I used to turn to restriction, I’d escape the negative emotion I was trying to avoid and feel a sense of mastery of control, in the early days anyway. All of these appeared congruent with my core values; self control, self discipline, hard working, dedicated. But the more I explored what my true values were, I could see there was an incongruence. It was bringing these values to the surface that helped me move past the ambivalence I felt towards recovery.

Some of my own values and how honing them helped motivate me in recovery..

1. Honesty and integrity. I don’t think I need to expand, I became extremely deceitful in order to protect my eating disorder. I could see that lying was causing a great power struggle. Giving myself permission to become my authentic self, learning to communicate with myself and support helped me to align with these values and realise living with anorexia was not living as my authentic self

2. Compassion, forgiveness, courage, perseverance, curiosity are some of my core values. Part of my self healing work has been to learn to set boundaries, to have an “off” switch, developing the compassion towards myself that I show others and practicing self forgiveness.

3. Solitude is important to me, I can be at home in my own company. I try and nurture this by following my morning routine where I get up slightly earlier and have 30 minutes to myself. I often use this time to journal and check-in. Expanding on this further I’m someone who needs routine to keep grounded

4. Connection is important to me, although I need time on my own, I thrive on connecting with others. My family, friends, other people in this community. This was incongruent to how I was behaving with my anorexia, I become isolated, withdrawn. I believed my behaviours were helping me connect, enabling me to control anxiety around social events for instance. However, what actually happened is I avoided the social events, I pushed people away. Highlighting the conflict of the ED value and my own.

Some food for thought…perhaps journal prompts

If you’re in a place where you are still trying to figure out your values, something I found helpful to start with, was thinking of people I admire. What is it about them that I admired?

What are some of your character traits? How do they help you or hinder you?

What are some things you believe in?

Identifying our core values helps us make decisions about the future, they shape our relationships are central to who we are. They help us to understand that when we are acting out of alignment to our core values it brings about distress and often maladaptive behaviours. This is why I truly believe connecting with our core values assists us with developing coping skills for situations and finding inner peace.

“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.

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“Weigh days” in ED recovery

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What are trigger warnings and do they work?

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Why do you feel the need to change your body- can you learn to accept your body at any shape size and understand a number on the scale has no bearing to who you are as a person or your health?

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On the days where your ED tries to convince you otherwise:

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