"Healing comes in waves". My stages of change.
Not even a week into your first attempt at recovery and you soon find yourself in an inexplicable physical and emotional mess. A chaos that makes no sense, as you expected everything to get better once you started the so-called healing. Meet Recovery from an eating disorder. It’s hard, it’s uncomfortable, it’s confusing and it sure as hell doesn’t feel right at first. Understandably, you want answers. And so, you seek them.
“How long does recovery take? Is anyone else experiencing nausea? Swelling? Why am I constantly bloated? How many calories do I have to eat? Where did the all-consuming thoughts about food all of a sudden come from? Is anyone else having bouts of euphoria followed by hysteria? I abundantly sweat at night, anyone else? I’m awfully hungry and can’t stop eating. Even after I binge, I still want more food. I could swallow my entire pantry. My appetite feels like an endless pit, is it normal? My body is aching, I’m in pain, what can I do to feel better? My stomach is huge, how long for weight to redistribute? How do I know when I’m at a healthy weight? Why have I gained weight but feel worse than ever before? Why am I so bloody anxious and depressed? Can you ever fully recover? I’m weight restored but still no period, anyone else? Does osteopenia ever heal? Are my symptoms common?”
The questions are endless, and the answers, besides infinite, are also inconclusive. They vary from person to person. No two individuals are identical, and no two recovery paths will be the same. Unfortunately, there is no amount of weight gain, no explicit time period, and no specific restoration of body imbalances that will mark the end of your recovery. But it is also the beauty of the process, because in sharing your story and hearing other peoples’ experiences you can find cathartic support in your healing. Everything you are experiencing is normal and there is at least a handful of people who can relate to the exact feelings you are describing.
You can find a generic explanation of the different stages of recovery from anorexia on official eating disorder websites, and they are helpful. But I find that first person narratives are just as useful, if not more, in that they provide reassurance that “you are not alone”. On that thought, I decided to break down and provide some details about my journey.
We each go through recovery in our own messy way. We each experience different phases, but if there is something I want to stress ahead of the story that is to follow, it is that you should talk about it. Talk about your recovery. Be it with your treatment team, your family, your friends, or a support community you find online. I extensively kept things to myself. Withholding behaviors that provided relief, compulsions that I saw as my failure at recovery, rather than symptoms of the illness. It is only later, through my own research that I discovered they were a product of anorexia itself, residual or morphed eating disorder behaviors that needed to be tackled. But more importantly than being addressed, they should have been discussed. Indeed, they left me feeling like I was never going to get better, that there was something wrong with me, that no matter how hard I wanted to recover, some things, I just won’t succeed letting go of. And that’s bullshit, because everybody can recover, and the only thing that is wrong is that you are currently sick. Getting better will take time but surely you can recover.
The slow addictive onset
The relief of starvation, in people with anorexic genes
This is the danger zone, and once you’re in it, it’s hard to recognize behaviors as anything but natural. The last thing on your mind is a reason for concern. Friends, family and acquaintances who think that stating the obvious will help could not be further from the truth. I was very open about never being hungry. I was very open about how I couldn’t eat. I was never trying to hide my emaciation. When people asked me if everything was ok, sure it was. My doctor tested me for stomach bugs, thyroid dysfunctions, anything that could be the cause. I always said that I just needed to push myself to eat more, despite having no appetite and a hard time doing so, “with work and all”. I always shared what I thought to be the truth; reassuring people everything was ok, and pointing to the fact that I’m hardly ever hungry, that I’m stressed, forever candid about having lost a lot of weight. I was thin, healthy, and energetic, worse stuff can happen, ya know?
If things at work took a different turn, maybe I would have snapped out of my disordered eating. Maybe with more time on my hands, I wouldn’t have been so busy to turn away hunger on an on, and as a result, could have prevented the continual rigidity of my food intake. Maybe things would have been different, who knows. But by the time anyone noticed, it was too late. By then, I doubt my “ending” would have been any different than hitting rock bottom. Indeed, there was a certain lightness and disconnect that came with under eating. A fuzzy feeling of joy, of euphoria, from running on empty. A rush of energy. An endorphin high. And every time I pushed myself to eat more, I suffered panic and anxiety. Hence, I did not want to eat, and experienced “feel good” rewards with further reducing my sustenance. A disorder was the last thing on my mind. (Later in recovery, I got some answers through research).
“For people predisposed to anorexia, therefore, starvation reduces the anxiety and irritability associated with their high serotonin levels. The problem is that the brain fights back, increasing the number of receptors for serotonin. This increased sensitivity means that the old negative feelings return, which drives the person to cut back even more on what they are eating. Any attempts to return to normal eating patterns wind up flooding the hypersensitive brain with a surge of serotonin, creating panic, rage and emotional instability.” 1
Among the numerous misconceptions, there is the belief that anorexia is merely a psychological illness, a coping mechanism to face, or rather avoid, issues of life. And that is simply not true. If you are genetically pre-disposed to anorexia, disordered eating is sufficient a trigger to set up a deadly illness. Anorexia is not psychological; it’s biological and locks itself into place. Sure it can start with a subconscious need for control, when life gets messy or when things aren’t going how we ought them to. In that respect, awareness about tendencies to disguise inner troubles with things within our control and the dangers of such behavior is important. But you can very well loose weight from an illness you are fighting, a few accidentally skipped meals, a desire to fit in a wedding dress, a well intentioned decision to eat more healthily. However pure your initial goal, if you are genetically predisposed to anorexia, improper eating alone triggers an illness, which left untreated, can turn out deadly. You may spend all the time analyzing what caused your anorexia, but for the purpose of getting better, it’s rather irrelevant.
For years you cruise the sweet highs of starvation, until body and brain start to fight back. When that happens, you loose all control around food in order to survive. You can fight it and fall into disorders of a different kind. Sadly, from lack of appropriate treatment, many go on to compulsively starve into a tragic end. Some, through what is nonetheless very hard work, go into recovery.
Life before recovery
Just a horrible existence
This was hands down the most dangerous place I found myself at, but it was also primordial, for it lead to taking action. By this time, anorexia had deeply grounded roots. To give a rather sordid preview, I was leaving my desk at work to go buy food, finding myself at the market secretly eating tomatoes I didn’t dare buying. I was chopping up lettuce in thousands of pieces, throwing on a drizzle of balsamic vinegar and calling it lunch. I was visiting food delis for tiny soup samples. I was trying to gain weight but couldn’t bring myself to eat unless absolutely starving. I was anxious if I ate a whole yogurt. I was waiting for the day to pass so I could eat. I was scared of food, scared of calories, scared to fall, scared to sleep, scared about these dizzy spells I was getting, scared about my strong heartbeats, scared about what my life had become. At this point, shit could have gone any direction. I don’t know how or why, but I realized, I had everything to loose.
The first dip into recovery
The shortest, sweetest moments
I believe this happens to everyone in recovery, or at least I hope it does because my memory of it may yet be the sweetest one I have. That one most extraordinary meal, binge or whatever you call that orgasmic moment in food heaven, that first feast you don’t fight.
On my way back home from work, I had a phone call with an eating disorder treatment center in the city. After giving them my height and weight, they informed me I was too unwell to join their program, urging me to check myself into hospital. There and then, not even scared (the hell do they know, I thought), I had an epiphany: it’s time to eat (what a brilliant fucking idea, right?). I vividly remember that moment, the emotions I felt, the thoughts that raced through my mind, and a sense of determination that I never had before. I went to the supermarket and bought a whole rotisserie chicken. I ate the entire thing, sucked on the skin, licked the oil around the bones, and drank the fat juice it was sitting in. The poultry disappeared in less than two minutes and I went to bed so satisfied, so proud, so happy.
That same night I woke up drenched in sweat and the next morning my eyes were incredibly swollen. I was feeling very ill and experienced my day with daze.
Welcome to life in early on recovery
The hardship of re-feeding
You will find yourself on what feels like an endless rollercoaster, sometimes the adrenaline is so empowering, and other times you just need a break from the ride.
I experienced night sweats, fever, constipation, stomach pain, tachycardia, swelling, bloating, water retention, need to constantly sleep, inability to think, to keep food down, to get out of bed, to function in the world, I can go on an on. Bottom line, it was the most painful experience I had in my 25 years of life, and unfortunately, the misery lasted for a rather long time.
Eating was so dam hard; I subconsciously slipped back into restriction. After the first three months of re-feeding I couldn’t take it anymore and went back into the world, with friends. I was still eating a lot compared to what I used to, but only in amounts I found bearable. So for a couple of months, I was gaining, but very slowly. The physical discomfort was relieved, I had a bit more energy and less anxiety but the obsession with food, inability to think, to relate, to function, all that stuff was there and possibly worse. People would see the old me, a bit more out and about, eating decent portions, looking slightly less emaciated, possibly with her shit together. Back in what my body interpreted as famine, it reversed to that “flight” mode and so, I was able to carry out more activity throughout the day. What is more, eating less food than what I initially started re-feeding at relieved some anxiety and that whole “feel good” mechanism kicked back in. Hello sweet calorie deficit! I was able to do more physically, but the brain was fighting, and so, mentally I remained a mess.
Long story short, I surfed that wave for a month or two, up until my pull to food and hunger caught up. Hunger is such a gift in anorexia recovery. Truth is though; it should play no role, it’s only a bonus. If you are beyond full, even about to die of satiation (which btw is BS because let’s be honest, you are mentally starving), you must still eat. I had a hard time understanding this. Each time the hunger faded or my messed up digestive system wasn’t processing the food, leaving me feeling full AF, anorexia crept back in. In another epiphany moment, I got it: if I wanted to recover, I must push myself “beyond tears”.
Simple in theory, I know. I went for a granola bag I had in the kitchen. I was eating and smiling, I was writing and crying, I was breathing and massaging my stomach. Within the next three hours, I polished off the supersized bag. You would be surprised how much food someone in recovery from anorexia can eat. So my advice to all recovery specialists out there, who are focusing on meal plans, food challenges and feelings with patients recovering from anorexia, just give us a basic structure but really concentrate on the message that we should eat as much as we can, whenever we please. What we truly need is a license to eat and shit lots of support through the torturous ride of doing so.
A later stage in anorexia recovery
A not so simple mess
So yeah, I started eating a lot more, and with no surprise, I resumed feeling heaps worse physically, and increasingly drained mentally. At this point I thought I would never get better. I was so sick and tired. I was gaining weight but anorexia was holding tight. I was sad, but kept believing. (I often cringe at the inspirational clichés of recovery, but honestly they are empowering and hence necessary. Like really really necessary).
The physical therapy “wave”.
This turnout was probably not ideal, but it’s part of my journey and I decide to view it as something that also played a role in my recovery, perhaps an important one at first.
My primary care doctor (who didn’t know about my anorexia, but thought that leaving work and its stress enabled me to gain weight) thought it would be a good idea I start lifting weights to put muscle on. Reluctant at first, I thought why not. Many people around me advised I start working out. Maybe they couldn’t stand looking at my bony figure; maybe they thought that if I kept gaining weight I will look fat, or start thinking that I do, I have no idea. Anyway, as I started working towards those #gainz, I got pulled into the whole maximizing muscle while minimizing fat mentality (obviously encouraged by the “coach”). It was just another eating disorder mindset. But with the exercise came a ravenous appetite. While I was carefully responding to it with lots of protein, the “right kind” of carbs and “healthy fats”, knowing that I needed a calorie surplus to gain anything was like getting that license to eat. I was literally gorging on food, because I was constantly hungry. After a few weeks, I no longer wanted to do PT but truth is, like many other commitments in my life, I didn’t really know how to get out of it. Plus, the anorexic tendencies liked being active.
Eventually I went to London, to be with my sister. I continued exercising for a little bit and then stopped altogether as I developed some debilitating pulling sensations in my legs. Ironically, I experienced even more physical discomfort after cutting out all movement. My entire body was aching to the point where it kept me up at night. Luckily, I saw this as a sign of physical stress and a demand for rest. Our bodies are that smart! Last thing I needed was to waste any energy left to repair the damages incurred from years of malnutrition. If my purpose with training was at first justified by an attempt to gain further weight, now that I passed the “healthy” range, I could stop. By cutting out exercise, by no means did I cut on my food. My appetite (or best bud, by now) stayed, so I kept gaining. Not doing jack shit and eating shit loads was exactly what I needed.
The vegan “wave”. (My post on Veganism in recovery)
If you are recovering from an eating disorder, I wouldn’t be surprised if you also toyed with the idea of veganism. A lot of the philosophy lies behind “eating in abundance” and “nourishing your body”, all while focusing on the health properties of food. Some may use concepts such as eating “cruelty free” or “for the greater good of the planet”. While all true, I wasn’t trying to conceal my eating disorder pull to veganism with some ethical reason. Truth is, this was yet another license to eat that spoke to my eating disorder. When veganism is promoted as the highway to health, with humongous and esthetically pleasing meals, containing minimal fat and maximal “clean” ingredients, for someone recovering from anorexia the attraction of such a diet is real.
You know what else is real? Orthorexia. When it came to consuming pulses, avocadoes, potatoes, nuts, seeds, bananas, and dates, I would make it rain. I was eating the “fatty”, not so healthy vegan food too. However, it’s the connotation that a vegan cake carries that gave me peace, as opposed to its non-vegan, milk, butter and other animal fat included alternative. So yeah, I got sucked into veganism for a second, and even that phase helped. When I discovered raw vegan deserts, all things coconut and nutritionally dense treats, the pounds my body needed to recover sure kept pilling up.
The large amount of fiber that would have me leave the table feeling very full and bloated didn’t bother me. We all know those are the last concerns for someone who used to gorge on fruit until physically unable to stand the thought of another strawberry. Anyway, I was very drawn to veganism but I also knew it wasn’t in line with what I expected recovery to be.
Establishing a neutral relationship with food, eating whatever the fuck I was given, being able to eat later if something just looked yucky, but also being able to accept the yucky when absolutely starving was the stage I wanted to reach. God knows that in my “non-anorexic days” I had eaten cheese fondue out of politeness for the host, doing my best to avoid breathing in the smell.
Yes, I poked around the idea of veganism and recovery. Although I don’t dismiss others’ recovery on such a diet (I certainly see where and why it can be helpful), I knew that for me, full recovery meant not caring if a treat was full of healthy ingredients, or saturated animal fats and hydrogenated oil. To my point, I am of the belief that whatever works for someone to get them to eat in a way where the weight goes up is good enough for now. Nutritional rehabilitation is key. Can’t stress this enough.
I knew how flawed my vegan thinking was, and I would still tell my mom not to fight me on this one. Eventually she stopped, and when she did, guess what happened. My anxiety loosened and I got over it. I was happy to crave chicken. We are fighting so many anorexic demons; please don’t add another battle to the war. Instead, show us love and support. I went vegan for a couple of days, acknowledging the pull, but refusing to give in. I told myself: “Two years from now, if I want to be vegan, I can. Right now, not a good idea”.
Anyway, with time, dozens of surplus calories and enlightening moments, I decided to ride yet another wave. This is when I gave myself the unconditional permission to eat and my mind has never been clearer. The “bigger” I got, the less I cared. Was it time, was it mental clarity, was it a certain weight, was it seeing more glimpses of my old self, whatever it was, it was recovery and I am forever grateful it happened.
Weight restored but not quite there
Light at the end of the tunnel
While reading up on anorexia, I often came across the notion of “half way there”. In short, a place where one is functioning much better, but still holding onto control, unlikely to be living life at its full potential. I don’t recall going through that specifically, but I also knew I wasn’t at the end of my journey. Indeed, I was ready to do anything for full recovery, for freedom of residual anorexic thoughts, for the inability to relate to the illness altogether one day.
Anorexia is not about food, weight, or control. Years of inadequate nutrition triggered some shifts in the brain that temporarily keep us from living a full life. As I was reaching that place where I could challenge the sneaky, lingering beliefs and behaviors, I got to see glimpses of light at the end of the tunnel.
Life “after recovery”
Where roses are red and food is black (if we agree it’s a neutral color)
My entourage tends to envision my recovery from anorexia as if I broke a leg and simply had to heal, expecting to regain the old version of A.K. Reaching the light at the end of the tunnel however, is all about me, and the version of A.K. that I want to be.
My journey is only starting, as I choose, to use my story, my experiences and my voice to hopefully make an impact and help others reach the freedom to live a meaningful life, fully and unconditionally.
1Arnold, Carrie (2016, March 29). Anorexia: you don’t just grow out of it. Retrieved from https://www.theguardian.com/society/2016/mar/29/anorexia-you-dont-just-grow-out-of-it