recovery= more than just gaining weight

After writing two posts yesterday which were both to do with the weight related aspects of recovery, I wanted to write a post highlighting the fact that recovery is about more than just gaining weight. Since anorexia is a mental illness with physical side effects, whether a person is recovered should  be determined by what is happening in a persons mind, rather than just how they appear on the outside.


Considering Anorexia is a mental illness, I think that there has been far too much focus on weight when determining whether a person is suffering/recovered from anorexia in the past. One of the diagnostic criteria for anorexia was once that the patient needed to have a bmi under a certain range- I think it was 17.5. Now however this is not considered as an important diagnistic criteria as a patient could be having anorexic thoughts and behaviours while at a slightly higher bmi than 17.5.

If you think about it, it is ridiculous to say that out of two girls with the exact same mindset, the girl with a bmi of 17.6 is not anorexic while the girl with a bmi of 17.4 is anorexic. For example  I was struggling with anorexic thoughts for the 6 months leading up to becoming underweight. While I was initially unable to lose the weight, my mind and behaviors were still really unhealthy.

An anorexic patient should never be declared recovered until a full psychological examination is performed on the patient as well as a physical exam.

When I left hospital I was weight restored and no one would have ever guessed I had anorexia but my mind was still as anorexic as ever. I was not recovered, in fact my anorexia was every bit as bad the day I left hospital as it was the day I went to hospital. It is completely normal for people to experience weight restoration and physical recovery before they recover mentally. The reasons why this is the case are explained in the following information, sourced from here.

There is one finding about anorexia which seems to me more crucial to treating it successfully than anything else.  It is a counterintuitive insight, but one that seems – like all the best facts – completely obvious when once one knows it.  It is this: that for the anorexic, gaining weight is the prerequisite for mental recovery, rather than vice versa.  Put another way: you can’t make an anorexic want to put on weight until he or she has begun to do so.  Put yet another way: the mind may make the body sick, but only the body can help the mind be well again.

It is essential that you firstly gain weight in order to fully recover as your mind will no be able to repair otherwise. So while weight restoration is an important factor in anorexia recovery, alone it does not constitute full recovery. You are not fully recovered from anorexia until you no longer have any of the following physical or emotional/behavioural symptoms. 

Symptoms 

By Mayo Clinic Staff

The physical signs and symptoms of anorexia nervosa are related to starvation, but the disorder also includes emotional and behavior issues related to an unrealistic perception of body weight and an extremely strong fear of gaining weight or becoming fat.

The Minnesota Starvation Experiment, also known as the Minnesota Semi-Starvation Experiment, the Minnesota Starvation-Recovery Experiment and the Starvation Study, was a clinical study performed at the University of Minnesota between November 19, 1944 and December 20, 1945. The investigation was designed to determine the physiological and psychological effects of severe and prolonged dietary restriction and the effectiveness of dietary rehabilitation strategies.

Physical symptoms

Physical signs and symptoms of anorexia may include:

• Extreme weight loss
• Thin appearance
• Abnormal blood counts
• Fatigue
• Insomnia
• Dizziness or fainting
• Bluish discoloration of the fingers
• Hair that thins, breaks or falls out
• Soft, downy hair covering the body
• Absence of menstruation
• Constipation
• Dry or yellowish skin
• Intolerance of cold
• Irregular heart rhythms
• Low blood pressure
• Dehydration
• Osteoporosis
• Swelling of arms or legs

Emotional and behavioral symptoms

Behavioral symptoms of anorexia may include attempts to lose weight by either:

• Severely restricting food intake through dieting or fasting and may include excessive exercise
• Bingeing and self-induced vomiting to get rid of the food and may include use of laxatives, enemas, diet aids or herbal products

Other emotional and behavioral signs and symptoms related to anorexia may include:

• Preoccupation with food
• Refusal to eat
• Denial of hunger
• Fear of gaining weight
• Lying about how much food has been eaten
• Flat mood (lack of emotion)
• Social withdrawal
• Irritability
• Reduced interest in sex
• Depressed mood
• Thoughts of suicide

Keep fighting everyone, and one day you will be free of all of these symptoms. Full recovery is possible as long as you believe that it is. Xx

Breakfast, Lunch and Tea

Something that I think is quite important, is to occasionally eat something different than what is on your meal plan so that you know you can eat other foods as well. It is quite easy to become comfortable with certain foods that are on your meal plan but still remain terrified of others if you follow the same meal plan every single day. I really do like my meal plan as it includes lots of foods that I love and I feel comfortable eating all of those foods now but I need to step outside my comfort zone too, so that I feel as though I can eat other foods too when I feel like them.

I know a girl in recovery who has eaten the exact same thing for breakfast, morning Tea, Lunch, Afternoon tea and supper every day for the past three or four years. While she has been able to gain weight while following this meal plan, she really struggles at even the thought of changing her meals and eating something different. She has said herself that she is 'addicted to her meal plan'. I don't want this to happen to me and I think that all people who follow meal plans in recovery need to vary there plan sometimes, to prevent this type of thing from happening.

I felt like something a little different for breakfast this morning so had a huge bowl of Creamy vanilla Oats with one large pear diced and mixed through it. It was yummy but really filling so it left me feeling a little uncomfortabely full. I will probably just stick to my usual toast with nut butter and smaller bowl of oats from now on as that provides my body with just as much energy but doesn't leave me feeling bloated and uncomfortable.

I decided to have nut butter and banana toasties for lunch. While I have had banana and nutella together before, I have never tried cashew butter and banana but it was super delicious. I definetely reccommend it. :D

 

Since I was home all day today I cooked myself a really yummy meal for Tea tonight. I had roast duck, tomato dish, mashed pumpkin and potato as well as carrots and peas. It was super delicious as wild duck is one of my favourite meats.

Please let me know if you do or don't want to see pictures of what I eat. Some people have said that they find it helpful while others may think it is unecessary or even triggering so please I would really like to hear your feed back. As I usually stick to a meal plan, I obviously wont post pictures everyday as often the foods I eat are repeated each day but I can post ocassional pictures if you like, especially when I eat something different or new.  

Well deserved rest day

Finally it is Thursday, the first day I have had to relax and rest for what seems like forever. In the last eleven days I have only had one day that I have not worked and on that day I had to drive to Launceston which is atleast an hour and a half away to get some errands done in the city. I love living where I do in the country but it also makes it hard having to travel long distances to get anything done.

So today I plan on spending most of the day on the couch. It will be good for me to give myself a good rest after such a busy few weeks. I will take Tess for  few short walks of course but besides that it will just be relaxing at home. While it would probably be better if I didn't do any exercise while trying to gain weight, I think of walking Tess as unavoidable exercise. Tess is my responsibility and as she is only eighteen months old and a very active breed of dog, she does need exercise.

I am planning on watching some Grays Anatomy and also doing some baking so I am stocked up with muffins and pudding for the next week. I find it hard to bake when I am working so much as I have very little time in the evening after work to bake. Usually I don't get home until 6 pm and then I still need to cook tea, eat tea, wash up and clean the kitchen, set and light the fire, take Tess for a short walk in the dark, have a shower, try and get a blog post written, do a load of washing as well as anything else that may need doing. It is very common for me to colapse on the couch and fall asleep before nine o'clock.

I plan to catch up on everyone elses blogs that I haven't been able to read as I have been too busy and write some more posts of my own. I find it really hard to find time to write posts when I am so busy working so I will try and get some extra posts written today so I can post those when I am really busy. Does anybody have any requests for post topics. I though I could right some posts about life in Australia, some more personal posts so that you can get to know me a little more as well as some recovery posts.

Luckily I only have to work tomorrow at the bank and then I have the weekend off as well which will be really nice. Sometimes I feel as though I would like to put more time and energy into my recovery but as you can see my life is so busy that this really is not possible. The thing is, I need to be able to work so that I can live. If I didn't work as much as I do I wouldn't be able to afford my rent, my phone/electricity/water bills, my car insurance/registration/petrol, to buy food or buy anything else I need. It really is quite expensive living out on your own.

While I need to work, I still make sure that my recovery is my main priority. The people I work with know about my situation and are very understanding about me stopping to eat when I need to. No matter how busy I get I always make sure I eat the entirety of each and every one of my meals. In fact I can not remember the last time I skipped a meal or didn't completely finish a meal.




Since my mum is working today, my little sister Amy will come to place place when she finishes school so it will be really nice to see her as I haven't caught up with her in ages. For those of you who are new to reading my blog, you can read an old post I wrote about my little sister here. We are very close and have an extremely special friendship. Luckily Amy is a bit of a couch potato and also a Grays Anatomy fan so she shouldn't mind just lazing around with me this afternoon while I rest.

I hope everyone has a fantastic day today. Does anybody have anything exciting planned?

Insomnia and Anorexia

I suffered from insomnia back when I was completely starving myself and trying to lose weight as well as in the more recent past when I was eating quite a bit, but obviously still not enough. The information explains why I am finally starting to sleep better now that I have significantly increased my intake and now that I am providing my body and mind with enough energy to truly repair and recover. 

I used to wake up early of a morning (like 2am) with a strange feeling which was a bit like hunger. After waking I could never fall back to sleep until after I had breakfast at at about 5am. I know now that it was my body trying to tell me that it was trying to repair and although I was eating quite a lot at that time, it still needed more energy. Now, I am eating a lot more food so my body can repair properly and I eat something just before going to bed so I no longer wake in the night unable to get back to sleep hungry.

I  found the following information from this site really interesting as it kind of explains why I have suffered from insomnia throughout my eating disorder;

How Insomnia and Anorexia Come Together

Insomnia involves difficulty falling or staying asleep. It is one of the most common complaints heard by medical professionals. It can come with some serious side effects or it can be a serious side effect of another potential life-threatening condition. Anorexia is an eating disorder in which the patient either severely restricts the intake of food or goes on a binge and then purges himself or herself after the binge. With either method presenting itself, there are dangers involved. Besides noticing extreme weight loss, there are other physical symptoms present and insomnia is at the top of the list. Anorexia and insomnia can take over your life.

How They are Linked

The brain is a complex machine, but it is also very primitive in some of its functions. Some of these mechanisms are activated when the body and brain reach "starvation mode." Finding food becomes the number one priority, everything else falls by the wayside. It even takes priority over sleep; therefore, the body gets less of a chance to do so. Trying to sleep can also be uncomfortable. The body of the anorexic has changed and it might not feel comfortable doing what it did before.

Lion on the Savannah

If you are always hungry, then your body may not be able to think about anything else. Think of it this way: you are a lion on the savannah. You might be asleep, but looking for your next kill, constantly thinking about your next meal. When you are underweight because of the anorexia, your body cannot get proper rest. It is concentrated on finding the next meal. Your body is full of adrenaline, looking for its next fresh kill.

The following information was sourced from here and explains why You need lots of energy throughout the night as well as why I am now able to sleep through the night since starting to eat more and now that I am eating closer to bed time.

Eat right before bed
A lot of our healing, repair and regeneration takes place while we sleep. It’s like rush hour for building muscle and lean tissue, so eating a healthy snack right before bed ensures a fresh supply of nutrients that are available to “go to work” inside the body. A great option that won't leave you feeling stuffed might be a small bowl of pasta saladmade with 100 percent whole-grain pasta (wheat or a gluten-free alternative), vinaigrette made with extra-virgin olive oil, chopped or shredded veggies, and a lean protein such as beans, chopped chicken breast or an organic crumbled cheese. 

So to make sure I have a good nights sleep tonight, I have eaten lots of yummy foods to ensure that I my body has enough energy to get me through the night. I try to eat nice balanced meals so that I am providing my body with all of the nutrients it needs. These photos are of my Tea and dessert tonight :)

Cheesy beef lasagna with corn, carrot and peas

Hot lemon pudding with vanilla icecream

Weigh in wednesday and ANGI update

I have been a bit nervous leading up to today as it was my first weigh in since last Wednesday when I significantly increased my calorie intake. I have been nervous about weighing in today for a couple of reasons. Firstly, while I am determined to recover and want it more than anything else, I am still struggling with the idea  of gaining weight sometimes. Well I suppose it is my anorexia that is uncomfortable about it and I have been worried that I had gained a lot of weight and that I would freak out when I saw it. As silly as it sounds, I have also felt worried because I was scared I may have maintained my weight and not gained anything at all. If this was the case I truly would feel as though I had let myself as well as the people who read my blog down. So I have had really mixed feelings over the last week. Part of me wanted to gain weight as I know that it is essential for my recovery and the anorexic part of me didn't want me to gain weight.

I held my breath this morning as I stepped on the scales and was really happy when I saw that I had...... GAINED HALF A KILO. Not only was I over the moon that I had gained weight, I was also excited because for the first time in as long as I can remember, I was actually happy about gaining weight. This goes to show just how much my mind set really has changed in the past little while. I know that as my weight increases more and more, gaining weight will become much more difficult for me to deal with but all I can do is take each day as it comes. 

Since seeing I had gained weight this morning, I expected my anorexic thoughts to be really strong throughout the day and I expected to feel as though I should compensate in some way by restricting or exercising but I can honestly say that this has not been the case at all. I think that the healthy rational part of me was just so thrilled that I had gained weight and that I haven't let anybody down that not even my anorexia could make me feel bad about myself. This was one achievement that I was not going to let my anorexia stop me from feeling happy about. I honestly think that all the extra food I am eating is what is making the non-anorexic part of me so strong. While I haven't always believed it in the past, I really do think it is true what they say, that food is medicine for someone suffering from anorexia. Since I have gained half a kilo this week, I am not increasing my calories this week but if I find that my weight does not continue to increase at a similar rate over the next week, I will have to increase my intake again next wednesday.

I went to my GP today and got blood drawn for the ANGI study I am particpiating in. ANGI stands for Anorexia Nervosa Genetics Initiative and is a study that I am really glad to be a part of. For anyone who hasn't heard of ANGI, you can read an earlier post I wrote about it here. You may even find that the country you live in is taking part in this study too and you may be able to participate as well if you have Anorexia. As I said in the last post I wrote about it, I am really passionate about the relationship between genetics and Anorexia as various family members of mine have suffered from it. While most studies that have been done in the past have investigated how environemntal factors influence wether or not someone develops anorexia, I honestly do believe that there are genetic factors that play a role in the development of the disease in individuals. Out of curiosity, do any of the people out there reading this with anorexia have loved ones that have also suffered from the same illness?

My goal weight

*please note. I have not talked about exact weights in this post but I have talked about bmi so if you think this may be triggering, skip this post :)

Today I got asked a really important question by a reader and thought it would be a good idea to write a post on the topic. The question was; 

I have got a question. When you write about a healthy bmi - which one are you thinking about? 18, 19, 20? :) i think there are different opinions about what is a healthy weight.

To be completely honest, while planning my weight gain throughout my recovery so far I have considered reaching a bmi of 18.5 as reaching a healthy weight as this is when I would no longer be classified as underweight. Since being asked this question however I am starting to remember back to my time in hospital when my doctor said that a healthy bmi for a recovered anorexic was atleast 20. I dont think I can really tell now what a healthy recovered weight will be for me and I may need to wait until I reach it before knowing that I am both mentally and physically healthy.

So I suppose you could say that the weight I will be at when my bmi is 18.5 is my FIRST goal weight or MINIMUM goal weight. After reaching this point I am very aware that I will most likely need to continue gaining weight.  Genetically, I am a thin person, just like both my parents and my GP has said that she thinks I need to get to xx kilograms (which is equivelent to a bmi if 18.5 for me).

I found the following information here and thought it explained the way doctors determine initial goal weight really well. 

A variety of factors go into deciding the target weight and range. Often, physicians will consult pediatric growth charts to determine a reasonable weight based on the individual’s height and age. These charts are important for revealing growth patterns and may show a tendency for the person suffering from the illness to be similar to a particular percentile within the population. Further consideration is given to lowest and highest weights the person has achieved within the last several months, as well as their growth and weight throughout their life. Also, they will look at the person’s body type, and the body types found within their family. “We note the height and size of her mother and the age at onset of menses in the mother and female siblings. We also note the patient’s growth and weight curve from the time of birth,” notes Dr. Katherine Halmi of Cornell University Medical College.

Becoming completely weight restored for me will not be when I reach this minimally acceptable bmi but when I reach my natural set point. At this weight I know that I will be physically healthy as my body will be able to work optimally. 

I would like to thank the reader who asked me this question as it has reminded me that reaching a minimally acceptable bmi does not constitute becoming weight restored. It has reminded me that while reaching this bmi may be an acceptable short term goal, my real goal should be to get my weight back to MY natural set point. Once I am satisfied that I have reached my optimum set point my plan is to stop counting calories and following a set meal plan and learn how to eat intuitively. 

For anyone who doesnt know what intuitive eating is, it is the concept of eating based upon what your body tells you it wants. I have read a fair bit about intuitive eating and believe that it is the best way to live a happy and healthy life. It requires you to have a lot of trust in your body as you need to listen to your body at all times without ever restricting. If you would like to read more about intuitive eating click here.

I found the following information from here really helpful to help determine what you natural set point is;

How do you know your set point weight?

A huge fear for people recovering from an eating disorder is to let go of control. Exercising control used to be the way to cope with difficult situations and negative emotions and in recovery you have to let that go. Focusing on a target goal weight reduces anxiety and fear because you “know where you’re heading”.

The truth is, after years of destructive eating habits, you can’t know upfront what your set point is, but in most cases it isn’t the lowest weight in the so-called healthy range. Depending on your age, you could only make a rough estimation by looking to your weight before your eating disorder.

Physiological speaking, there is only a small number of people whose set point weight corresponds with a BMI of exactly 20. In order to fully recover, you need to let go of the weight you consider acceptable. From my own experience I know this isn’t easy, but you can trust the wisdom of your body. At some point, your weight stabilizes at its most optimal weight. This isn’t a specific number, but a range in which your body genetically wants to be and gravitates towards, even when you have celebrated the holidays with elaborated dinners or when you spend an evening with a pint of your favorite ice cream.

You will know when you’re on your set point weight when all body functions are restored and your menstrual cycle has returned. However, return of menstruation is not always indicating you reached your optimal weight. When you can eat in an unrestricted way, without rules or compensatory behaviors and your weight remains stable, you’ve reached your set point weight.

When you change your diet when reaching a pre-determined target weight your body doesn’t get the chance to fully recover, restore deficits and reach your set point weight. I’ve been in the stage of partial recovery for years by maintaining the lowest acceptable weight set by my therapists while simultaneously pretending to be recovered. A combination which can never work. I was convinced the weight gain would never stop, holding me back from going the extra mile.

This is a fear many people in remission struggle with. Is it realistic? No! When you don’t change your food intake and continue to re-feed, allowing your body to recover and restore your metabolism, it will stabilize when it reaches its optimal weight.

In some cases, your body may need to overshoot its set point weight in order to return to a normal fat mass to fat-free mass ratio. However, this is only temporarily and will go away when all is restored. Be patient and trust your body.

Quick picture post before work

Since I have some new readers, I thought it would be nice to do a quick picture and caption post of my morning. I always find pictures a helpful way to get to know someone (and I don't really have time to do a long personal post before work.)

it was really cold on the beach at 7 am this morning when I walked Tess but still beautiful

Tess giving me puppy kisses

Back home and ready for work

packing my lunch box for the day

My morning tea, lunch and afternoon tea

what I wear to work

Have a great day everyone! :) x

Fear food list from 2012

A few days after I got out oh hospital back in 2012 I made a list of fear foods. I titled the list; Foods I am scared to eat but wish I wasn't.

Some of the foods on the list that I have already eaten are;

Belgium, pasta, magnum icecreams, muffins, chocolate, slice, lollies, gravy, butter, milk, juice, pastry, chips, grain waves, pudding, custard, cheese, hamburgers, kangeroo patties, alcohol, cereal, sweet spreads, Milkshakes, Nutella, Belgium and sauce sanwiches, Pavlova, fairy bread, icecream and topping, lasagna, spaghetti bolognaise, hot chips (cooked in oil), spring rolls/ dim sims, custard tart, fruit tingles, porrige, milo, Potato, sultanas and yoghurt, apricot delights, peanuts, corn relish dip, fish and chips, tartare sauce, Peanut butter, peppermints, top deck chocolate, smarty chocolate, mint mentos, tic toc biscuits, shapes, hillier chocolate, toasted sandwiches, toasted wrap, white chocolate frogs, dried fruit, honeycomb chocolate, lemon delicious, MnM's, Condensed milk, Lamingtons, Caesar salad, Rice, Carbonara pasta, pumpkin soup, chips and gravy, Stewed apricots, Silverside, Black Jelly beans, pasta salad


Foods I am yet to conquere from my list but am determined to before I declare myself healthy and recovered are;

(some I haven't eaten because I am still scared of them, others because the opportunity simply has not arose for me to eat them in the recent past)

Mince, BBQ food, Deep fried food, regular soft drink, Take-Away Pizza, Meat pies, fruit cake, sausages, regular fat cream, McDonalds cheeseburger and fries, Quiche, Homemade monte carlos, potato bake, curried sausages, chocolate teddy bear biscuits, Berry Mud cake,  Caramel slice, nachos, Chicken Burgers, Chicken Curry Pies, soft Serve icecream, White chocolate coated raspberries, Panacotta, tomato soup porcupines, Eggs and bacon, Sausage rolls, potato pie, chip sandwiches, golden syrup dumplings, CornJack, potato salad

I am really glad that the list of fear foods that I have overcome is now shorter than the list of fear foods I am yet to overcome and this shows me that I have made progress. You should know that even some of the fear foods that I have eaten and feel quite comfortable eating were usually prepared by me. I would find it a lot harder to eat it if it was prepared by someone else or at a restaurant, if I didn't know how it was prepared but I know that if I continue fighting, I will become more comfortable with this in time.

My all time favouritte meal if I ever went out to dinner with my family was Chicken Parmigiana with chips. At this stage I still do not feel as though I could go out and order this meal comfortably and eat it all but I have decided to declare it as my ultimate recovery meal. It is the first meal I will go out and order at a restaurant once I feel as though I am completely recovered. And by completely recovered I mean to be completely free of unhealthy thoughts as well as being weight restored.

If you had to chose an ultimate recovery meal or food what would it be and why?

Todays food intake

Breakfast; creamy vanilla oats topped with 1 small banana and two slices of wholemeal toast with Cashew butter

Morning Tea: 1 banana Up and Go and 1 chocolate muffin

lunch: 1 Belgium and tomato Relish sandwich, 1 cup of grapes and 1 full fat Raspberry and white chocolate yoghurt

Afternoon Tea: 1 fruit box, 1 apple and 1 chocolate bar

Tea: Spaghetti bolognese, mashed potato and peas

Dessert: 1 hot apple pie with vanilla icecream

Why having a healthy weight is necessary for a full recovery

While I am very serious about recovery, I have already started to worry about getting to a healthy weight. I have even considered stopping trying to gain weight before reaching my goal weight but know that this would be a bad idea. Afterall, as long as I am still feeling terrified about reaching a healthy weight, this is a good indication that I am still not healthy and that I need to continue repairing my body and mind. The following article sourced here explains why you should not stop gaining weight too early on in recovery and why having a healthy weight is essential for you to make a full recovery.

The Effects of Being Underweight

Most people who have an eating disorder are not noticeably underweight. Many will under-eat at times and binge eat at other times, so that weight is maintained overall within normal limits.

However, some people with an eating disorder maintain extreme control over their diet, and remain significantly underweight.

One of the diagnostic criteria for Anorexia Nervosa is a body weight less than 85% of the weight expected for a particular height. This is serious, as being underweight has significant physical, psychological and social consequences, and these consequences are often seen in people with Anorexia.

The Psychological Effects of Being Underweight

Physical effects of being underweight include profound effects on the heart and circulation, muscles and bones, intestinal function, sleep and temperature regulation.

Mental and emotional consequences have also been noted. Mood is generally low, and irritability and anger are exacerbated.

There is a tendency to become socially withdrawn and inward-focussed, and people who are underweight have an increased need for predictability and routine, with difficulty being spontaneous. Thinking becomes rigid, and concentration and decision-making capacities are markedly impaired.

Preoccupation with food is usually intense, with almost constant thoughts about food and eating, such that it is common for underweight people to become very interested in cooking, recipes, cookery shows and so on, with a corresponding decrease in their engagement with previous interests and hobbies.

Obsessiveness increases, with people becoming inflexible in their routines, particularly around food. There may be rituals around food preparation, the order or way in which food is eaten, the timing and circumstances of meals, with people often needing to eat alone, and food may be eaten very slowly.

The Minnesota Starvation Experiment

An important study of the effects of starvation has had a profound impact on our understanding of these behavioural and psychological changes. This study was conducted in the early 1940’s and has subsequently been called the Minnesota Starvation Experiment. As Allied forces moved across German-occupied Europe, they encountered starved and emaciated civilians, many of whom had survived largely on bread and potatoes.

As little was known about the effects of starvation or how to deal with the re-feeding of these people, a study was conducted in which 36 psychologically healthy young volunteers were subjected to a six month period of semi-starvation, followed by a three month re-feeding period. During the starvation period the men were given about half the calories needed for weight maintenance, and most lost about 25% of their original body weight.

The physical, social and psychological effects of the starvation on participants were studied in great detail, and reported in a two-volume text called The Biology of Human Starvation. The participants:

• Developed an intense preoccupation with food, with most of their thoughts oriented towards what and how they would eat.
• Had significant impairment to their concentration, judgement and alertness.
• Ate extremely slowly, with unusual concoctions and heavy use of condiments, caffeine and chewing gum.
• Sometimes resorted to binge eating when the desire for food became intolerable.
• Became more depressed, irritable, angry and anxious, and sociability markedly decreased, with the men becoming withdrawn and socially isolated.

During the re-feeding phase the men had difficulty regaining control of their eating, and struggled to identify whether they felt hungry or full. For the majority of participants their eating behaviour did not return to normal until they had been at their pre-study weight for several months.

Clearly, as the participants in this study were psychologically and physically healthy prior to the experiment, all the behavioural and psychological features seen were direct effects of the starvation itself.

Personality Changes

The implications of this study for understanding the symptoms of Anorexia Nervosa are clear: The behaviours and psychological changes that occur in people with this illness are direct effects of being underweight, rather than being due to the illness itself, and therefore will begin to resolve once normal body weight is restored.

The behaviours and characteristics shown are not indicative of peoples’ true personalities, which are in fact effectively masked by being underweight.

It is therefore clear that the primary goal of treatment for an underweight person with an eating disorder is weight restoration.

Many of the features of his or her underweight behaviour and apparent personality change, will gradually disappear after normal weight is restored.

As found in the study participants, the body does not immediately return to being able to regulate food intake on its own, but consuming a well-balanced and nutritionally complete diet, spread regularly throughout the day, encourages the body to re-establish normal weight maintenance mechanisms.

It is very important for weight to be fully restored in order to reverse the starvation effects. If only partial weight regain occurs, the effort applied to achieve that weight gain will not be matched by equivalent gains in mental and physical health.

It is often difficult for an underweight person to engage with treatment initially because many of the effects of being underweight keep a person “locked-in” to the eating disorder, creating vicious circles that maintain the problems.

For example, the rigidity of thinking makes it difficult to make decisions or changes; the obsessional, inflexible approach to life makes it difficult to imagine eating or living differently; the social withdrawal reduces engagement with others and lowers mood; the preoccupation with food makes it difficult to consider engaging in other aspects of daily life. Support from others is likely to be centrally important in helping get through the weight-restoration stage of recovery.

Once the effects of being underweight have been reversed, other psychological factors that contributed to the development and maintenance of the eating disorder may need to be addressed, and areas of life which have been neglected will be re-developed.

If you (or somebody you love) have disordered eating patterns and are underweight, it is extremely important that you see a doctor and have a comprehensive medical assessment. Please consider making an appointment with me, so that we can discuss your situation and explore treatment options.

I always tried to tell myself that I could recover without gaining weight but I now know that this is not true. For me, recovery means becoming the same person I was before my eating disorder and as stated in the article above, this is only possible if I become weight restored. Every time I get scared and want to stop gaining weight, I need to remind myself that it simply is not an option. Reaching a healthy weight is something I MUST do in order to recover. It is something I WILL do in order to recover. 

Recovering without professional help

I have tried to get help in the past for my anorexia but I never found any of it helpful at all. I honestly think that this is because there really is no one specialised in eating disorders in the state that I live in and no one really understood how they could help me. 

While the staff at the hospital I was an inpatient at forced me to eat and gain weight, no one actually tried to help me with what was going on inside my head. The whole time I was in hospital I was secretly exercising and planning how I could lose the weight again when I got out. I have spoken to psychologists but found that they were not able to offer any real advice either. While it was good to talk to someone and get everything off my chest, it wasn't really helping me in terms of recovey.     

One person I went to who claimed she had dealt with anorerxics before actually told me after a few sessions that there wasn't any point in going back if I wasn't willing to fight my anorexia. The thing was, It wasn't that I wasn't willing to fight my anorexia, it was that I didn't know how. No one had ever actually given me any advice about how to be stronger then my illness and I felt like I had no choice but to listen to my anorexia.

So for me, recovering without professional help has really been my only option but I wouldn't reccommend it. Perhaps recovering without professional help wouldn't be so bad if you had a really supportive family that were able to help you but unfortunately my family were not able to help me. I didn't even have close friends that I could rely on for support as I was so socially withdraw and the friends I did have didn't know anything about eating disorders and had trouble understanding.

The best thing that ever happened in terms of my recovery was that I started reading recovery blogs online. Seeing other peoples achievement and recovery journeys has shown me that recovery is possible. The advice and support that I have been offered through reading other peoples blogs has been so helpful for me and there is no way I could have made the progress I have without it. I also think that starting my own blog has been a wonderful motivation for me in my recovery.

There are a few things that I really don't like about recovering on my own. One of these is the fact that I still need to count calories. If I had a professional design my meal plan for me, I wouldn't even know how many calories I was eating and therefore essentially would not be calorie counting anymore. It was obviously necessary for me to design my meal plan around a specific number of calories so that I could be sure I was eating enough to gain weight. My first goal once I am weight restored is to stop counting calories all together and to learn to eat intuitively.

Something else I wish I didn't have to do while recovering on my own is weigh myself. While I am gaining weight, I honestly would rather not know how much I weigh as it makes me feel so anxious. All of this week I have been too scared to weigh myself as I am scared to see the weight I have gained. I know that I need to weigh myself this wednesday (in two days time) so that I make sure I have gained enough weight since last wednesday when I weighed myself. I know that this is essential as it is the only way I can tell wether I am eating enough to gain the weight I need to, but I would much rather to a blind weigh in with someone if I could. 

I know that different methods of recovery are better for different people but I would reccommend accepting good professional help if you can. Recovering on your own is really hard and will probably take longer than recovery with profession help. 

What does everyone else think? Have you found recovering on your own or with professional help easier for you? 

My Sunday

Considering I had to work today, I have still had a pretty good day overall. I got up early this morning and wrote a post for my own blog as well as my guest post for Izzys blog while eating a delicious breakfast. I had a bowl of honey oats topped with a banana as well as two slices of toast with honey nut spread. I had to work today so took my dog Tess for a quick walk early. It was freezing cold and terribly windy so I was glad when I got back home and could warm up by the fire for a little while before going to work.

I really like the people who I work with at the supermarket on the weekends so the day went pretty fast even though it wasn't very busy. Iam very lucky as everyone who Iwork with on the weekends knows about my anorexia and they are all great listeners and very supportive. Something that really annoyed me today was that two different customers at two different occasions told me that I should eat something and gain weight. The first man had overheard me telling the person I was working with that I was cold and he said, "maybe you should eat something then and gain some weight." I didn't know what to say so just ignored him.

The second man just came straight out and said, "gee your thin, you should eat more!" I attempted to tell him that I actually eat alot and then he accused me of lying, as "I couldn't posssibly." I wish now that instead of trying to justify myself, I had just told him to mind his own business. I know I have already written a post about how these comments annoy me which you can read here, but for two people to make these comments on the one day really did bother me.

I think the reason it is bothering me more then it usually does is because I am trying so hard at the moment to gain weight and I am eating so much. I don't think that anyone has the right to comment on how I look and don't see how it is any better than telling an overweight person that they are too fat and that they need to eat less. I know that I am thin but I don't need anyone else to point that out to me and I am currently doing everything I can to change it.

These comments surprised me as I honestly thought that I was beginning to look healthier. While I know I am still thin, I did not think that I looked thin enough so that people would notice and comment. It has made me doubt what I see when I look in the mirror and wonder how much of what I see is real. If these rude comments have done anything positive, it has made me realise that the way I see my body is still very distorted. It has reminded me that I shouldn't trust myself to decide how my body really looks as I approach my goal weight as I will more than likely think that I look a lot bigger then I actually am.

Luckily we only had to work until 4:30 today so there was still enough time for me to walk my dog and cook some chocolate muffins before making myself some tea. The chocolate muffins turned out really well and I am sure I will enjoy them for morning tea each day this week, along with a Up and Go meal supplement drink. For tea I felt like pasta as well as vegies so that is exactly what I had. For the rest of the evening I just plan on relaxing, blogging and watching television (the perfect Sunday night if you ask me). I hope that everyone is having a fantastic weekend!

My lunch; Nutella on 2 hot crumpets, 1 large apple and grapes

Tea; Tomato, onion and basil pasta topped with parmesan cheese and vegetables on the side 

My chocolate muffins :)