Anorexia recovery as an adult

Anorexia Recovery as an Adult: My body is not a calculator … and mental hunger counts! 19


When we start trying to control weight, food intake, and energy balance artificially we are messing with a system what we know too little about. Nutritional science is too immature to really know how and when the body uses energy and for what.

In recovery from Anorexia as an adult I had to deal with not only the Anorexia, but the food judgements and rules piled on top of that that came with being 26 and having a degree in nutrition as well as years of reading “health guru’s” opinions and being marketed at. Finally one day had the realization that my body is not a calculator, and that eating food isn’t math. After that things got easier. This post is about the process of recognizing the authority that the body has when it comes to determining the right food intake, and about where to find the hunger you may be missing.


Lesson One: Calories In – Calories Expended = Calorie Deficit/Surplus = BULLSHIT

I was taught in my nutrition degree that calories in should equal calories out in. That is not true. Goes to show that nutritional science 15 years ago (am I really that old?) was less of a science and more of a popular opinion kind of deal. I was also taught that with this calories in equals calories out logic, that additional calories eaten in would equate to additional weight gain. That is not true either.

The reason that these theories are crap is quite simple: the human body is more complicated than, say, primary school level mathematics.

The body uses energy as it sees fit and knows a lot more about what it is doing than we do. It is like the most complicated business bank accounting system of bookkeeping imaginable. It takes calories in, stores them as needed, and uses them as effectively and efficiently as it can to make the whole organism run smoothly. It is constantly fighting battles that we have no conscious knowledge of. It might be using some calories to fight off a cold right now for all you know. It might be using some to make some repairs to a muscle tear you haven’t even felt yet. The point is, that you don’t know what your body has to do in terms of expenditure — yet many of us try to control the income!

Trying to limit the food you take in because you have some arbitrary number in your head about what your expenditure should be is madness. This is like your boss saying to you, “It doesn’t look like you are spending much money this week so we are going to not pay you as much.”

Then you say, “But wait, I’m not spending as much money this week as I am saving up to buy a car next month,” and your boss replies with: “Well, I don’t know that do I so I cannot trust that you are actually doing that, so to play it safe I’ll just pay you less.”

None of it makes sense. You do not know what your body is using calories for. You have no idea. Yet, many of us are talked into limiting the amount that we give it anyway just because some plonker once decided that every woman on the planet should eat 2000 calories a day and every man 2500 and that is that.

I’ll let you into a secret, I eat at least double that. Turns out that the magic number 2000 when applied to me makes me very, very unwell. Turns out that my body is not a calculator. Turns out that when I stop trying to interfere, by body is the smartest accountant ever. It’s like the gold-star of accountants. Turns out I don’t need to worry my swede about all that because it is taken care of for me.

 

Anorexia is a very bad accountant 

When I interfered with my body’s natural food intake, I developed a mental illness that almost killed me.

Anorexia is a very, very bad accountant. It always underestimates expenditure and overestimates income so that a consistent deficit is made. Like any business or household, when expenditure exceeds income, bad things start to happen.

Anorexia is a bank manager’s worst nightmare. Anorexia says “No no no, you don’t need an income. You can actually survive on $0 income per day. Oh, okay, well maybe you can have an income of $10 a day. But only if you promise to spend $100 a day. Actually, you have to make sure that you have already spent $100 in the morning before you are allowed to bring in $2 at breakfast time. Then, before lunch, make sure you spend another $100 before you bring in another $2. And same before dinner. So all in all, make sure that you spend at least $300 a day before you bring in $6 income. No, no actually $6 is excessive, you don’t really need that. How about you spend $300 and bring in $3?  … Deal?”

One thing that I know, is that I cannot trust Anorexia to tell me what my intake should be. It will never opt to allow me to eat enough. Anorexia will always put me in the red.

So how to know how much to eat? Embarking on recovery from Anorexia I couldn’t rely on Drs to tell me how much to eat either, as they all seemed stuck on the 2000-2500 caloies a day advice like syndronised broken records. And please, don’t even suggest intuitive eating. No, that doesn’t work when one has a very strong mental illness that disguises itself as one’s own thoughts. Anorexia loves the idea of intuitive eating because it had shut down my hunger signals and given me a proclivity to salad. Recovery for me actually felt like the opposite of intuitive eating. My physical hunger signals were kaput at the start, but I had to eat anyway. I craved salad, but I had to eat chips. It wasn’t intuitive eating — more like unintuitive eating.

However, there was one thing that I could rely on to help me know what to eat. The mental hunger.

 

Let the Mental Hunger be your guide

Why is your hunger?

Right between your eyes.

Most of us don’t feel physically hungry in recovery — especially at the start. The presence or absence for physical hunger is beside the point. When you are underweight and restricting food the hunger to respond to is the same hunger that keeps you awake at night.

The mental hunger is that niggling obsession with food. Sometimes it comes blatently in the form of actually thinking about foods, such as a chicken sandwich or a slice of cake. Sometimes it is not straightforward thinking about food so much as the logistics of eating food like how much and when and how much compensatory behaviors (e.g exercise) you have to perform before you can eat. Either way, it is like this inner thought loop that won’t shut up. The mental hunger was a like my inner child poking me with a stick nagging at me to eat more.

Please Miss, please … I’m hungry, can I have some chocolate cake Miss? Or a cheese toastie? Didn’t you notice that I’m hungry Miss? Didn’t you know that you need to feed me more? Can we get some food now Miss?

You can ignore it of course. Most of us do. But it doesn’t go away. It keeps poking and nagging and asking.

After years of malnutrition, my mental hunger had a very long shopping list of foods that it needed. Fruit and veg were not on it. Neither was salad or low-fat yoghurt. Nope, it wanted cheese, and bread, and cake, and meat, and eggs and butter.  When I started eating these things the mental hunger didn’t want me to stop. When my stomach protested its fullness my mental hunger rolled her eyes and told it to grow a pair and shut up and eat more. This is what you need to do to survive. If I resisted it would get what it needed in nighttime recovery binges. These recovery binges ceased only when I learned to shut up, trust that mental hunger tiger, and eat the amount that she wanted me to eat rather than the amount the Bad Accountant told me to eat.

Once I had acknowledged the mental hunger, and understood it was more than just looping meaningless thoughts and that it was there for a reason, that battle about how much to eat got easier.  Finally I let go and allowed myself to eat unrestricted.

Unrestricted means that there is no magic number ceiling on what I can eat. Unrestricted means if I want the whole cake I eat the whole cake. Unrestricted means no upper limits. Unrestricted means whatever the mental hunger wants — and hold onto your hat, because she is hungry!

In recovery from Anorexia, my job was to eat everything that my mental hunger wanted me to eat. And rest. That is all. It was not my job to try and limit intake. It was not my job to try and pick the “healthy option” — that’s a cop out. And you don’t need to tell me how fucking hard that was. I know. But I still had to do it

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What about a balanced diet?

I get asked this a lot. “Is it really okay to eat all these fatty foods?”

The answer is YES!.

Then I get “But what about a balanced diet?

I understand the question because I used to have the same thoughts/fears about responding fully to what the mental hunger was asking for. Some days/weeks it felt like all I was eating was sweet/fatty stuff. I certainly worried that I was not eating a balanced diet any more. But I had made the decision that I was all-in eating whatever I was obsessing about and that just happened to be cake and chocolate … not kale. Turns out, I turned out just fine. I now eat what I consider to be a very balanced diet, and not because I am trying to but because I returned to the middle.

Despite understanding this question and despite having had these same worries myself it still makes me smirk a bit. When I hear someone repeat to me the exact same fears I once had I smile to myself because my Anorexia used to swear to me: you are the only person who has these thoughts. You are alone. 

I also am tickled at the obscurity of it all. Here we have a person who has been obsessively eating vegetables in massive quantities for years but not once during that time did they question if they were in balance or not. Yet tell them that they can eat more than 5 slices of bread in a day and all of a sudden a “balanced diet” matters. That’s Anorexia to a T.

 

Anorexia puts us out of balance. In recovery we often have to counterbalance

Here’s how it worked. For years and years I had survived on mainly fruit and vegetables. As a result of that, I had swung way out of balance. Like a pendulum, once something has swung very far one way, it tends to swing very far the other way when it is let go. When I let go, I needed to swing out the other direction and eat a lot of sweets, fats, and all the things I hadn’t been eating enough of for years. Then, in time, my obsessions with these foods dissipated and I started to feel like I would naturally like to bring a bit of fruit and veg back into my life.  The point is that by not eating enough fats etc I was way out of balance, and it took months of eating vast quantities of these foods to come into a place of balance.

If you have artificially tried to control your food intake, you have pushed your body out of balance. The only way to get back into balance is to hand control back to the rightful owner — the body — and it will sort the whole mess out for you. This is what the mental hunger is trying to do for you. She is telling you exactly what you need to eat.

 

The first thought is usually the right thought

Here’s the hard part: allowing yourself to eat whatever your first thought was. The mental hunger will throw a thought out there such as “I want ice cream,” and then a nanosecond later that innocent little ice cream thought gets rugby tackled by the eating disorder. Negotiations start to happen. Thoughts such as “It’s too early for ice cream, wait until after dinner,” or “ice cream is bad for you, why not have some low fat yoghurt instead.” Before you know it, you have settled for iced tea not ice cream at all.

You have to start reacting to that first, innocent thought. Acting on that first innocent thought. Eat the ice cream. No negotiations.

To address the imbalance that Anorexia created, I went through some very distinct stages in recovery. I had a sweets stage (where I ate ice cream for breakfast, cake for lunch, etc) I had a meat stage (where I ate steak for breakfast and steak for lunch etc) I had a bread stage (bread all the time) and I had a diary stage (all about cheese and milk). I had random and weird cravings. The mental hunger dictated all of these stages. She knew what she was doing.

Then, when I was weight restored and still eating unresticted,— when she was good and ready — the mental hunger left me. Her job was done. I naturally returned to just eating. My diet and appetite now is quite like what it was pre-Anorexia, as is my body shape and size.

TL;DR: Keep the calculator in the classroom and out of your diet. 

The mental hunger matters. The mental hunger doesn’t care what the dietician or Dr told you your food intake should be. It says “Your books are wrong doc, I need more food.” The mental hunger doesn’t respect what the Bad Accountant tells you. It says. “We’re in the red, Punk, and we need to eat to get to break even.” The mental hunger doesn’t care what the smiley health guru says about kale. It says “You can eat as much kale as you like, but I am still going to keep asking for the burger.” 

The mental hunger is there for a reason. It is there because you need to eat more food. It will stay there until you stop restricting food and until your body is the size that it was always meant to be. The mental hunger is there until that inner child sits back, puts her feet on the table, pats her tummy and declares “I’m done.”

Until then, Keep eating.

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About Tabitha Farrar

I work as Head of Marketing for a software startup in Boulder. As a recovered Anorexia sufferer, I advocate for proper understanding of eating disorders in my spare time. On that note, I wrote a book about my own journey into eating again called Love Fat.


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19 thoughts on “Anorexia Recovery as an Adult: My body is not a calculator … and mental hunger counts!

  • Firecracker

    …if only this blog could only be passed into the attention of therapists, nutritionists, and doctors across the BMI industry. It is a revolution of truth, and, as someone working my way through restoration, it is so important–vital–to take responsibility for my actions. Meaning: my body wants foooood and my recovery (actions) mean feeding it. I am experiencing nature in its finest form, this body doing almost magical mysterious things. It’s shocking, this process. It’s also shocking, the degradation I have suffered.
    Until I have, and if I earn, physical hunger, the mental kind will save my life. Know that I want to be hungry, know that i need and want to eat! This makes perfect, solid sense. You remind me to eat without question, and eat with simple and pure response. Don’t refuse the body’s messages. Don’t refuse the progress I want so deeply. Don’t refuse this life.

  • Jen

    I SO needed to read this. It’s hard because society, the medical community, and even eating disorder professionals, have so many rules and ideas about what people “should” be eating to be healthy, and I find it incredibly difficult to just ignore that. Logically I know I just need to eat a lot of calories to put on weight, but my ED will step in and complicate things by trying to tell me I need to eat x amount of protein, and the protein and carbs at every meal have to be balanced, and too much sugar is bad, and I shouldn’t eat more than x amount late in the day, yada yada yada. It’s ridiculous! And yet I have a hard time completely discounting it because, “well, I did just read that in a health article,” or, “yeah, I did read that doctors recommend that… ” Argh! Drives me insane!
    Anyway, thanks for this. It helps to counterbalance all that other bullshit chatter that tries to derail me. And it helps especially because it comes from someone who’s been there, done that, which is more valuable to me than someone who just has a bunch of random letters behind their name that they think make them sound smart ;p

    Tabitha’s RX: Just eat. Period. LOTS and LOTS and LOTS.

  • Alice

    FRICKIN YES!!!!!!!!!! I am so happy I found you. Yesyesyes I feel like you are me haha. This has exactly what I went through and what im trying to get other girls to understand as well. Any calorie counter will say I need a NET of 1700 calories just to MAINTAIN my weight!! But I ate a NET of 2400 calories and lost 20lbs of my recovery weight gain!! Now I eat a net 3,000 calories to maintain my weight which sounds like a lot but that’s just what my body consistently asks for everyday to maintain my weight. You’re amazing. Do you make YouTube videos??

  • Lucy

    Hi Tabs,

    First of all… thank you so much for posting your articles 🙂 I’ve just recently commit to recovery from Anorexia after struggling for almost 2 years. What you say in your post is really on point and that really makes me safe. Right now I’m assuming I’m in the “recovery binge” stage as I would always crave loaves of bread, bag of chips and jars of PB and eat them in one go without difficulty. It really freaked me out and I though I was crazy. But then I found your post and I realize I wasn’t alone 🙂 But anyway, I just wanted to know how long does this “binges” usually last.. because I’ve been eating my fridge out for the past 4 days non stop, and I still crave a lot of food. Although I’m trying my best, I’m really scared my ED will start convincing me that I will never stop eating 🙁 I hope you can help out, thank you !

    • Tabitha Farrar Post author

      Hi Lucy

      They last as long as your body need them. I know that is not a specific or very satisfying answer, but it is true. Your body gets to decide when you have eaten enough. And it will. Did you see the post about why recovery binges are not BED?

  • Emily Snelgrove

    But Tabitha, what if you are weight restored and still have strong mental hunger..? I am only just weight restored but I still have cravings all the time for calorie dense foods. I find this so frightening and am too afraid to give into this mental hunger, since that in terms of bmi my body is now “healthy”.

    • Tabitha Farrar Post author

      You can totally get weight restored and have mental hunger if you restricted or didn’t eat enough food during weight restoration (it is possible to gain weight while still not eating everything that you need to)

      If the mental hunger is there you are not done yet. BMI is a load of bullshit anyway. Eat without restriction and allow your body to do what it needs to do.

  • Alexia

    Hi, I’ve been listening to my hunger cues and been eating everything my body wanted me to eat (AKA, my cravings). I’m still exercising, but it’s less intense compared to back when I still suffered from the disorder. My weight has increased and now I am in a normal BMI. However, how am I still eating more and more everyday? It feels like it wouldn’t stop. Even after my weight has restored, I can still eat a jar of PB everyday, sandwiches after sandwiches, loaves of bread, tons of chocolate bars daily. I’m no longer restricting but I still can’t seem to feel full. Is this normal?

    • Tabitha Farrar Post author

      Hi Alexia

      You need to stop exercising and any other OCD-like compulsions that you have. Your ED will stay active so long as you are doing the compulsions. Also do not assume that a “normal” BMI means that you are done with weight restoration. If you are still hungry that indicates that your body still needs more food to recover. It is important that you stop exercise and eat as much as you want.

  • Kim

    I am so intrigued by your post . I have suffered anorexia for over 20 years . I am in my mid fortys and weight only 78 pounds. As I am working toward recovery I can’t imagine being able to eat the calories you speak of. I am now around 1300 calories a day and that small amount keeps me full . If I eat more I am so very uncomfortable physically. Do you have any tips and getting to the next level-please !!!!!
    Thanks
    Kim

  • Camille

    Eating unrestricted is a radical idea that I’ve never encountered before. I can see the brilliance in it. My concern is purging… that I’d be setting myself up to want to rid my body of all the food, at times. Thoughts or your experience with that?

    • Tabitha Farrar Post author

      Hey Camille

      You will only purge if you allow yourself to purge. Your eating disorder may deliver to you feeling of wanting to purge or whatever, but you get to make the choice. Decide now never to purge, and stick to that commitment.

  • Jane

    Hi Tabitha, thank you for all your amazing help 🙂 I can honestly that it is singlehandedly because of you that I am recovering.
    It is really difficult for me at the moment, I’ve always been large (and everyone in my family on my mum’s side is quite large/fat as well, and they are all perfectly healthy) and that added with the fact that I am in the overshoot stage is making it really depressing for me. It’s just awful when I’m surrounded by thin, pretty, ‘perfect’ girls and I’m the fat one and people tell ME to lose weight and count calories and blah blah blah because ‘you’re SOOO unhealthy being fat is UNHEALTHY’ and in nutrition class at school it’s like ‘everyone isn’t exercising enough and you all need to do more exercise run for an hour a day do this do that and SATURATED FAT IS SOOOO EVIL RUN FOR YOUR LIVES!!!’
    Sorry I’m ranting a bit it just frustrates me so much, several times I have almost let my anorexia win, I just wish people knew that you don’t have to be thin to be healthy or beautiful, cos that’s another thing, people tell me that I will never find a boyfriend because no-one will ever find me attractive. I don’t think I’m THAT ugly, jeez!
    ANyway, sorry about that, thank you so much Tabitha, you have no idea how much you’ve helped me 🙂

  • Erin

    Hi, so I just started to really recover recently after being in a pseudo recovery for weeks. I was on like 1600 ish cals a day so I was in a deficit but not starving, and i am technically a healthy weight. Do I still need to smash in the food whenever my brain wants me to eat? I do feel physical hunger and even extreme hunger but I really do feel as though I’m now eating an unnecessarily large amount.