This blog is a collection of things that people have told me — unedited — in the last couple of weeks. This collection circles around what I see to be one of the primary problems with eating disorder treatment: Professionals reinforcing the very fears that the eating disorder brain holds. That is rather like your skydive instructor telling you to jump out of the plane, but also reminding you that the last person do did so wrapped themselves around a telegraph pole and died on the way down.
In respect to eating disorder recovery, these fears are primarily:
- Fear of weight gain
- Mistrust of one’s own body to be able to manage establishing an optimum bodyweight
- The idea that dietary restriction is a normal
- The idea that one has to suppress one’s natural bodyweight
- The idea that weight gain has to be micromanaged and that there is an “optimal” rate of weight gain
One of the biggest and most healing tests for me in recovery was the challenge of unconditionally accepting that my body knows how to optimise it’s own weight, and that it doesn’t need me to micromanage it. Furthermore, I learnt, that whenever I did try and micromanage by bodyweight or my rate of weight gain via dietary restriction or exercise, by body justifiably reacted with a huge and unsatisfiable hunger.
I often use the analogy of healing a cut. If I cut myself I don’t micromanage the healing process. I shove a plaster on it and forget about it. I don’t accuse my body of healing “too fast.” I don’t pick the scab off because I think that I know better and that my body is healing at a rate that is unsafe. I leave it the fuck alone. And guess what happens? My body takes care of it and sorts it all out for me. Basically if I stay out the way and don’t fuck it up, my body does all the work.
That is how it is supposed to be. There is a reason we have automated processes that we don’t have to and aren’t supposed to manually oversee in our bodies. Micromanaging your own body is not a good use of your intelligence. Common sense should tell you that in order to heal from malnutrition you have to eat a load of food and your body will take care of it. Yet, an eating disorder brain (which is neither partial to common sense nor logic) will tell you that you have to control every bite of food that you take otherwise “bad things” will happen.
Which is nuts. That’s okay. You are excused for being nuts because you have an eating disorder and that screws your logic.
That’s your excuse. What is the professionals’ excuse then? Because over and over and time and time again it seems it is the treatment community that is the worst at reinforcing beliefs that the human body can’t take care of itself and we need to jump in with our judgement and tell it what to do.
Please. Do you think that humans would have ever got to the moon if they really had to obsessively manage every calorie of food that they eat? There is a reason we have automatic processes to do this for us! When we start putting our noses into things that really our none of our business — such as trying to decide whether or not a hunger signal is valid or not — we get stupider. And less healthy.
And the sad thing? The amount of damage a professional can do to a person in recovery with a comment such as “Well, are you sure you are hungry, it might just be emotional eating …” is devastating. I have clients in their fifties who still are stuck on a comment like that someone made to them twenty years ago.
Rather than take it from me. Here are the voices of a small slither of people in recovery who have had such experiences:
“They were more scared of recovery than I was. I wanted to eat. I was allowing myself to eat. I was gaining weight. And I was scared but also not scared. But they were scared of my hunger more than I was. They were scared of my weight gain more than I was.” -Said by a 19 year old in recovery about her NHS treatment team
Once when I was inpatient as soon as I got to BMI 18.5 my meal plan was stripped to the minimum (3 meals a day). And I was fucking starving. My set point has never been 18.5 and never will be. (Fair to say I was hungry). I remember saying to a psychologist there ‘I really want to try and get to a bmi of 20’ . Her response ‘oh that’s insulation, most people with anorexia wouldn’t normally want to get to that point’ (bloody hell, no wonder it’s difficult)
Thought these point although frustrating are quite funny. I guess you’ve got to laugh, ignore, and carry on Ey!The most disconcerting thing about recovery for me is believing that I am doing it ‘wrong’ by going against traditional methods. Finally, I have chosen to nutritionally rehabilitate by following mental hunger signals and eating in a totally unrestricted way having spent years being told that I should eat according to a strict diet plan, micro-manage my activity levels and look for underlying reasons as to why I developed anorexia. I now have to try and forget that the medical profession told me I was ‘binging’ when I ate over my minuscule meal plan. I have to try and forget that they told me that I gained weight too quickly when my starved body first started to eat. I have to try and forget that when I reached a BMI of 19 they told me I should maintain my weight and not gain any more. I have to trust that eating according to my body is the right thing rather than eating to the micro-managed treatment plan that the doctors prescribed.
All my body wants to do is eat a lot of food a lot of the time. Simple. But the traditional anorexia treatment reinforced the idea that I needed to carefully control my food and activity; that I can’t trust my body to do this for me. This makes absolutely no sense. Ignoring bodily signals by using a diet plan? Controlled weight gain? Recovery from a restrictive eating disorder using restriction? Total codswallop. As far as my own recovery goes, I only ever needed to know two things: firstly, I can eat whatever the heck I want and secondly, I can trust my body. Instead, I became dependent on a treatment team and was made to feel hopeless for not being able to recover in the way that they wanted me to. Signing off from the CBT-E therapy was the best decision I made. I now have the freedom to recover by listening to my body rather than to other people who are trying to speak for my body.
Of course this process is still scary. My body is in control and I don’t know where it is going or when it is going to stop wanting to eat everything in it’s path but at least I have confidence in myself again. I know that I have all the answers to heal myself. I know what I need to do to survive. I still have to speak to people about my worries – infinite weight gain and never-ending mental hunger – but I trust that it will settle down if I stick with it and accept.I do whole-heartedly believe that the first step in treatment from an eating disorder is allowing yourself to eat in a non-disordered way: no meal plans, no timing rules, no food that you can or can’t eat. Whatever you want, whenever you want, totally unrestricted.
I have quite a few stories. English is not my native language, I live in Germany and my treatment is here as well. Please excuse any weird mistakes regarding English I make. Also, I’m typing on my phone. Now the stories, 4 that pop right into my mind: 1.) I was told on more than one occasion when I was eating lunch after being upset about something else that I should not force food into myself like a horse and they fear I was punishing myself. I wasn’t. 2.) Also, I had to finish dinner within 30 minutes. That is not the problem and even though I never had problems with slow eating, it makes sense. Since I was a general ward and I ate as fast or slow as the others without EDs, it took us about 10 to 15 minutes. I had one nurse tell me that I should eat quickly, and another nurse who was in the same shift scold me for finishing before the end of the 30 minute time span, because it was clearly what my contract said…so she believed. She actually said I broke the contract when I ate too quickly and that 30 mins was not a maximum, but should be the exact time over which I should evenly distribute my eating. as my therapist in the clinic (I got one after signing the contract, yay!…even though I wasn’t allowed to switch to the one I liked more because of the threat of manipulation or idk, while at the same time being told I shouldn’t do it as an outpatient because it would take to long to meet with several therapists until finding a fitting one…:/ ) clearly pointed it out to her afterwards. I understand that the nurse was scared for me and interpreted the contract differently, thinking exactly 30 minutes meant a therapeutic approach to a healthy eating behavior. I was scared nonetheless because a break would mean being put into the locked ward. I didn’t have visitor rights back then and I was scared of being even more alone. 3.) Another incident: On the first couple of days while I was on the contract and had to eat everything (which I did, after I commited to eating, there was not one meal I did not finish, in spite of eating extra as soon as I was allowed to 🙂 ), I still got delivered a breakfast tray from before the contract that had snacks for throughout the day on it and a variety of vegetable spreads to choose from, because I had talked to a dietitian before. It’s a complicated story. 😉 I ate it all including the spreads, and snacks, for breakfast because I was hungry, I was commited to gaining weight, and because that’s what the contract said (my boyfriend calculated the calories afterwards, and yes, it was more than what most people eat in 2 days 😀 ). And because I could. I felt fine, it was early recovery, breakfast and I was hungry. My stomach could handle. One nurse made tea for me, told me how bad my brain must be (it wasn’t), and how I was sure hating myself now for the amount of food (I didn’t, I wanted to get my life back), and next morning, I had to show her my tray. She actually removed the snacks (notthe spreads, though) because she said she has worked in ED clinics and that breakfast should be way less. It all turned out okay after my dietitian adjusted the meal plan a couple of days later (to actually even less breakfast because she said I should learn what normal people eat…). But the gaslightning about how I was supposed to hate myself for the calories got me furious, because I really didn’t. I understand she wanted to be empathic and that with an ED you’re prone to hating yourself irrationally for eating to gain. But still, I think, if someone is vulnerable, maybe a side note of how the hate (which for me wasn’t there) was not necessary would maybe be helpful for some. 4.) And – this has nothing directly to do with restricting, sorry – I had often accidentally delivered low-fat, sugarfree products even though I had convinced my dietitation to get me full-fat milk and yoghurt. I totally understand that missunderstanding happen and the kitchen cannot always pay special attention to every patient, especially in a non-ED-treatment setting. But what was not helpful was the team not being sure whether I (or my ED) was to be punished if I ate it, or if I didn’t because my contract said I wasn’t allowed to eat artificial sweeteners.
When I was working with a CBT therapist, she told me that she didn’t want to push weight gain because I would likely just want to revolt and push back. Her goal was to make me “happy,” and if I thought I would be happier ten pounds lighter, then she would support that. The larger context was that she was asking me to look at my history, and if I would ever be happy at a lower weight. But all I heard was ok! Yay green light to lose weight. Mind you, I was already in a severely underweight body. It was irresponsible and unethical to further my emaciation. It also furthered my body dysmorphia, because I believed I didn’t look sick at the time. Fast forward a year and I’m diagnosed with osteoporosis. She also told me it was ok to fast a day after binging the night before, as long as I was listening to my body. In her own words, she was apparently “really good at treating eating disorders.”
I was also given a weight loss meal plan by my first nutritionist. She was trying to get me to eat more than I had been, but in no way was that what to prescribe someone with a restrictive eating disorder.
Since starting my treatment in the UK under the NHS my therapist has constantly tried to ‘reassure’ me that they only need me to get up to a ‘healthy BMI of 19’ to be considered as ready for discharge. It was only after asking her two weeks ago (a year into recovery) that I asked her to stop saying this as I didn’t believe this to actually be a healthy weight for me to aim for without having to continue restricting
My current therapist is very nice and I do like him a lot, but one thing has really given me a battle. He has accepted that before my ED I was in a larger body, and a higher weight, and has told me that I will be aiming for a higher than usual BMI – as in, higher than the ‘normal’ range – to achieve happiness and health. Thats a really great thing and I do feel lucky to get that much.
However he has also told me that it is unhealthy to be as big as I was before. That I can KIND OF get on board with… just before my ED, I had another illness that completely and utterly sent my body doolally and I think I was completely off balance anyway, which may have contributed to my body being pushed past even its own healthy set point (I could barely walk, etc). Still, it did put fear in me..
The worst thing though, was that he said that he believes I will ‘never be someone who can eat freely’ (i.e, will always have to restrict my intake to some degree/ignore hunger/calculate etc) to avoid gaining too much. He has told me that whilst he is monitoring my weight to make sure I don’t lose and that I steadily gain to the target they have in mind, he will also be monitoring my weight to make sure I don’t end up gaining TOO much.
He told me all this very early on in my treatment. I almost stopped going completely because I thought, what was the point then. If I always have to restrict, why am I going to treatment for anorexia? What are we actually trying to fix here? Is the aim to just restrict a little LESS? Whats the point of that… still miserable, still living a half life, yet now my ED is always mad at me too because I am just a bit fatter and eating just a bit too much. That situation is even worse…
I said that to him actually. quite bluntly… I said to him ‘Whats the point of still having to restrict, yet not being skinny to make up for it? I’d rather restrict and be thin than restrict and always be upset that I am still staying too fat’. He just went quiet and went ‘Hmmmm yes…’. He still hasnt answered that question.
I kept going though because I didn’t know what else to do. He hasnt said anything similar recently, but I think thats because I am still a way off the target weight he has in mind for me.
I’ve also had experience with an NHS dietician who restricted me to max 500kcals for a day to start because she didn’t believe I was already eating well but was overexerting myself. I was sooooo hungry and felt ashamed for wanting more than a professional told me I could have. I then found a private nutritionist who aimed to help people lose weight but told me to follow the same plan&recipes ‘just add whatevr you want to it’&take protein powders.An inpatient ‘specialist nurse’ removed yogurts and a blooming digestive from me because it was not on her plan.The leading nutritionist in NI didn’t know what I meant when I mentioned HAES or intuitive eating. My old GP insisted I gain 2kgs per week,no less or else I was doing sthg wrong. When I kickstarted refeeding on my own and are unrestrictedly,I lost weight and it fluctuated by about 6kgs both ways.Dr totally doubted&derided me. X
I remember my very first therapist before going in-patient. I have been underweight and an obsessiv exercise addict
I have been so afraid of gaining weight or stop exercising.
I never ever forget her words….“I totally understand your fear, because bring obese is so disgusting, don’t you think?”
No… I never thought so…..
She highly recommended me to continue going jogging, since it’s a mood lifter for depressive people like me.
Every time I saw her she constantly was swearing about “those fat ones on the street eating double cheese burgers” and told me that she herself just eats fruits and veggies in order to stay thin.Absolutely helpful……… NOT!
The first clinic I was in called me before, that I need to lose xxkg in order to be sick enough for the treatment there.
During my time there, we had to gain weight on schedule. Every Thursday we need to gain exactly xxkg.
My body didn’t give a damn about schedules and I gained much more in one week, but didn’t hit the jackpot the week after. That happened twice and eventually I was kicked out
Even though I gained a good amount, but not how there schedule expected me to
I was told to “stay the same until we can get you an appointment with the psychologist” by my eating disorders consultant psychiatrist, when I was first referred to her. At the time, my bmi was dangerously low and I had openly told her I was severely restricting and overexercsing. I waited 6 months for a psychologis (during which I kept seeing the consultant for monitoring and the message remained the same) and needless to say I lost more weight during this time so by the time I started seeing the psychologist I couldn’t even think straight.
my therapist told me two weeks ago, to better restrict again, when I told him that I was struggeling with my bodyimage.. He suggested to just eat the average food and to make sure to not allow myself too much ‚junkfood‘! bc this would be not good for my body, and if I would eat ‚too much‘ than I would not be able to resist my compulsiv behavior (exercise)
nooot really helpful at all..
In addition when I was IP last year, I was very malnourished, and I wanted to eat more bc I was hungry they told me that I can‘t, this woudn‘t be in the mealplan.. So I acutally asked for another fruit for dessert and they said no.. this would be to much..
One therapist which I used to go, told me to look up my fridge or freezer so I can‘t go to eat during the night or keep it looked between the meals so I‘m not able to eat more then my mealplan sais..
just so stupid..
I went to the GP aged 21 when I knew I was relapsing. Despite my history (severe AN aged 12-17), I was told my BMI was 0.3 units too high to qualify for referral and to come back in a week when it had dropped.
So let’s get this straight: We have people suffering from deadly restrictive eating disorders who are still very underweight being told to be careful they don’t overeat and gain too much weight by the professionals who are treating them. Can’t make this shit up, can you?
Time to wake up! If you are a professional treating people with eating disorders you have to recognize the damage that you could be doing when you advocate for restriction and “weight management.” Can can literally kill a person with a restrictive eating disorder with these comments. That, or you set them up to live a half-life of fear.
Please, professionals, therapists, dietitians, treatment providers, doctors … if you cannot trust yourself to be an advocate for the intelligence and brilliance of the human body, if you are going to tell a person that they need to dedicate their life to micromanaging their food consumption and their weight, do the responsible thing and do not treat people with eating disorders.
Do you have a similar story? Feel free to share it in the comments of this blog. Others will read it, and it is by sharing these stories of people in recovery that we can spread the understanding that we — people with eating disorders — cannot trust our bodies if the very people who are supposed to be helping us don’t.
I have so many stories like this…
First, I was told I wasn’t a low enough weight to be diagnosed. I was also told that I couldn’t be anorexic because I wasn’t cutting out certain food types, such as dairy and fats. (Needless to say, I took this as advice on ‘how to be anorexic’.)
One of my first dietitians gave me a meal plan of 1000 calories a day – more than I was currently eating, but still not a healthy amount. I also managed to talk my psychiatrist into setting me a much lower goal restored weight than I should really be aiming for. Due to being past Indian, I’m “allowed” to stay lower than some people. But I am not really meant to be at that point naturally.
I also have a lot of issues with parents giving me small portions, or expecting me to be overwhelmed by portions I’m given by restaurants etc. They often say they’d understand if I couldn’t finish it all. But usually, I want to eat it! I’m always hungry!!!
At my current ED treatment sessions, they also suggest meals to put on my plan for me, and they’re much smaller than I’d actually choose for myself. And honestly, I don’t want to have to plan everything. It’s annoying and it’s not how life should be lived. I just want to go out and eat when and what I want, like a normal person.
I feel the exact same way. When people talk about the size of meals “overwhelming” me It makes me want to restrict because I feel like I’m fake. I eat so much. All the time. But I’m still anorexic.
I haven’t even read this yet and I can already relate to the title.
The whole process of getting help for me was horrible.The whole thing was MUCH more complicated, but summed up, here’s my story, starting about a year and a half after I began restricting…
My parents knew something was wrong; they have told me now that they could hear me exercising in my room (I thought they couldn’t with the door shut) and knew I wasn’t eating much (though I lied and tried to hide it). They had no idea what to do though, because I bit their heads off whenever they brought it up. One day my parents intervened and tricked me into going to the doctor. While I stood outside they explained what was happening (I could hear through the door, I was so scared of being found out I wanted to run away). When they called me in, I lied to the doctor, listing all these things I ate and how the exercise was to make me feel good. Due to lack of knowledge or whatever…. the doctor believed me. So began an entire year of trying to find out why I was losing weight and not menstruating, a year of tests and visits to specialists (even a therapist, who didn’t event mention eating disorders), none of them picking up what was actually going on because I insisted I ate. After that year, I finally lost it and the real “me” broke through and wrote a huge letter to my parents explaining everything and asking for help. They were super supportive now that I allowed them to be, and helped me (I was now over 18 so needed to do stuff myself) get in touch with professionals. I was told there was a wait, to keep doing what I was doing, and wait for them to call. I was told about an eating disorder helpline, to call whenever I needed (unfortunately I needed them many times on the weekend but due to zero government funding, they could only afford weekdays). Going through my head was the thought that because they were making me wait, I obviously wasn’t sick enough. So between asking for treatment and getting treatment, I lost more weight. Finally I started at a day program. Don’t get me wrong, it helped in many ways, especially just to connect socially to people who were also struggling, but the eating environment was just so TOXIC. Every time we ate, it felt like a competition between us all, who could eat the slowest, cut their food into the smallest pieces. I probably could’ve eaten much faster, but my ed told me but if I did things better than the others, I would be kicked out because the team would think I was healed. Once a week there was a weigh day, and even the treatment team acted as if it was the worst day of our lives- they took us to private rooms, weighed us, then asked us how we felt about it (how do ya think?). I hated to see my weight creep up (i asked to not know my weight, but they said I had to, it was the rules). What made things worse was that they kept talking about this magic BMI of 20. And when I said something ed driven (or when anyone did for that matter), it was like the team was empathising with our eds, not us. They agreed with the eating disorder. Said I could stop gaining at that bmi, and be put onto a maintenance meal plan (I was already still hungry on the weight gain plan). By this point, I had discovered these wonderful ladies online, and it hard to figure out what was true. The treatment team seemed to encourage restriction (just a different kind than what’d I’d previously done), encourage exercise, encourage micro-management and meal-planning. My eyes were opening and instead of comparing myself to others in a negative way, I just started to see what each of us was going through and it was messed up. I won’t go into details. But one person had come in and out many times, always on that maintenance plan though she was obviously starving and under her set point. One person kept talking about these marvelous walks she went on to distract herself, and it was encouraged, when it was obvious to me at least that all she needed was rest. My ed would say something and the team would just confirm what it was thinking. “I had one cookie but wanted the whole jar!” (I want the dietician to tell me to eff it and eat the whole jar) They said just eat one and remember you can have another one tomorrow. “I ate so much yesterday, I feel horrible” (it wasn’t much considering I had starved myself). The nurse said: was it a binge? God, they treated one museli bar more than the meal plan as a binge. When I was at home, I plucked up the courage to eat more, but I felt I had to keep it secret (and I felt so guilty) because they treated anything more than the meal plan as a bad thing! As I was reaching that “magical” bmi of 20, I voluntarily left the day program because I knew I just couldn’t be there once I’d hit their “restored” weight number. I still had to see a therapist though, and some months later, I was weighed there and had overshot by some. She then went on to all these questions of what I was eating, when, how much. She suggested I eat less “yummy” foods and more veggies (I already ate heaps, trust me), and stick to strict meal times. I left that therapist and now rely solely on Tabitha and the other coaches online. I think I’m making so much more progress now. I’m gaining weight, but (mental aside) there’s still so many ways I haven’t physically recovered that I don’t think my body’s going to settle any time soon. It’s bloody scary and I fight every day, but I keep coming back to these helpful resources and realise that I have to keep going. The mainstream “professional” treatment was full of body-shaming, no body-positivity, fear of weight-gain, restriction… it was honestly training me to have a different kind of ed. I think the “professional” teams need more people who have actually recovered from eds to get in there and educate, rather than relying on 50-year-old essays written by people with no personal experience. Fingers crossed for the future.
Thank you, Tabitha, for blogging about treatment modalities and their dangers. I have had anorexia for years — I am 48 now, and started first restricting when I was 9 — so I have been in very many treatment centers. Indeed, most of them that I have experienced seem fixated with the idea of “emotional eating” and how “emotional eating” can be just as deleterious as restricting. Therefore, I was always having to walk this fine line between eating healthfully (as in, not too little and maintaining what one doctor called a “safe, low weight”) and eating too much because of some emotional situation. Over the years, the constant repetition that an under-eater could become what some treatment centers called a “compulsive overeater” or, these days, a “person with binge-eating-disorder” has become a form of PTSD: a never-ending nightmare that I can definitely become a compulsive overeater, so I better always “watch it” around food. Well, “watch it” of course translates, no matter how you go about it, to “restrict.”
Also, for a time, the 12-step program was all the rage for treating eating disorders. Any type of eating disorder was seen as an addiction, and the way to manage food in an addictive setting was to micro-manage it to a T. One cannot totally abstain from food, as one can from alcohol, etc., so 3 meals a day, nothing in between (what, in OA meetings — in which anorexics were also included — was dubbed the “3-O-1” method: “three meals a day, nothing in between, one day at a time”) was the way to handle the addiction. This ideology extended to anorexia too. So, in 12-step treatment, we were given food plans with meal exchanges on them, and timing of day to eat, and if we veered off of this in any way, we were “using.” That means, if we went outside of the three exchange-based meals a day with nothing in between, we had fallen off the wagon, gone back into our addictions, the worst of the worst. The pithy phrases of the 12-step program and the constant elimination of the “self” in 12-step belief have also formed a PTSD response in me. Please note that I do not denounce the 12-step program completely, for it works for some. But it does NOT work for me, and I especially believe anorexia has no place in the 12-step-recovery method. Sorry if I have offended anyone.
As a result of these many treatments and exposure to some really daft therapists/psychiatrists/nurses, I have a ton of stories like the ones posted above. Some of them are horror stories, some just plain jaw-dropping stories, but I’ll spare folks here with those! I just wanted to chime in about the 2 biggest things that I heard repeatedly in treatment that still dog me to this day….
Luckily, I found you via some internet research and what a revelation you, and some other enlightened people out there, have been for me! Because of YEARS of “You don’t want to become a compulsive overeater!” and “You are addicted to food and therefore ‘using’ if you eat a ton of cake,” etc., I have struggled to eat to mental hunger. The concept is absolutely foreign to me. But eating to mental hunger and allowing the body to sort out itself both definitely appeal to my intelligence (and to my innermost desire to eat as much as I want, when I want), and I am now trying to pit my intelligence over my fear. I’ve come a long way since meeting you and look forward to continuing on, never feeling judged or criticized over food/bodyweight again!
So many examples!
First of all, every place I have e
ver been has set my goal weight at the bare minimum. As I would approach that weight my food would be tapered off in order to not go over the “magic” number. If my weight went over at all my food plan would be adjusted. (Although generally, they were far too cautious causing my weight to drop and food needed to be added back in.) This reinforced the idea to me that food and weight must be micromanaged.
The last time I was in treatment was at a center that only did blind weighing. Apparently I was either not gaining or gaining very slowly so the dietitian wanted to increase my calories. However, the psychologist persuaded her not to because he thought I was doing so well and he feared another increase would cause me to revert to old behaviors.
At one of the places I was in treatment over Thanksgiving. In order to account for the “dessert” we would be having with the Thanksgiving meal (a crustless, sugar free pumpkin pie so basically, pureed pumpkin with white grape juice concentrate) we were instructed to remove one starch exchange and one fat exchange from our breakfasts so we could have a bigger lunch.
At an outpatient center we were required to eat dessert once a day. To account for the dessert we were to take three exchanges of our choosing off our other meals. It scared me to have this control. Exchanges are not all equal. Three vegetable exchanges are not the same as three fat or starch. So, in theory, I could have elected to eat all of my meals without adding any fat or eat a meal containing no starchy foods. I knew I was in too vulnerable a place to handle that kind of decision. This also taught me that dessert is something one must save up calories for in order to justify its consumption.
At one of the places I was at weight retired individuals were allotted four 45 minute walks per week in addition to four hours at the gym. We were only allowed to do cardio which meant one could run on the treadmill for 50 minutes at a time (plus a five minute warm up and five minute cool down) four mornings each week. We went to the gym first thing in the morning, then to a 12 step meeting, back to the center to shower and get ready, then, finally breakfast. All together, about here waking hours prior to taking a single bite.
At this same center there was another patient with a history of anorexia who, at the time of treatment, was considered overweight. She has previously been dangerously underweight but her BMI put her above the 18.5 mark. In addition to the exercise regimen above she was to jump rope for 20-30 minutes a day and box as use the boxing bag as much as possible. She was put on a very restrictive diet with almost no fat or starch. Not only was this horrible for this poor woman, it ignited fear in the rest of us who were simultaneously being told to gain weight and be freer with food.
At same place another patient once snuck into the kitchen and made herself two English muffins with sugar free jam. The doctors gathered us all in a group and it is not an exaggeration to say they yelled at her for an hour and half for bingeing and took away all of her privileges. The rest of us were encouraged to air any grievances we had about the poor girl.
You guessed it, same place! We were ordering sub sandwiches form a local shop and told we could not get the meatball sub because it was, “bulimic heaven.” The doctor thought it to be too bulky and filling and something only a bulimic who liked to et lots of food would want. Often underweight patients would set pillows on the chairs during groups due to bony butts. One patient who was at a healthy weight once arched for a pillow only to be told by the doctor, “Don’t flatter yourself!”
Okay, I”l stop now bit I have so many more. The sad thing is I never spoke up. I cared far too much about pleasing the doctors and winning their approval even when things didn’t feel right to me. For some of them I couldn’t put my finger on what bothered me about the situation, for other I knew but wanted so desperately to get better that i thought I must agree with everything the professionals preached in order to do so. And here I sit, years later, only now learning that unrestricted eating and full rest is the only solution. So, thanks Tabs for your testimony and advocacy.
Could you tell more about your recovery beginnings? Have you started it by the day? Stopped movements and gyms, started eating a lot? What was your weight level than? How was your weight when you started real recovery? xx
I have had the same experience
I began restricting around the age of 12 and my family, namely my mother, applauded me for it. It was how I gained her approval and small doses of her love when I would lose weight. I did this very intuitively (lol) and just ate as little as I could and exercise as much as I could. This very quickly, within two years, turned into bulimia. Now looking back it is SO plain to see that my body was clearly undernourished from the restriction and was trying to nourish itself. Of course, I at the time thought this was a cruel joke and its when I began my journey as an introvert. I was mainly extroverted before and when I started to eat and purge I was filled with so much shame and it damaged me at my core. I struggled for over ten years restricting for a few months to half a year, then binging for a few months or half a year. My weight has fluctuated within 50 pounds and I was never terribly underweight but also never terribly overweight(according to standard prehistoric measurements.) I wish I listened to my body initially because now I am facing the consequences compound by each year I stayed in the cycle of restriction. There were nights I would wake up and eat food, because it was when I felt free to eat. One night, my step mom-knowing I wanted to stop binging- came down and yelled at me for eating and told me to get back to bed. Saying ” you ate two hours ago, didnt you?? You shouldnt STILL be hungry!” I have also had many counsellors that viewed binging as the behaviour to reduce, which effed me up even more. I was already SO aware of my binges..demonizing them made it worse and made my behaviors more eradic and hard to control…not that I had much control over the cycle anyways. I had been so brainwashed to see bigger bodies and weight gain as a symbol of an individuals disrespect of self. I still have a hard time but I am in full recovery now trying to be ok being in a body that even professionals and people I am supposed to be able to trust dont understand.
When I was admitted to an inpatient hospital I decided to commit to recovery and weight gain. It all went well for the first few weeks as I was gaining what they said I had to and compiling with my meal plan. After my first home leave I lost which they took as me using it as a signal to start restricting again. I hadn’t I’d actually eaten more than my meal plan. The next time I was allowed home they didn’t increase my meal plan and the same thing happened. My bodies metabolism had increased and I was on their biggest meal plan. They assumed I was exercising in secret. I wasn’t. They put me on one to one. I didn’t gain what they wanted. I said I’d eat more. They wouldn’t let. It was stupid how was I meant to gain more weight if they didn’t allow me to eat more and I wasn’t doing any exercise.
I have had what is referred to as atypical Anorexia because I looked terrible and my health was suffering and was underweight but I wasn’t “underweight enough”. I had lost weight that I did not need to lose very quickly. And exercised 4 hours or more daily. As soon as I started eating adequate for my energy needs, and listening to my body, my weight starting climbing rapidly over the course of 5-6 months. I have settled steady in at a slightly higher body weight than the crazy BMI chart says, which I don’t see as an issue given I have a larger frame. As afraid as I am of weight gain, my dietician and therapist are the most scared people saying “We don’t want to see your weight keep climbing up”, or “It seems like you struggle with binging” even when there is no evidence of such. My meal plan I have been given seems ridiculous like almost as restrictive as I was when I spiraled into my eating disorder, and is less than I ate when I was 6 years old. My protein can only be very small (i.e. only two small chicken tenders (1 oz), and then I can’t overeat veggies either so it can only be one baseball of lettuce which amounts to about 7 pieces, and then about 9-10 pieces of shredded wheat cereal. Evidently, I have to count my 30 calorie almond milk as a food item, then my breakfast can only be two bird sized items. And there can only be 3 of these small items per meal in the meal plan. So given that meal is less than I ate as a 6 year old, and evidently my meals are still being called over eating just because I want more than 3 toddler sized items, seems not right to me. I added up the meal plan and it’s about 1200-1500 calories which is not enough for a tall, big framed, active male like myself.