Hello Tabitha,

I have now finished reading both of your books and have read/listened to most of your posts/podcasts/videos, and I’ve learned so much from them. I have begun earnestly trying to let go of my many ED behaviours, and in so doing, I have discovered—much to my dismay, but not really to my surprise—just how entrenched they are and how anxious and insecure I feel as I try to let them go. It’s a real battle and very discouraging at times.

I was wondering if one day you could do a blog post, podcast, or video on the following topics, as I’m not totally clear on these issues (or maybe my brain isn’t yet re-nourished enough for all your information to sink in):

1. How exactly did you know when you were no longer in energy deficit? Did you simply notice that you were no longer thinking about food (mental hunger) all the time and that your appetite was calming down? How did your body “tell” you that it was finally energy-restored? Was it a gradual thing, or do you remember one particular meal or day when you suddenly found yourself not as hungry as usual—and if so, were you surprised, or were you expecting this, given that you recovered on your own, with no one to guide you? I can’t yet imagine a time when I will be able to trust my appetite, so I don’t know how I’ll recognize when I’m ready to start eating “normal” (for me) food portions again. The extreme hunger that I’m currently experiencing is very frightening, even though I know from your blog/books that it’s a good sign and should be embraced. Incidentally, I’m 51 years old and have had an eating disorder for almost 40 years (I was 12 when I went on my first diet).

In Rehabilitate, Rewire, Recover! I talk about two key elements of full recovery: Nutritional Rehabilitation, and Neural Rewiring. I just want to note before answering this question that getting out of energy deficit (nutritional rehabilitation) alone is not full recovery. While there are plenty of mental state markers that indicate you’re getting nutritionally rehabilitated — cessation of mental hunger, food becomes less emotional etc as outlined on page 523 of the book — if you are still restricting, and have not convinced your brain that food is not scarce, then your brain may continue to use mental hunger as a tool to get you to eat more in what it considers to be an environment of food scarcity. So weight gain alone means very little in terms of mental state changes if one has gained weight while still restricting. That is important to remember. 

Mostly, the answer to this, is that if you are worrying about knowing when you are out of energy deficit or not, you are likely not out of energy deficit. One of the things that happens when we move towards recovery is we stop being so hyper- analytical about anything to do with food or our appetite, and tend to overthink and worry about that sort of thing less. It all becomes more natural, but this is a gradual process. That said, I still remember times when I felt full after eating a more “normal” amount and it shocked me that I was genuinely satisfied, and not pretending I was full for purposes of restriction. I was really just … full. That blew my mind the first couple of times it happened. 

As the Chapter on Energy Debt points out, nutritional rehabilitation is much more than simple weight gain. Sure, weight gain is an important part of nutritional rehabilitation if you have been suppressing your natural bodyweight, but it is not the whole story. You can’t tell from your weight if you are fully nutritionally rehabilitated or not. It is very important to look out for those mental state markers as outlined on page 523. 

1. In my opinion, one of the best recovery tools in Rehabilitate, Rewire, Recover—in fact, probably the most useful piece of ED recovery advice I’ve encountered from anyone so far—is your recommendation to adopt a “Fuck It” attitude. I really wish I could copy that, but when I say the words, my brain doesn’t believe them. The problem is that I am not thin, so I know that if I let myself fully recover, I’ll be overweight according to today’s (however unrealistic) body standards. I’m finding it very difficult to think “fuck it” when I know that many people will judge my appearance and in some cases won’t hesitate to voice their ignorant opinions to my face. Do you have any suggestions on how to handle this kind of triggering situation, which makes me want to jump back on the dieting wagon ASAP? I think that for many “overweight” people trying to recover from eating disorders, one of the hardest things to learn is how to ignore other people’s disapproval and sometimes cruel comments. I believe this fear of others’ negative judgments keeps many of us larger folks from even trying to recover, especially when the general population can’t even fathom that not everyone with an ED is thin—they think we’re lying or making up excuses for our weight. Ireally envy your no-nonsense, tell-it-like-it-is, fuck-it attitude! If you could bottle it and sell it, you’d make a fortune! 

Any advice on the above would be greatly appreciated! (And sorry for such a long email!)

Kind regards,

Well, the whole point of the “Fuck it” attitude is to not give a fuck, and that includes about what you think others think. The reality is that you don’t know what others are thinking, and of course because you are scared of weight gain yourself, your fear will project judgement onto others. You don’t know what others are thinking, even if you think you do. So what is the point in worrying about it. 

Your choices are thus: recover, and stop suppressing your natural bodyweight, or, keep suppressing your natural bodyweight and don’t recover. If you want to recover, you can’t suppress your bodyweight. Therefore, if you have chosen recovery, it is not an option for you to restrict to stay at a lower weight. If weight gain has to happen for you to be unsuppressed, it has to happen. Therefore, you can choose to either allow yourself to wind yourself up about it, or you can choose not to. 

I think I put this in the book, but one of the things that I found helpful was to pretend I didn’t give a fuck even if I did. It’s a fake it until you make it sort of thing and it works because regardless of what your brain is saying, your actions inform your brain. So if you are acting like you don’t give a fuck, eventually your brain stops giving a fuck. 

Try it. You have nothing to lose other than your eating disorder.