I use the term “in active
recovery” across the site, but what you achieve at the end of a
successful recovery process is, hopefully, a full remission. The end
state is not a full recovery. No one ever recovers from a
restrictive eating disorder. The nature of chronic neurobiological
conditions is that they cannot be cured.
I have often reiterated
the following as well: restrictive eating disorders are either active or
in remission. Remission can be permanent, or there can be flares of the
condition in times of stress (a relapse).
Signs of remission:
1) You look forward to gatherings and celebrations that center on
food. Like all those without an eating disorder, you indulge happily and
do not compensate either before or after the event.
2) You have no forbidden foods, unless of course they could actually kill you (think peanut allergy).
3)
You are a force for moral absolution. Your relationship with food is a
morality-free zone and it has far reaching influence on those around
you, not to mention yourself.
4) You experience your body, and
every body, as a miracle every day. You marvel at the healing of a
bruise. You stop to watch your fingers flying over a keyboard and are
amazed. You see form and function and the innate power of the body.
5)
You understand on a cellular level that “savoring” is a state of
transcendence and transubstantiation. Transforming food into life-giving
energy is freaking phenomenal!
6) You feel connected.
While
many with eating disorders can feel strangely energized and alive in a
state of extreme energy depletion, they rarely feel connected in that
state. In fact, they feel a high in the disconnection. Connection is
actually an ambivalent state and you are able to hold the ambivalence
with appreciation. It is not always joyous, supportive or healing to be
connected to others. But you are ok with that.
7) You are fluid. (I think she means like fluid, Changable, flexible)
-------
**Here is how you know you are ready to attempt eating to your hunger cues:
Your weight appears stable. (weighing yourself is not necessary to determine that).
If you have dealt with amenorrhea during your restriction, then you have achieved 3 consecutive periods in a row.
You are continuing to eat minimum amounts and it is comfortable to do so.
Other lingering signs of repair seem complete (no longer cold,
tired, achey, dealing with water retention, no brittle hair or nails
etc.)
You think you may need to start eating to hunger cues and are a bit anxious that you can trust those cues.
Note
Item 5—if you are feeling extremely confident about eating to hunger
cues then chances are you are a ways away from remission still.
You
move from meal plans or counting calories to eating to hunger cues by
attempting a 3-day experiment. Eat to your hunger cues but jot down
everything you eat. At the end of those three days you should discover
that your hunger has taken you to approximately the recovery guidelines
you have been following thus far. If so, then you can likely trust your
hunger cues and move into your remission with some confidence.**
If you have a couple of the following you haven't recovered:
- Reflections in mirrors/surfaces are 'dysmorphic' eg look disconnected etc.
- Don't feel muscles properly = nerves not repaired yet.
- fidgeting/restlessness/agitation = bodies way of getting you to move to find food.
-tingling
-no expendable energy
If you are six months or more into the recovery process and
you’ve found yourself unhappy with having to eat to the minimum intake,
then eat to hunger cues for three to five days. Log all the food you eat
in those days and at the end of the test phase, add up all the calories
and average the intake out to arrive at your daily average.
If
the daily average appears within 200 or so calories of the minimum
intake guideline for your age/sex and height, then try another five-day
test period in the same way. If you see no progressive restriction in
your intake, then Huzzah! You are likely in remission.
When body fat is completely recovered and fat free mass
recovery is still well below normal, excessive hunger is still evident, but disappears as fat free mass recovery approach to
100%.
