What you can expect in recovery from an eating disorder

People who recover from an eating disorder may soon go back to old habits unless they get knowledge about what to expect in the recovery process. Many are surprised that they get less energy instead of more when they eat more. They don't understand that the body wants to rest to be able to heal the damage the body hasn't been able to heal the time it did not get enough energy for the job. They don't even think damage has been done. In the beginning of the healing process many experience edema. Many freak out and think they rapidly gain fat, but that is not possible. Read about edema here:https://www.acute.org/blog/edema-eating-disorder-recovery-causes-prevention-and-treatment

Many also get surprised when they get extreme hunger and can eat ten thousand calories in a day, forgetting the body has been starved and need extra food. When this happens many are afraid they have just switched from anorexia to binge eating disorder and are not getting well at all, but this is a misunderstanding. A restrictive person do not become a binge eater. The extreme hunger will only last until the body has got the energy it needs to heal from starvation. Do not stop eating a lot just because you think you have reached a high enough weight. It is up to the body to decide when you have gained enough. After a period of extreme hunger the hunger will normalize and the weight gain will stop.

At this point it is important to continue eating enough food. Read the recommended amounts at the ED institute https://edinstitute.org/blog/2011/9/14/i-need-how-many-calories. Don't compare your own food intake with others, but eat when hungry till you are satisfied all day every day. Respect the bodys signals and eat. You need a lot of food. Do not trust a calculator online to tell you how many calories your body needs. The body will tell you that more precisely. 

Do not restrict even the slightest to lose weight or you may very soon go back to restricting more and more. No more restriction! No more starving! If you overshot your set point weight you will lose excess water and fat naturally if you continue eating enough and avoid purging and exercising. The body needs the food and weight gain to rebuild the muscle mass and heal the metabolism. You don't need to do strength training to rebuild the muscles, you need enough food and rest. The body gain water first, then fat, then muscle mass. So be patient.

To weigh yourself, track calories, look in the mirror and wear tight clothes can all make it harder to recover.

To accept your body the way it is, the way it is in recovery and the way it wants to be.

Accepting that you don’t get to choose what your body looks like at the end of the recovery process. (At times it might feel less like acceptance and more like admitting defeat.)

Are you missing out on all the things you could become because you are coveting your anorexic body? So attached to a dying body that you can’t let yourself really live in this new, healthy body? There is nothing good in this desire.

Avoid full length mirrors and long showers to avoid body checking.

Avoid buying clothes as much as possible. use loose clothes and buy clothes after recovery. Don't get hung up on sizes.

Remember that you will not gain forever. The weight gain will happen in a fast speed perhaps, but that will not continue for long. It will slow down. You will not have extreme hunger and edema forever. This will stop as soon as the body is fulfilled.

The weight will on many accumulate in the stomach area, and first as water. The weight will even out later.  The body composition will also adjust to what it is suppose to be. All will come into place eventually. Just keep on nourishing the body. It knows what it's doing. You just got to trust it.

The people who have a natural body, eats what the fuck they want and the amount they want are the toughest. Not those who are too scared of not pleasing the crowd and restrict their bodys needs.

Overshooting set point weight and the fear of becoming overweight.

I have and still are afraid of overshooting my set point weight. I have also been afraid that I will end up overweight. I have read on youretopia and found that it is normal to overshoot 10 %, but then taper down to set point within the next year. It is also a common reason to overshoot and that is you restrict during recovery. Do not purge, eat enough and binge if your body wants you stuff yourself. Theis advice can prevent overshooting, but it depends on your history as well.

All those subjects in the Minnesota Starvation Experiment temporarily overshot their pre-study weights with 10% and all returned to their pre-study weights in the 12-18 months following the end of the study. As for whether the temporary overshoot is necessary, there is some evidence that it may indeed have value in ensuring the return of an optimal fat-mass to fat-free-mass ratio. In fact, Abdul Dulloo and colleagues re-examined the Minnesota trial data and discovered that the depletion of fat-free mass and fat mass (occurring during starvation) separately trigger excessive eating in post-starvation subjects and that the excessive eating will persist until both fat and fat-free mass are restored.

Anorexics often maintain a higher proportion of fat mass post-re-feeding and this is likely due to the prevailing attitudes that excessive eating must be avoided during recovery at all costs as it is considered a marker of “bingeing”. Instead, what these post-recovery data may show is that the prohibition of excess eating  in recovery from restrictive eating disorders serves to halt the body’s ability to return to an optimal fat mass to fat-free mass ratio.

Between the ages of 16-25, the body will occasionally store extra energy, but usually it is using the extra energy coming in (through natural overeating sessions) as it happens. However, if a restrictive eating disorder patient hijacked his or her normal development as a child with self-administered starvation and/or excessive exercise, then the recovery process may mimic the energy storage/growth spurt that was supposed to happen but was stalled by the onset of the eating disorder. Give it time and it works itself out.

I overshot very much when I tried to recover when I was 19. Mayby because I purged sometimes and maybe because I didn't let the body finish the growth spurt in my teens, as mentioned above, if Gwyneth is right.

If the following is true we don't have to fear ending up overweight:

1. The candidate genes associated with inflammatory obesity, cholesterol, insulin and glucose levels are unrelated to the genes identified thus far for restrictive eating disorders [R Stöger, 2012; AW Drong et al., 2012; CJ Nolan et al., 2011; A. Hinney et al., 1999 and 2000].
2. Patients fully recovered from the restrictive eating disorder rarely reach final restored weights above BMI 25. 2% of the recovered population does go above BMI 25, however ALL return to weights at or below BMI 25 after one full year beyond recovery (with no relapse of restriction involved) [CM Bulik et al., 2006].
3. Leptin resistance is not a factor in either the activation or resolution of a restrictive eating disorder. Yet, leptin resistance is often present in patients with inflammatory obesity. [P. Dandona et al., 2004; JF Caro et al., 1996; S Herpertz et al., 1998 and 2000]http://www.youreatopia.com/blog/2012/10/31/bingeing-is-not-bingeing.html 

Gwyneth from youreatopia.com: There are circumstances that can interfere with the body's ability to remain at its optimal set point: 1) some prescription drugs and 2) high levels of constant, unpredictable and uncontrollable levels of bad stress. In both these case however, as soon as the offending interference is removed, the body is quickly able to return to its optimal set point. Weight cycling (yo-yo dieting -- nothing to do with any behaviors any of you experience on the restrictive eating disorder spectrum) can generate both leptin and insulin resistance making it much tougher for the body to return to its optimal weight set point. However, given enough time with no restriction this kind of metabolic damage does appear to be reversible.

As for points at which a person is "chubby" during development that is usually not over shooting an optimal weight set point at all, but rather the body's effort to store excess energy in anticipation of needing it for development.

Inactivity can account for about a 5% increase in weight, just as activity can account for about a 5% loss in weight. However our body's optimal weight set point is likely a range that accommodates that fluctuation easily. Activity is needed for health reasons, not really weight reasons.

In clinical studies of anorexics who manage to fully recover from restrictive eating behaviors of all kinds, 2% actually reach weights above BMI 25. (I really want to yell the next sentence for emphasis since I'm already bolding and italicizing here). Of that tiny 2% NONE of them remained above BMI 25 one full year beyond recovery. No relapse and no restriction involved.  

You can 'refine' your set point by about 5-8% through exercise (meaning our set points are ranges as well and exercise allows a small amount of fat mass reduction).

Avoiding any mini-relapses or a quasi-recovery will lessen the chance of overshooting, but you cannot be assured of it.

I hit the breaks.

I have been curious about how many calories I can add and live on on my current weight of 47. I think i have found out now, unless I a have 1 kilo of water retention because my period is coming soon. In case it is not because of that I hit the breaks. I can not remember gaining a whole kilo of water over to days.  I ate 1460 calories last week and this week jumped to 1510. It was then it happened. I will eat 1448 some days now and see what happens after i get my period. I have all the time in the world. I don't want to be scared, but do this very slowly. It's no fun to go up to 53 when I still have no extra energy to build strength. I don't want to gain 6 kilos of fat. I can handle 1 kilo, but the rest should be organs and muscles. Perhaps I am hoping for the impossible, but I have not given up on the idea.

I know I can lose weight ,very, very slowly, on 1550 if I walk 80 minutes a day and weigh 43. I think I should try to be flexible and not eat the same every day. I could increase my calories to the days I walk that much, and eat 1448 the days I don't. I will do that. I will perhaps eat according to my activity level every day, actually. Just have to figure out the numbers. Like on the days I have little energy and just walk 20 minutes I can eat 1448. And if I walk more or do yoga I add those calories in food. That will motivate me to move more perhaps, and it is to be more active that is more goal.

When I imagine being weight restored and not counting calories and having a meal plan I just see my self going crazy with food. But I remember when I once was weight restored, it was in fact the opposite. It is in recovery, now, I could eat like a maniac if I gave up all control over my body, but that is because I am starving my body. When I have given the calories the body needs I will be very relaxed about food. I won't crave it. I won't think about it much at all because I won't be starving. It is quiet a releif to come to that point. Pretty funny that one day I eat like a maniac like many days before that day, and the next I am ready for life, people and have little interest in food. The hunger is gone. I can lift my head up from the stomach area.

But I can't imagine eating freely ever again, in recovery or weight restored. Being maniac, being possessed with food, is a nightmare. Just thinking about food and how to get as much as possible into the mouth without being too full. I need to count and make sure the weight is stable and know if I eat enough, too much or too little. It's so difficult eating right amounts, just trusting the body. I do listen to my body now, but I am backing it up with data. After I got weight restored many, many years ago I wasn't eating enough so I acted bulimic. That is awful. It must be most important to make sure not to restrict anything once weight restored. Then the fear of gaining weight must be less than the fear of a relapse. To be sure I will have a sucsessful recovery I have to be ok with a bigger body, with fat. I am not there yet even though I have taken a step into that direction seeing the beauty in bigger bodies. To see me as bigger is so much harder. Me with a fuller face. O.M.G. How can I or anyone else take me serious then? I know that is a crazy thought, but I have not replaced it yet.