Life without Anorexia

My motto is
'Dont let the sadness of your past & the fear of your future ruin the happiness of your present'

My life at the moment is completely different to how it once was. I spent 5 years sick with anorexia nervosia and depression as well as struggling with self harm and overexercising. I spent 2 years in different treatment centres.
And since 2012 i have been declared healthy from my eating disorder.

I have been blogging for 7 years, and my whole journey is written in my posts. I now represent healthy and happiness. I want to show anyone struggling that it is possible to recover, no matter how hard it may seem.

I now blog about recovery, my life, veganism and positivity!

If you have any questions leave them in the comment section as i am much quicker at answering there, otherwise you can always send an email: lifewithoutanorexia@hotmail.com

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Monday, June 30, 2014

Stages of recovery

I was asked about digestive pain, bloating and water retention in recovery. And that is PART of it... its almost unavoidable. Your body has been under soo much stress, it just wants to recover and rpotect itsself. And water retention and bloating is part of that... its protecting your organs. But also, your body doesnt know what to do with the food, as it has gone so long without food. Its a shock for the body.
  Keep eating normally, regularly and enough. Thats my best advice, and especialyl for bloating.
 If you restrict to get rid of the bloating, you are making the situation worse and when you do eat normally again it will take longer for this phase to pass.

The text Below if from HERE

3. THE PHASES OF RECOVERY

There are three distinct phases and one critical final phase for complete weight recovery and here's a bit of what to expect.
Yes, you can experience symptoms of multiple phases at once and you can seem to progress from one phase to the next and then, for no apparent reason, seem to back track. That’s all normal and not cause for concern.
Remember the body is not a machine but it knows what it is doing as long as you are providing the energy and resting.
And finally, please keep in mind that no one (absolutely no one) sails through this process with no slips or problems. Whenever you slip back into more restrictive behaviors you have not failed. Instead you must treat the experience as an opportunity to learn more about what are your specific triggers that cause relapse—that will make for a far more resilient remission in the end.

Phase I—edema.

Water Onboard

The body seems to gain 7-16 lbs. (sometimes more than that) in the first couple of days or weeks when you get to re-feeding amounts for your age/sex/height.
Someone not prepared for this will panic and restrict before she gets too far along. The "weight" almost exclusively water retention (edema). The body needs the water for cellular repair and the normalization of both liver and kidney functions [WB Salt, 2004; GFM Russell, JT Bruce, 1990].
The water retention dissipates past the second month, but only if the patient is reliably eating to the minimum guidelines or more every single day.
Very rarely, extreme edema (most pronounced on hands and feet) is one of several symptoms of refeeding syndrome. It is one of the many important reasons why medical supervision is a necessity in the early phases of refeeding.
Further details on water retention are available in this blog post: Edema: The Bane (and Blessing) of the Recovery Process. 
One of the tenets of the MinnieMaud treatment approach is to stop weighing yourself at all. You will find the Your Eatopia Forums strewn with panicked ED-driven meltdowns after someone in recovery has succumbed to stepping on a scale.
The scales are one of the eating disorder’s most favorite of torture implements that it gets to use on you to generate an easy relapse. Do not give it the satisfaction.

Digestive Distress

Digestive distress is common in this first phase: bloating, gas, pain and abdominal distention, diarrhea or constipation. You can alleviate this a bit by eating smaller amounts more constantly throughout the day: 200-250 calorie increments from the moment you get up until you go to bed.
This digestive distress occurs because starvation has drastically reduced all the critical bacteria in your gut as well as all your digestive enzyme levels. In order for the bacteria to recolonize to acceptable levels they need the energy in. [MD McCue, 2012; PD Cani et. al. 2007]
For many patients in this phase they also have to overcome gastroparesis. [RW McCallum et. al., 1990]. Gastroparesis is a survival mechanism whereby the stomach doubles its emptying time to the small intestine, meaning the food is churned in the stomach for longer to try to allow for the small intestine to maximize the too-little energy coming in to the body. Gastroparesis begins easing within a few days of doggedly staying at or above the minimum intake and it resolves quickly if you persist in eating the recovery guideline amounts, usually within a couple of weeks to a month. In fact the motility of the entire gut is slowed to try to extract as much energy as possible during starvation [M Hirakawa et. al., 1990] and this resolves during dedicated refeeding efforts.
Don't be tempted to lower the calorie intake because of the discomfort—just space the food out throughout the day. Yogurt with active cultures will be your best friend [C Coker Ross, 2008; E Nova et. al., 2006]
If you could tolerate lactose before the restrictive eating disorder took hold, then you will again once recovered. However, many patients in recovery can experience transient, otherwise known as secondary, lactose intolerance. This is because the system is so stressed that it can no longer reliably produce lactase to break down the lactose. If you find having milk, cream and ice cream cause bloating and diarrhea, then replace them with soy and rice options or ideally use a lactase supplement (such as Lactaid). Do not have any low-fat or non-fat options for any foods in your home.
Also, while dehydrated in the early phases, resist the urge to drink lots of water. You will get adequate hydration if you eat to the recovery guidelines. If you do have drinks, make sure they are full of calories. So instead of sodas, it's ice cream shakes and fruit smoothies with full fat yogurts and extra oil and nut butters too.
Coffee tends to increase gut motility (that means moving things faster through the colon) [SR Brown et. al., 1990; PJ Boekema et. al., 2000] and this is usually not an issue as most have very slow gut motility due to starvation. However, do limit coffee intake to one or two cups a day and make sure they are loaded with creams and sugars to focus on getting food in the system.

Pain

Edema, water retention, causes a considerable amount of aching throughout the body. You may feel very sore all over.
When you twist your ankle and it swells with fluid, heats up and hurts, that is the healing process at work. In recovery, the process is happening on a body-wide scale. Pain forces us to stop and rest. That subsequently allows for the body to deal with whisking away all the damaged cells and providing energy for the development of new, healthy cells without having to deal with new damage all the time as you “push through the pain”.
Those of you who applied excessive exercise, purging, diuretic or laxative abuse when you were actively restricting, will likely experience more swelling and pain in this phase of recovery.

Rest

Many of you will feel like you have been hit by a freight train’s worth of exhaustion and tiredness. You will find this confusing because you were “so energetic” during active restriction and now that you are really working on recovery you just want to flop and sleep.
As mentioned in the previous section, there is marked hyperactivity during active starvation for those on the restrictive eating disorder spectrum.
In the throes of restriction, you have a very effective "signal jammer". Basically your brain is not able to really receive and interpret all the distress signals from your body. This is why non-ED people feel horrible when they starve and yet eating-disordered people initially feel energized, calm, dissociated from bad feelings etc. There are marked neurotransmitter anomalies that appear to have something to do with it and they occur in various emotional centers in the brain, specifically those responsible for threat identification.
It is a good sign if you are exhausted because it suggests your body is finally able to communicate its needs for recuperation and energy in a way that was not happening during active restriction.

No Exercise

Removing workouts and exercise from your regime tend to be more difficult than increasing food intake for many. It is a common question as to why it is necessary and can’t one just consume enough energy to support the expenditure of energy.
Most will profess that their exercise regime has nothing to do with restriction and that it is merely for all the mood-modulating benefits that exercise will provide.
Yah, no. Mood-modulating benefits can be achieved through simply sitting outside and the mood-modulating benefits of exercise are far from scientifically definitive as well.
Furthermore, because you do not have a mechanistic body you cannot actually magically consume enough energy to necessarily support expenditures because the body is conservative and cautious when it comes to how it chooses to use energy intake. In other words, even if you doubled your intake that may not result in your body being comfortable assigning energy to repairs and weight restoration because the cortisol levels suggest the body is under stress and therefore the energy should be socked away in case.
Just stopping exercise will be highly anxiety-provoking and that is why an approach of “replace and distract” is recommended by experts in the field of exercise dependency:
There is plenty of clinical evidence that there seems to be no way to return a woman who is on the Female Athlete Triad (inadequate energy intake, amenorrhea (lack of a regular menstrual cycle) and bone density de-mineralization) back to a regular menstrual cycle with adequate bone re-mineralization without having her cease all activity. No matter how much we increase the intake, or change the timing to try to negate any energy deficit, nothing happens until she is usually injured out and the forced rest reverses the situation [DL Wiggins et.al., 1997; R Olyai et. al. 2009; NH Golden 2007].
I also have my own direct experience with patients with this condition. One in particular spent 5 months trying to increase her intake to have her period return regularly (she was weight restored after a long intermittent history with anorexia, then bulimia, then anorexia athletica). Within one month of finally hanging up the running shoes, her period returned with no additional weight gain at that point (she was already BMI 23).
There is nothing wrong with taking this in steps, but essentially you have to keep focused on replace and distract while getting to the minimum daily intake every single day. Once you get there, then you have actually started a full recovery process.
So, replace and distract.
If you workout in the morning, that is easily replaced with sleep. If you set your alarm to do those aerobics sessions, then set the alarm later and then continue with your morning routine minus the workout.
For some, that morning session provides some grounding—in that case, still set the alarm, but do slow yoga stretching, or mindfulness exercises, breathing exercises, or just sitting quietly in the kitchen with a nice mug of something hot (and ideally full of calories too!).
Others have to also include distraction because the eating disorder ratchets up the anxiety when you don't follow through on restrictive behaviours. Have family breakfasts. Set up mid-morning get-togethers with a friend for a coffee and a muffin.
Enroll in activities (non-exertion) that you may have had some interest in in the past. Crafts, languages, learning new software packages—flip through what's on offer at a local community center to get inspired.
Getting out in the nature is mentally valuable, but put the breaks on the exertion and duration. So again, a bit of replace and distract. How slowly can you go around the block? Make that your task. See if you can get it to 15-20 minutes for one block. Take in absolutely everything in your surroundings. Note every change. Bring a camera and take a picture of the same view each day so you can then compare after your walk whether you actually missed a detail from one day to the next or not.
Consider pot gardening (as in plants in pots!) on a patio or deck. This will allow you to be outside and connected to some of the benefits of gardening without the more strenuous aspects of hauling mounds of dirt etc. Set up a bird feeder (I have a hummingbird feeder I love). Sit out and admire your handiwork growing in the pots and watch the birds.
If one kind of replacement strategy doesn't work, then try another. Basically enter the process with curiosity about what things you could include in your life to broaden your horizons, rather than entering the process with trepidation assuming you will simply be pacing the floors with nothing better to do.

Phase II—vital organ insulation

If you get here, then the body is now focused on protecting your vital organs. It assumes you will starve it again soon enough and without insulation around your mid-section, your organs are in grave danger.
The body preferentially lays down fat around the mid-section to insulate vital organs from hypothermia. [L Mayer et. al., 2005] Again, someone in recovery who is not prepared for this will freak. You can feel huge (a combination of fat around the middle and the residual bloating and gas of a digestive system struggling to get up to speed again). Unfortunately, many relapse here.
The redistribution of all that fat around the mid-section to the rest of the body only occurs if you persist right the final phase. [LES Mayer et. al., 2009]
Phase II is a neither/nor phase that is difficult for many to navigate. The body is focused on conservative maneuvers to ensure your safety should you starve again. For many this tends to be a phase of extreme impatience—following all the guidelines day and day out and yet still wearing floaty and stretchy clothes and feeling like an alien in your own body seems unfair.
You may still be restoring weight and that will bother your eating disorder-generated anxiety. Your ingrained sense of an acceptable weight may not be your body’s optimal weight set point. Your body may additionally need to temporarily overshoot its optimal weight set point in this process in order to return to a correct fat mass to fat-free mass ratio. [A Dulloo et. al., 1996, 1999]
This phase will test you. It requires that you double-down in your trust of your own body. It requires that you work to identify your value beyond weight, shape or ideals found in our cultures and society. It is a phase that lays the groundwork for your ultimate ability to maintain a resilient remission.


Phase III—bones, muscles, almost there

Assuming you have been purposefully eating to your minimum guidelines and responding to extreme hunger without compensatory restriction up to this phase, then you start to get rewarded for all your hard work.
Osteopenia and osteoporosis begin to reverse (the completion of that may take up to 7 years, but it begins to reverse in this phase).
The fat deposited around the mid-section is now beginning to be redistributed throughout the body.
Hair, nails and skin begin to have increased pliability and suppleness.
You also start to feel more connected and self-imposed isolation diminishes. You feel less emotional blunting and start to want things for your life.
This occurs for many at around the 4-6 month mark, but for others it takes shape between months 8-12.
Unfortunately this is often when an almost-fully recovered patient makes a series of mistakes (often also due to misguided advice even from her own medical and professional team). She assumes she can now maintain her weight and that she is recovered.

5 comments:

  1. In all of my ED recovery attempts, I've never really had issues with bloating, etc., do you think that's bad? Like I read about all these people getting bloating and edema and apparently that's good because it's a sign of their organs healing, so is that supposed to me my organs aren't healing? I just get so scared I'll keep relapsing for the rest of my life ):

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    1. Well bloating is common... its pretty much part of the body recovering. But maybe you're just unique? It doesnt necessarily have to be a bad thing... but talking to your doctor would be best.

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  2. this is a wonderful post, and is ever so helpful. however it makes my near weight gain look quite daunting aha. it has cleared up a lot of things for me though, so thank you for posting this!!:)
    also, the day I found your blog was the day I finally got true inspiration to recover. because if you could, why can't I?:) your blog is amazing!!

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    1. Im glad you like the post... alot of text, but its all useful!! I am so happy to hear that, and of course you can recover as well... if i can, so can YOU!! So dont forget that, even if its tough, keep fighting for health!

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  3. I wondering if I am in phase 2.. This is my third month in without relapse... Although the bloating has subsided much compare to first two months but my stomach and arm still look huge ... And I poo a lot during these recovery process... I wonder why? The only thing I take to aid my recovery is probiotic and somehow I need someone to talk to as I recovering on my own..

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