What you need to know as you embark on your recovery journey
If you’re in recovery from an eating disorder, we want to start by saying that we truly believe recovery is possible for every person! However, we also know that the early stages of recovery can be particularly scary as you face a tonne of new sensations and experiences. In this article, we’ll walk you through just some of what is going on inside your body during the refeeding phase so that you know what to expect during this period.
What will happen to my metabolism during recovery?
In a period of malnutrition like what is typically seen in those with eating disorders, the body slows the metabolism to preserve what little energy it is getting. However, as nutritional rehabilitation begins, the body becomes hypermetabolic.
This means that your body kicks into high gear and begins to utilise the fuel it was previously lacking, initially going towards repairing the vital organs and processes needed for survival.
Metabolism can remain heightened for several months. Until nutritional rehabilitation is complete, a person in eating disorder recovery will need more nutrition than someone of the same weight, height and age who has never had an eating disorder.1
Attempting to maintain one’s weight during recovery through the partial restriction of food can cause the proper functioning of systems like digestion and reproduction to be sacrificed for more life-sustaining processes. This is why it’s SO important to get adequate nutrition, no matter what that looks like for you.
What will happen to my weight during recovery?
Changes in weight are extremely common at the beginning of the refeeding process, but not for the reasons you might think!
The first cause is the body stabilising, moving from a catabolic state to an anabolic state – in other words, the body shifts from a state of decomposition to a state of repair. This can actually cause some initial weight loss in the first week of refeeding, but this will neutralise.
The second cause is the body becoming appropriately hydrated. People with eating disorders can become extremely dehydrated from behaviours such as laxative or diuretic use, purging, excess caffeine consumption or refusal to drink water. They may also be over-hydrated if they are consuming excessive amounts of fluid. As hydration levels balance out, shifts in weight should be expected.
Over time, weight will gradually increase as lean mass and fat mass are formed. Lean mass is usually created first, to rebuild the skeletal muscles (ie. those used for movement) and to repair damaged organ tissue.2 Fat mass typically comes later in recovery, and is often first seen around the abdomen to protect your vital organs.
It’s important to remember that reaching weight restoration is not the end of your journey, and that it is the thoughts, beliefs and behaviours that truly determine recovery.
What will happen to my digestion during recovery?
During a prolonged period of starvation, such as that seen in eating disorders, energy that would normally go towards maintaining the structure and function of gut is sacrificed for more imperative survival processes. This causes issues with digestion such as gastroparesis (slowed gastric emptying), reduced gastric capacity, tissue wastage within the gastrointestinal tract and slowed colonic motility.3 This is all just to say that the gut stops working how it should.
Thankfully, this is reversible with good nutrition! However, it takes time during the refeeding phase to repair the gut and restore its function. This means that in the beginning of recovery, it’s unfortunately common to experience discomfort or pain, nausea, constipation, bloating or distention, and premature fullness.
As you give your gut (and the other systems in your body!) the nutrition it needs to repair, you can expect it to return to its fully-functioning self.
Remember that eating disorder recovery is a long game, and it can take up to 12 months to fully restore from a state of malnutrition. It’s incredibly important to have a great support team around you to guide you through it – and that’s where we come in!
Reach out to us at [email protected] to find out how we can help you on your journey towards recovery.
Karli Battaglia, APD
EHL Team x
References
- Marzola E, Nasser J, Hashim S, Shih P, Kaye W. Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment. BMC Psychiatry. 2013;13(1).
- Golden N, Meyer W. Nutritional rehabilitation of anorexia nervosa. Goals and dangers. International Journal of Adolescent Medicine and Health. 2004;16(2).
- Georg S. Gut Function in Anorexia Nervosa and Bulimia Nervosa. Scandinavian Journal of Gastroenterology. 2003;38(6):573-587.