Intuitive Eating in ED Recovery
Intuitive eating has become a bit of a buzzword in the health and wellness space, especially on social media. And whilst the concept behind it is great - listening to your body, eating when you’re hungry, and stopping when you’re satisfied - it isn’t always an appropriate approach.
In recovery from eating disorder, many people come to me saying they want to learn to listen to their body and eat intuitively. To start with many are opposed to the idea of following a meal plan and eating when they aren’t hungry. Saying it feels ‘wrong’…And don’t get me wrong, I know it’s hard and uncomfortable to eat in a way that feels like you are ignoring the signs of fullness your body is giving you, in order to restore weight and health, but prescriptive eating (aka. following a meal plan set by a dietitian/nutritionist experienced in eating disorders), is an essential stepping stone in the path to recovery. It’s not forever, but it’s an important part of healing the body and mind, in order to (one day!) move towards eating intuitively again.
If recovering from an eating disorder was as simple as ‘just eating’ and dropping all food rules, fears and restrictions, then our lives would be a whole lot simpler. But if you have ever struggled with an ED or known someone who has, then you will know that that is far from the case.
Especially during the initial stages of recovery, the mind is still filled with disordered thoughts and beliefs that can very easily morph the concept of ‘intuitive eating’ into another excuse to restrict and control food intake. And someone in recovery’s idea of intuitive eating usually looks more like something I would describe as ‘overthinking and overanalysing eating’. Not helpful!
Here are some important things to remember:
A malnourished body (and brain!) will very often lack those physical hunger cues. This is due to the dysregulation of leptin and ghrelin, the hormones which control our appetite. When not receiving adequate energy intake to maintain normal physiological function and our day to day activities, the body dials down ‘non-essential’ functions in oder to conserve energy to keep us alive, and one of those functions is hormone production. Without adequate levels of those hunger and fullness hormones, physical appetite cues simply don’t match a persons energy requirements. Especially not for recovery.
Another one of the ‘non-essential’ functions compromised during periods of under fuelling is digestion. The digestive process is slowed down, meaning people in recovery from an ED usually feel full very quickly and for a prolonged period of time. Much longer than is normal. This is also partly also due to the physiological shrinking of the stomach due to eating small amounts for so long.
A person with an ED’s brain has become very accustomed to ignoring hunger cues and cravings, and can even manipulate someone’s perception of what is an ‘adequate’ portion and level of fullness.
During recovery, energy needs are high. Much higher than what the person was eating during their eating disorder, and quite often, higher than what a person without an eating disorder past needs on a daily basis to maintain their health. This makes sense because all of that healing, nutritional rehabilitation and often weight restoration requires a LOT of energy. Whilst hunger levels usually do increase during recovery, it is often still the case that in order to meet their energy requirements for recovery, eating past the point of physical fullness, and having meals and snacks despite not being ‘hungry’ is essential.
But aren’t meal plans restrictive?
They can be, absolutely. This is why it is SO important to work with a nutrition professional experienced in eating disorders who can work together with you in coming up with an appropriate meal plan.
Having a meal plan reintroduces some structure and reliability, which both in my personal and professional experience, is incredibly helpful in recovery. Having a meal plan takes away some of that burden of making decisions of what and how much to eat when everything seems overwhelming, as well as eliminating (or at least reducing!) that opportunity for the eating disorder to sneak in and negotiate elements to control, restrict and reduce food intake. Whilst at the same time, being flexible enough to provide variety and some flexibility - also really important parts of recovery and achieving a healthy relationship with food. It provides TRUST and guidance on the path the healing and freedom.
Meal plans for eating disorder recovery are not a plan of how much you are allowed to eat. They are a guide to the MINIMUM amount that is required. It is a foundation or a base. And when following a meal plan in recovery, you have the FULL permission to (and are encouraged to!) eat above your meal plan if you feel hungry or just would like some more. That is an incredibly important point to remember!
A meal plan for recovery should always still allow some flexibility, such as different snack choices, and offering a variety of different options to choose from at meal times in order to build a balanced and adequate meal. A stepping stone that teaches and guides a person how to nourish and fuel their body back to health.
And recovery is NOT just following a meal plan and eating enough. It is also building variety and flexibility in food choices, challenging and overcoming food rules, food fears and other eating disorder behaviours, in order to rebuild a healthy relationship with food, such as eating out and eating foods that were previously avoided and restricted. In my personal and professional opinion, a recovery meal plan shouldn’t be a macronutrient or calorie prescription (again, this is rigid and only maintains the eating disorder). The point of having a meal plan in the first place is having a guide on how much you need, without having to count calories or worry about numbers!
Will I need a meal plan forever?
Absolutely not! Of course the goal is to reach a place in recovery where a meal plan is no longer required and you are comfortable and confident in listening to and honouring your body’s TRUE needs to maintain both physical health and a healthy relationship with food. A meal plan is a stepping stone. A piece of the puzzle. And an important part of my work as a Nutritionist is guiding and supporting you step-by-step in moving forward in your recovery towards a more intuitive approach to eating, once you are ready to do so.
I hope this post was helpful, and if you have any questions at all or would like to book a consult for guidance in your path to health and recovery, please don’t hesitate to reach out!
References:
https://www.nationaleatingdisorders.org/toolkit/parent-toolkit/appetite
https://www.eatingdisorderhope.com/blog/understanding-meal-plan-eating-disorder-recovery-long-term
