Anorexia - eating according to a meal plan/eating intuitively/bingeing

[wonderingwanderer2]

God i am sick of this.

A little bit of background - I was diagnosed with anorexia at 13 and I’m now 32. I had various inpatient admissions as a teen which saved me from death and improved my physical condition but never got me to a healthy weight. I managed to live as a functioning anorexic from the ages of 17-25, very underweight but still going to uni and working etc and I flew under the radar of services because I actively avoided going to the GP. At 25, things got really bad again and it was picked up on. I was threatened with hospital treatment again but not managed to engage with outpatient treatment and hit a healthy weight 2 years later and was discharged. I have been managing recovery and muddling through on my own since then. I am currently a BMI of between 18.5-19 although I suspect my weight naturally sits higher than this as I still do not menstruate and have not done so without the pill for 20 years.

Recovery has meant different things to me at different times eg initially it was eating enough to stay out of hospital, then it was adhering to a strict meal plan to maintain my low but healthy weight, then it was incorporating some flexibility into my meal plan so that I could eat a variety of foods/accept a biscuit at work if I was offered one etc.

As my recovery has developed, my social life has grown and it has not always been possible to follow my meal plan and it is here where I always fall down. An example: I went to a 5 day festival last week from Thursday to Monday. From Monday - Wednesday I didn’t eat according to my meal plan in case I ate more when I was at the festival (I can see now that this is a very anorexic thing to do) but I also kind of enjoyed the freedom of not being a slave to my meal plan. Then I went to the festival and didn’t eat nearly enough (no meal plan to guide me/unreliable hunger signals/unknown calories) which tipped me over into an energy deficit and resulted in me unwittingly eating too little all last week even though I was supposed to be back on my meal plan. I had 2 social events this weekend involving food and I was in the mindset of ‘saving’ calories for them.

The upshot of this is that due to the calorie deficit I was in, by Friday I was really hungry. I didn’t understand why and then I sat down and worked out what I actually had/hadn’t eaten and realised I was down on a LOT of food (a total of at least 3 days’ worth just from not eating properly last week, let alone this week). I know it’s important for neural rewiring to make up any food that has been missed (been there, made that mistake far too many times before) so I attempted to make up some of the missed calories on Friday - not all by any means but I felt that I needed to do it to show the anorexia that in as going to fight back a bit and not allow it to become a pattern. And that felt AWFUL. Like a binge and that is something that I am terrified of - I know that people can go from anorexia from BED and I really don’t won’t to do that.

7 years into recovery and I still can’t veer off my meal plan really or trust myself to eat enough. Is eating unrestrictedly/intuitively/not according to a meal plan ever going to be possible for me? I just want to be ‘normal’ and be able to go to a festival and not have to suffer like this afterwards.

I can't answer your question, but my (just) 12 year old DD has just come out of hospital after a 3 week stay for anorexia, and your post terrifies me when I think of it in relation to her.

One thing I wanted to ask is how much support do you have on a day to day basis? Do you have a partner or a close best friend(s) who are aware of your issues that can remind you to eat? It sounds like it's utterly exhausting for you and a constant battle to keep the anorexia voices away. I hope that you manage to keep going in the right direction x

Please don’t beat yourself up OP, it sounds like you’ve done incredibly well. Focus on the positive.

I think lots of people (including Overeaters like me, Bingers, Bulimics and under-eaters, and other kinds of addicts) can’t ever eat entirely intuitively because our intuition is a bit shit. None of us are good at everything, and for you and me and millions of others intuitive eating is a weak point. I think it’s a lot less painful when you just accept it.

It might be helpful to think that this is a helpful learning experience so next time you are going to a festival or on holiday, you need to think in advance about what you are going to eat and how you will keep an eye on yourself.

As you say, things have to change a bit now because you are living a more flexible life, so you can’t know exactly what calories you will be eating at a Festival - but the deal is, if you want to go, you have to eat regular meals.

So plan next time how you will manage that- one idea night be to take muesli bars and apples for breakfast, and buy a latte. For lunch and dinner there are usually lots of bean stew with rice and salad or pitta type options that are pretty healthy. you take a notebook or use an app on your phone to note that you have eaten 3 meals and a snack if that’s part of your plan. Never mind other people haven’t - you need to.

I wonder if it would be helpful for you to get some counselling to help you manage this new phase of your life? It sounds like you are moving forward really well, but some support might be useful. BEAT is a good place for advice, or the Nightingale Hospt has people on staff or Shahroo Izardi is a behaviour change expert I think is really good. It’s important to have someone with good experience of eating disorders.

I suspect that ‘saving’ calories for a social event is probably not something that will help you, and it throws you back into a weight loss mentality. But if you need a way to manage it, then one idea might be to incorporate some extra snack allowance into your weekly food plan - which you either eat or drink at an event, or just through the week if nothing is going on.

Finally, I think trying to make up 3 days worth of food would make anyone feel grim - your body can’t process that comfortably. If you are very hungry because you’ve mistakenly undereaten, then try increasing your meals by 20% (experiment) for a couple of days till you feel fine. Your body can adapt and you don’t always need to make it all up, although fine if you eventually do.

I hope some of that is helpful. The main message is be positive - you have done amazingly well, and don’t make a huge deal of having to have a food plan, we all have weak spots.

Finally it’s worth checking with your GP just to get bone density and iron levels monitored.

ime, a large % of women have an unbalanced relationship with food. This is therefore "normal".

I went to Overeaters Anon for 2 years to deal with my ED & then I left OA because it was holding me back from becoming more healthy with food. However, I held on to, and suggest to OP "One day at a time".

One thing the helped me when I got into an unhealthy dither about food was to give my permission to go ahead (with unhealthy behaviour) but only after i tried something to fix some (always a long list of options) problem that might be the real reason I was obsessing. I still think this strategy, to face up to my actual causes of anxiety even in just a small way, is what took away the unhealthy compulsions for me, ultimately, with time. Good luck. x

@lljkk

That’s a helpful tip. I am trying OA at the moment and finding it useful, but it takes a long time I guess to work your own system out.

@RiderGirl oh my god I am so sorry to scare you, what I have written above is not reflective of my day-to-day life and on the whole I manage well, it's just that the festival experience has set me back a bit. For me, recovery is and always will be an ongoing process. I have just had it for so long that I don't believe the thoughts will ever go away but I am learning to manage them. I would like to stress that I did not get appropriate support for 13 years of my illness, which is possibly why my behaviours and thoughts were so ingrained. CAMHs were nothing short of useless and I had a number of medical admissions and an inpatient ED admission when I was 2 weeks from death but never the appropriate community follow-up care so I always relapsed. It wasn't until I received the right support as an adult that I was able to properly engage.

For the most part, I live my life 'normally'. I do follow a meal plan to ensure I eat enough as I have a tendency to restrict otherwise, but I have a successful career, friends, a thriving social life, a boyfriend and you wouldn't know I had an ED if you were to look at me or watch me eat. I was told by numerous professionals that I would never recover and that the best I could hope for was to live as a 'functioning anorexic' so, compared to that, I am doing pretty ok!

When I'm at home, I am in a good routine and I know what to eat and when thanks to my meal plan (it has got looser and less prescriptive as I have been in recovery so it is not too much of a bind) so I don't really need much or any support from my friends or family. Whilst some days may be harder than others, the meal plan is a kind of external non-negotiable and it is part of my routine now so that makes it easier. It is when I am out of my routine and veer off plan and try to listen to my body (eg at the festival) that I struggle. I must stress that this is not the case for everyone who has had anorexia - full recovery can certainly be achieved with early intervention and the right support. My parents and boyfriend are extremely understanding and supportive although my bad days are very few and far between now so I do not need to rely on them as much as I used to. Please DM me if you want any more info or advice and please remember that my original post is skewed with negativity because of my recent experience - it is not reflective of my day-to-day life.

@Luredbyapomegranate thank you so much for your advice, kindness and reassurance. I think you are right that I may never be one of those people who are able to eat 'normally' or 'intuitively' and that's ok! Perhaps I was naive to think I would be able to. I had good intentions of eating adequately and regularly at the festival and it just didn't happen so perhaps before I go to another one I need to make a plan for myself as you say - cereal bars and lattes etc. I think the looseness of it all really threw me. It seems mad to me that people can get up in the morning and not know what they are going to eat during the day and yet still be able to eat enough!

I LOVE your idea of tackling the need to 'save' calories - that is brilliant. It is so easy to say 'don't do it' but much harder to do. Your idea seems sensible and manageable and it will fit into my life and mean that I don't need to stress if I am invited out for impromptu drinks/coffee and cake etc. I also agree with not making up all of the calories at once. I didn't actually do that, I made up some of them and wrote the rest off (I was just too full) but doing it over a period of days is another good idea. Fortunately my bone density is monitored. My bones were in a shocking state for many years and I would fracture them really easily but with weight restoration and medication they are improving and are much much better than they were - I haven't had a fracture in 4 years and if I keep going the way I am the rheumatologist has said I can come off the meds in 2 years :) You seem to really understand me and my thought processes and I can't tell you how helpful and comforting it is to read your ideas and advice. Thank you, thank you, thank you!

@lljkk thank you for your suggestion, I will definitely give it a go. I don't know about you, but managing my emotions with(out) food is always more immediately satisfying than any other technique I've tried but I need to focus on the long game. And, as you say, 'one day at a time'. I slipped up. So what? I recognised, have learned from it and am now back on track. Thank you for helping me to get things back into perspective. I can be a very black and white thinker so if I slip up EVERYTHING IS TERRIBLE and THERE'S NO POINT IN RECOVERY but I do need to remember the shades of grey. Thanks again!