Why is my Eating Disorder controlling my mind and body?
Updated: Mar 3
Mac-Nutrition Live 2022
Who else gets frustrated scrolling through Instagram only to find one person shouting about how incredible intermittent fasting is for metabolsim right next to some one claiming Keto is the key to weight-loss, followed by another post advocating intuitive eating for anyone wishing to avoid eating disorders? How is anyone meant to navigate such a conflicting stream of information with seemingly valid points backing all corners?
I've been following Martin MacDonald's 'Not Another Nutrition Podcast' for about a year and a half now. His evidence based, and down to earth, approach to nutrition is exactly what the industry needs right now... especially when everything is getting so confused in hot debates and opposing opinions. Martin's podcast not only clears this all up, but it also teaches you how to evaluate information for yourself and seek your own answers.
In November 2022 I attended Mac-Nutrition Live 2022, Martin's annual nutrition conference, covering these Hot Topics:
How We Can Improve Our Relationship With Food Through a Somatic/Body-Based Lens - Rachel Hobbs | Specialist Dietitian & Therapist
Is Getting Clients To Intentionally Lose Weight Doing More Harm Than Good? What Does The Research Say? - Danny Lennon
Unique Insights into Hypothalamic Amenorrhea & Energy Availability from an Eating Disorder Dietitian - Ursula Philpot | Consultant Dietitian and Senior Lecturer Specialising in Eating Disorders
In this post I want to focus on Rachel Hobb's talk. I promise I'll touch on the others at a later date, but prepare yourselves for a bit of a longer read than my previous posts. If you can make it all the way through you'll get to some of the solutions Rachel proposes!
What support did I have during my ED recovery?
Alongside all the support I've had from friends and family, I have also sought professional help. I first saw a nutritionist who nurtured me towards weight restoration by providing me with the most comprehensive meal plans. My counsellor then helped me pave the way to a more fulfilling future by encouraging me to understand my past and my present self. Over the years, I have also been to numerous GPs, all of whom were pretty much useless to be completely honest.
Despite all the love and support I've had, there has always been something missing in my recovery journey. Part of me keeps clinging to the idea of controlling food and exercise to earn my worth. A defiant voice in my head still says that my body makes me undesirable. The child in me still ceaselessly craves validation from others. Most of the time I can cope with these remnants of my ED: I am weight restored; I enjoy my food and training; I understand where my disorder came from. But at times my body and mind still spiral into self-destructive bodychecking and self-hate. I even know most of the triggers behind these behaviours - they basically boil down to perceiving a threat of rejection. So what work is left for me to do?*
Here are my takeaways from Rachel Hobbs' talk...
Fight-or-Flight: The Body's Natural Response to Stress
Triggers like the threat of rejection become sources of stress (stressors) for people who develop eating disorders, and how the body's natural response mechanisms to stress can lock you into a self-destructive cycle much like many other psychiatric disorders and mental health disorders. The body's stress mechanisms don't distinguish between physical, psychological, emotional, or even real versus perceived stressors, and will react regardless.
In response to stress, the autonomic nervous system (the unconscious part of your nervous system) floods your body with adrenaline and cortisol, increasing your heart rate, breath rate, and blood pressure. This is called hyperarousal, and is an evolutionary adaptation to ensure survival in situations such as attack. Your body is preparing you to fight or run away, hence the term flight-or-flight, and is no longer capable of rational or logical thought processes because it's tuning in to automatic reactions and reflexes.
But is sprinting for your life an appropriate reaction to the idea of being rejected?
... Probably not. So our bodies turn to other coping mechanisms in an attempt to overcome the threat and allow the body to return to its happy place. A healthy response might be to disperse all that energy through physical activity, letting yourself cry, or turning to a comforting companion. However, some of us develop beliefs and thoughts that encourage us to turn towards less healthy coping mechanisms. For me, food restriction and over exercising became my coping mechanisms, stemming from my belief that being perfect would ensure rejection could never threaten me again. But no matter how much I restricted, no matter how much I exercised and tried to force my body to become what I believed was perfect, the threat of rejection never went away. And it probably never will.
A Frozen Mr. Rabbit
So what happens to our bodies when the threat doesn't go away? Picture a rabbit caught in the headlights - Mr. Rabbit freezes. His body has (rightly or wrongly) decided that fighting or running away is no longer working so he tries something else. In people today, this reaction can look like depression and is called hypoarousal. For Mr. Rabbit, everything has happened within moments, and he either survives or dies. If he survives, he can relax again until the next threat. If he dies, well then Mr. Rabbit won't be worrying about a threat anyways. However, in our modern society, the perceived threats might never go away and the body engages in a constant battle, often shifting between hyper- and hypo- arousal, never returning to a state of relaxation.
When you add to the mix the effect of underfuelling on the mind and body that comes with restrictive eating disorders, you create an internal environment that is simply unable to cope. You're undernourished, fuelled by adrenaline and cortisol, and unable to really process all that self-love and acceptance BS (it's not BS but certainly seems like it at the time) that people feel they should be feeding you with. No matter how much love and support your offered, your body is not in a position to receive, process and integrate any of that positivity or even neutrality into your own belief system. Seems like an impossible situation to be in right? And it certainly feels that way. When I saw my nutritionist, I was given another coping mechanism - a diet plan to stick to because I was told it would make me worthy of being on stage again. But that didn't take me out of my 'frozen' state - I remember constantly thinking, 'well, I'm gaining weight but this is just making me more anxious about how others may see me. How am I ever going to be ok with my body???'
Therapy helped me recognise what triggers cause me to feel threatened, and to understand that the beliefs behind this response are not helpful or rational. Therapy forced me to look at myself, process the changes in my body, and implement small life changes based on my true values. I believe that this helped me move out of hypoarousal. You'd think that would be enough to tell my body it can finally relax, but apparently not. When the body moves out of hypoarousal, it has to make the perilous journey back through the fight-or-flight state. Think back to Mr. Rabbit - he has survived, is now fully conscious again, and needs to run home as fast as possible so that he can finally relax. This is where some people tend to relapse. Moving back into hyperarousal need only be temporary but it can induce very intense feelings of anxiety - you're now hyperaware of the threats again and this can push you back into hypoarousal as your body seeks the feeling of numb security in hypoarousal.
Mr. Rabbit - home but still haunted
I'm happy to say I've definitely connected with myself enough to experience complete relaxation and freedom from disordered thoughts and behaviours at times and those times have been bliss. However, my body hasn't completely caught up, and my rational values and beliefs still need time to fully cement themselves in my belief system so that I stop perceiving certain things as threats. Seeing myself in the mirror, feeling someone's hand on my waist, and perceiving any negative response towards my body from those around me still initiates that stress response in my body, and I feel the effects so intensely at times that I've had some major break downs and very difficult moments in my relationship. A somatic (body-centric) approach to eating disorder recovery is what I need now to give my body time to feel completey safe again, and I believe it could help all of you you whether your stress is body-image related or not.
Increasing Autonomic Regulation -
Making sure Mr. Rabbit gets home safe every time
Increasing autonomic regulation basically means increasing your capacity to shift between relaxation, hyperarousal and hypoarousal appropriately. For eating disorder recovery this looks like being able to tolerate higher levels of stress, and developing the flexibility to return back to relaxation as soon as possible after experiencing stress. Ultimately, even when exposed to triggers and stressors that would previously have caused you to revert back to disordered behaviours, you learn to calm your mind and body so that disordered behaviours are no longer automatic. You are learning to respond in a valuable way, drawing on your rational and logical values.
The next steps...
Here are some basic habits that can help set the foundation for working on autonomic regulation:
1. Always allow yourself a satisfying breakfast every day
2. Get your Omega 3s (this could be from 2 portions of oily fish/week)
3. Get your B vitamins (from a variety of meat products or supplements and fortified foods if vegan/veggie)
4. Enjoy a balanced diet with carbs, fats and proteins that gives you all the energy you need every day
5. Enjoy regular movement
6. Seek out some green - engage in nature
7. Make some you time - relax and unwind in your own way
8. Find ways of incorporating probiotics into your diet - yoghurt and fermented foods can be super yummy
9. Avoid excessive drinking and smoking
10. Practice deep breathing regularly
I'm no professional (yet!) so I won't go into any of the following techniques in detail but I'll give a basic outline of how to approach situations where you notice yourself in hyper- and hypo-arousal. Note that NOTICING is the first very important part of the process. For this you may need to spend some time learning what your triggers are and how you usually react to them, so that when the situations come up you are in a better position to respond.
Extended exhale, box breathing (4 count inhale, 4 count hold, 4 count exhale, 4 count hold, repeat),
equal inhale and exhale breaths, try short forced inhales
Return to the present moment
5,4,3,2,1 Grouding Technique: notice 5 things you see around you; 4 things you can touch; 3 things you can hear; 2 things you can smell; and 1 thing you can taste.
Describe the space around you, using all the senses
Engage the senses
Discharge excess energy by shaking, running, walking, dancing, or whatever activity whether it's for 60s or a longer session that you enjoy. You can also ground yourself by meditating or relaxing into a comfy surface.
Try to get your body moving and engaged by going for a walk or working your way through the muscles in the body, actively engaging them until you feel more energised.
Find comfort from a loved one who helps you relax. They could be a partner, family, a friend or even a pet.
Find comfort from a loved one who makes you feel energised. They could be a partner, family, a friend or even a pet.
What am I taking away from this?
There are so many layers to eating disorder development and maintenance, so surely a holistic approach to recovery is what's necessary. There are so many people out there offering nutritional advice and therapy, and charging an often extortionate amount for their services. Sometimes it may be easier to seek out certain professionals or, if that's not financially viable, search for replacements online. Professional help is certainly an integral part of eating disorder recovery, especially if there are deep underlying reasons that need to be understood. I hope someday that professional services will be accessible to all. However, sometimes you end up handing the control over your recovery into their hands to relieve you
of feelings of guilt, and remove the burden of decision-making. Ultimately, YOU need to take control. It's up to YOU to look inside, understand your values, and teach your body how to respond in a way that is meaningul and fulfilling for YOU.
I hope that this blog post has given you something to take away for yourself or for a loved
Lots of love and hugs,
*I recognise that I will always need to work on my body image and continue cementing my values in order to grow as a human being. This work doesn't stop once you've recovered - it simply becomes easier and no longer takes up all the energy you need to go after your