By: Rachel Dodson RD. LDN.
What I always emphasize to my clients is that there is no one size fits all when it comes to what recovery from an eating disorder will look like. However, one conversation I consistently have with almost all of my clients is their fears surrounding body changes that may happen in recovery.
Diana Marlin, RDN says, “Your body belongs where you are nourishing it joyfully.” What does nourishing your body joyfully look like? Perhaps feeding it regularly and adequately with a variety of foods that you love and make you feel good. Perhaps it’s honoring your body by resting and moving in a way that is life giving to you (when medically appropriate in your recovery). Your body belongs wherever it ends up as a result of NOT engaging in disordered behaviors. If you're engaging in disordered behaviors, that is probably not where your body will safely land.
As a Pennsylvania Eating Disorder Registered Dietitian, I like to invite clients to put the idea of controlling where their bodies end up to the side in order to pursue a relationship with food. What I have personally experienced and what I have seen with clients is, over time (how much time can vary), the more peace experienced with food, the more peace that can be discovered and cultivated in our physical bodies, regardless of the size they end up at.
And an idea that I hear about a lot is body positivity. Body positivity is the, “idea that promotes appreciating your body in spite of its flaws, feeling confident in your body, loving yourself, and accepting your body’s shape and size.” Body positivity is awesome, but I think it can sometimes feel unattainable on some days, in my own lived experience and in my experience with clients.
Personally, I don’t wake up and love my body every single day of the week, but there are days where I tolerate it, and for me, tolerating my body looks like respecting it and treating it with dignity - enough to feed it and care for it in the ways that align with my values. I invite clients to think about their bodies neutrally - what does it look like for you to tolerate your body and treat it with respect? Maybe you can’t love it, but can you care for it in a way that is honoring to your here and now body? Body neutrality recognizes that, “complete positivity is potentially impossible for some, like those struggle with body dysmorphia, an eating disorder, a traumatic event that occurred in the body, or even those who live with injuries and disabilities that are difficult to celebrate.” Body neutrality makes space for the areas in our lives that maybe we are still processing or having a hard time reconciling certain lived experiences we have had in our bodies.
The Biology of It All
Our bodies are meant to grow and change and we see this all throughout the life cycle. Think about stages of life such as pregnancy or puberty. According to the growth charts from the CDC, on average girls can grow 10 inches in height and gain 40-50 pounds during their biggest growth spurt, between ages 10 and 14. Knowing the number of eating disorders among teens continues to grow, it is so important that we normalize our bodies growing and changing - between the ages of 13 and 18, most adolescents double their weight.
If you are in eating disorder recovery, weight gain may be necessary if you have lost weight, have low estrogen or testosterone levels, continue to have irregular or absent menstrual cycles, and/or have unstable vitals (low heart rate or orthostatic changes in pulse or blood pressure). It’s important to understand where your body ends up in recovery is influenced by many factors - your height, childhood growth charts, pre-ED weight range, and familial body type, and for females, whenever they last maintained normal menstrual periods. Everyone is built differently. You should not have to over exercise or starve your body in order to maintain a certain body weight. Remember, weight is an outcome of many things - your genetics, a balanced relationship with food and movement, your gut microbiome, etc.
In addition to the redevelopment of an adult body in recovery, someone may gain more weight in their abdomen. This is normal and it’s our body’s natural tendency to store centrally. Weight restoration is a mixture of fluid, fat, and muscle, but the body prioritizes protecting vital organs first, so someone may gain weight in the mid-section first in order to protect their organs. And after a long famine, the “cave person” brain will intentionally keep some fat stores centrally in case the person goes through another famine soon after. However, within a year of maintaining an appropriate weight, this will redistribute according to the genetic blueprint of what the person’s adult body shape and size was always meant to be.
Biological restoration and balance are critical in eating disorder recovery if you want to move towards practicing intuitive eating. That may look like weight restoration to your genetic blueprint, which obviously varies from body to body. It will be nearly impossible to consistently hear your hunger signals, let alone hunger and fullness until your body is fully nourished and knows it’s safe (aka regularly being fed). As someone pursues eating intuitively, 3 things can happen to your body weight - it could go up, go down, or stay the same. Our set point weight is a range and it is normal for there to be movement within it. Read more about set point theory here.
How to Respect Your Body
In recovery, it is crucial that you give your body permission to change. “Science has shown us that DNA programs each body’s size and shape. Rather than focusing on changing your body, now is the time to treat your here-and-now body with the respect it deserves.” Respecting your body is one of the 10 principles in intuitive eating. One emphasis of this principle is that you deserve to have your basic needs met - your body deserves to be fed, treated with dignity, dressed, and moved comfortably. Or put by the authors of More Than a Body, “Your body is an instrument, not an ornament.” But what could this practically look like?
Kyie Mitchell, RDN talks about “feeling at home in your body.” When I think about the day when I am a real adult (lol) and have a home to take care of, I think about how I would want to decorate it with all my favorite colors and patterns, I’d want to make it cozy with throw pillows and the smell of baked goods, I’d want to keep it fairly clean, I’d want to prevent unwanted pests from taking up residence (like mice or ants), and I’d want to practice hospitality - open my home and share it with people I love or am getting to know. What if we actually viewed our bodies as our home? In a way, they are - they are the one and only vessel we exist in. We have a mind, heart, soul, AND body. It’s not who we are, but it’s part of who we are. So how can we feel at home in our own bodies?
Tips from a Pennsylvania Eating Disorder Registered Dietitian
Maybe it’s dressing your here and now body - getting clothes that honor wherever your body is at and allow you to feel more comfortable
Maybe it’s honoring your hunger in the most enjoyable way to you - cooking your favorite meal, ordering take-out, sharing a meal with a friend
Maybe it’s not engaging in disordered eating behaviors
Maybe it’s doing something that connects you to your body in a safe way like walking outside, yoga/stretching, or praying
Another idea given by Kylie Mitchell, RDN is to practice not blaming your body for things, especially when they have absolutely nothing to do with your body. Something I heard on a podcast recently was to “counsel yourself the way you’d counsel someone else.” And I think these practices pair very nicely together.
References:
Breaking Free from Body Shame by Jess Connolly
Marci Evans Course - Nutrition Counseling for Eating Disorders
Intuitive Eating by Elyse Resch and Evelyn Tribole
How to Nourish Yourself Through an Eating Disorder by Wendy Sterling and Casey Crosbie
Sick Enough: A Guide to the Medical Complications of Eating Disorders by Dr. Jennifer Gaudiani
Feeling At Home In Your Body (Imma Eat That)
My Body (Imma Eat That)
Other Mental Health Services Offered in PA, NJ, DE, SC, MD, CT, and FL
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Recovered and Restored is an eating disorder therapy center founded by Gabrielle Morreale, LPC. We specialize in helping teens and young women heal from eating disorders such as anorexia, bulimia, orthorexia, and binge eating disorder and treat disordered eating, anxiety, depression, and PTSD. We provide eating disorder therapy in the towns of Horsham, Upper Gwynedd, Lower Gwynedd, North Wales, Lansdale, Hatfield, Blue Bell, Doylestown, and nearby towns with eating disorder therapy. Also providing virtual eating disorder therapy in New Jersey, Delaware, and Florida. Some towns served virtually but are not limited to Pittsburg, Lancaster, Harrisburg, Center City, Cherry Hill, Haddonfield, Mount Laurel, Cape May, Avalon, Brick, Dover, New Castle, Bethany Beach, Marydel, and Oceanview.
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