"Your weight doesn't determine your health"...but sometimes it does

I think it's pretty evident that I'm a non-diet and weight neutral dietitian if you follow me along on Instagram. I tell clients all the time that ultimately, I don't care where their weight ends up. In school I was taught about BMI, ideal body weight, and acceptable weight ranges. I DO use some of these to help determine a starting point for where I want my restrictive clients to end up, but ultimately they are simply equations that don't take into account varying shapes and sizes. And unfortunately, none of them allow for larger bodies to be considered okay. Thankfully, I now know that people can be healthy in a variety of shapes and sizes and that I simply cannot know the health of someone simply by looking at them. I also know that fat, fit people are far more likely to survive heart attacks, cancer, car accidents, etc than thinner, "normal" weight people. You can absolutely be healthy in a bigger body.

 
"Your weight doesn't determine your health"--but sometimes it does
 

So no, I ultimately don't care about people's weight. I care about their behaviors. I care about their mental wellbeing. I care about what's going on in their heart.  If a client is no longer restricting, listening to and honoring hunger signals and cravings, not manipulating food or exercise to control weight, having a normal period and other health indicators, and experiencing freedom with food, I don't care that their weight may be a few pounds lower than what I estimated. I also don't care if they are experiencing the above and are a few pounds heavier than I originally expected. The weight is not the ultimate issue, the heart and mind are. 

BUT, that doesn't mean that I believe you can pursue eating disorder recovery from anorexia and not gain weight in the process to becoming mentally healthy. No, ultimately the disorder is not about the body size. But the body size absolutely impacts the mind and it's ability to heal. We know that weight loss is a major trigger for the development of an eating disorder. It doesn't matter if the weight loss was intentional through dieting or unintentional through getting the stomach bug, mono, or other illness. For those that are predisposed, the weight loss seems to "flip a switch" in their brain that then tells them they need to move more and eat less. You can have someone who previously had no body image issues get sick, lose weight, and then become terrified of gaining weight and feel the need to restrict all of their eating. The more starved a person becomes the more preoccupied they become with their weight and the more fearful and anxious they become around food and their body. We also know that the more starved an individual is, the less they are able to think cognitively because their brain simply does not have enough energy to process everything properly. So it's two-fold, the starved brain can't think clearly due to lack of energy and it is stuck in the eating disorder mental illness. 

It's interesting when we think of restricting for some sort of event. The eating disorder brain convinces a person that they need to cut back on calories or increase exercise for some sort of event coming up, such as a special dinner, work party, etc so that they can eat freely and without stress because they've created some caloric margin. That seems to make sense--reduce calories earlier in the day or for a few days so that when the event comes and you eat more energy than normal, you don't have to stress about gaining weight because you'll be back at zero instead of the plus. But we find that is not the case. We find that if a person with anorexia restricts before an event (or several days before), that they actually experience MORE stress at the event, not less. The further they are in energy deficit, the more the brain tells them they need to restrict calories. The answer to creating less stress is eating more, so that the brain is not in further energy deficit.

 
Event restriction doesn't decrease anxiety
 

Clients who are gaining weight and getting their hunger signals back tell me all the time that they are concerned about gaining weight forever because their hunger is so strong. I get it--the brain is making you think about food ALL. THE. TIME. And that's because it and your body are starved. But once the body and brain are well fed, those constant thoughts about food, intense cravings, and intense hunger pangs lessen. However, this happens once the body reaches the point at which it is no longer in starvation or restriction. And this point may be higher than what they want it to be, what is deemed their ideal body weight, or a "healthy" BMI. Reaching a BMI of over 18.5 doesn't mean that the body is now healthy and where it wants to be. In fact, most people need to be well over it in order to be fully recovered. 

So, for those of you reading who are pursuing recovery from an eating disorder, you simply canNOT gain full recovery without adequately feeding your brain and gaining weight. If you're working with a therapist and hoping that you will have an aha moment without weight restoration, I'm here to tell you that it is very unlikely. You need to first gain the weight and THEN you will be able to do the brain/emotional work that is needed. You've got to get your weight to the point where the brain re-flips that switch so that it is no longer in the eating disorder mindset. It's interesting that the more weight you gain, the less you actually care about the size of your body and the less fearful you are around food. It's no surprise that research has shown that patients who discharge from in-patient treatment at a higher BMI have a higher success rate those who do not. The key is that you HAVE to get your body and brain out of energy deprivation. 

With my clients, I'm not looking for the point at which their body is healthy, I'm looking for the point at which their mind is. There is sometimes a difference. And if we want to see true eating disorder recovery, we as healthcare providers and caretakers need to throw out our fears and preconceived ideas that a person "should" be a certain size. We need to get rid of the fears of people being fat and instead care about the fact that they are healthy physically, mentally, and emotionally. I know the thought of gaining weight is terrifying for those of you stuck in your restrictive eating disorder, but the only way to truly get out is to start eating more and let your body decide where it needs to end up. 

 
Mental health is the goal, not just physical health
 

If you're struggling with restriction, bingeing, purging, or simply a stressful relationship with food, I am accepting virtual clients and would love to walk with you on your journey to eating disorder recovery.

My body has changed, and I'm not freaking out about it

If you've followed me for awhile or listened to the podcasts I've been a guest on, you know that I've had a rocky relationship with food and my body. In high school I struggled with an eating disorder and throughout my college years I struggled with disordered eating, not knowing that there was any way out of the anxiety, shame, and guilt I felt around food. It wasn't until a little over a year ago that I stumbled upon Intuitive Eating. I actually blogged about the beginning stages of that learning experience here and here

Since then, my life has changed drastically for the better. I can truly say that I live life without the fear of food. I am able to walk in freedom regarding the choices I make around food and exercise. And I am so so grateful for the change that has occurred in my actions, and more importantly, my heart. I was a prisoner, in bondage to food and what it would do to the size of my body. My life revolved around controlling my food and punishing my body with exercise. Whew! What a relief that is no longer my life!

 
My body has changed and I'm not freaking out about it
My body has changed, and I'm not freaking out about it
 

As part of the intuitive eating process, I let go of the dieting facade. I stopped believing the lie that I could control my weight through "trying hard enough" and limiting my food choices. I realized that my constant thoughts about food, cravings for sweets, and episodes of overeating were a direct result of restricting the foods I wanted and not giving my body enough energy. I started to trust that my body would regulate its weight through regulating my appetite, cravings for food, and desires for movement. I didn't freak out when I overate because I knew my body would naturally compensate later during the day, week, or month (so I didn't have to). But I also let go of the idea of having a perfectly chiseled body with very little body fat. I had to, in a way, mourn the body that I had for so long strived to achieve. I came to realize that the only way to achieve that body was through severe restriction and agonizing time at the gym. I decided I would rather have a life and freedom over that elusive, perfect body. 

Over the last year I've let go of the reigns when it comes to food and exercise. I've decreased the amount and intensity of what I do. I listen to it when its tired. I notice when something is hurting. I also listen to my cravings and eat food that satisfies my mouth, body, and mind. And as a result, my body has changed. I have gained weight and am less toned. For some of you, that idea is absolutely terrifying. It freaked me out too for 8 long years. But I've come to realize that there are more important things in life than what my body looks like. I don't even know if this current size is my body's new normal size. I'm not exactly sure where my weight is going to end up, but I am confident that it will stabilize and that whatever that weight is it will be healthy for me because I am taking care of my body. 

 
Not my original quote. I first saw this quote on Maddie Moon's instagram.

Not my original quote. I first saw this quote on Maddie Moon's instagram.

 

I'm not going to say it's been the easiest or that I absolutely love my body. I've definitely had to process through these changes. And there are times that my husband has to remind me to speak truths to myself rather than the harsh lies I'm buying into. Changing the way I see my body is something that I've had to work on and will continue to work on with regards to helping me to accept my new, healthy body size. A few of my thoughts as I've been on this journey?

The first is just that. My body (and mind) are finally healthy. For the first time since I was a sophomore in high school I am finally having a period without the help of hormones. A sophomore!! Physicians never seemed to think it was a big deal, but it's obvious to me now that my body wasn't spending energy on reproduction because I wasn't giving it enough food and was exercising too intensely. My Raynauds wasn't nearly as bad this winter and my toes were so much happier :-). Additionally, my body temperature regulation is SO much better. I actually enjoy it to be a little chilly now. These are things I have to remind myself of when I start to become dissatisfied with my new extra weight. I feel so much better physically in my body now. 

I've also had to come to the realization that it is unrealistic for me to expect to have the same sized body now as I did in high school. For goodness sakes! It's okay for me to have a woman's body, because that's what I am, a woman, not a girl. I refuse to feel ashamed or guilty for allowing my body to be the size it is supposed to be at this stage in life. Eating disorders often onset during adolescent years when our body's are changing and maturing. We need to do a better job of preparing girls for puberty and having different bodies and of letting them know that these new bodies are good

 
My body has changed and I'm not freaking out about it
 

When I look in the mirror and I see my now larger arms or slightly bigger love handles, I remind myself what it represents. It doesn't represent laziness, being out of control, being less valuable, a source of shame or disgust, etc. It represents my new life and all of its experiences. It represents cozy coffee dates with a friend (or by myself), spontaneous walks to braums for ice cream with my husband, going to social situations and not worrying ahead of time about the food or bringing my own, sleeping in on Saturday mornings, and trying new foods and new experiences. It represents LIFE. What a beautiful reminder to have with me all the time. 

I haven't had to buy new clothes yet, but I am definitely noticing a difference in the way that my pants fit. I've been wearing more stretchy pants or tights to work because jeans are less comfortable. I plan to buy new clothes to fit my body. Unlike what our society says, I'm not "giving up" or "accepting defeat" by being okay with my new size, getting rid of too small clothing, and buying new clothes. Instead, I'm choosing to respect my body by covering it with comfortable and stylish clothes that make be feel good both physically and emotionally.  

 
My body has changed and I'm not freaking out about it
 

It's okay that my body has gotten bigger--I forced it to be too small for far too long. And it's okay for your body to get bigger or softer too. Being healthy doesn't mean that we have to have a certain BMI or body fat percentage. I can tell you that I am the healthiest I have ever been physically, mentally, and emotionally, and that is all the result of easing up on food and exercise and gaining weight. Being healthy does mean that I feed my body the types and amounts of foods that is right for it in that moment, that I move my body in a way that energizes, strengthens, or relaxes me, that I connect with those around me, and that I have the freedom to do the things I truly want to do because my body is no longer holding me back. How about we pursue that kind of health together, regardless of what that means our waist size will be. 

P.S. Listening to Intuitive Eating podcasts such as Food Psyche, Nutrition Matters, or the Love Food podcasts and following body positive/HAES/IE people on instagram (rather than people posting pictures of themselves in bikinis 🙄) played a huge role as well!