Ask Amalie: "How Do I Know I'm Eating Enough In Recovery?"
Rule of thumb: if unsure, eat more.
“How do I know if I’m eating enough in recovery?”
I get this question from 1-1 clients and group coaching participants on the regular*. Very often, what is an underlying theme when someone ask this question, is fear; fear of ‘accidentally’ or ‘unnecessarily’ eating ‘too much’, and a need for reassurance it is actually OK to eat more. Truth is, there is no such thing as ‘too much food’ or ‘unnecessarily eating’ in recovery, so let’s start by tossing out the mindset that there is some arbitrary limit that thou shall not cross. Implying so is like telling someone who’s been holding their breath for a minute that they must be careful not to breathe too much when eventually gasping for air (credit to Emily Spence for serving this cracking metaphor). Seriously, just gasp. And no, you won’t keep gasping forever.
(Careful there, mate, don’t wanna start emotionally binge breathing!)
But let’s take the question at face value. How do you know you’re eating enough in recovery? To answer this, I’d like to re-frame it slightly: what are some signs that you are not eating enough in recovery? Here are some tell-tale signs (please note you do not have to experience every single one, and these things can be unrelated to recovery and your intake, too!).
After some time, you’re still experiencing classical physical symptoms of starvation, such as feeling cold, poor circulation, restlessness/urges to move OR fatigue/lethargy, dry/brittle skin, hair and nails, issues related to libido, hormones and sexual function (e.g lack of sex drive, and/or erectile dysfunction if assigned male at birth), slow digestion, hair loss, poor sleep and vitamin deficiencies (PS: your blood samples can be perfect even in acute starvation). Some of these may persist in recovery even on a generous intake, as they might take some time to resolve. Hair loss is a good example: you may experience hair loss in recovery, this is a delayed reaction to starvation and has to do with the hair follicles going through their natural ‘renewal cycle’, kind of like leaves falling to the ground and re-growing in spring. Similar goes w/ e.g digestion and hormones: this may take some time to normalise. Other things, such as body temperate, may normalise (or spike, hello night sweats!) a lot faster as you increase.
If you’re someone who normally menstruates (pre-menopausal, post-menarche, assigned female at birth w/o any intersex- or medical condition/treatment affecting your menstruation), periods may be absent, irregular or very light (please note that not everyone who normally menstruates lose their periods during an eating disorder, nor is this necessarily an indication of physical severity - someone can be on their literal death bed with functional cycles). Some also have seemingly ‘normal’ cycles, but w/o ovulation (anovulatory cycles). If you’re on the pill or certain other forms of hormonal birth control, chances are you’ll still have a bleed - this is not a ‘real’ period.
You’re still experiencing classical mental symptoms of starvation, such as food obsession, extreme hunger OR low hunger/early fullness, rigidity and OCD-like thoughts and behaviours (OCD-ED), body dysmorphia, compulsive movement urges, restlessness, low mood or mood swings (anxiety, depression, irritability, apathy, tendency to towards all-or-nothing thinking or catastrophic thinking), increased introversion and emotional numbing (besides anything related to food, of course). Overall, you’re not ‘fully there’ emotionally: still obsessed w/ food, routines, and lacking flexibility.
You’re not gaining the necessary weight in an appropriate time frame (if under your set point range). There’s no such thing as gaining ‘too much’ or ‘too fast’, but there is such a thing as gaining too little or too slow, and the ED loves to drag out the process. Sure, sometimes restoring weight can be a challenge physically, especially if experiencing hyper-metabolism or certain temporary digestive complications from the ED, but the solution remains the same: eat. It does not matter if you’re already on a high intake, if it is not leading to necessary restoration of weight, you gotta eat more!
…Or you’re gaining rapidly on a low intake. This is completely normal and unavoidable in early recovery, and is a sign you’re metabolically suppressed and need to increase your intake further (NOT the opposite). Remember, your metabolism is not broken, it is temporarily suppressed to adapt to a lower energetic intake, and will speed up as long as you give it the time and energy to do so. If you find that you’re maintaining on a low intake, too, this could also be a sign of metabolic suppression and a sign to eat more.
Please note that the physical and mental signs of starvation will be different from person to person, and that there exists far more signs than the one I’ve mentioned above! These are just some classics I see over and over.
(When the universe starts sending you signs via your Heinz Alphabetti you better listen)
Still unsure? Eat more. I’ve never seen someone with an eating disorder who’ve suspected they’re not eating enough, and been wrong about it. What I have seen over and over are people who convince themselves they’re eating enough when they aren’t. Your appropriate intake is an intake that satisfies you mentally and physically (or heck, it might be far over what feels satisfying!), restores your health (e.g physical repair and metabolic restoration) and takes you to your body’s natural set point weight range.
This intake will probably feel ‘too much’ - it’s not. This intake will probably make you feel like you’re eating more than those around you - maybe you are (although the ED loves to overestimate your intake and underestimate other’s) but that does not matter, because chances are those around you aren’t recovering from a restrictive eating disorder and repairing thousands upon thousands of calories worth of damage.
You know you’re eating enough in recovery when you’re physically and mentally healing. Feeling like you’re eating ‘too much’ or ‘more than everyone around you’ is a good start.
(*Moving forward, I will be prioritising questions from subscribers on the ‘supporter tier’ as a thank-you for monetarily supporting my work. By joining the ‘supporter tier’, you also get access to bonus content, incl. bonus podcast episodes.)