ED Information |

Recovery

Here is a comprehensive list of all treatments of eating disorders: http://www.something-fishy.org/reach/treatmenttypes.php. All information you could need for treatment of your ED can be found here http://www.something-fishy.org/reach/reachingin.php - the links in the top right corner are useful.

My personal guide to recovery

Motivation
The most important aspect of recovery is motivation - full recovery from an eating disorder is a long hard process. A person has to be ready for recovery and be prepared to change their entire life, rewire all their habits and thoughts, change their entire identity, work harder than they ever had before. All too often people with EDs try half-hearted recovery and because it doesn't work out they give up on it. Often they'll try to please others, maybe just on a whim - it's not enough. A person has to try and try and try, not give up, be determined, be ready for let-downs and hard times, be prepared to modify their strategy over and over, try new things.
EDs are almost always a coping mechanism for dealing with very difficult emotions and situations. A person cannot easily recover if they're going through a particularly stressful and difficult time because they will be relying on their eating disorder to give them some feelings of control and focus, and if one is stressed they will not be able to focus completely upon recovery. It is therefore best for full recovery to be started when the person is quite calm and stable.

It is quite important before one starts that they should get a health check to make sure there are no urgent medical problems before progressing to change ones eating habits and lifestyle, because though the changes are beneficial they could be harmful if someone is sick and needs specialist care.

Behaviours
The first step to recovery is to tackle individual addictive ineffective behaviours - mainly purgeing, laxative abuse, drug abuse, excessive exercise, some bingeing. Motivation to tackle these can be gained from the knowledge that most of them are completely ineffective for weightloss and in many cases inhibit weightloss as well as being dangerous to ones health. Dangers and effectiveness of the various ED behaviours are written on here and tips for overcoming certain behaviours are written here. The hardest behaviours to kick are restricting (and fasting) and bingeing, and these cannot be resolved at this stage easily. Other ED behaviours can be dealt with at later stages if they're too hard to eliminate at this stage.
This is a good stage to complete to help preserve some physical health if one is not psychologically ready for recovery.

Reasons
Throughout the process of recovery a person will go through hard times where they're tempted to revert to their old behaviour. To help combat this it is useful to have a list of strong reasons of why one truly wants to recover.
An example of some things on a list are:
- i want to enjoy my food
- i want to have children one day
- i'm fed up of always having a sore throat
- i want more time to do my school work
Other motivations can be useful too, such as photos of the person from times in the ED when she is really suffering.

Focus & Identity
With an ED the entire focus on ones life is upon the eating disorder. Thoughts about food/weight/etc are never far from the mind, and invade every aspect of the persons life and the ED behaviour holds presidence over any other activity. The ED takes over every part of the persons life, and by taking away the ED the person will be left floundering for some way to cope, something to focus their goals upon. As the ED takes presidence over everything else the ED becomes ingrained as part of the persons identity. They feel like an empty shell without their ED.
It's therefore a good idea for the person to find a new focus for their time, thoughts, and energy, such as a hobby, sport, learning something, etc. Something that they'd be proud to be linked to. This helps to build a new identity too.
It's also helpful for the person to remove labels they have for themselves such as "bulimic" because this engrains deeply into their identity. It's much healthier for such labels to be replaced with new ones such as "student" or "tennis-player".
It often helps to give the eating disorder a name (such as Mia) and view it as a person with a nasty personality who manipulates and harms the person, and as a completely seperate entity to the self, like a parasite.

Insight
It's a good idea for someone to have some understanding of where their ED comes from - what made them the way they are. This could involve certain events, certain people, certain experiences etc.
Talking to others who have insight into their own illness, talking to a therapist, using art therapy, reading about theories of EDs, etc are all good ways of doing this.
Often people get discouraged when they have the insight because they may feel they cannot cope without the ED because they don't know how to cope with the issues raised. However, those who have worked through recovery have found it isn't a problem.

Communicate
Often people who suffer from EDs tend to be very secretive and lonely, and many psychiatrists believe EDs develop as a result of a lack of communication, especially in families. It's important to talk about ones feelings, most beneficial being face-to-face, but in a journal or to a friend or to a helpline are also good options.
It's also very helpful to communicate with others who are attempting recovery too - they are invaluable for good advice and for encouragement.

Triggers
Each person with an ED has certain things which when they're confronted with them causes them to feel tempted to revert to their ED behaviour and/or makes them feel bad about themselves. It is useful to know what these triggers are and to avoid them during recovery. It is hard to recognise when one is being triggered, so it is important for a person to analyse how they're feeling when doing certain things. Some examples of triggers are tight clothing, fashion magazines, other anorexics, diet books, celebrity gossip, thin friends, dieters, etc.

Eating More
It is best for someone to make changes to their diet very gradually and to stick to "safe foods" initially. Taking one meal or snack at a time and modifying it to be a more ordinary is a good way to do it. A lot of anorexics and bulimics may need professional help from a nutritionist or therapist at this stage.
It's a good idea to see how much other 'normal' people eat and to copy them, and some people find it useful to have set 'meal plans' to follow, though this isn't good in the longer term.
Many anorexics or bulimics will binge alongside their ordinary eating, and it is important that they don't get put off, though this is exceptionally difficult. The bingeing does stop however when a person is consistantly eating enough, has returned to their natural weight and is not bingeing by habit (watch out for this!).

Record
It is very helpful for a person to keep some form of record of their recovery in which they voice their concerns, feelings and successes. This can help them evalulate their progress, and if read by someone else any ED-distorted thinking can be challenged. Successes are particularly useful because these can be read back over when one is struggling as encouragement, and encouragement or pride from others is also very helpful.

Rules
Most anorexics and bulimics have certain 'rules' made by their ED, and these should be recognised and slowly broken down. Some examples of rules are "i must not eat carbs" "i should eat no more than 800cals a day" "i must exercise off all calories consumed" "i must only eat 8 grapes at a time" "i should not eat anything with more than 6% fat in" and very commonly "i must check the nutrition labels". Most of these rules inhibit natural healthy eating and the person should rebel against their ED and these rules.
A big part of the rules is "safe foods". A good way to break down rules is to eat foods that are not safe foods, by adding more and more foods to the "safe foods" list. The new additions can be increasingly daring and be a rebelling to the new rules. The person can see this as a fun challenge, trying new foods, and it can get quite enjoyable.

Thoughts
After all of this there will still be thoughts which can inhibit recovery and make the person feel bad about themselves. Often thoughts are overly negative, unrealistic or all-or-nothing. It's a very good idea for the person to recognise these thoughts and to change them to be more positive thoughts, for example omg i've gained 2lbs i'm so fat! should be changed to i've gained 2lbs, however i'm a healthy weight and even though this weightgain is distressing this bad feeling won't last. If a person has particular difficulty doing this herself it is helpful for her to have assistance, such as Cognitive Behavioural Therapy.

Remember
It is important to remember that recovery from an ED is possible, if only to an extent. Many believe full recovery isn't possible, however it is feasable to improve ones quality of life significantly.
ED recovery does not mean getting fat. Recovery involves returning to a healthy weight for ones height, not obesity, and with recovery ones perspectives change so that distorted body image isn't so pronounced.
Recovery is not a failure of willpower - recovery is 1000 times harder than bowing down under the demands of an ED.
Recovery is all about being happy in oneself and achieving psychological and physical health.

The 1000 Challenge

Benefits of raising daily calories to 1000 calories a day:
- your metabolism will be much faster and you'll lose more weight. When you eat too little you burn muscle, and the more muscle you have the faster your metabolism. Also the body slows the metabolism so that it needs less calories to carry out normal functions - breathing, movement, making cells etc.
- you'll be less likely to binge. When restricting or when your weight is lower than it is supposed to, your body sets up cravings for fatty sugary foods.
- you'll burn much less muscle for energy. When restricting or fasting, as much as 90% of weightloss is from muscle. This muscle can include heart muscle (which can cause heart failure) and other important muscles (i was once in contact with a bulimic who was incontinent because the muscle that held in her urine had been burnt for fuel).
- You'll be generally more healthy - less likely to have vitamin deficiencies and so on.
- you'll have way more energy.
- you'll appear more 'normal' to loved ones, and it will prevent them from worrying so much.

The best way to get to 1000cals (or a higher number if you like) is to add 100cals to your daily intake every week. You can go straight to 1000cals, but if you do you might gain a lot of water weight. Remember, it's very unlikely you'll gain any actual weight doing this - any weight-gain will be just water.

Some people struggle to get to 1000cals because they don't know what to eat, as they usually eat such low-cal food, so here's some suggestions:
-carbs (they're not THAT evil - remember that asians use white rice as a staple in their diet, and they remain slim) - wholegrain bread, wholewheat pasta, potatoes, sweet potatoes, brown rice.
-protein - meats, beans, tofu, rolled oats, dairy products, eggs, soy products, nuts and lentils.
-fats - i know they are really REALLY scary, but some are actually good for you! olive oil is okay, as is canola oil.
- some people have the control to eat small quantities of junkfood and therefore could make up their cals with a small amount (bear in mind it's much healthier to eat 1000cals of chocolate a day than it is to eat 400cals of veg!!)

If you gain on the challenge (this is possible if you are small or have severe metabolic damage) and you have been on the challenge and building up calories correctly (adding 100 per week) then try either of these alternative plans:

-do a variation of the 2-4-6-8 which is 6-8-10-12, this will stir the metabolism into action. Any other plan which fluctuates the amount of calories will work too, as long as the average daily calories are around 1000.
-drop your calories to 900 or 800cals. If you do this a higher proportion of your calories has to be from protein and it's a good idea to try and build muscle too, and this will help avoid muscle wastage when you do start to lose weight.

Livejournal users can find extra support with the 1000cal Challenge at this site: http://community.livejournal.com/1000challenge/profile

Awesome Foods to Try

Cottage cheese. This is low-calorie and is full of protein (helps repair damage) and calcium (helps prevent osteoporosis and aids weightloss)
Satsumas/clementines. These are only around 25cals each and are full of vitamin C which boosts immunity and if eaten alongside iron helps the irons absorption.
Green leafy veg. These are low-calorie and are packed with vitamins and minerals.
Potatoes. Normally these are avoided because they're carby and have a high glycaemic index, however they are the most filling food, are rarely binged on (especially compared to other carbs) and can help ease depression.
Bananas. Often these are avoided for the same reasons as potatoes, however they are high in potassium (which is often lost through purgeing, laxative abuse and fasting) and are a great substitute for icecream if frozen.

Self-Esteem First Aid

Name at least one thing you like about your appearance. Name at least one thing you're good at. Name at least one part of your personality that you like. Think of something that you would dislike about your appearance which you don't currently have. Think of a personality trait which you don't have and which you don't want to have. Find someone and ask them for their input on your positive features - appearance, abilities and personality.

Do you hate yourself? If you do, think about why you hate yourself - is it logical? Where did your ideas about yourself come from? If your ideas about yourself are based upon what others have said - are they a reliable source - are you sure they weren't trying to hurt you or influence your behaviour? It is all too easy to adopt feelings about oneself from the comments of others, especially those who are nasty. Also, when you experience feelings of self-hatred, are they really aimed at yourself? Are you sure they aren't aimed at your appearance or an afflication (such as an eating disorder)?

Our Identity

Sometimes we have a habit of assuming that our eating disorders (and other mental illnesses) are part of ourselves when in fact they are seperate - they are more like parasites feeding off of us. It can be useful to think of your eating disorder as a person with a personality - Ana for example is a bitch who tells you to starve yourself because she says you are fat and worthless. She is clearly not a friend, so you should try stand up to her.

When dealing with an eating disorder there is the issue of labelling. Those who attach an ED-label to their identity - "I am bulimic" - are likely to conform to the stereotype of their ED and resist recovery. Therefore it's best to relabel yourself - "I have Bulimia Nervosa" which means you don't have to conform and therefore get sicker, and you can recover, and potentially gain a new ED-label "I am a recovering bulimic" or even better "I am recovering from Bulimia Nervosa".

It can also be helpful to look at other areas of your identity and focus on those - you are not your eating disorder. Old interests and hobbies get discarded in favour of the eating disorder and subsequent depression - try taking these up again or find new hobbies and excel in and enjoy something different and more worthwhile. Hobbies and interests can build self-esteem and give you an alternative focus and a feeling of pleasure. It is also worth making up with old friends and making new friends - they can instil a sense of normality, build your self-esteem and identity, can share hobbies and interests with you and boost your mood.

Calorie Restriction (CR)

(Please note - this is not referring to restricting like anorexics participate in, it is referring to very controlled restriction to 200-400 calories below the recommended amount)

- It is possible to channel the urge to control food intake and not gain weight that is associated with anorexia into Calorie Restriction.
- Studies show Calorie Restriction prolongs life and makes one healthier.
- It is difficult to attempt to turn your eating disorder into Calorie Restriction alone, though if you are interested visit http://www.calorierestriction.org and http://www.net33.com/thin/ (this site is owned by an anorexic - a BMI of 16.5 - who has been following a CR diet for 30 years and is healthy and happy, and is currently working with other anorexics to develop CR is an alternative to standard anorexia treatment) for more information.

Useful Websites

http://www.freewebs.com/wannarexia/ - Our sister site aimed for wannarexics (but can be useful for anyone), with good healthy weightloss tips and self-esteem boosters.

http://king-josie.livejournal.com/321479.html#cutid1 - Self-help recovery guide.

http://www.something-fishy.org/default.php - A really comprehensive pro-recovery website.

http://www.b-eat.co.uk/Home - A UK pro-recovery website.

http://www.webiteback.com/links.htm - Pro-recovery links.

http://en.allexperts.com/q/Anorexia-Eating-Disorders-1604/index_all.htm - A service where you can ask an eating disorders expert a question, and they will reply within 3 days.

http://famine.brokensanity.org/ - a pro-reality site.

http://www.freewebs.com/builtonadream/index.htm - Cauliflower000's ED website.

http://community.livejournal.com/ed_ucate/ - discussion of ED-related topics.

http://community.livejournal.com/1000challenge/ - support with the 1000 Challenge and related pro-recovery efforts.

http://community.livejournal.com/ed_recovery/ - ED recovery support.

http://nhlbisupport.com/bmi/bmicalc.htm - Body Mass Index calculator.

http://www.bodybuilding.com/fun/core_march_8.htm - An article about the disasterous effects of restricting upon the metabolism.

http://www.freedieting.com/tools/calorie_calculator.htm - A daily calorie needs calculator (not totally reliable, especially for those with EDs with slowed metabolism).

http://www.caloriescount.org/cgi-bin/calorie_calculator.cgi - Calories in foods.

http://www.primusweb.com/cgi-bin/fpc/actcalc.pl - Calories burnt doing different activities.

http://www.caloriesperhour.com/ - Many weightloss tools including calculators, tips and forums.

http://convert.french-property.co.uk/ - Calculators to convert between imperial and metric measures.

http://www.primusweb.com/fitnesspartner/library/weight/0698metabolism.htm - Information about the metabolism.

http://www.skwigg.com/ - Awesome articles and advice. See what happens to typical wannarexics: http://www.skwigg.com/id32.html

http://www.bodybuildingforyou.com/articles-submit/faisal-khetani/3-keys-burn-fat.htm - A huge list of weightloss articles.

http://www.starbucks.com/retail/nutrition_beverages.asp?cookie%5Ftest=1 - Starbucks calorie counters.

Tips

Stopping Purgeing - Tips

-remind yourself continuously that you're only getting rid of less than half the calories

-read horror stories of purgeing gone wrong (see the Purgeing page of this site)
-remind yourself of how it can make you ugly with yellow teeth and hamster cheeks (only works for some though)
-if you use an object to purge - get rid of that object or put it somewhere hard to get to
-sit with a sickbowl after eating and put a treasured possession in it and consider throwing up over that (i did it with my teddy - i was only 14 when i gave up..)
-remind yourself that others have given it up and so can you
-give rewards for when you dont purge, or go a certain amount of time without
-plan exercise to replace the purgeing
-if you're taking a gradual approach - try only allowing yourself a certain number of purges per day

Stopping Laxative Abuse - Tips

- try switching to a healthier alternative such as herbal laxatives, laxative teas, prune products or fibre pills (though bear in mind these aren't healthy to abuse either, but are an improvement upon normal laxatives)
- alter your diet to include high-fibre foods such as fruit, vegetables and wholegrains to counteract any constipation you experience when coming of the laxatives
- drink plenty of water, take diarrhoea replacement salts and/or eat bananas to try preventing strain on the heart from dehydration and electrolyte imbalances
- throw out any laxatives at home and make it difficult for you to obtain more
- cut down slowly - only allowing yourself a certain number per day
- reward yourself when you're successful with your goals
- remind yourself constantly of why you're giving up laxatives

Preventing Binges - Tips

- eat as much as you can per day whilst still losing weight (this has many added benefits too)
- eat foods high in fibre and with a low glycaemic index (wholegrains, fruit and vegetables)
- fill up on low-cal foods
- try not to have much sugar, but let yourself have some to prevent denial - dark chocolate, wholegrain cookies/biscuits and flapjack all have sugar plus added benefits
- don't completely deny yourself any particular foods
- change your routine and environment so you avoid binge-situations
- eat some oil/fat each day - nuts, hoummous, olive oil and canola oil are good sources
- don't consider a day ruined if you binge (make a chart with days divided into sections - for example, morning, afternoon and evening (if bingeing is bad, more sections may be needed, and they may need to be in specific times, like 10am til 1pm). If at the end of the section you have eaten what you were planning and have been �good�, mark the section with your favourite colour. If you have eaten something you regret and have been �bad� mark it with your least favourite colour. At the end of the day you can say a certain fraction of your day was �good�, and this encourages you to keep any bingeing within one section of the day and therefore binge less.)

If binges are a persistent problem see a doctor, especially if you're overweight - sometimes binges are caused by physiological problems.

If you tend to binge as a way to deal with emotions:
- try looking for therapies to help Binge-Eating Disorder and Compulsive Overeating Disorder
- attempt to find different ways to deal with the difficult emotions
- find out about sugar addiction and sugar sensitivity if your binges are primarily on sugary food and you feel out of control - a physiological addiction to sugar isn't generally acknowledged by the medical community yet but there are treatments for it available - see http://www.radiantrecovery.com/

ED Information