What helped me...

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Caitriona
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please read carefully this really helped me but may be triggering so publish at ur own discression
First of all, the bloating and severe gastrointestinal discomfort is happening because you have starved and largely killed off all the bacterial colonies in your gut that are actually responsible for digestion and turning food into energy.

You have to dependably eat substantion energy a day to put enough energy into your system that the bacteria can rebuild the colonies and start digesting properly.

You can alleviate some of the bloating, gas, pain and distention, but eating constantly throughout the day (that means 12 and half snacks a day). After a few weeks of eating enough a day, you will be able to return to normal 3 meals a day plus snacks.
While you allow the eating disorder spectrum thoughts to generate all your behaviors, you cannot recover.

Recovery includes repair.

Your kidneys may fail. Do you know what dialysis entails? You do not have any more room to continue to cater to your ED-skewed neurotransmitters in your brain. They have to be pulled in line because your health is shot.

You are not connecting enough with your immediate health risks and instead spend most of your post continuing to feed the compulsions and anxieties around weight gain. That's totally understandable at this point and not a criticism to make you feel worse -- just a truism that you must face. As you attempt to recover, you will feel an increase in the anxieties around weight and weight gain. I address how to overcome this with proper support at the end of this post.

You have done damage to your body. A calorie is an energy unit. You don't need to burn off food because food is used as energy for all your body's vital functions. If you burn it all off in excessive exercise, then your body literally has no more energy to keep your heart beating.

Work on reprogramming your thoughts.

Be diligent about forcing yourself to think about food as energy for repair.

I'll apologize now for the length of this post, but I want to cover off four more major things:

1) Why do you have an eating disorder.

2) The math of why you need the calories to fix the damage.

3) What to expect in the phases of recovery.

4) What kind of help you need now to improve the chances of recovery.

1) Restriction Eating Disorder Spectrum

One of the unfortunate aspects of recovery from an ED is that some things have changed in your body in ways that do not occur for non-ED people. So I'll first explain a bit about the shifts that happen when ED-genetic mutations are activated with starvation.

When a non-ED and ED person both starve their leptin levels plummet in their systems. Leptin is a hormone that manages metabolism, appetite, bone formation and reproductive hormone function. When we are healthy and taking in adequate energy, then our leptin levels are at an optimal level. When they plummet, two things happen: the metabolism is suppressed and the appetite increases.

For the ED person, the starvation activates genes that shift the normal function of neurotransmitters in the brain. It is these neurotransmitters that generate the anxious and compulsive thoughts, feelings and behaviors surrounding food.

A non-ED person will say she feels irritated, fatigued, hungry and moody when starving. The leptin levels dropping are creating unpleasant moods and extreme hunger to signal to the brain that it is time to go find more food/energy to eat.

An ED person will say she is not hungry. Although experts dispute whether she actually does feel hunger or not, it is clear she feels calmer, energized and dissociated from negative feelings (emotionally blunted) as a result of suppressing her hunger. The ED-skewed neurotransmitters are able to override what the leptin levels should be triggering: unpleasant moods and the desire to eat more.

One third of all people who diet end up on the restriction eating disorder spectrum. While not all of them develop clinical cases, they all experience lifelong anxieties and compulsions around food and weight gain (if left untreated). They can develop clinical cases at any point due to life stressors (anything from a cold to a break-up) and they can slide up and down the spectrum or express multiple facets of the same spectrum at once (anorexia, restrict/binge, bulimia, orthorexia (extreme focus on healthy foods) and anorexia athletica (over-exercise)).

As leptin acts as a gating hormone for the normal functioning of reproductive hormones, a recovered ED patient needs sufficient leptin in her system to normalize reproductive function, bone formation function and neurotransmitter function.

In recovered female patients where their periods have not returned, we know that further energy will be needed to return to optimal leptin levels which is needed for normal resumption of reproductive hormones, bone formation and neurotransmitter function.

Much of our understanding of how to best help ED patients fully recover and avoid relapse has come through the research of W.H. Kaye et. al.

2) The math of why you need the energy

To repair damaged heart, skin, nails, hair, kidneys, digestive system, brain areas, bone and blood formation systems...we need a lot of energy
The less you eat, the longer it takes to recover because the harder it is for your body to find any excess energy to repair the damage.

There is not a cell in your body that is not in need of extra energy for repair at this point.

3) The Phases of Recovery

Digestive distress is common in this first phase: bloating, gas, pain and abdominal distention. You can alleviate this by eating smaller amounts more constantly throughout the day.

Don't be tempted to lower the energy intake because of the discomfort -- just space the food out throughout the day. Yogurt with active cultures will be your best friend.

Coffee tends to increase gut motility (that means moving things faster through the colon) -- which is usually not an issue as most anorexics have very slow gut motility due to starvation. However, do limit coffee intake to one or two cups a day and make sure they are loaded with creams and sugars (ideally) to focus on getting food in the system.

Hair, nails and skin begin to have increased pliability and suppleness.

You also start to feel more connected and self-imposed isolation diminishes. You feels less emotional blunting and start to want things for your life.

A marker for sufficient leptin in your body will be the resumption of a regular period. An anorexic needs to continue increase energy until her periods resume -- she also needs to avoid exercise until that happens.

You can resume modest activity through these final 6 months, however (taking care to add that into the maintenance amount so there is never an energy deficit -- always energy plus 30%)

You will not continue to gain weight. The extra energy intake is used to completely normalize the neuroendocrine system. This final phase is critical for quieting the neurotransmitters in the brain that cause all the ED thoughts and behaviors.

4) What kind of help improves the chance of recovery

You need a recovery team around you that you see pretty-much weekly to ensure some accountability and support.

While your GP is there for the physical check-ups and confirmation that your refeeding is going as planned, she is not too much help (as you discovered) in providing with many ideas on how to up calories etc.

So, a dietician or nutritionist is a great addition to your team -- helping you with food ideas and perhaps meal plans if you find counting calories is creating too much initial anxiety and reactive restriction.

A psychologist or psychiatrist that you like and trust who will offer you cognitive behavioral therapy is the single most effective way of ensuring you have a complete and permanent recovery. If you see one and don't like him or her, move on to the next one. But the accountability of the process will help generate new neuronal pathways that will initially side-step the ED-skewed neurotransmitter pathways and eventually weaken them and override them.

Again, sorry for the huge post but I wanted to give you some background so you can frame your next steps for recovery in ways that will ensure you not only survive, but thrive.

Remember. All the damage, as monstrously serious and severe as it is, is completely reversible at this point. My absolute best wishes to you.

marie
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Hello Catriona, some

Hello Catriona, some wonderful tips and great use of knowledge – well done
Many regards
M

There is always a solution…:):):)

Katy
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Thank You :)

kizzy
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very interesting , thanks
kiz

Michelle
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Caitríona, thank you for this

Caitríona, thank you for this informative and thought-provoking post.
While I dislike some of the labels used (I understand terms such as the different manifestations of ED and 're-feeding' are necessary for professionals exchanging information, but this is a self-help site), I must admit that it was the condition, not myself, with which some of the other content jarred.
And this is a good thing.

The distorted mindset of which I am unfortunately still climbing out of would have me skirt around the bald facts you present here. Getting scared is unhelpful, but ignoring the real dangers we potentially present ourselves with could be very harmful indeed, and I appreciate the reminders of facts I was already aware of, and the new information you've also provided here. Thank you.

There is not a cell in my body that is not in need of energy - this is very important for me to remember.
I CAN trust in nature and science.
Michelle

Caitriona
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hi lilly m this might help

hi lilly m this might help xxx

butterfly
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brilliant post, i have

brilliant post, i have forgotten this post very very informative thnx xx