Roadblocks to Recovery: When Hunger (Doesn't) Strike

This particular roadblock wasn't on my list of cons to recovery, but I just realized how relevant it was.

(Not) feeling hungry

As I've started my new job, I've noticed that no matter how many hours I go without eating, I don't get hungry. There are any number of factors to that, not the least of which are I'm really busy, I'm around food and so "full by osmosis," and that it's hotter than Hades in the bakery. When I get done with work, my hunger cues return to their post-ED norm. But at work? I don't feel hungry. I just don't.

This makes it really hard to eat my dinner and snack when I'm not even hungry. The ultimate problem is that I feel I have to rationalize my eating. Maybe it's that someone is watching me, or that I want to at least pass for normal at a group luncheon. Or maybe it's that I know I'm going to pass out if I don't eat something quick, even sometimes if my hunger is gnawing at me and I know beyond all reasonable doubt that I need to eat something. But eating when I'm not hungry (and no one is watching me)? I feel so absurdly guilty. I tell myself I don't need this sandwich, this piece of pizza. I don't. I'm not even hungry! Why should I eat?

Why, indeed.

It's easy for me to say things like "An eating disorder may mess up your hunger cues so don't rely entirely on them," but it's another thing entirely to live this statement. Much of my treatment involved schooling me in the theory and practice of intuitive eating. For those who aren't familiar with intuitive eating, the premise goes something like this: eat when you're hungry, stop when you're full. When I was freaking out about weight gain, my dietitian told me that as long as I ate when I was hungry and stopped when I was full, I wouldn't gain weight.

I don't blame her for making this statement (it is both true and useful), but it also didn't account for all of the times when it is time to eat but I'm not hungry. It feels somehow wrong to eat (yes, even after all of this time), and to eat when I'm not hungry seems almost heretical. Before the AN struck, my appetite was just fine. I wasn't a huge eater, but I got hungry rather predictably and all was well. I know that all of these years of having this eating disorder have probably messed that nice little system up. Maybe it will come back, maybe it won't. It's certainly not a reason to throw in the towel and give up. I need to work with my body, as it is right now. And that might mean eating when I'm not hungry or eating at times that I haven't designated as "meal" or "snack."

Part of this, too, is breaking all of those rigid rules I had for so many years about what eating was acceptable and what wasn't. It's hard to trust that my body won't tell me it's hungry when it doesn't need food, and then to hold off on trusting it entirely to tell me when it is hungry. What I need is a system to help me eat when I need to and flexible enough to accommodate everyday life.

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9 comments:

Cammy said...

I am definitely dealing with this too. My hunger cues are completely unreliable, and often absent. And I find that if I don't stay on top of my eating, sometimes the less I eat, the less hungry I feel, which is a dangerous recipe. I don't know if your D still has you keeping food records, but mine has me record my hunger before AND after eating (on a 1-10 scale), just to get me to start paying attention to those sensations more. I think that sometimes when we're busy or in a new situation, it makes it way easier to ignore cues that we're still learning to recognize again, and it takes a while to repair the distrust between brain and body that's involved in recovery...
Great topic, as always!

Cathy (UK) said...

I agree with Cammy; great topic.

Not feeling hungry when I'm 'supposed' to feel hungry (i.e. because of being underweight, and because it was the 'right time' to eat) was one of the biggest barriers to my recovery.

And so I return to a comment I left at the end of yesterday's post to an individual who commented:

"If people can't tell how much they
are eating by listening to their own bodies, publishing calorie counts would be such a crutch that it would ruin any chances of their learning to do that."

It is well documented that in all EDs there is a dysregulation of appetite such that it doesn't equate to bodily demands. This dysregulation and poor interoceptive awareness can play a significant role in the driving of an ED. For these reasons people may over- or under-eat.

After many years of restricting anorexia nervosa (AN) I had virtually no appetite whatsoever. This was in part because of 'faulty' messages linking body and brain, but also due to the physical effects of starvation - especially gastroparesis.

Had I continued to eat in accordance with my (absent) appetite I would be dead by now. In order to gain weight (> 30 pounds - which saved my life) I had to eat a LOT more than I felt like eating. It was ESSENTIAL for me to count calories as a I gained weight to ensure that I was eating enough (i.e. > 2000-2500 kcals/day).

Just as I had obsessively counted calories while restricting, I had to count calories to gain, to retrain my body to eat enough and to meet its nutritional requirements.

Abby said...

I actually just posted something similar about my "rules" and regulations towards meals and snacks. I always eat by the clock, but at the same time I get anxious thinking I'm going to be hungry (rarely happens) and will either (a) not have something available or (b) have something available, but it not being the "right" time to eat. And while I hate the anxious-if-I'm-hungry thing, I like being hungry because then I know my body is actually ready--not just my head (as my head is always ready).

Anyway, I'm never "hungry" and often wish I was, as then I would feel permitted to increase all the time. As it is, I realize I can't do intuitive eating and trust my body know--essentially going against all conventional advice--as it's still rebelling. Trust the process and not my brain, I guess.

A:) said...

I find now -- almost weight restored, I occasionally get hungry after long stretches without eating (5+ hours) -- however, I am definately not hungry ever 2-3 hours. It would be hard for me to eat intuitively and I am definately not ready for that yet.

That said, I find it hard to differentiate between "wanting more" and actually being hungry. This would be problematic for intuitive eating. Even deep in my AN, I loved food. I have no problem with spacing meals out which are 6-8 hours apart, but I also have no problem eating a snack 1 hour after eating dinner. This concerns me.

Strangely, I have never been a binge/purge anorexic and I have always restricted. The idea of a planned binge is foreign to me, but this love of food is quite contrary to what I think of in restricting AN.

Recovery is full of opposites. Sometimes I want food and am not hungry and sometimes I want nothing to do with it. Sometimes I am hungry at appropriate times and sometimes I am not.

I wonder if I am the only one who feels this way?

A:)

Carrie Arnold said...

A,

If it makes you feel any better, I totally relate. I think it's normal to see food and want it, even if you're not hungry. And yet it is very frightening to want something you're simultaneously terrified of. In some sense, working in the bakery has given me lots of exposure to these conflicting feelings and I'm starting to become more comfortable with "Oooh that looks good" even when I'm not hungry. It also helps to know that I don't need to have whatever I'm craving right at that very second if I'm not hungry; it will still be there later or tomorrow or the next day when I am hungry. I've brought a few items home (with the 20% employee discount, it's not too overpriced) because they did look good and I knew I would like them but I had no desire or time to eat them while I was working.

Danielle said...

Hi, I have been struggling with this very same issue for years. I have never met anyone who understands. Everyone tells me to just eat. They can't comprehend how it really isn't that easy!

Thanks for your blog. It is an encouragement to know I am not entirely alone.

I have my first appointment with a nutritionist today. Hoping it goes well.

Kim said...

Thanks for this, as this is a major issue for me still. My appetite vanishes so often, and it's incredibly frustrating. The idea of "intuitive eating" frustrates me too. Eat when I'm hungry? Um, ok, I'll starve then. That doesn't work with me. The closest I get to intuitive eating is considering what kind of snack I want come snack-time. I don't feel like I'm at a place when I can decide whether or not to HAVE a snack. I hope it gets better... It's a really hard part of recovery.

Katie said...

I wasn't ever aware of being hungry when I was actively restricting, but once I'd increased up to a weight gain intake in recovery I was hungry all the time right up until I got my period back. I never felt stomach hunger, but I always wanted to eat at the times I usually ate, if that makes sense. But funnily enough, I'm struggling with this at the moment. I've had a lot of stressful stuff happen over the last few weeks and my appetite has disappeared. While I was gaining weight, if I didn't eat at my usual times I would feel shaky, sick and confused, but now I'm weight restored my blood sugar seems to behave itself just fine so I don't realise that I've drastically over-shot dinner time or whatever until I look at the clock. I never thought I would say this, but it's actually really annoying. I wish my stomach would remember what hungry feels like already.

Angela E. Gambrel Lackey said...

I have also been taught about intuitive eating, but if I went by that I would eat maybe once a day. I rarely feel hunger; oddly enough, the few times I do feel hunger is after eating something like a snack or small meal.

So I just eat by the clock; time for breakfast, time for lunch, etc. It makes life a bit rigid, especially around dinnertime because I can't get it out of my head that I shouldn't eat dinner later in the evening.

The hard part for me is whenever I get depressed, anxious, or stressed, any hunger I might feel goes out the window. I've always been that way, even pre-anorexia.

I'd love to eat intuitively, or even eat without really thinking about it - just eat because it tastes good — instead of calories and what the food could do to me floating in my head with each bite.

LIke someone else who posted, when I weight-restored last year (I'm back at it again due to a relapse), I had to count calories and was consuming about 3,000 calories daily for months to gain weight. I never felt hungry; in fact, I always felt at least slightly too full and bloated. That's why I am so reluctant to weight restore now; it just wasn't a pleasant experience.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote



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