The Dreaded ReFeeding

Re-Feeding is something that is overlooked frequently in the medical community. It is mostly associated with people who were once prisoners of war, or kids from a third world country who never had proper nutrition, but this is something very common in the ED community of survivors. So, what is it?

Re-feeding is when a person finally has access to proper nutrition after a prolonged period of malnutrition. Though binge eating and people with obesity are sometimes malnourished despite their size or weight, the re-feeding is most severe in anorexics, bulimics, and ruminators for the simple reason that food in these sub types don't usually digest food.

Your body's ability to learn how to digest and absorb nutrients is hindered after an extended period of starvation. I like to use fitness metaphors as much as I can to explain this painful process.

Think of it like this: If a person spent 24/7 on the couch, never engaging in any type of exercise, but then one day decided to hit the gym and do a 5 hour total body workout; what do you think the outcome would be? PAIN! All of those muscles that haven't worked in a full year, were challenged and stressed so much that the persons' entire body would be in some massive pain and discomfort! The same is true in re-feeding, but unlike an exercise routine, re-feeding could be life threatening if we aren't careful.

Food provides nutrients. Nutrients provide our body with the ability to produce hormones, thought processes, movement, etc.....nutrients are necessary for sympathetic and parasympathetic nervous system function. Nutrients give us the ability to make voluntary and involuntary movements and functions.

If a person starved of nutrition all of a sudden overloads their body with certain fats or vitamins, the body may not be able to take on that metabolic load, resulting in some pretty serious stuff.

In my re-feed, doctors warned me of taking in too much fat, because they feared I would have a heart attack. They were right to warn me. They also let me know that eating too much, too fast, could put pressure on my already fragile diaphragm and esophagus which could cause a rupture and death.

Beyond the possible harms of improper re-feeding, we need to take a look at some other issues associated with it.

• BLOAT

Bloat isn't just a distended tummy. For recovering EDers, bloat is a sign that the body still isn't functioning properly. Food is not moving through the system effectively, or it could be delayed "emptying" known as Gastroparesis. This is also something many severe EDers suffer from that goes undiagnosed. It is never good to blow off the bloat as being "just gas", or constipation. Bloat can be the sign of something more serious.

• SWELLING

Swelling of tissue is called EDEMA. Edema is caused when fluid gets built up in the body. Since an EDers' body is not used to the processes of digestion OR elimination, you may start to swell and retain fluid. This causes some massive discomfort, along with the psychological distress of seeing one's body in a truly bigger, puffier form (every EDers worst fear). In my case, I would wake up with one hand double the size of another! On one occasion, I even woke up with a "micro- penis" from edema that occurred in my vaginal area! Thank goodness edema is temporary, right? Wrong. Depending on the seriousness of the eating disorder, you can have life-long edema issues, like me.

• CRAMPS

Not only can we look forward to menstrual cramps when our periods return (after hormones regulate), we also have to deal with the cramping in our bladder, and intestines. Those muscles and organs have gotten lazy from lack of use, so when they start getting some exercise, they have to remember how they were originally intended to function! EDers have groomed their bodies to take some serious abuse, so flipping the script on our own structure and expecting it to just know what to do without the proper training is a tall request. You just have to be patient with this.

• IBD/IBS

When your body is training itself to function again, you have to expect a few hiccups. If you're lucky, the issues of IBS or IBD will eventually pass, so I'm not a big fan of getting on any type of medications during the re-feeding process. You have to just let your body learn what to do. My IBD never ceased, but it has gotten much better as my nutrition stays consistent.

• CRAVINGS

I always hated beets, but man, when I was re-feeding, that was all I wanted! After speaking with my doctor, I was informed that my body would crave certain foods that possessed particular nutrients. My body wanted iron, so I craved a veggie that was rich in iron! When I needed potassium, I had bananas on the brain! I still find the human body so amazing, and this is one reason why! Always listen to your body!

• BRAIN FOG

When your body is finally getting nutrition, you have to understand that your mind will start to fire differently. There will be times when your sight is blurry, then clear. Times when you can remember a conversation word for word, and times when you can't recall even having a conversation. Don't panic! Your brain function is heavily dependent on what you feed on. EDers have trained their brain to function on nothing, so when food is reintroduced, you can imagine there will be some funky days, and even weird dreams!

• NIGHT EATING

I thought I was going crazy when I would wake up with a peanut butter jar next to my headboard, and pretzel crumbs under my pillow, until my then-fiancé woke me up while I was sleepwalking.....or should I say sleep EATING!!!! Your body knows it needs food. EDers are notorious for depriving ourselves. So, when we are unconscious, we have been known to get up and find something to consume. In documented cases of night eating, many have reported to eat straight mayonnaise or even dish detergent! It hasn't scientifically been recorded that this is an issue in the eating disorder community, but through my own communications with survivors, this is fairly common.

• NO POOPING

This one is tough, because it adds on to the other issues such as bloat and cramping, but one thing to remember is that the body is going to hold onto nutrients for fear that it won't get them again. If your feed on a regular timed schedule, you are putting your body at ease knowing that you are not going to deprive it of nutrients again. It might take a while, but the more regularly you consume food, the quicker your body will catch on and start eliminating what it no longer needs.

• HOT FLASHES

Hot flashes can sometimes occur when your metabolism starts to function properly again. When there is energy available, it needs to go somewhere. Hormones play a major part in re-feeding, so again, don't panic if you start to get the sweats here and there.

• MENTAL TORMENT

There are many things that happen during re-feeding, some are positive like increased energy, hair growth, better skin, balanced hormones, and clearer thinking; but there are the hard times too, like GERD, acne, and the things I already listed. The biggest hurdle in re- feeding is the mental torment. You have to face the fact that you chose to abuse your own body. For whatever reason, no matter how valid it seems, you chose this mode of coping, and now you are faced with the painful process of re-feeding in order to survive. Many of us feel like losers. Some feel ugly. Some feel like "what's the point?", or "what did I do?!" Feelings of guilt, shame, embarrassment, fear, and frustration rear their ugly heads. Our moods will swing when we are saying goodbye to our old "frenemy" and are scared of what's to come.

I want to say, even with all of these issues, whether temporary or permanent, it is COMPLETELY worth going through the pain. Life without an eating disorder gnawing at your mind, body, and soul is like being reborn. Almost nothing is worse than living with an eating disorder. Your new life is going to be amazing, no matter what it feels like now.