Life after recovering from an eating disorder is far from linear and filled with unpredictable directions on the journey to intuitive wellness. One of the most commonly asked questions post-eating disorder is “When can I lose weight?” or “Will I ever be able to explore healthy weight loss” … these questions are complex. They will be different for any person recovering from an eating disorder. Depending on the eating disorder, weight will fluctuate to return to a new baseline, which may very well include weight gain. Weight gain often holds a negative connotation as society has primed people to believe weight gain is unhealthy and undesirable. Weight loss is often associated with praise and success as society projects the desire for thinness. Harm reduction post-eating disorder will help mitigate the potential regression of maladaptive tendencies while strategizing sustainable habits that promote overall wellness. The first step of harm reduction is challenging the narrative around weight. Weight gain is not “bad,” and weight loss is not “good.” Fluctuations in weight are normal and part of being alive, changing metabolisms, life circumstances, health conditions, and wellness objectives. Using these moving parts, we can challenge unhealthy standards around weight in society and create individualized systems for sustained progress.
When referencing harm reduction in substance use disorder, there is an emphasis on every individual having specific needs and incorporating a range of techniques that promote safer, managed habits, which will also apply to the ultimate goal of navigating life post-eating disorder. The following harm reduction principles are adjusted using the harm reduction model for eating disorder recovery:
- Accepts that eating disorders are part of the world of mental health and with a choice to work to minimize the harmful effects instead of ignoring or condemning them.
- Understand that eating disorders are complex and multifaceted and involve a range of intensity from severe to remission, and some are more deadly than others.
- Establishes quality of individual and well-being — not the shame of eating disorder or weight — as the criteria for successful interventions and progress.
- Calls for non-judgmental, non-coercive approaches, services, and resources for those in recovery from eating disorders to aid in reducing relapse.
- Encourages that people with a history of mental health or eating disorders specifically are advocates in the creation of treatments designed to serve this population.
- It affirms people diagnosed with eating disorders are the main agents of reducing the harms of their disordered habits. It seeks to empower others to share information and support each other with efficient strategies.
- Recognizes that the realities of poverty, class, racism, social isolation, past trauma, sex-based discrimination, and other social inequalities affect both people’s vulnerability to and capacity for effectively combating eating disorder harm.
- Does not attempt to reduce or dismiss the real and tragic harm and danger that is associated with eating disorders.
These principles will offer a secure reference point while discussing the reality of risks from traditional weight loss approaches. An average person above the recommended BMI (body mass index) for their height/weight recommendation who decides to lose weight could decide to limit to 1800 daily calorie intake and engage in HIIT high-intensity interval training 4x per week. Risk factors are generally low when someone decides to engage in this weight loss system with a clear objective of losing ~15 lbs in 4 months. When someone with a history of an eating disorder decides on a weight loss regimen, it’s helpful to reflect on the following questions to create mindfulness around the state of the eating disorder, its relationship with movement, and to reduce the risk of eating disorder relapse or excessive exercise.
How do you define your present eating habits?
How do you hold yourself accountable to structure around meals/snacks?
How do you rate your balanced protein intake, vegetables, carbs, fruit, grains, etc.?
Is there adherence to bodily cues, including both hunger and fullness signals?
When do you recognize regression with intuitive eating habits?
What are your concrete objectives around weight loss/weight gain?
What is your expected time frame to reach your wellness objectives?
What’s your relationship to physical movement (including leisure, commute, household, gym, etc.)?
What is your most comfortable form of physical activity?
What is your least desirable form of physical movement?
How much time do you have available to dedicate weekly to exercise?
By responding to these reflection points, you will gain a better understanding of your current relationship with your eating disorder and body. These answers will guide you toward creating a specific plan with your therapist, nutritionist/dietician, and fitness instructor to reach the weight loss/gain post-eating disorder objective. The primary goals are often centered on general wellness, including muscle growth, strength, flexibility, stamina, endurance, speed, etc., rather than any given number on the scale. As we know, numbers on the scale are not an accurate indication of one’s physical health and can be risky for a relapse. Devices that measure muscle mass and overall body composition may be healthier markers for progress than a weekly weigh-in focal point. When people work toward healthier habits within appropriate time frames, they naturally increase their distress tolerance and ability to regulate emotions through a vulnerable experience. Consider the body has reached a new homeostasis post-eating disorder, which will lead to a different rate of weight fluctuation during recovery.
The journey of reaching goals post-eating disorder can feel debilitating and highly overwhelming, although possible with intentional strategy and ongoing support. One of the most crucial parts of life through recovery is the community in place to offer perspective, guidance, appropriate feedback, and emotional safety. Another helpful quality is exercising flexibility in your mindset through the process. Integrate grace and compassion for yourself for all you have overcome and continue to achieve for your body. The goal is not perfection or linear progress but a sustainable relationship with yourself that feels authentic, resulting in minimal harm. Ultimately, your body is a vessel; we are given just one that brings us through all of life. Treat it with kindness, care, intention, and love.
References:
https://harmreduction.org/about-us/principles-of-harm-reduction/
https://www.thecenterforgrowth.com/tips/will-i-gain-or-lose-weight-in-recovery
