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Coping With Weight Changes Throughout Eating Disorder Recovery: 5 Strategies to Try

Maybe you’ve heard it, maybe you’ve said it: “I want to get better, I just don’t want to gain weight!” Unfortunately, there is no magic wand to make that possible – especially when weight restoration is recommended by your team. Decades of research all boils down to an undeniable fact: emotional and mental recovery happen when physical health is reestablished through weight restoration. Body and mind really are inextricably intertwined.

The silver lining is that once you get to the other side of weight restoration, the emotional and psychological healing that is likely to occur can make weight changes more manageable. Many people even come to appreciate their healthy bodies and have trouble remembering why weight ever mattered so much! I know that might be hard to believe right now, but it’s true, and it’s worth it, so I invite you to take the leap of faith. Here are 5 strategies that might help:

1) Focus on Your Values and Motivators

It’s normal to feel uncertain or ambivalent about recovery in general – especially the weight piece. That’s why it’s important to figure out right at the beginning of treatment why recovery matters to you. These things are going to be harder to remember when you’re having a tough day, so write them down on an index card and use it as a bookmark so that you can keep looking back at it when you need a reminder.

To come up with your list, here are some questions to ask yourself.

  • What things do you want to do that the eating disorder gets in the way of? For example, going out for dinner, getting a degree or having a family.
  • How has the eating disorder interfered with your values or who you want to be? For example, many people find themselves being less honest or isolating from family and friends, even though they value honesty and relationships.
  • What do you dislike about the eating disorder? For example, you might dislike thinking about food all the time, the fact that you’re numb to positive emotions or that you lack energy or motivation for things you used to enjoy.

2) Learn about the Process

When you know that weight restoration is part of your treatment plan, you might focus so much on possible body changes that you start to see almost everything as a sign that your weight is skyrocketing. For example, it is very normal to experience fluid shifts and digestive discomfort that make you feel bloated and uncomfortable. These sensations happen regardless of whether or not weight is changing. It’s also common to believe that, since you are eating more, you must be gaining weight. However, your body is often using the added nutrition to make repairs rather than to restore weight.

The bottom line is, when living with an eating disorder, predictions about your weight are usually skewed. Even if your prediction is somewhat accurate, it’s probably not as dire as you might think. Did you know that weight continues to redistribute itself for 6-12 months after restoration? Knowledge is often power, so in this case, I would recommend talking to your team and asking them to explain what is happening to your body and what to expect during the course of treatment. And do your best to trust what they tell you – they’ve witnessed this process many times before!

3) Turn Your Attention Outward

The more we fixate on something, the more distorted our thoughts and perceptions get. For example, have you ever stared at your computer screen for so long that the words and images become blurry? Similarly, when we focus on our bodies for too long – including its appearance and sensations– our perception can become distorted, thus increasing distress.

Break the cycle by purposefully directing your attention outward, away from your body (but not onto other people’s bodies!). Focus on something in your environment, like the view out the window. Make a list of as many dog breeds as you can think of. Call a friend and ask them how their day is going (rather than talking about what’s upsetting you). Color. Listen to music. Read. Anything that pushes body awareness to the back of your mind.

4) Talk Back to the Eating Disorder

Sometimes, it’s hard to shift your attention away from negative thoughts about your body, fears about weight change and body checking behaviors. When this happens, use your values, motivators and what you’ve learned about the recovery process to challenge the eating disorder thoughts or “voice.” Practice disagreeing with it assertively and repeatedly. The more you do it, the easier it will get.

5) Practice Self-Compassion

Compassion is an alternative to judgment that recognizes difficulties as a universal part of what it means to be human. We experience compassion for each other when we notice that someone is having a tough time, feel emotionally moved by their pain, and therefore respond with kindness, warmth and a desire to help. Do the same for yourself: recognize that you are having a tough time and respond with kindness and warmth. Speak to yourself in a gentle and understanding way, like you might speak to a friend. Try putting your hands over your heart or giving yourself a gentle squeeze (corny, but scientifically proven!). If it’s too daunting to give yourself kind encouragement, you might imagine an inner ally, a positive persona who voices kind and encouraging things to you, drowning out or talking back to the eating disorder’s negative voice.

Of course, none of these strategies is going to guarantee you smooth sailing (that magic wand still doesn’t exist). Anorexia, bulimia, and other eating disorder recovery is hard work, but that hard work is part of what leads to lasting health and happiness. If you let your team and support system help, and if you draw on these strategies for inner support, you will get through it. And yes, it will be worth it!

Natalie Hill, LICSW, M.Div., is a clinician in Walden’s residential program. Ms. Hill’s professional interests include Narrative Therapy and innovations in Eating Disorder treatment.