Should NG Tubes Be Used In The Treatment Of People With Eating Disorders?

When it comes to treatment for people with eating disorders there are many different options and interventions to be explored, various therapies, meal plans, pieces of group work and even hypnotism. However, alongside all the perhaps more psychological treatments, there are other more invasive practical treatments that can be used such as the NG tube (a tube that is inserted through the nose and into the stomach to feed a patient who is unable to consume food orally themselves), and this is something I never had much of an opinion on before it happened to me recently for several weeks of my admission to hospital. It may seem silly or odd to be bringing this up now as my tube came out over 8 weeks ago so surely I should be over it and not thinking about it anymore, but I have to say that even though it has been a while since its removal, the method of being NG fed still affects me to this day, is a fairly traumatic thing for people to go through, and it has made me wonder whether or not NG feeding should actually be used in eating disorder treatment full stop. 

Obviously if I am going to open up a debate in this blog about whether or not NG tubes should ever be used I am going to have to say that aside from all the ethical, psychological, long term effect complicated sides to the issue, bluntly yes NG tubes should be available as a way to treat people with eating disorders. Despite their perhaps negative side effects down the line, it makes no sense to rule them out completely (unfortunately…I really hate admitting this…excuse me whilst I go away and grumble). 

Sometimes, whether we like it or not, NG tubes are life saving necessary pieces of treatment and there are people out there who arguably would have died without them. If a person is unable to nourish themselves adequately and becomes seriously medically compromised, sometimes the only option is to NG feed them as a matter of saving a life and I know that, as much as I disagree with the methods used on me and wish more than anything it hadn’t happened, that that is the argument doctors and nurses have had with me in defending that method of treatment. 

Aside from life saving serious stuff, NG tubes can also be positively used not just for getting nutrition into people but for providing a motivation to eat orally despite the screaming eating disorder wailing in their head like a banshee who just stubbed her toe on a particularly sharp piece of lego. 

When someone is struggling to eat because of an eating disorder it is often made harder by the fact that eating always feels like a choice, an option you actively choose to partake in, and who would choose to torture themselves by forcing themselves to eat when they knew their brain would go off screaming at 90 miles per hour? With an NG tube in place however, the act of getting nutrition is no longer an option or a choice, it is going to happen one way or another and with this choice of whether or not the food will go in eventually being taken away, sometimes eating becomes easier. 

Personally I can at least admit and testify to the fact that I found the NG tube helpful in the sense that it did motivate me to eat because the choice was taken away. No longer did I have the raging debate of “do I eat or don’t I”, it was just a matter of how it was going to go in/happen (“up the nose or down the throat” as I used to think). It also gave me encouragement to eat in a way because there were times when I knew that if I didn’t consume what was in front of me orally, I would get an increased number of calories down the tube and that certainly served as some motivation! 

Indeed at my unit there was a rule that I was presented with a meal and if I were not to complete it, the entire meal would be started again via the feed. Therefore if halfway through a meal I was struggling and really wanted to give up, having the tube there motivated me to carry on as I knew that were I to stop, we would have to start all over again and I would essentially end up having to go through the same meal twice. NG tubes can also be helpful in the sense that they offer a way for medication to go into a patient when a patient is unable to take a medication themselves (another thing which I hated and disagreed with personally but can understand is necessary in some circumstances.) 

As I said at the beginning of this debate however, alongside these positives there are a lot of negatives and it is the effect of these long lasting negatives that I am still feeling today. You see, when you have an NG tube, it takes responsibility for eating away, and whilst this is a good thing when a person is unable to eat by themselves, it is a bad thing because in learning to eat again or going through the re-feeding process they are not actually learning how to do it for themselves. Indeed, people go from needing the tube in an emergency situation to becoming dependant on it and that is what happened to me. For the first few months of re-feeding I was going through the motions but psychologically was making no progress and then when it came out I didn’t know how to eat. Without the tube, suddenly the guilt became much worse because eating went from being the lesser of two evils with the tube in to simply “evil”. 

Another negative from using an NG tube and perhaps the one I am struggling the most with today is that of rapid weight gain. When you are on the tube it is possible to gain a lot of weight very quickly that mentally you are not ready or prepared for and although it can again be life saving and good treatment medically, it can be an incredibly traumatic experience. Similarly, now I have been left at a weight far higher than I am comfortable with because of the tube and because I reached this stage far quicker than I would have done without it, I am still struggling with the repercussions and am feeling overwhelmed. 

In terms of trauma it can also be a traumatic experience to be restrained for feeds and when this happens it can damage the patient vs treatment team relationship. For example I used to trust my treatment team and even get along with a lot of them, but if I am honest, now I resent them all and want to be discharged from the entire service because the act of having something so traumatic being done to me has led me to dislike and mistrust them all. Having something like an NG feed physically done to you whilst you are held down means being treated as an object not a person, there is no therapeutic benefit, you are just a thing being pumped full of stuff you are terrified of with no chance to work through it or figure out a long term solution at home. It is a temporary fix and though you can force feed someone food, you cannot force feed them long term recovery, so in a sense the NG tube method is unhelpful long term. Then again that is just my experience and I know that for other people actually starting with an NG as a temporary measure can help long term as it gets enough nutrition for their brain to work and allow recovery long term afterwards so it really is all down to personal experience. 

Overall then, should NG tubes be used to treat people with eating disorders? Well, I don’t know is the honest answer, it is a tricky one because I think the answer will be different for different people. For some people using the NG tube is not a matter of something to be debated but a necessary life saving act of treatment and sometimes it can even help long term recovery by motivating someone to eat orally by taking away the choice. Also the more nutrition someone gets the more likely it is that their brain will be receptive to treatment but then again there are the negatives of cases like mine where I have been fed up to an unbearable weight via physical methods without going through the proper therapeutic work, meaning that I am now stuck unable to deal with it and thus struggling with relapse. I don’t think when it comes to this question there will ever be an answer for everyone but it is certainly a controversial topic that I think we need to keep working on and talking about. 

Take care everyone x 

NGdebate

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The Difficulty Of Eating In Public When You Have An Eating Disorder

To the average person the idea of going out to eat is a pleasant one, and when someone suggests going out for a coffee and a piece of cake in a local cafe or out to dinner at a fancy Italian restaurant, the usual reaction would be “Why yes what a lovely idea”, or “of course! I think I shall order the lasagne”.
To someone with an eating disorder however, it is likely that the idea of eating food out will be a terrifying one, reserved to the realms of nightmares rather than sweet dreams, and if you are anything like me when it comes to life with my eating disorder, it is likely you would rather dance a tango with a giant hairy spider than go out to “grab a bite to eat”. It is for this very reason that when I was in ward round this week and I was told that I had to go out to a local coffee shop for a snack with a member of staff, I started to wish there was a chance to whip out my dancing shoes and go to a ballroom with an enormous arachnid instead.

It is silly really because like I said, as a rule people generally enjoy going out for food (even if, like my mum, that is simply because you don’t have to wash up at the end of the meal), but for me there are so many things to be scared of and I don’t think people realise just how many things there are to worry about when it comes to going out for something to eat when you have an eating disorder rampaging in your frontal lobes.

First off there is the difficult task of looking at a menu and choosing what you are going to eat. Alright you may have to make some food choices in the home or out at the supermarket, so choosing food shouldn’t be a sudden and new experience, but at least with that kind of thing you can plan far in advance and prepare what you are having yourself so you know exactly what the meal comprises of. When you are eating out however, the ability to plan everything and control each stage of the process is whipped out from under you quicker than a slippery yoga mat on a vaseline coated floor. Ok, nowadays most restaurants and cafes tend to have menus online so in a sense you can prepare for what you are going to attempt and do not have to make a choice on the spot, but even if you make a choice from an online menu you can never guarantee that what you decide on will be available in the branch of the restaurant that you visit in particular. What if you have your heart set on the roasted aubergine spaghetti and then get to the table only to be confronted by a waiter breaking the news to you that they are all out of pasta and severely lacking in terms of aubergine supplies? What if you get your head all psyched up to tackle a chocolate muffin with multicoloured sugar strands and then find that the muffin man got caught in a traffic jam on the way to deliver his cocoa rich rainbow sprinkled delights? HOW CAN ONE RELAX AND MAKE A DECISION WHEN THE WHEREABOUTS OF THE MUFFIN MAN AND AUBERGINES ARE ALL UNKNOWN?

Then again, what if the aubergine harvest has been plentiful and the chef can prepare your chosen dish? How are they going to prepare it? How much pasta will they use? Will there be oil? Will there be butter? How will it be arranged? Will the sauce be served on top of or mixed into the spaghetti? Exactly what kind of concoction should you expect? Also what if you can’t even get that far and can’t make a decision as to what to have in the first place, either because there are too many options or not enough safe ones? When it comes to people going to restaurants a little bird told me (a very little bird. about half the size of Tweety Pie to be exact) that people chose what they “fancy,” but again when you have an eating disorder and find most of your decisions controlled by calories and grams of fat, what exactly does it mean to “fancy” something?

Even when food is chosen and aubergines can be found in abundance, the worries don’t end because then you have what I would say is the hardest thing about going out for food and the thing that I worried about most after this news about a snack out had been broken to me: eating in public. Indeed the choosing from a menu worry wasn’t even what made me anxious about the excursion as when I went out for snack with my nurse I actually took the food with me to the coffee shop from the hospital (not that that is technically allowed in terms of coffee shop table taking up without making a purchase regulations, but when you are terrified and have an eating disorder you don’t give a damn about the rules!), so it wasn’t the menu issue but the eating in public part that was troubling me.

Truth is, when I eat I prefer to do it in private because even though I am well aware that other people have too many things on their minds and in their lives to have space to think about what is on my plate, I am always paranoid that everyone around is looking and judging me for every mouthful that I consume. Why do I care what random strangers have to say about my choice of snack of an afternoon? I have no idea. Why do I think that a business woman on her lunch break or a student cramming for an exam over an espresso and a laptop, care about whether or not I eat a hobnob? Who knows, but regardless of the reason, I do care and I care a lot. For other people I do not see the act of eating as something to be ashamed of at all but when it comes to me there is something so guilt and shame filled about it that the idea of eating in public is sort of how I imagine the idea of showering in public would feel to most people, aka self conscious and like you want to throw a sponge and curl up in a ball so nobody can see you.

No matter what you do or what you eat, it feels like everyone is staring at and judging you, even if you can see for a fact that others around you may even be eating more than what you have on your plate and are not actually looking anywhere near your direction. When I was out for snack there were plenty of people busy reading papers over plates far fuller than mine, yet still I thought that they were somehow looking at me with some kind of laser vision and thinking that I was greedy for attempting what I had before me. It was so bad that just to get through the snack I had to close my eyes and play that childhood game where you imagine that because you can’t see other people ,they can’t see you either (side note: it is surprisingly hard to eat a snack when you can’t actually see it…).
Somehow I got through it using my head down, eyes closed, just keep munching method but still it was a horrendous experience and one that I am not planning to repeat in the near future or ever if I can help it.

Overall then, though it would seem that the idea of eating out in public, either for a snack or a meal, is some kind of treat to be looked forward to, when you have an eating disorder, it really isn’t that simple a task nor is it a particularly enjoyable one either. Like I said, I know I for one am not going to be attempting such a thing again voluntarily simply because even without the ordering stress and malarky it is the actual act of eating in public and being judged (however irrational that thought may be), that causes all of the anxiety. A snack out in a coffee shop may be a piece of cake physically, but in practice I can assure you that it certainly isn’t! PLEASE DON’T EVER MAKE ME DO IT AGAIN!

Take care everyone x

EatingPublic

5 Ways To Deal With Weight Gain When You Are In Recovery From An Eating Disorder

If I had a penguin for every time I have heard someone say or have said myself “I want to recover from anorexia but I don’t want to gain weight”, I would have more penguins than exist on this planet and would therefore have to get the existing penguins to rapidly reproduce in order to make up numbers (which is why all the penguins of the world are probably grateful to hear that I don’t have to have a penguin for every time I have heard that sentence or else they would have a lot of egg hatching to do).
Admittedly, there are many sides to the Rubix cube confusing madness that is recovery from anorexia, both mental and physical, and there are a lot of fears revolving around all of them, but I think when it comes to recovery, probably one of the top three things most people worry about is the weight gain side of it all. Personally at least, I know that the fear of weight gain is certainly a big thing for me and is particularly relevant right now as in my current admission to hospital it is the forced and rapid weight gain that has ended up distressing me most of all to the point that I haven’t even been able to focus on any of the more long term mental health sides of the illness as I am too focused on the scales.
I know that to other people, my weight does not define me as a person and that the number that flashes up when I step on a little machine should not dictate the way I live my life but when you have an eating disorder, those thoughts are often automatic and knowing they are irrational doesn’t take them away.

Unfortunately, despite the fact that the weight gain side is incredibly hard, if you really want to recover from your eating disorder, the fear of weight gain is an unavoidable thing that will need to be tackled and that, if neglected, will never truly allow you to get back to a healthy mind and body again.
So how do you manage it? If you want to recover from your eating disorder (or even if you don’t and are in forced treatment at the moment…ahem), how are you supposed to deal with one of the most frightening challenges to face someone struggling with anorexia: weight gain. Well, if that question has been on your mind at all then welcome to a blog post containing some possible answers, because today I am here (wearing a bow tie no less because I am fancy and have dressed smartly for you on this occasion), with 5 thoughts to help you deal with weight gain when you are in recovery from anorexia. So without further ado, lets get into it *straightens bow tie and gets down to serious business*…

1. Weight redistributes – When you start the re-feeding process after depriving yourself of adequate nutrition for a long period of time, your body will have no idea what the hell is going on or what the hell to do (something I explain a little more in this post here: Five Things You Need To know About Re-feeding During Eating Disorder Recovery). Because of this confusion and deprivation, when your body first starts gaining weight, it will want to prioritise on life saving things first (handy that) and for this reason a lot of people find that weight gain in the early days primarily goes to the tummy area so that the body can focus on repairing things like a dodgy liver or an out of whack kidney. This has happened to me multiple times (including right now) and understandably it can be quite distressing as your body can start feeling out of proportion, but what I want to emphasise with this point is that even though weight may initially go to life saving organ places, it WILL redistribute and spread out eventually as long as you hang in there and give it time. Restricting your intake to lose the weight again will only make this process more dramatic, so the key is to stick with it and always remember that redistribution will happen!

2. You are gaining weight you shouldn’t have lost in the first place – Whenever you see or hear an advert for a weight loss diet club, the people will emphasise how good it is to have lost the weight they did with whatever weird low carb eat upside down with a pineapple up your nose (difficult task, would not recommend) diet they have been following and therefore the idea of gaining any weight back is automatically “bad”. Culturally this has then created this false idea that the act of gaining weight is a bad thing in itself however this is not always the case, especially when it comes to recovery. Thing is, when you are regaining weight you have lost through an eating disorder, you are actually not gaining weight but are regaining parts of your body that you should not have lost in the first place, so whenever you see that number go up on the scale remember, it is not weight gain in the negative way that the diet clubs claim it to be, it is just re-finding a little puzzle piece of the wonderful you that may have been lost to this terrible illness.

3. The alternative is worse – I will hold my hands up and admit it: weight gain is scary. Then again, if you think about it, isn’t the alternative, aka death (for anorexia is the mental illness with the highest mortality rate of all), even scarier? “I am not that bad” I hear you cry, “I am not going to die of anorexia”, but hey, that’s what they all say and in a lot of cases, it turns out not to be true. Anyway, even if you are one of the fortunate souls whose body somehow manages to survive the abusive nature of an eating disorder and live, what kind of a “life” is it to spend your days tortured and tormented by a beast in your head? Weighing things up then (no pun intended…actually screw it…with me the pun is ALWAYS intended), although weight gain is scary, when you are going through the process it is important to think of the alternative, and remember that that alternative is a hell of a lot worse.

4. Weight gain is not as visible as you think – If you are like me, when you stand on the scales and see that the number has gone up, you can immediately see where that extra weight has gone to. This however, in the nicest possible way, is utter nonsense because in actual fact changes in body weight are no where near as visible as we might think. I remember one week when I gained one pound and instantly I saw my physical appearance change into something unrecognisable to the person I had been before that pound. Know what everyone else saw? Nothing. I would be lying to say that no weight gain is ever visible (as someone who has just spent 5 months in hospital I can guarantee I do look very different now), but my point here is that weight that you gain every week at weigh ins is not as visible as you might think and if you think you can see that pound or two of extra weight then it is simply proof that your eating disorder is distorting your vision. Don’t listen to its lies I say!

5. Getting bigger doesn’t mean you are big – If I ran a banana farm and after the harvest found that I had 1000 bananas, that would be a lot of bananas (and I would clearly be one hell of a good banana farmer). In that circumstance then, 1000 banana would be the definition of a lot of bananas. If the next year I then had 100 bananas would I think that I had hardly any bananas (trust me I do have a point here and am not just trying to send subliminal messages to you all about my secret dream to become a banana farmer). If however I had 0 bananas one year and then the next had 100, 100 bananas would be my definition of “loads of bananas” and that is what it is like with weight: aka all relative. Just because you are gaining weight and getting “bigger” it does not mean that you are big. You might think “I am huge” because the number on the scales has gone up but what I am saying is that just because the number has got higher it doesn’t mean that number is big. 100 bananas only looks like a lot of bananas if you previously had no bananas, just as a certain number of kilos only seems “huge” because it is bigger than the nothing you had previously and every “high” number you fear only seems high because you are looking at a lower one first. Getting bigger does not mean getting big therefore and if it was the other way round (aka the 1000 banana situation first) then your “high” number would be someone else’s low in a different situation. Whenever you see you have gained weight and feel like your weight is high, remember the bananas and the fact that a high number only seems big because it is bigger than the previous number and it is not that the number is big in itself.

SO there you have it! 5 thoughts to help you manage the fear and stress that is the weight gain side to recovery from an eating disorder! As always I am not saying that this blog post is going to solve the problem, nor will it probably make gaining weight any easier, but these thoughts are at least important and sometimes helpful/comforting things to bear in mind when the voices are getting a bit too loud for comfort and you have no arguments to fight against them. These thoughts are therefore your arguments against all of those bad thoughts, your weapons for the recovery battle, so take them brave soldier and use them wisely to outwit that cunning eating disorder who is trying to fool you into making weight gain seem like a bad thing.
In the meantime, if you are someone struggling with the anxiety ridden process that is gaining weight, please know that I really do feel for you as someone who has gone through the process multiple times myself (and is still going through it today), and I hope that this blog post has perhaps helped a little bit. Remember, recovery and weight gain is hard but losing your life to a cruel demon in your mind is far worse.

Take care everyone x

WeightGainFear

Should The Government Be Teaching Children To Count Calories?

When it comes to the government, they are always coming up with handy suggestions as to how people should live their lives. You know the stuff, “eat at least five portions of fruit and vegetables a day”, “don’t drink more than 14 units of alcohol a week” and “drive on the left hand side of the road” (actually that one might be a rule rather than a suggestion…I wouldn’t know. I failed my driving test and every time I asked my instructor for more driving tips after that, he ran away screaming which really did not help with answering any of my questions…)
Always ready to tell the population what to do then, for 2018, the government in the UK have come up with a new suggestion, complete with its very own catchy advert, where play-dough people morph around the screen and a happy jingle plays advising parents to teach their children to restrict themselves to “100 calorie snacks, two a day max”. Now I am not one to turn down advice from our dear Theresa May who is doing such a wonderful job of running the United Kingdom without any trouble whatsoever (pause for laughter), and even I can admit that it is a catchy slogan with a tune that isn’t bad either, but in my opinion this “handy lifestyle suggestion” is a terrible thing that should cease being taught to children immediately.

Obviously for someone (aka me) who is in hospital trying to recover from anorexia and is following a meal plan where snacks exceed 100 calories and are more frequent than twice a day, this kind of thing is unhelpful and triggering. On one hand I have dieticians and psychiatrists coming out of my ears (I really don’t know how they got in there in the first place), telling me that I need to eat this far higher meal plan than the one Theresa May suggests and on the other hand I have play dough people telling me to restrict my intake, which as I have said is obviously confusing and not particularly useful, but it is not just to people with eating disorders that I think this advert is detrimental, rather it is bad for the entire population (far worse for your health in fact than, dare I say, more than two snacks a day comprised of over 100 calories each).

The problem I think with any lifestyle suggestion or diet tip from any source, is that people hear it and immediately take it as gospel. In the real world however, nutrition isn’t governed by blanket black and white, one size fits all rules like that, and there is no such thing as a “diet expert”, only people who have done a lot of research about food and have opinions about it, a point highlighted to me during my brief stint working in a bookshop.
Unsurprisingly, this job involved various tasks including book shelving, and one day I was in the self help department (insert joke about how I need to spend a lot more of my time in such a section here), which was helpfully next to all the diet books. Therefore whilst shelving, I couldn’t help but get a good look at all the titles and diets being advocated.
Now generally, when it comes to reading about a topic, one would assume the more books you read, the more educated you become. For instance say you read 30 books about penguins, it is then likely that you will be more intelligent on that topic than someone who has only read one and that you would do better on any quiz regarding penguins. Alas, when it comes to nutrition, things are not like that, for as I shelved those diet books (working very hard I might add just incase my former boss is reading this…), I realised something ridiculous. Turned out if I were to read all of the diet books, take all of the information, all the “no carb”, “no protein”, “no fat” nonsense and I were to mush it together to make one overall diet plan (which you would think would be the best and most informed having been the culmination of so many books’ worth of information), I wouldn’t be able to eat anything. All the health advice added up together in the world and the conclusion from it? No food is safe, which I think is fairly unhealthy considering such a thing would lead to death, and, were we all to follow that advice, the extinction of all human life on earth. Marvellous. Therefore when it comes to rules like this “twice daily 100 calorie snacks” thing dolled out by nutritionists, taking them as gospel is never a good idea as they are merely opinions rather than facts.

“But for some people limiting snacks to twice daily amounts of 100 calories might be a good, healthier idea than their current lifestyle choices” I hear you cry and I am not going to disagree with you on that, but another thing I want to point out when it comes to guidelines is that they are not universal and are actually only helpful or beneficial to SOME people, which is why it is not helpful to have them rolled out as rules for the general population. As I have already said, this advert is obviously not applicable to people who are in recovery from eating disorders, but neither is it applicable to a large number of the population who all vary in height, weight, activity levels and nutritional needs. What about athletes for example. Is this rule supposed to apply to them too because I am pretty sure that that Mo Farah and Usain Bolt wouldn’t get very far nor would they get any more gold medals were they to restrict themselves to two 100 calorie snacks a day…
Okay I get it, there does need to be some kind of suggestion out there as to how to live a healthy lifestyle and it is important to teach children about food and nutrition but whatever happened to “general education” and suggestions like “eat your vegetables”, “everything in moderation” and try to have a “balanced diet” as opposed to these rigid rules and guidelines ridden with fixed numbers. Where pray did these numbers come from because last time I checked people don’t eat numbers, they eat food (and for good reason too. I once tried to eat a number nine and it was terrible. Tasted purely of pepper.)

It is just somewhat ironic that the whole focus of this campaign is to encourage health but encouraging children to see food in terms of calories and numbers really is a disordered habit struggled with by many people with eating disorders. If healthy snacking is the priority then advising healthy snack foods and providing possible examples would be a far better way to go about it because this focus on calories isn’t healthy at all. When numbers are brought up things start to get obsessive and this is where I think the problem lies. By specifying 100 calorie snacks they are labelling a strict limit to adhere to, but how ridiculously close are people supposed to stick to it? Is a 101 calorie snack ok? What if it is a really healthy snack that is slightly over? Should an “unhealthier” food be chosen instead simply because it fits the amount? Should we weigh already healthy fruit to check that they are “safe” in this new government scheme? Should children be taught how to count calories from the moment they exit the womb? Is that a normal healthy attitude to food? Seriously, think about it, does all of this sound healthy and worth advocating or more akin to rigid disordered behaviour seen in people with eating disorders aka a mental health condition needing treatment?

Overall then, if I had any say or control in any of this government malarky, I would say the whole “100 calorie snacks” with “two a day max” idea needs to be binned and for calculating numbers to be kept in children’s maths lessons in schools rather than in their lunch boxes or at the dining table at home. If you want to educate and give healthy food guidelines from the government then fine, go ahead, but when this advice is given it should be just that, GUIDELINES like the old “eat more fruit and veg” rather than strict, prescribed, rigid calorie counted rules that must be followed exactly and are carved in stone and sung over the breakfast table like some terrible national anthem.

If you have or even if you don’t have an eating disorder but are finding these adverts unhelpful, as hard as it is, my advice would be to do your very best to ignore them. Remember, just because it is prescribed by the government it doesn’t mean it is automatically healthy and it doesn’t mean that its obsession with numbers is not disordered. Nobody is the authority on rules regarding food and diet, it is all opinion, and strict rules, hell even general guidelines, are not applicable to everyone.

Take care everyone x

GovernmentFood

The Difficulty When Mental And Physical Progress Move At Different Speeds In Eating Disorder Recovery

In a few days time, I will have been in hospital for 16 weeks aka a grand total of 4 months, and because of this, I am often being asked questions like “How are you getting on?” or “are you feeling better?” which are both very complicated and difficult questions to answer when you are in treatment for an eating disorder. You see, on one set of paper work, things are going rather swimmingly and I am indeed doing much better, yet on the other set of paper work in my opinion, I am actually feeling and am “doing” worse than I ever have done in my life.

Oddly enough, this discrepancy between paper works is not because I have two very different doctors with opposing ideas writing sets of notes about my progress, but because when it comes to recovery from an eating disorder, there are two very distinct and different sides to it, the mental and the physical, and unfortunately these two sides do not work as sleeping otters do (aka hand in hand – yes, fun otter fact for you, otters hold hands when they sleep to make sure that they don’t drift away from each other. Apparently they also make waterslides and play with pebbles. Conclusion: Otters are cool).

Indeed the two sides to eating disorder recovery are so separate that I think that asking someone in treatment for an eating disorder how they are, is a question that needs to be asked twice, once for each side of recovery, because otherwise getting one coherent answer is impossible.

To be fair, towards the beginning of my admission, the physical and mental sides of how I was doing were fairly in sync. Mentally things were a bit all over the place and physically things were too. This then continued as I struggled to work with the program at the eating disorder hospital, until the introduction of my NG tube and since that most unwelcome introduction, everything has changed, in my eyes, for the worse.

Before, when I was mentally struggling and didn’t feel able to manage food, I was able to avoid it which obviously didn’t help my body very much but it prevented my anxiety levels from getting worse. Now though, since the NG tube, I have a constant and unavoidable source of nutrition and it doesn’t matter how I feel, food cannot be avoided. If I don’t eat, the food still goes in, and consequently my mind is in utter turmoil. My body on the other hand is as they say “loving life” and ironically, it is killing me.

Seeing as food is unavoidable now, I have been following my meal plan in one way or another for weeks and the affect this has had on my body is dramatic. I am gaining weight faster than I have ever gained weight before (perhaps because I have never had such an unavoidable source of nutrition stuck up my nostril before), so health wise, I am “improving”. I am no longer at a weight where I require a wheel chair, I am now able to stand in the shower for long periods of time, even on one leg (I am a fantastic flamingo impersonator these days), and when I get out of bed in the morning, the world doesn’t swim before my eyes and go black. Objectively these all sound like good things and for the medical professionals and my friends and family, these are good things but to me, these are terrible things.

I really don’t know how to explain this idea to people who may not have eating disorders as I know that to most people it sounds absolutely ludicrous. Physical health, the ability to stand in the shower and walk down the corridor are abilities to be appreciated not feared, but when you have an eating disorder, these abilities mean entirely different things.
To me, not being able to stand up without things all going fuzzy was a sign that I was “behaving” myself, a sign that I was doing a good job at punishing myself so the guilt I felt at being alive was lessened. Now though, I am unable to “behave myself” by not eating because even if I don’t eat the food will go in without my permission, so with things not going fuzzy, it is like a sign that I am doing something “bad” (even if it isn’t always me who is doing the eating), and I guess I am feeling all the guilt and shame as anyone else would were they to do something they thought was bad, like stealing or punching someone in the face.

Now I take up too much space in the world and with the weight going on as it is I take up more and more space each day, which is something I have always struggled with. When you hate something you want to make it as small as possible (or you want it to disappear altogether), you want it to take up as little of the world’s space as possible so as there is more room for the good things. In gaining weight I feel like a weed taking up too much space in the flower bed and stealing all the sunlight from the marigolds.

It is incredibly hard to watch this body you hate, morph in front of your eyes into this thing that is getting bigger everyday, getting “better” everyday whilst inside you are all the more depressed and tormented.
I don’t have any idea if I am making sense here because to be honest I am on so many medications right now that my brain is not functioning but if I had to resort to the good old Born Without Marbles way of explaining things, aka an analogy, it feels like my body and brain are one of those cars people drive off in after a wedding with tin cans on the back and “just married” scrawled across the rear windscreen.

My body is the car and as it gains weight it is zooming off full speed. Meanwhile my brain is the collection of tin cans tied to the back, being dragged along and through all of this road that it is not ready for, each can bouncing and denting, bruising and breaking a little more with every mile that passes. My body gains weight, my brain cracks a little more, I feel more broken, depressed and bruised and the faster my body goes the further it is from my brain which is actually all the way back at the starting line. I guess this analogy isn’t perfect because you could say “but your brain is moving in the right direction like your body if it is tied to the car” but that is where the analogy fails because that is not happening at all, like I said, as the car moves the brain just gets battered and even staff have admitted that in the past few weeks things have mentally become worse and worse as time has passed and weight has gone on.
Christmas day is a perfect example of this. When I woke up on Christmas day I was weighed (NOT something I asked Santa for and if I ever wake up to a set of scales in my stocking on Christmas morning again I swear to God I am marching to Santa’s grotto to give that beardy man a piece of my mind…and his scales back), and I had gained a lot of weight. On paper then and to the doctors, my body had got “better” but mentally the shock of it all had such a strain on my mind that I totally lost it. Within minutes I was having to take medication to calm down from the anxiety and agony and when my family came to see me for our two hour visit, the visit wasn’t better for the weight gain, it was worse. It should have been better logically, my body was healthier than the last time they had seen it but in becoming that way I became so upset, distressed and anxious that I had what we shall simply call “ a little incident” and I had to ask my family to leave early.

It is that which I think illustrates my point best as to how impossible it is to answer the question as to “how are things going” when you are in recovery for an eating disorder. Am I better? In a way, yes and I am getting “better everyday”, but in the other more important mental side am I better? Am I progressing? Not at all. I hate myself more than ever, I am more unhappy than ever and I feel more trapped than ever in a body that I no longer relate to. The distance between my body and mind is so great now that I have asked staff if there is any chance we can slow down on the weight gain so that my mind has got a chance to catch up but they are refusing and it all feels like I am being dragged and pushed too far out of my comfort zone. I am in hospital being treated for an eating disorder and the physical problem is being taken care of by a tube, but the mental aspect is being torn apart and I really don’t know how much longer I can handle it.

It is so frustrating trying to explain all of this and I guess in the end the main thing I want to do at the end of this blog post is apologise because I feel like I haven’t made any sense and that I have wasted your time with my incoherent waffle. Like I said though, I am on all sorts of crazy meds at the moment (to calm me down because I am in so much distress due to this whole struggling mentally with the physical progress my body is making right now when I am not ready for it), so please blame those meds and not my inabilities as a writer. I don’t understand half the things that are going on at the moment so explaining them coherently is somewhat difficult. I really am sorry. I am just so battered. I hope this makes some sense at least or that I have got the point across in some way that physical recovery and mental recovery for an eating disorder do not go hand in hand and can sometimes be literally travelling in opposite directions. “How are you doing?” is such a simple question but good lord when you have mental health problems is it a difficult one to answer.

Take care everyone x

RecoveryCar

Is It Ok To Give Food Related Christmas Presents To People With Eating Disorders?

As soon as winter rolls around, there are certain questions that suddenly pop up every time you interact with another human. These questions vary but include things like:
“Are you doing anything nice for Christmas?”
“What do you want for Christmas?”
“Do you really need to buy more penguin themed decorations this year?” (Yes. Yes I do)…
And of course the ever sigh inducing “Have you started your Christmas shopping yet?”

Due to the birth of commercialisation and consumerism (two things that, although very much involved in Christmas, were not actually born in Bethlehem and laid in a manger), Christmas shopping is a big stress over the festive season both for money reasons and of course wondering what the hell to buy for everyone. Mental health wise however, there are further complications because sometimes there is a question not just to what you should buy a friend or relative, but whether there is anything that you should definitely not be buying…

As you may know, I have a lot of friends with eating disorders and several of these friends have come to me in the past exasperated and fed up, poised with a story to tell me about a distant relative who sent them food as a birthday or Christmas present. I know a lot of people with eating disorders might get frustrated, find the gift insensitive, rude, or even cruel, like taunting an alcoholic with a bottle of gin, and the majority of people I know have stated that “people should not give food related presents to people with eating disorders”.

I think that one of the difficulties in this issue, is trying to decide whose responsibility it is for someone to manage the whole gift giving/receiving situation. Is it the responsibility of the person who is choosing the gift to give (maybe an unfair burden considering not everyone will know every personal detail of whoever they are buying for this December and surely if it is “the thought that counts” any present is incredibly kind and generous), or is it the responsibility of the person receiving the gift, to manage what it is appropriately for them?
If you give a Dolly Parton hater (for-shame! Come on now, you have to at least like Jolene? 9-5? IT IS A SONG ABOUT THE MONOTONY OF WORK LIFE! DOLLY GETS US!), a copy of Dolly Parton’s Greatest hits, whose responsibility is it to deal with the CD? The gift giver for not knowing about a person’s hatred of the world’s greatest country singer and for not being too careful, or is it the responsibility of the gift receiver to simply donate the generous present to a charity shop where it can be enjoyed by someone else who is able to appreciate a bit of “I will always love you” blasting from the speakers? However, what if a gift is medically inappropriate? Whose responsibility is it to manage then?

For example what about Horris who is deathly allergic to peanuts? Maybe Horris didn’t write a Christmas list this year (always a risky move), and maybe his third cousin twice removed’s husband’s goldfish wants to send Horris a gift (for he is a very generous goldfish), but is unaware of Horris’ unfortunate peanut condition.
If this lovely Christmas loving goldfish sends Horris three tonnes of peanut butter, a t-shirt made from knitted peanuts and a trip to the “World of Peanut” theme park with the “Ultimate Peanut Experience Peanut roller coaster” (you ride around the track within the shell of a giant genetically modified peanut and then at the end enter a flume tube filled with peanut butter that will leave you utterly soaked upon plunging into it). If Horris uses this ticket to the theme park, surely it is partly his fault for not taking proper care of his health requirements (aka the requirement to not plunge into a pool of peanut butter at 100mph in the shell of a giant peanut). Then again, what if Horris is so allergic that the mere sight of the ticket and the tonne of peanut butter sends him off in an allergic reaction without him having any warning of the deadly gift? Who do we blame? Goldfish or Horris? Surely this is a very different kettle of ethics than the previous Dolly Parton debate? So what about people with eating disorders?

On one hand, as a person with an Eating disorder myself, I can see the point of those who say that giving food as a present to someone with an eating disorder is inappropriate or something they don’t like happening. It can indeed be frustrating to be given food presents that you fear every year and are possibly unable to enjoy due to your illness. I have heard people with anorexia say that it makes them feel more isolated from the rest of the Christmas festivities because being given, say a Christmas present that is a box of merry smiling gingerbread men with chocolate buttons, a freshly cut yule log or a batch of homemade mince pies is like being shown something “normal” about Christmas that others can enjoy and that they may want to take part in like other people, but due to their illness, feel they can’t. Some could say that getting food presents makes them feel misunderstood or like their problems/disorders have not been taken seriously, belittled and assumed to be “a mild difficulty with food” that can easily be solved if you put a nice bow on a box of chocolate penguins, rather than a fully fledged eating disorder ruining their lives no matter how many bows you stick on top of that box of rich 70% cocoa waddlers.
As well as food presents for disordered eaters being problematic in the sense the present receiver may be too scared to enjoy them, there is also the risk that food presents could trigger someone in other ways, for example someone who feels the compulsion to binge and maybe purge afterwards. Some sufferers keep certain foods that they are likely to binge on out of the house to make them feel more in control, so when that food is suddenly handed to them wrapped in glittery ribbon tied paper, they struggle to deal with it in the way they might like to when fighting their disorder.

That said, though what I am about to say is something most Eating Disorder sufferers would disagree with, I don’t think that people should put a full-on ban on food presents for people with eating disorders and I think that getting a food present once in a while is more likely to help rather than hinder your recovery.
What if one Christmas as the countdown to the 25th was underway, you went into some form of new treatment that you started to find more beneficial than any you had tried before. What if an image of what life could be like without your eating disorder started to give you hope in a positive future and what if, like a Christmas miracle, your eating disorder backed off a bit and you felt strong and determined enough to kick some ass. What if in this Christmas miracle you became so inspired to fight your demons that you made a promise to join in on all the scary Christmas food things this year, finally buy that advent calendar, make that gingerbread house with the candy cane decorations, try one of Aunt Enid’s famous mince pies and join in on all the party canapé platters at the work Christmas buffet (I hear the brie and cranberry filo tarts and chocolate penguin profiteroles are a delight). What if all of these goals arise, all this determination to fight and join in with everyone else…and then nobody gives you the opportunity to do any of it because they are all too scared to offer you that filo tart or wrap up that tub of Celebrations. To me, that would be incredibly triggering, if I were to be there ready to fight, ready to eat and join in and everyone just left me out anyway because they assumed I wouldn’t do it. This year, considering i am in hospital and not particularly well right now, that assumption might be right but in my head, never being given food presents at Christmas or any other time of year like Easter or a birthday, is simply a way of other people confirming the idea you already have in your head that you don’t deserve or need food and therefore shouldn’t eat it. People treat you like an eating disorder and you will find it hard to see another identity for yourself. Furthermore, when would the food ban stop and would it ever? How would that be decided and wouldn’t that be more triggering in itself to have food presents suddenly reintroduced? If you have an eating disorder at one point, are families to avoid food gifts even if you are recovered “just incase” which again isolates you from certain celebrations. Yes food can be triggering as a gift but wouldn’t it be more triggering to be very unwell for years and then one year to be maybe doing a little better mentally and physically, so much so that people notice, give you food and then you freak out thinking that they are insinuating that you “aren’t ill anymore” or that they think you have put on weight so are clearly fine with eating again.
Personally to avoid all of these issues, when it comes to food presents, I would rather be treated as normal, like everyone else, receiving the odd box of Quality Street and being offered the iced mince pies. Even if I can’t accept the mince pies or have to give the Quality Street to my mum, I would rather they were there to make other people treat me “normally” until I am in a place to play that role of “normal person who eats food presents at Christmas and gets two candy canes stuck in their gums by getting a bit too enthusiastic when impersonating a walrus”.

Overall though, I guess that with this topic, it is impossible to make any conclusion because whether or not you give food to someone with an eating disorder is going to be a tricky thing to gauge and will vary from person to person. As I said, even I and my group of friends who share the diagnosis feel very differently about the topic so to be on the safe side, if you are wondering whether or not to give someone with an eating disorder a food related gift, you might want to check with the individual or maybe a relative of that individual first to see how they might react to it. There are many types of eating disorder and even people with the same one will experience them differently at different times, such as when they are going through periods of relapse or recovery, so as much as I would like to have given you a black and white simple answer (and we all know how much I love things that are black and white ahem penguins ahem), I am afraid I will have to conclude in a rather hazy grey as the answer will vary from person to person.
All I would say is, if you are the gift giver, try not to get too anxious or caught up in overthinking it because ultimately you have a 50/50 shot of getting it right and if you get it wrong, it isn’t your fault, nor does it make you a bad person. Similarly, if you are the receiver I am sorry if food present wise, things don’t go your way this year, but equally remember that other people may not be thinking as deeply into the meaning or significance of a box of chocolates as you might be and maybe it is just their way of trying to show they think you are pretty awesome. A Christmas present is a Christmas present, it isn’t a holy significant statement laden with meaning as to how someone views you or your body, it is a sign of appreciation, a sign someone cares, and at the end of the day, it is always the thought that counts.

Take care everyone x

Pudding blog

The Difficulty Of Knowing What Counts As “A Behaviour” When You Have An Eating Disorder

How do you tell the difference between an elephant and a letterbox? You check to see which one has a trunk and which one is filled with neatly addressed handwritten letters that will soon be lost in the abyss that is “the postal service”.
How can you tell the difference between a brand new slipper and a boomerang? You throw it to see which one comes back and smacks you in the face.
So far so good (apart from the fact you may have just been smacked in the face with a boomerang or lost a perfectly good slipper), but now for the third question:
How do you tell the difference between the genuine preferences of someone with an eating disorder and the disordered behaviours of someone with an eating disorder? The answer? With extreme difficulty…if at all.

When you are on an eating disorder unit, the food aspect of things/what you can and cannot do with food, is a lot more regimented and controlled by sets of rules than it is in normal life.
Rules will vary depending on what hospital ward or inpatient unit you have been admitted to, but as a general list of examples these rules will be things like “no eating cereal with tea spoons”, “no breaking food up into tiny pieces”, “no sleeves at the dinner table”, “you must scrape the plate that you are eating from clean to complete the meal”, “only X number of minutes to eat your meal” and “no inserting parsnips into the nostrils of the person sitting next to you” (pretty sure that last one is also relevant in real life actually but I am not quite sure…my mother was never very clear when it came to table manners.)
These rules are often frustrating and can seem a bit harsh but they exist because often an eating disorder controls how a person eats and behaves around food, as well as how much or little of it they eat, so part of treatment during recovery involves tackling those food behaviours as well as things like the amount of food someone might be eating. Like I said it can be annoying, but it makes sense. Take the “you must scrape your plate to complete a meal” thing. It may seem over the top (and is a rule that will destroy the lovely willow pattern adorning all of your best crockery), but were it not for rules like that in hospital, there is the risk of people arguing that they have finished their meal when really all they have done is smear it across the good china.

With behaviours like that, I think it is easy to tell the difference between them and genuine food preferences as I don’t think I know any people without eating disorders who “prefer” trying to mash a lasagne into oblivion rather than consuming it.
There are however, a lot of actions people do where it is far harder to tell if the person is making a genuine choice or following a behaviour, and in these situations it is less like trying to distinguish an elephant from a letter box, and more like trying to tell the difference between an elephant, a tea pot and a vacuum cleaner (if you line all three up together you have to admit they do look rather similar…trunks, nozzles and spouts are easily confused…I learnt that the hard way…and broke a teapot).

For example at the hospital I am in at the moment, there are certain rules regarding condiments such as “only two pepper/ketchup/vinegar/mayonnaise/brown sauce etc sachets per meal”. The logic behind this is that some people with eating disorders tend to totally cover their food with a certain condiment in order to make it all taste the same/spoil the food and make it taste horrible as a punishment etc.
Then again, as well as people who use pepper to burn the roof of their mouths off by using it excessively, there are people who use what looks like an excessive amount of pepper simply because they like it. Every time my Dad eats a meal he uses so much pepper that even people scuba diving at the bottom of the Atlantic start sneezing because he likes the spice, and I have a friend who uses what may look like a lot of salt because she has been brought up using that amount and things taste wrong without it. Neither of these people have eating disorders, but they would still struggle living by the rules that are in place to help someone in recovery from a disorder. I guess you could say that the way you tell the difference is to see which came first, the food preference or the disorder, but that isn’t as easy as it sounds. Eating disorders are sneaky, they slip into your life gradually without you really noticing, so it is rare for someone to be able to pin point the day they officially became unwell.

What if my Dad, who currently does not have an eating disorder, developed one in years to come and had to go into hospital? Or my friend who likes a lot of salt? They might, quite rightly, argue that their preferences existed years before their illnesses began and they may be right but the thing is, in hospital, that doesn’t really matter and this is where it gets frustrating. Once you are tarnished with the Eating Disorder brush, suddenly people assume that EVERYTHING you do around food is because of that disorder and they rarely give in or believe you even when you are expressing a genuine dislike. It can be really annoying when you know that your love of toast that is not particularly well cooked is because you like soft as opposed to crisp bread, yet when you are consistently told that everything you do is disordered, sometimes you can start to doubt and be unable to tell the difference between your own choices yourself (aka the is it an elephant, teapot or a vacuum cleaner situation).

How about timings and things like time limits on eating disorder wards? Admittedly they are necessary to avoid still working on Monday’s bowl of cereal at Sunday dinner time (rather soggy cereal I would imagine), but in addition to timings perhaps being affected by disordered thoughts or behaviours, people naturally have varying eating speeds. I certainly know that in my household my Dad will always finish his dinner a good 10-15 minutes before my mum for the simple reason that he has a bigger mouth and more violent set of gnashers (not abnormally large I might add…like he is still a handsome chap and isn’t frequently being mistaken for a shark who needs to be sent back to the aquarium…just clarifying…love you Dad.)

The main rule/“behaviour” that got me thinking about this topic however, the rule I have seen come up in every single one of my admissions to an eating disorder unit and the rule that is carved in a stone tablet and worshipped on a mountain guarded by holy cherubim:

“Thou shalt not dunk biscuits”.

Some of you reading this, who have never heard of such a rule, may be a little shocked, stunned and perhaps distressed to hear that there are people all over the country being forced to eat rich teas that have never actually taken a dip in a real mug of the beverage after which they are named (I know, it is upsetting but we can get through it).
Again, as with all hospital rules there is a reason behind it, that being that people sometimes submerge and drown their biscuits rather than dabbling in a quick dunk and then smear the soggy remains around the inside of their mugs or leave them in sorrowful abandoned mush mountains at the very bottom.

The issue though, comes when you are someone who wants to safely and appropriately dunk their biscuit, yet are prevented by the rule that may not be relevant to you. Of course rules have to apply to everyone on the ward to make them fair, but that is what is annoying, i.e. having an eating disorder and then having EVERYTHING you do with food put down to your disorder when maybe you have just grown up liking a lot of ketchup on your curly fries, or genuinely prefer the texture of a cookie that has had a quick swim in a mug of hot chocolate. Dunking biscuits CAN be a disordered behaviour, but it isn’t always.

Just imagine if the world had to live by eating disorder ward rules with the act of dunking a biscuit being classed as a disordered/unhealthy behaviour and thus banned for all. How would any of us ever eat an Oreo? The dunking aspect to those delights is even in the damn advert! They literally explain how to eat them on the packet! First you twist it, then you lick it, then YOU DUNK IT. If that bit was deleted from the process the country would grind to a halt and living rooms across the world would be filled with poor distressed people holding opened licked Oreos and crying out in agony “WHERE DO I GO FROM HERE?” Think of the number of teeth that would be broken on undunked ginger nuts!

You could maybe be a generous dictator and say that only people who appropriately dunk their biscuits are permitted to do so (something I have asked for on multiple previous admissions), but how can you tell if someone is dunking appropriately? What if someone is genuinely dunking for the resulting soggy biscuit end goal but is such a poor judge of the strength of their chosen biscuit that they get the timings wrong and remove their Custard cream or Bourbon from their brew not to find a perfectly melted vanilla or chocolate cream centre but instead a blank space, an empty half in which biscuit perfection had existed seconds before it was too late and the perfection turned into a sinking disappointment of heartbreak, sorrow and missed opportunities.
Should biscuit dunking be classed as an eating disorder behaviour just because it can sometimes be used as one or can it just be a preference?

Overall then it is clearly very difficult to tell the difference between an eating disorder behaviour and a genuine food preference, especially when you yourself have the eating disorder. I guess when it comes to people who have no issues with food the answer is obvious…until that person is unfortunate enough to develop the disorder and we are caught in the whole confusing “which came first the soggy biscuit or the mental health problem?” dilemma which has plagued scientists for years (scientists who I feel are doing valuable work but are also perhaps taking advantage of their right to order in free biscuits from the big companies under the guise of “research purposes”….)
Of course there will always be ways to figure out the disordered act from the genuine preference but it isn’t always as clear cut as the elephant and the letter box example and sometimes even knowing your own reasons for doing things can get you into a confused muddle of soggy biscuit yourself.

Take care everyone x

ElephantHoover

Five Things You Need To know About Re-feeding During Eating Disorder Recovery

Whenever you enter treatment for any kind of eating disorder, you will often be given about a million worksheets, pamphlets and photocopied passages from text books, about the mysterious topic of “re-feeding”.
Indeed, over the years I myself have been handed many of these scientific attempts to explain the various processes the body goes through during re-introduction of food after periods of starvation, and having been through those various processes multiple times, I thought I knew it all. I thought that when it came to re-feeding a patient with anorexia, I was an expert, an oracle of knowledge when combining my scientific genius (aka facts I memorised in text books) and personal experience. So arrogant and confident was I in my “know it all” attitude, that had I been asked to take part in the UK gameshow Mastermind, I would have chosen “the re-feeding process in treatment from an eating disorder” as my specialist subject and would have had a cabinet built for the trophy in my living room before I had even answered the first question. Luckily, nobody has ever asked me to be a contestant on Mastermind because if that had happened, I would have looked like a fool and would have had a very sad and lonely, empty of trophies, trophy cabinet.

Today then, rather than sit and mope with regard to my lack of trophies (and whopping great useless cabinet in my living room), I thought I would use my current situation as “person attempting re-feeding” to share with you the five things everyone needs to know about the re-feeding process when in recovery from an eating disorder.
This is not just the explanations that you get from the science books, this is the Born Without Marbles, real life, honest guide to get you through all the surprises that can happen during the re-feeding experience, even if you have been through it before and think you already know it all…

1. Taking it slow is important: I think there is often this misconception that the more food you can get into a person who has been starving for a long time the better, when really, that can be quite dangerous. When your body isn’t used to being given food, it sort of turns off and goes into a stand-by mode, so booting it up again is a process that needs to happen gradually. It is like if you had an out of work clown, to get them back into juggling you need to start again with 3 soft balls rather than going straight in with 10 flaming knives and a live alligator riding a chainsaw. When coming into hospital for example, people are often started off on half portions to build up from gradually over the space of a few days, to avoid the body going into too much shock and sending your electrolytes and cardiac functions all berserk. Now, this is not an excuse to let your eating disorder sneak in with “well, if it is dangerous to eat much even though you are in recovery, you should probably just eat a little bit of lettuce” because NO. All I am saying is that when you are getting back into the habit of giving your body food, you need to be gentle and start off slowly, preferably under medical supervision/working with a dietician to keep you both physically safe and to make certain you are gradually building up to the amount of food you need rather than sticking to the initial “half portions” of the first stage.

2. Any weight changes on the scales are not going to make any sense: In life, I think we treat scales a lot like calculators, machines that give us logical results and answers to various calculations of input and output made over the week. Unfortunately this is not the case, especially during the re-feeding process of recovery from an eating disorder, and instead of giant body calculators, I would encourage you to treat scales like a very drunk friend following a night out at the pub. This is not to say I advise taking your set of scales to the local takeaway for some cheesy chips and a lamb kebab (scales prefer pizza with a side of garlic bread), rather it is to say you should take everything they say not as fact, more as a vague approximation of reality/what is going on. I am not going into specific numbers here, but when I was admitted to hospital almost three weeks ago (my how time flies when you are in a mental institution!), I ate less than I had been eating at home, due to anxiety and because everything served to me was different and none of it was what I considered one of my safe foods. After a week of eating less than half I had been previously, I stepped on the scales expecting to lose weight. To my horror, I gained. A lot.
“Oh my goodness” I cried out dramatically fainting on the clinic floor. “What is this? My body is broken! Everyone says that when you eat more food you gain and when you eat less you lose weight but I am defying medical science. Someone send me to a laboratory for experimentation!”
When the doctors increased my meal plan, I was even more terrified than I had been before, figuring that if I was already gaining when I wasn’t eating, were I to eat more, my weight would spiral up and out of control. Therefore I continued to restrict in an attempt to lose the weight I had gained…and I gained again.
Soon enough, I had no choice but to start complying a bit and eating a little more, so on the next weigh day, I braced myself for another increase in kilos. You can imagine my surprise then, when I actually lost all the weight I had gained over the previous week despite having eaten double the calories. Logically, that made no sense to me, but, bodies and weights do not make sense during the re-feeding process. As food is reintroduced, chemical reactions explode like fireworks throughout the body, electrolytes get confused, the fluid levels go all over the place so when you get on the scales, any shifts you see are likely to be “false” weights due to all the internal changes going on. Thus, going back to the drunk friend comparison, when they show you a number aka tell you a story summarising the night before, though they will be able to give you a vague idea of what is going on/what your body weighs, they will not provide a logical accurate explanation of your situation/true body weight that you can gain any real knowledge or conclusions from.

3. Your body is going to do some very weird things: When people talk about the re-feeding process they will often whip out phrases like “nourish to flourish”, as if the second you start eating again, sunlight will start shining from your eyes and you will find yourself skipping gaily in a field of daisies. Admittedly, one does need to nourish in order to “flourish” and become physically well, but again this is a gradual process, and at the beginning it is likely your body will do less flourishing and more random weird things that you never expected or understand.
You will probably get tummy aches and indigestion, feel full one minute and ravenous with hunger the next, your bowels may go to sleep or into overdrive, you may fall asleep all the time or even be unable to sleep at all, night sweats and drastic changes in temperature may occur, blood sugar levels will be unpredictably random (recently mine were highest after a day of very little food and then too low after the biggest meal of my admission so far – another reason why medical supervision in re-feeding is vital), and you may experience abdominal bloating as well as this weird thing called Edema. Edema is basically when your body goes through dynamic fluid shifts and parts of your body (mainly your feet and legs) may puff up.
This Edema thing has been especially bad for me this time and my legs and feet swelled up as if someone had thought I was a bouncy castle and plugged me into one of those air machines (during this time I learnt that life is hard when you are a bouncy castle as children are constantly jumping all over you. On the positive side, if you are business savvy you can charge them a few quid a time and make a tidy profit to buy yourself something nice/ice packs to soothe all the bruises made by violently jumping feet all over you).
I think the Edema one had me especially scared because naturally your mind will convince you that rather than water retention your legs are swelling with actual weight and fat, and as someone who is currently managing Edema I can hand on heart promise that is not true. Like I said, I swelled up like a bouncy castle, but after keeping my feet elevated for the past fortnight my legs and feet have started to deflate a little. It feels as if it is a disaster and going to last forever, but it DOESN’T. Me warning you of all these things is not to put you off the re-feeding process, far from it, as it is far more dangerous to remain undernourished with no chance of flourishing in the near future. Instead what I am trying to do here is let you know what might happen so that if it does, you are prepared and know that this kind of thing is totally normal and it is not an excuse for your eating disorder to convince you that it is your body and yours alone being weird and “rejecting food”.

4. Your mind is also going to do some very weird things: You would think that with your body off galavanting and causing mayhem, your mind might perhaps wait to kick up a fuss until after all the physical stuff is over, but no, your mind is going to go a galavanting as well and will also be doing some very weird things. The re-feeding process is very much like the descriptions of puberty I was given in a lesson by my primary school teacher (good Lord was that a terrifying conversation), in that your emotions are going to go all over the place. Like I said, when you are not eating, your mind and body go into standby mode and occasionally emotions shut down. When you start eating again however, the emotions turn back on at weird and unpredictably inappropriate moments. One minute you will be numb and feeling nothing at all, the next you could be laughing hysterically at your shoe, then you will be filled with rage for no particular reason before being overwhelmed with sadness and crying yourself to sleep…It is a lot more fun than it sounds…actually it is not, but again this is not to put you off the process, rather so that you know what to expect!

5. It is different every time: This is probably the most important lesson I am currently learning as I go through the re-feeding process and I imagine it will also be the most important one for people who, like me, have been through it several times before and may be reading this thinking “this is not new information, I know what to expect” much as I may have two weeks ago. I thought that because I knew how my body had reacted to re-feeding before, I would be able to predict how it would be this time round, but that was not the case. Every time you go through re-feeding it will be a different experience and your body will react differently. The longer you have been ill or the more trauma your body has been through, the weirder the experience may be. Like I said, I have really struggled with Edema this time round, and the reason I mentally struggled with it so much is because it has never happened to me before.
I knew all about it and had seen it happen to other people, but when my legs swelled up I was convinced that it was real weight rather than water retention, because my body hadn’t reacted like that on any previous occasion and therefore I thought that kind of problem could never affect me. Had I had Edema before I think I would have coped better with it, as well as the weird things I have noticed this time round on the scales, but it was the fact that “my body doesn’t do this usually” that had me frightened that something was going on and I was actually gaining and swelling with actual weight. Just because your body hasn’t done something before it doesn’t mean it won’t give it a whirl this time and if there is one thing I would want you to take away from this post it is that for all the preparations you make, this is still going to feel very random and very unpredictable…

…What a great final point to end on! Basically I have just told you a list of things to expect during re-feeding and then told you to go into it with no expectations because you cannot predict what will happen…hmm…Great advice…Good one Katie…

To be perfectly honest with you all, I have no idea what is currently going on with my body, what it will do tomorrow and quite frankly I don’t understand a damn word or second of this re-feeding malarky right now.
All I know is that it is scary, it doesn’t feel necessary to me, and I am still doubting the words of every doctor I come into contact with/struggling to accept or trust any of this.
Regardless of any of the mental rationale behind this admission or eating however, this is an honest account of what is and what can happen physically during the re-feeding process as I am trying to get through it, so if you have ever wanted to know what to expect or are going through similar things and are scared, you know that it is not just “your” body being weird and that there is someone else out there with swollen legs covered in the bruises of toddlers who have mistaken you for a bouncy castle.

Take care everyone x

Refeeding

How Physical Health Problems Can Trigger Mental Health Problems

Last week I talked about a recent incident where my mental health, more specifically my eating disorder’s obsession with drinking a lot of water, had a detrimental affect on my physical health and in a hilarious twist of fate and example of bizarre symmetry (and by hilarious I mean literally the most unamusing thing to happen ever), this week I am talking about how the opposite can also be true, and how physical health conditions can end up triggering or making a pre existing mental health problem worse.

So when we last left off, I had explained how I had been admitted to hospital for water intoxication and was being treated for this problem via a strict fluid restriction plan to get all of my electrolytes back to acceptable levels (it is at times like this when I wish I had one of those “previously on” video clips that they show before episodes of various TV dramas…I should really look into that…ooh and a theme tune! I do love a good theme tune!)
Now, after a few days, the fluid restriction, whilst being incredibly annoying for me, seemed to be working, and my sodium levels kept improving until they were back to normal. Really, that should be the end of the story, the problem was solved so I should have been packing my bags and making my merry way home, but alas the story did not end there and developed into what I like to think of as an epic novel of utter ridiculousness.

You see whilst my sodium levels were improving, I wasn’t feeling any better which didn’t make much sense. I had been admitted for a problem that was being successfully treated yet bizarrely, as the days went on, I became more unwell with a pain in my stomach. The doctors couldn’t really make sense of this and before long I was in so much pain that I couldn’t stand or lift my head off the pillow and was in need of all the morphine I could get. A few tests were run but no answers were revealed so a surgeon was sent to have a look at me.

After thumping me in the abdomen with an iron mallet a few times (she said she was only going to “press gently” but trust me from the pain I am pretty sure that woman had a mallet and a vendetta against my stomach region), it was concluded that I might have a swollen appendix. I was told that normally the surgeons would book me in for an operation to whip it out just incase, however due to my already poor physical health from my eating disorder, they wanted to avoid taking me to theatre (alas the operating one and not the version where you get to watch The Sound of Music on stage whilst eating a little pot of ice cream with a spoon that is basically just a mini plank of wood with no resemblance to a spoon whatsoever), because they weren’t sure I would survive an anaesthetic.

Thus it was decided that they would only operate if they were absolutely certain that such a thing was necessary and therefore some more tests were scheduled to try and clear up what was going on. The problem with this was that by leaving time for tests, we were also leaving time for things to go downhill which they did fairly rapidly. Again the surgeon visited and again an operation was suggested but also feared so I was sent to yet another test in the form of a CT scan where I was basically shoved in and out of a tube a few times whilst doctors took photos of my insides (I really hope that my organs put on their best clothes and posed nicely for the occasion…it isn’t every day someone wants to photograph your intestines).

After the CT scan was complete it was around 1am and I was finally allowed to have some more morphine and attempt a snooze, whilst my sister, who had been sitting beside my bed for the past few days, went home. That was until 4am when another surgeon woke me up, to tell me that the scan had shown that things were rather serious and I was scheduled for emergency surgery immediately, my sister being called back in by the nurses having only just left. The next little bit of time is somewhat of a blur but from what I remember I was pumped with anaesthetic and taken to theatre (again, the operating one. I didn’t get so much as a lick of ice cream and I saw no children dancing in curtains. Livid.)
I was so knocked out that it was about 24 hours before I woke up from the procedure, dazed and confused with a tube coming out of my stomach and leading to a bag of some unidentified liquid.

It was then that I was informed that my appendix, in being left for so long, had ended up exploding. (The surgeon told me that I shouldn’t say that it “exploded” because in technical terms you should say that it “ruptured” but damn it I went through a hell of a lot of pain and nonsense because of what happened so if I want to say that my appendix literally exploded like a firework on the 5th of November then I will jolly well do so!)
Consequently my body had been filled with poison, hence the tube and bag scenario coming out of my stomach after the appendix had been removed, to drain the poison out (the poison being the funny liquid in that bag.)

Since then the job has basically been to free my body of poison, recover from the surgery and try to build my body back up after its internal beating, a job that isn’t going too well at the moment because this whole physical health problem extravaganza has triggered the life out of my mental health problems, more specifically my eating disorder.

Admittedly I haven’t been doing particularly well for a while now, but I have been clinging on to some sense of stability by rigidly carrying out the same routine meal plan via some form of repetitive autopilot action. Unfortunately, this event has utterly destroyed my autopilot “just do what you did yesterday” routine.

I think when you have an eating disorder, eating your meals is kind of like a recovering alcoholic avoiding the pub.
If you force yourself to eat the same meal plan every day, you get into a sort of rhythm, a rather bumpy and unpleasant rhythm that you can’t lead a good conga to, but a rhythm all the same. Missing one meal however is like an alcoholic downing one mouthful of vodka after a few months sober and then suddenly finding it impossible to stop.

Knowing that missing one meal will always make the next one harder is the reason that I fight so hard to complete my meal plan even on the bad days because I know that not doing so will make it harder for me in the long run, but in this whole “my organs are exploding” situation, missing a meal wasn’t something I had any control over.
For the first day of the hospital admission, eating was mentally impossible because I was in a different place with different foods. This problem was somewhat solved when family and friends hauled bags upon bags of my safe foods to my bedside, but by that point I was physically in too much pain to lift my head let alone grab a spoon to chomp down on some cornflakes. During all of these pain days I was also constantly being wheeled in and out of various tests that doctors were telling me I wasn’t allowed to eat before, and incase I was going to need emergency surgery after some of these tests, my stomach also had to be kept empty on the off chance that people would be whipping the scalpels out (apparently it is significantly harder to operate when one has just demolished a peanut butter sandwich…or any kind of sandwich…not that there is any other sandwich worth mentioning).

Post surgery I was finally allowed and encouraged to eat to regain my strength and I genuinely tried, but again there were hurdles. Firstly the combination of anaesthetic/poison/million medications made me extremely nauseas, and I was being sick multiple times a day. My taste buds had also suddenly gone haywire and for some reason I could not tolerate sweet foods which for someone who always picks sweet over savoury and who lives off sweet things like porridge and cereal, this was somewhat of a problem. Even the flavour in toothpaste made me throw up (all over my toothbrush I might add…suffice it to say my breath was not minty fresh), and shock of all shocks, I started to be repulsed by peanut butter. Me. Repulsed by peanut butter aka the food that was previously the holiest substance on earth? Who am I? I think I am going through some kind of identity crisis. You might as well start calling me Malcolm.

Therefore I was trying to find new foods that I could both mentally and physically tolerate, family and friends bringing in new groceries every day (including my parents who had had to cut their holiday short and catch an emergency flight back to the UK with fears that they might not get “back in time”…safe to say their relaxing trip to Malaysia was somewhat of a disaster this year..).

Excitingly, a new safe food that I could physically and mentally tolerate was discovered in the form of mashed potato, but by this point it had been so long since I had eaten properly even that was a struggle. I felt sick at every meal time and I could never be sure why. On one hand it could have been the “genuinely physically ill with poison and anaesthetic” sick that I shouldn’t have forced myself to fight as nothing I ate would be kept down anyway, or it could have been the simply sick with anxiety and fear of food sick that I really should have been challenging to prevent it getting any worse. Sometimes food would arrive and I would feel so ill that I wouldn’t risk a mouthful only for the food to be taken away, the sickness to go and me to realise that all that nausea had been anxiety as apposed to anything related to physical complications.

After multiple meetings with my eating disorder services who visited me a lot on the medical ward, it was decided that I would be discharged home incase eating became easier there due to familiar surroundings. Armed with a ridiculous amount of mashed potato, I really tried but a few days in found that I was struggling to swallow. Again I assumed this must be that whole “throat closing up with anxiety” thing, so I persevered, but then after finding some weird white nonsense all over my tongue and throat and a trip to the doctor, it was discovered that life had thrown yet another curve ball and in my weakened post surgery state, had given me tonsillitis and oral thrush, conditions that make swallowing rather difficult and would therefore interfere with anyone’s ability to eat…Oral thrush? I didn’t even know that was a thing? WHAT THE HELL IS GOING ON WITH MY BODY.

Now I am three weeks post surgery (happy no appendix anniversary to me!) and in positive news, the nausea from anaesthetic and poison is practically gone. Having started another lot of antibiotics and some weird throat drops I have also regained the ability to swallow but after so many physical preventions to eating, I am now mentally more terrified than ever at the prospect. I have been to my eating disorder unit and the scales say that I have lost weight yet somehow I feel bigger.
Doctors are telling me that I have to get back to my old meal plan immediately so that we can add new things in to regain all that I have lost but it feels impossible. I cannot comprehend how the hell I was managing to eat before, despite the fact I was doing it only a few weeks ago, because now such an ability has become alien and frightening. I am tied up in a bundle of fear over food, throwing up, weight gain, trying to eat whilst being laid up in bed unable to carry out my usual exercise routines and consequently recovery from surgery isn’t going very well because I don’t have the energy to recover. Both the physical affects and mental health problems are feeding off each other like my body is an all you can eat buffet, and ironically the one person not getting fed in this situation is me. I have been on the edge of collapse for months now, clinging to the edge of stability with all the strength I can muster, but this has thrown me. I have fallen off the cliff. I am spiralling.

…And on that jolly note, that is pretty much my explanation of how a physical illness can go on to affect/cause/trigger a relapse in a pre existing mental illness. As with a lot of my blog posts, it hasn’t been a particular barrel of laughs as far as topics go, but it is the honest truth, and as always, that is what I am determined to put out there in terms of raising awareness of mental health problems.
Now after all this typing, I think I am very much in need of a nap and then maybe I will give some more mashed potato another go. Eating food is the last thing I want to do right now and my stomach is already full from terror, but I promise, I really am trying.

Take care everyone x

AppendixExplode

The Dangers Of Drinking Too Much Water When You Have An Eating Disorder

So in last week’s blog, I talked about a recent lesson I had learnt about the importance of familiar surroundings when you struggle with OCD, and funnily enough I have learnt something else in the past week too.
I am learning a lot of things lately. It is like being back in pre-school only Daniel Jones hasn’t stolen my green crayon (if you are reading this Daniel then yes I know it was you and I still want it back), and the topics of these recent lessons have been far more focused on mental health and less on how messy one can get whilst finger painting/what noise a cow makes (hint: it is moo).

In life, we are constantly being told to drink more water. If you have ever sat in a doctors’ waiting room you will have no doubt seen several posters about how drinking a lot of water is very important, how kidneys love the stuff, how dangerous it is to get dehydrated, and from all of these posters and health warnings you may assume that the more water you drink the healthier you are, which…well… isn’t exactly true, especially if you are someone who is struggling with an eating disorder.

Drinking too much fluid is by no means something common to all people with eating disorders however, and in my years of experience getting to know fellow sufferers, there seem to be three camps of people and how their disorders manage fluids.
In one camp we have the people with eating disorders who struggle to drink enough water and end up extremely dehydrated, then there is a second camp of people who could drink a whole swimming pool if they had a big enough straw, and then finally in the third camp there are the people with eating disorders who do not have a problem with maintaining safe fluid levels and would therefore like to leave the camp I have just put them in and go back home to a habitat that is slightly less tent like.

As it happens, I am in the second aforementioned camp (ours has a lovely log fire and on Saturdays we roast marshmallows), and I struggle with drinking too much water even if I am not at all thirsty.
It is odd because I have always known that drinking too much liquid isn’t good for you, but when it comes down to it, me gulping down glass after glass of water is like some uncontrollable compulsion, a kind of outer body experience.
Many a time I have been pouring myself another litre and in my head have been thinking “NO. STOP! THIS IS DANGEROUS NOW” but my body won’t listen and carries on filling up my glass anyway. It doesn’t matter how ill I feel, drinking the water feels like an urgent and necessary task as if I need to dowse a fireball that is burning somewhere in my stomach, no matter how much water it takes.

Even in the camp of people with eating disorders who struggle with drinking too much water, it is likely that everyone will do so for a variety of reasons and it is rare for two sufferers with the same disordered behaviours to have the same reasons for carrying them out.
When it comes to me though, my compulsion to drink a lot of fluid is partly because of posters I used to see at my local gym telling me that if I didn’t drink enough my body would hold onto water (leading me to fear that the number on the scales would go higher), but mainly it is because no matter how many doctors or dieticians talk to me about the science of the intestine, I am convinced that if I do not drink ridiculous amounts, any food I eat will get stuck in me forever.

Technically I know all about stomach acids and the body’s ability to break down solid foods via various muscle contractions and other clever things that go on behind one’s belly button, but in my head, eating anything solid conjures up an image of that solid thing getting stuck in a tube. Say for example I eat an apple, it doesn’t matter how much I chew it, when it is in my stomach I still picture it as a big red cartoon like shiny apple with the stalk attached, a lump that will stay there unless I am able to create enough waves to erode and wash it away.

For this reason, to try and keep my drinking under some form of control, I have been on a fluid chart for years where I write down everything I drink to try and keep an eye on things so that it doesn’t get out of hand. If I don’t write my fluids down my brain tends to trick me and convince me that I haven’t had a mouthful of water in days (even if I am surrounded by empty bottles of Evian and have been peeing every five seconds), so it is safer for me to keep a record of it so that when the compulsion to drink a lot comes, I can remind myself that I have already drunk more than enough and need to distract myself elsewhere. Last week however, this fluid chart thing went a little bit off plan with the disappearance of my parents on holiday.

I have had several people message me asking what on earth happened after the mass break down described last week, whether my parents ended up cancelling the holiday or whether we gave it a go despite plan A being a rather sizeable fail.

Well, after people had realised that I couldn’t stay at my parents’ friends’ house for the duration of the holiday, the immediate conclusion was that the holiday would be cancelled, but eventually we managed to come up with an alternative plan wherein mum and dad would go off to Malaysia as planned and I would stay at home with my sister and my most legendary friend of all time alternating sleeping over to try and help me stay safe.

It was going rather well for the first few days (or at least better than the disaster that had been plan A), but as time went on I started to get more and more anxious about my parents being away and consequently the urge to drink increased in order to wash all of that anxiety and stress away. I know it sounds pathetic but without my mum there to verify how much I was drinking and suddenly in total control of my fluid intake myself, things started to get out of hand. People who stayed over would be able to support me in the day time but when up late at night I couldn’t help but manically gulp glass after glass of water over the sink. All the people who write those “yay kidneys like water, stay hydrated” posters would probably be thinking that is great but as with most things in life, moderation is key and you can have too much of a “good thing”.
Drinking too much water can cause problems for anyone who has been hitting it hard on the old H20 because your kidneys cannot process it and consequently the water stays in you where it can dilute the salt/sodium level in your blood and cause a condition called hyponatremia, which doesn’t sound particularly exciting but in general language this is known as water intoxication, and I am pretty sure that phrases containing the word “toxic” are never good phrases to hear describe someones physical health.

In healthy adults eating and maintaining a healthy diet, a few extra glasses of water will not cause this kind of thing, but the risks when it comes to people with eating disorders is often greater purely because they may not have been consuming enough salt/sodium in the first place, and essentially there is a risk of drowning your cells on the inside. This then leads to things like heart problems, fainting, water on the brain, seizures, psychotic episodes, death, and basically a lot of things that mean you “aren’t very well” which is exactly what happened to me a few days after my parents flew off to Malaysia and is exactly why my poor sleepy friend had to call an ambulance at 2am on a Saturday morning having been woken by me banging around, generally delirious and spouting nonsense (and a little bit of water. I was like a living water feature. Delightful).

The reason I stayed in hospital for so long however is a slightly more complicated story which I will have to get around to next week, just so that we are all up to date and clear as to why I was so rude as miss a blog post two Mondays ago (Oh the shame. And I was raised in a house with such good manners!), but as an initial explanation, the problem was that I was hospitalised for drinking too much water, and it is now after some severe tellings off from several health professionals that I feel the need to write this post about it so that people realise just how dangerous drinking too much water can be when you have an eating disorder, in case it is something other people struggle with themselves and seriously need to seek support for. If you are one of those people who struggles with drinking too much water I know you are probably doing what I used to do upon hearing these kind of things, the whole “surely it can’t be that bad” and “it would never happen to me” but trust me when I say that water intoxication is extremely dangerous and potentially fatal so if you struggle with it, even if your head tells you “you will be fine”, it is vital you get regular blood tests to check your sodium balance.

Luckily after a few days of being on a water restriction in hospital (good lord was I thirsty), my sodium levels returned to a more acceptable level…it is just that other things started to go wrong after that but again, patience dear friends! All in good time!

Now what I don’t want is for someone who already struggles with drinking enough to read this blog and suddenly panic and start restricting their fluids more than they already were because that is NOT what I am saying you should do and that is dangerous for a different bunch of reasons all on their own. I am just saying it is dangerous to go ridiculously overboard when it comes to fluid consumption even if your eating disorder tries to force you in that direction, and that instead of not drinking anything, just do it all in moderation. Water isn’t dangerous, everyone loves a good paddle or dip in the swimming pool, you just have to keep it at a safe level and be careful not to drown.

Take care everyone x

Kidney

P.s I am sorry if this blog is a little bit all over the place. Physically I am still not in the best place right now and my ability to write is somewhat affected but please bear with me! I am sure recovery will hurry up soon!