Did you know that, much like substance addictions (such as alcohol or heroin), there is a kind of “detox” that occurs with eating disorders?
Well, it can happen for several different reasons but they’re all associated with suddenly stopping or decreasing the use of eating disordered behaviors.
Eating disorders are diverse and can look very different from person to person but their function is generally the same: coping. Unfortunately for the sufferers, this form of coping comes with significant medical and physical consequences. (I might add more to this paragraph later) In this blog, I’m focusing mainly on restrictive and purging based eating disorders because that is my experience so far as a patient. Note that I utilize the words “addiction”, “addictive”, “withdrawal”, and “detox” very liberally in this post to make my point.
Restrictive based eating disorders such as Anorexia or Atypical Anorexia (OSFED) generally lead to starvation- no matter the body size or shape or weight. If you’re like me, you know that starvation can be addictive mentally. Did you know it can also be addictive physically? Purging and laxative abuse, common in not only Bulimia but also Anorexia (purging type) and OSFED, also have physically addictive traits.
Bodies are so good at adapting to adverse circumstances that they eventually can view starvation, purging, and laxative abuse as “normal”. After prolonged use of starvation, the body learns not to expect food. It slows down and all of the biological processes adapt to living in a fasted state. If someone purges a lot, the body anticipates that it won’t be digesting the food that person eats, so it won’t even bother trying to digest it- the body might even purposefully try to reject the food. After prolonged use and overuse of laxatives, the body forgets how to poop on its own (and, with restricting and purging, the body can forget how to poop at all).
In recovery, we’re not only battling mental demons. We’re battling physical illness. Our bodies have to relearn how ask for food (hunger cues). Our bodies have to relearn how to keep food in the stomach and digest it. Our bodies have to relearn how to POOP, for G-d’s sake. Our chemistry also has to relearn how to cope with the presence of food and without laxatives (essentially, a drug). This can lead to not only dangerous constipation, but also something called Refeeding Syndrome.
With a body so used to eating itself, switching to eating food is actually traumatic.
“Refeeding syndrome usually occurs within four days of starting to re-feed. Patients can develop fluid and electrolyte disorders, especially hypophosphatemia, along with neurologic, pulmonary, cardiac, neuromuscular, and hematologic complications.” –Wikipedia
This is why I will now always implore persons looking for eating disorder treatment to utilize treatment centers with licensed therapists, psychiatrists, a doctor or nurse practitioner on staff, and 24 hour nursing care available. A medical emergency can occur at any time during the refeeding or detox process- just like when a substance addict is detoxing from their addiction.
I do not share this to deter persons from treatment. The grass is MUCH greener on the other side of that refeeding speed bump. Once you get through it, the physical symptoms get much easier and even dissipate. Once the mind is well fed, amazing progress can be made in therapy.