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Did you know that, much like substance addictions (such as alcohol or heroin), there is a kind of “detox” that occurs with eating disorders?

How?

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.

Disclaimer:
this is my blog.  I can do or say whatever the heck I want. If I want to post incomplete articles and finish them later, I’ll do just that.  Check back every now and then to see if I got around to finishing it. Comment if you want more info sooner/now/sometime this century.
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So you wanna go to rehab?
Some things to consider:

-I AM SO PROUD OF YOU FOR LOOKING INTO THIS

-Treatment can be costly and expensive.  Even with insurance.  If you live in a state that allows you to have both private insurance *and* Medicaid, look into whether you will qualify for Medicaid.  It will help with your co-pays and deductibles for treatment, appointments, medications, and even transportation to facilities/appointments.

-There are scholarship programs available for persons looking to get treatment for eating disorders.  A popular one is called Project Heal.  There are more if you look hard enough.

-Look for a treatment center that has LICENSED therapists, Registered Dietitians, a psychiatrist, and nursing staff. Eating Disorders are serious conditions that deserve the best and most qualified care. Medical needs can change rapidly and suddenly- so it is imperative that a nurse is available 24/7 for emergencies and incidental needs at night.

-You may hear about “free” treatment facilities run by religious organizations.  These programs can be helpful for some people, however, they may not have qualified licensed professionals nor nursing or medical care available. Those who are interested in such programs should complete a traditional eating disorder program first to ensure medical stability during the refeeding process. Once that speed bump is conquered, it should be safe enough to proceed with a program such as a religious one that does not have medical staff.  Persons considering such programs should be serious about pursuing obedience and adherence to their faith as a permanent substitute to their eating disorder.

-Don’t just ask if a provider treats your eating disorder…. ask exactly how they treat it.  Ask which methods and philosophies (ex: DBT, ACT, CBT, ERP, EMDR, etc.) are utilized and why.  If you have a particular method you’re already interested in, ask if they utilize it and how they utilize it.  If they don’t utilize that method in a way that satisfies you or your needs, ask if they would be willing to accommodate you in individual therapy to utilize that method more or to its fullest extent.

-Remember that treatment centers are primarily businesses FIRST and foremost.  They will do whatever they can to get you into your door, even if they’re not actually the right program for you.  They will petition insurance, reassure you, make promises, and more.  Do your research.  Get those promises in writing.  And always shop around before you decide on any single program.

-Social Media is an excellent way to get in contact with persons who have already been in the programs you’re looking at.  It will take some effort, but it’s worth it.  Start asking around in groups and forums online whether anyone has been to the place you’re looking at.  Many times, you’ll find someone who had a friend go there- and you’ll be put in touch with that person.  Find out the good, the bad, and the ugly.

-Google is your friend!  Look for photos, reviews, anything on the place you’re considering.  There are a lot of phonebook style websites with a review option available, scour those posts.  Also check out dedicated websites, such as http://www.edtreatmentreview.com and http://www.eatingdisorderstreatmentreviews.org .

 

Disclaimer:
this is my blog.  I can do or say whatever the heck I want. If I want to post incomplete articles and finish them later, I’ll do just that.  Check back every now and then to see if I got around to finishing it. Comment if you want more info sooner/now/sometime this century.