The Anorexic Wish and “Feeling Fat”
In last week's blog post, we discussed how "feeling fat" impacts eating disorder recovery. Now, let's talk about what it's like to feel this way during treatment and why you may "feel fat" (the reasons are very real!). Many of our patients want to recover from the cognitive symptoms of anorexia, like obsessive thoughts about food, body image, and weight, without having to actually gain weight.
We refer to it as the anorexic wish.
Anorexia is a challenging condition to treat because so many of the symptoms serve to reinforce the disease. For instance, oftentimes, both the dietary restriction and weight loss feel rewarding to the individual, especially in the early stages of anorexia. When weight loss first begins, there may be compliments about your appearance or your eating habits. People may even ask about your weight control efforts and diet tips. Of course, anorexic behaviors are rarely sustainable. Patients often face a deterioration of health as well as a mind that is totally preoccupied with thoughts focused on food and weight.At Columbus Park, we often see individuals who are simply exhausted by the constant internal chatter about food and eating. Although they may have mixed feelings about getting better, our patients engage in the eating disorder treatment efforts, accepting that eating is an important piece of their recovery journey. In fact, it’s impossible to heal from anorexia without eating and weight restoration. Still,“fearing fat” is a hallmark of anorexia. Patients fear not only consuming fat but also getting fat, which tends to cause them to “feel fat.”
Let’s talk about “feeling fat.”
It’s important to note that there is some truth to feeling like your stomach is sticking out. After your body experiences malnourishment, fat cells first deposit around your midsection in an effort to protect your essential organs. Over a few months, the fat accumulation redistributes more evenly throughout the body.Another issue that patients often experience is delayed gastric emptying. After prolonged food restriction, there’s a decrease in function of the muscles that line the stomach. Food is then pushed to the small intestines at a slower pace. This delay means it sits in the stomach longer, which can cause gastrointestinal issues like pain, nausea, bloating, gas, and a premature feeling of fullness. You’re not imagining it: Your stomach is distended as the food just sits there and churns. However, this side effect doesn’t last forever. As the stomach adjusts and heals over several weeks, it begins to function more normally, and the pain, nausea, and bloating subside. “Feeling fat” is a real but unavoidable part of eating disorder recovery. There is no way around it as your body returns to health.
It’s also important to note that people with anorexia tend to have a distorted body image, which compounds their experiences of “feeling fat.”
At Columbus Park, we’ve found that it’s during the earliest stages of recovery that patients often focus on their perceived “fatness.” They look critically ill, yet, because of a starved body and brain, they experience a distorted reality that tells them otherwise. The distortion is actually caused by disruptions in the circuitry of the brain that may exist before the patient develops anorexia but worsen under starvation. In other words, with anorexia, there is an inherent distortion in self-perception and body image, and thus, it is highly probable that an individual will see themselves as “fat.”As the patient experiences weight restoration with proper nutrition, they also experience improved brain function, and their perception returns to normal. It is a slow shift, so “fat” feelings can last for several months. It takes time for the cognitive healing to catch up to the physical healing. Next week, we’ll dive deeper into body image. We’ll share a few tips to help you recover from anorexia even when you “feel fat” as well as some triggers to this feeling. Stay tuned! If you or a loved one is struggling with an eating disorder, please reach out to our team at info@columbuspark.com to discuss treatment options.
