Eating Disorders Don’t Just Disappear When Someone Gains Weight

This week is EDAW and I couldn’t decide what I wanted to write about. Eventually, after many lists and deliberations I settled on discussing how eating disorders don’t just magically disappear when someone has gained weight. This is something I have definitely experienced, but I want to preface this post with a couple of things. Firstly, if this is a topic that might be triggering to you, please feel free to scroll on and ignore me! Secondly, I know I highlighted this in my post on eating disorder statistics (you can find it here), but it is estimated that less than 6% of people with an eating disorder are medically underweight, and therefore weight gain might not be the goal for everyone with an eating disorder – I am basing this purely off my own experiences!

Eating disorders are incredibly complex conditions and there are so many components to recovery – weight gain is just one of those components for some people. Whilst weight gain can be crucial for some people with eating disorders, it doesn’t mean that once weight gain has happened the disorder just goes away. Unfortunately, a lot of specialist services are so underfunded that they can only see the most physically compromised patients and many services have weight thresholds that people have to meet in order to access care. This also means that often people are discharged once their weight reaches a certain point and can contribute to the perception that people have that weight gain = recovery.

Eating disorders are deeply rooted in thoughts, emotions, and behaviours, not just physical symptoms – they are mental health conditions, after all. It is incredibly common for people to restore weight whilst still struggling with obsessive thoughts about food, body image, and self-worth. If we only focus on weight gain and don’t address the underlying issues, then how can we expect someone to reach a state of full recovery? Anxiety, guilt and shame are just three feelings that can persist long after weight has been restored.

As well as this, it isn’t uncommon for disordered behaviours to shift as people gain weight. For example, someone who is diagnosed with anorexia nervosa, might start to struggle with binging and purging – behaviours that are more commonly associated with bulimia nervosa. Food restriction might turn into over-exercise as they struggle to cope with the guilt of gaining weight and their ‘new’ body. Or, they might start to restrict in more subtle ways – only eating ‘safe’ foods for example. This is something that I have struggled with a lot – I spent the best part of 3 years only eating the same 5 foods. No matter how boring it got or how fed up I was with eating the same things on repeat, I didn’t feel able to push myself beyond those foods that my brain had deemed ‘safe’.

It’s also very easy to become preoccupied with a fear of relapse or of the consequences that might come with relapse – for example, hospitalisation or being forced into treatment again. This can feel like you’re trying to balance on a tightrope, carefully trying to stay the right side of the line between freedom and being trapped in hospital. It can, therefore, be incredibly easy to fall back into old patterns when stress levels are high or when people make comments about your body or diet.

When you are recovering you have to go back to basics. It will probably sound strange to anyone who hasn’t struggled with an eating disorder, but in some cases, it can feel as though you are having to relearn how to eat. You have to get used to your body’s hunger cues again, how to cope with the feelings and emotions that eating ‘normally’ can bring up, and how to manage these without resorting to old patterns. Just because someone ‘looks better’ doesn’t mean that they are feeling better or have developed a completely healthy relationship with food again.

I had an OT when I was in hospital who took me right back to basics. When I was terrified of food, she would get me to do things like playing with food, or turning the food on the plate into a picture – things that probably sound quite juvenile, but were actually incredibly beneficial to me in terms of relearning what a proper relationship with food looked like. Just as babies learn about food and different tastes and textures through making a mess and experimenting with different things, I, too, had to learn to do this again. Gradually this made it easier and easier – to begin with I was scared to hold food as I thought that it would cause weight gain, and over time I learned that this was just my brain warping reality and I began to find being around food became second nature again.

Recovery from an eating disorder takes time. This isn’t what anyone struggling, or anyone caring for someone, wants to hear, but it’s true. It takes time and a lot of effort. No one else can recover for you, and a lot of work has to be put in to maintain the changes that are being made.

Telling someone that they are suddenly ‘better’ because they have gained weight can be a pretty harmful and invalidating thing to say. It can make people feel as though they can’t be honest about how they’re feeling and leave them feeling as though they need to put up a mask, or it can go the opposite way – leaving people feeling as though they need to prove that they are still struggling in order to get any support. True recovery, which I do believe is possible, requires both physical and psychological healing which takes time, patience, and professional help.

But don’t be discouraged if you’re not feeling like you’re getting anywhere in your journey – it is entirely possible to recover, even though it might not feel like it now.

All my love,

Anna x