Atypical Anorexia Recovery

Photo: mine

It’s been nearly a year since things with my former eating disorder ‘therapist’ went far enough down the tubes to feel like therapy, such as it was, was over. Nobody had asked about my intake for a couple of years, so it seemed like it didn’t really matter if I ate or not. I knew I’d have to make myself get in enough fluids and food to make sure that my kidneys had enough on board not to get worse. It’s been hard, and there are a lot of days when I think about just going back to what was less physically uncomfortable. The emotional end of things has been much harder considering all that has gone on with my former non-therapy.

I’ve tried multiple times over nearly 4 years to get rid of the nasogastric tube that gets enough fluids in for adequate kidney function, as well as blood pressure support. The tube is back in after another try at not having it last month. I made it a few days, with lower volume food intake (tried to eat higher density foods, but I don’t like a lot of them), but then struggled for 3 days, and that’s my self-imposed limit. I can’t risk going longer since I’ve been in acute renal failure twice in the past 4 1/2 years. But I am still maintaining fluids, even if I need the tube to do so.

Food is still a problem. “Normal” eating is still something I don’t feel I deserve, and it’s physically unpleasant with bloating and feeling too full. I’m not a purger, so once it’s in, I have to put up with the side effects. I’m not as ‘avoidant’ with the types of food I will eat, but am still consumed with not eating over X number of calories per day. Tracking food is something I tried to get away from, but I have to know carbs for insulin dosing, and protein for my kidneys. It’s very difficult to get in enough protein when I have to restrict the options because of gout.

I’ve been trying to do the opposite of what my head says, and at times I can do that, but only with some types of food (single serving sizes are helpful). I’ve wanted to let myself have one meal a week or month when I just have what I want, but that hasn’t gone well for several reasons. The medical restrictions on food, only getting X amount of insulin per month, etc are hard to deal with when attempting to break some ‘head rules’ about food. The current “never restrict” goals of eating disorder recovery are hard for someone who has literally always been restricted (when I was a child) or my own active and passive restriction… For me, active restriction is when I relapse and passive restriction is eating how I did for my entire life, eating about one meal stretched over the day. For me, that was ‘normal’. And what I see in the mirror still doesn’t look like it deserves food, even though I’d give more to someone else, whether they were larger or smaller than I am.

I am starting to understand that like dogs, birds, fish, or whatever family of animals, humans have different sizes and shapes that ‘just are’. There’s no ‘defect’, just natural differences. I’m not sure what my set-point weight is (natural weight without restriction) because I’ve never NOT restricted in some way (or been externally restricted). I’ve read or heard (YouTube) that it takes time and an extended period of not restricting to get to that place, so I’m nowhere near that since I’m still restricting to some degree with the fear of going over X number of calories that are below what the dietician I saw told me is ‘normal’ for my age, activity level, and body type. I will never be a greyhound. I’m more of a Labrador retriever. And I still have the urge to be a greyhound.

I understand that repairing the damage I’ve done to myself over decades takes time and food. I know that I’ve gained muscle in my arms and legs, and that there is a difference in swelling if I don’t eat enough protein (hardest thing to get in with medical limitations). Some of that muscle gain is starting to atrophy a bit. I’m tired of most ‘safe’ protein sources, so there is a lot of forcing in of stuff just to get to the minimum, and honestly, I miss that mark many times a week. But I’m still trying. My heart rate is still wonky, and my blood pressure stays low normal unless I’ve taken trash out to the dumpster; then it goes to high normal for about 10 minutes. The higher blood pressure is probably better for my kidneys since poor perfusion is why they are damaged.

Most days I don’t feel like anything will really work to get me rid of the restricting. I still feel worth less than I did 5 years ago when I relapsed, after 3 1/2 years with my former ‘therapist’. It’s hard to feel worth anything when I’ve felt worthless for decades, and I felt kicked to the curb by someone who had no interest in me getting well even though that was the sole purpose of that relationship. I also know it had nothing to do with me personally, I was just another failed patient because I was too broke to be worth the time to get well. I’m not alone there… lots of examples online, which helps in knowing it’s not about me, but also sad that so many have been left suffering more because of that relationship that fizzled out without the decency to finish what was started. I’m working on getting past that, which is hard, but it’s not like this is the first person to be a disappointment and something to recover from. I generally land on my feet, and thankfully am as independent as I can be within physical limitations. There is no limit to my emotional independence since that’s pretty much all I’ve known. So, while I’m broken, I’m not destroyed.