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Constantly Hungry After Years of Disordered Eating

By December 13, 2012

I had anorexia for four years, and then transitioned into bulimia for another 12 years. I have been recovered from the symptoms now for 17 years. I was into eating disorders before they were well known and before there was much help. I was into bulimia before the term was even coined. The bulimia was extreme and just about killed me. I finally was able to stop the symptoms in AA, even though I wasn’t an alcoholic. However, I never addressed the root causes through counseling and thus dealt with a lot of depression and self hate for many a year after that. Over the years I gained some 30 pounds and am now just a bit overweight, although at the high end of what might be considered healthy by a doctor. Over the years I have learned to ignore my weight and body image and just concentrate on other things. I have heard about intuitive eating, which sounds nice, but I wonder if I have messed up my regulatory system through so many years of eating disorders such that I could never do that. I am constantly hungry. My strategy is to do the best I can with a healthy meal plan and using low density foods, lots of water and tea, and then live with whatever weight I am at. It has worked for the past 17 years, but with continual and gradual weight gain. I would really like to be free of constantly battling ravenous hunger. Every day is such a battle. If I ate to satisfy hunger, I would be gaining weight very quickly and doubt there would ever be an end to it. My guess is that the normal regulatory system of feeling full and satisfied after eating is permanently damaged in my case and I will just have to live with always fighting that ravenous hunger. It is a bit annoying; to the point where it is hard to concentrate on other things or even sleep. Is this how it is for some in eating disorders who have been so extreme for so long, or am I missing something such that life could be easier and not a constant struggle against hunger? – Lynn

Dear Lynn,

Thanks so much for taking the risk to ask these important questions. This is exactly what I hear time and again from women who have suffered for years with eating issues – “Did I permanently mess myself up? Will I ever be normal?” I personally believe and have witnessed over the years, that internal cues of hunger and satiety are completely restorable. If you were once capable of knowing what to eat, when to eat and when to stop, then you can certainly regain those abilities.

First, two resources that I strongly recommend for you are: 1) the book, Intuitive Eating (I bet it makes a lot of sense to you) and 2) the workbook, Moving Away From Diets (this deals with connectedness in eating and why we can become so disconnected from our bodies).

I can assure you that it is nearly impossible to permanently destroy your metabolism, even after years of an ED. However, the truth is, we are connected mind-body-spirit. So sometimes when our mind and spirit are wrestling with pain and other uncomfortable feelings, it wreaks havoc on our body. It is possible that you aren’t completely dialed into your natural body cues of hunger/fullness due to lingering emotional issues which distort and confuse these internal regulators (i.e. you feel “hungry” all the time).

This could also be physiological. If you are eating “low density” foods and drinking lots of water and tea, you may not be getting the right balance of nutrients to create satiety.

We all need fat in our diet; fat is one of the best nutrients to offer satiety (satisfaction factor) in eating. Also, we know for certain that years of dieting result in some amount of extra weight gain for about 95-98% of the population.

It makes sense that you have gained some weight over the years. Not only because of the ED but because of hormonal changes later in life that are conducive to some weight gain. This is perfectly natural.

The best approach is to make sensible lifestyle choices. Eat foods that are tasty and satisfying with balance, variety and moderation. Be active, not addicted to exercise. Don’t smoke, and learn how to handle stress effectively. Make lifestyle choices that support health and let your body weigh what it will.

Do not be deceived by the weight standards in our culture today. Every body is designed to be a different shape and size. Sensible lifestyle choices are where it’s at.

My wish for you is to return to freedom with food. No, this is not an unrealistic goal. It is my mission with every eating disordered person I see. Try to find a dietitian who supports a “Health at Every Size” approach. I truly believe that you have started asking the right questions and with continued hard work, you will return to freedom with food. Go for it!

Best wishes,

Juliet N. Zuercher, RD