Thursday, 7 March 2019

the HAES® files: Recovering Abundantly in a One-Size-Fits-All World

by Erin Harrop

When I began my recovery journey from an eating disorder 13 years ago, I had a certain set of expectations about how the recovery process would go. Healthcare professionals told me to expect several things. They reassured me that as I learned to eat a broader variety of foods that my anxiety around eating would go down. What?! They said the more I faced my fears, the more comfortable I would feel. They also told me that my body would start to “adjust,” and that with regular consistent nourishment my hunger and fullness cues would normalize, my digestion would become more regular, and my physical discomfort with the eating process would decrease. It was hard to believe at first, but in the end, they were right. The more fear foods I approached, the less anxiety I had; and even though I felt very uncomfortable physically in the beginning, the more consistently I ate my meals and snacks, the more everything started to “flow” a little better.

They also measured my body with scales, bone density scans, and labs. They calculated my resting metabolic rate, my body fat percentage, my hormone and electrolyte levels, and exactly how dense my bones were. And they used all of these wonderful scientific measurements to tell me exactly how much my body would weigh when I was “fully recovered.” In fact, they were so precise about their measurements that they even gave me a mere five pound range for where my body would eventually settle and be the perfect weight—after I completed nutrition therapy. They reassured me time and time again that they were the experts, and my body would be and look a certain way—and that with time (even though it might be the last thing to get better) my body image would improve.

The problem is: they were wrong. For all the expertise of my medical team, for all the years of experience that my physician had in treating eating disorders, metabolic disorders, and high performance athletes, my body’s wisdom was different than they all expected. It was not (like many bodies) 100% predictable. During my nutritional rehabilitation, my body met, and exceeded their wildest expectations. Before I had even left inpatient treatment, my body had crept out of that “perfect weight range.” My body was not done restoring; after over a decade of restriction and compensatory behaviors, my body was healing. But it was not healing in the way my medical team had told me to expect.

This experience was difficult to accept. A sick, eating disordered part of myself had found comfort in the health professionals who had reassured me that “I would not get fat.” My eating disorder still feared fatness. Like many eating disorders, it feared being a different body size; it feared the seeming loss of control over my body (which I never really had in the first place). It feared the stigma that fat bodies experience every day.

When I found myself in a body that was larger than I had been told to expect, I worried that I had failed at recovery. Was I eating too much? Was I overcompensating by “bingeing?” Was I not following my meal plan carefully enough? Did I somehow do recovery wrong? Was that why my body had failed?

Fortunately, my outpatient team did not collude with my eating disorder. After asking me about my eating and behaviors, we determined that I was not “doing recovery wrong.” I was not experiencing “bingeing” or “overcompensating” or having other eating disordered behaviors—those fears were simply remnants of my eating disorder. I was, however, learning to eat more intuitively. I was honoring hunger and fullness—still with a tendency to restrict at times or push my body too hard. I was doing recovery—imperfectly, with bumps, but I was doing it. And my body was continuing to heal. My labs were improving, my blood pressure was stabilizing, my EKG’s were normal. And all of this happened (for me) at a higher weight, at a weight considered “obese” by current BMI standards.

Recovering into a fat body—and learning to embody, honor, and nourish my fat body—has been a journey. I have had to do a lot of work around my own fat phobia and body fears. I have also encountered others’ fat phobia—in society, in the medical system, and in the eating disorder recovery community. Sometimes I fear that I will be less believed because of my fat body; I fear that my recovery story will not be valued. It is easy to discount and devalue my own healing; it is also easier to slip back into eating disordered thoughts and behaviors when the world judges my body the way my eating disorders does.

Looking back on my journey, I realize I had put recovery in a box—and this box was simply too small. Today, I study eating disorders remission processes, and I hear from folks every day whose experiences do not align with what I was initially told to expect in my recovery process. Our healing journeys are unique and shaped by our lived identities—our races, genders, spiritualities, sexualities, abilities, ages, chronic illnesses, and bodies—and these do not fit neatly into one recovery box. We recover in different ways. We recover into different bodies. Today, as I listen to others’ stories of illness, daily coping, and remission, I am heartened that there are so many different stories and paths to healing out there, and I try to honor my own path in the process.

This blog post was also published on NEDA’s website.

 


Erin Harrop is a doctoral student in social welfare at the University or Washington. She researches eating disorders and weight-stigma utilizing patient centered approaches. Her research addresses how systemic factors of weight-stigma impact the illness journeys of eating disorder patients. She employs an interpretive, critical feminist theory and anti-oppression lens to her work, as well as an explicit Health at Every Size® approach to the promotion of health behaviors. Her research is informed by her clinical experience as medical social worker at Seattle Children’s Hospital, where she has worked for the past five years. Erin recently was funded for two NIH TL1 Translational Research Training grants for her dissertation research with women who have atypical anorexia. Erin is also active in the student group, SWAG (Sizeism, Weightism Advocacy Group), which she co-founded in 2012.



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