A few days ago, I wrote about my experience with exercise in relation to my eating disorder, and how I felt that to be able to move around more during the refeeding process would have been so helpful for me.
I have been overwhelmed by the supportive comments and really enjoyed how people have told me about their experiences and their views – it’s broadened my own viewpoints and given me a bit more insight into the way we all deal with things. But on every blog, every now and then, we get a not-so-positive comment:
Nicole Marie Story says:
“During refeeding?” Oh my God… you are a hot mess, Fiona. I like your other blog so much better… you have balls in that one.
So. I decided that I would address the point she has raised in this – “During refeeding“.
Since I didn’t care to ask – I assume that she means “WHAT refeeding?” As in, you are still one of those ‘skinny ugly mean anorexics’. And yes, I do still have a LONG way to go, but I’ve also come a long way – I’ve been partially refed, I suppose. I will post proof of how far I have come at the bottom of this (as usual) TL: DR post. (Trigger warning)
I have done the refeeding process so many times I’ve lost count. And I know that everyone out there who has had relapses of their eating disorder has probably done it too. Even people who are fighting eating disorders and overweight need to go through a refeeding process. No, they aren’t focussing on gaining weight like those who are underweight must – but their bodies still need to have crucial nutrients restored.
You don’t need to be underweight to be malnourished.
And as we know, part (and only PART – don’t forget the emotional, psychological issues either!) of what drives our eating disorders is our malnourishment/deprivation. Our bodies are starving for nutrients. As long as they are lacking, they are going to give us a song and dance about it! They’ll drive us to overeat, to binge, at the very least, they’ll drive our obsession about food, our weight, our appearance, exercise, etc.
Are any of you familiar with the Minnesota Semi-Starvation Experiment? Many of you, I expect, will be. It seems to be a go-to education tool in many treatment programs. And for good reason – it’s mind-blowing! The first time you read it, you are shocked, because you thought your behaviours, your obsessions, everything you did was unique. Some of you might even have argued when told some of what you did was stereotypical ED behaviour. “I do this because I want to.. because I love food.. because I’m just a very active person who loves to exercise.. because I LIKE to eat strange combinations of food.. because I LIKE chewing gum and drinking 109092 teas and coffees and diet colas…” etc etc etc. But it’s not part of having an eating disorder, hell no.
Oh yeah? Well it IS, folks.
At the end of World War II, with returning POW’s, with famine in Europe and Asia, and many more people in danger of mass famine as a result of the war itself, a clinical study was undertaken at the University of Minnesota under the lead of Ancel Keyes. This study – the Minnesota Semi-Starvation Experiment – was to investigate the effects of semi-starvation, and the impact of different ways of rehabilitating those who were starving.
36 healthy men were selected from over 400 who applied to take part in this study. These men were aged between 22 and 33 years old, had demonstrated strong mental and physical health, commitment to the study, and the ability to get on with a group of people while enduring deprivation and hardship.
These men volunteered to subject themselves to a year-long invasion of privacy, nutritional deprivation and physical and mental hardship necessary to complete the study.
For the first twelve weeks, the men, who were as close to their ‘ideal’ weight as possible, ate a controlled, varied diet of roughly 3200 calories. Then, they were starved for six months.
During the 6-month semi-starvation period, each subject’s dietary intake was cut to approximately 1,560 calories per day. Their meals were composed of foods that were expected to typify the diets of people in Europe during the latter stages of the war: potatoes, rutabagas, turnips, bread and macaroni. On average, each man lost a quarter of his starting body weight.
After this six months of starvation, the men had a twelve week restricted rehabilitation period where they were divided into four groups and given four different calorie allowances. Within these groups, they were also divided into subgroups in order to be given different regimes of protein and vitamin supplementation. At the end of this twelve weeks, they had eight weeks of unrestricted rehabilitation where they were allowed to eat as they wish, but still carefully monitored.
So what happened to the men, when they were starved?
Most of the men experienced severe emotional distress and depression. One man even cut three of his own fingers off with an axe.
All of the men developed intense preoccupations with food while being starved – which continued even during rehabilitation.
Also, all of the men experienced (among many things):
- Hysteria and Hypochondriasis
- Withdrawal and isolation
- Reduced sexual interest
- Decline in concentration, comprehension and judgement capabilities
- irritability and impatience
And physically (also just a few of many):
- Marked decrease in basal metabolic rate (energy required by body at a state of rest)
- reduced body temperature
- reduced respiration rate
- reduced heart rate
- edema (swelling) in extremities - thought to be from the massive amounts of water the men drank to fill their stomachs.
- increasing physical weakness
From an interview later with participants:
“As semistarvation progressed, the enthusiasm of the participants waned; the men became increasingly irritable and inpatient with one another and began to suffer the powerful physical effect of limited food. Carlyle Frederick remembered “… noticing what’s wrong with everybody else, even your best friend. Their idiosyncrasies became great big deals … little things that wouldn’t bother me before or after would really make me upset.” Marshall Sutton noted, “… we were impatient waiting in line if we had to … and we’d get disturbed with each other’s eating habits at times … I remember going to a friend at night and apologizing and saying, ‘Oh, I was terrible today, and you know, let’s go to sleep with other thoughts in our minds.’ We became, in a sense, more introverted, and we had less energy. I knew where all the elevators were in the buildings.” The men reported decreased tolerance for cold temperatures, and requested additional blankets even in the middle of summer. They experienced dizziness, extreme tiredness, muscle soreness, hair loss, reduced coordination, and ringing in their ears. Several were forced to withdraw from their university classes because they simply didn’t have the energy or motivation to attend and concentrate.”
But most interesting is what happened for the men in relation to FOOD.
“Food became an obsession for the participants. Robert Willoughby remembered the often complex processes the men developed for eating the little food that was provided: “… eating became a ritual … Some people diluted their food with water to make it seem like more. Others would put each little bite and hold it in their mouth a long time to savor it. So eating took a long time.” Carlyle Frederick was one of several men who collected cookbooks and recipes; he reported owning nearly 100 by the time the experiment was over. Harold Blickenstaff recalled the frustration of constantly thinking about food:
I don’t know many other things in my life that I looked forward to being over with any more than this experiment. And it wasn’t so much … because of the physical discomfort, but because it made food the most important thing in one’s life … food became the one central and only thing really in one’s life. And life is pretty dull if that’s the only thing. I mean, if you went to a movie, you weren’t particularly interested in the love scenes, but you noticed every time they ate and what they ate.Two volunteers broke diet and were excused from the experiment; one stopped at various shops for sundaes and malted milks and later stole and ate several raw rutabagas and the other consumed huge amounts of gum and admitted to eating scraps of food from garbage cans. Both also suffered severe psychological distress during the semistarvation period, resulting in brief stays in the psychiatric ward of the university hospital. Another participant broke diet and later suffered some urological complications that prevented his data from being included, but he was asked to stay on and help in the kitchen. Initially the participants were allowed to chew gum, but some of the men began chewing up to 40 packages of gum a day. One of the participants was later excluded because his pattern of weight loss was not consistent with the amount of food intake and energy expenditure, and there was concern raised about excessive gum chewing.
After the rehabilitation period, many of the men found it hard to not eat too much – One man was taken to hospital to have his stomach pumped from eating too much food. Another was sick on the bus on the way home from eating because he was eating so much. Many of the men reported eating excessively long after the study was over. Read about it here They Starved So That Others Be Better Fed.
So what does this tell us?
It tells us that starving our body of nutrients has a long lasting effect on our bodies and our minds. It drives us to eat – our body’s way of trying to survive. It drives us to obsessiveness and compulsiveness.
And it tells us that if we want to NOT BINGE – we have to EAT PROPERLY. Restricting will always cause the opposite reaction eventually.
Most importantly, it demonstrates why, if we want to be free of the eating disorder’s symptoms we do have to refeed our bodies. These men all had NO issues with food, weight, depression, obsessions and compulsions, etc – before they were starved. It was starving that caused them to develop them!
Please note – it’s adviseable to be under medical supervision whilst undergoing refeeding especially if you are identified to be at risk. Refeeding Syndrome can be unpredictable – and deadly. It’s actually one of THE most deadly aspects of eating disorders according to The Academy of Eating Disorders.
Okay – here is the trigger warning. I’m about to post photos of myself when I was very unwell – not the sickest I’ve been by far, but at what used to be my ‘average’ weight. I used to drop about 5-6 kilos lower than this to be admitted, and be taken up to about 5 kilos higher than this to be discharged. I am currently 10 kilos heavier than in these photos. This is me NOW:
And THIS is me when sicker:
I don’t look happy do I? *pout*
Probably because I was MISERABLE..
My face:
I had actually just been discharged from hospital the day I took this photo. I didn’t see how haggard I was then. Now – I’m shocked.
And my LEGS, before they totally wasted away (and I wasn’t able to walk):
YUCK.
Compare these to today’s legs:
Gotta dance! That’s what I need healthy legs for!
So, Nicole, even though you don’t believe I have undertaken at least some refeeding – I have. Proof is above. Yes, more is needed. But I’m not just talking about ‘refeeding’ without any actual experience of undergoing it.
And because we all need a reason to keep going – here’s mine 
She keeps me warm – and warms my heart
Thank you for reading! I hope I made sense.
Can you see how your body’s deprivation of all that it needs has affected your eating disorder – your thoughts, your behaviours? Has nutrition helped you to improve your life?
Quickly edited to add -Happy Independence Day to all you Americans
