When you understand that restrictive eating disorders are an addiction to the state of energy deficit, you can also appreciate the steps that might be most beneficial to overcome one. The gold standard approach to overcoming addictions is abstinence from the addicted drug (which can also be behaviours). In earlier posts, I have explained why abstinence from your drug (of energy deficit) is the best way to ensure effective brain reprogramming. My recently published book, Addicted to Energy Deficit, explores this topic in more detail.
Abstinence from the behaviours that lead your body into a state of energy deficit is the best way to ensure effective brain reprogramming and physical restoration to emerge fully from an energy deficit state. There are though some additional advantages to an abstinence approach.
Advantages of Using an Abstinence Approach
Mentally, it can be easier to abstain. Abstaining from any drug or addictive disorder can be mentally easier to manage. When you try to, 'cut back', you are still allowing yourself to engage in your addiction but just not as much which creates extra mental gymnastics to navigate in terms then of how much you will still do, where you will cut back, what is ok or not ok, and it gets very complicated. Setting limits for yourself and trying to keep within them takes more stamina and mental effort than just saying no to everything.
While still engaging, even if in moderated amounts, you are still using eating disorder brain pathways, pushing up your dopamine levels and both these factors will make your cravings for more much stronger.
Abstinence provides more clarity to the extent of the eating disorder than you can gain when still engaging in it.
Abstinence provides black-and-white rules for the eating disorder behaviours that are easier for you and anyone supporting you to understand.
Eradicate the feel-good hits. When you are still engaging, even to a lesser extent, you still get 'hits' from your drug. When you continue to use your drug, your brain will want more, making sliding back a greater risk.
Yes, the thought of abstinence from the eating disorder probably sounds very confusing but hang on in there—we will get to the how part in a moment. But putting how to abstain to one side, this is also all going to sound overwhelming. You might think that you can't do it, it will be impossible and you will never cope. But I say to that—give yourself more credit. If you have been strong enough to survive an eating disorder, you are strong enough to (imperfectly at times) abstain from it. Take it one day or even one hour at a time, using support and you will get through.
And one final note before getting into the nitty-gritty of how to abstain from a restrictive eating disorder—any of you who think this doesn’t apply to you because, I've never restricted that much; I don’t do much exercise; I only purge a couple of times a week; my weight is actually not that low.... If you have any level of restrictive eating disorder that's harming your life and you haven't been able to stop the related behaviours because of how compulsive they are, then this applies to you just as much as it does to anyone else. Tell your thoughts saying otherwise to shut up!
How to Abstain from a Restrictive Eating Disorder
I appreciate that abstaining from a restrictive eating disorder takes more creative thinking than with other forms of addiction, but it’s not that complicated. It just takes logical thought and going against everything you feel is right, not to mention diet culture.
Grasping what it means to abstain from energy deficit can become clearer when you think about what the opposite of energy deficit is.
The opposite of energy deficit is energy surplus. To abstain from an addiction to energy deficit, you need to pursue energy surplus. This means stopping any behaviours that maintain or deepen your energy deficit state, i.e. behaviours that would typically lead to weight loss or control your weight at a level below your set point and engaging in behaviours with the opposite effect.
Yes, it's time to be positive about weight gain and doing things that will cause it so you do get this miserable eating disorder out of your life. Gaining weight is essential to emerge from energy deficit and allow your body to find energy balance. Weight gain is a good thing—it's where your ability to heal mentally and physically to find a free life sits. And a note here—the advice to pursue weight gain to emerge from energy deficit and reprogram your brain is the same irrespective of your starting weight. I will talk about restrictive eating disorders in bigger bodies in future, but please understand that this information applies equally to anyone of any size, so keep reading.
Now that I have terrified you a little more (well, terrified the eating disorder anyway, as I reckon that the real you is nervously intrigued), let's get into more details about how to abstain from your addictive pursuit of energy deficit.
Some the behaviours are easier to make black-and-white rules about how to abstain. You can decide to say no to the following behaviours:
Purging through vomiting
Weighing yourself
Chewing and spitting
Calorie counting
Weighing or tracking foods
Using Fitbits
These you abstain from. That's not to say it will be easy but you can make clear rules about these behaviours.
Abstaining from Restriction
When you have been eating restrictively for a long time, being able to begin to understand what unrestricted eating looks like can be very hard to grasp. Suddenly just eating an extra cereal bar in the day can feel extreme (for anyone unsure, it isn't).
Therefore, grasping how to go from eating with restriction to being told to eat without any restriction can be a bit complicated for a brain that just doesn't get it yet.
To help you begin to process what abstaining from restrictive eating might look like, it can be helpful to ask yourself,
What would someone who was eating to deliberately gain weight do?
Someone doing the opposite to being on a diet?
The answers to this would include eating most of the time and predominantly high-fat, high-calorie, dense foods. Eating big meals and lots of snacks. No avoidance of processed or fast foods. Including all food groups and types, understanding that high density is better, and avoiding nothing other than diet products. They wouldn't count calories or have limits, and they would eat like a person who didn’t care a fig about weight gain.
And this image of this kind of eating and approach to food is precisely what abstaining from restriction can look like.
This approach also addresses some of the complications your brain can create about ensuring that you are eating enough, which we all know means not too much or eating the right amounts. If you are eating to gain weight and with an aiming to gain mentality, the only right amounts are as much as you can and deeply really want!
More of the benefits of this abstinence approach to eating and details of how to go about it will be covered in future posts. In the meantime, the book covers so much more so feel free to pick up a copy.
Abstaining from Compulsive Movement & Exercise
The other compulsive behaviour that many people struggle from with a restrictive eating disorder and from which abstinence isn't so clear-cut is movement and exercise.
Compulsive movement or exercise manifests differently for everyone and can change over time. Some people might go out running every day without fail, while others might walk the dog each day for twenty minutes or do low-level yoga twice a week. The amount of exercise you do is largely irrelevant. If the exercise or movement you engage in is compulsive and addictive—meaning it’s hard to stop because doing so creates high anxiety or agitation—then it doesn’t matter how intense it is or isn’t. It’s all valid. It’s damaging your life and abstaining from it is the best way to overcome this addiction.
Your chance of success at abstaining from compulsive movement, as with any habit, will be much greater if you have a plan for what you will replace the movement habits with. Decide on something you will do instead of your usual movement rituals that is sedentary and ideally can be done with food in hand.
With formal types of exercise, it is easier to make black-and-white rules for how to abstain:
No formal exercise
No walking that isn't essential. Dogs should be walked by someone else.
No yoga or other forms of 'it's just stretching'. No.
No cycling even if you try to convince yourself you have to to get about. Use another means of transport—car, bus or Uber and if you can't then stay home.
But what about lower level movement?
This is where it gets harder to be so black-and-white because lower-level movement is necessary for life to an extent and this is where only you can be honest and upfront with what is essential and what isn't and cut out what isn't!
For anyone who isn't sure, compulsive lower-level movement includes things like moving about the home, standing rather than sitting, doing housework or laundry, fidgeting and just moving for the sake of moving. It's sneaky and it's very compulsive for many people with restrictive eating disorders.
Unless you address these lower-level movement habits, they will prevent you from fully reprogramming your brain and overcoming the addictive pull of the eating disorder. Some ideas for how to address it include:
If you could be sitting then make yourself sit and keep still.
Avoid household chores. Ask others to do it for you while you are overcoming the eating disorder or get a cleaner or gardener.
If you really really don't have anyone to help with the chores and can't afford to pay for help in the short term then set very strict limits for yourself on how much time you will spend cleaning each week and keep to it. Your house doesn't need to sparkle. This is your health and future at stake.
Prepare a lot of food in one go and take it all with you to sit down—no excuses to keep getting up for more.
Park the car in a space closest to the door of the store and then in the shop, visit the aisles you need and go straight back to the car.
Make people in your life aware of how much the lower-level movement you are compelled to engage in matters for your ability to overcome the eating disorder. This will make them better informed and able to support you.
Overall, exercise and movement can make or break your chance to overcome the eating disorder because it can be so hard to stop. Abstain from it all as much as you can, being honest with yourself and those around you about how much of what you do is compulsive. Seek support to get through this and you will.
Laxatives, Diet Pills, Alcohol & Other Substances
It is not uncommon for people with restrictive eating disorders to also habitually use laxatives, diet pills, alcohol or other substances. Of course, it's also critical to address these but it might not be medically advisable to use a cold turkey approach with them. In the case of some ingested substances, your body might have developed a physiological dependence on the drug and stopping them abruptly could lead to physical symptoms or even be harmful. In these cases, I always advise you to seek medical advice and support about how to stop them safely and whether a slower withdrawal or cold turkey approach is best.
Rituals
An earlier post explored the power of rituals, explaining how powerful rituals are at driving you to engage in the full addictive behaviour. Once you begin to engage in a ritual that usually precedes an eating disorder habit it is much harder to put the brakes on and stop yourself from fully engaging in whatever the behaviour is.
For each of your addictive behaviours, consider the rituals you have that surround them because these rituals act as triggers. If you can address the triggers, you will find it easier to stop the deeper addictive behaviours that take you to energy deficit.
Identify your rituals and find ways to stop them. Changing everything about what you do, when and how in your everyday life, so you are shaking everything up is often the best way to flick your brain out of its usual paths that drive so many of your daily rituals and addictive habits.
Overall, anything you can stop and that is safe to abstain from to overcome the eating disorder will give your brain the best chance of effective reprogramming and your body the ability to restore so you get out of the state of energy deficit.
Of course, no one said it was going to be easy. I know how impossibly complicated and hard this feels and how terrifying. Going through this process will leave you experiencing emotions that are going to challenge you. You might feel very depressed at times and as if you are on a rollercoaster ride of exhilaration one minute and deep dark blues the next.
Doing this necessitates support. I don't recommend you do this alone.
For some, especially those with a history of trauma or other mental illnesses, going through a process like this might trigger past events or other conditions to worsen. In these cases, I always recommend working with appropriate professionals, such as a psychotherapist.
But for everyone, I believe that beating this eating disorder and overcoming the addiction to energy deficit is possible and you will get through the challenging process.
In the next post, a moderation approach to overcoming an addiction to energy deficit will be explored and then future posts will cover refeeding syndrome, the question of binges, recovering in a bigger body and the evolutionary theory for eating disorders and how it ties into the addiction model. So stay tuned!
**The information here is taken from my newly available book, 'Addicted to Energy Deficit - A Neuroscience Based Guide to Restrictive Eating Disorders' which you can buy now!**
If you like to listen, as well as (or instead of read!) then this blog post is the transcript of a podcast episode which you will find on my podcast series,
available on this website, all mainstream podcast platforms and on YouTube.