Recovering from anorexia — what to expect?

Originally Published: April 17, 2009
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Dear Alice,

I am recovering from anorexia any my doctors will not tell me what symptoms I should be expecting. They just say everyone is different. But I am bloated and my stomach is so firm, almost hard. Like I am pregnant. Will this go away and is there something I can do to fix this? Also, what other symptoms can I expect during my recovery?

Dear Reader,

Your doctor is right that everyone recovers from anorexia differently, but having an idea of what to expect may help you manage what's to come in your road to recovery. As you gain strength, you may experience some common physical as well as emotional or psychological changes related to your improved, healthier habits. Throughout your recovery process, it is essential to maintain ongoing treatment and/or counseling, which will help you handle whatever physical or emotional obstacles you may face.

The bloating you describe is a normal reaction to increasing your food intake following a prolonged period of under-consumption. As you eat, produced insulin helps re-balance minerals, like potassium and phosphorus, inside your body cells in order to make energy. Water shifts in this process too, thus leading to a water-retaining bloated feeling. However, after you've been eating a balanced diet for a while, your electrolytes should stabilize and the bloating should subside.

More physical changes can be expected as your body reaches a healthier state. For adults in recovery there aren't many growth hormones in the body. Instead, there may be an imbalance of other types of hormones, like cortisol, a hormone produced when eating cycles are disturbed or in response to stress. Hormones tend to be in command when it comes to how any weight gained will be distributed around the body. Some survivors experience weight gain at first in their mid section and/or arms. Over time, as the body equalizes caloric intake and becomes more accustomed to a healthier modus operandi, a shapely figure will begin to emerge. Moderate physical activity, along with your new balanced diet, may help you feel stronger and fit. However, consult with your health care provider about your exercise routine — being overly physically active can be a symptom of anorexia and would prevent a full recovery.

Even though improved nutrition and weight recovery are no doubt some of your goals, resulting changes in body composition will probably call upon you to access your inner strength. Gaining weight can be a source of stress for anyone. Watching your body go through these and other changes may be difficult — our minds and our bodies are intimately connected, and changes to the body can affect the whole person.  Some people recovering from anorexia experience a sense of panic, loss of control, anxiety, or other emotions over the changes in their body. While these changes and related feelings may be difficult, they are entirely normal. Seeing a therapist who specializes in eating disorders can help you with this. If you are a Columbia student, you can make an appointment with a professional on the eating disorders team in either Counseling and Psychological Services or Primary Care Medical Services. For counseling, you can make an appointment by calling x4-2878; for a medical appointment, you can call x4-2284 or log on to Open Communicator.

There is certainly a flipside of symptoms to expect in recovering from anorexia: positive ones. As your body begins to get all the nutrients it needs, your hair may become more lustrous, your nails shinier and stronger, your eyes brighter, and your skin more supple. And positive physical changes are just the beginning. True self-confidence, grounded in a realistic and proud self-image, is perhaps the biggest payoff for your hard work on the road to recovery.

The recovery process for anorexia is considered a lifelong commitment — as such, it's important to know that relapses happen. If you notice a relapse to old patterns, rather than getting down on yourself, try to strategize how you will react to triggers and situations next time you encounter them. Staying in close contact with your support team — friends, family, doctors, counselors, etc. — can help you become prepared to face the ongoing challenges of recovery. Also, reminding yourself of your goals on a regular basis (think post-it note on the bathroom mirror) will deepen your conviction to stay healthy. As you develop skills and coping mechanisms for the emotions associated with eating disorder recovery, you will become more adept at handling whatever gets thrown your way.

Asking questions and staying abreast of your recovery needs, like you are doing now, will put you in strong stead in your efforts to be fully healthy.

Alice