Eating Disorders - fieldi

Recovery Through Nutritional Counseling 45
As Sue gained weight, every single pound scared her. She went
through phases where she would eat normally and not exercise at
all, or restrict her eating and exercise a lot, so we had weight fluctuations
throughout the recovering period. This happened three
times during the refeeding phase. The first occurrence was when
Sue initially stopped purging and starving and gradually started to
eat, immediately gaining five pounds, mostly in water weight. (Normally
patients gain from 2 to 7 pounds within the first week or
two.) In a couple of weeks this bloatedness was gone. The second
time Sue experienced weight fluctuations was when she stopped
denying the hunger. This immense body signal was overwhelming
for Sue since she felt that responding to it would result in overeating
to the point of becoming overweight. Instead she began to
restrict again and lost a few pounds. With remotivation she was
again able to gain weight. Sue’s third and last struggle with the
scale was when she approached 100 pounds. Being below 100
pounds meant being special: She felt strong. She could count her
ribs, a wonderful sign of success. When the scale tipped slightly
above 100 pounds, she felt she was no longer special, that she
weighed just what everyone else weighs. So again she began to
restrict her intake and exercise a lot.
What came to be most important for Sue was her ability (in our
sessions) to see how her thinking was distorted and how she was
able to turn it around to being realistic. This helped her be happier
with herself. For example, if her mom told her that she had to have
dinner, she would get scared for a moment and react: “No, she cannot
make me eat! I am bigger than she is. She cannot make me do
this, she is shorter than I am. She cannot force-feed me!” Then she
would feel strong. She would also tell herself, on seeing someone
eating cake, for example, that that person was weak, that she herself
was strong by not eating that cake. She would make similar
comments about any other foods that she used to eat and that now
were forbidden to her. At her very first visit Dr. Mickley told her,
“When you are happy it doesn’t matter how much you weigh.” Sue
couldn’t believe her ears; she thought Dr. Mickley must be crazy! It
was the stupidest remark she had ever heard; but if one were to ask
her how she feels today, she would tell you she’s never been happier
and honestly doesn’t know how much she weighs.