352: The Myth of Endless Calorie Burn

Chris Sandel: Hey, everyone! Welcome back to another episode of Real Health Radio. I’m your host, Chris Sandel. I’m a nutritionist and a coach and an eating disorder expert, and I help people to fully recover.

On today’s episode, I want to look at a topic that in a lot of ways I’ve been talking about for a really long time in terms of the way that I explain physiology and how the body works, especially how the body works in response to overexercise, restriction, basically what happens when someone has an eating disorder and then what happens as part of the recovery process. But I’ve never talked about it with this label.

The label is Constrained Energy Expenditure Theory, and this is a concept or a theory that was told to me by a past client. She mentioned it last year and I looked it up, and I found it very interesting because it really explains what I’ve been talking about for a long time, but it just gives it this scientific name, and there’s real research connected to it.

So what I want to do today is explain what this is and why I think it’s important to know, because I think for a lot of people, when living in restriction, living with an eating disorder, things just start to not make sense. There’s a lot of logic that we have around how the body should behave, and actually it just doesn’t behave in that way because we have some misunderstandings about what the body does and how it is trying to keep you alive. So that’s what I want to cover as part of this.

00:01:37

The additive model of energy expenditure

Let’s start with the opposite model of this, or the counter model to the Constrained Energy Expenditure Theory. This is the additive model. Let’s just use exercise as an example. I’ll demonstrate that this isn’t just connected to exercise, but exercise is used a lot as part of the research around this.

And what I’ll say is I’ve got a ton of notes on this, so if you’re watching the video, you’re going to probably see me reading it at various points, but I wanted to make sure that I hit everything.

With this additive model, the idea is as you add more things in, your energy expenditure goes up. I’ll just use some simple calorie math to demonstrate this. If you add in an extra 500 calories’ worth of exercise, the additive model would say that your total energy expenditure would increase by 500 calories. If you add in 1,000 calories’ exercise, your total energy expenditure would increase by 1,000 calories. Basically, everything that you continue to add on top would continue to increase that total energy expenditure.

But what we see when we start to look at humans is that this isn’t actually what happens. And it’s not just with humans; we see the same with lots of animals. We can have experiments where we increase the exercise by a certain amount, but then when we start to look at it, especially as we start to look at it over the long haul, we don’t see an increase in total energy expenditure in the way that we would imagine, or we don’t see a decrease in someone’s weight in the way that we would imagine.

This starts to propose the question of, if this isn’t an additive model, what’s going on? Where are these missing calories going? If we’ve added this extra in, why isn’t the total energy expenditure increasing in this way?

00:03:36

What is total energy expenditure?

If we look at total energy expenditure, what are the things that are included as part of all the energy that the body uses across a day?

We have basal metabolic rate, or resting metabolic rate. I often describe this as what you would need to use if you were in a coma. This is the basic functioning that the body is doing. It’s about cellular maintenance, it’s about organ function, but doing this at the most basic of levels.

On top of this, we have activity energy expenditure, and there can be some different categories with this. You have your planned exercise, so if you go to the gym or you go for a run or doing some form of exercise.

There can be occupational movement. As part of your job, maybe you’re building houses as part of your job, or maybe you’re a nurse and you’re walking around the hospital for a lot of your shift. Any of the energy that is used as part of our occupation.

And then we have a thing called NEAT, which is non-exercise activity thermogenesis. This is things like fidgeting, changes in posture, spontaneous movements – hey, I just picked up this cup to have a sip – all of these little tiny movements that we do across a day. Some of these are somewhat intentional, like I just did with the cup, but a lot of it’s not. You’re noticing that your hands are moving just a little bit or your feet are tapping a little bit. All of these little bits of movement.

We then have the thermic effect of food. This is the energy that we use to digest our food and to run that digestive system, but also to then store that food, or to take that food out of storage because we’re now needing to use it for energy.

Then on top of this, we have other costly systems that we’re running. I think about this in terms of this is all the functions that your organs are doing and your systems are doing on top of what you would need if you were just lying there in a coma. So it’s your immune activity; it could be the inflammation cycle that gets released as part of your immune response. It’s reproduction, so ovulatory function, the fact that you ovulated, the fact that you had a period and you had to produce all the hormones as part of growing the uterine lining, pregnancy, lactation. Growing that human costs a lot for the human body. All of the sex hormones that are running this and the repercussions as part of this.

Just general growth and repair – tissue turnover, injury, recovery. I think a lot about sleep and so much gets done when you’re sleeping, so much of the physical repair that gets done when you’re sleeping, so much of the brain stuff that happens in terms of consolidating memory, being able to process what happened that day. All of that uses energy.

And then the stress response and your body turning on stress hormones, and what that changes as part of the body. For example, you’re turning on the stress response and your heart starts to beat differently, you’re pushing your blood towards your bigger muscles, your vision becomes more acute in this very narrow band. All of these changes that occur as part of that stress response – again, they use energy.

I think this is really important to understand this. I had a conversation with a client about this yesterday where she was like, “I didn’t really do anything, so I didn’t really use any energy across that day.” I was like, “Maybe you didn’t use as much as you do on some days when you’re doing more activity, but there are all of these other things that are going on. You’ve got your basal metabolic rate, you’ve got all of these costly systems that are going on.”

So there can be this real misunderstanding of “I didn’t really do much today from a physical standpoint” in terms of what people think about when they say that. Like “I didn’t go to the gym, I didn’t go for a run, I didn’t do ‘exercise’, so I mustn’t have burnt anything” and that’s just not true. Your body is using energy at every point of the day for so many functions that you’re not even noticing. Even just your brain alone is using a ton of energy.

So being able to remember that it’s not just movement we use energy for; we use it for a ton of things that I just went through. Your body is doing this day in and day out.

00:08:17

Constrained Energy Expenditure Theory

If we then look at the Constrained Energy Expenditure Theory, what this looks at is that total energy expenditure is regulated within a range. It’s not just endlessly additive. You can add on some exercise – I’ll use, again, some numbers and examples. You may add on 200 calories of exercise, and because it’s a smallish amount, and if your body’s in a good place, there’s low stress, all of this, your body may then increase total energy expenditure by 200 calories. So yeah, your total energy expenditure has gone up to match that exercise that you’ve just done.

But you can also have an instance where you’ve done a little more exercise or you’ve still done that 200 calories’ worth of exercise, but because of the state that that body is in, rather than actually adding on to total energy expenditure, it starts to pull this from other areas. What we tend to see is in the very short term, if someone’s in a healthy state, your total energy expenditure increases, but as time goes on, there is much more of this you hit a plateau and your total energy expenditure is not going up in the way that it was before, and you’re now starting to pull resources from other areas.

If we look at where this comes from, it comes from all of those different areas that I talked about before. There’s a lot of research around this. If you’re upping one area – again, if we up the exercise piece – someone may have more of a reduction in terms of their NEAT, their non-exercise activity thermogenesis.

And a lot of this isn’t conscious. So much of the body is just sending you these different signals that at this subconscious level change your behaviour. So maybe you’re just not fidgeting in the way that you were doing before because the body turns that down. Or your propensity to want to go and exercise or move or do anything physical gets decreased because your body is sending you these different signals so that you’re less motivated to do this.

And I know that this can go haywire with an eating disorder and there can be this compulsion to move, and this is where things somewhat go awry with this in that even though someone can be in this low energy state, there can be this real push to continue moving. But in someone where there isn’t an eating disorder, if we’re increasing at this one end in terms of activity, it’s trying to turn it down in other areas.

We can then change a lot of our resting physiology connected to this. You lower your thyroid output, so this turns down your resting metabolic rate, so your day-to-day metabolic rate is reduced or your sleeping metabolic rate is reduced. So you’re doing less of that repair while you’re asleep. You can have this improved efficiency in certain processes, so your body gets better at doing certain things while spending less, but that only goes so far, and then at some point your body’s like, “We’re just not able to do this to the same degree as we were doing before.”

Thermogenesis can be decreased, so you become colder. There’s less heat production that starts to happen. We slow down our digestion as well, so we’re not putting as many resources towards digestion as we were doing before. Reproductive suppression. This is a very common thing as part of having an eating disorder. People start to lose their period, or for guys, they’re not waking up with a morning erection and their sperm count is drastically reduced. All of these reproductive hormones are then starting to change. We can have altered immune function.

I know this can be a little confusing for people, because what I hear so often from people with eating disorders, they have this long list of symptoms in pretty much every category, and then they say, “Well, I never get sick, so I think my immune system is really strong.” What I then see is once they start recovery and once they start doing the things that are important for this in terms of bringing in more energy and getting more rest, that’s when they start to get sick again. That’s when “I had this chest infection and then I had this cold and then I just got over it and then I got this next thing.” In a sense, there are lots of things that are going on within the body; it’s just the body’s not picking up on them because your immune system is turned down.

This is what happens as part of this constrained model and the way the body works. And if we look at this from an evolutionary perspective, it makes total sense. We live in an environment now where we do have more access to food, or at least the majority of us have more access to food. We do have a more sedentary existence and our jobs are often more sedentary. We’re not having to do the movement that we were doing before.

I know that everyone talks about this is the undoing of human civilisation and this is why we’re all getting sicker and all of those things. I don’t necessarily believe that; I’ll save that for another podcast. But if we think about 10,000 years ago, 20,000 years ago, and we’re in a situation where it’s wintertime, there’s less food available, and you’re now having to walk a lot more to try and do your hunting to find food or to try and gather berries or whatever it may be, what’s happening is your activity is increasing.

And if we were in this endlessly additive model, as food became rarer and rarer and more difficult to find, the amount we’re now using is going up and up and up because we’re now trying to hunt and gather and we’re spending more and more hours out looking for energy. If we were in that situation at these very perilous points where things weren’t available, we would be in a really dire situation. So from a very smart evolutionary perspective, the body has a control around this. It can say, “I’m noticing we’re in this famine or I’m noticing food’s not as available. We’re going to turn certain things down and turn certain things off. If you are forcing my hand to use some of this for hunting and gathering and for movement, that’s fine, but we’re going to turn down reproduction. We’re going to turn down your digestion. We’re going to turn down all these other things so that this doesn’t endlessly keep increasing.”

It is a real demonstration of how dynamic the body is and how adaptable the body is, and that really makes sense. We would want this to be the case, because otherwise we would’ve died out a long time ago. We would have situations that would put us in a very bad situation. But this actually helps us when we’re in those situations.

00:15:30

How stressors impact energy expenditure

What I want to say in terms of the constrained model versus the additive model is it’s not all or nothing here. As I said, normally in the beginning we can increase things, but as time goes on, that’s where we hit a plateau. I tend to think about this as a band. There is this band of energy that we can use. We can be at the lower end of the band, we can be at the higher end of the band, but as soon as you start to go past a certain point, that’s when the body is like, “Hang on a second, this isn’t feasible. We need to start turning things down and certain things off.”

And this is especially the case if there’s this big mismatch between energy in and energy out. Because it’s one thing for someone to be doing a lot more exercise when they’re also doing a lot more eating and then we’re matching those two things up. And there can still be a point where that’s going on where it doesn’t matter how much energy you are trying to provide for the body; its capacity to repair and recover is still limited. There is still a threshold with that.

But there’s a big difference between “I’m doing a lot of exercise and I’m doing a lot of eating and these two things are fairly matched up” versus “I’m doing exercise and I’m not doing a lot of eating.” Or, as is also true, you don’t have to be doing exercise. I know that I’ve talked about this from this exercise standpoint, because that’s often how the research is looking at it, but it’s also true with anything that tells the body that there’s not enough energy going on.

So we can be having the same situation where someone’s not actually doing any exercise or very limited exercise and the amount of movement that they’re doing is pretty small, but yet the amount of energy coming in is really small, or is less than what the body is needing.

I think what is a useful way of conceptualising this is to think about, what are the things that are tending to send the body this idea that things are scarce or that the environment is currently unsafe? When we think about this, again, from an evolutionary perspective, ‘unsafe’ can mean there’s not enough food available. So scarcity signals can come about because of low intake; it can come about because of uncertainty, so there’s stress, there’s threat, if the body is picking up that “The environment that I’m in feels unsafe.” It could be because of illness, it could be because of sleep deprivation. There are lots of different ways that the body can start to get this message that things aren’t safe.

In terms of how the body responds to this, this also depends on the individual. I think it’s useful to recognise that there are lots of variations depending on genetics, depending on developmental history, depending on training history in terms of, was someone very active all through their life? Was this something they got into later on? It can be affected by body composition. It can be affected by a whole host of different things in the same way as there can be 100 people who go on a diet, but there’s only a small subset of those people who end up with an eating disorder because there’s a lot of genetics connected to this.

The vast majority of people do that and they’re on this diet and within a very short amount of time they’re like, “This is deeply unpleasant. This isn’t enjoyable” and they stop doing it, versus for a subset of people, actually that feels pleasurable, or that leads to some level of calmness, or there’s some euphoria that is felt in that phase, so that’s why someone goes down that route. I think it’s just recognising that there is some variation as part of this.

And as I said, really thinking about this from a safety perspective. If the body is receiving these messages that it is unsafe, that is going to have an impact on how the body uses energy.

If we think about stress and this threat, any time the body is recognising that things are unsafe, there is this paradox with stress in that stress is very expensive to run. The stress hormones are expensive to run; they make the body’s use of energy very inefficient. And the reason for that is because this is meant to be short-lived. If there’s a lion that is about to attack you, it’s not the point to be super conservative; it’s the point where, “Hey, we’ll throw everything at this in this very narrow band of activities that we think are important.” We’re not feeding digestion at this point. We’re not throwing energy towards reproduction. We’re doing this in this very narrow set of things that we think are important in terms of this life-and-death danger.

But what tends to happen over the long haul is if this goes on where it’s not just a very short-term thing and it becomes long term, the body does get into this much more conservation mode. It gets into that conservation mode especially, as I said, by turning down all these functions it doesn’t think of as being life or death. It just triages everything into “These are the most essential things, and we’re not spending energy on anything else.”

So you can get in this situation where in the beginning there’s this acute mobilization, so you’re wired and driven and appetite is suppressed, but as that goes on, it just can’t go on indefinitely, so you get into this later stage where there’s this much more conservation piece. You’re much more fatigued, you’re much more cold, your body’s much slower to recover because as I said, it’s now really turned down and turned off all of those different functions.

Threat doesn’t just burn energy; it changes whether the body believes that it’s safe to spend that energy. In the beginning it can spend very freely because it’s like, “Let’s get out of this,” but over the long haul it creates a lot of conservation because it’s now seeing life and death not as this very acute thing but life and death as being this longer thing.

00:22:09

Why relationship to food is so important

This is where I think our relationship to food becomes super important here, because if we think about fear and the impact it has on the body, this can turn on that conservation mode. This can change the physiology within the body. So if we compare someone who has a really good relationship with food, they have good food safety, there’s good food availability, they don’t have all these different rules that are connected to food and “what I can have and how much I can have” and all of these things, that person’s going to have a fairly consistent intake.

There’s going to be low vigilance or no vigilance connected to eating. There’s not going to be these punishment or compensation cycles. The body’s expecting that food’s going to be coming in. They’re not in this situation where the body is looking around at the environment and the signals that it’s getting back and is saying, “Oh, we must be in a famine or we’re in an unsafe environment.”

And when we’re able to have this very nice relationship with food and taking actions in a way that supports that – eating enough, eating regularly enough, all of these things – we have higher thermogenesis. We’re turning on more of that energy burning, and that’s leading to more energy production, but it’s also leading to the body being warmer. We’re more flexible in terms of our appetite regulation. Some days you might be a little hungrier, some days you might be a little less hungry. But the body is able to really adapt to the demands of the day. We have easier digestion because the digestive system has the energy it needs to be able to run it. We have more spontaneous movement, so things like NEAT, things like being able to move as part of our job, etc., because we have the energy to allow those functions to happen. There’s more available for repair and reproduction and all of those other costly functions that I talked about.

But if we then compare this to where food is threat, so there’s lots of monitoring and lots of moralizing around food choices, there’s this real anticipatory restriction – so maybe I’ll eat, but tomorrow I’m definitely not going to eat, or I can eat but I can’t actually start eating till 2 p.m., and there’s all of this, again, threat that is being taught to the body that food’s not going to be available, might not available tomorrow. There’s all this fear of weight gain, there’s all these compensation plans, whether that be around exercise, whether that be around skipping meals.

Again, all of these things send a message to the body. What the body then does is there’s this tighter conservation in terms of what it spends. There’s this much more dysregulated hunger and fullness symptoms because, again, the body’s not having enough energy to be able to produce all the different hormones that run these systems well. There can be a lot more stress around eating, which then amplifies that threat and that this is not a safe thing to do. Again, the body then turns on more of those stress hormones, etc.

What I want to get across as part of this is it can be very easy to think, “Well, if I’m doing more exercise, that’s increasing energy” or “If I’m doing less eating, that’s decreasing energy.” Yes, both of those things in terms of actual calories have an impact on the constrained energy of the body, but it’s not just about calories. It’s whether the body thinks that those calories are going to be reliably coming in. Again, all of those threats can have an impact with this.

This is why I think it’s so important to have this healthy relationship with food. And I know if you’re in the depths of an eating disorder, we need to work our way back to that and it’s not just you hear this information on a podcast and everything clicks and that relationship comes back. There is a lot of retraining that has to happen of allowing the nervous system to see that food isn’t a threat again, and that comes about by doing certain things that allow it to be able to see this – by having more food come in, by being able to rest, to do all these things to retrain.

But this is why that relationship with food is so important. It’s not just you have better fun or you have more freedom. It has an actual physiological impact on the body. So having that better relationship with food increases digestion. It increases your immune function and capacity. Every system and organ is impacted upon for the better when you have that better relationship with food. It changes your NEAT and how much the body’s using there.

And it’s not that we need to get NEAT to the highest possible level so that you’re using all this energy, but there’s good that comes about by having those little small movements. It’s going to be helping in terms of blood flow, or it’s going to be helping in terms of your lymphatic system. There are lots of reasons why these things are important.

And on the whole, you’re going to have this calmer physiology. And that’s not to say that you’ll never have anxiety again or you go from someone who’s high anxiety to having no anxiety. If you’re wired more to be on the higher anxiety side of things, you’re probably going to be like that even when you have a better relationship with food or even when you’re doing the things to not have an eating disorder. But compared to where you were, from a relative standpoint, things are drastically different.

What I want to say is I know a lot of talk can be like “Oh, that person’s really lucky. They’ve got a really great metabolism. It’s just this trait that they have. That’s just how they were built.” Again, there can be some of that that is true. There is some genetics that are having an impact on that. There can be things that happened in their life that have meant there are more of these things going on. But so much of metabolism is state-dependent. As I talked about earlier, your body is adapting to the environment that it is in, and when we’re able to change the safety, when we’re able to change the things that are giving that feedback to the body, that then changes it.

I’ve seen this over and over again where people were eating small amounts of food and their weight was steady, or they increased their food a little bit and their weight started to go up, for them, what felt disproportional to this. And then as we fast forward as they’ve done more of recovery, their ability to eat double/triple what they were eating before and still be weight steady is hugely increased. That is because their metabolism has adapted because of the environment being changed.

00:29:31

Why increased energy expenditure can feel ‘better’ at first

I want to talk about something that I think catches people out with this stuff, which is there can be this reflection of “When I was doing things in a certain way, I was able to function really well.” I think what gets misconstrued here is “I was functioning well, my body was doing really well, everything was working well” when actually, what was really going on was that the body was struggling; you just weren’t recognising initially.

For example, in the early stages of exercise increasing or restriction increasing or where there is this mismatch between the amount of energy that is being used and the amount of energy that is coming in, in the beginning, someone can actually feel quite good doing that. They feel like, “Man, I should’ve started doing this years ago. Why wasn’t I doing more exercise like this? Why wasn’t I changing my eating like this? Why wasn’t I cutting out X, Y and Z food? I just feel so much better when I do this.”

The thing that is actually often going on and is propping someone up in that situation is there’s a lot of adrenaline and cortisol and stress hormones that are being mobilised, and that can, in the short term, give you a little more clarity, give you a little more acuity. It feels like “I’m just sharper. I’m much more on the ball than I was before.” It can lead to more appetite suppression when that’s going on, so it’s like “By changing what I’ve been doing, I’ve realised I just don’t need what I was eating before. I think a lot of what I was doing was emotional eating. I think I was just bored.” There are all these stories that then start to come up.

There can also be the dopamine reward that comes from “Hey, I’m doing something good. I’m making ‘progress’. I’m getting this societal feedback from people of ‘Hey, you’re doing something really great. Oh, did you lose weight? You’re looking so much better than you were before’,” as horrible a comment as that is.

The other one would be as you’re doing this and your body is losing weight, you’re often losing glycogen, and glycogen is the energy that the body puts into storage. It’s a form of carbohydrates that gets put into storage that you can then use in emergencies. What tends to happen or the way it is stored is there’s a lot of water stored as part of this process. So as you start to deplete your glycogen, the amount of water the body is holding on to also shifts. So it can feel like “Oh man, I’ve lost a lot of weight. I’m not as puffy as I was before.”

So again, all of these things can give this feedback of like “This is a really good thing to do. I’ve got more clarity. My body’s looking ‘better’. I just feel like this is the thing that I should be doing.” And it feels like “Hey, my body’s responding really well to this.”

That honeymoon period only lasts so long. I think what happens is that there can be this physiological point where you are starting to knock up against your body not doing so well, but actually there’s this psychological point that takes longer to get there. You can start to misinterpret certain bits of information, either misinterpret them as meaning something else or you just put them to the side, you don’t really notice it. You’re feeling a little bit more fatigued, but at the same time, “Hey, I’ve got some more soreness from doing that exercise, so I’m putting that up as being a really good thing. I’m feeling a little more cold than I was before, but I did quite a tough workout this morning, so I think that’s to be expected. I’m still losing weight; that’s obviously a really good thing. I’m still getting that social feedback.”

So even when there can be these physical symptoms that I’m starting to notice, I’m maybe a little more irritable, I’m getting a little more headaches or I’m having a little bit more trouble with my sleep or whatever it may be, I’m able to override what those mean because from a psychological factor, I’m focusing on these other things that mean that this is a good thing.

What often happens at this point, especially if we hit a little bit of a plateau in terms of the weight coming off – because if I’m being honest, even if someone wants to dress this up as “I’m doing this for ‘health’,” it’s normally, am I seeing the number on the scale go down? Am I seeing my body composition change? And that’s how I’m determining whether this is working or not.

So there can be this second honeymoon phase once someone’s hit a plateau. I’ve hit this plateau and I’m not noticing it go down, so what do I do? Now I’m going to pull out that snack. Now I’m going to cut my carbs in the evening time. I’m going to delay my breakfast. I’ve been reading all of these health benefits of doing intermittent fasting, so I’m going to reduce my eating window. I’m actually going to start increasing the exercise I’m doing. I was doing it X number of days a week and I’m going to add in another couple of sessions on top of that.

And then again, because we’ve now increased things, in the short term we start to see a change again. Maybe I start to have a decrease again in terms of my weight. We’ve probably jacked up those stress hormones again because we’re now in less of an energy balance because we’ve just made these changes. Again, there can be more symptoms that are starting to accrue at this point, but psychologically we’re able to override them. It feels like “Oh okay, I just needed to make these other changes and now it’s working again. I just needed to adapt. It makes sense that my body just got used to that level and I needed to change things again, and now it’s started to respond again in the way that I want it to.”

How long this goes on will depend on the individual. It’ll depend on a whole host of different functions and a whole host of different reasons. But at some point this starts to run out in terms of it’s now harder and harder for me to start to put those things to the side. And yes, I can have a lot of fears around the healthfulness of eating certain foods, or I don’t think I could ever possibly stop exercising – there can be fears around making changes, but there can be this awareness that starts to creep in, and then at some point becomes very loud and is really obvious of “I am having so many symptoms now that it is really obvious to me how much this is having an impact.”

There can still be varying awareness around those things, and again, I can chalk them up to something else or I can rationalise them away through “But what I’m doing is healthy,” but there are more and more of those moments where this is starting to show me how much this is having an impact on my body.

This chronic constipation mode then becomes your baseline. As I said earlier, your body’s really turned certain things down and turned certain things off. If someone’s basal metabolic rate previously – I’m again going to use some basic maths to demonstrate this. If your basal metabolic rate, what I’m using in a coma just to keep these organs going, is 1300 calories, because of everything that’s gone on, you’re now down to 500 calories. What it used to think of as basic essentials is now like “Yeah, that’s not basic essentials. We’ve gone down to even more basic essentials because there’s not as much coming in.”

The symptoms become much more stacked up. If I look at every system within the body, there’s more and more of these symptoms. So this honeymoon phase at some point runs out. It’s no more a honeymoon phase, and this is where people then feel like they’re trapped. They’re like, “I’m damned if I do, I’m damned if I don’t. I know this isn’t working for me, but man, am I scared about making a change to this, especially because of the way the eating disorder presents this.” The eating disorder is like, “You don’t know what’s going to happen. Maybe you’ll make all these changes and nothing will improve and all that’ll happen if you stop doing exercise, or all that’s happened, is you’ve started to gain weight.” It comes up with all these reasons why it would be a bad idea, and those things just aren’t true.

00:38:39

How constrained energy theory applies in eating disorders

If we come back to this constrained energy theory and look at the way that it works, it really works and really tightens its constraint when we’re to the extremes. If we look at an eating disorder, there’s this chronic energy debt and deficit, and this is true even if someone is binging. Even if there are binges that are going on, when we look at the total amount that is going on across a week or across a month, the intake is not matching up to what the body needs, and often in quite a drastic way.

There’s this huge threat around food. There’s fears. There are all these rules, there’s this threat response. The body has this full nervous system response. There’s often high activity. And for a lot of people, that has continued to ratchet up more and more because there can be this – when you’re in the depths of an eating disorder, again, it depends on the person, but there can be this compulsion to continue moving. So even though there is so little coming in, the amount that I’m using now on movement has increased. The body is using less on movement than it would be doing if it was getting everything it needs, so it’s still trying to be conservative about what it uses, but hey, if you’re out walking X number of hours or you’re out doing this each day, etc., you’re forcing the body’s hand to use a certain amount of energy. And what it has to do then is turn everything else down.

There can also be this metabolic memory that starts to come about where if I’m having constant repeated cycles of this – maybe I’ve been doing it and then it got a little better, or it then got a little worse – your body is learning more and more that “Hey, this is unsafe. We don’t know when this famine’s going to end.” And even when I start to eat initially, maybe this has gone on for so long or maybe there’s been so many repeated versions of this that the body is still very gun-shy about using that energy. It’s like, “Yeah, I know there’s more coming in now, but we’ve been living with this for a really long time. We’re not sure this is going to keep up.”

So it can take longer and longer for the body to get the message of like “No, we are not going back to that. This is going to be the way that it is.” And I know that sucks for a lot of people, or for everyone with that situation going on, because it feels like “Hey, I’m now giving my body what it requires and it’s not instantly bouncing back.” But we’ve got to be honest about what’s gone on. If there’s been this restriction that has happened for 20 years, just because you’ve been eating more for a couple of weeks or even a couple of months, doesn’t change the fact that the body needs to have a good chunk of time to start to relearn that this isn’t going to go back to what we were experiencing before.

00:41:44

How do we move the body out of energy conservation mode?

Then if I’m thinking about, how do we start to change how the body reacts to this? How do we have the body no longer see this as a threat and move out of that conservation mode? It’s all the things that are recommended as part of recovery.

It’s doing the resting, and by doing the resting, it means the energy that was being used for all of that different movement is now available for the body to, often in the beginning, store as fat so that it has this extra insurance in case you go back to doing movement before it’s done all the repair, but also using that energy as part of the repair.

It’s eating, and eating more. Because again, that is providing the body with energy so it can then do the things that it needs to do. But it’s also, in terms of the threat response, giving the body the idea that there is permission to eat. There is food available. We’re seeing it consistently, we’re seeing it reliably. This is signalling that it’s not just a one-off or it’s not that we only get this in a very small window every day so we still need to be on guard. It’s like, no, this is coming in repeatedly and regularly.

By doing this, it starts to reduce the fear as we do this more and more consistently. In the beginning it’s still really scary, but as you continue on, it becomes less scary and then the fear disappears. And this can happen as well as we start to bring in different foods. This food that used to be more of a fear food, I’m allowing myself to eat it. I’m doing it repeatedly, so my body now learns, oh, that food is okay. That food is not a threat.

Really, the thing that matters so much with all this is consistency. This is where, again, I see people stumble a lot. There can be this very on-or-off thing where “I had three or four really good days and then I had this day of restricting” or “I had a day where I had a binge and I ate a lot more, so then the next day I pulled back and I didn’t have breakfast and I did a lot more exercise because I needed to ‘compensate’ or make up for that.” Again, this sends the body the message of “No, no, no, we’re still in this conservation mode. We don’t know when food’s going to come in.”

So with all clients, whether they’re having binges, whether they’re having extreme hunger, whether they’re having days where there is a lot more eating, we then need to still keep that consistency. We’re not, the next day, starting to cut back and send the body that message.

So that is really what I wanted to go through as part of this. I think if you reflect on yourself, maybe you can answer some of those questions for why it felt like the body was doing things that didn’t make sense. This could be “Hey, I’ve been eating this really small amount for such a long amount of time, but I’m not losing any weight.” The reason for that is the body has turned everything down and turned everything off so that you won’t lose any more weight. It doesn’t feel like it’s safe to be spending more energy.

And it’s not about weight per se; it’s about, one, safety, but two, calories and the energy. As I talked about before, you’re needing so much energy to run and power everything.

00:45:12

Why ‘calories in, calories out’ is not the case

You can be in a situation – and I’ve seen this with many clients, and I think unfortunately, because of the way that people talk about calories in and calories out, it feels like it’s this very fixed thing. So when someone’s getting into a situation where they’re eating very little and they’re not losing weight, they get gaslit by people saying, “You must be lying. You’re not really eating that little amount. What else is really going on? Because if you were eating that amount, of course you’d be losing weight.” And that’s just not the case.

I know there’s a stereotype with anorexia that everyone gets into this emaciated stereotypical body, but that’s the tiniest fraction of the people who have anorexia that actually get to that place. And it’s not because those are the people who are doing the least amount of eating. It’s just their body, for a variety of reasons, has a different threshold in terms of when it will turn things down and turn things off.

I’ve worked with many clients all across the weight spectrum, and I can have someone who’s in a much larger body who is eating a tiny amount of food and yet their body is still keeping them there because that’s where their body has drawn the line of like “No, we’re not spending more than this.”

It can be why in the beginning, if someone increases their intake a little bit, they notice a real bump in terms of their weight. Again, some of this can be coming down to glycogen storage. We have this energy that comes in; my body’s not actually spending that energy because it’s in conservation mode, so it stores some of that as glycogen. You then need to hold on to more water as part of that, so in a very short amount of time, I’m noticing I’m feeling more puffy, I’m feeling more swollen. The number on the scale really jumped up in just a day or two – yeah, that’s because your body is still storing. It’s storing this thing as glycogen and it’s not allowing your body to spend it effectively. It can be the same thing where it feels like “I had a break from exercise for a couple of days or a week or whatever, and I’ve seen this big change in terms of the number on the scale. It doesn’t make sense.”

I think the trap that people get into is they extrapolate this. “If I only increase my eating by this little amount and it jumped up that much, if I increase it by a large amount, it’s going to jump up exponentially.” And it just doesn’t work in that fashion. In the beginning, the body is storing more, and as time goes on, it’s using more of that energy for repair. It doesn’t work in the way that the eating disorder is convincing you it works.

But this is why I wanted to go through all of this, because I think it explains why so many of the symptoms that happen in terms of eating disorders occur, why those things that don’t seem to make sense do actually make sense, and why this is the body being really smart. Your body is not this machine that breaks down when you don’t control it properly. It is responding really intelligently to the environment around it, and those symptoms that you have – the fatigue, the hunger, the weight changes, the weight plateaus – all of these things, they’re not because of weakness. They are signs of your body protecting you and signs of your body thinking about more than just today and saying, “If this goes on, we can’t live like this, so we need to be really conservative here.”

When energy isn’t reliable, the body learns to hold on. When food becomes fear, the body learns to not spend energy freely. So in a sense, recovery then isn’t about proving to yourself that you deserve food or that you deserve rest; it’s about changing the conditions. And when you change the conditions, the body responds differently. Changing the conditions is about taking those various actions so that the body can then have more energy and be able to have that feedback that this is safe.

So that is what I wanted to go through as part of this episode. I’m currently taking on new clients. If this episode has demonsntrated that I know a thing or two about eating disorders and I understand how they work, I would love to be able to help you out. I’ve been working with clients for the past 15 years and I’m very good at what I do. So if you are wanting to fully recover – and I know full recovery can sound like a pipe dream, but I truly believe that everyone can get there – if you want to get to that place of full recovery and you want help doing that, then please get in contact.

You can send an email to info@seven-health.com and just put ‘coaching’ in the subject line, or you can go to my Instagram @sevenhealthcompany and send me a DM and say “Hey, I want to find out details about working together.”

So that is it for this episode. I will be back with another episode next week. Until then, take care and I will see you soon!

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