357: Planning vs Flexibility, Eating “Bad” Food, Dealing With Numbers on the Scale, and Recovery During Menopause

Chris Sandel: Hey, everyone! Welcome to Episode 357 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 show, it is a Q&A episode. For Episode 350, I asked people to submit questions for a Q&A episode, and I got so many questions that this is the third Q&A episode I’m doing, and there’s still more questions, so there’ll probably be a Part 4 or a Part 5. But thank you for everyone who submitted questions.

Again, I’m not getting to all of them today, but some of the questions that we’re going to be hitting is: identity and recovery; planning and flexibility or planning compared to flexibility; food cost from eating more in recovery; handling urges for ‘unhealthy’ or ‘bad’ food; recovery during menopause; dealing with the numbers on the scale; and much more.

Before we get started, I just want to mention that I’m currently taking on new clients. If you are in recovery or you want to be in recovery, if you’re living with an eating disorder and you want help, I would love to be able to provide that help for you. I truly believe in full recovery and that everyone can get there, so if that is what you want help with, irrespective of whether that feels like it’s a pipe dream or something so far off in the future or “Hey, I can definitely feel this and I just want to have the help to get there”, then please get in contact.

Hopefully an episode like this helps to demonstrate my depth of knowledge, my breadth of knowledge, my compassion, my understanding in terms of the knowhow of recovery. So if this episode resonates with you, if you’re wanting help, then please reach out. You can send an email to info@seven-health.com or you can send a DM to @sevenhealthcompany on Instagram and just put ‘coaching’ or ‘support’ in the subject line or as part of the message, and then I can send over the details.

So, let’s get on with the questions. For everyone who’s asked questions, often there were some really lovely comments beforehand, before we got to the questions. I’ve just stripped all of that out and will just ask the question upfront and then I will give my response.

Kathy had a couple of questions, or a few of them. I will answer three of her four questions because I think they’re good questions and fairly relevant for lots of people.

00:02:36

How can I balance identity in recovery?

Question 1: “A big part of recovery is to leave the identity and problem of the eating disorder behind, so I’m finding it difficult or confusing to know how much focus I should still have on recovery versus seeing and acting like I’m the new person who doesn’t have issues with food and exercise. It sometimes feels like I’m reinforcing my own issues when I constantly think about recovery or plan food or question movement or consume recovery content. How can you find a healthy balance here?”

Especially if you’re in the early stages, or even the mid-early stages of recovery, it does require a lot of considered effort and planning and structuring around food, around meals, around challenging exercise rules, engaging in recovery content. I’m very much a believer, especially in the beginning, of you wanting to create this bubble to reinforce pro-recovery messages because it’s not what you get in the outside world.

I don’t think that this is in any way reinforcing the eating disorder. It’s how you rewire the brain, it’s how you repair the body, it’s how you change those habits. So yeah, there does need to be a considered amount of thinking about and planning in terms of recovery.

When I think about this, the goal isn’t to stop thinking about recovery; it’s to start living in ways that the eating disorder wouldn’t allow you to live in. So doing different things that the eating disorder is saying, “No, you shouldn’t do that” or “That’s too much” or “We couldn’t possibly.” I’m now going to do that despite what the eating disorder says.

In some ways, a good test could be “Are my actions expanding my life?” That doesn’t always work because there are some times where it feels like “Me doing this created so much more anxiety or it was so much more challenging”, so in the very, very short term it feels like “Actually, it’s not expanding my life.” But actually, looking at “If I continue to do this and this becomes more normalised and becomes easier for me to do, is this going to expand the quality of my life?”

Really, with the goal that you let recovery shrink as your life starts to expand, but we don’t do it the other way around in terms of “I need to shrink everything connected to recovery first and then I will start to bring more of life in.” I think this can very easily become just another eating disorder thought or eating disorder trap of “Oh, you shouldn’t be planning your food so much. That’s not really recovery” or “You shouldn’t be doing this so much because that’s kind of like the eating disorder”, so it then becomes this trap.

Whereas actually, for the first chunk of recovery, which could be 6 months, 12 months, 18 months, you need to be putting a fair bit of focus here – and with the intention of “I’m going to have good amounts of time where I’m just not going to think about recovery. I’m going to hang out with friends and be with them and we’re not going to talk about recovery. I’m not going to talk about the emotional stuff I’m going through and where I’m at. I just want to have a laugh.” Or “I’m going to go to that comedy show” or “I’m going to do this thing.”

Yes, I think it’s really important to have life and have moments of life where it is unaffected by the eating disorder, or as unaffected as it can be, and also recognising that “If I want to recover, there are things that I need to do, and that is going to require more of my attention upfront.”

00:06:08

How can I navigate structure + planning vs flexibility?

The next question then is “How do you navigate timing and planning versus flexibility when timing is off (you missed a meal or a snack or life gets in the way)? I find it quite disordered to then feel guilty for it or force myself to make up for it since time fluctuates and I don’t want to be so rigid and controlling all the time. That’s what the eating disorder was also all about, so it feels like another pressure cooker, just in a different format.”

I would be really conscious of this with, what is the direction that these things are going? Is there a real asymmetry here? Because it’s one thing for you to say, “Well, if I have to be rigid and controlling all the time and make up for it”, that is because you actually missed a meal or a snack and we’re trying to bring that back in because it really supports your recovery to “Hey, I had a situation where life got lifey and I missed my morning snack” – you bringing that in later in the day or you rejigging some of your other meals so that we still get that food in, I think that is really important and is very pro-recovery.

And if anything, it shows flexibility. I don’t think that’s rigid; it’s you saying, “Okay, this thing happened and it changed the plan, and now I want to be flexible with bringing this thing in and finding a way to make that work even though it’s not what was originally meant to be happening today.” That actually shows real constructive flexibility, which is what we want in recovery.

It’s interesting; I wonder if you would be asking this question if “Hey, every time, I’m eating my things earlier than they were meant to be planned” or “I’m finding that I’m having two snacks instead of one. Is that okay?” All of the fluctuations that you’re referencing here are about the eating disorder getting its way, in essence. “I missed a snack, I missed a meal” and then there being ‘rigidity’ about bringing that back in. I just think it’s interesting that it is seen in this way, because actually, as I said a moment ago, I think this is about real flexibility here and you being able to bring this back in.

And what actually might be more appropriate is then looking at, “Given that there are going to be these situations, how do I be more flexible on the fly?” Meaning “Do I need to have snacks in my bag at all times so that if I’m out and about and it’s really not the normal snack that I planned or the normal meal I had planned, I’ve got something to be able to cover myself?” Or having that anticipation of “Hey, I know these meetings tend to go longer or I know this thing can often get in the way; what do I need to take with me in advance so that that doesn’t happen?” Or “The last three times this has happened, I’ve missed out on my snack. Okay, I need to eat that snack before this thing. And yes, that means that I’m eating it an hour early or an hour and a half early or whatever it may be, but that’s what I need to do for recovery.”

So being able to frame it in that way of “If I’m trying to do everything for recovery, how would I go about doing this?” Because as I said, I think this can very easily veer into just the direction the eating disorder wants to take you as opposed to doing the things that are required as part of recovery.

00:09:44

How to approach food costs due to eating more in recovery?

Then the next question is, “How do you approach the mindset / resistance towards eating more or increasing metabolism to ‘need’ or ‘require’ more? I don’t actually want to be dependent on more food during the day, as it’s also a financial factor and feels like I would be training myself to a higher standard I may not be able to afford when I could sustain myself better now with a lower maintenance intake. I know it’s very tied to scarcity mindset, hence my question, because it’s a big resistance factor for me where I keep questioning if I need really that much food to recover or that’s just for other people.”

Yeah, I would say this very much reads like the scarcity mindset. And that’s not to say that there can’t be cost factors or financial factors that are involved as part of this, but it definitely reads like the scarcity mindset. And this is very common in terms of eating disorders and as part of the illness. This is often where the restriction and the control and everything can get built around it, and maybe that was not how you thought to start with, but then these kinds of thoughts become more sticky or it becomes like “This makes more logical sense; why would I want to be eating more? That’s going to cost me more. It would be better to just stay in this place.”

I think a helpful reframe is that food is not a wasteful expense. It is the primary input that supports your energy, that supports your work, that supports your relationships. It supports your quality of life. This is one of the most important things that you can be spending money on. And I’m not talking about the way that food is often moralised and talked about in certain places where “This is why you have to go organic and people need to be spending more on their food.” We’re talking here about your basics and how to get in enough energy and enough nourishment to adequately support your body.

I think if you look at the idea that you can sustain yourself on less, it’s really the eating disorder confusing survival with health. Yes, the body can survive on a low intake for long periods, but it does so by cutting back on things like hormones and bone health and temperature regulation and condition and emotional stability and all of the different things that are affected. So yes, you can survive, but it’s not thriving. It’s not delivering a real good quality of life. It’s not allowing you to have the kinds of experiences that you want to be able to have.

I think this is just another way that the eating disorder manipulates things and twists things. Really, eating is not something that is this unnecessary demand. It is important for where you are, restoring normal biological function, and then once things have been restored, being able to adequately meet the demands of the body.

So I would say yes, there can be some financial pressures connected to this, but my sense is what is driving this line of thinking is much more about the eating disorder than anything else.

00:13:13

Can I ask someone with an eating disorder how recovery is going?

Then the next question is from Colette, and she says “Is it okay to ask my daughter, who has an eating disorder, how she’s doing with her weight restoration? I feel she’s hit a plateau and is struggling to get through it.”

This is one of those things where I think it is okay to ask how your daughter is doing with her eating disorder and with various aspects of it. But what is more important is how you ask those questions. If the questions feel like monitoring or pressure, of course that can then increase shame and defensiveness.

I think it’s how you ask those questions. When I’m working with clients, I will do conversations or have a consult with a partner or a parent or whoever is that person’s main support in recovery, and one of the big things that I talk about as part of that is “Once we finish this conversation, I want you to go away and have a conversation with that person, my client, to have the conversation to work out what your role is going to be as part of this.”

I don’t know based on your question, Colette, how old your daughter is; I’m making the assumption that your daughter is an adult, and if that’s not correct, then obviously it could be different. If she’s not an adult, there could be other things that you could be doing in terms of family-based method with recovery. But if she is an adult, it does become a lot trickier. And it’s not that it’s not tricky when someone’s not an adult, but when someone becomes an adult, your role somewhat shifts as part of that.

So having the conversation with her, and doing this at a time where it’s not a tense moment, you’re not bringing up grievances or worries or concerns, you’re being able to have an honest conversation of like “Hey, I want to figure out how I can best support you in recovery and I want to figure out what my role could be in that or what you would like my role to be in that. How can I help you? What would be useful if I’m seeing this or seeing that?”

Or before you even get into the “what would be useful” questions, just say “Hey, what do you think?” Allowing her to then be able to answer that question, because you’re really wanting to focus it on “How do I be a partnership here?” rather than it feeling like oversight, and how can you frame things from a place of curiosity instead of judgment. So there isn’t one right way of doing this, but a lot of it comes down to having that conversation of figuring out, “What’s my responsibility? What’s your responsibility? How do we navigate this?”

The difficult part – and I’ve said this on here before, and I say it to clients all the time, or to partners or parents of people who are struggling – the difficult thing with an eating disorder is you don’t have ultimate control over someone else. As much as you want your daughter to get better, you can’t force that on anyone. So it’s, how do I then support that person? How do I offer that place where they are wanting to be honest with me and they do feel comfortable being honest with me, whether it’s telling me about the good stuff or telling me about the parts they’re struggling with?

So my first suggestion with this, as I said, would be having that conversation with her and trying to figure out what each of your roles are as part of it.

00:17:01

How to stop the eating disorder from manipulating recovery behaviours?

The next question comes from Jordan, and they say, “How to stop the eating disorder from manipulating pro-recovery behaviours?”

I think this is something that can happen really easily, where someone feels like “I’m doing recovery and I’m taking this action” and then upon reflection, it’s like “Oh, actually, that wasn’t what was going on. There was a lot of moving deck chairs on the Titanic and I felt like I was busy and I was doing all these things, but fundamentally nothing has really changed.”

So I think a couple of things would be look for the direction of the change. True recovery behaviours usually move things bigger and freer, so that would be more food, more variety, more rest, more spontaneity. Depending on where you are in recovery will depend on which ones of those are more appropriate. At the beginning, it’s much more about adequacy and regularity with your eating; as time goes on, it can be more about spontaneity and eating with other people and those things. So what direction are these changes taking you in?

Because really, when we reflect, eating disorder behaviours tend to make things smaller or safer. Safer foods or tighter routines or subtle compensation or those kinds of things.

And look, this is where there can be a grey area with this, because for someone, yes, there might be a lot of safer foods that are appearing, but if those safer foods are actually increasing in quantity and leading to you having more total energy come in, that is actually a useful strategy, or could be a useful strategy, depending on the stage of recovery you’re at. A helpful check could be: Does this behaviour increase nourishment or flexibility or life engagement? Or is it quietly maintaining restriction and control and avoidance? Again, I think this is where there can be a little bit of grey area.

But this is why when I work with clients, we set very clear, binary recovery goals to really remove a lot of that grey area so there is a very easy yes/no “Did this thing happen?” Having a goal of “I want to eat more” is very vague. What’s ‘more’? Did ‘more’ really happen? Versus if I say that I’m now going to be adding a bread roll with butter and cheese to my morning snack, and my morning snack is remaining the same so I’m not removing anything else from that, it’s fairly clear whether that did or didn’t happen. We can then put constraints on other parts of the eating, like nothing else is being reduced throughout the rest of your eating. It then becomes much clearer about did the goal happen or not.

I think this can be really helpful because the eating disorder can make it feel like either everything’s going really badly and this is really not heading in a right direction when the reality is it actually is, or it can make it feel like “Yes, I did so many things for recovery and I’m really putting in all this effort” and the reality is, there hasn’t really been much of a change that’s happened.

And again, this is why it can be useful in terms of the goals because you can have a week where there’s a lot of emotions, there’s a lot of eating disorder thoughts, there’s been a lot of tension, and when we reflect, it’s like, “And you did the goals every single day. I know there’s been these challenges and there’s been this uncomfortableness with this, and we can see that these things are moving in the right direction because you actually did the goals.”

00:20:49

How can I handle urges to eat ‘bad’ foods in recovery?

The next question – it’s a couple of questions – come from Kerry. Question 1 is “I still get urges to eat ‘bad’ foods. It’s always biscuits, chocolates, and cake, and when I have it, it’s a large amount. Now that I’m allowing it, I just can’t get past the feeling that I’m setting up a bad habit, especially as the whole binging stage for me has gone on way longer than just my restricting stage. How do I know what’s an urge I should be listening to and what’s an urge that, if honoured, will start a habit that is hard to undo down the line when my relationship with food is healthy again?”

I know that this is a huge fear for people, and for people who either “I had no binging as part of my eating disorder and now that I’m doing recovery I feel like that is happening; I’m either having binges or I’m eating bigger meals that feel like a binge or I’m trending in that direction, and man, I don’t want to change from one eating disorder to another”, especially when eating disorders are often graded in terms of a restrictive eating disorder is ‘better’ than an eating disorder where I’m eating more food. And none of that is true, but there is this fear of “I’m going to trade this one thing for this other thing, and this other thing is a worse version of it.”

Or “Hey, I did have binges as part of my eating disorder, and it feels like now that I’m doing recovery, that’s happening more often. I’m allowing myself to have more of these foods, and I’m just really unsure whether that is the right move, because it feels like at this point, my eating is ‘worse’ compared to where it was before.”

What I would say with all of this, whether binges were part of your eating disorder, they’re starting to happen as part of recovery, they’re not happening as part of recovery but you’re worried they’re going to be happening as part of recovery – is that the urges for these foods, like biscuits and chocolates and cake and the things that you mentioned, are a sign of prior restriction and that these things have been off limits for such a long amount of time, it’s not about a ‘bad habit’ forming, as you said.

When the body has been deprived, especially of energy-dense foods, it then tends to have a strong pull towards these when they become available, and the intensity and frequency can often persist with this until the body fully trusts that this food is consistently available.

I think this is the big piece that people often mistake, because there is physical restriction (i.e., I’m not actually eating this thing), but there’s also mental restriction (i.e., yes, I’m eating this thing, but I’m telling myself I shouldn’t be eating this thing, or I’m telling myself I should’ve only had one of these things but I’ve had two or four or five or whatever it may be). So even though I’m actually physically eating it, the message that I’m sending is “You shouldn’t be doing this, you’re doing something wrong, this is the wrong thing to be doing with food, you’re creating these bad habits.”

So I wonder, Kerry, if part of it is you’re doing well on the physical piece – and again, I don’t know if that’s true; maybe your body is asking or more of this and there’s still the holding back, so “I’m still not fully giving myself everything my body’s asking for.” Or “I truly am giving myself everything it’s asking for; there’s just a lot of judgments and a lot of the self-talk of this is creating a bad habit.”

Because if I’m dealing with someone, working with a client who has binge eating disorder, and binges have always been their problem, the goal is complete food freedom. And the way that someone gets there is by allowing themselves to eat all the food. It’s not doing some ‘lite’ version of restriction, which I know is what is often prescribed for many people, especially if someone is in a larger body. The version that they get given is like “The way that you should now eat is that you can have some of these things but you don’t want to have too many of these things.”

And I really just don’t believe that is the way to get through this. Paradoxically, the way that these foods stop feeling so compulsive is because they’ve become ordinary. This means giving them to yourself regularly and sometimes in large amounts for quite a while until the novelty and urgency fades.

And I truly believe that the novelty and urgency fades with these foods. I’ve seen it time and time again with clients. The novelty is baked into the fact that either (1) “I’m not allowing myself these things, so I don’t get them very often” or (2) “There’s this whole heightened emotional experience when I am eating them because I keep telling myself I shouldn’t do this, I’m not allowed it”, and it only comes about where these things become just food again when all of that is chopped away. I’ve done it enough.

So I’ll often recommend – not everyone does this, but I’ll recommend have more of those foods. Really keep doing it. Because there is no food – I don’t care how much you like pizza, how much you like burgers, how much you like crisps, wherever it is – there is a point where that stops becoming enjoyable. You just need to have more of it. So if you’re like “Pizza is that food for me”, have pizza three times a day. You will reach the point where it is no longer enjoyable pretty quickly. Maybe it takes a couple of days, maybe it takes a week, maybe it takes a month, but at some point that novelty has worn off because you’ve demonstrated to your body, “Hey, you can have all this thing”, and however lovely it tastes in the beginning, at some point you’re like, “This just doesn’t taste good anymore. I’ve had so much of this.”

I think it is then really important to be doing the food piece and allowing the food piece and really be doing it in this repetitive way. But I also think this is where the other parts of recovery, like learning tools connected to emotions and how to deal with uncomfortable thoughts and how to have these different constructive coping practices are really important. Because I think this is where true discernment starts to come in, where you can actually label emotions, you can have a good understanding of what’s going on in terms of your emotional experience or the state that you’re in and how that’s affecting your thoughts.

And I’m not saying all this so that then “That’s how I then eat less.” It’s to say that when you’re able to notice all of these different things about your experience, you less get caught up in this very black-and-white thinking about food, and “If I’m having this food, it must be because I’m emotionally eating” and more being able to recognise how you’re feeling in this moment.

And two things can be true at the same time. It can be “I do need more food in this moment, and I can also recognise that it has been a really tough day, or I can recognise that I’m dealing with grief in this moment, or I can recognise that there’s a lot of loneliness that is showing up.” Having that ability to recognise different emotions, to be able to come back into one’s body, that’s the really important part of recovery.

It’s something I work on a lot with people because I think of recovery in two broad stages; there is the physical and nutritional rehabilitation, neural rewiring part of recovery, and then the second stage is everything else, which is learning how to deal with life outside of having an eating disorder. This is the bridge where it’s important in the first piece to allow you to then do the eating and the nutritional rehabilitation and all that part because you have these tools that allow you to push through or to be able to have these thoughts come up, but “I’m still going to take the recovery action”, and this is then what you use for the rest of your life as you develop “How do I like spending my time? What is important for me? And how do I deal with these challenges now that I don’t have my eating disorder?”

So I think this is a really important part of the recovery process that I want more people to be doing. And I feel like often what happens is you either do one or the other. It’s either “I just do all-in and I’ve been told the dream that if I just eat more food, that’s going to resolve everything” or “I just go and see a therapist and I just need to work on my inner child and I need to do all the inner work around emotional processing and what happened in my childhood and stuff with my parents and all of those kinds of things.”

From my perspective, you need to do both. If you’re just doing the eating piece, for 95% of the population who have an eating disorder, that is not going to be enough. Yes, there are some people who it is just a biological thing, and they got really unlucky by going on that first diet. That is not the case for the vast majority of people.

And then the second option, if it’s just doing the therapy piece, you’re not taking the action that is required as part of recovery. So it is really bringing those two things together.

00:30:29

How do I deal with the urge to be ‘attractive’?

Then Question 2 is “I’m in a long-term relationship and do not want or need to be attracted to others; however, the urge as a female to be attractive (my mind heavily associates thinness with this) is so strong and is there for a reason biologically as well as culturally. How do I ignore this urge when it’s a biological response that is deliberately there?”

I would be a little cautious in terms of the biological drive to be attractive. Yes, I think there is a part of that, but if we actually look at what’s underneath this, it’s “I want to be considered part of the group. I don’t want to be a social pariah. I don’t want to be cut off from the group.” If we go from an evolutionary standpoint, if I’m excluded from the group, then I’m not going to be able to have food, then I’m not going to be able to have shelter; that can lead to certain death, so it makes sense that I fit in as part of the group or as part of the tribe.

We all have this feeling of “I want to be loved”, and there’s the worry of “But am I lovable? Am I enough?” and all of this as part of it. So yes, there can be the attractiveness piece in there, but I don’t actually think it’s necessarily about that. I think it’s about, how do we feel like we’re part of the group – or how do we feel safe within ourselves?

I think what happens is there is this feeling of “If I can sort out the attractiveness thing, if I can be in a thin enough body, if I can match up to society’s standards of beauty, then I will feel safe, then I will feel okay.” And sometimes that can work, or it can at least get someone a little of the way there, but it doesn’t get you the whole way there. Because you’re then just waiting on that external validation to have that feeling – and look, the reality is we are all aging out of beauty standards. I don’t know how old you are at this point, but at some point you’re going to be another 10 years older and then another 10 years older, and what is considered attractive is people who are young.

So at some point, you’re going to grapple with this, or you’re the 70-year-old where this is the most important thing in your whole life and “how I look and how attractive I am is my whole identity.” I also don’t think that’s a great place to live in, either.

So my suggestion would be, rather than “Let me keep doing the eating disorder so I can have a body that matches up to society’s standards and hopefully that will help me feel better about myself”, there’s lots of other ways to work on this. Ways to work on stuff internally in terms of yourself and your self-worth and your belief in yourself, but also, “How do I have relationships that help me feel part of my group? How do I have friends where I know that they care about me and they love me, irrespective of whether my body matches up or doesn’t match up to society’s standards?”

The more that you can then cultivate that within your life, “Where irrespective of how I look, I feel good, I feel stable, I feel grounded, I feel like I have value and worth”, the better. And you are right; we live in a culture where we value thinness, where we value beauty, where there are these assumptions that can be made about how someone looks. None of that is going away, and I don’t imagine that anything I say is going to change that for you. And look, we’re all going to have days where “I don’t feel like I look my best” or anything along those lines. So it’s not getting to this place where you have transcended all of that. I think that is a fantasy.

And you can get to a place where “This just does not affect me in the way that it was before. I really have diversified my identity enough and I diversified the way that I feel good about myself and the things that add to the quality of my life in such a way that this thing is not important in the way that I believed it was.”

But again, if you’re having all of these thoughts around food and “I’m eating too many bad foods” and all of this, this keeps the idea around ‘my body and my attractiveness’ really front of mind. So I think in a lot of ways, you’ve got to work on these things at the same time.

00:35:21

Advice for recovery during menopause?

Then the next question is “Recovery during pre-menopause or menopause? I’m 46 years old and it’s hard to rest and challenge fear foods when not only the ED voice says it’s wrong, but everyone else also tells about ‘exercise and eat healthy’ during this period of a woman’s life.”

What I would say to this is much of the mainstream advice around menopause is very rooted in diet culture. I think we can remove the word ‘menopause’ there; mainstream advice around health is rooted in diet culture, and messages around cutting carbs or eating clean or “you have to have this amount of protein grams” or shrinking your body or exercising more or all of these different things just reinforce more of that restriction and weight control rather than real, genuine health.

It’s just not advice that is appropriate for someone who is in eating disorder recovery. I mean, I don’t think it’s appropriate for anyone, but particularly if you’re living with an eating disorder and going through recovery, the generalised advice is not for you. This is a conversation I have with clients pretty regularly when they say “I’ve heard about this diet for this” or whatever. It’s always like, are they recommending that this is the exact thing that you do to recover from an eating disorder? And no, that’s not what’s being recommended.

So I do understand that it is tricky going through recovery in menopause because it is a really changing time of life, and there are different hormones that are changing as part of that. There is natural weight gain that happens at this point of life regardless of whether someone’s going through recovery or not. There are lots of changes that are going on. It can be a time where there is more monitoring from doctors, depending on where you are in the world and what’s going on with that.

But yeah, you can start to be getting more lab tests done, and there can be more scrutiny around that stuff, especially because when you’re going through recovery, your numbers can not look how they are ‘meant’ to look. It can be your cholesterol numbers are a lot higher or your blood sugar numbers are a lot higher, so it can be read into in the wrong way of like “We need to now be cutting back on this thing.” Having someone you can work with who can really understand those numbers I think is actually really important.

But yeah, really understanding that this advice around what you should be doing as a menopausal woman that you’re getting in the mainstream is just not appropriate for recovery. And it’s not just not appropriate, it can be actively harmful because it really validates the eating disorder voice. It makes recovery behaviours that are essential, like resting more and eating more and challenging fear foods, feel like they’re wrong when that’s exactly what the body needs.

Recovery-supportive health just looks different. It looks different to what is being suggested for the masses. It looks different to what’s being suggested for someone in menopause. Bu it’s what needs to be done. Adequate nutrition, creating flexibility around food, reducing chronic stress, allowing more rest, supporting hormones, supporting bone health, nervous system stability – all of these different things, this is part of what recovery is about.

And look, if we just talked about we want to be nourishing the body, we want to have flexibility around food, we want to reduce chronic stress, we want to support hormones and bone health and nervous system stability, most people, most health practitioners, would be like, “Yeah, I’m totally onboard with that.” It’s just the mechanism by which that is done that will be different, and the way you do that from a recovery standpoint is going to be different to the way that’s being suggested online that someone needs to do it in menopause.

00:39:37

How can I recover while having a demanding job?

Then the next question is “I have a full-time job and it’s very demanding physically and mentally. I can’t leave my job or take time off, and sometimes believe that I can never rewire the link between activity, movement, productivity, and ‘earn your food and rest’.”

I don’t think that you need to quit your job to recover, and I’m very much of the opinion and suggesting that people do recovery in the real world as much as possible. It’s not that I don’t think there is a time and a place for inpatient or that there is a time and a place for taking a break from work, but I want to encourage someone to do this as much as possible in the real world.

And also recognising that in the early stages of recovery, the body is already under significant stress from the energy deficit, so if you’re doing something that is physically demanding, that there is this high workload as part of that, it’s going to make it more difficult to do the repair work and to do the things that are required as part of recovery.

Sometimes it could be helpful to think about this like a physical injury. If you had a broken leg or if you needed surgery, you wouldn’t expect to keep doing your physically demanding job without this adjustment. You would need to take time off to be able to do those things, and we’d recognise that it’s important to get the support and the recovery and to heal from that.

So when you say “I’m unable to”, I don’t know if that’s just “I don’t want to” or “there is no possible way that I could do this.” If there is some wiggle room, if there is the ability to take some time off and that’s what’s needed, or to at least reduce your hours, then I would suggest that. And if that is just not practical, “I just can’t get that to work”, then you need to look at “If these are the constraints I have within my recovery, what do I need to do differently as part of this?”

Because if it’s true that you now have to keep up this demanding job, I now have to do these things, then you need to do recovery different to the average person because there are these things that are in addition creating energy usage for you.

There’s lots of times when I’m working with clients where there is something that they can’t change where that now is a constraint that is adding something to your recovery that we need to figure out a way to navigate.

This is the case for you, so if this is truly the case, you can’t then use the eating disorder to talk about earning food or rest and productivity and hijacking your current situation. It needs to be “This is the situation, and if that’s the case, then I need to be eating more. Whatever minimums people are talking about online, I need to really jack that up because my job is physically demanding and that’s using a lot more energy.”

So it’s about “I need to become intentional about fuelling. I need to be intentional about when I’m not working, I can’t be doing anything extra. I really need to be resting as much as humanly possible outside of my job, as much as I can do that, depending on family situations or whatever is going on. But I need to be really intentional that if this is my job, outside of that I need to be doing everything in my power to get the rest and the food that I need as part of this.”

Really, I want you to be able to drop that “you need to earn your food and rest” rule, and I’m a believer that that comes about by just proving to yourself that that’s wrong. It’s “Hey, I’m going to eat even though my brain is telling me not to eat. I’m going to rest even though it feels like I’m being lazy when I’m resting. When I do this and do this repeatedly, that’s how I then demonstrate to myself that this rule was an eating disorder rule, and it isn’t actually true, and I don’t buy into it because I’ve been able to prove that.”

00:44:18

How to deal with wanting to get better + stay ill at the same time?

The next question is “How to deal with the conflicting feeling of wanting to get better and remain ill at the same time?” That’s from Emily.

What I would say with this is ambivalence is a really normal, natural part of recovery. Almost everyone feels the way that you’ve described. Being pulled in these two directions where one part of you wants the freedom and the health while this other part of you wants the familiarity and the perceived safety of the illness.

Those two parts in a sense reflect different parts of your mind. It’s actually really useful to look at the part that wants to stay ill and look at it from the perspective of it is trying to protect you. Even if it is a harmful strategy, there’s lots of collateral damage, there’s lots of problems with it, it is trying to do something really useful for you.

Bring in the curiosity with this. I think it’s a Tony Robbins quote that I’ve heard – “People keep their problems for a reason.” I think it’s recognising that “I’m doing this for some reasons, and I want to look at the needs that are being met by staying in this place. What are the needs that are being met by the eating disorder?”

Because once you can recognise that that is, you can then start to look at either, one, “How do I start to meet those needs in other ways? If I have a need for certainty, how can I start to get certainty in some other ways outside of my eating disorder?” If you have this need for safety and feeling safe in your body and this is how you currently do it, how do we start to develop tools and practices and ways of being that you can start to feel more safe and you can start to be more capable of tolerating when you are feeling discomfort?

So the first goal is, “How do I understand my needs so that I can either (1) meet those needs, or (2) what needs to change so that need is no longer important to me?” It feels like this thing is super important, but actually, as I start to change these things, I realise that’s not so important.

Coming back to an earlier question about the need to be attractive or to be in a thinner body or whatever it is, what would have to change so that that thing becomes no longer so important to me? Maybe I need to change my identity through different habits and behaviours that I’m going to start to bring in so that there is this diversification of my identity. Or how can other aspects of my life change so that this thing is no longer so important for me?

I think there can be this feeling of “I need to figure this out in advance. If I still have this feeling of wanting to remain ill, then obviously I don’t want recovery badly enough”, and that’s just not true at all. This ambivalence is really normal, and the goal as part of this is, one, being able to honour there is this other part that gets something out of staying stuck or staying ill. It is meeting these needs – and also, I’m able to act in alignment with the healthy part of me, even when the other part protests, or even when there are thoughts or feelings coming up.

You don’t have to eliminate that part of ‘wanting to stay ill’ voice to start with; it just happens by “That voice was there and I still took the recovery action, and I did that again and again, and then I recognised that voice doesn’t have as much power over me anymore, or it’s not coming up as much as it was before because I’m recognising that I’m able to meet my needs in other ways and I’m recognising I’ve become more resilient through this.”

00:48:20

How do I deal with thoughts like ‘I’m not sick enough’ or ‘It’s not that bad’?

The next question comes from Elizabeth. “My question is, why is my knee-jerk reaction to anyone knowing about my eating disorder to assume that they think I’m faking it or being dramatic? I have a lot of fear about people thinking I don’t look anorexic enough or saying ‘You seem fine to me.’ But alternatively, if anyone says that they feel worried about me or point out behaviours, I get defensive and say ‘It’s not very bad’ or ‘I don’t do that very often.’ The mental gymnastics makes me feel pretty crazy.”

What you’re describing, again, like I commented with the previous question, is really, really common in recovery. Especially as the eating disorder goes on and you get into this more difficult place, it becomes a little bit of ‘damned if you do, damned if you don’t’ mindset where the illness is constantly scanning for invalidation. So if someone says “You look really good, you look fine” or “It’s so great to see you looking healthier”, the eating disorder is like, “See? You’re faking it. You’re not really sick enough.” But if someone then says something about “Hey, I’m really concerned with you”, the eating disorder’s like “You really need to minimise this. It’s not really a problem.”

Both reactions, though, are triggered by the same underlying fear, and that underlying fear is, from the eating disorder’s perspective, “We don’t want this to be taken away from us. We really need to hold on to this thing.”

I think a big part of this is the ‘not sick enough’ trap, and this comes up time and time again with people. They feel like they must prove that their illness is legitimate and “I have to prove that through my behaviours or through my appearance”, while there’s another part of them that really wants to hide this and to avoid the scrutiny or the pressure. So there is that push-pull dynamic that you’re talking about. So I just want to acknowledge that what you’re describing is really common.

And none of this prevents you from doing recovery. I’ve said this on the podcast many times before, but eating disorders are highly illogical. What often keeps people stuck is “I’ve got to understand this, I’ve got to be able to pick this apart, I’ve got to be able to make sense of why I’m having these different thoughts that feel like they’re in opposition to one another but at the same time, or at different times but on the same day.”

My thought process with this is like, you don’t need to solve any of these things. Eating disorders are illogical. When you get into this energy-depleted state, it has an impact on your brain and your mind and your perceptions, and if you’re trying to solve this and make sense of it, you get stuck trying to solve an impossible riddle.

So really, the way that you solve all of this is by doing recovery – by doing the food stuff and the movement stuff and the things that are important there, but also doing the things around developing other coping mechanisms and ways to being able to deal with thoughts and feelings and emotions. It’s then when you continue to do that work that a lot of these kinds of questions and “this feels really difficult to get past” start to become less challenging and in a lot of ways less relevant as you continue to go forward.

So rather than getting stuck with this, Elizabeth, my suggestion is just keep going with recovery, recognising that with time, this will start to shift, and that what you’re describing is a very common occurrence with an eating disorder.

00:52:15

How to cope as numbers increase on the scale?

The final question is from Julianne, and she says “How to cope as numbers increase on the scale?”

Yeah, the number on the scale, I know, can be a really big challenge for lots of people. From my perspective, there are a number of options with this. If the scale is distressing, the first option is simply to not weigh yourself.

If I reflect on the clients I’m currently working with, there’s probably two or three where I’m using the scale with them, and everyone else, we’re not. With those two or three, we’re using it for a very specific reason, but everyone else we don’t need to use it because we’re able to judge how recovery’s going without seeing the number on the scale.

We can see based on, is your eating increasing compared to where we were a week ago or two weeks ago? Is your movement and exercise decreasing or stopped from where it was a week or two weeks ago? What is going on with the various symptoms that you have? And it’s not that everything is going to be improving immediately, but what’s happening in terms of your emotional regulation? What’s happening in terms of your sleep? What’s happening in terms of your bloating?

We can use all of these other metrics to get a sense of how things are going with recovery. It’s not that the number on the scale is the be all and end all. It’s useful; it can be a piece of data that can help us have one extra element or angle to be able to look at. But that’s it. It’s not that this is the thing that solely determines recovery.

For me, I don’t use weighing clients very often. If you do need to be weighed – and this is if your team, your clinician, whatever, wants to weigh you or thinks it’s important as part of it, you can do a blind weighing so they know the number, but you don’t see the number. You can do this even if you’re working with someone online. I think it’s called ClearStep is one of them. I think there’s a number of different scales that you can get. You stand on the scale and it sends that information to your practitioner or your clinician, so they get that information but you don’t actually see it. So that’s one way if you’re working with someone remote.

If you’re going to be in the same room with them, you get on the scale facing backwards, they’re able to get that information, but you don’t see it. Or you stand on the scale backwards and your husband or your parents see it and they then email it to your practitioner. So there’s a way that that number is getting to someone who can use that in an effective way as part of recovery, but you don’t actually know it.

And then the final thing is if you have to know that number – even as part of this, I start to question, why do you have to know that number? Because even if we’re looking at “I want to get to a place down the line where I’m okay with that number”, that might not be where you need to start with this. If someone that I’m working with wants to do that, we’re not doing that from the very beginning. We’re doing that later on, when they’re in a position where I feel pretty confident that irrespective of what we’re seeing on the scale, it’s not going to alter their behaviour.

What I mean by that is it’s not going to alter their behaviour in the direction of the eating disorder. If they’re seeing that it’s lower than it should be or it’s not increasing in the way it should be, I want it to alter their behaviour in terms of “Okay, cool, I am going to be adding to my snack or I am going to be adding to my lunch. I’m doing things to move in the right direction. But if the number is higher than what I anticipated, I’m not going to use that to start to cut back and make changes as a way of trying to mediate that.”

So from my perspective and what I’ve seen, people tend to need to be further along for that to happen. So the simplest solution is just not weighing yourself as part of it, or if you need to be weighed as part of your team and the people you’re working with, just not knowing the number.

And if you have to know the number for some reason, going in – and I often will talk about this with clients beforehand – let’s do some journalling beforehand of, “What does it mean if the number is lower than what I expect? What does it mean if the number is what I expect? What does it mean if the number is higher than what I expect? And what am I going to do in each of those situations?” So I’ve made an agreement in advance of it.

Because if you’re unable to say “I’m going to keep following my plan if the number’s gone up”, then I’m pretty categorically saying it’s not a good thing for you to be standing on the scale. If you know in advance this is going to alter behaviour in the direction of the eating disorder, it’s not a great thing to be doing for you.

But if you’re able to say “Irrespective of the outcome, it’s not going to be detrimental to my recovery” and have done this journalling prep” – also, connecting it to things that are actually valuable as part of your recovery. So if I’m seeing the number going up, this means that my energy stores are improving, that my hormones are going to be improving, that my bone health is going to be improving, that it’s going to support my brain function, that it’s going to help my metabolism – if you can start to make that connection to really anchor the recovery and the weight gain to positive outcomes, that’s a really helpful way of doing it and getting around this and show that “My body is moving out of the starvation mode it’s been in and it’s moving toward health.”

It’s not that you have to buy into all of that. There can still be ambivalence around it. But “I need to be able to recognise that this is actually for the best and is helpful as part of my recovery.” If you’re able to do that, then great. Stand on the scale and use whatever you’ve done in terms of the pre-work journalling to help with the behaviours after that.

So, that is it for this week and for these questions. Thanks to everyone who sent these in. There will be another couple of these podcasts to come because I still have quite a good chunk of questions.

As I mentioned at the top, I’m currently taking on new clients. If you are wanting to recover, you want to get to a place of full recovery, then please send an email to info@seven-health.com or you can send a DM to @sevenhealthcompany on Instagram.

That’s it for this week’s episode. I’ll be back with another one next week. Until then, take care, and I will see you soon!

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