Does the Homeodynamic Recovery Method Apply to Me?

This exceedingly common question has a trick answer. If you have an eating disorder, then the food intake guidelines don't actually apply to you (Whaa?).

Charlotte Powell:

Charlotte Powell:

When people ask "Does the HDRM apply to me?" they are usually only talking about the food intake guidelines. And those guidelines are actually laboratory-confirmed intake requirements for everyone who has never had an eating disorder in their lives. If you need to review all the scientific references, then please read Homeodynamic Recovery Method, Doubly-Labeled Water Method Trials, and Temperament-Based Treatment.

For anyone who has dieted;restricted food type, groups, or amount; cycled through constantly trying to return to a diet after experiencing so-called binges; used exercise, workouts, clean-eating; or all the other approaches for trying to get to a specific weight, size or shape; then HDRM re-feeding guidelines are not enough for rectifying the damage.

Dr. Rebecka Peebles contacted me recently (this is an update October 2016 from the original post of 2014 BTW) to say that she would like to refer patients and families to my site, but that she could not as the intake guideline of 3000 kcal/day (for women under the age of 25) is too low. Dr. Peebles is the medical director and director of research and quality, Eating Disorder Services at the Children's Hospital of Philadelphia. And Dr. Peebles is correct for her entire patient community: 3000 kcal/day will not help them achieve remission from an active eating disorder.

No matter your history of restrictive eating behaviors, the HDRM food intake guidelines will only apply to you once you are in remission from your eating disorder. In active recovery you will usually need double to triple that amount, depending on your individual circumstance and treatment recommendations.

Once you are energy-balanced, you will naturally shift your intake (with absolutely no conscious effort to reduce intake!) to around the HDRM food intake guidelines. But there are many, many months of eating far more before the body is actually returned to an energy balanced state. That holds true even if you say "But I only restricted a little bit/a little while."

The reason that the HDRM food intake guidelines are set where they are is that they are laboratory-confirmed intake levels that are already in excess of what unscientific government RDIs are set at. Such is the disbelief and panic associated with needing to eat more, the HDRM food intake guidelines are an irrefutable starting point. But the guidelines are clearly listed (everywhere on this site) as a MINIMUM.

If you treat the food intake guideline as a maximum then you are not taking in nearly enough energy to reverse the deficit and repair the damage throughout the body.

Initially the intake level will feel enormous and likely uncomfortable. However, at some point (it varies for everyone) extreme hunger will kick in. That's normal. And in order to move forward in recovery, you have to respond to that hunger by eating.

Because it can never be said enough: begin recovery from an eating disorder when you have adequate medical and psychoeducational advice and monitoring in place.