Extreme Hunger One
What Is It?
Extreme hunger is a common experience for almost everyone undergoing recovery from any kind of eating disorder. Next to the presence of edema (water retention), extreme hunger is one of the most anxiety-provoking elements of recovery.
It can happen at any time in the recovery process and varies for everyone as to how long it lasts. Many of you will have already seen this information, but it is worth repeating:
Extreme Hunger:
May start on day one.
May start a few days or weeks in.
May not happen.
May last from roughly months two through six uninterrupted.
May show up, disappear, show up, disappear all the way along.
May show up right near the end of weight restoration process.
May blast away like a fire hose from start to finish with no letting up at all.
And if I have missed any variation in the above 7 items I can assure you that it is still perfectly normal.
During this time you will want (and very much need) far more than the HDRM intake guidelines and may find yourself consuming anywhere from 6000-10000 calories in a single day, and for many, many days in a row. That causes panic for pretty much everyone in recovery and they lock down on the incorrect thoughts that they are eating for the wrong reasons.
The enemy is restriction. When extreme hunger hits then you commit to never eating less than the recommended guidelines on any given day no matter what you ate the day before. It is restriction that will pull you to relapse, not responding to the extreme hunger itself.
A few patients (very, very few) do not experience extreme hunger and just go through the process steadily at a few hundred calories above the minimum. The vast majority hit extreme hunger.
It is a unique experience because often the digestive system struggles to keep up with demand. Many describe it as “I’m not hungry, but I’m hungry”, or (because the emotions are so difficult to put into words) they will define it as though they are just eating out of boredom. I will delve into the science of hyperphagia (extreme eating) in recovery in Part Two of this series.
Usually, when there is no eating disorder present, people are energy balanced and the complex signals that arrive from both the digestive system and all other areas of the body are in agreement. The physical fullness of the digestive system coincides with the much more arcane and complex satiation experienced throughout the body’s cells.
The signals that the brain receives as to whether the digestive tract is physically capable of handling more food or not is best described as the sensation of “fullness”.
The signals the brain receives as to whether there is sufficient energy present throughout the body is the experience of satiation and it involves an emotional response as well and that reinforces the neural pattern demanding action.
For those in recovery, often the digestive system is somewhat atrophied in several ways: the stomach may be practicing gastroparesis (drastic slowing of the emptying of the contents into the small intestine to try to extract maximum energy from the too-little food coming in); the production of enzymes is running at half-speed (again to conserve energy); and the bacterial colonies in the large intestine (the good ones) have been decimated due to insufficient energy as well.
As you begin eating to the recommended minimal guidelines, the digestive system has quite a bit of catch-up. And if that coincides with the cells throughout the body demanding a massive infusion of energy to repair damage, then you end up experiencing fullness and hunger at the same time, which is disturbing of course.
The digestive system is frantically sending messages to the brain “I’m going as fast as I can here” and the cells throughout the body are screaming at the brain “More energy now!” Again, the science behind this will be revealed in Part Two .
Respond to the hunger always and never allow any restriction to creep in. To deal with a digestive system still getting up to speed, eat very calorie-dense foods (lots of ultra-processed, fast food options are great for this), snack on nuts and seeds constantly and eat tons of small meals to help the digestive system cope as it gets back to normal.
To summarize, you may find extreme hunger triggers relapse and you need to be prepared and remind yourself of the following facts when it happens:
You do not keep eating 6000-10,000 calories a day indefinitely. There is no concept of “getting used to” the amounts, or being unable to stop.
Your body really, really needs that amount of energy.
Sewing Your Body Back Together
A daily dose of wear and tear is naturally repaired each day in the human body.
Now imagine a fully stitched hem on a skirt, but there are always five stitches of the hem that come undone by the end of the day and have to be sewn up that night. Once an active eating disorder takes hold, then those five stitches go unrepaired.
After only a few months’ worth of restrictive eating behaviours of any kind and the hem is now frayed throughout. There are stitches missing everywhere, long loose threads that can catch and unravel even more of the hem, and so on.
Now, the owner of this skirt finally decides they’re going to get out the thread and fix the whole mess. But they still wear the skirt everyday and those five stitches still have to be dealt with at the end of the day.
If they only pull out enough thread to support a couple of stitches, well that hem will never get fully repaired and will continue to deteriorate—think of that as analogous to providing around 2000 calories a day to your body to ‘recover’ from an eating disorder. It’s not nothing, but it’s still not matching even supporting the daily five-stitch repair that must happen
If they pull out more thread, they’re able to attend to the five stitches every day and that’s an analogy for eating the HDRM-recommended guidelines every day to recover from an eating disorder and treating them as a maximum instead of a minimum. It means that there is a superficial stasis, but the underlying damage throughout the rest of the hem is still going to slowly unravel and deteriorate.
If they pull out even more thread to attend to some of the areas where loose threads may unravel the whole hem, then that’s responding fully extreme hunger.
Because the person sewing is essentially the body and we cannot see the hem it needs to fix, we have to go with the demand for more thread when it comes up.
Nature Abhors a Vacuum—Aristotle
Extreme hunger happens because your body is not just addressing the need to restore weight to it inherited optimal set point, it also has to repair a lot of physical damage that occurs when you create energy deficits within the ecosystem that is your body.
When you restrict energy intake and/or create energy deficits with exercise and exertion, then the body does two things in response to that vacuum you are creating: stops whatever biological functions it can to save energy and takes energy from fat tissue, bones, muscles, organs and nerves to fill the void.
You essentially damage the power plant and steal raw materials as well. If you just replenish the raw materials, then that’s not good enough because you also need to bring in additional materials and crews to repair the damage to the power plant otherwise the raw materials still can’t effectively be transformed into energy.
And in the middle of this entire restoration project, the power plant still has to be up and running to some extent. That is why extreme hunger hits.
Think of extreme hunger as hiring a crew of 25 guys to fix damaged equipment in the plant while the plant still provides the town with basic electricity needs.
Think of denying extreme hunger as insisting that one guy can work on the damaged equipment while the plant still provides the town with the same basic electricity needs.
That one guy bitterly complains each day that all he can manage to get done is fix the one faulty bolt on the equipment because while you continue to provide the town with electricity that bolt keeps breaking and he can’t get to all the other problems.
Obviously providing the town with electricity is non-negotiable. We cannot take the town off-line anymore than we could take you “off-line”.
I think I’ve come up with as many different analogies as I can at this point to try to relay the reason why extreme hunger occurs in the recovery process for almost everyone and why it is critical to respond to those demands for energy.
Next up Part Two.
