Weight Restoration in Eating Disorder Recovery
Weight restoration is the most reliable predictor of remission from anorexia nervosa (AN) and is necessary for a successful recovery. Without implementing weight restoration in treatment, the eating disorder will stay. Gaining weight after intentional food restriction and overexercise can be scary and challenging, as it requires not only a behavioral change but also a shift in mindset. Weight loss can no longer be seen as the main objective — weight stabilization should be the primary goal.
by: Enchi Dai
Weight restoration refers to an individual in eating disorder recovery reaching a stable weight that is easy for them to maintain in the long-run. Today, we are going to talk about its importance in the recovery process, risks, and the support needed in the process.
Why is weight restoration important in eating disorder recovery?
“Weight restoration is not an optional part of recovery; it is an essential part. It is not just about facing fear foods, restoring hunger and fullness cues, eating mindfully, and discovering true balance and moderation. Even more, it is about returning your mind to a healthy place rather than one in starvation mode, so that you can actually do the emotional work” (Haglund, 2016).
Source: Brain Over Binge
Indeed, restricting food intake is what makes the binge-purge eating cycle stronger and more intense. In order to break the cycle and start recovering, one needs to abandon diet mentality and food restriction, focusing on intuitive eating and weight restoration. Research has also supported the practice of weight restoration. Lund et al. conducted a longitudinal study and found that clinical deterioration occurred significantly less often among participants who gained 0.8 or more kg per week than those below this threshold. Therefore, the weight gain rate during inpatient treatment for anorexia nervosa is a significant predictor of short-term clinical outcomes after discharge.
What is the process of weight restoration?
For many, changing dieting behaviors ignites a spark of fear about increasing weight. However, with time and hard work, individuals may start challenging their beliefs around the importance of weight, shape, and beauty standards. That is to say, adopting this mindset is an important psychological component in the process of weight restoration.
Weight restoration may take months depending on the individual. For individuals with anorexia nervosa, the medical recommendation is that they need to reach more than 500 calorie surplus per day. Individuals with severe anorexia nervosa need to reach more than 1000 calorie surplus per day. Most weight restoration meal plans include three meals, three snacks, and sometimes supplements in between. Individuals who previously engaged in overexercise will need to decrease their movement in order to facilitate weight restoration. Yoga is commonly recommended and utilized during this period of recovery.
What are the risks of weight restoration?
During weight restoration, individuals may experience physical side effects such as bloating, constipation, headaches, and other gastrointestinal issues due to the increase in food intake. Individuals will have to be careful not to increase the food intake too quickly for fear of refeeding syndrome, a potentially fatal complication of increasing food intake too quickly (Miller, 2017).
In addition, the adoption of intuitive eating is often challenging during recovery. As a result, individuals may experience depression or anxiety symptoms resulting from potential weight gain.
What support is needed?
Professional support (The Emily Program):
Weight restoration can be one of the most challenging parts of eating disorder recovery because it necessitates a change in both eating and thinking. That being said, professional help from both a dietitian and a therapist is recommended. A dietitian will be able to help with the nutrition in food intake, while a therapist will be able to assist an individual in working through complex emotions and to develop healthy coping mechanisms.
Social support (Miller):
Families and friends can provide encouragement and support to individuals during weight restoration. For example, they can help make the mealtime experience pleasant and take the focus away from calories, weight, and size by discussing neutral topics like TV shows or movies.
At BALANCE eating disorder treatment center, we treat the spectrum of eating disorders, including anorexia, bulimia, binge eating disorder, compulsive overeating, and other disordered eating behaviors and body image issues. We offer a variety of virtual programs and services to help our clients not only reduce eating disorder symptoms but also move toward a more harmonious relationship with food and their bodies. Click the button below to browse our full selection of virtual programs & services.
This post was written by BALANCE Blog Intern, Enchi Dai.
Enchi is a Bachelor's-Master's student at New York University, majoring in Psychology. After her recovery from disordered eating, Enchi became passionate about spreading ED awareness, advocating for intuitive eating, and promoting Health at Every Size. Enchi is also an ACE Certified Personal Trainer and Registered Yoga Teacher (RYT 200). Her goal is to help people become healthier both physically and mentally, instead of encouraging them to pursue a certain body image. Along with her internship at BALANCE, Enchi works as a Research Assistant and Crisis Counselor to prepare herself for the future career as a Clinical/Counseling Psychologist.
References
Haglund, K. (2016). How to Work Through the Weight Restoration Phase of Anorexia Nervosa. Eating Disorder Hope. https://www.eatingdisorderhope.com/blog/work-weight-restoration-phase-anorexia-nervosa
Hayley Miller. (2017). Working Through the Weight Restoration Phase of Anorexia Nervosa. Mirror-Mirror. https://mirror-mirror.org/getting-help/working-through-the-weight-restoration-phase-of-anorexia-nervosa
Lund, B. C., Hernandez, E. R., Yates, W. R., Mitchell, J. R., McKee, P. A., & Johnson, C. L. (2009). Rate of inpatient weight restoration predicts outcome in anorexia nervosa. The International journal of eating disorders, 42(4), 301–305. https://doi.org/10.1002/eat.20634
Musby, Eva. “Weight-Restoration: Why and How Much Weight Gain?” Eva Musby. anorexiafamily.com/weight-restoration-eating-disorder/?v=7516fd43adaa
Understanding Weight Gain in Recovery. (2019). The Emily Program. https://www.emilyprogram.com/blog/understanding-weight-gain-in-recovery/