Re Feeding : Recovery from Eating Disorders

Re feeding, nutritional plans, and weight restoration are crucial parts of the medical stabilisation process which is necessary in order to proceed with treatment and eventually achieve recovery. There are many serious and some deadly complications that arise during re feeding process which is why medical supervision is of the upmost importance.

Starved brain leads to cognitive deficits which make it difficult for a patient with malnutrition to engage in psychotherapy. It is for this reason that nutritional rehabilitation and weight restoration are key components of the recovery process.

Brain Fog

Another common occurrence in anorexia is a state often referred to as “brain fog”. The more technical term for this would be “Organic Brain Syndrome”, or cognitive difficulties that result from actual physical damage to the brain.

With extreme starvation and malnutrition, the brain will actually shrink in size, which decreases the amount of grey and white matter.

This can result in a confused state, inability to concentrate, forgetfulness, depression, apathy, etc. These symptoms are frequently seen the person with anorexia who is underfed. On the outside, it may seem that this individual is disconnected, unable to engage in conversation, and withdrawn. The reality behind it is that their brain is literally unable to function properly due to the lack of nutrition available to the body.

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Getting the Body Functioning Again

For these reasons, the first aspect of treatment from anorexia certainly involves nutrition, feeding the body to adequate levels. A person with literal brain damage resulting from starvation cannot effectively receive psychotherapy, let alone think rationally.

This state of damage to the brain also helps explain the irrational thinking that individuals may exhibit: fear of fat or weight gain, fear of eating certain foods. The brain has been compromised, therefore cognition is also altered.

The initial re feeding stage of anorexia recovery may feel more robotic and automatic than anything. When in a malnourished state, many basic senses are lost. After constantly ignoring and shutting down the body’s hunger cues, the basic intuitive eating instincts are suppressed.

Because of this, someone in recovery from anorexia cannot rely on himself or herself to know what and how much to eat in the earliest phases of recovery.

The body is not physically able to discern what is needed when under a constant state of deprivation and starvation. Having professional guidance and support are important pieces of the puzzle. A Registered Dietitian, who is often an important component of the treatment team, can help monitor and guide a patient through this journey.

Prioritising Calories for Essential Functions

The body will prioritise using what little calories it receives to fuel the heart and brain. The eventual lack of calories and nutrition will essentially cause the body to break down it’s own tissues, muscle, etc as a means of survival. In a person with anorexia, body systems eventually begin to shut down and fail as adequate nutrition becomes scarce.

Lack of macro and micro nutrients, including carbohydrates, protein, fats, vitamins, minerals, and fluids, will jeopardise the body’s capacity to function normally.

For these reasons, it is not uncommon to see damaging side effects resulting from severe malnutrition, including cardiovascular complications, gastrointestinal distress, arrested skeletal growth and more.

The Dangers of Re feeding Syndrome

The most feared and potentially deadly complication of the re feeding process is re feeding syndrome. Re feeding syndrome occurs when patients that have been starved begin to eat and metabolise calories. The body shifts from a catabolic state (a state of breaking down tissues for nutrients) to an anabolic state (a state of rebuilding tissues/growth).

This change in metabolism leads to secretion of many hormones which contribute to shifts in salts and fluids in the body. The body is so hungry for nutrients that in an effort to rebuild cells, it moves many salts from the blood to the growing cells.

Low levels of salts such as potassium, phosphorus, and magnesium in the blood may lead to complications such as:

  • Heart failure
  • Arrhythmias (abnormal heart rhythms)
  • Respiratory failure
  • Muscle breakdown
  • Death

It is for these reasons that the re feeding syndrome should be avoided and if it occurs, patients should be closely followed by specialised doctors.

Relearning Intuitive Signals

As recovery and physical health progress over time, the body will be in a state in which intuitive signals can be relearned.

Recovery from anorexia can seem a daunting process, and understanding the foundations of your recovery can be instrumental in making forward progress. If you or a loved one has struggled to take that first step, know that you are not alone in this process. Healing your body through adequate nutrition is crucial towards a life in recovery from anorexia.

Gaining Your Whole Life Back

The good news is that much of the damage to the body from anorexia can be reversible with long-term recovery.

Weight restoration along with replenishing nourishment allows the body to piece back what has been lost due to emaciation. Though a gradual and slow process, the body can be restored physically, and nutrition is a key component of this recovery process.