If you have checked out my blogroll you will notice 180 Degree Health there…I e-mailed the author Matt Stone on Friday and he did a blog post in reply this morning. I am going to multi quote it and reply with my ‘thoughts.’
Over the weekend I was asked a question about anorexia, and since my thoughts and feelings about the disease are so vast, I saved my reply to this anonymous poster for its very own blog post:
This was me! I gave Matt took it upon himself to do a blog post for me. I e-mailed him with a very VERY brief recap history or mine and asked for his opinion and advice on recovery. You can check out the whole blogpost at 180 degree health. http://180degreehealth.blogspot.com/ . He also has a free e-book I recommend anyone interested in health/diet to check out.
To begin with, anorexia is a lot more complex than most people give it credit for. It’s also a lot more dangerous and debilitating than many give it credit for as well. In the words of Furious Pete, former anorexic that nearly died from it – “it’s a bitch of an illness.”
Yes, Matt pointed me to furious Pete, then I did my own research on him. Amazing accomplishment. Nothing better to describe this horrendous illness than a bitch.
Most assume that anorexia is purely psychological, stemming from body image issues and a desire to appear like supermodels or something like that. While this mentality can certainly instigate undereating and lead to the powerful physical and psychological addiction that best describes anorexia, once the disease has set in, to say that it is purely psychological is a huge error.
Aint that the truth. Nothing is more annoying than the fact that no one will ever, ever get it. No one will understand why I have gone through the ‘phases’ of eating I have and why I say what works for me works. No one will understand how I could eat meat solely for over a year, or why when I weighed close to 90 lbs I was fine, felt high on life and ‘wasn’t going to die.’ No one will ever understand how I wagered deals with myseld, convinced myself of so many ridiculous lies, and fed into my own highs. No one will understand how for me, a college diet turned into a fulfilling obsession that was never good enough, thin enough or worked enough. At the same time, I will personally never understand someone who can body build and go through cut and bulk phases in a healthy manner. My little brother for example is currently in a ‘cut phase’ because he is a huge testosterone filled meat head obsessed with lifting. He is living off fish, plain chicken, fat free cottage cheese and moutains of steamed vegetables. But for HIM, this is okay. He doesn’t get overly obsessed with it. Me, I would come running through the woods to starve and live off fish and never turn back. I feed into that shit. It is sick.
I liken anorexia to addiction. From what I suspect, most cases of anorexia begin with a desire to lose weight. When someone loses weight as we have been discussing at length over the past month, this is accompanied by a large rise in catecholamines – the adrenal hormones that break down both fat and muscle tissue to be used as fuel. This breaking down of body tissues is referred to as “catabolism.” Catabolism… catecholamines. Coincidence?
College diet turned starvation turned exercise addict turned caffeine junkie…. Couldn’t get enough could I ?
Along with the rise in catecholamines comes a rise in neurotransmitters dopamine and beta-endorphin. These are energizing. Pain goes away. A state of subtle euphoria sets in, and we get a little “high” from it. We are talking about opiate substances here, and they are very addictive – as addictive if not more addictive than actual opiate drugs. Dopamine… dope. Coincidence?
Ever anorexic knows about this high from starving. Youre freakin on top of the world like you just climbed Mt Everest. Youre full of life, of fake-energy, of everything. Nothing can stop you or deter you. So addicitive. Good thing I found this 12 step program meetings I currently attend. It enables me to see the addicition side of me and force me to accept routines, behaviors and the like I am absolutely control-my-bubble addicted to. It calms my head down to be on beat with everything I am ‘use to.’
Anything that causes a big rise in catecholamines typically triggers a rise in beta endorphin and dopamine. That’s why you hear so much “buzz” from those who practice intermittent fasting for example, on how good they feel, how much energy they have, how clear and focused their thinking is, etc. They are getting a natural high, just like vigorous exercisers get. Very low carbohydrate eating often has the same impact, and while an anorexic can self-medicate by keeping carbs low enough to trigger dopamine and beta endorphin release, it is counterproductive to recovery for reasons explained below.
Nothing started a bigger argument than when I still lived at home and took it upon myself to quit ‘conventional’ treatment for anorexia and start eating low carb because I COULD do that. It did not overwhelm me, I was calm and could rationally and sanely think straight, carry on conversation etc etc. but like most things, it was never good enough for me, I got to jittery with it and had to drop lower, cut out vegetables, and ultimately stumble upon zero carb living. I got attached, and had to get the calm release from it. I was eventually eating once a day and only meat.
The problem is when a person with susceptible physiology meets activities and substances that spike these neurotransmitters to great highs. This is what makes the difference between a person that gets addicted and one that does not. What is susceptible physiology? Susceptible physiology is someone who naturally produces LOW amounts of these neurotransmitters for whatever reason – typically poor nutritional history on behalf of themselves and their parents I suspect, as nutrition needs to be excellent in order to have sound production of these neurochemicals (naturally weak adrenals may in part be responsible as well – and there’s no doubt that adrenal stressors heighten a person’s susceptibility to addiction).
We will rest assured it was inherited for me. I have always been kind of…off I guess. I always feel the need to think on things, over rationalize and have a mental freak-day-break-down over aspects of life that stress me out. I do all think overanalyzing and freaking out to myself- no one would ever think I am flipping out in my head but acting normal. It’s like a game. I present someone I am totally not. Inheritance wise, my dad has anger, stress, panic attack issues. He use to be addicted to exercise, he was dieting in the ‘fat free phase’ of the 80’s and 90’s and was addicted to it. he has dipped tobacco since the age of like 16, tried to give it up in his early 30’s and had a panic attack driving, thus he still dips. He also drinks Friday, Saturday and Sunday- yea like your average Joe. He also was shortly addicted to cocaine when I was very very young. I did not know this until one night at the table I was hanging out at home while my parents were drinking, they got pretty drunk, and my dad informed me of it. he use to hide in the basement and set up his line on the pool table. My mom caught him on day and said ‘you quit or I will take the kids’ thing, and he has not touched it since. He has been on and off medication since I can remember. He understand how my head works but does not understand why I wont shove my face full of mac n cheese with hotdogs and just ‘get better.’
When levels are naturally low, substances or activities that spike these neurotransmitters are particularly alluring. That’s because a person that naturally has low levels of these neurotransmitters correspondingly has a lot of receptor sites wide open to capture this small amount of dopamine and beta endorphin. Anything that causes a surge of these chemicals causes quite a thrill ride.
I am trying to get ahold of a book called “The Diet Cure’ by julia ross. She talks about amino acid therapy, eating disorders and the connection. I truly believe that the mental/physiological part is due to ‘bad genes’
At the same time, spiking these neurotransmitters results in what is called “downregulation” in which some of those wide open receptor sites close down. This is precisely what makes anything that spikes feel good brain chemicals habit forming and addictive. With a low production of dopamine and lots of wide open receptor sites, life feels good, balanced, stable, and normal. But with a low dopamine production and closed receptor sites life feels slow, sluggish, depressing, painful, and so on – the opposite of a dopamine high.
Ahhhh….possibly why recovery SUCKS ASS ALL THE TIME.
Once dopamine has been spiked enough, and enough receptor sites shut down – even if dopamine production is still the exact same as it was to begin with, the person feels nothing but withdrawals and has the experience of insufficient dopamine, beta endorphin, or whatever. They need increasingly larger spikes of these neurotransmitters just to feel normal, much less good, just like any true long-term drug addict or alcoholic. This is exactly the pathology of anorexia. A susceptible person starves him or herself. When that happens, beta endorphin and dopamine levels rise – making the person feel VERY good at first. If a person manages to fight their hunger signals hard enough, and long enough with a large motivating factor such as body image issues to override natural physical feedback…
Kinda like I couldn’t just be low-carb, I had to cancel out all carbs and start exercising again…
Then receptor sites start to shut down. Undereating, at this point, then becomes self-perpetuating and the normal hunger feedback loop is broken. Resuming eating once again induces instant withdrawals for which abstaining from eating is the medicine. Undereating, from a functional standpoint, becomes a drug to get a dopamine and beta endorphin feel-good fix. Without it, a person feels miserable physically, and depressed, lethargic, and dark psychologically. At this point, anorexia is not something that can be cured with a Club sandwich any more than a heroin addiction can be cured with a Club sandwich.
Yikesssssssss…. I still wonder though, why is it so many anorexics turn into bulimics, binge eaters etc?? is it because they 180 the disorder and need to over stimulation from the other extreme?
Recovering from anorexia is like recovering from serious drug addiction and should not be underestimated. Any person suffering from anorexia, if he or she has any hopes of recovery, must first be able to grasp what addiction is, how it operates, and what MUST be done to recover. From this vantage point, the psychological pre-requisite for recovery can hopefully be mustered. That psychological pre-requisite is one of understanding how the body and mind work, and grasping fully why eating makes you feel shitty and depressed with an uncontrollable urge to stop eating.
From my health blog obsession, over reading on the brain, metabolism and disease I do grasp and understand what is wrong with me, changing it and keeping up with it every, single, day is the bitch of it. I ‘know’ what I need to do…I think every sufferer knows exactly what to do.
I imagine a typical anorexic seeking recovery is at odds with themselves, frustrated as to why they can’t just eat when they know they need to, and confused at all the terrible physical and emotional trauma they experience when eating. To get to the other side, it really takes full recognition of the problem, how to fix it, and a whole lotta self compassion. Otherwise you’ll just beat yourself up for not eating instead of realizing exactly why you don’t want to, taking it easy on yourself because of it, and taking the proper steps knowing fully that it is going to be a major hellish battle that every cell in your body will try to resist.
Self compassion…soooo NOT one of my good points, at all. Friday for example(the only day I get on the )(#^)@#$^@ scale), I informed my mom via a text I have gained 10 pounds in the last 9-10 weeks and that it ‘hit me’ and I was acting like a complete lunatic psychotic person. I literally felt like one of those people in a straight jacket in the corner of the room rocking back and forth with padded walls. She replied ‘don’t take it so personally.’ I WAS SO FUCKING MAD, LIVID every hateful emotion you can think of over this. I didn’t talk to her all weekend, I did not eat all day Friday but managed to go sit in a church pew after work and find my ‘sanity’ enough to force myself to stay up the rest of the night/early morning to meet my calorie goal. Everything about that day sucked. I cannot describe the frustration, feeling of absolut hate I had. I cried Saturday because I felt so miserable and ashamed for temporarily hating my mom.
To recover, I believe that there is no way around achieving “upregulation” in which the receptor sites for beta endorphin and dopamine open back up again – allowing you to feel normal with your naturally low production of those neurotransmitters instead of experiencing too little and having an unquenchable thirst for anything and everything that spikes it. A very low carbohydrate diet, in the short-term, could very well make for a substitute for anorexia, as could very strenuous exercise, as could various psyche meds and stimulants. However, that is ultimately trading one form of addiction for another, and is not genuine recovery. However, it can make for a great stepping stone.
As the story goes…one thing it did manage to do was force me to realize fat is good.
But ultimately upregulation must occur. For this to happen, it is essential to focus on doing everything possible to keep beta endorphin and dopamine levels as low as possible. This, ladies and gents, is brutal for someone with downregulated receptor sites for these chemicals. The withdrawals can be major.
Sad, and so true.
For someone seeking to keep these levels as low as possible, major tactics include:
1) Eating frequent, starch-based, whole food meals at above-maintenance calorie levels. The food should actually be somewhat bland, in whole food format, with some, but not too much added fat or protein (protein raises adrenal hormones and associated neurotransmitters, and really good food, especially sweets mixed with fat, triggers a big release of opiates that you are looking to avoid). A non-vegetarian macrobiotic-ish diet would actually be decent for recovery. This will also help in fixing reactive hypoglycemia, which I would guess nearly all anorexics suffer from to some degree (although it too will exacerbate hypoglycemic symptoms in the short-term).
Not that I have any clue what my ‘maintenance’ is, but obviously it means eat a lot, more often, and starchy. Funny about the bland thing. As a child, I hated foods or dishes that mixed food together. I refused to eat spaghetti but would eat a bowl of plain buttered pasta. I hated salads b/c dressing was gross and I didn’t want all that stuff in one bowl. Staples for me were mac-n-cheese, hot dogs, bologna sandwiches. I even refused anything in a sandwich but plain bread and a piece of meat until the age of like 22. everything was bland and plain. Lately I have been trying to eat more starchy. The first night(about a week ago) I tried, I bloated up, prolly gained 10 lbs of water weight overnight, and took my blood sugar before and after. Before, it was 75 and 1 hour after it was 137, 2 hours was 109. that’s a huge jump up. Now, prior to this I was focusing on HIGH HIGH fat meals and lots of protein. My blood sugar routinely did something to the degree of… 70-80 before eating, and then drop from there.
2) Sleep a lot, including regular naps.
Oh my gosh I wish. I slept 13 hours Saturday and Sunday this past weekend. During the work week I have the MOST horrendous time managing recovery, eating, stress and a HUGE lack of sleep. Take last night for example, I was up until like 345… I wake up at 6am everyday. Monday I am usually okay, Tuesday I am feeling sleepy, Wednesdays BLOW, Thursdays I will nap on my lunch hour if I can, and Friday I get through only because I know I can SLEEP as long as I want. I am taking L-tryptophan(starting like 4 days ago) to help me fall asleep. It works, but I still have that go go head when I lay down.
3) Perform various relaxation techniques, from gentle yoga and breathing exercises to meditation.
Hmm… I am not good at this, goes along with ‘take care of your self’ and self compassion. Yoga makes me laugh. Breathing exercises may help, and meditation I try to do but I doubt I do anything right lol. I just kinda sit and have a convo mentally with God and ask him to guide me and help with my boundaries.
4) Avoid stress as much as possible.
MAYBE IF I COULD SLEEP I could manage life better. A lot of my ability to fight roots in sleep problems. I just don’t have the energy to fight myself and head everyday.
5) Avoid strenuous exercise.
I think osteoporosis takes care of this. My knees kill sme 24/7 and I cant even squat.
6) Avoid stimulants.
Fuck… I knew this was coming. I drink coffee, one cup EVERY MORNING. Now, this is a vast improvement in itself because I use to go from 4 cups of coffee and switch to diet soda (about a 12 pack like a 2 liter) everyday. Artificial sweetners prolly impacted my fertility more than starving. Even at the 12 step meetings, all the girls BESIDES me either have coffee, diet soda, or some calories free energy drink… ALL OF THEM and they are actually in an inpatient program…?
7) Avoid drugs – recreational and psychoactive.
I smoke cigarettes, Marlboro Mediums to be exact. I cannot give up cigs and stay sane that the same time. My one cup of coffee I can drop and deal with my withdrawl…but cigs, eeeegolly-gee lol.
8) Avoid sweets.
Easy. Except my parents are on the ‘start eating more fruit’ bandwagon.
9) Avoid anything overly pleasurable. The more miserable you are, the faster you are upregulating.
Hmm…well considering my desire to have sex is like zilch (wait I do occassionally have an aching desire to have wild monkey sex but…lol). Also, the past couple weeks I have been hit with this HUGE desire to wake up, chug a bottle of bacardi and go back to bed. I rationalize I wont have to deal with myself hating myself and eating or food at all. And I would get to sleep easily. Obviously I have not acted on this, hell I havent drank in like a year or so.
This is obviously a lot to ask for, and would require tremendous support from family members, loved ones, and potentially demand professional assistance like that required for a drug addict attempting rehabilitation. Unfortunately, I’d venture to guess that most professional eating disorder rehab joints, just like most drug rehab joints, provide many forms of self-medication from candy to cigarettes that lessen withdrawals and limit true fundamental healing of the core problem.
Haha I can see it now..”hey mom, this guy on the internet who I asked for advice from and runs a blog says this will help…” hahahhaha
Once you have upregulated, be very cautious about meal-skipping, drugs, stimulants, stress, and other adrenal stressors that can cause a relapse, as your sensitivity to such things is greatly heightened in an upregulated state.
It is a lifelong battle…
Bulimia shares a similar pathology. Know how miserable you feel right before puking and how euphoric and instantly healed you feel immediately after vomiting? That’s some endorphins for you. Addictive as hell if you do it enough to start shutting down your receptor sites.
EWWWWWWWWWWWWWW, I hate nothing more than barfing which I havent done since college when I was wasted lol. Like a month or two ago I ALMOST puked at like midnight. I felt sick, ran to the bathroom, opened my mouth and water poured out like homer simpson style when he burps…but I wouldn’t let myself barf. Ew geez, I could never be bulimic- that scares the shit outta me.
Next, I am going to share a couple pictures Iam VERY embarrassed and ashamed by…This is kind of where my body has been through for the past….6-7 years. As far as recovery is concerned, I have gone from 90lbs to a good 115-118 currently in the past few years standing at almost 5’8. So here I stand. I admit I am ashamed of my old pictures:
I will update this with a current picture today even though I am not at all comfortable or happy with my body. Not to mEntion, MY FREAKING FACE is breaking out…grr