Refeeding FAQs

Eating to nourish our bodies and help with nutritional healing is key to flourishing in eating disorder recovery. Some nutrition goals include repairing negative food relationships, incorporating foods that induce fear and develop a lifelong routine of normalized eating patterns.1 Weight restoration can also be a key factor in recovery if individuals present as weight suppressed.2 During this stage, the quantity and density of food types is especially important.1Like in other stages of the recovery process, there are no food rules or restrictions. 

Is it normal to feel anxious and overwhelmed in the beginning stages of mechanical eating?

In the first stages of refeeding, individuals are working hard to transition from a negative relationship with food to a positive one. They are challenging their minds to ignore food rules and unrealistic ideals portrayed by the media, and instead, put faith in their bodies again. At this time, we want to focus on eating energy dense foods multiple times each day to meet the body’s nutritional needs while also keeping the volume load of the stomach manageable. This helps to reduce some of the uncomfortable digestive issues that can arise when first starting out 3 IT IS NORMAL TO FEEL ANXIOUS AND OVERWHELMED! You are asking a lot more out of your body than usual. You will be eating more than you’re used to and going against the eating disorder thoughts that constantly reside inside your mind. The good news is, our bodies are quite resilient and get used to the higher amounts of food quickly. The gas, bloating, constipation and/or diarrhea will be alleviated within a couple of months. 

How will I know when and I’m hungry? What if my body doesn’t tell me?

Once our bodies start to receive food on a regular basis, hormones begin to regulate and the body can revert back to its natural bodily processes. Cortisol levels decrease and the fight or flight response subsides in response to our bodies’  and being nourished adequately. Eating several meals throughout the day will eventually stimulate digestive processes to facilitate the response of hunger.3,4 When our bodies’ requires energy, there are a few things that happen. First there is a drop of blood suga, followed by a shift in hormones.  Signals are interpreted by the brain and sent to the body causing our stomachs to growl and the feeling of hunger to kick in.4 Our sensory and psychological cues also influence hunger and the desire to eat, which includes sight, smell, taste and emotions.4

It may take some time for hunger cues to be restored, and that’s why we use mechanical eating in the initial stages of refeeding. Working with a Registered Dietitian trained in the refeeding process can help you learn how to mechanically eat for your own body to help restore your hunger and fullness cues. 

How will I know if I’m eating too much or too little?

Energy consumption is increased gradually throughout the recovery process. Recommendations are individualized and based on the individual’s energy needs and stage of recovery. However, the basis of eating in recovery is relatively the same for everyone. Clients usually start off by repairing their nutritional deficits and increase their food intake. Over time, the amount of food consumed slowly increases to best meet the client’s needs. The important factors of a meal plan for standardized eating are the quantity and type of foods consumed as well as the timing of the meals being consumed.1 It is important to note that some individuals are more susceptible than others to gastrointestinal symptoms and may be vulnerable to bodily complications. A dietitian will work with individuals to help with refeeding syndrome by developing a plan that is tailored to the specific individual needs.1

Why can’t I follow Canada’s Food Guide for eating normally? 

One of the main goals in recovery is to get our clients’ bodies to a place where they can live a life they want to live. In order to accomplish this goal, our team helps clients take steps to repair their body with increased energy and specific nutrients. Canada’s Food Guide can be a useful resource for populations but is not tailored to the specialized needs of individuals living with eating disorders.3 Instead, Registered Dietitians create individualized nutrition care plans with their clients to help them make adequate nourishment a priority.  


References

  1. Garner, DM. Desai, JJ. Desmond, M. Good, A, Wohlers, J. (2017) Nutritional Rehabilitation for Eating Disorders: River Centre Clinic Program Description. In Ann Nutr Disord & Ther. Retrieved from https://www.austinpublishinggroup.com/nutritional-disorders/fulltext/andt-v4-id1044.php
  2. Marzola, E., Nasser, J. A., Hashim, S. A., Shih, P. B., & Kaye, W. H. (2013). Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment. In BMC Psychiatry,13(1), 290. https://doi.org/10.1186/1471-244X-13-290
  3. Waterhous, T. (2015) Normal Eating. Retrieved from https://www.mirror-mirror.org/noreat.htm
  4. Kornell, N. (2014) Hunger Comes From Your Mind, Not Just Your Stomach. Retrieved from http://www.psychologytoday.com/blog/everybody-is-stupid-except-you/201411/hunger-comes-your-mind-not-just-your-stomach