These are our next steps when we’re here with disordered eaters: first, we want some 24-hour recalls of what gets eaten on average days, so we can assess where they are roughly in terms of adequacy and consistency. I can tell you that when people are tending to binge or experience what they call “food addiction”, I rarely find the 24-hr recalls to show adequacy and consistency. There’s usually an overall deficiency in calories as well as too much time between meals and snacks (breakfast is a common culprit). Restrict-binge cycling is ofc very common as well.

Another issue is that people think rectifying an energy deficit is a short-term effort, and anyone who’s recovered from an ED can tell you how laughably and cry-ably wrong this is. In the most aggressive clinical refeeding, I have never seen the process take less than several months… and that’s closely monitored high-calorie intake day in and day out with no lapses. Most people who are doing this on their own are extremely inconsistent when trying to refeed. Consistent refeeding can actually feel quite brutal when you’re used to restrictive patterns. If you’re doing it casually, you may not be doing it at all.

"BUT... YOU UNDERSTAND IT NOW, RIGHT?" "I will be the one to strike."

People who lacked emotional engagement in childhood, men and women alike, often can't believe that someone would want to have a relationship with them just because of who they are. They believe that if they want closeness, they must play a role that always puts the other person first."

someone: what have you been up to?

me: dunno