I have talked a lot about hunger cues and how they can be really off in ED patients. It is not that patients are trying to lie that they are not hungry - it seems that the brain and body actually do not sense hunger in ED, But, what about 'fullness' cues? Do patients with ED, specifically AN, feel full? This something that I really struggle with. I definitely do not have good hunger cues, and this is why I need to eat by the clock. It does get annoying, to be honest. Imagine trying to eat when you do not feel hungry or do not have an appetite. It feels so...wrong, especially for someone who has/had ED. But now, think about the opposite side: feeling full. When I was sick, I had a great excuse for why I could never eat: I already felt full. In recovery, I felt this way as well. How could I be expected to eat when I still felt full from the last meal? How could I eat when I felt fell? In later recovery. the problem remained: how could I continue to finish my meals when I felt full after taking a few bites?
Fullness cues are related to hunger cues: if you feel full, you do not feel hungry. If you feel hungry, you are not full and can still eat more. But with ED, the problem remains that foods needs to get in and the patient needs to eat. But how does this happen when the patient feels so full all the time? For example, I often feel full after taking a few bites of my meal. I look down on my plate to realize that I have only eaten half of my meal. Then, somewhere in my head, I realize that ED wants me to stop eating.
That's enough. You have already gained all the weight back, even more than you needed to. Why keep eating? You were not even hungry at the beginning, but you still ate. Now, why on earth should you continue to eat? You are full. Eating more makes you a pig. Come on Is it not bad enough that you have gained all the weight back? Do you want to become fat again, and go through it over again?!
What makes this hard to deal with is that inside, I really do feel full. It is not like in ED when I had not eaten anything. Now, in recovery, I HAVE eaten. But the thing is, I have not completed my meal. So, what to do? Inside I know that I did eat something. but at the same time, I know that it was not my entire meal. Was it enough? Sometimes I feel that I actually do not know what is enough! This makes it hard - I am trapped and have no idea what to do. If I keep eating, I will feel even MORE full and then I will get uncomfortable. But, if I do not eat, I will not have finished my meals, and how can I be sure that I am eating enough?!
It seems like a lose-lose situation. I hate feeling full - this time, it is real. I feel full of food. I have eaten. I am uncomfortable, and my jeans are getting tight. When this happens, I panic. I start to feel fat and ugly. But at the same time, I know that I cannot depend on my fullness cues - just like my hunger cues. With hunger cues, I can look at the clock and know when to eat next. But what do I do with fullness cues?
The solution, for me, is to simply eat. Yes, I may not feel hungry now. But if this is what I had planned to eat today and I am following a meal plan, this is likely what mu body needs to be well. On the other hand, if I have eaten something extra today and am REALLY feeling full, maybe it is okay to eat a bit less at this meal. But the important thing is that I ensure that I have truly eaten enough. It is frustrating, to be honest, to not be able to rely on my hunger OR fullness cues. But in the long run, I know that this is what my body needs. I may not like it, but I know that this is best for my health. Maybe my hunger and fullness cues will return to normal some day. Maybe they will not. But whatever happens, I have found a way to keep myself well. As long as I am healthy, life will move on and I will stay strong in my recovery. That is all that matters - I can wait for my cues to return some day. What matters is today: how strong and healthy I am, and how happy I am. Thank God, despite the messed up hunger signals and the stresses of life, I am doing well. Life is tough, but I am tougher.