Dear Lesley: Is it Common to Binge Eat During Recovery from Anorexia?

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Lesley Williams 1234544

Lesley Williams, MD, CEDS

Dr. Lesley Williams is a certified eating disorder specialist, family medicine physician, and positive body image advocate. She co-owns Liberation Center, an eating disorder treatment facility, in Phoenix, Arizona. Dr. Williams is dedicated to ensuring that all women and men who struggle with eating and body image issues receive the help that they need to overcome and live happy, healthy lives.

Dr. Williams regularly educates other healthcare professionals about the diversity and dangers of eating disorders. She has made several media appearances as an eating disorder expert and regularly speaks at national conferences. Her most recent body image advocacy project is writing the children’s book, Free to Be Me. It encourages young girls and boys to love their bodies, no matter what size, and is scheduled to be released later this year.

Is it common to experience binge eating during recovery from anorexia?

The ultimate goal of recovery from any eating disorder is to have a healthy relationship with food and your body. Regardless of your diagnosis, you may experience that your eating behaviors change throughout the recovery process. This is often a reflection of how the eating disorder can alter our hunger and fullness cues.

In a perfect world, everyone would feel confident that their body will give them the right cues to eat when their body needs fuel and stop when they are fully nourished. Unfortunately, one of the downfalls of eating disorders is that they may disrupt our natural hunger and fullness cues. When the body has been sending signals of hunger for a long time that go ignored, like in anorexia, or we have grown accustomed to eating regardless of whether we are feeling hungry, like in bulimia and binge eating disorder,  those hunger and fullness signals often become altered over time.  

The body may begin to send loud signals to eat certain foods that it has been deprived of or it may stop sending signals to eat all together because they are being ignored. This can be very confusing when you are seeking recovery and want to eat normally again. That is why it is best to partner with experienced eating disorder professionals when you are navigating the recovery process. 

What I frequently see in my patients is that the fear of eating too much or binge eating paralyzes them and becomes a stumbling block for recovery. As we work together, I help them understand the impact that the eating disorder has had on their hunger and fullness cues. Over time, their trust in following their meal plan as prescribed increases. Ultimately, those hunger and fullness signals begin to normalize and they learn to trust their body again.  

They start to recognize that their binge urges were likely just messages that the body was not getting enough of something. We work with their dietitian to make sure that the body is getting its nutrient needs met. Without a supportive treatment team, their natural instinct is to restrict what they see as the scary food item. This may set them up to binge in the future because their body feels deprived. Binge eating may occur during recovery from anorexia. 

However, with a moderation approach that embraces incorporating all foods into a regular meal plan, the likelihood of engaging in new or different eating disorder behaviors during the recovery process decreases significantly.