Caveat: when I say that intuitive eating won’t work, this is in the context of an eating disorder recovery.

Why I like intuitive eating

I’m a big fan intuitive eating and I’d say that the way I eat is pretty intuitive: I eat what I like and what feels right at the time. Sometimes it’s more nutritious than other times, but I trust that my body can cope with that because it did before I got ill, and it has done it ever since I have recovered.  Often when people come to me, they tell me that they want to be able to eat “normally”, a bit of everything and without guilt, which sounds a lot like intuitive eating. “I wish I could just go to a café and order something I like without fearing the consequences. Other people do it all the time, why couldn’t I?”

Why I don’t recommend intuitive eating to everyone

The answer to this is that you can eat intuitively but not straightaway. Intuitive eating is marathon and both your legs got broken with the ED, so right now you’re having to relearn how to walk.

Intuitive eating is seductive, but one must proceed with caution. Is it seductive because it would confer you with more brain space and that you’d finally be able to eat normally? Or, is it because the ED sees it as a way to restrict?

You see, intuitive eating is a great idea for someone whose physiology is “normal” i.e., the body responds to given and predictive cues. Anorexia, however, implies a pathophysiology i.e., things aren’t as they should and so we can’t imply the same principles as we would with normal eaters.

What does eating intuitively mean anyway?

The main principles of intuitive eating are as follows:

1. Eat when you are hungry and stop when you are full.
2. Eat Slowly.
3. Pay attention to the tastes and textures, as well as the sensations in your body.
4. Take time to appreciate how good the food is.
5. Eat without distraction, away from screens.

Let’s review them and see why they can’t apply to anorexia recovery.

Eat when you are hungry and stop when you are full.

People in recovery from anorexia, especially at the start and if they are on a structured meal plan, will almost never be hungry and always feel full. This is because their digestive system has slowed right down, this is called gastroparesis and 98% of my clients present with this when they first come to see me. When we restrict, we don’t just lose fat, we also lose muscle. Muscle doesn’t just mean biceps, quads etc., it also means our smooth muscles and that includes our digestive tract.  Our digestive system becomes less active and therefore doesn’t move the food as fast as it normally would. There may also be an attempt from the digestive tract to slow things down so that it can mop up the little nutrients provided in the diet. Restriction also leads to a slowing down on the metabolism and this isn’t to be annoying but to save you.

Your metabolism will slow down to save you

You see, if you, let’s say, need 2,000kcal and that you eat 2,000kcal, the body is happy and it does what it’s supposed to do metabolically. If it needs 2,000kcal but that you only give it 1,000kcal, you lose weight because of the deficit, but the body will also start to panic a bit “thinking” that if it carries on, you’re going to disappear into thin air. That’s not ideal as far as the body is concerned, the body wants to live, that’s its main job. So, it will react by slowing down the metabolism and that means doing things more slowly (perhaps not doing things at all, like periods) to spend less energy. Calories are energy by the way, so the body will try to do what it has to, spending less energy doing so. Of course, there are very important things like the heart and brain that it will try to protect for as long as possible, so this is not where the slowing down first happens. The digestive system, however, is important but not as vitally tuned so it can afford a bit of slowing down. So, the combination of the loss of muscle tone and your metabolism slowing down leads to a digestion that has slowed right down – gastroparesis means paralysis of the gastrointestinal tract. It’s obviously not a complete paralysis.

You are going to feel full all the time

So, it takes you ages to digest and on top of that you are required to eat a fair amount of food because you need to restore the weight that you have lost (or at least some).  That’s the irony of this illness: the more weight you lose through restriction, the more food you will have to eat to get better. The effect of this is that you are going to feel full all the time. It’s not uncommon for people to tell me that at lunch they are still full from their breakfast and morning snack and I believe them. Regardless, lunch needs to happen. No, you can follow the intuitive eating principles at that moment because listening to your body would get in the way of your recovery. Worse, those cues would in time be giving free rein to the ED to restrict.

Eat Slowly

Slow eating with careful mastication is something nutritionists often recommend, it’s a way to help with digestion, a way to properly taste your food and a way to make your meals last longer. “It would help my digestion!!”, I hear you say. You are not wrong there but that’s not enough to turn a blind eye to two problems with this idea of eating slowly.

The longer you are at the table, the more time you are having to face what scares you the most. If the last thing you want to do is eat that plate of macaroni cheese, is it really a good idea to spend 2h looking at macaroni cheese gradually congealing on your plate? Get it over and done with. Yes, it’s going to be hard and yes, the thoughts after will be loud but let’s be real for a minute: as far as anorexia is concerned any food is bad/too much, so if you’re going to be shouted at, it may as well be for something. You can’t recover from anorexia without eating enough, you can’t talk yourself out of this I’m afraid.

Satiety isn’t your friend right now

Did you know that feeling satiated normally takes around 20min or so? This is because this sensation of satiation relies on a dance of hormones and hormones take a bit of time to do their jobs. The thing is, as far as your brain is concerned, feeling full is the same as feeling fat and when you feel fat what do you want to do? Eat less. Can you see, therefore, why spending ages to eat might not be the smartest of moves?

This is why, by the way, meals usually cannot be longer than 30min in in-patient settings. It’s not just because they want to clear the table.

Pay attention to the tastes and textures, as well as the sensations in your body

A starved brain is a scared brain. Normally, when we eat, a small part of the brain, called the insula, is in charge of telling us whether this feels good and whether we should carry on. With anorexia, the insula is quiet and that triggers another part of the brain, the amygdala, to panic. Textures become slimy, gritty, yucky etc. You’re not lying, this tastes disgusting.

Also, since you are going to feel really full, paying attention to your body’s sensations is going to be like having someone repeatedly shouting in your ears with a megaphone: THIS IS ALL WRONG! Not a good move. Eat mechanically, get it done.

Take time to appreciate how good the food is.

As seen above, this isn’t going to be possible in your case. Food isn’t going to taste good. Even the food you used to love won’t taste good, it’s just not. Not yet. Everything will feel wrong in recovery. It’ll come back though. All of this will come back when you are renourished and that your brain isn’t panicking constantly.

Small caveat here, if food does feel good or at least some food, you’re not doing anorexia “wrong”. It probably just means that your brain is trying its best to save you by giving you glimmers.

Eat without distraction, away from screens.

This is something we get told all the time, isn’t it? And yet I disagree. I disagree even, to an extent, for normal eaters. When we have a conversation with someone at the table, are we really mindful of all the tastes and textures? Nope and yet how many memories were created around animated dinner tables?

Anyway, let’s go back to anorexia recovery. Eating on your own at the table might feel like being thrown in a pit full of spiders when you have arachnophobia. It’s going to be horrendous. The very thing you need is distraction, so eat with people you feel comfortable with, listen to a podcast, or eat in front of your favourite series. Your only job is to put the food in your mouth and to swallow it.

Intuitive is great but only when you are ready. You’re not ready for a marathon yet. First you need rest, then physio, then training and then you can give it a go.

I know we are often extolled the virtues of intuitive eating: eat when you are hungry and stop when you’re full. There’s a lot of sense in that, but it’s not always that simple and, as always, there are many nuances.

A couple of weeks ago, I posted something in my stories about me “forcing” myself to have lunch and why. That afternoon, I got a lot of DMs thanking me for talking about this and asking me lots of questions, so I decided to create a post to expand further.

Intuitive eating doesn’t always marry well with busy schedules

Let me paint the scene first if you didn’t see that story. It was circa 12.45pm, a time around which I normally take my lunch break. I took the break but just wasn’t hungry for lunch. The reason being was that I had had breakfast circa 8.30am that morning (not late but not early either), and my breakfast was rather substantial. In all honesty, I cannot remember what I had but I know it was a good breakfast because I was really hungry that morning after my yoga session. I was then faced with a dilemma: it’s lunchtime but I’m not hungry, what do I do?

Do I:

• Skip lunch and wait for the hunger to come?
• Have something small, like a snack, and then see whether I need more during the afternoon?
• Have lunch anyway?

To be totally honest, I didn’t ask myself these questions, by now I know what I should be doing but I know such questions do arise in my clients.

Intuitive eating when you are working full time

Intuitive eating would have you skip lunch and wait for the hunger to come but that’s not always practical. I normally work in the afternoon; what if the hunger comes when I’m in the middle of a session with someone? Sure, I could have something after the session since I’m in the fortunate position of working from home. But what about if I have back-to-back appointments? I can’t eat in sessions and not eating is likely to cloud my thinking, which would be pretty unprofessional.

What happens if you are not at home?

It just so happened that I had taken the afternoon off that day to go watch my youngest son play football with school, and this is at the core of the story. I had to leave the house an hour later to get to the match and I knew that I wouldn’t be home much before 6pm. Having a meal by the side of a football pitch isn’t exactly practical, unless we’re talking a sandwich of course. From having done this before, I know it can be hard to fit in a sandwich on the side of the pitch when there are lots of parents there. I don’t mind eating in front of them but it’s hard to have a conversation when you’re the only one eating.  I could have brought some snacks, I hear you tell me, because they’re small and easier to eat. Sure, I could have. However, snacks such as cereal bars, nuts and fruit aren’t exactly filling. They might be yummy, and even nourishing, but if I’m hungry a cereal bar isn’t going to do the job. That would mean me being slightly uncomfortable all afternoon with latent hunger and that doesn’t appeal to me. Another issue with having a later lunch, in the form of a meal or a string of snacks, is that you may then not be hungry for dinner and then you end up with the same conversation and dilemma.

Eating when you are not hungry is sometimes the smartest choice

If your relationship with food is a bit shaky, this could be dangerous territory. This is when the disordered eating voice might creep in telling you to skip dinner. It can also pipe up again the next day telling you that if you start having lunch now, that’s greedy because yesterday you managed without etc… To round off my point, there was also the option of skipping lunch altogether and hoping for the best but again, personal and professional experience have shown to me that “hoping for the best” in that situation would be rather foolish. Hunger will come because it always does and you’ll find yourself with no food, getting more and more irritated, not concentrating and probably demolishing the kitchen on your way back.

Intuitive eating and recovery don’t mix

Let me say this first of all, when you are in recovery, scrap intuitive eating. You simply need to follow your plan, full stop, no questioning or bargaining (you can read more about this here). That aside, if you are recovered, or even if you are a normal eater, you may also benefit from not always being intuitive with food. Bear with.

If you are hungry, of course do eat, that’s fairly simple. If you’re always hungry, though, you may need to question why that is. Are your meals too small? Disordered eaters sometimes are so entrenched in their habits that they can’t see that what is a normal amount for them, might not be for other people. Are your meals lacking something important? Protein and fibre are pretty filling while starchy carbs and fat are satisfying; are they absent from your meals? Could it be that you never finish your meals? I often see that, people having all the right meals and snacks but never finishing anything (because they got distracted, it got cold, they had to work etc., i.e., delaying tactics) and then wondering why they are hungry all the time. I’ll try to write something on that at some point.

Eating has to be practical

So, back to my point. Sometimes, I think it is wise to eat “now” because you won’t be able to “later”. You might not be hungry “now”, but the hunger will come, it always does, and if you know that “later” you won’t be in a position to eat for whatever reason, “now” is the right time to eat, despite the lack of hunger.  This will prevent: the sneaky temptation to skip a meal (hello, potential relapse), surviving on “tissue paper snack” i.e., without substance, or getting really hungry and bingeing when you get back home.

What to eat when you are not hungry then?

• Something that is appropriate for the meal for you: breakfast things at breakfast, lunch things at lunch etc. Work with patterns.
• Known, classic, combinations: porridge, yoghurt and fruit, eggs and avocado toast, soup and bread etc. Work with habits.
• Things that you normally like. Work with memories.
• What people around you are eating. Work by mimicry.
• What you have learnt to be “right”: protein, carb, fat. Work systematically.

Spoiler alert, it won’t be the most enjoyable meal, but it will do the job, free some space in your head and ensure that you don’t completely derail.

How did I fare?

I had roasted vegetables, black rice, hummus and avocado, I seem to recall. Did I enjoy my meal? Not particularly. I liked all the elements of the meal, and I know that in other circumstances I would have loved it (I decided to work with memories) but that day it just ticked the box and did the job. Not all meals have to be amazing, it’s just food, it shouldn’t be the most important part of your day.

This meal enabled me to get on with my afternoon freely. I ended up talking with a dad most of the time, so having to feed myself would have been tricky. I wasn’t hungry so I could be present and concentrate on the match (7-nil to them, since you’re asking) and even attempted to learn what off-side actually means (don’t ask me now).

By the time we got home, I was ready for some food and luck had it that I had already prepared dinner, so all I needed to do was reheat it. Obviously when I say “luck” I mean preparation and organisation… Anyway, this was another cunning strategy in place knowing that we’d all be hungry by then and that starting dinner would be the last thing on my mind.

The cult of wellness or the cult of disordered eating?

I often come across the expressions “cult of beauty” or “cult of fitness” and in as much as I understand the message conveyed by those expressions, I can’t help but wonder whether the word “cult” is exact here.

I have long been fascinated by cults and sects; name a Netflix documentary on the subject, I’ve watched it. I’m fascinated because from the outside it is so obvious what is happening and yet those involved are totally blindsided.

But back to beauty and fitness for a minute. Those two “cults” are in fact enmeshed, aren’t they? Often people want to be fit to be attractive (fit and attractive have even become synonyms) and you’d be hard pressed to find someone deemed attractive by all who is not also sporting a fit (as in athletic) body.

What is a cult?

Why don’t I think they are cults? Because the definition of a cult is as follows: a relatively small group of people having beliefs or practices, especially relating to religion, that are regarded by others as strange, or sinister, or as imposing excessive control over members. A lot of it fits but not sinister, to me; and bear with me on that one.

Is it a bad thing to want to be in good shape or attractive? No, I don’t think so. It might not be important to everyone but, equally, it should be ok for it to be important to some. To me the confusion over the fitness and beauty industries being cultish lies in the fact that they, indeed, have tribes whose practices, sometimes punishing, tend to require commitment. They echo the same concepts and can be a little be evangelistic about whatever it is they are preaching.  There’s there’s an alikeness to their flocks and, more often than not, what that congregation is after is a sense of belonging.

Take me to church

I have lost count of the number of girls in their twenties I have come across at the yoga studio I frequent who are donning matching tight high waisted shorts and bikini-like sports tops, usually in taupe colour. The look wouldn’t be complete without a messy high bun and an Oura ring dutifully positioned on the index finger. Nothing wrong with any of that, they are visually sign-posting which church they belong to. I am there too; my place of worship is “the pod” and my yoga mat is the altar upon which I sweat several times a week; but I belong to a slightly different denomination.

Regardless of your faith or denomination, I believe that what makes people keep to their practices is a yearning for connection, acceptance and belonging. We have, seemingly, never been so lonely that in this world where we can connect with anyone in the world in an instant. Together but apart, we are collectively lonely. Loneliness is perhaps the greatest ill of our society and so it is not surprising that we seek solace in group of like-minded people. This is a good thing.

Religions are good and even perhaps needed. It doesn’t matter who or what you believe in, believing is what matters. Can there be hope without faith?

When things become sinister

I know what you’re thinking: how can religions be good given all the wars? How can we condone faiths after the atrocities perpetuated by so many religious leaders? And I’d agree with that. There is a dark side to religion that we cannot ignore, and this is where things get murky and that the lines between religions and cults become blurred.

You see, most of the times, cults start as innocent enough small religious groups but before you know it, in the shadows cast by their somewhat excentric beliefs, the practices become sinister.

I sometimes wonder if my fascination with cults has anything to do with the fact that I deal with them every day. Or perhaps it is the other way round, who knows?

Religion is to fitness and beauty what cults are to eating disorders. One is an order, the other a disorder.

Me, you and the eating disorder

There are always at least three of us in the consultation space: me, the client and the eating disorder and, boy, does it become clear when I start asking the “wrong” questions.

The way I see it, a person suffering with an eating disorder is like a person trapped in cult. In case you didn’t watch any of those documentaries, you should know that leaving a cult is hell and usually can’t be done overnight. First there is denial and anger, then there is doubt, fear, guilt, shame, clarity and a desire to escape, followed by more guilt and shame, perhaps even wanting to go back to the safety of what you know even if it hurts you.

Vulnerability exploited

Cult leaders always operate in a similar way: pick someone who is vulnerable, someone who is either at rock bottom or someone who is figuring out who they are. It is no surprise that eating disorders afflict so many teenagers but also people experiencing transitions in their lives: breakups, pregnancy, menopause, injuries, ending of sporting or professional careers, sexual changes etc.

Then you promise to these lost souls that you can provide them with a solution to their “brokenness” and that by becoming a follower you can be part of an enlightened community. You are chosen because you are special and if you follow the advice, you will receive unconditional love.

Ecstatic, you might start cutting out UPFs and instead consuming reems of materials on the benefits of “real food”. You will listen to the same sermons coming from that community and will accuse those who are refuting those dogmas of being corrupted by “big pharma” . This echo-chamber will soon enough turn into propaganda with more and more bizarre practices to follow. It’s not just UPFs you need to watch out for, food needs to be organic, low sugar to avoid insulin spikes, you need to eat thirty plants a week for your microbiome, you need protein but also fermented fibre, you need to sleep but you also should carve out time to work out and lift weights because “sitting is the new smoking” etc.  

There is truth and there is dogmas

You see it always starts with a nugget of truth and then it escalates to dogmas. Of course, cooking from scratch and eating protein and fibre is important. Of course we should move our bodies. Do we need to spend hundreds on glucose monitors, anti-spike supplements, trackers, etc.? No. Do we need to feel guilty because we fed our kids fish fingers? No, it’s flaming fish for Christ’s sake!

Ok, back to you. You have now fallen down the rabbit hole and that’s when things turn sinister. So, you gradually detach yourself from your loved ones. Now, you go out less with friends and don’t spend much time with your family. That is a tried and tested technique: isolate the victim and make them think that you only hold the truth. Then ensues the rules and rigorous rituals but also the repercussions for failing. “You have eaten some cake? Then thou shalt do a hundred sit-ups”. Ecstatic turned into acetic.

Notice how someone in the throes of a cult always ends up having to work unpaid for hours on end for a salvation that they will only know when they are dead. The eating disorder is always asking you for more, but does it give you what it promised? Are you more popular, happier, pretty enough, thin enough? No, it will never be enough. The eating disorder wants you hollow so it can inhabit your space entirely. It is a type of parasitical terrorist if you wish.

Time to escape

In time, you might become tired of the rules, and you might start to doubt that this is right. Oh, but if you listen to your loved ones or your team, the eating disorder will not be happy.  The eating disorder will get angry at those profanities and shout that the advice you are given is pure heresy. “Three meals and three snacks is way too much, they don’t know what they are talking about! They don’t love you; they just want you fat so that they look better!”

As I said, leaving a cult is hard. Something at some point must give for someone to break away and there will be hurt, shame and perhaps even regret following that decision. The same goes for an eating disorder. I believe that you can’t make someone want to recover. Something must give; something must happen intrinsically for someone to be willing to put themselves through a different type of hurt. They don’t have to be ready, but they must be willing to endure that stress. There will be pain (physical and mental), there might shame (the body changing) and there might be regrets (things were easier before).

The good news is that people do leave cults and people also recover from eating disorders.

The problem isn’t faith; it’s the abuse of power.

The problem isn’t wanting to be fit or attractive; it’s sacrificing your mental health for it.

Amen

An eating disorder is a crutch to make you feel more stable

The question of “why” often poses itself. Why did I/ my child have an eating disorder? Finding the exact answer to this can be useful but, over the years, I’ve come to realise that the general answer tends to always be the same. At some point in the person’s life, something rocked them enough to make them unstable on their feet. And what do you do when you become unstable? You reach for something nearby to stabilise you. An eating disorder is a crutch to help you feel more stable. That seems fair, doesn’t it? But. This is based on a lie.

Surprisingly perhaps, I’m not about to launch into how the eating disorder lies about thinness and food or, how the goal post will always move and that you will never be enough. You know this. The lie is that you should always be stable and that wobbling means you can’t stand on your own. The lie is that you need a crutch when you don’t. The eating disorder offers to fix a problem that isn’t truly one. We all wobble in life, some more than others because life presents us all with different challenges.

However, you never needed a crutch

I don’t know how much you know about yoga but try to picture someone doing a balancing pose in yoga (say warrior three). Now imagine someone comes along and pushes them, they are going to wobble and, almost certainly, fall. That’s similar to life dealing you with a bad hand and something really hard happening to you. You couldn’t predict it and it wasn’t your fault.

Imagine the person is wobbling simply because it’s their first try at yoga, they don’t really know what they are doing and, really, they just need more practice. I find a lot of young teenagers are in that category. They come to me at the age of 14/15, anorexic, telling me that they put lots of weight on when they were 12/13 and that they are now terrified of this happening again.

Hormonal changes during puberty is often a factor here. That aside, I’d say that those tweens simply didn’t know what they were doing with food. They had more freedom, stopped at the corner shop, perhaps more often than is reasonable, but it’s not a big deal. It doesn’t mean they needed their eating disorder to make them better, most young teens do that. There was no real problem, nothing that needed to be fixed. They just needed to grow into themselves both physically and mentally.

When being the best makes you miss the woods for the trees

Another configuration is someone who has strength and who could easily hold the pose. However, they don’t quite get that no one is going to give you a medal for lifting your leg the highest. They will want to showcase their athletic prowesses without giving too much thought to the value of stillness. So, they will push and push and might check the clock to see how much longer they have to hold. These people are likely to wobble and fall too. Pursuing the “best diet” at all costs is precisely likely to cost you a great deal, as you will have lost sight of your overall health.

Now imagine a person who is quite versed at yoga, it’s not their first time. They are more than capable, except that they haven’t quite got the principle of yoga, which isn’t based on competition. There’s only you and your practice, what the others are doing is irrelevant. So there they are, in their poses, but they want to check what everyone else is doing. They want to make sure they are not doing anything wrong, or they get distracted by the shiny Lulu lemon leggings over there. No doubt about it, they will wobble and perhaps come out of their pose. In yoga, like in life, you have to do your own thing instead of comparing yourself to others. The moment you start comparing your diet, or your body, with those of others, you’re in trouble even if you’re normally quite solid.

Your drishty is what keeps you stable

What’s the secret then? Well that’s your drishty. It means “focused gaze” and in yoga we use to hold still. You pick a point in the room and you stay focused on this while in a challenging pose. This enables you to withdraw into yourself and concentrate solely on you and your practice. This, I find, we tend to acquire when we age. We become less bothered by what the others are doing and we are more able to tune out the noise around us telling us to be blonder, younger, thinner etc.

Yet even those who are seasoned “yogis” are always at risk of wobbling because you never know who might come and push you. We all have bad days and the noise can sometimes get too much for all of us. That’s ok, it doesn’t mean you’re rubbish at yoga or even at standing, you don’t need a crutch. You might just need to sleep it over, to gather yourself, to rest etc. You might need to talk it over with someone so you can understand that the fault was in the person who pushed you and that you are still more than capable to hold still unaided.

Finally, I have come to notice that the people who wobble the most are those who just haven’t found their drishty in life just yet. It’s not always easy to find and you might need several attempts. They may struggle to find their purposes and their values preferring for now to look around at what others are doing and being swayed by popular opinion. Perhaps that explains why so many teenagers are falling prey to eating disorders? They don’t know who they are and what they want yet, so finding that point of focus is going to be harder.

Wobbling is part of your life practice

Know that it’s ok to change focus. You may wobble along the way. Remember, there’s no rule dictating that you have to keep the same focal point at all times. People also get their drishty wrong thinking happiness will come from doing that successful job, or earning that amount of money. However, if that doesn’t truly resonate with them, they will wobble. I often see people with no hobbies who are unstable. Usually, they either haven’t yet found what makes them tick, or they have found it but think it’s not cool enough. So, they don’t pursue it and instead chase something that society will more readily validate. If your thing is carp fishing and that’s what’s going to make you happy, then do that.

You know the saying: those who mind, don’t matter and those who matter don’t mind. Allow yourself not to mind because you are the only person who really matters.

In this eye-opening episode of Dr. Marianne-Land, I’m joined by Anne Richardson, RD (@theeatingdisordernutritionist), to talk about the disturbing return of the super skinny ideal—and how this 90s-era body trend is resurfacing in modern media and pop culture. From TikTok to fashion runways, the thin ideal is back, fueling body dissatisfaction, disordered eating, and a dangerous normalization of extreme thinness.

In this episode of the MyoMinds Podcast, George speaks with Anne, a Registered Nutritional Therapist, lecturer, and supervisor. She has been practising for more than ten years and exclusively works in the field of disordered eating. Anne suffered with anorexia in her teens and now draws from her lived experience to blend her knowledge of nutrition with her CBT skills. She works with people all over Europe to help them achieve food freedom. She is also invested in helping other practitioners work with disordered eaters as she recognises that general nutritional advice can be extremely damaging to disordered eaters. 

I chat with Anne Richardson, aka @theeatingdisordernutritionist, to explore her incredible journey of eating disorder recovery across two countries—France and England. Anne shares how navigating different cultures, varying levels of anti-fat bias, and personal challenges shaped her path to healing. From confronting food anxieties in a small village in France to building a support network abroad, her story offers a unique perspective on the complex process of recovery. Whether you’re on your own journey or supporting a loved one, Anne’s experience provides inspiration and valuable insights. Let’s dive into her powerful story!

Should our weight be kept in check?

Weighing was at the centre of one of my sessions this morning and so I decided to write some more about it while my memory was still fresh.

Should we or should we not weigh ourselves? That is the question.

As always, the answer isn’t clear cut, in fact would there even need to be a question if it was clear cut? My answer will depend on whether we’re talking weighing someone in general (“normal eaters”) or weighing someone in recovery. I would never suggest that people who are struggling with food are abnormal but they have different needs in my opinion, hence the needs for some differentiation.

On a very basic level, I can see why weighing “in general” might be useful. It’s common practice, for example, to frequently weigh newborn babies to make sure they are eating enough and that they are growing properly. If you are to receive general anaesthetic, the doctors might need an indication of your weight, as the dose needed won’t be the same if you are 7st or 22st. So weighing for functional reasons makes sense.

Should we weigh ourselves to make sure we are healthy?

By the way, have you ever wondered why weighing scales are kept in the bathroom? Isn’t the subtext here that it is to keep our health in check? I think this has something to do with painting the scales as a health tool in the same way as vitamins and medications are. Yet, we know that weight doesn’t equate health. They can sometimes overlap (being underweight can be damaging to your health and carrying an excessive amount of weight can lead to co-morbidities) but most often they are not linked.

ED diagnostic criteria are not based on weight per se but on the amount of weight lost/gained in respect of time, and, mostly, on the importance the person gives to their weight/shape. You can be very unhealthy at a “healthy” weight and you can be totally healthy while clinically under or over weight.

If the scales aren’t a measure of health, why do we keep them in our bathroom?

Because that’s where we take our clothes off? We also do that in our bedroom, don’t we? In fact, wouldn’t that make more sense? Isn’t our checking our weight more about appearance than health? Should it therefore not be where we keep our other appearance relating stuff like our clothes?

Anyway, back to whether we should, or not weigh ourselves.

Do I think people in recovery should be weighed? Yes. Do I weigh myself? No.

Weighing can be useful in recovery

Let me explain. I think weighing is useful and, often, even necessary in recovery but that depends on the person and diagnosis/problem. 

I mostly work online these days, so I don’t weigh people, this is done by their GP/nurse/hospital and the number is then relayed to me. Why is it important? To keep people who are restricting safe. We need to know what is happening to them weight wise, so that we don’t realise months down the line that they have been losing weight and are therefore at risk medically. I also often use the number on scales to show people that the food they are eating and fearing isn’t having the impact they thought it would on their weight and this can greatly help them move forwards in their recovery.

The optic here isn’t: “look, you can eat and not get fat”. It’s more: “see, the way you have linked food to your weight is somehow skewed, as it doesn’t seem to work like this from the evidence that we have. What else might you have heard that is holding you back in your recovery?”

Do I think we should weigh people for fear they don’t gain too much weight? No. What about to check they are losing the correct amount of weight? Well, I don’t work with weight loss clients, so the answer is still no.

Some people might come to see me and want to lose weight, but that is never the focus of my sessions. If they do, they do but I’m interested in their relationship with food, not the number on the scales.

In recovery, it is my opinion that the best way to weigh someone is blind i.e., the person taking the weight sees the number but not the person being weighed. It’s important to keep track of what’s happening but it’s also important for people to reconnect with how they feel as opposed to being a slave to a number. I want them to start as they mean to go on i.e., not using a machine to measure their worth or happiness, and once they’re out of the woods, weight wise, once the person is weight restored, the weighing can stop. 

I’m not scared they are going to gain “too much weight”, I trust their body to do the right thing. If they have gained weight, it’s probably because they needed to; it’s not my role to set an acceptable weight for an individual. It would be wrong and potential harmful because our weight is genetically programmed in the same way as our eye or hair colour are, it’s not for me to arbitrarily decide.

There are brackets but once someone is above a certain threshold (the “healthy” range), I know the next bracket is pretty far away so I’m going to let the body decide where it needs to settle.

The reality is that some people will naturally be at a BMI of 26 and that will be healthy for them, while some will settle around 20; we are all different.

If someone is in the healthy range but that they still don’t have a functioning endocrine system (no period, no sex drive, erectile dysfunction), that’s a pretty sure sign that they are not where they are supposed to be and that they need to carry on.

Ok, so weighing can be functional and it can be to check a person isn’t losing weight or that an underweight person is regaining enough weight for them to reach a biologically appropriate level.

Weighing for reassurance

Some people tell me that they still like to weigh themselves for reassurance but I worry that this still maintains weight at the centre of it all.

Reassurance from what exactly?

Surely you can see whether your clothes fit or not? Do you really need a number to orient you towards your next step in life? Most often it’s not about the weight but about the meaning you attach to the weight. I’m more or less than I used to be/than I expected to be/than I wanted to be/than my friend etc. Weighing is always comparing and isn’t comparing pretty much always despairing? To me, stepping on the scales is still saying: my weight is a measure of my worth.

I also worry about the conclusions people might draw about their ability to trust themselves if they still use weighing for reassurance. Imagine that if you feel good in yourself, that you step on the scales and that the number isn’t what you expected, what will that do to you and what will that mean about you? Are you likely to conclude from that that it is in fact ok to be bigger since you felt good 10 min before, or are you likely to conclude that your feelings can’t be trusted since the number is evidence you are not good? I’d rather let myself feel ok and sometimes not ok and letting the feeling glide on me knowing it will soon dissipate and that I can use other measure for my worth such as my career, the love from my family and friends, my abilities etc.

I was weight obsessed as a teenager, I don’t know where it came from but I had what I call a “magical weight” a weight at which I thought my life would be perfect. Of course I went lower than that because the goal post always moves with anorexia, it’s never enough because you’re chasing a perfect life, which will never happen. I remember refusing to be weighed at the rheumatologist but then seeing the number and being horrified. I remember the shift from being ok before the consultation to wanting to rip my skin off after seeing that number. That was a crucial day for me, that was a spark for anorexia (which clearly was already simmering in the background) to light up and start burning me thin.

As I was reflecting about my personal relationship with weighing something struck me. We didn’t have scales at home, so instead I would go in the attic and weigh myself on an old fashioned pair of scales intended for animals and goods.

Let that sink that: I was using a device used to assess the weight and therefore price of goods to assess my own worth. That makes me so incredibly sad. I wish I could rescue that poor teenager from this dark abyss.

Scales are a clinical tool not an everyday item

Nowadays I have scales but I don’t use them and I’m not tempted to. They live in my office, they are not in the bathroom or bedroom and they are not intended for the family’s use. They sit on the floor next to my desk and I almost don’t see them, they could be a plant pot for all I care, I don’t need to interact with them. They are just an old tool left from when I used to see clients face to face. Given that last time I used them was to weigh my suitcase before going on holiday, I will probably dispose of them – more floor space.

I don’t weigh myself because I don’t need to: I can tell I’m fine weight wise and that my clothes haven’t changed for years. It doesn’t mean I stayed at that weight all those years by the way. I probably have gone up and down by several kilos over the years but not enough to require my attention so why should I care about the number? I also worry that I won’t totally be neutral about it when that number used to mean so much.

Not wanting to weigh myself is about limiting the potential harm it still could do, even if I don’t realistically think seeing the number would induce a relapse. I don’t want to change my body, I don’t think there’s anything wrong with my weight but what if seeing the number could rekindle the fire?

If I was at a higher weight than expected, I know I wouldn’t diet my way down but I also know I’d have a reaction to the number and I’d therefore have to unpack that, work through it temporarily to neutralise it and move on and I’d rather not do that because it’s easier that way.

It feels like being on top of a building, getting slight vertigo and having the desire to jump.

I won’t.

I would never jump but I still have the giddying desire to because I know it’s possible.  

A flan pâtissier is essentially a giant vanilla custard tart but with a French accent!

I have many culinary memories of my childhood in France and I’d like to tell you that this was something I used to make with my mum but the truth is that it wasn’t. My mum was a full time mum in charge of all the household tasks and even though all our meals were home cooked, they were quick and easy. She was also a terrible baker, who tended to burn most things – she used to say it was “well cooked” but really it was burnt… In her defence, why would she have bothered making something could easily have bought in any boulangerie?

I’m the mum now and my boys really love it, especially my youngest, hence why I often make it on his birthday. He went to school with the last piece in his packed lunch today!

Ingredients:

• Shortcrust pastry, you can buy a block, or you could make my basic shortcrust pastry recipe. I think traditionally it is supposed to be with puff pastry but I prefer it with shortcrust pastry; I like the contrast between the snap of the outside and the creaminess of the inside.
• 700 ml milk
• 300 ml double cream
• 1 vanilla pod
• 100 g corn flour
• 160 g caster sugar
• 4 egg yolks
• 2 eggs

Method:

Roll out the pastry the thickness of a one pound coin and place in a Springform tin (mine is 24cm). Trim the excess, prick the bottom and refrigerate – this helps the pastry not shrink while in the oven.

Split the vanilla pod in half, scrape out the seeds inside and place both seeds and pod in a large saucepan. Add the milk and cream and heat up slowly until it starts to simmer. At that point, take off the heat and go off to do something (ideally fun) for a couple of hours. This step isn’t strictly speaking needed but I think it’s worth it. What will happen during those two hours is that the vanilla will infuse into the liquid so you’ll get a deep vanilla scent as opposed to a hint of vanilla – we’re aiming for Madagascar, not just the travel brochure. Given the price of vanilla pods, I think it makes sense.

When your two hours are up, remove the vanilla pod halves but don’t throw them away! Rinse and pat them dry and then place them in your sugar jar; in time, you’ll get vanilla sugar!

When you are ready, preheat the oven at 160 degrees then bake the pastry blind for 15min. Remove the baking beans after that and bake for a further 5 min.

While the pastry is baking, gently warm up your liquid again. In a large bowl, crack the eggs, add the sugar, and whisk. Then add the corn flour and whisk again until you end up with a smooth mixture without any lump.

Slowly add a bit of your warm vanilla infused liquid to the bowl and whisk quickly at the start – you don’t want to end up with cooked bits of eggs in your cake. Repeat the operation until you have added all the liquid to the bowl.

Pour the content of the bowl back in the saucepan and gently heat that up, stirring constantly. When it starts to thicken, remove from the heat and pour into your tin.

Bake in the oven for 45min at 180 degrees – the top of the custard should be brown.

Leave to cool and tuck in.

Anne’s home life was chaotic due, mostly, to her unpredictable father who wished that Anne had been a boy.

Her anorexia kicked in from the ages of 16 – 21. She knew she’d never recover at home so she packed her bags and moved to London where she rebuilt her life.

In this episode we explore Anne’s relationship with her father and how his absence still resonates.