Fatigue is a part of the experience of people who have eating disorders that is seldom talked about. Even with a great attitude, people in the throes of their eating disorder find that they have to start low and go slow. Eating disorders make everyday life a constant struggle for several reasons.
People who live with anorexia nervosa simply don’t consume enough calories to feel energetic
When your body is conserving calories by restricting blood flow away from your hands and feet to your core, there’s simply no way you will have enough energy to feel good. In healthy people, there is a kind of crosstalk between heart and brain. A strong, steady heartbeat lifts mood. A depressed heart rate with low blood pressure is depressing, even when things are going well otherwise. People who have severe anorexia nervosa don’t consume the calories to make the energy to feel energized. People in recovery from other eating disorders can have a similar experience.
People who live with exercise bulimia exhaust themselves with physical activity
Exercise bulimia is a condition in which its sufferers feel compelled to “burn off” the calories they eat. They exercise so much that they never get to rest. But they also eat so much that their cells never have a chance to repair and remodel themselves through a process called autophagy. They are constantly trying to force their metabolisms to burn calories so that their metabolic processes never get to do repairs. People in recovery from other eating disorders have the same problem on a less consistent basis.
People who live with binge-eating disorder deal with “digestive congestion” after binge eating
There is an implication of the epithet "you’re full of (fill in the blank)" that is at the same time descriptive and unfair to people who live with binge-eating disorder. It’s descriptive in the sense that binge eating leaves people with binge-eating disorder uncomfortably full. The mass of food consumed has to be eaten and waste matter eventually has to be released. The sensation is like carrying around extra weight all the time. The epithet is unfair because binge-eating disorder is a disease, not a lifestyle choice. Not everyone who has a binge-eating disorder is obese, but those who are naturally become fatigued by their body mass. People in recovery from anorexia or bulimia can have the same experience, just not as often.
All eating disorders are frequently accompanied by depression
People who live with anorexia, bulimia, binge-eating disorder, or EDNOS (eating disorder not otherwise specified) are prone to anxiety and depression. Anxiety and depression sap psychic energy in addition to the physical problems caused by the eating disorders.
During the early stages of recovery, fatigue can get even worse
As people who have eating disorders return to healthier eating habits, they don’t necessarily feel better at first. In anorexia, the body turns down its internal “thermostat” to stave off starvation. During the first few weeks of improved eating habits, the body may put all of the additional calories just into “turning up the heat” of its core. The recovering anorectic may be objectively better physically without feeling subjectively better physically, all the while processing the mental changes that will be necessary to sustain progress.
In bulimia, cessation of purging activity helps the body heal, but there can be a huge psychological struggle to overcome the purging habit. And in binge-eating disorder, it’s necessary to replace the binge-eating habit with something else to fill the emotional need satisfies by blindly overeating.
Recovery is difficult, but possible
So how can people seeking to recover from eating disorders keep up their physical and mental energy? Here are some suggestions:
- Accept treatment for depression. This may be drug therapy. This may be talk therapy. This may involve treatment for PTSD. It’s simply not possible to feel energized and depressed at the same time. Work with your psychologist and psychiatrist honestly and openly to deal with this drag on your life.
- Find a support group to help you get past slip-ups. Most people relapse once or more often during their recovery from an eating disorder. The important thing is not to give up on living a life free of the disease. Whether it’s a trusted therapist, a support group, or a knowledgeable and trustworthy friend (and preferably all of these), invite people in your life who will support your getting well. And find a different place in your life for people who weigh you down.
- Avoid perfectionism and perfectionists. The media bombard us with images of beautiful people, some of whom maintain their stylized beauty for eating disorders. Turn off the TV. Put away the fashion magazines. Learn to like what you see in the mirror. This is far easier said than done, but accepting yourself rather than judging yourself, and others, is a foundation for recovery.