Day Twelve: Some Links on the Subject of Refeeding

Somehow, I've gotten all of my days out of whack. I was supposed to do this yesterday, but (evidently) I did not. None-the-less, here it is! A list of links! Hooray! Today (which should have been yesterday), we'll be discussing the wonderful world of re-feeding. As they say in Toy Story, "Oooooohhhh..."

Eating Disorders Online   

This website says, "Renourishment involves increasing feeding slowly in order to allow the patient time to adjust, as the body switches from using stored fat reserves to the process of digesting food." That is how "re-feeding" went for the first couple of days for me both times in the hospital and when I went to residential treatment last summer. In short, it's awful! They give you an amount of food that a 2 year old would eat. It's because they don't want to pump you with too many calories and get you sick because the body isn't used to such food consumption (or else you wouldn't be in a condition of malnourishment). It was poopy for me because 1.) I wanted to eat, and 2.) I was used to eating larger amounts of food, but were less calorie dense and had high volumes of water. It's never fun when you want something and can't have it, especially when it's food.

 F.E.A.S.T.

This website says, " Much of the damage of anorexia is not the obvious loss of body size or fat, but muscle and tissue and organ damage. The heart, largely made of muscle, is weakened and often shrunken. Bulimic behaviors also cause massive internal damage. With both restrictive and purging behaviors the digestive system is damaged in numerous ways: structurally and chemically." That is probably one of the scariest, if not the scariest, things about eating disorders. One could look perfectly "normal" or "healthy", but on the inside, they are dying because of organ failure. It's especially scary because the person affected can't feel it (or at least I couldn't). Some of the internal effects of eating disorders can be reversed, but it can be a challenge. The effects can even lead to death. That's why it's important to love and respect yourself enough not to get an eating disorder...easy...(not so much).

US National Library of Medicine National Institutes of Health

This website says, "In starvation the secretion of insulin is decreased in response to a reduced intake of carbohydrates. Instead fat and protein stores are catabolised to produce energy. This results in an intracellular loss of electrolytes, in particular phosphate. Malnourished patients' intracellular phosphate stores can be depleted despite normal serum phosphate concentrations." I found this interesting because I was restricting my carbohydrate intake, and could have cared less about proteins and fats. When I was admitted into the hospital, I was diagnosed with a bad electrolyte count and rough phosphate levels. I don't know what "normal serum phosphate concentrations" are, but I do know that medicine doesn't lie. Eating disorders are interesting because one of the things that fuel them is the desire to be unique, when in reality, all eating disorders are essentially the same. It's the person that is unique. 

Healthy Place

This website gives a list of "specific topics that nutrition therapists discuss". These include 

• What kind and how much food the client's body needs
• Symptoms of starvation and of refeeding (the process of beginning to eat normally after a period of starvation)
• Effects of fat and protein deficiency
• Effects of laxative and diuretic abuse
• Metabolic rate and the effect of restricting, bingeing, purging, and yo-yo dieting
• Food facts and fallacies
• How restricting, bingeing, and taking laxatives or diuretics influence hydration (water) shifts in the body and thus body weight on the scale
• The relationship between diet and exercise
• The relationship of diet to osteoporosis and other medical conditions
• The extra nutritional needs during certain conditions such as pregnancy or illness
• The difference between "physical" and "emotional" hunger
• Hunger and fullness signals
• How to maintain weight
• Establishing a goal weight range
• How to feel comfortable eating in social settings
• How to shop and cook for self and/or significant others
• Nutritional supplement requirements 
  
  
  All of these things fascinate me. I want to know about all of them because I'm not used to any of it. I've never been a "normal" eater, and I've never been at a constant, "normal" weight. I've always either ate too much or eaten too little. I enjoy learning mostly about the amounts and types of foods the body needs, hunger and fullness signals, and how to maintain weight. 

Up To Date 

This website says, "Patients other than those with AN are at risk for the refeeding syndrome [5]. These include oncology patients undergoing chemotherapy, malnourished elderly patients, certain postoperative patients, and homeless or alcoholic patients who have not eaten for many days." Throughout my time in treatment, I've always been told that my disease is no different than cancer patients. Just as they have to do kemo-therapy to get better and they don't like it, so eating disordered people have to eat, despite their desires not to, in order to get better.

If you're interested in learning more about re-feeding or anything relating to it... Google it. I'm sorry; I'm not a book, even though my life is like an open one.