Metabolism in Eating Disorder Recovery

Our genetic makeup plays a large role in how eating disorders develop and an equally large role in recovery.

The most important risk factor for an eating disorder is an extended period of food restriction. Surviving a dearth of food has been necessary for human survival, so genetic encoding and inheritance of these metabolic adaptations enabled humans to still be here.

People can survive famine by both slowing metabolism to function on little food or binging when food is plenty to live on the energy stores for as long as possible. Many people have both genetic predispositions and some have neither.

People trigger these tendencies with dieting. Once engaged, the metabolic changes don’t always turn off so easily. Even when food is aplenty, once adaptive metabolic behaviors start, they won’t necessarily stop which leads to anorexia or binge eating behaviors. In these cases, the behaviors are an adaptive response to food restriction that persists for our survival.

In recovery, people switch from disordered eating to eating regularly, hopefully on a consistent basis. At some point, our metabolism recognizes that food is now available and can adapt to the new energy available and abandon strategies to cope with food deprivation.

For some people, metabolism adjusts quickly and returns to baseline function that would have existed without an eating disorder.

For many people in recovery, metabolism won’t adjust so fast. Once triggered, metabolism sometimes is primed to expect another famine on the horizon. It does make sense that if one prolonged period of food restriction happens, our bodies will protect against the next period that may very well arrive. This is a clear and evident survival adaptation.

However, for people recovering from an eating disorder, it’s a challenge because the adaptation in metabolism leads to a period of weight gain not commensurate with food intake. Body image is hard enough to tolerate in recovery and even harder when weight gain does not match the meal plan.

Metabolism usually does respond over time by gradually resuming pre-eating disorder function or a lot closer to that function. Some people benefit from medication that communicates to your body that food is now plentiful and will continue to be available.

These metabolic changes through an eating disorder and recovery and the differences people experience in their bodies all reinforce how eating disorders are genetic adaptations triggered by food restriction. A significant part of recovery is recognizing that healing means listening to your body and what it needs. Without trusting your body to heal, recovery isn’t possible.