There are lots of side effects to extreme calorie restriction, widely documented among people with eating disorders. They include memory loss, fatigue, loss of concentration, emotional dysregulation, heart problems, and many others. One of the symptoms that I experienced most acutely while I was in the midst of my eating disorder was memory loss. In my freshman year of college, I was trying to study for a Latin final. I spent hours looking over the same passages, trying to remember exactly what they meant, but when the test came I only scraped out a B (which was not normal for me).
The incompetent feeling that comes with not being able to remember anything doesn’t help when it comes to treating yourself better and feeling worthy. Unfortunately, not all of these side effects disappear the moment that you start to increase your caloric intake again. Even if your body starts to look and feel healthier again, there are some lasting impacts, most particularly fatigue (does it ever go away? Please say it goes away) and difficulties with focus and memory.
One of the skills that lots of therapists and therapy techniques promote is building mastery. The idea is that if you learn how to do something relatively well, you start to feel more confident of yourself. That radiates across lots of different aspects of your life, and especially if you work to become better at things on a regular basis, your mood will probably improve across the board. From my personal experience, I’ve found it a very helpful skill, especially when I can take the time to recognize that I’ve become good or competent at something. The feeling of realizing I know how to do something without any help or instruction is basically the best, and it’s a big part of what keeps me going on a daily basis. I start to know who I am a little more, I start to understand that I don’t need someone else to tell me if I’m doing alright, but that I know myself because I can see that I am capable.
The problem is that my brain is hazy and my body is tired. I was learning a new process for work today, but no matter how hard I tried to concentrate, my eyes kept slipping in and out of focus, and I would miss sentences, jumping back into the explanation and desperately trying to backfill the information I had missed. I felt like a failure. I wrote a blog post last week in which I completely forgot to add citations, the whole thing sliding out of my fingers in a blur without any real realization of what I was doing. And then there are the days that I fight with myself about exercise and movement, trying to get my body up and out the door to go to the climbing gym or for a run. I know I won’t get better if I don’t do it, but my eyes can barely stay open. It seems as if I can’t learn anything, I can’t remember anything. I swear I did this before, but what did I do?
Trying to build your life and identity into something that feels like self after an eating disorder is hard enough. It becomes even harder when your mind and body don’t cooperate to let you learn and grow, establish your abilities, and feel able of taking on the world. Failure is one of the fastest ways to set off depression, anxiety, or perfectionistic tendencies, all of which are quick ways to trigger a relapse into eating disordered behaviors. All of that means that the disorder itself is set up to keep you from getting better: you’re less competent after you’ve starved yourself, so you convince yourself that you’re incompetent, a failure, a loser, you don’t deserve food, and so you refuse to eat further. It’s vicious, and even when you start to get out of the cycle it takes time for your brain and body to catch up in the recovery process.
I suppose this all should serve as a reminder that certain skills need to be used with care until you reach a more stable state. Relying on external successes might not be the most important factor in building up an identity and self confidence at the beginning of recovery. It’s also a reminder that mastering a skill has to come in the context of where we’re starting and the resources we have available. For me right now, running 3 miles is a success. For lots of other people, or if I were healthier, that might be almost nothing. But at this moment, it is building a skill that I didn’t have before, and that still counts as growing and learning.
All of it still counts, no matter how much harder it is now.