Does what you eat in recovery affect how (and where) you store weight?

In an Instagram Q&A I was recently asked whether or not what kind of foods you eat in recovery affect how and where you (re)store weight. For example, does eating a more processed diet in recovery mean more or faster weight gain for the same amount of calories, or gaining more weight in certain areas, e.g. the stomach? Does eating more protein mean more muscle gain?

What I suspect1 this person was really asking: “Will holding onto certain disordered eating patterns in recovery give me a body composition that me/the ED considers more favourable?” And here’s the thing, even if the answer to that question was “yes” (it’s not), I still wouldn’t recommend doing recovery on the ED’s terms, because that is in itself an oxymoron.

The short answer to the question: not really, but kind of, but not in the way you may expect.

Let me make one thing very clear first. Your body does not store body fat differently because you ate more or less nutritious foods. Body fat storage pattern is driven by genetics, hormones, age2, sex, and a cluster of other things. How many vitamins were in your oatmeal is not one of them.3

Importantly, body fat storage in recovery is also driven by time and starvation status. A starved body will often tend to prioritise slightly more weight gain in the abdominal area first, only for this to even out later once the body has been consistently fed over a period of time (perpetual starve-reactively binge-starve-cycles can therefore prevent weight from redistributing, until the cycle is broken). Water retention, body dysmorphia and bloating can exaggerate the ‘bigger belly smaller limbs’ effect further4.

A starved body will also tend to initially prioritise body fat gain, whilst lean tissues (like muscle, organs, bone) take slightly longer to restore (and require more energy - this ‘calorie expensive’ repair process has been proposed to be one of the drivers of extreme hunger, and the generally elevated appetite some people experience also in the months after weight restoration5).

What makes you gain weight is eating enough calories for the body to store some as body fat (or muscle - more on that in a bit). In very early recovery, when still hypometabolic (‘slow metabolism’), the body is sometimes able to store fat on a relatively low intake (hence some people gain weight eating an amount that most people would lose weight on). This is not because metabolism is ‘broken’; hypometabolism is a necessary and temporary adaptation to famine (temporary as long as you actually increase your intake rather than panicking and restricting).

Once enough energy is coming in over a sufficient time period, and you’re not engaging in behaviours to burn it all off, the body gets more ‘greedy’ with its energy needs, sometimes to the point of hypermetabolism where you struggle to eat enough to restore, or even maintain, weight. (Sounds fun, until you’re there.)

But! There is nuance here. Not all weight gain is body fat - oftentimes, not even a majority of it. A large portion of rapid and seemingly uneven weight gain in early recovery is the result of water weight (oedema) and more foods in your stomach/system. And those can to some extent be affected by what you eat, but again, perhaps not in the way you assume.

Firstly, when someone is starved, their glycogen storage is usually rather empty. Our bodies like to carry around stored glucose (carbohydrates) in our muscles and liver for quick and easy to access energy (kind of like a backup battery), and this process comes with some fluid. In early recovery, these dried out storages can refill quickly, and when restricting, it can sometimes empty quickly too. The former factor can make recovery scary (“Why am I gaining several kilos seemingly overnight?”); the latter factor can make restriction tempting (“I lose weight so quickly when cutting calories/carbs!”).

Rule of thumb: if you’re suddenly gaining or losing large amounts of weight seemingly overnight, chances are it’s not ‘real’ weight (fat or muscle tissue). Even the most starved body has a cap on just how much real body mass it can gain or lose in the span of a day, usually in the realm of a couple of hundred grams at the very most, and that is with an extreme surplus or deficit.

On top of this, water retention in recovery often goes beyond ‘just’ refilling glycogen stores. For reasons beyond the scope of this article, many genuinely hold a lot more water in recovery (or during their eating disorder, e.g. after a binge) then what is normal or natural for them. (I have a picture of myself from during my eating disorder, where after a particularly bad binge-purge episode, my face looks swollen to the point of mimicking an allergic reaction6.)

But - this reaction happens regardless of whether your glucose comes from pasta, spoonfuls of sugar or kilos of carrot. Sure, theoretically you can just… not eat carbs. But with the exception of a few exceptional medical situations, this is an awful idea for someone in eating disorder recovery. Not only is another strict, rigid diet antithetical to full recovery, it is also metabolically unhelpful, as it prevents your body from ‘relearning’ how to properly process carbohydrates again, meaning you may end up in a sort of semi-insulin resistant state. Not to mention that the vast majority of us have bodies and brains that function the best when running on glucose.

People with eating disorders sometimes fear high-sodium foods due to sodium’s role in water retention, and many drink excessive amounts of water (or tea, black coffee or diet soda). What they often fail to realise is that dehydration can worsen water retention too, and eating too little salt combined with drinking too much water can paradoxically worsen oedema rather than ‘flushing it out’ - especially if combined with funky electrolyte/salt balance, and/or high caffeine intake (diuretic effect). All you flush out is the salts and electrolytes you need to be hydrated on a cellular level.

‘Dehydration by drinking too much water’ sounds like a joke, but it’s a thing - rare in the general population, but worth mentioning in the context of restrictive eating disorders. Needless to say that usage of diuretics or laxatives (including artificial sweeteners with a laxative effect) can worsen dehydration too, and trigger more water retention long term, despite occasional relief short term.

Although some degree of bloating in recovery is expected, people with eating disorders have a tendency to make their bloating worse than necessary by filling up on low energy, high volume, high fibre foods that further slow gastric emptying. A starved body and suppressed digestive system typically will not tolerate this very well, and benefit more from quicker, easier to digest sources of energy. More on that in this podcast episode.

It is true that protein is important for muscle restoration, but what is equally (if not more) important is rest, and enough overall energy intake. People with eating disorders have a tendency to overestimate their protein needs relative to carbohydrates and fats. Over-prioritising protein is also a common ED strategy to ‘manage hunger’ because of a belief that protein is inherently ‘more filling’. Truth is, the more filling macronutrient is the one your body actually needs.

Stuffing yourself with egg whites when your body is screaming for carbs just doesn’t give you genuine satiation. If anything, it often creates the feeling of being ‘filled up but not satiated’, which is a common binge trigger (more on that here). Excess protein converts to carbohydrates through a process called glycogenesis, so you end up getting some carbs in your system anyways, sans the satiation.

So no, holding onto disordered eating habits during re-feeding will not necessarily ‘improve’ your body composition (who says a certain size/shape is an ‘improvement’ anyways?). And even if it did - even if there were some secret code on how to intensively biohack your way into ‘the perfect body’ - how is that compatible with recovery, where the aim is to focus on your body less, not more? What is the cost? Isn’t that just doing ‘recovery’ on the eating disorder’s terms? The ED doing a cheap, shitty rebrand that will keep you stuck in the same mindset, the same never-ending cycle? For what?

If it looks like a duck, swims like a duck and quacks like a duck, it’s probably a duck. “I’ll just eat super ‘clean’ and gain all muscle” sounds like ED quackery to me! You can’t heal through the same mindset that made you sick. You can’t get out of the prison cell whilst still saying in the prison cell.

^{(Photo by Quân Mạnh via Pexels.com)}

As hard as it is, try to accept and trust the process. Allow all feelings, but don’t allow all behaviours. It’s fine if you don’t like your body right now, it is even fine if you don’t fully trust the process, as long as you keep on going through the process. What is not-so fine if your goal is full recovery is engaging with ED behaviours - be honest with yourself with what those are. Don’t fall for ED quackery.

I’m currently taking on new clients for 1-1 coaching! Head to letsrecover.co.uk for more information, and to apply.