Sometimes people who have recovered from an eating disorder can slip back into restriction with compelling diets like intermittent fasting. These diets have a sneaky way of convincing people that they are healthy and an ideal way to eat. But any form of restriction is dangerous territory during recovery.
In this article, I respond to a mom who is worried about her daughter who had anorexia and is now practicing intermittent fasting. The mom is understandably concerned, so I address whether intermittent fasting can be “intuitive” and also whether it can be healthy.
The letter
Dear Ginny,
My 18-year-old daughter has been in recovery from anorexia for a few years. Treatment was awful, but it seemed like things were going well until a few months ago. Basically, she started intermittent fasting. She insists that there’s evidence that it’s healthy. And she says that intermittent fasting is intuitive eating. Do you think this is a relapse? Is she right about it being healthy? Can a person who had an eating disorder use intermittent fasting safely?
Signed, Alicia
My response
First, Alicia, thank you for writing in, and congratulations on helping your child recover from anorexia earlier.
That’s not an easy thing. And I imagine you’re still recovering from her recovery.
It makes a lot of sense to me that you’re worried about intermittent fasting and how it may impact eating disorder recovery. And I do think there’s a lot to unpack here.
/coa
Is intermittent fasting intuitive eating?
First, let’s address intermittent fasting as possibly intuitive eating.
It’s definitely not intuitive eating, but your daughter is not the only one who thinks it is, partly because Gwyneth Paltrow just published a book under her publishing arm called Intuitive Fasting, which I 100% do not recommend.
Not a great book.
When we talk about bodily intuition, we’re talking about the automatic biological things that our bodies do to keep us healthy. Our intuitive biological processes include breathing, sleeping, going to the bathroom, blinking, and of course, eating and drinking.
To alter any of these automatic intuitive behaviors is always something we want to be really thoughtful about. And we definitely wouldn’t call it intuitive.
For example, when we meditate, we are actively calming our breathing. We are slowing down our breathing. We’re focusing on our breath. Usually, we’re trying to slow our breath down. And that’s certainly an appropriate practice. And meditation is really helpful for a lot of people.
⭐ Get ready for recovery and find out how you can prepare yourself for maximum success.
⭐ Find out the essential steps and family rules you need to have in place for recovery.
⭐ Make your home recovery-ready with six simple steps that anyone can do.
But meditation is not intuitive breathing. Intuitive breathing is what we do naturally, without thinking, 24 hours a day.
Intuitive breathing is when we take a breath without thinking about it, we don’t worry: do I really need more air right now?
Or think about the intuition of going to the bathroom. Yes, you technically can override your biological instinct to use the bathroom, but most of us know that it’s not healthy to do so for long periods of time. Intuitively going to the bathroom is using the bathroom when you need to go.
And that’s a super simplified way of thinking about intuitive eating.
Intuitive eating is about eating when you feel hunger. And just like you don’t question your urge to breathe or go to the bathroom, you don’t then question hunger. And this is why fasting is absolutely not intuitive. Because fasting uses our brain to make decisions for our body.
Now here’s where things can get a little tricky in eating disorder recovery.
A lot of people who have eating disorders lose touch with their hunger cues. People who have eating disorders often don’t feel the same hunger urges as other people.
In this way, intermittent fasting may actually feel more intuitive to your daughter than eating regularly throughout the day. But while I completely understand why she would believe that intermittent fasting feels intuitive to her, it’s still not actually the same thing as intuitive eating.
Is intermittent fasting healthy?
So next up, is intermittent fasting healthy? I know that there have been some studies suggesting that there might be some health benefits, but every registered dietitian I have spoken to does not recommend fasting, especially if they’re in the eating disorder space. I have never heard anyone say that fasting is a good idea for someone who’s in eating disorder recovery.
And I think that’s because one of the main behaviors of an eating disorder is trying to extend the windows between eating food. This is a characteristic of almost all eating disorders.
So in other words, your daughters’ intermittent fasting sounds like it would be a red flag. If I were her parent. I would be concerned as well.
The dangers of diet culture
And this is exactly what’s so upsetting to me about all diet trends or eating trends. The idea that we constantly need a new way of eating. That the latest trend is better and healthier.
These are trends that come and go, whether it’s don’t eat any fat or don’t eat any carbs or don’t eat between the hours of 7 p.m. and 7 a.m. Those are all rules that we impose on an instinctive biological drive to eat.
Our natural and instinctive drive to eat when hungry has something that somehow becomes shameful in our culture.
And it’s a major problem.
Just like all diets, intermittent fasting legitimizes eating disorder behaviors. Many eating disorders go undetected because powerful marketing machines have normalized disordered eating.
So yes, from my perspective, your daughter may be in danger of relapsing. I would certainly be trying to figure out how I can encourage her to get treatment.
Of course, the challenge this time around is that she’s 18 and that does make things a lot harder.
⭐ Get ready for recovery and find out how you can prepare yourself for maximum success.
⭐ Find out the essential steps and family rules you need to have in place for recovery.
⭐ Make your home recovery-ready with six simple steps that anyone can do.
Try this
Let’s just take a minute to consider how best to approach this issue. First, it’s important not to play this podcast episode for her so that she can hear how dangerous I think intermittent fasting is.
It’s just very unlikely to go well. So I definitely don’t recommend that as a next step.
I’m going to use an analogy of the elephant in the room. There’s a giant elephant in the room and it’s making a mess. Your daughter brought the elephant into the room. So you say, “Hey, there’s an elephant in the room and I demand that you take it out of here.”
If you say that she’s very likely to respond with some version of ignoring the elephant because you’ve accidentally made the elephant your problem, not hers.
The key when working with adult children who have eating disorders is that you need to respect them as adults, even as you try to influence and support them into getting treatment somehow.
Parents need to help kids see the elephant and then support them as they take action to address the problem themselves.
Is this an ideal situation? Not really. But once your child is 18, we just don’t have a lot of other options.
Building relational authority
What we can do is build what’s called relational authority. And when parents build their relational authority, they are more likely to help an adult child seek treatment for their eating disorder.
Doing that is a much larger conversation. And it takes some practice and training and really understanding what’s going on between you and your daughter right now.
But I hope that I’ve given you enough to think about in terms of your next steps.
I just want you to know that a lot of parents who have been through eating disorder treatment with their child are still a little traumatized from the process.
Seeing a potential red flag like intermittent fasting during eating disorder recovery is understandably making you nervous.
This means it would make a lot of sense if you feel a little shut-down or overwhelmed or terrified by what’s going on right now. And I just want you to know that I have so much compassion for you and for all parents who are trying their best to help their kids recover.
Want some help?
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