Most important: Gain weight.
My movement urge subsided slowly as I gained weight. There was no point when that urge disappeared as if a switch had flipped overnight. And again, restoring fat levels is what will finally get anorexia and its symptoms to cease. However, my ability to resist the urge to move had flipped overnight like a switch.
What got me to stop moving excessively was learning of Dr. Guisinger’s Adapted to Famine theory. I finally understood why I had movement compulsions and how they didn’t serve me. And that by following my compulsions I was only reinforcing to my body that I was in a famine.
To fight the movement urge, mentally:
I forced myself to sit down for at least 20-30 min after eating and distract myself by engaging in something.
I got my OCD-like traits to work for me by automatically responding to my thought to move with a counterthought: to not move and instead sit still for longer.
I did the same with food. If I had the thought to restrict food, I instantly told myself I had to eat more as a result of having the thought to restrict.
This actually worked as a kind of game. I kept reminding myself of the Adapted to Famine theories too.
To fight the movement urge, I also made many changes to my environment to also prevent myself from excessively exercising. More detail on this:
I realized that me being able to exercise excessively depends on both time and environment. If there's no convenient spot or time for me to exercise then I won't do it
So, I'd put myself in an environment or situation in which excess movement wasn’t possible.
Social situation example: I eat a meal with friends and socialize with them afterward while sitting. So I’d "surf the urge" to exercise and delay it until the urge disappeared. I realized that when eating alone it was just too easy to start exercising afterward, so I would make a point to eat with others.
Time example: I'd also schedule things (e.g. meetings) right after a meal so there's no time for me to exercise after a meal.
Environment example: I eat somewhere (e.g. at a public cafe) where it's a little more of a social faux pas to start doing jumping jacks, versus being in my room. In my room and home, I removed all exercise equipment.
If I designed a meal in which all 3 factors were at play (social situation, time, and environment) to discourage post-meal purging behaviors (e.g. exercise or vomiting), then I wouldn’t purge for sure.
For instance, in college I'd schedule a meal out with friends on campus, and right afterward we'd have class. So I would be socially eating with others - and I tend to enjoy conversation so I'd stay there and eat rather than disappear to purge. Then because of the time constraint we'd have to go straight to class afterward, which is another environment in which I'd rather absorb the material than awkwardly leave the class.
How to use your OCD tendencies to your advantage
Tabitha Farrar has an awesome article on this: https://tabithafarrar.com/2019/08/getting-your-weird-little-ocd-traits-to-work-for-you-in-recovery/ Highly recommend! It was practical actionable ideas
A way to take the OCD tendencies and use them to your advantage is to say to yourself, “I can’t go above X steps today.” And if you think about doing compulsive movement, instead instantly tell yourself “This means I have to stay still for at least 10 minutes longer”
So basically, compulsively correct your compulsive movement.
As we know our genes make us more OCD. So we can’t overcome that as easily, but we can instead do behaviors that clap-back at what our instincts say. During recovery, when I considered restricting food or skipping a snack, I made myself eat more than initially planned.
Here's advice I wrote to one client about overcoming an exercise compulsion:
Do something that engages your brain but involves staying in place, like studying or reading. Even fiddling with something while sitting down is better than going on a big walk
I noticed that during meals I would move A TON. always back and forth to the kitchen and stuff - not sure if you did too. But it helped me to also remind myself to sit down to eat properly
The nervousness is so real, but it will keep fading as you can sit more and your body learns it’s not in danger! remember, your body thinks it has to move to escape danger, to escape famine.
I also felt like I would go crazy, like I would just explode, when I had to sit down. I also dreaded days when I had to sit and study more because I was so restless - I liked it also when I as alone and could move around like crazy. It did interfere with my studies!
Looking back I realize how silly all my pacing was, my need to walk everywhere.. I was driving myself insane! The more I walked, the more anxious I think I was making myself. Evolutionarily, I was telling my body that I had to flee famine. To run away. When I sat down and ignored my desire to pace, I finally relaxed. It was unnerving at first to not pace, but then slowly I grew more and more comfortable with being sedentary. And liked it. Because my body needed to rest to heal.
If you do the opposite of move - if you are still - you will teach your body that it’s not in danger
The more you walk, the more your body thinks it must flee somewhere. The more you sit and lie around, and rest, the more your body can calm down. And do things like digest food properly.
During recovery, some days it felt like the only time I got up to walk was to go to the bathroom and kitchen!
Sitting is hard, and it’s hardest if all we do is sit and think about how we’re still sitting. That’s where the distraction aspect comes in! 😊 For me, I really enjoyed listening to Beat Your Genes to instance. And yes, maybe doing something to keep your hands busy will help.
An ED takes so much time away from us by making us hyperactive and think about food a lot. When you’re free of the ED you’ll have SO much time back and the ability to pursue your dreams 😊
I don’t think I have very strong or unusual willpower. I was just very tired of feeling so unwell all the time. I had bigger goals that I wanted to chase - I wanted to be a better friend and family member. I knew anorexia was holding me back.
More encouragement to not pace
What I wrote to a client:
Michelle: Instead of doing a morning walk you could sit in the kitchen and eat to your delight or just do anything else while sitting down. To actually become less anxious, you have to sit down and eat. Don’t give in to the urge to pace - it’s tricking you and stealing your time.
Client: You’re right because as soon as I stop pacing I feel anxious and guilty again
Michelle: It’s actually contributing to it because you’ve been doing SO much pacing but you’re still very anxious. It's time to do something different to cure the anxiety for good.
The client decided to tell her parents that she wanted to stop pacing, and this helped keep her on track to the goal of not pacing.
Michelle: the compulsive exercise and pacing took me away from doing more meaningful activities too
if we look at it, the pacing around a room isn’t actually getting us anywhere
it’s actually pretty silly to look at! people laughed at me, haha. They saw me going around and around
and it’s true, I wasn’t accomplishing ANYTHING by pacing. It wasn’t solving my anxiety
eventually, tracking the number of steps you take daily to hit a goal won’t seem as important
a lot of my anxiety melted away when I let go of my need to have my daily walk. It was hard to wake up and instantly feel anxious like I had to go walk and exercise straight away. When I replaced that with other things (including eating right away) instead, it helped a lot. I realized my anxiety was centered around getting the task and completing it, like having homework. It didn’t actually give me joy to do the task, I just liked to complete things.
But in this case, completing the goal I’d set for myself (daily morning exercise) was bad for me. It was a goal that was taking me farther away from what I REALLY wanted to do, which was to recover from anorexia
nobody was telling me to do daily morning exercise but me. In fact, everyone was begging me to stop exercise. And they were right - when I stopped, I felt better. I realized that I was like a rat running in a wheel, going nowhere, running myself to death
Gaining weight = control of life again
Gaining weight will definitely make you feel better. It won't be an overnight flip of the switch - rather you will gradually see your hyperactive behaviors diminish. You'll feel better mentally and physically. I was also SO SICK of feeling like I had no control of my life - whenever I did constant activity it was not out of a sense of control, but a sense that I was out of control. By gaining weight I finally got control back over my life. You'll experience this too :)
How anorexia causes compulsive movement
Anorexia causes compulsive movement. Exercise doesn't necessarily cause direct weight loss (food intake is much more crucial to this). If you exercise past your calorie budget, your body will steal energy from other body functions to continue allowing you to move. But the thing is, this energy stolen from other body functions is contributing to other unpleasant symptoms you may be experiencing.
This is why anorexic people often have digestion issues, constipation, dry skin, slower heart rates, etc.
This is why not exercising as much is so important, even if exercise doesn't cause direct weight loss.
One of my clients with anorexia told me one day:
In 15 years I have never accepted weight gain as the goal. That is without the intention to lose it again. [But today,] I did notice that I have almost accepted that weight gain is the goal. So when I was measuring today, an extra gram or two didn’t bother me. Because it’s like, well I am supposed to gain anyway, so who cares if it's more? And I sat and studied and it felt good not to pace. Like why walk when I am supposed to gain?
I'd responded: "I’m really glad to hear that you see weight gain is the goal, so measuring more food and not walking feels better! I felt the same way - once weight gain was my goal, I was very happy to eat more and not move. And learning that I could rest instead of pace was SO amazing."
For me right now, if I move or exercise, it’s more for joy than out of obligation or fear. I am fine being sedentary and fine being more active. I only move for joy (e.g. dance! take a walk for fresh air!). I like Kelly McGonigal's Joy of Movement book for more on how to move for joy rather than out of a desire to change one's appearance, burn calories, or lose weight.
How the evolutionary explanation of compulsive movement helped me overcome it
I've always been a pragmatic person, so I was always most concerned with body function rather than appearance. At an extremely low BMI I was frustrated with how I was constantly cold, irritable, and faint. Yet because as I've learned from Dr. Shan Guisinger's work, anorexia dampens pain signals and motivates physical activity, I kept doing crazy physical activity all the time. I was literally doing intense outdoor activity often. Like when I worked on agriculture projects I was filling up pickup trucks with dozens of pounds of mulch and carrying loads far greater than my bodyweight. People were startled by how much energy I had given my very fragile-looking body.
So I never thought I was that sick, since I could still do physical activity, until discovering the Adapted to Famine Hypothesis. Then I realized all this physical activity was eating away at my bones and heart, which explained my low heart rate, low body temperature, and the feeling that my limbs were like jelly.
I did feel this restless urge to exercise all the time. For example, even after a meal when doing the dishes, to dry the dishes by hand I would walk around and around. And while eating I would constantly walk around the room. It was strange and I didn’t know why, but I just needed to move.
I think this is why the Adapted to Famine theory really resonated with me because it was the only theory that explained why I felt like I was constantly trying to flee something.
I write more about how I overcame compulsive movement in other articles on EndAnorexia.com. Also I have an article on how it's not possible to build muscle while underweight.