My Body Is Not A Machine

Mechanical eating... What happens when we change someone's intake without changing what intake means to them?

A simple sip of water made me feel like I had gained 30 pounds. I asked for help and a week later I was handed a meal plan that instructed me to eat 3 meals and 3 snacks per day. I went home alone with my same eating disorder that had zero intention of cooperating… This meal plan is described as “mechanical eating”. It is essentially a tool advised by eating disorder professionals to reintegrate consistent nourishment and structure. I believe there is a place for mechanical eating in recovery; however, I simultaneously believe that it is dangerous to treat it as a be all-end all solution. 

Understanding the disordered mind

Mechanical eating is incredibly complex for the mind of someone with an eating disorder. You need to imagine your most irrational fear, something so obsessive, so all consuming, so debilitating. Next, imagine being told that the only way to survive is to do that thing 6 times a day… Not only is this process excruciating, we are expected to do it on our own in between appointments before getting to even the slightest place of trust within ourselves. For me, and for others I have met in treatment, this did not dismantle disordered beliefs. At times, it cemented them. The fear of this intake, these calories and the sensation of losing control gave me impulses to compensate like I had never felt before. 

Compliance vs. Recovery

I’m tenacious. Nobody forced me to get help because the severity of my disorder was unseen by most. I chose recovery for myself, I chose to comply. Compliance for me looked like following the meal plan exactly. I ate at the right times, I ate as much as my treatment team told me to, I challenged fear foods, I used the support I had to its fullest potential. Not only did I comply, I stuck with it for three years… Three years included two residential treatment stays and consistent outpatient appointments in between. It also included an indescribably preoccupied mind. I could not enjoy anything fully. I couldn't enjoy my friendships, my conversations, my job, my alone time, I couldn’t see life outside of the lens of my disorder. Every single moment of my day was spent thinking “I ate my meals and snacks today, so I should change dinner plans with my friend so I don't need to eat”. Birthday parties for the people I love most were spent thinking about how I can leave to purge before my body digests the food I ate. Cozy Friday nights were spent anxious that I didn't burn enough calories in the day to make up for my meal plan. Naturally, I found myself questioning when I was going to feel better. My treatment team assured me that recovery is a long process, but that it's worth it. Because of this, I stayed, I continued and I remained hopeful that following my meal plan will, one day, grant me food freedom. I also remained incredibly sick. There was simply not enough psychological thought interruption, to regulate my catastrophic thinking. For me, there was  no meal, no snack, no food group ingested that could counteract the distortion in my mind. Not without an incredibly high level of supervision and care. 

What was missing? 

The motive at the end of each therapy session, both in treatment and as an outpatient, was to try out the goals and update the clinician on how it's going, during the next session. This meant “do your best until we chat again”. I couldn't even begin to count the little disordered behaviors and significant disordered thoughts in between then, and the next session. A dysregulated system cannot regulate itself. Living with an eating disorder is living in a chronic state of dysregulation and emotional distress. The weight of carrying my recovery alone was unsustainable. 

I didn’t need conversations about my thoughts and behaviors after they had passed. I didn't need a set of rules showing me how much and when to eat. I needed help learning how to trust my own body. I was born with hunger and fullness cues for pete’s sake! I was incapable of doing the work alone. That meant I required someone in tune with my mind and so intentional about my recovery that they could point out behaviors I didn't even know I had. For a period of time, I needed someone to not trust my sneaky, desperate disorder. Someone had to sit beside me 24/7, hearing me tell them I can’t do this and replying with “good, we will do it anyway”. When I found support like this, I had moments where my therapist and I sat for two hours, tears in my eyes, hesitation in my bones, terrified to ingest two bites of a cookie. Eating those two bites was non negotiable, it didn't matter if it took me all day, I had to do it and that was the attention my disorder needed to get to a better place. 

Beyond Compliance

So what happens when we change someone's intake before changing what intake means to them? We change how fueled their body is without changing their relationship with food. We teach them how to eat, without teaching them how not to be afraid of eating. When mechanical eating becomes the solution rather than a strategic, temporary support, we can teach patients to rely on new rules instead of rebuilding trust in their own body. Mechanical eating gave me structure, and unfortunately structure alone could not give me freedom. The goal of recovery cannot be to get us to finish our food, it needs to be to get us to sit at that table without believing that the meal is going to destroy us. 

-Katie <3