This post explains negative energy balance in eating disorders.
What is a negative energy balance (sometimes called energy deficit)?
Anything that means that the energy you put out is greater than the energy you put in. The most common — although not only — cause of such an energy deficit is going on a diet.
When a person decides to lose weight, they do so by maintaining an energy deficit so that their body is forced to utilize fat stores as the energy taken in is not enough to fuel the body on a day-to-day basis. However, this can happen without the person actively deciding to lose weight at all. If for example they are unwell, or they have a stressful period in which their appetite is suppressed.
As I explain in my book, Love Fat, my energy deficit was caused as I wanted to lose a bit of weight so that I was light enough to exercise my favorite racehorse. Not all weight loss is about wanting to look good. But, for most people, the pressure of society wanting them to look skinny can be the influence that starts the weight loss. While this pressure may influence an energy deficit initially, it is a whole different game of cards once an eating disorder kicks in.
So what happens with a person who has an eating disorder?
If a person with the genetic predisposition for an eating disorder such as Anorexia goes into a negative energy balance for any reason, the eating disorder is activated and they then begin to experience the mental illness that an eating disorder is. Most of all at the initial stage it is simply a little confusing — because one doesn’t really want to eat when one knows that one should — but doesn’t feel like anything that bears worrying about. At least that is how it felt for me. But, it slowly morphs into something far greater and far more malicious.
What began as an innocent diet can therefore turn into a full-blown eating disorder. The person will begin to have eating disorder thoughts in their head, they will start to have a fear-reaction to food, and they will often begin to show signs of weight loss.
Because one of the symptoms of an eating disorder is not knowing that you have one, the sufferer will usually be unaware that anything is wrong with them until the illness has caused them to lose a substantial amount of weight. Even then some sufferers (like myself) cannot see that they have an eating disorder.
When people with restrictive eating disorders such as Anorexia stop eating, it feels good.
But as most of us learn. What feels good could ultimately kill us.
For most people who go on a diet in order to lose a couple of pounds, the diet is a means to an ends and they cannot wait to be able to eat normally again. The feeling of negative energy balance for most people is stressful. That is why most people get cranky when they are on a diet. When they begin eating normally again they feel happier. The opposite happens if a person has a predisposition for an eating disorder.
For a person with a restrictive eating disorder such as Anorexia, when they go on a diet and create that negative energy balance within their body, they feel really calm, relaxed and have an huge sense of wellbeing. Then, when they go to eat again, they feel stressed and anxious. When the starve themselves is feels “right” and eating or trying to eat again feels “wrong.”
Here is the most important point in all this: For those of us with restrictive eating disorders, restriction feels like safety and wellbeing. This is why we go there. It becomes like a drug. We have to learn to resist it. We have to learn to eat regardless of how horrible eating feels. We cannot be lured into the safe space that restriction feels like.
Energy balance — as caused by eating enough to cover energy outgoing — on the other hand, feels like chaos, pain, mania, panic, unrest, anxiety. We have to be brave and do it anyway in order to not die. The good news is that after a certain level of weight restoration, energy balance starts to feel good again.
This is how I explain what energy deficit really is:
Not eating gave me this warm and fuzzy feeling. Energy deficit is the feeling of snuggling by a log fire under a blanket with a good book. Energy deficit is the feeling of being safe inside when there is a storm brewing outside. Energy deficit feels like a safe space. Energy deficit will kill me.
Energy deficit is a trap. Energy deficit is a wolf in sheep’s clothing. Energy deficit is the witch that lured Hansel and Gretel into the house made of sweets. It lures you in by making you feel snuggly and safe then it traps you there by turning eating food into a painful and terrifying experience. The longer you are in energy deficit the better it feels and the harder it is to eat.
That is the reality for a person recovered from an eating disorder. The lure is always there. It weakens, yes. But in times of stress it loves to present itself as an option that will help them feel better. This is why stressful events etc are high-relapse risks for people with restrictive eating disorders. The good news, is that for me at least, the “attractiveness” of energy deficit weakened substantially as I gained weight.
Silver lining
Once I had reached a threshold of being the right weight and not having a negative energy balance for a prolonged period of time I stopped feeling stressed about eating and went back to being the person I was before my eating disorder. That is, a person who loves food. A person who loves eating. A person who especially loves eating high-fat foods like cheese, ice cream, peanut butter, butter, etc, etc.
Now, I can get that “good” feeling from eating too. If I want to feel warm and safe on a cold night I turn on the gas fire, snuggle into a blanket, and do so with a lovely big mug of full-fat hot chocolate (with marshmallows).