Q&A Wednesday: I Lost Weight While I Was Sick, but Now I’m Scared to Eat!

Q: I hope you’re having a great day! I wanted to ask you about emotional eating since your blog is the first place I really learned about it and how much it applies to me. But I’ve now found myself in an exceptionally rough place and I’m not sure what to do.

I’ve been sick for 2+ months with abdomen issues that have only recently been finally diagnosed as stress/anxiety ulcers, but before that due to all the nausea and pain I couldn’t eat much of anything. Physical health needs aside, suddenly not being able to eat my feelings during a high stress period (trying to find a diagnosis, generally not feeling well, and other struggles) was somewhat awful. Between not being able to eat, doctors putting me on a clear liquid diet while they tried to figure out what was wrong, I’ve lost 39 pounds without trying.

So now that I’m starting to go through treatment for my ulcers and can start to eat foods again, I find myself being torn between wanting to eat ALL THE THINGS (diet is still limited, but I just keep wanting to eat now) and never wanting to eat anything because ‘yeah I was definitely starving/weakened towards the end there, but I also lost like 40 pounds so…’. I’m torn between seeing hunger as an excuse to eat and seeing hunger as an accomplishment of sorts.

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I was hoping you might have suggestions on resources for support/help, any ideas on what I should do “in the meantime,” anything at all really. 

Wow, I almost got a little choked up reading this comment. I can certainly understand the feeling here.

When I listen to people talk about having to start eating again after a debilitating injury or illness, there’s always this sort of fear of returning to food. It’s a sort of, “well, not eating helped me successfully achieve X weight, so the problem must be food…right?”

And, because the weight loss associated with the illness was the kind of weight loss they’d never figured out how to achieve healthily before, they remember the time fondly. They forget the pain and agony of enduring ulcers, which are weak points—sometimes holes—in your stomach that allow stomach acid to seep out and cause pain and discomfort and damage to other parts of the lining in your stomach or, worse, spread to other organs and cause damage there.

They forget the reflux, the dizziness. The mood swings. The zombie-like state with which you wander around when you’re starving. The headaches. The frustration. The difficulty that comes with everyday thinking. The lethargy. The pain. They forget all of the unpleasantness, because it resulted in the weight loss they’d been pining for.

And don’t get me wrong. I completely understand. I understand the feeling of fear in going back to eating, especially when you know that you have an emotional eating issue, because you know it’s ill-gotten. You know that you did the thing you shouldn’t do—cutting far too many calories—but it resulted in the thing you wanted. And, in many cases, you feel guilt for being glad that you were sick, because you lost the weight without deliberately doing the thing you shouldn’t do.

Here’s the reality, though: you feel guilty because you know you didn’t change anything in the way you lived, prior to being unwell, that would result in successful weight loss. And, because of this, there’s a looming reality: the weight is going to return. Maybe only some of it, maybe all of it. But this situation is untenable because you can’t spend the rest of your life eating so little.

We have to think critically about post-illness weight loss really represents. Your body is fighting to get well at a time where you’re not able to properly fuel the fight. During that fight, you’re not focusing on emotional eating, calories, macros, exercise, none of it. You’re focused on getting well. It changes the way you do everything during the time you’re fighting to get well.

But what happens when you’re well again? You go back to what you know. And what you know, is a lifestyle that contributes to a 35lb-heavier you. You know those habits, you know those choices, and you know those foods.

You have to change that lifestyle in order to accommodate and maintain that weight loss. You have to know that you now need to eat this breakfast instead of that one. You need to snack on these instead of those. You need to eat this portion size. You need to avoid these foods. You need to understand which foods trigger the emotional eating cycle for you, and govern yourself accordingly.

Weight loss that comes from illness can be exciting because it’s still weight loss, but remember—it comes from you being unwell. You want a healthy body, you just want it leaner, and you can’t get there starting in the position that being unwell left you.

Basically, you should expect to start gaining the weight back. I knooooow, I know.

And, no, it doesn’t mean you’re doing something wrong—it means you’re nourishing your body to be healthy, because you deserve that much. It means you’re figuring it out, and you’re developing new habits to help you make your weight loss permanent and sustainable, and that’s not an easy process. You’ll learn what behaviors contribute to weight gain, and which ones contribute to loss, and the gratification you receive from those results will help guide you in developing new habits.

In the meantime, keep your diet close to fresh produce and quality sources of protein. Make sure you get lots of protein and healthy dietary fats, and make sure each meal has lots of fiber to it. Watch your snacking, drink less sweetened drinks and more water, and find a sport or activity you love and stick to it. Read a few books on emotional eating to help you understand the root cause, and give you a leg up on coming out on the other side of this in a positive way.

Nourish yourself. Eat. Treat yourself well. Give your body what it needs to thrive, so that you can tackle this weight situation healed and healthy. Do the same for your mind and heart too, while you’re at it. And, like I always say, your body will thank you for it.