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Appetite

The End of Feeling My Hunger Becoming Nausea?

The difference between being hungry and starving yourself

I started a blog post a few months ago about the difficulties I was having with hunger when it got too extreme. I never finished it, partly because the problem stopped recurring. This was in turn partly due to the fact that, during a 20-week post-treatment check-up session with my therapist, I asked her for advice, and what she said helped me to deal cognitively with the problem when it arose. I've been thinking lately about how these difficulties now seem to have dissolved more lastingly, and decided it's therefore actually more important, not less, to finish off what I started writing before.

Most things are so easy now, compared to how they used to be: days don't feel like infinitely repeating battles - against coldness, tiredness, and hunger. But now and then I struggle, and am angry with myself, and sad, that I can't yet quite manage to be better effortlessly.

Three episodes stand out in the past months, and all have followed the same pattern: going too long without eating, feeling hunger again, and then struggling to eat when I try to. The first time, my boyfriend and I had driven to his office on a Saturday morning, for him to finish something off there while I kept him company and worked on my thesis. It was quite fun and cosy, at first, sitting there at separate desks, going down to a café for coffees (and a slice of cake for him), asking each other for advice once in a while. But it soon became clear that it was going to take him longer than he'd thought, and lunch time came and went (though breakfast had been quite late), and my hunger became all-consuming, yet I couldn't make myself say to him: let's stop.

He suggested we go for lunch and come back, but I couldn't bear the idea of having to come back and spend the rest of a precious sunny Saturday in the hot office, so I said no, and we carried on. I think maybe I asked him a few times how much longer he'd be, and then offered to help, and did my best to, and then went back to my own work again. All the while my hunger and hence my misery and anger were growing, and yet I couldn't bring myself to succumb to the need for food, when there was still so much work I could do, and he needed to.

It wasn't till afterwards that I configured it clearly as a struggle between all the old triggers and impulses and habits and the new logic I'd developed with my therapist to deal with them. It just felt feverish and messy and irresolvable. I don't know quite what gave me the strength, in the end, to get up and go to him and say: I can't bear it any more; we need to go. I suppose then he saw in my face the exhaustion and the incipient anger, and we went. We stopped at a sandwich shop on the way back to the car, just closing for the day, and bought big filled baguettes, and went to sit by the river to eat.

But everything in me rebelled against eating: I didn't want to be here with him at all, could hardly speak to him or even look at him for my (unreasonable) anger, and the sight of him eating repelled me as it never had before and never has since. I felt sick with hunger, and as though I'd been plunged deeply back into everything that hunger had meant to me, so recently. I wanted to cry, and not to have any of these awful complexities. It had been so easy, before: food had its place, late at night, and work had its place, for as much of the day as I could manage, and never the twain could meet. And now I was supposed to be eating regularly, but what if life didn't allow it? But then I'd brought some chocolate with me, so why hadn't I eaten it, or had some cake myself with coffee? Life did allow, almost always, but I still couldn't let myself - and why should I, if there were things to be done? And why hadn't he noticed - but why should he have done?

We were silent in the car most of the way back, until I began to cry, finally, and he began to understand. We talked it all through, and he felt deeply guilty for having orchestrated the perfect set of circumstances to make me feel this way. He also tried to reassure me that at least, in the end, I had said: stop now, I can't bear this any more. We both learnt a lot from the episode, I think.

A couple of months later, my father and his girlfriend had come for a weekend on the boat after my last session with my therapist, and we had a lovely time cruising upriver in the sunshine, and having a barbecue in a meadow in the evening. On the Sunday morning, my boyfriend and I were up before they were, and had cups of tea while he fished and I watched him or did some work; and when the others did get up, they said they wanted to go into the village for a newspaper before breakfast, and by the time they were back we were both terribly hungry. My boyfriend had persuaded me to have a piece of bread, I think, and had had something himself too, but the morning had stretched on, and by the time he and I began cooking I felt angry, faint, and sick.

We went out on to the bank with the fried breakfast, but as we began to eat, the sound of everyone chewing and swallowing seemed magnified to a grotesque degree, and they seemed oblivious to the anguish they were causing, and I began, again, to cry beneath my sunglasses. I think it was as much a cry for sympathy, or understanding, as anything: I wanted them to know that I still struggled, even as I hated to reveal my weakness thus, on the weekend celebrating my official recovery. Maybe I wanted them to acknowledge the extent of that recovery, just by giving them a glimpse of what fragilities it still contained. I don't know - at the time it just felt like deep nausea and the longing to be anywhere else in the world but there with that plate of food on my lap.

The third episode was the one I wrote about in a separate post, ‘Bumps in the road to recovery'; that evening trying to eat dinner while a friend made comments about eating and her body was the occurrence which sparked off writing about the others. That November evening is a long time ago now, though, and I haven't felt the shift from hunger to nausea again since.

My therapist, when I asked her about it, said that the most important thing was to distinguish between the hunger I was feeling these days and the sort I used to feel when I was really starving. The old hunger was one of self-denial and power, and all the attendant illusions; the new one is a much lesser thing, of waiting till the next meal is ready, and with the knowledge that it's right to be hungry because food is on its way.

She also suggested that instead of just musing on the sensation, I might try physically distracting myself from it, by doing some cleaning or some other exertion, and ‘checking in on myself' at intervals: both fighting the hunger with another activity, and contemplating it as an object of inquiry. I suppose another thing she might have said was, ‘just eat something small', except that then I was also slightly worried about seeming to keep putting on weight despite not feeling I was eating excessively. By that point, I was slightly above the top end of the ‘healthy' BMI range, and feeling periodically anxious about it - though not willing, either, to begin anything much like dieting to deal with it. Recently, though, I've lost a little bit of weight: in part by watching things like portion sizes a touch more than not at all; but more importantly just through being busy and through food having lost the status of something ultimately meaningful and incomparably delightful - though it still can be the latter. I've now lost enough to put me back in that (ultimately quite arbitrary) ‘healthy' box - and so perhaps other worries have been diminished too. (That might in itself be a cause for worry, of course - a sign of taking a dangerous pleasure in weight loss - if it weren't for the fact that it occupies my thoughts rather little compared to most other things going on just now.) In any case, her comments helped hugely - and so has the simple passing of time: the ever-increasing ease with a pattern of eating that's neither completely routine-bound nor very chaotic, either in timing or in substance.

Maybe I'll talk next time about what the knowledge of having lost weight again has been like; certainly, despite not preoccupying me, it feels as though it has the status of another minor milestone. There are so many more of those than I could have imagined before I began, and each matters quite a lot without my having to try too hard to reach it, or thinking about it much once it's passed. The loosening association between the hunger I feel now, if a meal is too late, and the hunger I used to feel, when my single meal was always too late, is a grand and symbolic relief.

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