I was first introduced to the “all in” approach through  Stephanie Buttermore’s Youtube channel. As a former bodybuilder, Stephanie dieted for years to stay lean for bikini competitions. As mentioned in the “starvation” section, hunger cues may be dysregulated as a result of restriction. In the beginning stages of recovery, someone with disordered eating may not feel hungry despite their body’s energy needs and/or become prematurely full while only eating a small amount.

Conversely, as with my experience, I felt hungry all the time even though I was completing my meal plan in treatment. Some call this “extreme hunger,” which is the body’s response to coming out a famine. It doesn’t know when the next drought will be, so it attempts to consume as many calories as possible in the window you’re eating. I want to highlight the importance of dieticians helping  to destigmatize extreme hunger with a short retelling of my experience:

On day 2   at my second treatment center (second attempt at recovery, first ED center in 2021), I completed my meal plan. I was feeling scared and discouraged that I had consumed more food that day than I had eaten in months AND I still wanted more. When I asked the dietician on assignment,  she questioned whether it was really hunger or just physical pain from my stomach stretching. While this was likely due to  her own failure to look inward and admit she had “messed up” her calculations of exactly how much I should eat, it should’ve been celebrated as a brave accomplishment. Instead, it caused greater confusion and mistrust, simply because she was uneducated.  While there are a lot of benefits to doing recovery the conventional way, this is one area that needs a lot of improvement. Professions in the field should be  encouraging trust and respect with one’s body, rather than attempting to control intake with science.

In an effort to restore her hunger cues, Stephanie ate to satiety every day for three months. This allowed her ghrelin (hunger) and leptin (satiety) hormones to regulate. While Stephanie initially overshot her set point weight (see the page on Movement), her body eventually fell into a new normal, unsuppressed, body size despite continuing to eat to satiety. While this method may work for some, I was/am  afraid to gain weight at such a rapid pace. This is why most treatment centers gradually increase/adjust your meal plan in recovery.