Many of the folks who know me are aware that I neither drink nor do drugs. While I tend to have several boundaries about what I do and do not share about my path of recovery online, I will say that the healing that I have done in the 8+ years since I committed to sobriety is an important aspect of my work with body love, strength, and self-acceptance.
Something that has been on my mind a lot the last few weeks has been a topic that is, I believe, not discussed enough in either the recovery community or the fat liberation and body positive communities: the complex relationship between recovery from drugs and alcohol and healing from internalized fatphobia.
An Overly Simplified Bit of Background
All too often, drug addiction and malnutrition go hand-in-hand.
In fact, a study of over 250 opiate addicts revealed that “Clinical signs of nutrient deficiency were diagnosed in about 74 % of drug addicts [while] biochemical values and nutrient deficiency signs indicated that more than 60 % of drug addicts were suffering from multiple malnutrition.”
Further research has revealed that “Excessive alcohol use is highly prevalent and a major cause of nutritional deficiency in developed countries,” and that “the prevalence of malnutrition varies depending on the presence and degree of cirrhosis and ranges between 20 to 60 percent.”
The reasons for this are complex and multifaceted: some (but not all) of the factors include the effects of drugs and alcohol upon the digestion process and the brain’s ability to recognize hunger signals, the financial challenges that are involved in avoiding withdrawal symptoms, and the pragmatic difficulties presented by finding food within food deserts.
Impact on Early Recovery
This malnutrition often, but not always, is accompanied by a decrease in body size that occurs concurrently with the horrific health consequences. This wasting away becomes profoundly problematic when we examine the impact of institutionalized sizism and internalized fatphobia on people in today’s world: all too often, folks who are in the throes of active addiction can cling to their smaller size as one singular source of positive self-worth.
Enter the desperation that leads to a commitment to recovery, whether through the help of a therapist, medical detox facility, community of recovery, and/or spiritual community.
As the body begins to heal from the harm done to the digestion system and as the brain clears enough to once again recognize the body’s hunger signals, a healthy appetite returns that once again enables the person in recovery to nourish themselves with adequate nutrition.
One result of this is that the body is able to once again find its set-point. This is a wonderful turn of events for the recovering person’s health and wellbeing, as the weight set-point that the body naturally maintains when its hunger cues are listened to and honored is the body’s homeostatic point for optimal functioning.
It is also often, though of course not always, higher than the weight that the recovering person’s body was at when they were in active addiction. This wouldn’t be a problem in the least… if it weren’t for the impact of systemic sizism and the resultant fatphobia that most people in 21st century America have internalized.
What can happen is that the certainly precious and almost inevitably vulnerable recovering person can be faced with the very real challenge of navigating the complex emotions that arise in early recovery… while also feeling that one of the sources of their understanding of their self-worth (the smaller size that resulted from active addiction) is vanishing.
The resultant suffering is real, and it needs to be met with the messages of the fat liberation movement: neither your size nor your level of socially-recognized attractiveness has any impact on your value, worth, or all-around awesomeness. Who you are, exactly as you are, at precisely the size you are is whole, complete, and endowed with more power than you know.
Self-Harm is Transferable
Unfortunately, those are not the messages that are most prevalent from rehab centers or communities of recovery. All too often, the response to a recovering person’s concern about their weight change is some combination of commiseration at the supposed misfortune of gaining weight and suggestions for a restrictive diet.
This is horrific in its implications. It has long been known within the eating disorder recovery community that “Frequent dieting disrupts our body’s natural relationship with food… and stands as one of the primary predictors of eating disorders” (Source here). A three-year long study showed that “Dieting is the most important predictor of new eating disorders,” and it is well documented that anorexia has a higher mortality rate than any other mental illness.
As a result, when recovery communities (including medical detox facilities) recommend changes in diet to those who are seeking recovery from addiction, they are very literally placing them at risk of developing an eating disorder and risking early death from yet another source, even while they are still vulnerable from having survived the ravages of addiction.
The urge to self-destruct does not magically disappear when someone puts down the drugs and alcohol. To reach the level of healing where one truly wants to flourish, grow, and live a full life takes deep, hard work: it is work that is many times over worth doing, but that doesn’t make it easy.
As a result, communities of recovery are called upon to unlearn the toxic body shame that permeates present-day society: to do otherwise is to share deeply harmful messages that promote self harm to folks who are already facing the challenges that are implicit in learning how to live a life without drugs and alcohol.
With all of this in consideration, it is of no surprise to me that, according to the National Eating Disorder Association, “Up to 50% of individuals with eating disorders abused alcohol or illicit drugs, a rate five times higher than the general population. Up to 35% of individuals who abused or were dependent on alcohol or other drugs have also had eating disorders, a rate 11 times greater than the general population” (Source here). We simply cannot ignore the harmful impact of restrictive approaches to eating on people who are recovering from addiction.
In order to help people in recovery discover their potential for healing, the messages of radical body positivity and fat liberation must be learned, understood, and embraced by the addiction recovery community. Food shaming, diet talk, and fatphobia have no place in spaces of healing.
Feeding and Clothing Oneself Through Renewed Health: The Financial Challenges Are Real
Another very real consideration that needs to be acknowledged in the capitalistic society of present-day America that is so steeped in class inequity is the financial challenge of feeding and clothing oneself through the physical changes of early recovery.
As a result, it needs to be acknowledged that some people in recovery from drug and alcohol addiction have an even greater difficulty in establishing a healthy relationship to food due to food insecurity.
My hometown, Rochester, NY, is fortunate enough to have several organizations that work to combat food insecurity, including Food Not Bombs, Foodlink, and a variety of food cupboards; it can be profoundly helpful for each of my readers to learn about the various organizations within their areas that are working to ascertain that everyone has access to adequate amounts of food. In addition to Google searches, calling 211 may be a way that you can gather additional information that you can use to help yourself or others.
Unfortunately, even these are not enough to truly eliminate the impact of food insecurity within the Greater Rochester area. The humbling truth of food insecurity cannot be overstated, and it has a magnified impact upon those who have had to navigate drug and alcohol addiction.
Another way that changing body size can impact people is, of course, through the resultant need for new sizes of clothing. This is an inconvenience for many, but can be nearly impossible for people who are navigating the financial realities of early recovery.
Some options for people within my local community of Rochester, NY are the Goodwill Clearance Center, Greenovation, and Matthews Closet. While I am not certain what options there are in all locations, reaching out to 211, your local food pantries, and/or the hospitals in your area can be ways to find information about what is available in your area.
Rochester, NY is also fortunate enough to have several “Buy Nothing” and “Free for All” Facebook groups that encourage their members to post items that they no longer need and/or to ask other members for items that they are in need of. These groups encourage moving away from the exchange of currency for all of our needs, reducing waste, and building community. If you are on Facebook, search for “Buy Nothing” and the name of your town to see if any similar groups exist in your area… and if not, consider starting one!
Access to food and clothing are basic human rights that are denied to all too many people. When people who have faced the effects of poverty, eating disorders, and/or drug and alcohol addiction experience changes in their body size, it is imperative that their needs for food and clothing are adequately met; to deny these basic needs is to deny our fellow humans their right to survival and healing.
You Are Not Alone: Help Exists
If anyone reading this is navigating the process of accepting and learning to love the changes in your body size as you heal from disordered eating and/or drug and alcohol addiction, I want you to know this: you are not alone. There is an entire community of people working towards fat liberation who offer support as you heal from the narrative of sizism and self-judgment.
With the understanding that healing is complex, multifaceted, and not in the least bit linear, I offer the following suggestions to your consideration:
- Do not deny yourself the value of professional help as you navigate your path of healing. The Association for Size Diversity and Health (ASDAH) maintains a list of therapists, social workers, registered dietitians, and other specialists who are committed to the values of fat liberation and Health at Every Size (HAES).
- Unfollow/unfriend social media pages that discuss food restriction, food moralizing, dieting, and/or thinspiration. If any of your friends, family, or loved ones share about intentional weight loss, dieting, or food restriction on their social media, unfollow them or snooze them for 30 days to give yourself a respite.
- Instead, follow the folks who are doing the important work of fat liberation! Some of my top recommendations are Substantia Jones of Adipositivity (on Facebook and Instagram), Christine Walker of Fat Folks Can (on Facebook and Instagram), Amber Karnes of Body Positive Yoga (on Facebook and Instagram), Charlie Shipley of all-around awesomeness (on Instagram), Jenna Weintraub of Body Love Yoga (on Facebook), Melissa Toler (on Facebook and Instagram), Decolonizing Fitness (on Facebook and Instagram), J Aprileo of Comfy Fat Travels (on Facebook and Instagram), and Nalgona Positivity Pride (on Facebook and Instagram). You can also follow me on several additional platforms, including Facebook, Instagram, LinkedIn, and YouTube. That’s just a very, very partial list… but if you follow those suggested folks, you’ll be getting the right auto suggestions from there!
- Learn about the fat liberation movement; one place to start is this earlier post of mine!
Above all, question every single assumption that implies that you, your body, and your worth need to be smaller in order to be more valuable. The world needs more of you and your bold, deliberate self.
If you have questions, or if you think your company or organization would benefit from more training in the area of fat acceptance, please feel free to leave a comment or to contact me through www.positiveforcemovement.org!