edema in recovery from a restrictive ED (Q&A pt. 3)
There are some symptoms and side effects that come with recovery that aren’t talked about enough – because they’re kind of uncomfortable. And one of those symptoms is water retention. Edema in recovery is the norm rather than the exception, and it doesn’t necessarily make weight gain any easier to accept. But first, let’s look at what water retention actually is, why it’s so extreme in recovery, and how you can best take care of yourself now.
Hey, I'm in recovery from a restrictive eating disorder. For the past few months I've had uncontrollable extreme hunger and I've been eating to the point where I've had really bad water retention all over my body. I sweat at night and I can go up to 4000-5000kcal daily. I'm scared of developing binge eating and my body is changing so fast it's bothering me. How long does the water retention last? I don't know if this is normal and I don't know what to do 🙁
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What exactly is Edema/ water retention?
First a small disclaimer: I am not a doctor and do not know your individual case. I will only show you possible causes and solutions here – if in doubt, consult a doctor, because water retention can also be a sign of refeeding syndrome, which should best be treated in hospital.
Water retention or, in medical terms, edema, comes from the Greek: οιδημα (“oidema”) – swelling. Synonyms are also water retention, or “dropsy”.
Edema is when fluid builds up in an area of the body (outside the blood vessels in the tissues). Due to gravity, the fluid often collects in the legs, especially around the ankles. In general, edema is caused by excess pressure in the smallest blood or lymphatic vessels, which causes fluid to leak into the surrounding tissue.
They can have different causes – for example, summer/heat and long periods of standing, high salt consumption, allergies and infections, hypothyroidism, hormones and medication. Unfortunately, there can also be more serious causes, such as heart or kidney weakness, venous weakness, liver weakness or lymphoedema.
So if you are unsure, always consult a doctor!
possible causes of Edema in recovery
Although the pathophysiology of edema in the refeeding phase of restrictive eating disorders is not fully understood, there is general agreement that water retention is a common symptom in recovery. According to studies, the following points can be considered as possible causes:
- Increased insulin secretion that occurs with refeeding – By now having more energy available in the form of glucose than during malnutrition, the body increases the secretion of insulin – which opens up the body’s cells to absorb and store energy. This is an important and good process. However, an increased insulin level also means that (to put it simply) more salt is stored in the body. This in turn binds water in the body.
- Medication and hormones (especially estrogen and progesterone) – these also play an important role in recovery, since the hormone balance must first be restored and balanced after malnutrition
- Malnutrition itself: a so-called “bulge of hunger” can result from a lack of protein and too little calorie consumption
How you can recognize Edema in recovery
- Rapid weight gain – or greater weight gain than expected based on your calorie intake
- Swellings on the body extremities (arms, fingers, legs), but also, for example, eyelids and in the abdominal cavity
- cracked skin caused by the swelling
- Stiff limbs: it’s like feeling “run over”.
- Sensation of pressure up to pain
"it´s just water, I haven´t actually gained weight"
And what would be the problem if it’s not just water? In most cases it is important, right and necessary for the weight to stabilize and for you to reach your set point. (In the optimal case, the weight overshoot even occurs, as this can be associated with a lower relapse risk).
So, no matter how difficult it is for you right now – try not to fool yourself. You’ll probably need to gain weight anyway in the recovery process. Your body alone knows how much. In any case, I advise you to deal with your fear of gaining weight. What happens if you actually gained not only water but also body fat?
A coachee once summed it up nicely: I’ve gained 12 kg and I’m still alive. What the eating disorder once called “the end of the world” is actually not that bad and you will learn to accept your new body as it is. It’s not going to look the same every day for the rest of your life anyway. You don’t have to be afraid of gaining weight or Edema in recovery.
tips to soothe the symptoms of Edema in recovery
- if that’s allowed in your case: moderate exercise – such as yoga or leisurely walks to boost blood circulation
- Cooling: Get cold compresses or take a cold shower once a day (or contrast showers, for example)
- Put your feet up – relax. Declare war on your urge to move
- wear loose clothing – this not only helps you to deal with the weight gain, but also prevents clothing that is too tight from possibly cutting into the tissue and thus promoting water retention
- Pineapple, melon, strawberries, raspberries, asparagus, potatoes, brown rice, artichokes, … are said to have a draining effect
- Studies show that a low-salt diet can make sense, especially for patients below a BMI of 15, who are very afraid of gaining weight
- wait and see and drink tea (literally!) – it sounds paradoxical, but not drinking enough promotes water retention.
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