Written by Talia Cecchele
Just the thought of recovering from an eating disorder can be daunting. Trying to imagine a life without your eating disorder can seem impossible and ambivalence about taking that leap of faith extremely strong.
You may have come across the term "All In" during your recovery. It became popular when YouTuber Stephanie Buttermore decided to document her All In journey to food freedom two years ago.
All In is a glamourised and catchy phrase for full commitment to eating disorder or disordered eating recovery but with a slight twist. Going All In means:
giving yourself full permission to eat until you are full and responding to your hunger (both physical and mental hunger)
no tracking calories, macros or following a meal plan
ditching the scales which means no tracking weight or measuring your body in any way
giving up eating disorder behaviours
allowing your body to rest and take a break from physical activity
All In in the initial stages is not "normal" eating or eating according to government dietary guidelines. Initially, if you give yourself unconditional permission to respond to hunger there is a possibility that you could eat more than double the amount of food the average person requires to maintain their weight (I'm talking 4000-5000 calories a day). This can be an extremely distressing and confusing process in eating disorder recovery but it is a well known response to starvation and severe hunger which was documented in the starvation study in the 1940's.
In All In there is nothing holding you back in your recovery which sounds very promising, but let's look at this approach from all angles.
Positives of going All In:
Potentially quicker weight restoration as going All In means that your body will receive the energy it needs without restriction as you stop trying to fight against biology and trust that your body will go back to a weight it thrives at
Overcome fear foods and food rules by giving yourself unconditional permission to eat all foods, including nutrient dense (high energy) foods such as burgers, cake, ice cream and biscuits which is what the body commonly craves in recovery
Normalises portions and volume of food needed for recovery and potentially normalises regular eating quicker
Permission to respond to and trust hunger cues (and fullness cues with time) which helps to achieve the volume of foods required for recovery
Commitment to full recovery
Negatives of going All In:
Eating disorders aren't just about weight, so as much as weight restoration and restoring normal eating behaviours is needed, psychological treatment is recommended as well. Going All In can sometimes neglect that psychological treatment is key to recovery from an eating disorder. Weight restoration alone does not lead to full recovery
Lack of meal support and direction on how to return to normal eating and intuitive eating which can be confusing to navigate alone
Meal comparison and distress over eating larger than normal portions. This can lead to feelings of over eating or binge eating. The fear of continued loss of control or binge eating can cause people to stop eating the required amount for recovery which leads to feelings of failure
Many people experience extreme fullness after following a restrictive diet for so long and/or being underweight. If they were to eat according to hunger following the All In approach, there is a risk that they might not be able to eat the required volume to weight restore
Going All In without the support of a treatment team is not safe if you are at risk of developing re-feeding syndrome or are medically unstable/at risk (e.g. abnormal blood tests results, low heart rate). Anyone at medical risk requires close medical monitoring and a graded increase in carbohydrate and nutritional intake to prevent re-feeding syndrome form developing
Going All In is not appropriate for everyone. I would not recommend this approach if there is a history of trauma, self-harm, severe dietary restriction or engagement in significant compensatory behaviours (e.g. purging, obsessive exercise or laxative abuse). Therapeutic support and medical monitoring should form a part of treatment as it is important to receive support for body image distress, weight changes and help to replace any unhealthy coping mechanisms with healthy ones.
Of course, some people choose to go All In with the support of a treatment team however the approach would be different to the one seen on social media.
It is important to remember just because you don't choose to go All In that does not mean that you are failing at recovery. I have not know anyone to be 100% committed to recovery at all times. Eating disorder recovery looks different for everyone and takes time. There is no quick fix and sometimes it may feel like you have taken ten steps back only to take one step forward. What matters is that you keep showing up each day and do the best you can.
If you need support in your recovery, we offer 1:1 support at the TCN clinic to help you overcome food rules and find food freedom. You can find out about more about how we can support you here.
Talia Cecchele Nutrition is a team of registered dietitians specialising in eating disorders and disordered eating. We aim to bring balance back to nutrition, help you to break free from food rules and find food freedom. To enquire about private consultation please fill out a contact form.