In this episode, Julia Trehane provides an in-depth exploration of extreme hunger, a common experience during recovery from restrictive eating disorders. She begins by defining extreme hunger (also known as hyperphagia) and outlining its key characteristics, including persistent cravings, a drive to eat large quantities, feeling out of control around food, and physical symptoms like fatigue.

Julia delves into the biological reasons behind extreme hunger, such as hormonal imbalances involving ghrelin and leptin, metabolic adaptations during starvation, and nutrient deficiencies. She also discusses the psychological factors at play, including refeeding syndrome, food preoccupation, and anxiety around eating.

The episode highlights that the experience of extreme hunger can vary greatly between individuals, influenced by factors like the severity of restriction, metabolism, psychological traits, nutritional status, and activity levels. Julia shares her own experience of near-constant grazing.

Throughout the episode, Julia addresses common concerns and questions about extreme hunger, such as whether to exercise to compensate for increased intake (which she advises against), fears around weight gain, societal pressures related to food and body image, worries that the extreme hunger will never end, and concerns about developing "bad habits" like frequent snacking.

Julia provides reassurance that extreme hunger is a temporary and necessary part of recovery, helping restore nutritional deficits and repair the body. She explains the set point weight theory, which suggests the body has a natural weight range it works to maintain.

The episode offers practical tips for coping with the emotional challenges of extreme hunger, including surrendering to the process, seeking professional support, educating oneself, practicing self-compassion, maintaining a structured eating schedule while honouring hunger cues, and finding enjoyable distractions.

Overall, Julia aims to normalise the experience of extreme hunger, provide a compassionate perspective based on science, and offer guidance to those navigating this difficult but crucial phase of eating disorder recovery.

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