We Need To Talk About Overshoot.

I know, I know. This is a scary topic.

I remember being in hospital and overhearing a conversation between two patients about it and thinking it was some sort of myth or joke to scare me. (It should be noted that during this time I was pretty paranoid about practically everything, but now looking back on this exchange I can rationalise the fact that not everyone is always talking about me or plotting against me…).

But after a few more admissions, a lot of therapy and hours of research, I think I can finally say that I understand overshoot. This post is my effort to share what it actually is, why is happens and hopefully put someone at ease if they’re struggling to trust the process.

Deep breath, don’t hate me, here goes.

The definition (well, my definition) of overshoot is: the temporary storing of extra fat, when recovering from a restrictive eating disorder.

Important emphasis placed on “temporary” here, as the overshoot WILL GRADUALLY and NATURALLY BE LOST once the body reaches it set point.

Now that’s out of the way, lets get one important thing straight.

I don’t care what that one GP, dietician or psychologist told you once – a “healthy”, but low BMI is almost certainly not going to allow you to fully recover. Especially if you’re coming from a severely underweight state. I know that health-care professionals often give you a “target” weight to reach, but newsflash, once you reach that number you are not recovered. Recovery doesn’t care what weight you’re at. It’s about your mind.

Of course, anorexia can affect people at any size, weight or BMI. But if you are restricting your food in any way, your body probably needs to gain more weight, no matter what your BMI is.

Also, something important to remember is that even if you’re classed as “overweight” or “obese” in terms of BMI, if the thought of gaining weight, eating more or resting scares you, that’s probably exactly what you need to do. Yep, read that again. If the thought of gaining weight, reducing excessive or just eating more scares you – you need to do it.

Once again, anorexia is a mental illness. If the mental symptoms are still there (like having fear foods and feeling guilty for eating) you still have a way to go with recovery.

By this point you’re probably thinking “okkkkkkkk but what does that have to do with overshoot?”.

Well, the thing is: if you are eating whatever you want and not exercising and you’re gaining weight, YOUR BODY NEEDS TO GAIN THE WEIGHT. And your body really, really doesn’t care what weight it’s starting at.

Something I used to always forget and often on remembering never believed, is that people without eating disorders do genuinely eat what they want and don’t excessively exercise and guess what…. their weight settles.

So, if you’re recovering from a malnourished state (again, at any weight because you can be in a calorie deficit at any size), and are eating more than you were previously, your weight will have to increase.

This is where overshoot comes in.

As previously mentioned, overshoot is the phenomenon whereby your weight increases above the level that it was BEFORE ANY RESTRICTION OR WEIGHTLOSS. (This means that in recovery you’ll probably weigh more than you did before your eating disorder kicked in).

Now this can understandably be scary. If you’re like me, you’ve probably imagined reaching a “healthy” body weight then your brain magically reaching “healthy” too. That’s not how it works. During overshoot you’ll actually need a heck of a lot more fat than the average person without an eating disorder before you brain even behind to recover (more on this later).

However, overshoot does and will naturally and gradually drop back, restoring pre-eating disorder weight, IF and only if, you don’t interfere with the process by trying to manipulate your weight again.

Full refeeding (i.e. letting overshoot happen and committing to the whole shebang) is absolutely essential for reaching your true set-point and restoring the optimal ratio of muscle, bone, water and fat in the body.

Now let’s talk about fat.

The thing about recovery is that fat tissues need to be restored before other tissues, like muscle and bone. And yep, this means that during recovery your body will probably feel a lot softer than expected but this is ALL PART OF THE PROCESS.

This is obviously extremely scary, but its important to know that if the fat isn’t restored first, the extreme hunger will continue and the fat-free mass will never have the chance to restore itself.

It also means that it’s important to rest and completely reduce your exercise in recovery. To be honest, you should be doing as little as possible. YES, even if you’re “overweight” in terms of BMI.

You’ve probably heard of the term “set-point theory”. Your body has a fixed ratio of fat to fat-free mass (which is your set point), which means you literally have to gain the “extra” fat and overshoot to complete the restoration process and fully heal.

An important thing to note is that, shown in a study by Dulloo et al. 2017, it was found that the more underweight and severe the initial starvation is to begin with, the more overshoot is needed to complete the healing process.

This is kind of a big deal to me and I’m pretty sure I cried when I heard this, because when I began to overshoot, I did a LOT of reading on the topic. I read blogs, articles, captions, tweets. I saw that people were overshooting but by about 10% of their pre-eating disorder weight. I read that the “average” person overshoots by around xyz and they wore X size bigger jeans. I saw damaging and triggering overshoot before and after photos.

Personally, I couldn’t relate. They were barely bigger than their pre-ED weights. I, however, was well over 10% heavier, well over X size bigger jeans and well over their “after” photos.

So I’ll say it again, set points and natural body weights differ between everyone.

Keesey and Hirvonen 1997 showed that set points can be influenced slightly by environmental factors, but for most people a BMI of 20 will never be healthy or a natural place to sustain your body weight.

Even if your set point before an eating disorder was 20, your recovery should definitely not stop as soon as you reach that weight.

Also, because like many people, my anorexia developed in my mid-teens, I don’t actually know what my healthy, adult set point weight is. For us, we just have to wait and see and…. TRUST THE PROCESS!

So back to the point. You CANNOT recover from anorexia if you “decide” a weight or BMI that you will get to and stick to. That would involve actively restricting and dieting.

It seems obvious, but dieting and recovery are completely incompatible with one another – both physically and mentally.

And then there’s your metabolism.

Metabolism is so confusing. But one thing is for sure: your metabolism won’t normalise until you overshoot then reach your set-point.

Overshoot boosts your metabolism from the devastatingly slow rate when malnourished, to the normal rate. Once your metabolism has been boosted (after spending a considerable amount of time at the overshoot, allowing the body and mind to heal), you’ll be able to eat whatever you want, whenever, and not exercise without gaining any weight.

To reiterate: this can only happen if you let your weight get to where it needs to be without interfering.

If you do interfere by trying to manipulate your weight again, your metabolism will remain lowered and you’ll end up needing to restrict forever in order to stabilise your weight. No thanks.

Once at overshoot, your body won’t increase it’s metabolic rate or repair anything straight away.

According to Gwyneth Olwyn, the order of healing during recovery goes:

1. Retention of fluid for cellular repair

2. Normalising the functioning of the kidney and liver

3. Deposition of fat (particularly around the midsection to protect vital organs)

4. Major long-term repairs

5. Neuroendocrine and metabolic reversion to normality

Right ok. What does all that mean?

Number 1 tells us why we gain weight SO FAST during the first few weeks of recovery from restriction. It also explains the swelling, bloating and fullness.

Number 2 tells us why we experience things like extreme, insatiable hunger and get sleepy all the time. They’re signs from our body that we need more energy to fix the internal stuff. It also explains why eating still feels so hard, because our brains haven’t even started to fix themselves yet. It’s doing the life-saving physical stuff first.

Number 3 makes us terrified. But, it tells us why often “recovery bodies” involve having a much larger waist than our pre-eating disorder bodies and that our bodies really do not care about being toned right now. If you are yo-yo-ing between recovery and restriction, this phase will last a loooooooong time because your vital organs need constant energy (who would’ve thought eh?!) and probably don’t trust you enough to normalise the fat deposits yet.

Number 4 can only occur if enough energy remains available after all the other repairs have happened. Once you reach phase 4 though, things like extreme hunger ease off and by the very end (the actual end, not the end your anorexia wants you to believe), your metabolism will be speedy, your brain will be ED-free and your overshoot will drop off. Woohoo!

So, if you’ve started recovery but are scared, or an unhelpful professional has set you a “target BMI” (🤢), remember that REAL, full recovery to your natural and unrestricted set point weight can only happen once overshoot has occurred.

You can’t predict or compare absolutely everything about recovery to anyone as everyone’s journeys are different. And that’s terrifying. But take it from people who have done the research or experienced it first-hand: embrace the fear, trust the process and KEEP GOING.

• 

Dulloo, A.G., Jacquet, J., and Girardier, L. (1997). Poststarvation hyperphagia and body fat overshooting in humans: a role for feedback signals from lean and fat tissues. American Journal of Clinical Nutrition, 65(3), 717-723. Abstract here

Dulloo, A.G., Jacquet, J., Miles-Chan, J.L, and Schutz, Y. (2017). Passive and active roles of fat-free mass in the control of energy intake and body composition regulation. European Journal of Clinical Nutrition, 71(3), 353-357. Full text here

Kelsey, R.E., and Hirvonen, M.D. (1997). Body weight set-points: determination and adjustment. The Journal of Nutrition, 127(9), 1875S-1883S. Full text here