Hi Sam,
Thanks for your message. It's absolutely great that you are in recovery, it sounds like you've come along way.
There are a few of things to consider.
Firstly I would really encourage having the support of a dietitian if you are planning to become pregnant so they are able to support with the right food choices. But even more significant is to have the support of a dietitian after you have had the baby (I know you're not pregnant yet, but it's good to think ahead). This is a time you will be vulnerable as post-pregnancy can mean you are susceptible to depression especially when your hormones are all over the place, and with an eating disorder it's very easy to try and lose your baby weight unsafely. Just something to consider.
- One of the things which you need to consider is just how far you have come. Be kind and congratulate yourself, you are doing really well. It's also completely normal to have set-backs. One of the things that really helped me is having portion guidance as this has pushed me to eating carbs because I don't feel I'm having too much. The flip side to this is that I do measure and calorie count (something my dietitian agreed was more sensible as I would be inclined to eat under). Obviously I'd like to move away from this, but it has really helped me spread away from "safe" foods.
- While you are gaining, have you thought about being under a health team (GP, dietitian...perhaps some counselling?). You're dealing with a big thing, and having support can help you manage challenges that come up and where you want to give up.
- Mental coping mechanisms. I previously worked with a therapist and our prime focus was on DBT (dialectical behaviour therapy), which is a cousin of CBT. DBT works on sitting with difficult emotions and feelings. Techniques such as mindfulness, pros and cons, connecting with the senses, taking time out in the day to be kind to yourself, putting things in place which you enjoy doing...
For me, mindfulness is awesome, but I also utilise things such as my music playing, candles and writing. You can get DBT apps on your phone which give you plenty of suggestions and help you label your feelings. I use something called DBT diary, but there are plenty of others out there too.
- On following your meal plan and exercise. You need to focus on your goals. Your eating disorder holds you back in every area of your life. During the last two years I've completed a part time MA, and it's amazing to see the quality of my work and enjoyment of it transform over the course of the time scale. Even something like that shows just how much of an impact it has on your competence. Similarly with work, I have literally just got my dream job (starting today) which I would never have had the confidence to apply for. Keep a poster of your goals as it can help motivate you when times are tough.
On exercise, it's a tough one, it can be really healthy to do exercise as part of your recovery, but if you are not medically safe, you should not be doing it. I am allowed to do exercise as I'm at my target weight, and was also allowed to once I was menstruating again. My dietitian has encouraged me to do classes rather than the gym (where it is easy to get target driven). I have a lot of interests so alternate each week with a maximum of two classes. I have found pilates and yoga to be really helpful as it also helps with toning the parts I don't like about myself, but again is a healthy approach. Doing a class you enjoy (I recently went back to gymnastics, which I love!) makes exercise fun, rather than a necessity to fuel your eating disorder.
Finally, you are not a failure. You have done so well to get this far, and recovery isn't a linear or quick process. It can take a long time (I'm 27 and have had this since 11! But for the first time am doing amazingly). Don't beat yourself up for set-backs or for things not happening quickly enough. As a former therapist said to me, "there's no such thing as failure, it's how you learn from the set-backs and move forward that counts".
You are more than welcome to PM me, but you are doing really well!
Kat