Unlike many anorexics, I can never remember the science or the numbers of food and nutrition. Then starvation makes your cognition go haywire, which makes the incomprehension worse. According to Carrie Arnold, this is a sign of a malfunctioning insula, the part of your brain that maintains interoception. That’s the process of monitoring and integrating internal feelings, both physical and emotional. It must also, therefore, be central to the sense of self. Starvation dismantles your identity.
Sensations are remarkably hard to tease apart, especially when there’s no longer any trust in the relationship between mind and body. I no longer recognise hunger signals for what they are, among all the confusion of thought and feeling. I can’t tell the difference between the urgent and the indulgent, or an empty stomach from the desire just to taste yummy things – that tangy umami at the back of the throat.This doesn’t release you from hunger’s torment. You feel it all the time, mixed up with doubt.
This is a classic eating disorder dilemma. We’re extraordinarily indecisive, anyway. Apparently, this is caused by further brain malfunctions, of the pre-frontal cortex and the insula. In the end, though, you always opt for denial, because you view hunger with such suspicion, because you fear weight gain and indulgence, and because you discount your own thoughts. To combat this, I now have to eat entirely by plan, by rota. Rigidity is typical of anorexics, but in this case, it keeps me eating.
I didn’t know what I was doing right, when I started losing weight, so I worried that those encouraging, falling numbers might suddenly go into reverse. “To be on the safe side”, I cautiously, but constantly, amplified everything: a little more exercise; a little smaller portion sizes (for me).
I also felt that my value in the family came from producing beautiful, healthy, low fat food for everyone. Meals could never be complex or lean enough. Luckily, the children were still young. They ate separately and earlier, so I never compromised their diets. I was always able to maintain a clear sense of what was good for them but I didn’t apply the same rules to myself. It’s a good example of anorexic double-think, the ability we have of gravely and sincerely acknowledging the truth of a proposition and then acting in an entirely contrary manner, with no apparent motivation.
For poor Jo and I, every time I was able to produce a good meal while reducing the oils or the carbs or the protein, that level of low-fatness became the norm until there was a chance to reduce it again.
 Decoding Anorexia (2013) Hove: Routledge, pp27-31
 Perhaps overweight people have the same confusion and the same lack of self-belief, but opt for the opposite response, out of a defeated sense of being unable to resist.