Expert: Joanne - 12/25/2008

Question
QUESTION: I have noticed questions on this site pertaining to struggling with metabolic issues left over by her anorexia. My problem is slightly different. For the past two and a half years, I have been struggling with "poor gastric compliance" which means, basically, that my stomach does not expand. When it began, if I ate too much, I would either experience severe discomfort or my stomach would contract and I would throw up. I saw a gastroenterologist, etc, etc, but the short story is that I didnt eat normal amounts for about 2 years. I ate way way less. I started to gain weight about a year ago. I thought "this is weird" and upped my caloric intake, figuring that I was not eating enough. (This caused immense discomfort at first, but through breathing exercises, I was able to almost fix the stomach issue). And then, eating about 1400 calories a day (I am 5'8' normally 125 lbs) I gained weight really really fast (and continued to over this past summer). Just like the other woman, I know all about healthy eating and exercising and I do everything right. I have stabilized my weight (around 160 now) but I still probably eat only around 1000 calories a day (mostly veggies and protein and whole grains). Part of this is for comfort reasons; another part is that I do not want to gain any more weight.
1. how much exactly should I be eating
2. What is the trick to healing this: just eating regularly and sensibly? how many calories?
3. How long does it take to fix it?

ANSWER: Elizabeth

Basically, you should be eating no less than 1500 calories, and the closer to 2000, the better.  As you have already experienced, this may cause some initial weight gain, especially since your metabolism may have slowed.  The quickest way to reverse this is to increase your calorie intake as soon as possible, and then eat regularly.  If you struggle to eat full meals, eat little ones maybe up to six times a day.  In fact eating small and regularly may help improve things more quickly as your body should become used to the idea that it will be fed regularly and set about expending more calories as a fuel as it realises that it doesn't have to store much as the next meal won't be far away.

I understand that you really don't want to gain more weight, but if it happens trying to increased your calorie intake just now, it may be off better in the future.

There is no set time frame on this sadly, every person will recover in a different amount of time, and there is no way to even hazard a guess at that.

Firstly, I would recommend visiting a doctor just to make sure that there is no long-term health problems caused by your eating problem, and would also get them to check things like your thyroid to ensure that there are no underlying conditions that could have an effect on your metabolism and weight.

Joanne

---------- FOLLOW-UP ----------

QUESTION: Thanks for your helpful response. I have been seeing my doctor and Gi person a lot. I have also had tons of blood/thyroid tests, and everything comes out normal. on top of that, neither doctor seems to care about the caloric intake issue, even though I KEEP mentioning it to my doctor. Honestly, I don't think she believe that I am really eating relatively little.
I terms of upping the intake, would you recommend doing it rather slowly so that the body can get used to it day by day? And anywhere about 1500 is ok? I am probably getting above 1000 now, and really thats whats comfortable for my stomach, but I can up that with cheese, mayonnaise, olive oil, liquids.
Do you have any recommendations? and what about exercise?

Answer
Hey Elizabeth

I would definitely recommend getting above 1500 calories, closer to 2000 if you can.  As for how quickly you do this, that is up to you.  I would normally suggest trying to increase it as quickly as possible so that your body gets used to eating as many calories as that as quickly as possible, and therefore hopefully stabilising your metabolism and weight as quickly as possible, but if you feel that you would find it easier to slowly increase these calories then do that - so long as you are eventually increasing the calories.  Just please increase the calories and continue to do so!  It is easy to just increase them slightly and then never increase them enough - so make sure that you try your best to get to your calorie intake target!

Joanne