Expert: Leigh-Anne Persing, PA-C - 9/29/2008

Question
Hi. I am currently 19 years old, 5 foot 3 inches, and about 97 lbs, and have been struggling with anorexia for about 3 years. I was hospitalized for about a month and went from 76 to about 96 pounds after 4 months of struggling. I eventually made my way to 110 (through binging) and then again made my way down to 93. I rarley EVER eat more than between 400-650 calories, escept on the odd occasion where it may get up to about 1200-1500 (but NEVER any more). My question concerns metabolism. It seems that every time I eat anything over 650 I gain weight like mad, and it can't be water weight for I do not loose it afterwards. I was just wondering to what speed a metabolism can slow down to by my habits or by starvation in general. My bmr I think is somewhere around 1100, so even at 650 shouldn't I be loosing weight (which trust me, I clearly am not). I don;t want to loose weight, just maintain...but it seems logical for me to believe that I will gain like mad eating more if I maintain at 650. It is just really frustrating not being able to eat like a normal person, yet still remian the same size...sometimes even gain at the smallest amount of calories. I've been researching to find a good number to have without gaining weight, but can't seem to find an average number, or the rate to which a metabolism can slow down to. Also, I do a lot of chewing and spitting, but I include that in my calorie intake...and usally the 400 calories comes from things I've chewed and spit through out the day (excess). I am just really confused with what is going on with my body and would appreciate some insight.

Thanks in advance,

Leah

Answer
I can pretty much guarantee that your body is in starvation mode and that is why whenever you eat anything more than your "normal" calorie intake you see the numbers on the scale go up. When your body is in starvation mode anything that you do take in your body will hold onto for fear that it's the only thing it's going to get... it's a survival mechanism really. Metabolism is highly individualized, and has a genetic component, but when you add an eating disorder into the mix it can become a bit confusing. Your metabolism can fall quite quickly when your body is in starvation mode and doesn't always recover as quickly as we would like... depending on the length of time you have been struggling with your eating disorder it may take longer for your metabolism to start back up again... which is also a reason why you notice big jumps in your weight when you eat slightly more than usual.