Expert: Joanne - 1/23/2009

Question
Hi I am a 19 year old female, 5'9" and I have been struggling with anorexia for about 4 years.  Two years ago I was at my lowest weight of 114 and admitted into the hospital.  After discharging out of the hospital I began to relapse and restricted my intake to about 1200-1300 calories and ran 2 miles every day.  My weight dropped to 120 pounds.  Then once I tried to recover again I noticed that as I gained weight I was bigger than I was at 128 pounds than I was before.  I know this because my clothes fit tighter and my measurements were bigger.  Now, I have relapsed again, my weight is about 123-125 pounds and I am currently eating about 1300-1400 calories, and doing about an hour of exercise (walking) every day.  I know that I need to gain weight but I am scared because now I am bigger now at 125 pounds than I was last year.  Why is this happening?  It seems that every time I relapse and then try to put on the weight again I just keep getting even bigger.  This scares me because if I ever get up to a healthy weight, then my body will be the biggest that it has ever been.  Help!

Answer
Keiko

Unfortunately, this can happen as a result of 'crash dieting'.  By starving yourself, you can slow your metabolism down so that your body can get by on few calories.  When you begin to eat again, your body still thinks that it may be starved, so doesn't speed up your metabolism again and begins to rebuild itself and replenish stores.  Eventually your body should begin to recognise that it will be fed enough and regularly, and has repaired itself, so will allow your metabolism to recover.  As your body is repairing and building stores, you will likely be gaining weight as it is storing excess calories, and needs to, scared that it will be starved, so has back up there!  If you interrupt this, like you have when you have panicked about being even heavier than you were originally, your metabolism will not recover properly, meaning that you may continue to store what you are eating, etc.  This is the cycle that many crash and yoyo dieters get stuck in, and it is just the same for people recovering from eating disorders!

In order to try and stop this happening, you need to begin to follow a sensible diet again, and this would be best done with a dietician or nutritionist.  If you stick to a good meal plan, eating enough calories for a few weeks or even months, you should find that, yes you may initially gain some weight, but in the long term your weight should stabilise or even drop slightly, allowing you to maintain a much healthier normal weight.  Obviously this does not occur overnight, and really requires you to keep eating enough calories everyday.  To try and skip meals or cut calories while doing this is likely to prevent progress, so you really need to be committed to beating this once and for all, trying your best not to worry to much about weight gain in the short term.

If need be, once you have reached and can maintain a healthy weight, you may even be able to lose some weight to make sure that you are happy with this weight, providing it does not mean you will become underweight, and is done properly, eating a well-balanced dieting, and exercising, but not excessively!

Joanne