Expert: Joanne - 1/25/2009

Question
HI- I'm 45, and have just been diagnosed with an eating disorder, that
looking back, I've probably had since I was 20.  I have  never gotten super
skinny, nor have I ever binged/purged.  I come from a family of over-weight
people, and have always been scared to death to be fat.  Both of my older
sisters are over 300#, and I simply cannot live that kind of life.
I love to work out, and have been doing so, on and off, since I was 20.  I have
used it to lose weight, while really restricting my caloric intake.  I guess you
could call me a yo-yoer.
I went to a doctor and a nutritionist just a few months ago, out of vanity
really, to determine why I cannot lose the last 10 pounds, and they did a lot
of blood work, and determined that I have an eating disorder (news to me),
and something called General Adaptation Syndrome, caused by near
starvation (also news to me since I am no where near skinny).  On top of that,
I have body dysmorphia syndrome.
I am currently scared to death, as they asked me to stop working out ,and to
do no cardio whatsoever, not even walking my dog.  I am to eat ,eat, eat to
try to restore my metabolism as well as hormone balances, etc.
I have gained 20 lbs, and I am now FAT.  I have gone up to a size 12 pant,
and I'm only 5'4".  
PLEASE, if you can, assure me that eventually my body will naturally start
losing this weight, and that I'm doing the right thing.  I have faith in my
doctors and nutritionist, but I'm scared to death.

Answer
Janet

I am not going to lie, I had never heard of general adaption syndrome before, but I have done some research now and think that I understand it.
Basically, this is the body's way of coping with stress.  There are 3 stages, alarm, resistance and exhaustion.  When your body firsts has to react to stress, it releases some hormones which help you physiologically cope with that stress initially, in this case the stress was probably low calorie intake combined with high calorie demand due to over exercising.  In the alarm stage, your body would release huge amounts of these hormones, like if you were to be chased by a bear, the adrenaline is pumping, making sure that your muscles are getting enough blood and glucose to keep you running.  If your body is under stress constantly, like when it is being starved, lower levels of these hormones are being released all the time  In time, you deplete your sugar levels, mineral excretion in the body gets mucked up, etc, and in time this can lead to the 'exhaustion' stage.  At this stage, your cells of your body aren't getting the sugars and nutrients they need to survive, different minerals in your body are there in levels that shouldn't be - you may get rid of too much of one, and not get rid of enough of another,etc and this all puts a lot of stress on your organs.  If levels of salts such as potassium get even slightly out of range, they can cause things like cardiac arrhythmias, etc, and these can be fatal.

I don't want to scare you, and I am scared that my explanation above is rubbish.  I think you should have your doctor clarify this for you if he hasn't already!  I do think that it is very important that you are aware of how much danger you could be putting your body and life in if you are restricting calories too much and over exercising.  I'm not sure of your exact calorie intake, but for someone who exercises a lot, it shouldn't be less than about 2400-2500 a day!  I'm not sure if you are aware of this either, but some people may eat enough calories in a day, sometimes even more than enough, but over-exercise to burn them all off, and that in itself is an eating disorder called exercise bulimia where the sufferer basically uses exercise to get rid of excess calories rather than vomiting!

Your doctors and nutritionist are experienced, and will know what they are talking about, you must follow all their advice.  It is very common for people to have problems with weight gain when they first begin to eat as their body rebuilds itself, repairing all the damage done to it, and during this time your metabolism is likely to continue to work slowly, but as your body begins to get used to being fed enough, and regularly, your metabolism will recover and you should find that your weight stabilises or even falls slightly, and then you should be able to maintain a weight that is healthy for you.  For this to happen though, it is important that you do not try to cut out calories at all.  You must stick to the meal plan that you have been given and don't exercise until your doctors tell you it's safe to do so.

If you haven't already, I would suggest trying to find a therapist or counsellor, or get your doctor to refer you to one.  It is great that they are treating the physical effects your eating habits have had, but it is just as important to treat the causing factors.  You mention body dysmorphia and that needs to be treated by a professional.  You need to work with someone to help you challenge your self image and also to help you deal with all the emotions and reasons that you developed such eating patterns.

Please try to get that psychological help soon, especially since you are going through body changes just now that are obviously concerning you!

Joanne