Expert: Ryan Hale - 11/22/2009

Question
Hi, I am a competitive cross country runner and previously I had never really thought about my weight. In the summer I had an accident and was unable to run for a while, and suddenly I was scared of gaining weight so I limited my calories to about 1000 or less a day. It was a big shock for my body since before that I used to eat a lot. I am 5'5 and I went down from 130 to about 115 in the period of 2 months. I stopped having a period, and I was always really cold and tired.
I realized that I probably was suffering from anorexia, and in the past couple of months I've been eating 5 meals a day, lots of protein, and trying to get my weight back up. I've gained a bit of weight, but my hair is falling out like crazy.
It feels soooo great to not be obsessed about my eating anymore, but I'm worried that my body is weak and damaged. Also, I love running and I want to start running again, because it helps me with stress, but I'm trying to get my period back and I'm really worried that running will prevent it from returning.
I just want to be healthy again. Emotionally, I'm pretty much over the eating disorder, but my body is not.
Thanks in advance for any suggestions you might have

Answer
Katie- sorry for the delay in getting to your message.  First, different parts of your body may take longer to get back to normal than others.  For example, your hair may recover before your metabolism fully returns to normal, or you may get your period before your metabolism fully gets back into a predictable pattern (or visa versa).  So, just concentrate on getting healthy and your body will eventually respond most likely.  Some who have had eating disorders for a long time never fully return to "normal."  As you know, many women will lose their period over weight loss or even stress.  For some it takes a lot of stress or a lot of weight loss.  For others, all it takes is a small change from normal and it will happen.  There is no set point for body fat that says when a woman will stop menstruating.  For some, it is near starvation, and for others, it can be the drop of a few pounds.  

Assuming your diet is good and your weight is returning, I think it would be ok to return to running (and add some weight training into it as well), with the focus of getting out and moving your body, fitness and fun.  For now, it is a chance to remember why you began running and not focus on times and distance or competition.  Look into Pilates or yoga or add in some weight training as adjuncts to your fitness.  It is a chance to "re-invent yourself" in a way.  Try some exercise activities that maybe you've never tried before because you may have been very focused on just running, or take the time to work on areas of your running that you never took the time to improve (strength or mental aspects).  I've worked with a few runners who hit a similar bump that you have and found that it was an opportunity to try new activities and exercise that they would have never tried before.  I think if you don't overdo it and are sensible about it, that it would be fine to work fitness back into your routine.  It is very important that you are consuming enough calories for the additional activity and that you aren't going about it in such a way that your body perceives it as more stress.

Your body stops having a period in times of physical and emotional stress because it believes that it is no time to be bringing a baby into the world if things are bad right then, so it essentially doesn't allow it.  Adding the new activities are for your health and we don't want your body to see it as another hardship.  It is important for you to return to a regular cycle because it heavily influences hormone regulation and such things as calcium absorption.  So the focus is on health and not on performance when it comes to your exercise right now.