Expert: Jeanne Rust, PhD - 12/19/2009

Question
QUESTION: Thank you for taking the time to read this. I am twenty years old. I went away to school last year and dropped alot of weight in a very short amount of time. I started eating alot healthier, but I definately over-exercised and did not eat enough to compensate. I eventually started getting really bad gas and constipation pains and thought that I had some type of IBS. I ate even smaller portions and exercised even more in an attempt to get rid of the constipation, but I felt like I was caught up in a downward spiral. No matter how many probiotics I took, the constipation and gas got worse. I would eat an egg, and i would get really bad cramping. I would eat a sandwich, and I would be so bloated that it would put me to sleep for hours. I am seeing a nutritionalist now, but she's doing it more as a favour to me, instead of being paid, but it's really hard to meet up with her. She said the constipation problem was all a result of my metabolism being worn out and working really slow. She has been having me increase my calories by increasing the number of ensures I drink but because my weight gain has been slow, she doesn't want me to get much more exercise than a twenty minute walk. My lowest weight measured in the morning was 85 and now when I measure it in the morning over almost four months it is now 97. Although I'm not constantly constipated, I still can't eat very much in one sitting and it's hard to get all the cals in that she wants me to, especially working at a restaurant all day. Do you know how long it will take for my metabolism and digestion to get back to normal? Can I fully recover from this? Do you know of any other problems that can develop from this? I never got to the point where I started losing hair. I actually wanted to be able to eat, and it felt like I was always forcing myself to eat, but as the digestion got worse, i would end up eating less, and the less I ate, the worse the digestion got. It's really frustrating not being able to eat like everyone else without feeling sick, and I really miss being able to emjoy food. Will increasing calories faster make my digestion and metabolism get better faster, or will it overstress it? Do you have any advice? Thank you so much for your time, Sincerly, Tanya

ANSWER: Hi, Tanya,

I'm so glad that you wrote!  I wish I could answer your question specifically but recovering from anorexia is such an individual thing.  Your nutritionist sounds wonderful -- and very kind.  Your weight gain has been good -- not too fast.
My recommendation to you would be to do everything exactly as your nutritionist suggested -- I think she knows what she's doing.

The re-feeding which is what you're doing, can take anywhere from a few months to up to a year.  You're eating small meals -- this is a good thing -- and yes, your metabolism will recover.  More calories usually helps it start faster --but it's more important that you do this step by step -- if you stuff yourself, you won't be able to keep up with your weight gain psychologically.

Please keep in touch and let me know how you do!

Warmly,
Jeannie Rust, PhD
CEO/Founder
Mirasol Eating Disorder Recovery Centers
www.mirasol.net
www.edrecovery.com
888-520-1700




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

QUESTION: First of all, thank you so much for answering my other question. I don't really know anyone who has any experience in this kind of thing, but I was also wondering about something else. When I was seeing my GI specialist when I was in Oakville and I was trying to figure out what was going on,he asked me if I had any trouble keeping my food down. i.e. throwing up or nausea. At the time I didn't. I felt like I was finally starting to get better and thenone night, I think I might have overdid the amount of food that I could eat. I didn't feel that well the next morning but I made myself have breakfast and take my ensures. Several hours later after not feeling very well it all came up. After a long time of having digestive problems, keeping food down wasn't one of the problems that I've had. I thought that maybe it could be the stomach flu, but I sometimes get full again after just a really small amout. My stomach bloats out really big, and one night I kept on burping up bile. However it wasn't as bad a few days later. I don't know if I should be worried, if this is only temporary, or if it could be something permanent. Even though I didn't starve myself in Oakville, I definately over-exercised, and when the digestion got worse I ate less. I heard that alot of anorexics can get gasteoparesis afterwards, but I dn't know if this is usually a permanent thing, or if it usually goes away in time. I don't want to self-diagnose but I want to know if it's something I should really be worried about. Thank you again for all your time I really appreciate it.
P.S. I was just wondering, how did you go into working for people with eating disorders? Did you take pyscology or nursing or is there a special program you take just for that?

Answer
Hi, Tanya!

It's good to hear from you again!

It would probably be a good idea to get checked out by your GI specialist again.  Wouldn't hurt.  When you are refeeding yourself, it's easy to run into difficulty -- to have a lot of digestive problems.  Just keep eating small amounts of food often -- 3 meals a day and 3 snacks -- this will help the bloated feeling.  Feeling bloated is the hardest part of recovering -- it's one of those things where you just need to gut it out -- literally one day or one meal at a time.

It will get better --keep in touch!!

I had my own eating issues -- and I also had parents who were compulsive eaters -- so I certainly wasn't going to do that!  :o)  I got a masters degree in counseling and a PhD in clinical psychology.  I started treating a lot of eating disorders in my private practice 20+ years ago.  I learned how i thought eating disorders should be treated -- because people can get completely well!  That's when I started my own treatment center -- and I've just gone on learning more and more.

Thanks for asking, Tanya!

Warmly,
Jeannie