Expert: Joanne - 2/23/2009

Question
QUESTION: Hey there. I've been recovering from anorexia for about 2 years now. At first things were going smoothly...No matter what I would eat I would actually maintain..but after a small relapse of about a week, I started gaining non stop on any amount of calories I decided to have.
Before this I maintained on 1,400...but Im sure I could've maintained on more...since before going down to 1,400 I was having 1,800 and maintaining quite easily..Bur sadly I panicked and ended up lowering my cals again (bad idea and something I still regret very much.)

Well now I'm having around 1,500 calories, and still gaining weight, and I'm scared that this amount is not enough for me.
Im 20 years old, 5'4'' and about 108 pounds. I know that Im still underweight, and that the gaining is probably because my body wants me to gain some more weight to be healthy...but Im scared that 1,500 is not enough and that I'm gonna end up gaining past my pre ED weight (112-113) because my body things Im still starving!

Please help...I really need help with this.
What should I do??? calculators tell me that I need around 1550-1600 to maintain my current weight...should I up my calories? or is 1,500 enough??

thanks

ANSWER: Anne

1500 is the least that you should be eating.  I realise that this is scary for you right now and is hard to continue with this if you are gaining so quickly, but I do believe that this should resolve itself soon providing you continue to eat well.

When your body is recovering, it is so easy to send your metabolism all over the place if you cut calories.

What kind of calculators have you been using?  If these are web-based things, bare in mind that they don't take into consideration the fact that your body is trying to rebuild itself after being starved for quite a while!

I think that you need to increase your calories, preferably more than 1500, and then continue to eat like this.  You may continue to gain weight initially, but hopefully your body should quickly recognise that it is going to be fed properly and regularly and allow you to maintain a weight.  It is important that you do not cut out meals or reduce calories again though, or you will find that this will happen all over again, and then it is very easy to overshoot your pre-ED weight - in fact this is exactly why yoyo dieters usually end up heavier than they started!

You need to try and just focus on recovering just now.  Your body should stabilise and then your weight should become a case of maintenance rather than gaining, but if you do become slightly heavier than before, don't panic and reduce calories right away.  Sometimes your body weight can fall slightly before it stabilises, so reaching over 113lbs may be nothing to worry about as it can fall again, but if you cut calories again too soon and to the same extremes, this will just continue to happen.

I would actually recommend visiting a dietician and working through a meal plan with them so that they can accurately assess how many calories you should be eating and then help you build a meal plan to suit you.

Joanne

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

QUESTION: Hi Joanne! thank you so much for taking time to answer my question.

Thing is I wasnt such an extreme case of anorexia...I only under ate for about 2 months only (300-400 calories a day) and lost about 20 pounds. After this I started eating more...I gained a bit initially but then I was able to maintain easily on 1,800 calories. Then cut to 1,400 and maintained with that amount for about 5 months or so, until I relapsed for a week and started to gain on 1,500 and pretty much any amount. Since then its been an uphill battle. I've gone up and down a lot with my intake, and I know its going to take a while until it stabilizes...but Im really scared that I'll gain too much weight!!!

I'm thinking of eating 1,600 at the very least...I searched around and I think its the proper amount.

Because of all my ups and downs, do you think I'll gain past my pre ED weight? if so , how much can it be (considering I dont have binge problems, thankfully I shouldnt gain as much as other girls recovering I believe) and how long does it take for it to settle down again?

thank you!

Answer
Anne

There is no way to say how long it will take for your weight to stabilise, but hopefully if you continue to eat well and regularly, it shouldn't take too long.  I wouldn't think you should gain too much above your pre ED weight, if at all, but again, if you do, try to wait and see if it falls again naturally before panicking about it.

Have you ever heard of people that go on crash diets and then regain the weight very quickly - basically that is what you have done by cutting your calories to only 300-400 for a couple of months.  I think that to begin with, your body could cope with that possibly and has allowed you to maintain a weight, but then cutting calories again when you relapsed has maybe made your body panic that this is something that it is going to have to put up with a lot, and therefore is now making an effort to build stores incase it is starved again.

If you are worried about this weight gain, then it maybe worth visiting a doctor to make sure that there is nothing else that could possibly be causing you to gain weight.  Make sure that you are honest with your doctor about what you have been doing though so that they have the full picture and know in case there is anything in particular that they want to check for.

Joanne