Expert: Joanne - 2/10/2009

Question
QUESTION: I was diagnosed with anorexia about 2 months ago, and right now I have to gain around 10
pounds to reach what my doctor views as healthy. I can't ask anyone- like my parents or my
doctor- questions because they just get mad at me for not doing something right. My question is
that I'm gaining weight too fast and I want to know why. For the past 2 weeks I have eaten
around 1700-1800 calories and went from 5.3 pounds to 7.5!!! My maintenance is around 1500,
so that would mean that my maintenance that was calculated for my weight and height (5 ft 1 in)
is majorly wrong! I can't ask anyone questions about this because they want me to go to 2000
calories a day, but if i do that ill gain weight TWICE as fast! I exercise 2 to 3 times a week (tennis
90 min 1-2x weekly, wii fit 1-2x weekly, less lately because they don't think i should be
exercising). So whats wrong with my metabolism! It takes some people in recovery 3500 calories
just to MANTAIN there weight when I gain at what most teen aged girls my age (14) would look
at as there maintenance calories! Is my body still in starvation mode and holding on to every
calorie possible or am I just some lazy-ass girl who is doomed to becoming overweight because
she wrecked her metabolism with stupid eating habits? PLEASE HELP ME!

ANSWER: Jackie

Please do as your doctor is telling you!  I think this is just a case of your metabolism not catching up yet, but it will happen providing you continue to eat enough everyday and do not attempt to skip meals.

I am surprised that your maintenance is so low considering the tennis you are playing, but I'd imagine that has been worked out by someone very experienced, so please do as they ask!

Some people recovering do have to eat loads in order to gain weight, but not everyone does!  I know that I didn't, goodness I think I probably gained even faster than you are!  But don't worry, my weight is healthy and I didn't end up overweight!

Who wants you to go to 2000calories a day?  If it is your doctor, or someone involved professionally in your care, then I think that you should try it.  In fact, increasing your calories more, especially if you are continuing to exercise may in fact help your metabolism recover faster believe it or not.  Your body needs to be sure that it has repaired itself and has rebuilt sufficient stores, as well as be sure that it is going to be fed properly and regularly before your metabolism will settle, so it is definitely just a case of persevering.

Are you receiving any psychological help with this, or are you simply being treated physically?  If you are not in touch with a counsellor/therapist, then I would suggest trying to find one!  You really need to work out what led you to developing an eating disorder and then work to make sure that whatever it was has been dealt with properly so as you don't return to these behaviours.  You may also find it helpful to have someone help you with your self-image as you gain weight in order to make sure that you can emotionally cope with the changes that your body must be going through right now!

I wish you all the best with your recovery, and feel free to contcat me again if you need to!

Joanne

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

QUESTION: but will my maintenance ever be back to where it used to- and should- be?

Answer
Jackie

Hopefully your maintenance weight and calories should be as they once were, providing they were both in healthy ranges!  In order to make sure that you don't overshoot this maintenance, it is important that you continue to eat the numbers of calories you have been told to, and make sure that you don't skip meals, over exercise, etc.

You need to eat around the 2000 calorie mark everyday, and make sure that you account for exercise you do.  If you initially go above the weight you are expecting, DO NOT TRY TO CUT CALORIES!  It is important that you continue with this eating plan, and hopefully your body should sort itself out and possibly decrease in weight slightly before it stabilises.  After a few months, if you find your weight is steady, eating a healthy number of calories, and you are not happy with your weight, it would be acceptable to try and lose weight providing it was done healthily and slowly and you don't become underweight!  If there is any risk of you becoming underweight, then don't lose weight!  These weight ranges have been calculated for a reason, and even being just a little bit underweight can cause health problems in the long term!

Joanne