Expert: Joanne - 3/22/2009

Question
Hello!

I am what you might call a controlled anorexic, i.e. my BMI has never been under 16, but I have maintained a low calorie diet for 18 years. I was advised to gain weight about 10 years ago and did raise my BMI to about 18. After my hair started falling off 6 years ago I went to see a nutritionist who diagnosed, among other things, a lack of potassium. I have since tried to take multivitamins etc. to maintain vitamin levels, but my hair is still falling off. Only now excessive hair loss starts 5 days after each time I stop taking double/triple portions of multivitamins. This all has made me realize that I need to start eating properly. I've been eating 1200-1500 calories per day for 1,5 months now, but I am gaining weight so much, that it makes me feel disgusting (BMI currently at 20). I don't know how long I can keep this up. Would taking pills that boost metabolic activity help to stabilize the situation?

Thanks for your advice!
Anne

Answer
Anne

Its great that you are trying to improve your health, but really, in order to do this properly, you really need to make sure that your calorie intake everday is adequate.

I would suggest increasing your calorie intake even further, but can imagine that you will not want to do this just now.  Please realise that as much as you may want to be at a lower weight, a BMI of 20 is in the lower half of the normal range!  Your BMI should be about 19-25.  18 is classed as underweight, and it is called underweight for a reason.  At a weight that gives you such a BMI, you are putting yourself at risk of health problems.  To be at your healthiest, your weight should be in this 'normal' range.

Weight gain can be a problem initially when trying to improve your diet, but it is important not to let this put you off.  The sooner you are eating a healthier amount of calories everyday (try to avoid restricting and cutting out meals at this time), the sooner your weight should stabilise.  Your body needs to be sure that it is going to be fed regularly and well before it will stop trying to store everything that you eat.  Basically your body is trying to repair itself just now, and also rebuild stores, scared that it may be starved again.  Try to eat a number of small meals everyday rather than 3 big one.  Maybe have 3 small meals with 3 snacks throughout the day.  I would also recommend trying to increase your calories to nearer 1800-2000 calories, but due to the length of your eating problems, not knowing your height, age, etc, I would strongly recommend revisiting the nutritionist to have them workout a daily meal plan for you that provides you with the correct calorie intake.

Please also consider receiving some sort of therapy.  Improving your diet is a huge step in trying to recover from an eating disorder, however, it is also important to work on the psychological reasons behind the eating disorder.

I would not recommend taking any pills that are supposedly intended to boost metabolism.  Very few of them are proven to do much, and as many of them are regarded as supplements, they are not tightly controlled.  Many herbal supplements are known to react with other medications that you may have been prescribed if you are taking anything, and you should not use any of these pills without first talking to your doctor.  In fact, many of these pills can have extremely adverse effects on your health and/or horrible side effects!

Joanne