Expert: Joanne - 3/21/2009

Question
Hi, Joanne.

I am 16 years old, and for the past 7 months or so, I have obsessively been monitoring my weight. (My height is 5ft 3) And my weight over this time, has dropped from 7st,6lbs to around 6st,5lbs at my lowest. The weight loss has been due to excessive vomiting (Bulimia) and a lessened daily calorie intake (unsure on precisely how many calories). The weight at first dropped quickly and easily, however over time it has become progressively more difficult to lose. This is a concern because I feel that I am gaining weight, even if I restrict a healthy daily calorie intake. I feel that food is beginning to control my life, and I'm sick of it!

I don't exercise excessively, only as much as the average person should. However, over the last few months I have recently experienced skipped periods and irregular ones. This, I am positive, is due to the sudden weight loss.  

I am unsure if I have an eating disorder, although I would like to eat a 'normal' amount again. My main concern is that I may become overweight, even though starting a normal eating regime again. And, I would like to eat as much as I did before dieting, without weighing any higher than at least 7st, preferably.   

Is weight loss more difficult now, due to a slower metabolism? And if so, (if I eat normally again) will it return to it's previous state, before my weight increases too much!?

Tips on how to regain a good metabolism will also be appreciated.

Your opinion will be highly valued. As I am struggling for direction from family, or other means for help.

Thank you, Hope to hear from you very soon!

Rebecca.  

Answer
Rebecca

Firstly, you have recognised that you have a problem, and show that you do want to try to correct this, and for that, you should be proud.

Are your family aware of these problems?  In what way can you not get direction from them?  Would it be worth sitting down with you parents or other relative and explaining exactly what you are doing and why?  Do you think that you would receive the support that you need?  Even if they can't give you the advice you need, can they give you love and support?  This is really essential in recovery, priceless in fact.  

As you are only 16, are you still at school?  If so, is there a guidance teacher/counsellor that you could possibly talk to?  They should be able to point you in the direction of good services available to you, if they aren't in a position to help you themself.

I would also suggest that you speak to your doctor.  I would advise that you have a physical to make sure that you have not already caused any lasting damage to your body, and if so, look at the best way to correct it.  They may also be able to refer you to more specialist help in order to address you eating difficulties, be it therapy, nutritional advice or even programmes that you may benefit from.

As you continue to restrict your calorie intake, your metabolism will slow in order to compensate and make sure that your body doesn't burn too many more calories that it is receiving.  Initially, you will see fast weight loss, but your metabolism catches up in order to make sure your body can survive longer term on fewer calories, therefore your weight loss slows down and you possibly may even find that you no longer can lose weight even on a restricted diet.  As you lose weight quickly, a lot of the body mass you lose is actually from lean tissue such as muscle.  Muscle cells burn a lot of calories compared with other cells, and well as you lose muscle, you lose the calorie burning.  Please take note though - Your heart is also a muscle, and your body will not spare this!  Your body's priority is the brain, and it is quite happy to break down heart tissue in order to protect the brain.  A smaller, weaker heart quickly can become a heart that has the potential to go into arrest at any time.  Combine that with your vomiting....Vomiting can cause an imbalance of electrolytes, and that in turn can cause fatal cardiac arrhythmias.  Basically you are putting yourself at a huge risk of death.  Eating disorders, especially anorexia carry quite a significant death rate!  I don't want to scare you, but if this will make you really think about what you are doing to yourself and makes you more determined to beat this, then it is worth it!

In order for your metabolism to speed up and recover, you need to increase your calorie intake to a 'normal' amount of about 2000calories.  Yes, this will cause weight gain, but providing you do eat this everyday and stop skipping meals and purging, your metabolism should recover pretty quickly (varies person to person though!) and your weight should come to stabilise at a healthy weight for your height.  I can not guarantee that you will not gain over 7st though!

I think that you should look into getting an appointment with a nutritionist and ask them to develop a meal plan for you that will ensure that you are eating the right amount of calories for your height, age and activity level.  They should be capable of making sure that weight gain is done healthily and over the correct period of time!

Please come back if you have any more questions!

Joanne