Expert: Saffron - 6/13/2009

Question
I have had anorexia for about 3 years but am now in recovery. I am 5"5' and my lowest weight was 86lbs. It took me about 2 months to get my calorie intake up from about 100 a day to 1600 a day. I could deal with this as I did not gain any weight. However after a push from my support team, I increased my calories to 1900, then to 2300. I have gained about 7 lbs in the past 3 weeks from doing this and am very confused/scared as a dietician I saw at a bried hospital admission told me that I would need around 3000 calories a day to gain 1 lb a week, but I have been gaining over 2 lbs a week on so much less than this. At first I was told it could be water weight and that my metabolism would catch up so i would gain slower and need to increase my cals again, but this hasn't happened.
Now I am so scared of this fast weight gain that I have dropped my cals to 1500 again because I can't cope with gaining this fast.
Why is my body doing this? I am so confuse and scared :(

Answer
Dear Hannah:

What you are experiencing is very normal and I personally think it is one of the problems with refeeding.  If you were seriously anorexic, for some reason when you start eating again, your body just doesn't seem to register the calories and you can eat a lot of food and either not gain weight or gain very little.  But when you are malnourished your body eventually will indeed gain the weight and much faster then someone who is not malnourished.  In fact nutritionists view this as confirmation of malnourishment.  Your metabolism is definitely going to be a little screwy and I know it is scary.  I personally think it is not advisable to press you to eat more than you are comfortable with as it may mess up your progress.  You'll want to revert to your old ways.  Why anyone thinks that an anorexic person should suddenly be fine with eating a whole bunch and gaining weight really quickly is baffling.  The important thing is it sounds as though you genuinely want to recover but to do it healthily you should do it gradually and in a way with which you are comfortable. It may indeed also be some water weight but I can tell you from experience that for me it took quite a while for my metabolism to sort itself out.  After a while my problem was that after more than a decade of not eating so many different foods and being so hungry for so long, I ended up binging occasionally and gained a lot of weight really fast.  And it is very scary.  Slow and steady is better and better for the healing of your metabolism and your mind in my opinion.  Listen to your body and try to eat when you are hungry and stop when you are full and not do all this breaking out of the calculator.  I truly think this is healthier.  You sound very reasonable about the recovery process so I feel I can give you that advice.  And be patient, your body will normalize again.  It felt like ages that I had destroyed my metabolism and couldn't eat anything and then gradually I actually started losing the weight without trying.  You're going to feel uncomfortable for a while and you'll have to accept it unfortunately, it's part of the process.  Wear baggy clothes if you have to. But the good thing is you know you're helping to start helping your body get back to normal in every way.

I hope this helps and don't hesitate to ask any other questions.

Best,

Saffron