You are here:

Anorexia/Eating Disorders/Maintaining as a first step to recovery.

Advertisement

Expert: Jeanne Rust, PhD - 8/15/2009


Question
Hi there, i am 19 years old and 5ft2. When i went to university i gained weight and reached 120 pounds. Throughout the course of 4 months my weight plummeted to 90 pounds through restrictive eating (400 calories or less a day) and ocassional purging. I recently sought help as it has become an obsession. My pshychiatrist has told me that i am not mentally ready to gain weight, and that first i must learn how to maintain my weight before putting on weight. He has told me that i must eat 1250 calories a day to maintain my weight, he has given me one week, and has said that if i lose weight i cannot go on holiday, and if i gain weight he will change my eating plan. For me this amount of calories seems huge, i am concerned that my metabolism has slowed down and that this amount of calories will result in weight gain, which he has specifically told me he is not aiming for. I am happy to eat this amount if it will not result in weight gain. I weigh myself every morning, and each pound that i put on freaks me out and determines how easily i can eat. Any advice would be greatly appreciated.

Jo

Answer

Jeannie Rust, PhD
Dear Jo,

I'm so glad that you wrote!  And best of ll, I'm so happy you're getting help!  Your psychiatrist sounds very cool.  He knows that right now you wont's be able to keep up with any weight gain psychologically but he also knows that you're body desperately needs nourishing -- you've been starving yourself!!

Did you know that concentration camp survivors ate 700-800 calories a day?

What will happen when you increase your caloric intake, is you'll feel pretty terrible for 2-4 weeks (at least most people do).  You'll feel puffy, fat, gross -- and this is the part of recovering that is really hard -- just getting through these feelings.  Another thing that happens with most people is that their metabolism speeds up!  Yes, you'll probably maintain because of your metabolism speeding up.

This is one of those cases when it's important to do exactly what your psychiatrist tells you!  He's very very good -- I'm so glad for you.  Most psychiatrists don't know anything about eating disorders and they try to get people to eat 3000-4000 calories a day which is really horrible.  Your guy is very good, Jo!!

Let me know how you do!!

Warmly,
Jeannie Rust, PhD
www.mirasol.net
www.edrecovery.com

Jeanne Rust, PhD

Expertise

I have been treating eating disorders for over 25 years and I have a doctorate in clinical psychology. I am an expert in anorexia, bulimia and binge eating disorders and in co-occurring disorders as well -- depression, anxiety, obsessive compulsive disorder, etc. I was the official eating disorder therapist for the University of Arizona athletic department and love working with girls and women of all ages! 12 years ago I started my own treatment centers in Arizona where we treat adolescents and adults. I love working with people and have been helping people online since 1994. My hearts go out to the people out there who are unable to find help, who aren't sure whether they need help, and who don't have much of an understanding of the terrible consequences, emotionally and physically, that go hand in hand with the eating disorder. I view eating disorders as coping mechanisms that people use when they are under stress. I believe that eating disorders most times have many similarities whether it is anorexia, bulimia, or binge eating. The good news is that people can heal from an eating disorder and learn to create the lives they would like to live.

Experience

I have 25 years of experience in treating eating disorders of all kinds. I also do consultations for people who are starting treatment centers.

Education/Credentials
Northwestern University -- BA Masters in Counseling Doctorate in Clinical Psychology -- Saybrook institute

©2012 About.com, a part of The New York Times Company. All rights reserved.