Expert: Ginger - 10/24/2010

Question
Hi. I've been restricting for many years, due to a phobia. This is the lowest I've ever been, at 5'11" and 96 pounds. I want to start to live again. The other day I ate 2 big bags of chips, and after I got a panic attack. I'm used to hte panic attacks, I've had them for years, but this was different. I had a strange tight feeling in my chest and felt like I had an adrenaline rush that would not go away. I've been reading whatever I can find, and I'm afraid it was something to do with "refeeding syndrome." I dont' want it to happen again, in case it was my heart. I would like very much to know what the best things to start eating are, and how many calories I should start out with. So, a meal plan, pretty much, or just the information I need to put a plan together. It would help so much...the other day scared me. I do not have the money for any kind of outside treatment, or even a regular doctor right now. Any reply would be very much appreciated, and thank you for your time.

Annie

Answer
Hi Annie,
Sorry it took me so long to reply to your question- I had a sick baby (who's better now).

I understand how scared you must have been by the panic attack you had. Have you had the same thing happen since? If it was a heart issue, I think it wouldn't just happen when you ate. That being said, it's absolutely a good idea to get your heart checked out by your GP.

The panic attacks that come with eating, after years of restricting, often do feel more intense and adrenaline-driven than a typical panic attack, at least in my experience. I had the same experience you had, quite a few times. It wasn't to do with refeeding syndrome, but the eating disorder or phobia. The bad part is, as you continue with your recovery, this is likely to happen again. It's a normal part of what the eating disorder makes you feel when you start to eat again, and the only way to overcome it is to accept that it's going to happen and treat it as normal. Try and talk yourself through it, reminding yourself that nothing bad is going to happen to you, and you're actually doing your body so much good by eating. It's not easy (for me, in the beginning, I cried every time), but you can do it.

My concern is that you are slipping from restricting (a symptom of anorexia) to bingeing (a symptom of bulimia), by eating things like two big bags of chips at one time. This is also normal for people with anorexia who are in recovery, but it's not a good thing, and it's a difficult thing to get a handle of without some help.

I can't really offer you a meal plan, since I'm not qualified to do that, and I don't know about your history (how many calories you've been eating until now, your level of activity, etc.). I do know that some good things to start with are proteins. Avocado and almonds were two things that were recommended to me when I was at your stage, since they're full of good things for your body and gentle on your stomach.

I know you said you don't have the money for any kind of outside treatment or a regular doctor right now, and I know you're going to be frustrated to hear this, but you really need to see someone. After restricting for so long, you really do need to be monitored as you start recovering, and have your heart checked. A doctor can also start you off on a meal plan. Even one visit is far better than nothing, and it's something you really should do. I'm not sure how old you are, but if you're in university, there are free counsellers who can even help you. You owe it to yourself and your body, after all these years! Recovery is amazing, I promise you. It's a hard road, but once you get there, you won't believe how great you feel.

E-mail me anytime you think I can help.
Ginger