Expert: Ryan Hale - 5/9/2010

Question
Dear Ryan.
I have no idea what to do anymore since it seems almost impossible for me to lose the extra weight I gained after recovering from anorexia. I was diagnosed with anorexia back in year 1998 when I was 16 years old and had a BMI of 15.8. When I was 21 I gained a lot of weight (42 pounds) and my eating pattern shifted to eating everything in sight for a year. I was medically on the border to being overweight during that year. I'm now 27 years old and have for the past 6 years tried to lose the extra weight and going back to being slim (not at all skinny). But obtaining a BMI of about 19 seems to be almost impossible for me. I'm constantly dieting (and after being anorexic I definitely know what to eat and what not to eat ). When I eat with my family (and only stick to the healthy food and stick to smaller portions) I always end up gaining weight (even thought they stay on the same weight). I live by my self and have tried living for several months on a diet consisting of 1500 calories, which makes me slowly gain weight.....why? most people eat this amount of calories to lose weight!
Then of course I get frustrated and start cutting down on my calorie intake, since a reasonable 1500 calories a day doesn't work. I have tried to stay on about 1000 calories, which makes me maintain my weight. For the past month I thought "well in order to lose the extra weight I guess I will have to cut down more", so I have lived on 400-600 calories for the past month and have lost 1 pound. My university is about 11 km away, and riding my bike back and forth, should give me plenty of exercise. So my question to you is: What is wrong with my body? Have I messed up my metabolism after my 5 years with anorexia? Every book on weight loss says that you need to measure your calorie intake against the calories you burn, and if you burn more than you take in, you will lose weight. Why doesn't this very simple rule apply to my body? I have absolutely no idea what I can do to stay on a normal and still attractive weight and eat a reasonable amount of food at the same time.
I want my body to function normally. What can I do? and what have I done wrong?
Thank you so much for your answer.
( My BMI is right now 20.5 )

Answer
Emily- it seems that you are not as far away from your goal as you might think.  It sounds like you've learned a lot about diet and healthy eating from your past treatment so you are halfway there!  Your metabolism is no doubt effected by your anorexia.  What is going on now, is that your body is very hesitant to burn calories because it is afraid you will be in starvation mode again at some point.  In other words, your anorexia has sort of taught your body to store calories even more than before.  One of the aspects that may be missing is the exercise piece.  I know you bike to school, but it may not be enough time or intensity to have a large training effect.  A qualified exercise professional can help you adjust your activity to help burn more calories.  The goal is health, fitness, and enjoyment.  You'll need to find an activity you like to do, do it intensly enough that you get a fitness effect, and that you enjoy the activity enough to do for fun and not just with a goal in mind.