Anorexia/Eating Disorders/Anorexia recovery?

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Question
Hi, ive had anorexia for 9 years, im 24. Ive pretty much always had purging subtype,incase that makes a difference. 8 weeks ago i was admitted to a womans crisis house as i was suicidal. Since then i have eaten on two occasions, the first was quarter of a muffin the second was a large (400 cals) cookie. 2 weeksago i was admitted under section to a general psychiatric unit, as i had reached the maximum stay for the crisis house. This last week, with the threat of being tube fed again, i promised to have calories if given leave. So everyday this weak i have had one skinny starbucks cappaccino at 82 calories and (the ward dont know as ive had alcohol issues) half a bottle of wine per day. That has been my total calorie intake eah day for this week.Yesterday i was told i need to go to a medical ward unless i agree to an eating disorder unit and to eat 3 meals and 3 snacks (in time).

My question is,and my problem,
I am willing to go to the eating disorder unit as i hate being tube fed but i have gained 5 pounds this week from the calories in the starbucks and wine.
In the past going into EDU's or tube feeding i have gained weight VERY fast (3kg per week on maximm 1500 calories) and i was binge/purging on 2000caloreis PRIOR to these admissions.

This time haven not eaten at all, and only had the calories mentioned above, but still gained 5 pounds this week, is it likely im going to gain even quicker then i have done in the past?
Im terrified im going to gain so fast and not stop gaining weight. If im currently gaining on these calories from liquids and i havnt eaten solid foo apart from the two occasions for 8 weeks now, surely, i am going to keep gaining and in the initial stages am i not likely to gain like 5 kg a week type thing?

I feel SO stuck.I want to get better, but im so scared of gaining too fast. Do you think i will have ruined my metabolism perminently? Is it likely like ive said above that im going to gain huge amounts really fast given my recent history? I know you cant say oer say, but your opinion would really help me.

Im 24 years old, female, 167.8cm Tall and weigh 34 kg

Thankyou

Answer
Hi Charlotte-Marie,

I am so sorry you are going through this. I have a few thoughts about your predicament.

I do recommend that you go back into treatment. If you do not want to do that or are not ready to, please look into some self-treatment options.

I recommend the following resources:

The Body Image Workbook by Thomas Cash - http://www.amazon.com/Body-Image-Workbook-Eight-Step-Learning/dp/1572245468
Diet of Despair by Anna Paterson - http://www.amazon.co.uk/Diet-Despair-Eating-Disorders-Families/dp/1873942192

In addition, here are several good web resources for healing your eating disorder:

http://www.helpguide.org/mental/eating_disorder_treatment.htm
http://www.healthyplace.com/eating-disorders/articles/eating-disorders-self-help
http://www.healthyplace.com/eating-disorders/articles/eating-disorders-self-help
http://www.eatingdisorderself-cure.com/
http://www.eatingdisorderhope.com/recovery/self-help-tools-skills-tips
http://www.something-fishy.org/whatarethey/coe.php
http://anred.com/welcome.html

We also need to work on your diet. Liquid calories are not getting your nutritional needs met. I want you to go to this website and create a profile: https://www.supertracker.usda.gov/CreateProfile.aspx. Once you've done that, it will tell you how much you should be eating of each food group each day. If you click around, you'll even find sample meal plans.

Now, to your question about weight gain. Will you gain weight rapidly when you start eating again? Yes and no. Let me give you a little biology lesson.

Early in a diet, caloric deficit results in weight loss from fat stores being burned and loss of body water from glycogen depletion. After a few days, your body notices this change in fat stores and decreases Basal Metabolic Rate (BMR) to replenish lost fat. BMR might decrease by up to 45%.

When you start eating again, two things happen: 1) you will start to put on water weight because your cells are trying to get re-hydrated (this may even cause some temporary bloating, but it will pass after a few days), and 2) because your BMR has dropped and your body is in starvation mode, it will attempt to store any calories you consume for extra energy later. That being said, you would need to eat 3500 calories to gain a pound of actual weight. So your previous weight gain was likely primarily water weight. This will slow down once you are no longer dehydrated and your body begins to re-normalize.

As you begin to eat again, your BMR will also start to increase as your body realizes that you are no longer starving yourself. This too will slow weight gain down.

In a nutshell, yes - you will gain weight and it may seem like it's too fast, but as most of what you are gaining is water weight, it should begin to stabilize within 1-2 weeks of eating again and your weight will go back down.

Let me know if you have any other questions or if there is anything else I can do to help. Good luck!

Anorexia/Eating Disorders

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Mary Pritchard

Expertise

I can answer questions about the psychology of eating, disordered eating attitudes and behaviors such as drive for thinness, drive for muscularity, binge eating, body dysmorphia, dieting, excessive/obsessive exercise, and body dissatisfaction. I can also answer questions about anorexia and bulimia.

Experience

I have a PhD in Psychology and teach courses in the Psychology of Health and the Psychology of Eating. I have been conducting research on disordered eating and exercise behaviors for 15 years.

Organizations
Midwestern psychological association, rocky mountain psychological association

Publications
Over 50 peer-reviewed journal articles in journals such as Eating Behaviors, Eating Disorders, and Eating and Weight Disorders

Education/Credentials
PhD in Psychology from the University of Denver

Awards and Honors
30 teaching awards, have received funding to conduct my research from academic institutions and state and local government

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