Expert: Meg - 5/11/2006

Question
Hi Meg,
I've 20 years old and have been anorexic since 15. I've been getting help for most of that time. I've even been Inpatient for a while. I have a great team of a pyschitrist, doctor and nutrionist. Recently i've decided i'm sick of being sick and i should gain weight. I'm 5'7'' and 105 lbs. My lowest was 95. Anyway, my doctor promised me i can stop gaining when i get my period. We don't know how much more i have to gain, but i'm hoping only 5 lbs. My nutrionist thinks that this could be enough.
My concern is that when i get to where I want to be, that i won't be able to stop gaining weight. It seems like alot of recovering anorexics just keep gaining, and get back to where they started, or even beyond that! My highest weight was 130/135, which i know isn't fat, but i did not feel comfortable there. I was 120 for a long time and kind of shot up to 135 which freaked me out.
I've been having some troulbe with recovering too and binging. It's so freaking scary. I purged twice too and i NEVER want to do it agian.
I'm just SO scared that I will have to gain tons of weight to get my period and that I won't be able to stop at a healthy but thin number.
I was over exercising and in the past week I stopped cold turkey. My team said i Can keep exercising at a healthy level (45 minutes a day several times a week) but I lost all motivation. I"ve become depressed and have been sleeping so much. In the past week, i've been eating around 1700 caloires, not exercising (but doing some walking/shopping/cleaning type stuff) and have put on a few lbs. I feel fat and miserable. I'm also taking lexepro and wellbutrin which help some what. I dont want to have to buy new clothes! Do most anorexics end up at the weight they started at or more? i'm sorry this e-mail is so long and confusing but i just need some advice/guidance from someone who has been there. My metobolism is whacky. For awhile i was eating 2000+ and not gaining at all, now i'm gaining on 1600 to 1800 but i guess thats because i've been so lazy and not gotten any exercise. I know thats affected my mood. THanks so much. I look forward to your response.
Alison

Answer
Hi Alison,

Thanks for your question and I hope that I can be of some help.  I really feel for you as I know that you're in the midst of a difficult time in terms of recovery and I hope that you can stick it out as I promise that it does eventually get easier.  Its also really good that you have a treatment team to help keep you on track and I applaud your wanting to get healthy again even if a part of you is questioning doing so.  

Because you have been dealing with this for five years, it is natural that you are feeling really uncomfortable right now as you start getting rid of some of your behaviors (restricting, overexercising, etc).  I remember being totally terrified about weight gain-and I think its pretty normal and understandable considering that it is contradictory to all of the "rules" that you've been living with for the last 5 years.  I've known lots of anorexics who recover and don't end up heavy or at a weight that they feel unhappy with so there is no reason to believe that recovering for you has to  equal being "fat" and hating your body.  That said, it is pretty common that you are going to "feel" fat for a little while as your body adjusts to getting regular nutrition so for this reason, its very important to separate "feeling fat" from actually getting too heavy.  Its very good that you have nutritionist and team who can help serve as a reality check in that matter for the time being.  Also, as unappealing as this sounds, it can be very helpful (and was for me) to give up the scale for awhile as it becomes way too easy to continue to fixate on that number rather than work on being healthy.  Honestly, your weight will level out at an okay level when your body is healthy but its normal to be up and down for a bit while you're getting there.  Especially if your metabolism is whacky (as was mine).  The way that I looked at it was that the sooner my body got back to normal (and by that, I mean healthy and working properly-which it can't do when its not getting nutrition) the sooner my metabolism would start working properly and the sooner I could get a body that I was happy with and also be healthy.  And again, I promise you that this is TOTALLY possible.  Just keep on working on getting healthy, okay?

In terms of the binging, this is also a really *normal* part of recovery for a lot of people.  This happened to me as well, as I felt like my  body was so excited to finally be getting food/nutrients/stuff not on my "safe" list that sometimes it went a little wild and I did binge.  The good news is that generally when this happens (especially in early recovery) it is because your body *needs* the energy/nutrients and it doesn't make you gain a ton suddenly.  Also, the healthier your body gets (yes, I know it sounds like I am harping on this but it really is true) and the more you can consistantly eat a balanced diet, the less you will feel the need to binge.  So, this is another reason to push all of the ambiguity that so often comes with recovery to the side and keep pushing ahead.

In regards to exercising, I know that its a delicate balance and that its hard not to fall into that all or nothing mentality.  However, exercise (in moderation) does help with mood improvement and since your team has cleared you to exercise lightly 3 times a week, you might want to try some new easy routines (like walking with a friend, a new aerobics class, etc).  I found that if I tried to do the same routine I had done while I was sick, it was easier to slip back into that mentality so switching things up a bit was really good and also fun :)

Finally, I would really recommend trying to add some *fun* stuff to your  life as well.  It helps shift the focus from your ED to living (which is a lot more fun and makes it all worthwile).

Good luck and please write again if any of this is not clear.

Best,
MEg