Expert: Meg - 6/6/2006

Question
what i can't understand is that i exercise obsessively and only chew and spit my food or eat carrot sticks so how could i not burn up the calorie that i have taken in? shouldn't i have lost weight? what is the amount of weight gained or lost? Also how can you get rid of the flab i have it everywhere thighs, arms, stomach, back everywhere!If is start eating again will i get back to the weight that i was again when i ate more and weighed less? i am terrified of any gain so if i eat and gain more weight i will be so unhappy like when i went from 48 to 51 i had such an axiety attack! mum said that i looked like i had lost weight how is this so? could her scales be out? how do more serious anorexics not have the flab and gain any amount of weight at all?and actually lose it? Please help me!
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Followup To

Question -
Sorry to bother you again you must be so sick of me! i went to the doctor the other day and had put on weight! i now am 169cm tall and 51kg but all i have been doing was chewing and spitting my food! the nurse said she had no idea how i could put on weight and said that i actually looked really sick and as though i had lost weight! how is this possible? Mum keeps telling me that if i eat 5-6 small healthy meals reallt tiny to start off with that it will get my metabolism going and burning fat and will notice a few kilo weight loss in a couple of weeks! She also said that because i had been starving myself that it was going into survival mode and holding on to the fat stores to get some food is this true? please give me an honest answer as to whether i will gain or lose weight from eating? because i can't stand another gain! every where you look on the internet one thing tells you that you lose and the other tells you that you gain? please tell me! if there is weight loss what is the expected amount of weight loss to occur?

Answer -
Hi Jen,

I'm totally not sick of you and I understand that it takes a lot of time and thinking about things, and asking questions in order to make the decision to get better.  So, seriously feel free to write as much as you'd like.

As far as gaining weight from chewing and spitting, it *is* possible as digestion begins in the mouth and you do absorb some calories from doing this.  That said, it is pretty unlikely that this is making you gain a lot of weight (unless you are chewing and spitting a LOT-which is almost impossible).  However, your Mom is right that your metabolism is probably a bit wacky right now and your body is not responding normally to food.  The reason for this, as you Mom said is that your body is in starvation mode and is holding onto whatever it can get so that you can survive.  It sounds like your Mom has some good information and is correct.  Hopefully, you can work with her to start to put some of these new, healthier ideas into use.  

In response to your looking very sick, despite an increase in weight, this is quite possible as your body is not functioning well right now and so it follows that you will look sicker as this progresses.  This is yet another reason to take some steps towards getting healthier.  

As far as if you will gain weight from eating again, that really depends on your body.  I don't want to lie to you and say that there is no way that you will, although I think that its pretty likely that you will not gain any considerable amount and will ultimately get your metabolism back into good condition if you are able to eat healthfully for an extended period of time.  Some girls actually  lose weight when they first start eating again, so that is just as possible as your gaining.  It really depends on *your* body, how well it responds to refeeding and a lot of other factors.  I hope that you can take that leap of faith and listen to your Mom (who sounds like she has done some good research of her own and can be an ally for you right now) and try to start eating small meals so that your metabolism can get started up again and your body can recover.

I hope this helps some and I'm sorry that I can't predict more specifically what will happen as you begin to eat again.  What I CAN predict with assuredness is that as your body gets healthier and you begin to feel better, a lot of this will be easier to deal with and things overall will get better.  Keep fighting, okay?  It sounds like you're on the right track.

Best,
Meg

Answer
Hi again, Jen,

I hope that this finds you having a good day and taking care of yourself.  Your note sounds like you are really stresed out about your weight/food and are pretty deep into your eating disordered thinking.  I remember that well, and I hope that you can trust me in knowing that  you need to take some steps to get better as unfortunately this obsessing is pretty circular and  will keep going on and freaking you out until you do.

It sounds to me (and I really suggest that you consult your medical doctor about this as he/she can measure physiologically what is going on) like your metabolism is really not working properly at all right now due to all the stress on your body.  

Yes, restricting at such a intense level would cause a healthy person to lose weight, however your body is barely functioning and probably fighting for its life right now so what would happen in a more healthy individual is not going to be what will happen for you right now.  

It is possible that you  have gained some water weight from the chewing and spitting (perhaps if you're chewing/spitting salty foods) or that your electrolytes are out of balance and causing you to retain water.  Either way, these are signs that your body is in danger and is having problems due to what you are doing to it.  I know that you are pretty deep into this right now, but I hope that you can see that you need to get some type of help so that YOU are choosing to get help rather than eventually being forced into getting it.  For many of us with eating disorders, control is a big thing, and I know that for me-knowing that if *I* didn't take some steps to get things turned around, my parents would see to it that I go into a hospital...this motivated me.  Hopefully, you can find some similar motivation and get some help as soon as possible.

As far as the flab all over you, I would be willing to place a bet that your thinking is incredibly distored right now and no matter what the scale tells you-you are going to see "flab all over".  Again, this is common as one gets sicker and is another tragedy about this disease.  You will probably never feel thin, even as your body is dying...However, as you get healthier again and your brain chemistry gets back to normal,  it is very possible to see a body that you like and that is healthy and thin.

Here are some sites for you that deal with distorted body image.  Perhaps they will be of some help:

http://www.suite101.com/article.cfm/eating_disorders/117487

http://www.healthyplace.com/Communities/Eating_Disorders/body_image_impact.asp

I would really recommend staying off the scales for awhile (I know, this would be incredibly challanging for you-but I know you can do it and it would really help stop some of the obsessing I think) and talking with your Mom-who sounds really like she cares and wants to help about finding a counselor who deals with this and/or a nutritionist who can help you find an eating plan that will not freak you out but will allow your body to heal enough that your metabolism (and everything else) gets back to normal.

I hope this helped and again, write anytime if there is more than I can help with.  

Take care,
Meg