Expert: Meg - 7/20/2007

Question
QUESTION: Hi, I've been anorexic for a little over two years now.  This is something that I have just recently been able to admit.  I've come to terms that I need to get help and to change.  I've read a lot of the other questions posted and I haven't found any case exactly like mine.  I am 5'4" and weigh about 120, give or take.  The lowest I've ever been has been only 108.  So, I've been within the "healthy weight" range.  So, if you looked at me, you wouldn't be able to tell I had an eating disorder.  I am athletic and physically fit.  Here's the thing, I work out about 5 times a week for about an hour, 40-45 min of which is cardio.  I also only eat about 700 calories a day.  Not that I wanted to, but why did I never drop down to below 100 like most anorexics that you think of?  In the past few months, I've noticed that it's been progressively harder to lose weight, or even to maintain it sometimes.  I feel like I have to exercise more or eat less.  I have been gaining a little bit of weight too, but nothing I've done has changed.  I know that my metabolism is messed up right now and I need to eat more in order for it to go back to normal.  I also know that you can gain some weight back when you go back to normal eating.  I haven't lost my period or anything, and I have a composition and body fat and muscle.  So, while it's vital for underweight anorexics to gain weight, I don't have that problem.  I do, however, NEED to eat more.  I'm kinda scared that I will, like most others, gain weight.  But, my body doesn't need that extra weight.  I love the way my body is right now, even with some of its curves and jiggle.  How much weight can I expect I might gain?  I know that my weight will be leveled and controlled once my metabolism is back to normal, but how long could that be?  Also, in my plan to eat more.  Should I go slowly (such as add 100 calories a day every one or two weeks), or should I just go straight to eating a more normal amount?  Is there a difference in how fast my metabolism recover between them?  Wow, I know that's a lot of questions.  I'm just so confused and ready to change, but I need some answers that can help me prepare for what to expect.  Thanks!

ANSWER: Hi Susie,

Thanks for your question and I hope that I can be of some help.  I'm really glad that you're finally able to admit your eating disorder (seriously, this can be a really huge step) and are working on taking steps to get healthy again.  That's wonderful and I know that you can do it.

As for not feeling like you are a "typical anorexic", I think many people feel this way and fit into your category.  You're right that regardless of your not being severely emaciated, your body is not functioning properly and your metabolism is off because of your eating disorder.  While you may not feel like you are really *sick* (again, this is actually pretty common as most people are not as *sick* as the severe anorexics who are on talk shows and the like) obviously this is effecting your body and can still be dangerous.  So, know that you are sick enough to get well and that you deserve to be free of this and not caught up in such an unhealthy cycle.  I think you know that, but I just want to reiterate as its easy to sometimes think "its not that bad" when recovery gets hard or you're having a difficult day.

As for weight gain, its hard to say how much you might gain from eating more and how your  body will react.  It is possible that initially you might gain a little bit of weight, but I really believe that because you are not striving to be severely underweight that your body will probably level out pretty quickly.  Again, I can only guess in terms of how long that will take and it is really specific to how much damage your body has undergone.  I wish there were a more scientific formula, and perhaps a doctor knows of one but I've never heard of it.  What I do know is that you will not get FAT from eating a regular amount of calories and its possible that your metabolism will start back up and you'll even lose weight before it levels out.  It really depends on your body.  What I recommend (and I know its hard) is to give your body a month or two scale free, focus on increasing your calories and taking good care of your  body.  Know that you will most likely FEEL fatter but that it will simply be a feeling.  And then, check back in a few months and I would really bet that your weight will not have changed much at all, and yet you'll be eating again, feeling healthy, having energy and thrilled that you can be have all this without your eating disorder.  It really is possible.

As far as feeling fat, oftentimes, restricting helps people feel in control and so when you give up some of that control and increase your calories, you FEEL like you're getting fat.  In reality, you are just letting go of the eating disorder and some of that fake control and the feelings can be transposed to a feeling of "fat" or gaining.  It can be scary and feel like you're going to end up huge, but in reality you are actually just gaining your health and life back.  Which is a good thing.  

As for increasing your calories, I would say increase them somewhat slowly.  Since you've been living this way for 2 years now, your body might be a little shocked if you suddenly went back to regular eating (not to mention that you'd probably feel stuffed and again possibly really out of control).  I think your plan of gradually increasing your calories until you are a healthy level is a good one.  

If you still aren't sure, or want expert help, consulting with a nutritionist is such a good thing as he or she can take into account your history, specifics with your body and help you plan a healthy meal plan.  

I hope this answered your questions and please feel free to write again if anything in this message wasn't clear or if there is anything else that I can help with.

You sound really committed to getting better (yay, which is wonderful so great job) and I know that you can do it.  Just be patient and know that some days are hard but it gets easier with every day that you take steps away from your eating disorder and back towards your life.  

Good luck and take care,
Meg



---------- FOLLOW-UP ----------

QUESTION: Thanks for the answer!

I've been trying to get back on track for a week now.  I've been eating around 1000 calories.  I've noticed that I'm always hungry!  I can eat a meal and an hour later be hungry again.  I've also lost a couple pounds.  While, this is kind of cool, I just want to know if it's just something shortlived, and not to get excited about.

Answer
Hi Susie,

Its hard to say for sure, but I think that as you continue to eat enough calories (probably more than you are even eating now) your body will level out at a healthy level for you.  The hunger and not gaining weight from eating more calories (and closer to a normal level) are good signs that your metabolism is on the mend and should be working again soon.

As for getting excited, I think that its best to focus on getting healthy and getting your metabolism working again rather than if you're losing as that is likely to lead you back towards your eating disorder.  

Good job and its great that you're making some progress.  Keep up the great work.

Take care,
Meg