Expert: Meg - 12/16/2005

Question
Hi Meg,
The last time I asked a question to an expert on this website, I was in the throes of Anorexia, severely underweight, and extremely depressed.  I've come a long way since then.  Let me give you a little background on my current situation...
For a number of reasons which seemed to all develop at rather precise timing, I developed my eating disorder(s).  In April, '04, I pretty much just stopped eating very suddenly.  I weighed around 145lbs to begin with, and had weighed as much for a few years.  I was 18 years old at that time.  By August of that year, I was down to around 102lbs.  I had no friends, no family to help, and was working full time while attending college full time.  From August to January, I dwindled down to my very lowest, 86lbs.  After my parents threatened to put me inpatiend, I began to recover...slowly.  I went back and forth between 105-110lbs for a good six months.  I had a boyfriend at the time, who tried to support me, and the family too, was very supportive.  I struggled with laxative abuse, moderate bulimia, and chew/spitting behaviors.  My periods returned after over a year's absence, in August.  I began taking the antidepressant Lexapro in May, but stopped as I felt they were unnecessary, I also took Ambien, which helped me sleep for a few months.  As of now, I am on no medication.
Anyway, I quit my job, (where I spent most of my time) in September, and I weighed about 120lbs, but I was wearing a size four and not eating much.  I have never been able to regain my ability to sit down and enjoy a meal, eat fast-food, or eat even close to as much as I did before I got sick.  I stick to cereal, oatmeal, etc., diet soda, fruit, vegetables, etc.  I rarely eat meat or bread, cheese or butter, or anything which is obviously very unhealthy.  I practice various ED behaviors sometimes (i.e., purging, c/s, hiding food in napkins at dinner), and yet, the last time I checked, I weighed 140lbs., and I am very positive that I have gained at least 10-15lbs in the month since I last checked my weight.
I try to avoid that now, because it just brings me down way further.  Not a day goes by when I don't worry about what I eat, and hate the way my "new" body feels.  I would have loved to stay around 125lbs, but look what happened.  I don't understand it at all.  I am so unhappy with my body, and I am so scared that I am only going to keep gaining weight if I don't do something.  Like I said, I obsess over food and calories.  I always reckoned that 1200 was my daily limit, so I constantly try too keep things around there.  I recently got a new job, working in a candy store (ironic?), but only ever eat sugary candy, no chocolate, etc.  But even at that, I don't eat much else.  For example...today I ate a pear, stood on my feet at work for 10 hours, ate some candy here and there during that time, then came home, ate a handful of potato chips (which I broke up into little pieces to make it seem like more, a habit I've never given up), and then tried to eat the stew my mom made.  I ate all the carrots out of it...but I saw how much butter she put in the potatoes, so tried to avoid those...and the meat was out of the question in my mind.  I portioned myself way less than everyone else, then ate 5 forkfuls maybe? Then I went and purged a little bit.  That type of daily calorie intake is normal for me.  I try to avoid set numbers, so as to avoid knowing exactly how much I have consumed.  You probably know how much all of those numbers can consume your every thought.  
Anyway, I just don't understand the weight gain.  Was it being off of my feet and not working (as I had done regularly for 2 years), was it a hormonal thing, or is it a metabolism thing?  I went to the doctor to be tested for Hypothyroidism/underactive thyroid.  I am expecting results tomorrow.  I almost hope that is the problem so I don't feel so gross and out of control.  Do you have any suggestions as to how I can reverse the damage I've done to my metabolism, how to stop the weight gain and get my body where I want it to be.  I am interested in losing weight the right way (i.e., exercising, eating right) in order to get to 125lbs if possible.  I am 5'3", is that a reasonable goal if achieved the right way?  Anyway, I want to get off to a good start.  I want to quit gaining, because its not easy to be almost twice the size I was when I was at my worst.  Any advice you could give, or answers to my many questions would be wonderful.  Sorry for this really lengthy question.  

Lesley

Answer
Hi Lesley,

First of all, I want to say that although you're not happy with your current situation...you really deserve a whole lot of credit for working so hard on recovering.  I hope that you can see how far you have come.  Its easy to forget all of that when you are feeling badly about where you are (trust me, I understand that all too well) but I feel like its important to at least keep in the back of your mind.  Anorexia is really difficult to recover from and is often deadly and its wonderful that you have been able to find the strength to work on getting healthy again.  This is something to be very proud of.

That said, it sounds like you are still struggling with some eating disordered thoughts and behaviors.  This is normal, and from your letter it sounds like you have only been in recovery for a relatively short time.  One thing that I found is that it really takes a long time to unlearn all of those eating disorded mindsets and to learn other tools in dealing with things than not eating, c/s, purging, obsessing about numbers, etc.  These behaviors are still serious and can still have physical consequences as well as make you feel pretty awful (as I think you know).  And really, you deserve to feel better than this...I promise you that.  

I'm wondering if you have tried any type of therapy or working on any of the underlying issues that you mentioned contributed to your developing an eating disorder.  I know that I was always rather adverse to this, but I have come to find that there is certainly some truth that until you can understand what is behind these behaviors and feelings, they are difficult to be free of.  It sounds (since you mentioned the various issues that occured at the same time and initially triggered your ED) that you are at least somewhat aware of some of them...which is good.  If you have the means to do so, it might be helpful to talk with someone or even try a support group.  There are free ones all over the country from www.anad.org that might be of help.  If there is just no way that you are willing to try talking with a professional (which I really do believe can make all of this a lot faster and easier) I still recommend really doing some soul searching on your own.  Perhaps journal, talk with friends, read up about eating disorders and what can bring them on so that you can begin to understand the reasons for yourself.  Cheesy as it may sound, I (and many other girls I know) have found that with knowledge comes power for you and begins to take away the power of those irrational thoughts that can bring on eating disordered behaviors.  When you can really understand what it is that you need, it is possible to find healthier ways to get that-and without dieting, overeating, doing behaviors, obsessing about food/weight/etc.  So, this is one thing that if you haven't already worked on, I would really suggest that you try.

You mention that you have a lot of trouble sitting down for a meal and still eat a very limited range of foods and feel guilty for doing even that.  This is a very common problem that many girls face, myself included.  It makes me sort of sad to hear this as I went through it and remember how truly horrible it feels to be still "restricting" in a sense, and yet still feel so terrible about eating at all.  This is definitely something to work on as (and I'm sure intellectually you know this) EVERYONE has to eat.  Its what humans have to do to stay alive-and although it may go against what you believed when you were sick and anorexic, eating is nothing to feel badly about and really no different than breating air.  Just as you have to breathe to exist (and who really feels badly about that), you also need fuel for your body so that it can continue on.  I know that this is easy for me to say, but a harder concept to encorperate into your thinking, but it really is important as it takes so much energy to feel so badly every time you eat...and there really is so much more to life than feeling badly all the time.  Especially about this.

I'm wondering, since you mentioned your very restrictive diet as well as some lingering ED behaviors, if you have perhaps been able to speak with a nutritionist.  Sorry to be recommending that you seek out these professionals, but it is quite possible that the reason your body is not getting its normal metabolic rate back the way you'd like is that it is not getting the nutrients and all of the vitamins and componants that it needs.  Especially, with such a restrictive diet, this is quite possible.  Talking with a nutritionist even once would probably be helpful in at least understanding what makes up a healthy diet, what each of the componants add to your body working well and why this can actually help you feel better and get your body back to a place where you feel comfortable.  Again, if you are not willing to do this, one place to start might be at least researching healthy eating yourself so that you can understand the role of protein, fat, carbs, fiber, vitamins, etc.  I, personally, found that in doing that, eating became a little easier in that I felt like I was contributing to the health of my body more rather than just taking in calories because I knew that I probably should.  So, that's another thing for you to think about.

I think that you are wise to try to avoid the scale and number counting-as you are correct that it not only leads to feeling depressed about this stuff but also can bring you right back to obsessing.  That said, I really feel that because you are fairly new to recovery (and working on it) the less emphasis that you can put on weight *for the moment*...the better.  I know that this probably goes against all of your beliefs about this subject but it is true that it takes one's body awhile to regulate and balance out.  This can be an uncomfortable time, and I assure you that many people have gone through this and your body WILL eventually balance itself out but it may take a little time and consistancy with your diet.  

I'm also worried about your purging and hope that you can take whatever means possible to work on this and eliminate it from your life.  Not only can it cause health problems (as you know) but you deserve to be without ALL behaviors and this is one that is only going to keep you from getting completely past this.

My guess is that the reason that you are feeling so out of control is just that your body is confused by all its been through in the last few years and trying to find a healthy place again.  That said, good for you for getting tested for thyroid problems.  Hopefully, that helped in finding out if that was an issue.  You can ask the doctor to check your hormone levels as well, since you are curious about that.  If neither of those are an issue, than I stick by my previous declaration that it just takes awhile for the body to find its equilibrium.  Frusterating, I know...but it gets better.

My heart really goes out to you as I remember saying a lot of the same things (like being nearly double my unhealthiest weight at one point in recovering-and how out of control that did feel).  It will get better and again, find a nutritional plan that is comprehensive and that you can stick to and is healthy-and give your body some regularity and I really believe that you will get to a place with your weight that you are happy and healthy.  It definitely is possible.

And, in the meantime, I really hope that you can find other things to focus on besides only your weight.  There are millions of fun, exciting, interesting things out there and while its true that weight/food/body image may always play a little role in your life, it really is easier to be happy and move fowards when you allow other things to play a part as well.

Best of luck to you and please feel free to let me know how your test came out as well as if you need further clarification on anything or there is anything else that I can do.

Take care, okay?
Meg