Expert: Joanne - 9/23/2006

Question
so after about 11 years of struggling with anorexia and periods of intense over-exercising, my body hit a wall about a year ago. i had been extremely underweight, but suddenly started gaining and gaining, until about 30 pounds had piled on and put me within the normal range. there had been no change in my eating habits, if anything i was consuming less calories (tops 500 per day). how this is physically possible, i cannot understand. i have since been diagnosed with an underactive thyroid, but the medicine does not seem to be helping--my metabolism seems to be shot.
at any rate, after numerous sources have told me i need to actually INCREASE my calories to regain a normal metabolism and stop gaining, i have started to try to do this. though it seems counter-intuitive, i like to believe that there is hope for my body.
i am tired of living a warped lifestyle and exercising to the point of exhaustion and barely eating and still struggling to not gain more. i don't understand how a body can be burning more calories on the damn cardio machine than it takes in (not even considering calories out due to rmr) and still manage to put on pounds. i have been known to have a deficit of 1000 calories (not including rmr) a day, and still maintain or gain.
so i have started to try to change my ways. to develop healthier habits. i have gotten myself up to about 800 or 900 calories a day, and am exercising less--about 700 a day. but this increase in calories has caused me to gain about 3 pounds in the week i have tried it...and my net caloric intake is only about 200 a day (actually less, if i have any rmr whatsoever)! what is going on?
i am seeing a therapist (i have been for years), and i've sought the medical advice of numerous physicians, none of whom can explain this phenomenon. my dietician just tells me to eat more.
can you provide advice as to how to get out of this starvation mode? i don't want to lose weight, but if i'm going to be within the normal weight range, i'd like to at least be able to consume a normal amount of calories. i'm tired of this.
thanks. alice.

Answer
In order to lose weight, it is true that you have to eat enough.  It is recommended that when your metabolism is working at its best, 1500 calories allows you to lose weight healthily and safely, and 1800 calories or so will help you maintain that weight

Until your metabolism is working properly, you will gain weight, but that usually evens itself out once your body realises that it is going to be fed what it needs and so can stop storing and working to half capacity.

I'm not sure exactly how metabolism works yet (studying it still) but I don't think that your body will burn as many calories on the treadmill as someone who does have a normal healthy diet.  The body finds ways to make sure that it spends its energy most efficiently when being starved.  Your muscles are most likely wasting as they will be broken down to provide your body with energy.  Your muscles will therefore use less energy than someone whose muscles are being fed what they need and are bigger.  People that don't have eating disorders are constantly using calories to keep their bodies at the correct temperature and things, where as you body (so as not to use too much energy) will keep your body a lower temperature (warm enough to keep you alive and functioning though)and that is why you will feel the cold (I imagine that you do).  Basically, your body adapts and sacrifices spending energy on somethings in order to keep others working.  If you are anything like me, you probably experience being unable to concentrate at times, and it is simply because your brain is getting enough energy to control your organs and things like that, but not enough to allow you to focus and learn or take things like that in.

I'm sorry, this is really the only explanation I can think of.  I would recommend seeing another Dr and getting them to check your thyroid medication is working, and other than that I think you should see a dietician and see what they recommend you eat.  I think you need to try and get your metabolism working properly, which means trying to eat up to 2000 calories a day, but a dietician will be able to work this out with you as they will be dealing with people in your situation all the time, so will be able to work out the best way for you to get you calorie count up, and do it slowly.  They will probably keep an eye on your weight so as to adjust your diet accordingly.

I hope that this has been of some help, and if you have any other questions, please feel free to come back.

Holly