Expert: Susan Downes - 7/31/2007

Question
Hello,
I am 32 years old, and I've been struggling with anorexia (with some purging as well) for about a year and a half. (As a teen I had some minor ED-NOS related problems (I was sexually assaulted as a child), but it resolved itself, and this new ed situation didn't come full circle until my early 30s) I've been recovering for 6 months or so, working with my nutritionist and going to a support group (I was in therapy for a while on PTSD issues, but when those improved, I stopped weekly therapy)  My question is related to gaining weight in recovery.

My weight became low enough to lose my period for a few months and also lose some hair (along with some other physical problems) although I was only slightly underweight for my height and build (I was 122 (from my normal and consistant 142) and 5'7" and I have a medium, athletic build) Over the 8 months of recovery, my weight was stable for 2 months, and then I started to gain a pound to two pounds a month. Last month, I gained seven pounds in a month, and to be honest, seeing that has put me into a tailspin, I have a meal plan to follow, and (when I follow it) I eat 2000 calories a day, but I'm frightened that the pounds will continue to pack on and that I'll end up bigger than I was originally (I was 137 at my last weigh in)
Can you tell me if it's normal to have a big jump like that  (following the same meal plan) and then settle back to normal? I was a superstar with my meal plan for several months, but in this last month I've been messing up a lot, afraid to eat enough to gain, and I lost a couple of pounds. I'm so worried about relapsing all the way, and while my nutritionist has been so wonderful (even just calling me out of the blue a few weeks ago to see how I was doing and giving me strategies to finish my meals and follow my plan) I'm so nervous about my upcoming appt, I don't know how to tell her that I'm messing up.  It's harder to make the right decisions, I'll restrict for most of the day and then make the calories up at night some days, other days I'll restrict all day. I've also started to over exercise again, walking 4 miles a day on a low amount of calories. I have not purged since May, but   whenever I finish a meal, the urge to do it is very strong. It gets harder to talk myself out of it.The frustrating thing is that I can see that its happening, and I'm so frustrated that I know the "right things to do" but have such a tough time doing it.

Thanks,
Margaret

Answer
Hi Margaret, A couple of things you said really got my attention. First, you said that the abuse "resolved itself". Being hurt cannot resolve itself, it takes constant work, and the work is always about your self-esteem. You know that don't you?
Secondly, the bulk of your message to me was worry about what the scale says to you, calories, weight, exercise... Throw away your scale! Cover or toss out all of your mirrors too if you must. You are still trying to control your world, like you tried so hard to do long ago when it was spiraling out of control. I have found that it is the worst kind of thinking for us, we need to focus on eating normal and healthy. We need to nurture ourselves by helping others become empowered. If you stay consumed with controlling your intake and weight, the slightest bump in the road will seem big. You, Margaret, your self-worth as a person is NOT dependent on who you are on the outside, it is Margaret that is within that is loved and lovable. Personally, I call it chasing the mice in my own head. Whenever I begin to feel that I am chasing mice, or see someone else doing it, I stop and try to help others or nurture myself. Read back the letter you wrote to me, analyze it and read how nervous you were when you wrote it. You were concerned about small details, how you are messing up, what your nutritionist will think... Slow down, love yourself, let someone love you. And please get off the scale. When I threw out my scale, my weight stabilized on its own because my metabolism got back to normal. Eat frequently, eat well, and don't burn those valuable calories with worry. Life is way too short and you are only shortening it. Please follow-up, leave feedback and let me know that you are okay.  I know that this will all make sense to you, if not now, than later. In the meantime, I will be praying for a speedy recovery for you and hope that you take good care of the wonderful woman that you really are inside. Warm Regards, Susan