Expert: Meg - 5/3/2007

Question
QUESTION: Hi Meg,
i have been on a low calorie diet for half a year, and has lost weight from 115 pounds to my current 78 pounds/36kg. i guess this diet has goine way overboard and i havent had my period for 5 mths. i wan to get well and learn to eat normally again but i also understand that my metabolism is screwed up . i am afraid that my weight will just spiral up and go out of control, afer reading tt some people even go up 30 pds beyond their initial pre-dieting weight when they try to eat normal. i wan to eat till i reach 40 kg and maintain it right there. can you advise me on how many calories i should consume\? i am a student now so my lifestyle isnt that hectic or energy demanding.
also, i havent touched bread for a long time and i wan to start eatin it as well. will it make me put on weight very fast cause its all carbs?
my diet is like 99% fat free...and will beginning to eat more fat cause my weight to go up very fast?
i'm getting desperate this ED is ruining my life and famliy...hope to hear from you soon.
Lotsa of love and thanks, from meefael
ANSWER: Hi Meefael,

Thanks for your question and I hope that I can be of some help.  It can be very difficult (although not impossible) to recover on one's own and although it sounds like this is what you want to do, I hope that you will continue to educate yourself about eating disorders and stay open to getting some help further down the line if you need it.  

As far as how many calories to consume in order to gain weight healthfully, I would recommend slowly upping your current intake until you get to about 1800 or so.  Depending on how low calorie your diet right now is, this may take awhile and it really is better to do this slowly (for instance 1000 then 1200 then 1400 and so on) as it can be a shock to one's body to go from barely eating to eating a normal amount.   Your optimal calorie amount to maintain that weight really depends on your body, how active you are, your metabolism, etc but I would guess that it will be at least in the 1700-1800 range.  

As far as the carbs and the fat, I personally feel that calories are calories and the total amount is more important than if they come from fat or carbs.  That said, as you probably know, fat calories are more dense and it is easier to eat more of them with a smaller amount of food which is why sometimes people get fanatic with cutting fat.  I, too, at a very fat free diet at my sickest and my body actually responded very well to adding some fat back into my diet as it is a vital nutrient and important.  So, I don't think that you're going to gain a lot of weight from adding either carbs or fat, but as with everything its important to keep a balance.  The good thing about fat is that it causes you to feel more full (as can protein) so it has a benefit in that way.  As far as carbs, I would try to eat whole grain and healthy carbs if possible and they shouldn't cause you sudden or drastic weight change.

That said, as you know (since you mentioned it) you do need to gain some weight.  The reason why many people do get treatment is that it can be difficult to go against your eating disorder and the patterns that you have established over the last year and be okay with this.  It is so important for you to remember that you are gaining weight that you need to gain, and if possible focus more on being healthy again than how much you are gaining.

Here are some web pages that might be of help to you:


http://www.something-fishy.org/

http://www.anad.org/

http://www.mirror-mirror.org/eatdis.htm

Hope this helps and please feel free to write again if anything in this is not clear enough or if I answer anything else for you.

Take care,
Meg

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

QUESTION: Hi Meg,
thanks so so s o much...could u provide me w more advice on how i should go about with my eating? like adding a slice of bread slowly day by day to my diet? i went on a buffet yesterday and ate a lot, esp chocolate and the worst part is i lost another 1 kg when i weighed myself this morn. and i've got to admit its really hard to get myself to eat like normal. i cant stand the look of my emaciated body and i cant stant the look of gainng back the weight till being overweight like when i was younger. where will the extra weight that i gain appear? on those areas where i lost them? or like shuffle and move to my belly? how long did u take to gain back till healthy weight and remain like that? how do people actualy gain up to 30lbs beyond ther initail weight when they recover? sorry this follow up sounds like a mess of qns ...i'm in a mess....thanks for the reply, i really appreciate it, love, meefael

Answer
Hello again Meefael,

Its good that you still sound like you are wanting to work hard towards recovery.  It can take awhile and just as you eating disorder didn't develop over night, getting better will probably be a gradual process.  

As far as how to start getting your diet more healthy, I think that first you need to get the basics about what a healthy diet means (as its very easy to lose touch with that when you are sick with an eating disorder).  Basically, you need to  be sure that your diet contains all of the food groups and nutrients and minerals that your body needs.  Once you make sure that you are getting protein, fats, carbs, etc...then you can gradually start increasing each of the groups until you are at a normal level for all of these.  Again, a nutritionist can help with this but it is also possible (though a lot more work) to figure it out on your own.

Here is a pretty comprehensive nutrition site:

http://www.hsph.harvard.edu/nutritionsource/pyramids.html

As far as how you will gain the weight back, that really varies from person to person.  But, the one thing that is generally true is that your weight will redistribute normally eventually.  

Most people do not (at least in my experience or understanding) gain 30 extra pounds when they recover.  Generally, one's body has an optimal weight that it will go towards and that is usually what most doctors consider "normal".  Usually, with healthy eating, a body will end up there and not overweight.  Most women that I know who have recovered remain thin/normal/healthy.  But, the most important thing right now is for your body to get healthy once again and hopefully you can keep this goal in the forefront of your mind.  

I know its not easy, but you sound very determined and I know you can do it.  

Take care and please feel free to write again if you have more questions.

Best,
Meg