You Cant Just Eat a Cheeseburger: How to thrive through eating disorder recovery

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Now that the academic school year has come to a close, many college students have flown back to the nest for a summer reprieve. Some of the red flags that parents first report include:. So, how do parents approach such personal topics with young adult children, while still respecting them as an autonomous individual?

Next Steps? Refer to our brief online assessment , which can be completed by your child themselves, or by you based on your observations of their behavior. This brief assessment provides valuable information about potentially problematic eating behaviors along with resources and suggestions for how to proceed.

These groups are open to anyone — meaning your child does not need to be a patient at CED to attend, and parents are welcome to attend with or without their child. Here at The Center for Eating Disorders, we have licensed mental health professionals available to consult with you over the phone and diverse programming throughout all levels of care. She joined the research team at CED as a volunteer research assistant in and worked on researching the utility and efficacy of telemedicine in the treatment of eating disorders.

Anorexia and Bulimia Care. National Eating Disorder Association. Warning Signs and Symptoms. No Comments. She is an Associate Professor of Psychology at Dickinson College, where she teaches courses on psychopathology, research design and analysis, and eating disorders. Her scholarship examines factors associated with the development and maintenance of eating disorders, particularly cultural features such as fat-shaming environments and pseudoscientific diet fads and difficulties with interpersonal relationships.

Ambwani is also currently involved with two clinical trials investigating technology-based guided self-help interventions for anorexia nervosa and strategies for caregivers to best support their loved ones with eating disorders. Q: How did you become interested in the field of eating disorders research and the factors that contribute to them? That initial research led to a senior honors thesis examining relationships among gender, body image and experiences in romantic relationships. Delving into this area of study sparked more questions and helped me to understand the urgency of examining the complex, multifaceted factors associated with the development and maintenance of eating disorders.

What makes your research innovative? We hope that furthering our understanding of these factors will inform preventative efforts and facilitate more effective interventions for patients and their loved ones. We have used this work to inform guided self-help interventions for individuals with anorexia nervosa, and are presently collaborating on two clinical trials using these approaches in the UK.

Recently, we have also begun investigating systemic factors, such as anti-fat bias and pseudoscientific dietary fads, to better understand how these could be targeted to prevent eating disorders on a broader scale and thus improve population health. Bryn Austin, in which she advocated for policy translation work as a macro-environmental lever to prevent eating disorders. I was also able to assist with training and dissemination efforts, such as a training program for primary care providers on screening and referral for eating disorders, and a workshop on developing online courses about eating disorders and other public health concerns.

Why is this an especially relevant topic for our current culture? Could there be any risks associated with this dietary strategy? Q: What makes something pseudoscience versus actual science? What are some of the biggest sources or promoters of pseudoscience? Q: What are some examples of systemic factors that might contribute to the development or maintenance of eating disorders?

For instance, our cultural preoccupation with thinness and stigmatizing attitudes toward fatness create an environment where it is simply not ok to live in a larger body. As another example, our diet, weight-loss, and fashion industries shape unrealistic standards of beauty and fail to represent the real diversity of human bodies. Alternately, relatively low awareness and misinformation about eating disorders may contribute to failures in detection and thereby maintain eating disorder symptoms.

Similarly, lack of access to appropriate care could be considered another systemic factor that serves to maintain illness symptoms. Q: Who are some of your academic, clinical or advocacy role models? Any favorite books you think people could benefit from reading on the topics of eating disorder recovery, prevention or diet myth-busting? A: I greatly admire Dr. Austin is a wise and prolific scholar, a thoughtful mentor and leader, and a passionate advocate for policy change to improve public health. Those who wish to bridge the gap between science and policy to address eating disorder prevention and social justice should follow the work of STRIPED and consider contributing to support their efforts.

Her scholarship has fundamentally shifted our understanding of brain processes, social relationships, and treatment approaches for eating disorders. In terms of recommended readings, I highly recommend the following:. Q: In addition to mental health providers and folks in the fitness and nutrition fields, who else do you think could benefit from attending your talk on March 3? A: I think young people — older adolescents and young adults — could benefit from the talk. They could learn about the risks of these dietary fads and share the information with their peers.

A: I hope that they understand the research on dieting as a risk factor for eating disorders and the harmful impact of embracing pseudoscientific dietary fads even those marketed as health-promoting strategies. I also hope that they start to think about how we can make a change in our culture, in our policies, and how doing so could serve to reduce eating disorder risk on a broader, population level.

Many thanks to Dr. Ambwani for her time and effort in answering our questions! Join us for her free presentation on March 3 in Baltimore. RSVP here. February 22nd, in Celebrity Topical News. Over 13 percent of teen girls suffer from an eating disorder by the age of When we get right down to it, eating disorders are serious and people living with them have a higher risk of dying compared to same-aged peers. Still, disordered eating is often joked about and normalized in pop culture.

Unfortunately, some movie scenes can be quite triggering for folks with eating disorders and those in recovery. This movie, starring SAG awards winner Emily Blunt, reminds us that no goal is ever worth starving for. Nourishing your body consistently is a better way to keep yourself healthy enough to reach your career goals and be present to enjoy them. Take a step and ask for help before things get worse. Romy and Mishelle share all sorts of diet obsessed banter in this movie, including this extremely dangerous quip.

All foods can fit in a healthy pattern of eating but one type of food on its own — whether candy or kale — can never meet all your nutritional needs. Incorporating a variety of fun and nourishing foods is best. That could be one reason why Regina was always so negative and, quite frankly, pretty nasty to the people around her. Did you know that perfectionism is a risk factor for the development of eating disorders?

Our bodies need different nutrients to fuel them. Social isolation can lead to all sorts of other diffculties and can worsen depression and anxiety. Derek and Hansel are misinformed when it comes to losing weight. The fact is, purging is not an effective way to lose weight or prevent weight gain. In fact, over time, purging behaviors are associated with weight gain and a whole host of serious medical consequences. On top pf being misinformed, the characters explode in laughter when Matilda opens up to them about her own history with bulimia.

If a friend shares with you that she or he is struggling, take it seriosly. Cher and her friends engage in awful lot of weight shaming, diet talk and appearance bashing throughout this movie. Critical body talk and weight shaming — even when self-directed — has a lot of negative consequences.

Remember, your vibe attracts your tribe. Any coach who puts an emphasis on weight is bad news for the whole squad. Never be afraid to get a second opinion if a coach is steering you wrong. Something you think is a harmless joke about what someone is eating might actually have major repercussions for them. Also, burgers are great and can be enjoyable and nourishing at any age! A better message for kids? Join the conversation with us on social media using popcultureED. The pressures of resolutions and new beginnings after the holiday season can be overwhelming.

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So why not make a change that will help free up time and headspace while also improving body image? Your social media life may be an area to evaluate…. Social media has undoubtedly become more and more prominent in our lives. On the one hand, these sites have showcased benefits, such as maintaining social connections and sharing meaningful content and life experiences with others 1.

Even taking selfies, and excessively editing and manipulating these images, has been associated with greater body-related and eating concerns 2. As you reflect on the past year, think about how much time you spent scrolling through social media and comparing likes. What if you could start the new year off with a healthier and more productive approach to care for yourself and your self-esteem? On average, we use social networking sites for over an hour a day 3. While some of this social media time may be used in productive ways, maladaptive use of these sites for over an hour a day could lead to significant negative thoughts and feelings.

Think about unplugging and limit time spent scrolling! For some, it might seem impossible to remove social media entirely in a world where use is growing rapidly. So, while we can limit use overall, it can be greatly beneficial to change the way we perceive what we are exposed to when we are using social media. Take some time to go through your social media and analyze what you are being exposed to and how it makes you feel. While the negative effects of social media have been the focus here, there are many reasons why these platforms have skyrocketed in recent years.

Sites such as Facebook and Instagram can be great to share accomplishments, keep in contact with distant friends, or even see what your favorite musician or politician is up to. We can help to control what kind of messages and content we are exposed to by changing who we follow on social media. Her past research projects include researching the relationship between specific personality traits and motivations for using online dating applications. The highly specified nature of eating disorder care lends an important fact about treatment: Evidence-based eating disorder treatments are as complex as the disorders themselves and require well-trained and experienced clinicians to provide such specialized care.

Eating disorders, on average, affect at least 30 million Americans of all ages and genders. As a result, they are often forced to make difficult decisions, choose between less than optimal options, and deal with potentially negative consequences such as:. Telemedicine allows clinicians to deliver specialized care to patients in a remote location via videoconferencing. In the field of general health care, telemedicine has existed for decades as a means to provide treatment to patients who could not travel to qualified providers. In this format, a patient can receive the same high-quality care they would from a specialist treatment center remotely in the comfort of their own home.

Though more research is needed to support this method of delivering therapy, the existing studies show that eating disorder treatment delivered through telemedicine can lead to positive outcomes such as:. The Center for Eating Disorders at Sheppard Pratt now offers telemental health services for patients who live far distances from our offices.

Jennifer Moran and Dr. Ekaterina Amarando are trained and licensed to provide psychotherapy for patients located in the state of Maryland, and Dr. Meghan Gaare is trained and licensed to provide psychiatric care for patients in the states of Maryland and Virginia. For inquiries related to receiving telemedicine care, please call , or visit CED Telemental Health Program.

She joined the research team at CED as a volunteer research assistant in , working under the supervision of Dr. In this role, Jacquelyn is currently researching the utility and efficacy of telemedicine in the treatment of eating disorders. Anderson, K. Utilizing telehealth to deliver family-based treatment for adolescent anorexia nervosa.

International Journal of Eating Disorders , 50 , Simpson, S. Does video therapy work? A single case series of bulimic disorders. European Eating Disorders Review, 14 , Eating Disorder Statistics. Yager, J. Practice guidelines for the treatment of patients with eating disorders.

Mitchell, J. A randomized trial comparing the efficacy of cognitive—behavioral therapy for bulimia nervosa delivered via telemedicine versus face-to-face. Goldfield, G.

update: my coworker acts like the food police

Delivery of family therapy in the treatment of anorexia nervosa using telehealth. Telemedicine Journal and E-Health , 9 , — Chakrabarti, S. Usefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches. Waugh, M. Telepsychiatry: Benefits and costs in a changing health-care environment.

Consider the following:. Before I answer properly, would you mind telling me roughly what your BMI is at the moment? A little detail about what your diet is like just now would also be helpful. My BMI is I have been in hospitality for the past 5 years and my eating schedule got very mixed up. I could't eat when I wanted to and became a stress eater. I gained and lost weight in the past 5 years. When I get stressed I eat loads of chocolate and carbs eg pasta with mayo. During my anorexic years I blocked carbs and sugar completely and only ate meat, vegetables and yogurt.

Recently I developed some sort of dairy and gluten intolerance, I get very bloated every time eat dairy products, same happens if I eat bread or any type of pasty. On the top of that now I don't have appetite for any type of meat or poultry. I usually eat vegetables, eggs, cold cuts and cheese which I shouldn't do because it makes me super bloated. I just quit my job so I am trying to follow a balanced diet and go to bed at the same time every day. I couldn't do it before I eat breakfast every day usually oats or something sweet but often I wake up between am, have breakfast and then go back to bed for another few hours.

In the past year I ate a lot of junk food as I was just so unhappy, tried to aid my unhappiness with sugar and binge eating. It can of course be very hard to distinguish between the constant underlying hunger of only partially resolved malnutrition and the kinds of hunger for comfort or solace that are more emotional in origin. The second point to make is that exercise is not an effective means of controlling bodyweight. Diet is much more important a factor than exercise in this respect. I gather that on the whole this can be expected to make the pain worse in the short term and better in the longer term.

Obviously expecting to do a standard gym workout of the kind you might have been able to do before the onset of this condition is unreasonable. But starting really modestly, with small amounts of timed walking and gentle stretching, and with at least two days in between sessions to begin with, might be worth a try? Finally, as regards diet, given that you do have some currently unavoidable restrictions already, doing all you can to keep as much nutrition and variety in what you do eat must be a good thing. PS Are you still doing the horrible stressful job, or have you now found something that lets you be happier?

First of all I would like to highlight that I'm totally blown away by the special attention you give to everyone who writes to you and by the amount of detail you include each and every response. Now, here on my end, Yes, I have left that stressful job and started something completely different. The new lifestyle allows me to maintain a consistent sleep pattern, which appears to be very helpful. I only get the muscle pain before and after my period.

I think both my recent weight gain and the muscle pain are related to hormonal changes in my body. I still exercise very little comparing to the amount I used to, but I stopped being anxious about it as all my freetime is occupied, so I actually don't have a minute to stress on it anymore. I still struggle with having the basic remarks of my anorexia on my mind every day, and I recently stopped eating sugar. This makes me feel more energetic and I stopped my nightly binge eating since then. As you suggested I eat meat, eggs and vegetables for breakfast, a lot less calories than I used to.

My problem is that I still worry a lot about eating and i struggle with going out for meals with others which affects my social life. It's great to hear about your new less unpleasant job, and how that's helped your sleep patterns and in turn your pain levels. Keeping anxiety at bay with busyness is a decent tactic in the medium term, but obviously you don't want to end up so reliant on it that whenever you do find yourself with time to think, you have no resources for being at ease with yourself, and have developed no resistance to the old ways of thinking.

Blocking the anxiety out is, ultimately, a way of avoiding dealing with it, such that in effect it's always kind of there in the background, waiting to leap into the foreground again when other distractions are lesser. It's like drowning out the sound of your neighbour's music by turning your own up loud, rather than going and asking them to turn it down.

So maybe try to build in a little time every day - even if just ten minutes - where you sit and meditate: you might focus on counting your breath, say, or simply sit and see what your mind does, and try not to get caught up in your thoughts, but to observe them coming and going. Granting yourself time to take gentle walks without music - the metaphor isn't just a metaphor! Living happily with your own mind is an important skill - one we should all devote more time to learning. On the diet front, it's good that not eating sugar seems to have helped increase your energy and moderate your nighttime hunger.

You should beware of any hard and fast dietary exclusions, though, in the aftermath of anorexia. Particularly given that when you were ill you excluded sugar too, building in exceptions on social occasions or also on your own, periodically as a matter of course will help make sure that psychologically you keep making progress too. Eating with other people should be treated as a significant part of the recovery process, so that while the meal lasts, the social stuff matters more than the biological stuff.

Treat these times as times when your usual dietary habits are suspended, and where you eat what appeals to you, or what is socially most 'normal'. If you get used to letting those times be different, you should gradually find doing so less anxiety-inducing, and be able to value these times for what they are: the chance to be at ease with the people you have chosen to spend time with. This may or may not appropriate for you right now. In my previous reply I raised the possibility that at a BMI of 23ish, your recovery from malnutrition is not yet complete.

If that is the case, then attempting to calorie-restrict, or to temporarily elevate your metabolic rate through temperature extremes, are counterproductive activities which will together actually keep your metabolic rate chronically suppressed and prevent full recovery ever taking place. You may not feel that this applies to you any more - but do ask yourself this question carefully, and answer it honestly: does my desire to lose weight feel like a remnant of my eating disorder?

If your answer is yes, or even maybe, take this seriously, and assess your current thinking and behaviours accordingly. Whatever the answer, though, you may want to bear in mind two small points: 1 that eating lower-carb meals is not meant to entail a calorie reduction on the contrary, the logic of this approach to dietary balance is that overall energy intake may be higher, but the benefits of reduced insulin response will still be present and 2 that someone with a serious eating disorder in their recent past should not be using a sauna regularly for its potential weight-loss benefits if it's doing anything, it's probably just dehydrating you, and upsetting your electrolyte balance.

Anyway, I hope all this doesn't sound too negative. I am really glad to hear that in some ways life is so much better now than it was when you first wrote. It would just be sad if you got stuck in this in-between place of only just about feeling OK if you keep yourself busy enough, and still feeling worried about food and eating and especially eating with other people. Better than this is worth aiming for, and is achievable, but may well require you to actively resist the anorexic instincts for a while longer. I'm also a long-time reader of your blog and find it to be amazingly informative yet accessible, something that is both rare and delightful to find.

What isn't delightful is that I've struggled with an ED--overexercising and OCD that led to being underweight--for 10 plus years now. While I've had inpatient treatment before, insurance never covers more than a week and to be honest, it never helped. I have a clear idea of what I need to do, but getting myself to do it on a consistent basis is the issue.

I eat around 2, calories a day, but at 5'8" and 91 lbs, I realize that's not enough. The problem is that I have a hard time convincing myself to eat more or eat "different" things when I can be satisfied with the routine I've set up for myself. If I can't exercise, I feel like I can't increase. But even when I do exercise, I still like to play it safe. I feel like my body is used to where I am, and I don't know if this is simply my "normal.

I don't know how to get past that point, so I'm just living with it I suppose everyone has the right to say that they can't or won't improve things any more: that here is as far as I'm going to get. In your case, given that your BMI is so very low, I would think that such a 'decision' couldn't be sustainable for long in any case, but assuming for the sake of argument that you could live like this for the rest of a long life if you so chose, that decision needs exploring a little further.

The terms of the decision or the inability to decide otherwise can usefully be interrogated: what does it mean to you to be 'satisfied', to 'play it safe', to be physically 'used to' a particular state, and are all those assessments put together enough to make the decision an informed and lasting one? The fact that you're thinking and writing about it in this context implies that you're not sure you do want to live forever like this, and the confidence with which you mention the 'physical effects of being underweight' suggests you don't really believe that they are your physical 'normality', any more than the point you're at now is what you really envisage as your ideal - or perhaps even your acceptable - state or destination.

Perhaps the single question all this comes down to is: does my fear of change outweigh my frustration with staying the same, or not? Even if it does today, and tomorrow, it may not always. The sheer tedium of anorexia was for me, with hindsight, one of the important factors that ultimately hung in the balance. Combined with the nastier symptoms of long-term under-eating, it was one chronic flaw in my life, which in my more honest moments I was able to recognise.

And given that you do already know what's needed, and given that you do seem dissatisfied with life as it is, it seems to me as an outsider that there is only a small step left to take. You may have to deal with the difficulties of taking that step on your own without the support of inpatient care - or at least with brief inpatient treatment as only one short stage in a much longer journey. But wouldn't it be lovely to be able to exercise for the sake of it, rather than just to earn your food - and indeed not even to 'exercise', but to do sport, or do something sociable or something skilful that enhances your body and your mind rather than diminishing it?

Just 'living with it' is a sad way to watch life slip past, I know, and ten years feels and is a significant chunk of time to do that for. Really living may cost that short period of physical upheaval, but in my view, and from my experience, that is negligible in comparison with what it makes possible. I dropped to 40kg after being exposed to heavy metals.

Now I gain weight if I eat anything. Perhaps insulin resistance? I didn't eat for at all really for 2 years. Hello, I need a bit more detail to be able to respond meaningfully here. What kind of exposure was it? What does 'not really eating at all' mean, exactly? Why do you suspect insulin resistance in connection with the heavy-metals incident?

And what precisely is the problem you want advice about? Presumably gaining weight once you start eating is a good thing - and even if you can't currently accept it as such, it's at least a completely predictable and normal thing. Quick question - did you ever find yourself binge eating at all during 'recovery'? If so, how did you mentally cope with it? No, I never did. That is to say, I never ate more than planned in a way that felt uncontrollable.

But after the first four or five months of following my plan very carefully I did increasingly eat a lot, no longer counting calories at all, with large portions at most meals, and a lot of meat, sugar, and fat. But by the time this was the case, I had adjusted to my continual hunger and to the conviction that the best thing I could do was to respond to it and, for the most part, enjoy doing so. The development of that period of substantially increased intake was determined by the fact of getting together with my then new boyfriend, who liked and still likes to cook for me, and I don't know quite how things would have progressed if it hadn't been for him and the deeply pleasurable novelty of eating with someone I cared about romantically.

His being there and sharing everything with me certainly made the whole thing mentally much easier than it would otherwise have been, although I hope that if I hadn't had him I would have found related pleasures with family and my few remaining friends, and certainly kept on with the plan such that my thoughts and habits would have loosened up of their own accord as my weight continued to increase.

I suspect it would have taken a good deal longer, though. The key point here, as in my post on the relation between anorexia and binge-eating disorder, is that binge-eating rarely happens without restriction, and that if eating a lot is required to become healthy again, and if it isn't mentally evaluated as something that should be stopped but can't be, it isn't binge-eating, it's just eating. It's much better to do the mental adjustment before the fact rather than after, so that it's no longer a question of coping in retrospect, but becomes one of accepting, and anticipating, and, eventually, being glad.

Hi Emily - I have read through all of your posts - beginning to end - again. After scanning a couple other ED blogs, I fully appreciate your topic choices and point of view. Thank you, again, for modeling how to overcome an eating disorder. I look forward to reading more from you when you have time!

Thanks, Karin; I'm glad you're still finding them helpful. I seem to have settled into the pattern of posting once a month, around the end of the month, and so will be writing something new in the next few days. Hi Emily, Thank you so much for all your posts - it is helpful and refreshing to read about anorexia nervosa recovery from an intelligent and informative perspective.

I am just in the first month or so of recovery and Im finding it extremely difficult. If you dont mind, can I ask you about what point you got your periods back and did regaining this hormonal cycle help aid recovery? Also did you have any long term physical complications for anorexia. Of course, every single anorexic would like to avoid the overshoot, every anorexic would like to remain 'slim', every anorexic is terrified of anything else happening.

And, crucially, giving in to all these fears is why so few ever fully recover. We don't have as much choice as we might like to think about our body shape and weight, which is significantly genetically determined, and for the recovering anorexic it is more important than for anyone else to find and accept not the weight which one's eating disorder dictates as desirable, but the weight at which one's own particular body can thrive.

Whether or not that weight is one which you would currently categorise as 'slim' will come to matter less and less if you can find the courage not to let that preconception determine how you go about recovering. As for your question about my periods, what was going on was obscured by the fact that from very early on I'd been taking the contraceptive pill as a hormonal regulator and inducer of menstruation. Then as I recovered I kept taking it for contraceptive purposes, so I'm still not actually sure when and to what extent my hormonal cycle normalised.

I'm just starting an experiment of not taking it for six months and seeing what happens, but I'll have to report back on that one As far as I know, I did no long-term damage to myself. I had a bone-density scan about five years in, and there was no significant damage then. And although my bones would have continued to get weaker, I suppose that the past three years of eating well, combined with the density-increasing effects of strength training, will have reversed most if not all of that damage.

My blood sugar and cholesterol are at healthy levels, and I feel well and strong and resilient. The very gradual nature of my decline, and the fact that I never got into the unstable and destructive cycle of bingeing and purging, probably spared me from some of the worst effects of anorexia, but many complications can be reversed by the introduction and maintenance of appropriate nutrition.

The first weeks are the very hardest, and if you persevere and don't succumb to those worries you express - which all amount to not wanting to let your body get fully better - it will all get much easier, easier than you can at present imagine. I can't believe I only discovered today all of the helpful articles on this website about eating disorders. I have to say, I'm particularly interested in hearing more about the physical effects of weight gain after starvation and during restriction. I've been actively recovering for half a year, and I'm halfway to achieving my given "goal weight" which will give me a BMI of 20 - safely and comfortably above the bare minimum BMI of However, I'm still experiencing a lot of discomfort when and after eating.

Not mentally, but physically. Numerous times I have attempted to eat heartier meats with my family and by myself, only for to experience diarrhea sorry, TMI I know! I know you don't HAVE to eat red meat to recover, but I liked the occasional burger pre-ED, so I'd like to know I can still eat one without the paralysing intestinal pain and leaky GI tract afterwards. Also, is it common to experience so much flatulence in recovery?

I love going out to eat with my family, but I'm sometimes embarrassed by how stinky it is to be around me. Are there other common physical symptoms and signs of recovery that are off-putting? Will they go away with full recovery? I've talked in previous posts about the emotional volatility that often accompanies recovery as starvation-induced depression recedes , and I described in some early posts my own experience of physical difficulties related to those you mention, so you might look over those, if you haven't already, to reassure yourself that your problems aren't unusual. As for your particular difficulties at the moment, red meat is relatively hard to digest compared, say, with white meat or fish , so might be more likely to cause diarrhoea, and the sulphur it contains might be conducive to flatulence.

But red meat is also, of course, an excellent source of vitamins such as B12, and of protein, which is crucial when recovering from malnutrition, in restoring muscle and other tissues and in combination with adequate calcium in improving bone density. And it's almost certainly much healthier in the long term than more easily digestible foods such as refined carbohydrates. At the moment, however, your highest priority must be to keep eating enough food that is calorific enough to sustain your weight-gain and restore your weight to a safe and healthy level.

If the side-effects of eating burgers and so on are in danger of seriously compromising that aim, it might therefore be as well to do without them for a month or two, to give your digestive system more time to adjust. On the other hand, if the pain is rare, and you're happy joking about all the rest with your family, that's probably a good way of connecting with them in a light-hearted way - very different, I imagine, from how things were between you before you began to recover.

It is highly probable that these and any other difficulties you may currently be experiencing will come to an end as recovery proceeds and a healthy weight is reached and maintained. Though of course everyone farts, and some naturally more than others! I can't immediately think of any other physical effects beyond those mentioned here and in my post, but let me know if there's anything else in particular you want to ask about.

Finally, I'd just like to say how admirable your attitude to recovery seems: the combination of pragmatism and humour is an excellent armour against the humourless essence of anorexia and the surmountable obstacles that recovery always involves. I'm really glad to have been of help! I hope knowing a bit more will make it easier to persist well beyond day 3! Hi First I have to say that your posts have always been a very guiding light to me. So inspirational and they resonate so much for me. I have only increased my calories from about a day and have already gained near 4 pounds.

Is this 4 pounds the water weight you refer to? Will it continue to go on this quickly with such a small increase? I feel so lost and disgusted with myself, each time I reach again, knowing it is all just piling on me. I would really appreciate your experience in how weight can fluctuate, is this all real weight? Will the speed with which I am gaining subside? Thank you. Thanks for this; I'm happy that you've found my posts helpful, inspiring even. Your experience - down to the fact of feeling you've ended up with a raw deal, that you're gaining faster than you should, and faster than other people - is completely normal.

On weight gain and water, I suggest you check out the links I posted in response to the previous reader's comment on this page. As for your calorific intake, you really haven't increased it by enough. If you were maintaining a steady weight at a day, you should now be on at least I was treated according to the 'additional calorie' principle, which is of course relative to pre-recovery intake; others e.

In any case, you've added too little. The extra calories are enough to initiate the processes of cellular rehydration but not to drive sustained weight gain in the medium term. And as you say yourself, you feel at the moment as though you're gaining rapidly while still feeling 'completely restricted'.

This is a psychological issue as well as a physiological one, and it is important to get the balance between the potential for weight gain and the inevitable side-effects mental and physical of eating even a little bit more, so that you don't get all the 'pain' of increasing and its effects without the lasting 'gain' of actually healing your body. It's very easy to lose motivation if 1 you're hardly eating any more than before, but see your body weight increasing rapidly, and then 2 you see the weight gain level off while still dealing with all the traumatic feelings associated with eating more, or even 3 the 0.

You really shouldn't be aiming for as minimal an increase as that; double that 1 pound, or 0. If you are determined to recover in earnest, you need to make your goals both more ambitious and more realistic; adding at least another kcal per day is the way to do both. Finally, yes, the weight you've already gained is 'real weight' in the sense that it is vital to your body's healthy functioning, and a positive sign of regeneration. What it isn't is fat. It probably isn't much else 'real' except water right now either: the regeneration of bone, cartilage, skin, etc.

I as well am freaking out over the extra weight I've seemed to have added. I was 5'8" and 86 lbs. Now I've gained weight and I am not eating too much more, but I'm always hungry. I injured myself working out and no exercise for six weeks. My clothes are tight and I look in the mirror and see the enormous person. I won't weigh or measure myself because those numbers will freak me out. I'm back to exercise now, and want to know when this will even out?

Coping with this weight is more than I can handle. You don't say how much weight you've regained, or how quickly, or in what sense it's 'extra' weight, but starting from a low-point BMI of around 13, you had an awful lot of weight to regain to reach a healthy level.

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This process is bound to be difficult, both physically and psychologically, but there are certain things to bear in mind to reduce the trauma. An important one in your case is the finding that, as I noted in response to another reader, bodyfat takes time to redistribute after weight gain; in particular, it seems to take around a year for the initial disproportionate deposits of fat round the midsection to even out Mayer et al.

These things will all happen, but only once you're fully weight-restored. Until your weight is at a healthy level again you also shouldn't be exercising; there's no point risking repeated injury when your body is already working flat out to repair all the damage done to it by extreme malnutrition. Furthermore, increased levels of cortisol caused by exercise seem to discourage the body from directing the available energy into those necessary long-term repairs. So anything more than gentle walking should be avoided during the weight-gain phase.

Extreme hunger is your body's way of signalling that it requires a significant nutritional surplus beyond the intake that would maintain a stable weight, to carry out all the restoration of fat reserves and repair of organs etc.

Cheeseburger In Paradise

Your hunger will probably not abate until the weight-gain phase approaches an end, and you should capitalise on that hunger to make and follow a daily food plan that involves at least three decent-sized meals and three snacks. This is the only way you're going to get well and be in a position to do sport again without injuring yourself or compromising your long-term health.

Finally, completely avoiding weighing yourself can be as psychologically problematic as doing so to excess, since the numbers you don't know but are constantly making guesses about can take on more and more cognitive significance. So if you can build fortnightly or monthly weighing into your recovery process, with someone else there to help you if need be, and chart your progress with you, that would be ideal.

Starting from such a low weight, I hope that you've sought professional - therapeutic and possibly also dietary - advice; if not, you should definitely do so, and the question of regular weighing might be something you'd want to raise with your therapist. When people say you look a lot better, they mean it, and you will come to agree with them in time. Certainly anyone with a BMI of 13 can look like nothing other than an emaciated husk of a person, and although the distribution of fluid and fat won't yet have evened out, just bear in mind that continuing on the path of weight gain is the only way to achieve a body that looks and feels good.

What types of foods would you reccomend? I am looking to eat about calories if I can. I work a full day and want to do it relatively cheap. Is it bad if I go to Mcdonalds or something like that or is it better to eat that than a really small lunch just because its easy? Basically, eating enough is far more important than the details of food types. So McDonalds is infinitely better than a 'really small lunch'. Enjoy it if you can! More generally, you should ideally aim for decent quantities of fat and protein in addition to carbs, so meat is good and fattier cuts are generally cheaper than lean ones , as are eggs nice and cheap too and milk full fat.

For now, your single priority is to regain weight to a healthy level. Once you've achieved that, you can make decisions about the details of what kind of diet will be most sustainable for you, physically, psychologically, and financially. By then your tastes may well change in any case - I certainly found my cravings for salty and sweet foods gradually waned of their own accord as my body came out of starvation mode. Hi, I'm currently in my 4th month of recovering from and E. D for about a year and a half i was really restricting my cals and lost over 3 stone.

I have experienced all the things you spoke about- disproportionate weight gain etc etc. I have now gained about a stone and my bmi has gone just from the edge of being underweight to being But i'm really freaking out because it seems as if the weight gain isn't stopping its just going up and up. I use to be overweight and i really dont want that, as it may trigger me to stat starving again. And i would hate to be a yo yo dieter cos to me thats just as unhealthy- i just want to eat normally and not make food run my whole life.

I understand i have to gain weight but im at healthy weight and size now i just really do want to become overweight again and then never be able to loose it. Is this a common thing for people in recovery- to gain too much weight and not be able to loose it? Sorry for all the questions but i just want to move on from this and get on with my life without worrying if im gaining more and more.

No one wants to 'gain too much weight', but it does seem to be a relatively common thing in the short term, followed by a gradual return to pre-illness levels in most cases see e. Certainly it happened in my own case: my BMI went up to about 26 and only then stabilised and gradually decreased to where it is now, a very stable 24ish. I was eating really a lot by that stage, and made only very minor changes to my diet to help bring about the end of the gain fruit instead of dessert at lunch most days, for example. In my case, I'm convinced that allowing my weight to reach that level was key to a full recovery: it was only then that the extreme hunger which was a feature of most of the weight-gain phase finally came to an end.

You may have read stories of people recovering from anorexia only to end up overweight, but there are far more cases of people never recovering from anorexia at all because they're too scared to let their BMI go above 19, or 20, or 21, or some other arbitrarily chosen figure. Every body has a different optimum weight, so that while 21 may be healthy for one person, it won't be for another. In general, weight maintenance shouldn't require a reduction in daily intake from what was being consumed during the weight-gain phase see e. Do you know what sort of amount in kcal you're eating at the moment?

It's a good sign that your periods are back to normal, and that other things seem improved too, but even though your illness was relatively short, there will still be all kinds of longer-term and less conspicuous repair e. At the moment, the greatest danger you face is probably not continuing to gain weight, but relapsing into weight loss again. The best way of ensuring that food doesn't keep controlling your life is therefore probably to keep eating as you are doing until the weight gain naturally slows and stops.

Yo-yo dieting is a very destructive habit to get into, but constant 'successful' restrictive dieting isn't a great way to live either, since for someone who used to have anorexia it basically means resigning yourself having a low-level or not so low-level eating disorder for the rest of your life. So, anyway, a bit more detail on what your current diet looks like would be helpful. Finally, is there any way you could talk to a doctor or other professional about this? I'd definitely advise it if at all possible. Thankyou i really appreciate the time taken to write all of that it was really helpful.

One of the biggest stresses is not the weight gain itself but the idea that maybe it wont stop. But the fact that you said it does normalize again really brings me a bit of piece of mind. I also worry about my mental hunger- i know a lot of the time i would be physically full but mentally starved and would binge and crave this would make me feel so upset and angry with myself. But just about 3 months in and im finding these cravings are subsiding and the binging stopping- which is actually making me feel positive about recovery and wanting to continue.

But before i was restricting i had other problems with food. Just to explain myself a little more: So when i was about 16 i got really bad stomach problems and turned out i had quite bad IBS. There was nothing the dr could do so i managed it myself through regular exercise and healthy eating at regular intervals. I was really happy with my body, weight wasn't a stress for me and neither was food, and it was probably the healthiest i had ever been i wasn't counting calories but just eating well. But naturally because i was moving more and the IBS bloating went down, some weight came off- but my dad would always comment, 'don't you loose any more weight' but for me then it wasn't about the weight, it was about going out without worrying about my stomach or needing the toilet!

But because i felt bad that dad didn't like it i would make a conscious effort to eat around him. But because it as food that i didn't want to eat due to it causing me problems. So i would eat it and then leave the room and spit it out. I was 16 when that started i am 20 now but i managed to stop that- but its like i replaced one habit with another with restriction, which i done for about just under 2 years. My chewing and spiting actually made me gain weight; i went from about 8 and half-9st to over 11st.

My diet now: I have actually tried to eat different foods but have found that bread, fried food like chips of heavily oily food like roast potatoes does really make my IBS flair up. I was worried that all carbs would upset me but i have no problem with rice, mash, boiled so just incase you thought, I'm NOT using it as an excuse not to eat carbs :. So for breakfast: either cornflakes or porridge with either raisins or banana in. I know im probably not reaching as much as what i should be i find it physically really hard to do so.

But i do ensure i eat at least and i'm actually eating what i enjoy and what i fancy. You asked about my hunger-Well i did feel pretty much constantly hungry, but over the past week this hunger seems to have leveled out and i'm getting hungry at meal times and im not constantly craving. Iv been trying not to deny myself anything which has actually really helped- when i 1st started in recovery i would still feel bad about eating stuff like chocolate and it would make me crave and binge it.

Many Thanks Again, the info your given me is making me gain a lot more perspective and rationality : Emily. The absolutely key issue here is eating regularly and frequently, as well as in sufficient quantities, of course. This is absolutely not sufficient to sustain a healthy or near-healthy weight. As for whether your weight will revert to its original 8. In which case, well done for getting to this stage! Thankyou so much its nice to know what will happen- i dont think my dr had had much experince with eating disorders and when i 1st went to him simply said eat more; so to begin with i just didnt want to change i was only going to the dr because my family wanted me to.

But now even though a bit selfconcious due to the change in my body and the full feeling i get i am actually so smuch happier with more energy, actually able to concentrate on uni work and nice to have my periods back to how they should be! So thankyou for the reasurance and honesty, its nice to know that as long as i address my eating habbits and not slip back into the restriction or chewing and spitting, that i can maintain a normal comfrotable weight.

Im making more of a concious effort to addres these issues by writting them down in a diary; its strange I seem to be very rational about my irrationalities so im hoping this way i can reflect on what im thinking and feeling a bit more and work through what my troubles are. Feels like iv wasted so much time worrying about food, im just really looking forward to moving on with my life. I've taken on board what you said and have been trying to consume more- found it hard to physically eat more beacuse it cn feel just so fillin, so been trying so have food with higher cal content, like peanut butter and milk.

It's really great that you're feeling so positive and so aware of all the benefits weight gain has already had. I should think you'll soon get used to how your new healthier body looks and feels, and also to what it feels like to be eating enough again, especially if you keep reminding yourself of all that these feelings signify in terms of your health and your future.

The diary could be very helpful. Many sufferers from eating disorders are highly lucid about their situation, and the inconsistencies and paradoxes that maintain it, and it can be useful to document these, disentangle them, and use that analytical process to work at altering how one thinks and behaves. My own experiences with diary-writing would suggest that two points are key, though:. It very much did with me - though primarily in the illness rather than the recovery stage -, to the point that I was stopping in between almost every mouthful while I ate, to write about how amazing it tasted and analyse that delight and then analyse the fact that I needed to analyse it thus I kept writing some way into recovery, but then I found I simply wanted and needed to stop, to give myself space simply to live and eat rather than constantly writing about living and eating.

But your own situation, not having written much before, will obviously be very different. Just be careful not to let it get out of hand and become more a trap than a tool. Despite the frequent high degree of 'intellectual' understanding manifested in anorexia, the key skill of transferring insight into action is usually what's missing, and it's usually the hardest - but always the most important - thing to achieve. For example, you might find that you eat less one day, and find your concentration on your work suffers but that you nonetheless feel some pleasure in having eaten too little.

You then write down and analyse that irrationality, and conclude that the pleasure was a mixture of predictable factors like the addictiveness of the 'hunger high', the illusion of control that comes from the return to old restrictive habits, and so on. You also note that it had noticeably detrimental effects on things that matter to you like your academic work. Then you should highlight the key elements of this insight and deliberately use them the next time you're tempted to skip a meal, or the next time that for some reason you eat less than planned, to stop the not-eating continuing or the feeling of pleasure from going unchallenged.

I think these considerations ought to help ensure that the writing becomes a way of moving on and spending less time worrying about food, rather than risking contributing to the overwhelming sense that food dominates your life. Based on the figures you've given me, your BMI is between As you say, it is within the healthy range now, but as I also said, some amount of further gain may well still be necessary, in the context of the consistent healthy eating habits around 2, calories a day that we've already discussed.

Hi Emily, I wrote to you in August last year when I had just begun my recovery journey in earnest. My head is still completely caught up in calories and weight. It's been so difficult to continue. From July to the end of September I gained 7 pounds from doing that.

I have continued eating that amount into the new year but for some reason I have put on 4 pounds since the end of December. I didn't increase my calories and all of my activity is the same. I feel extremely out of control and frustrated. Any idea what could be at play here? It makes me scared to ever eat more. Can you maybe give me some logic here? My ED is screaming at me that I just need to cut back to again. Firstly, I'm glad to hear you've been persevering with the increased intake, but sorry that you're having some problems with it now. The change from gaining weight on ish calories to your bodyweight plateauing is obviously very natural, as your body begins to adapted to the increased availability of energy by increasing the metabolic rate and initiating major repairs e.

They key here is 'if enough energy is still reliably available'. I of course can't be sure, but I suspect that what's happened with you is that the first two stages happened fine, and then there was insufficient energy to bring about the final increase in metabolic rate and other associated changes.

Your metabolic rate might well have decreased again in response to an intake that is inadequate to fuel full systemic repair and normalisation. This is why you need to be eating at least 2, calories a day at the moment, and ideally 2, see the post I linked to above.

You know exactly where you'll end up if you revert to the place from which in July you bravely decided, for all sorts of good reasons which all still apply , you had to try to escape from. Why waste all the progress you've made over the past six months or so? This is the point at which to build on the dietary changes you've already made, to allow all that physical repair to continue and be completed, rather than keeping it halted somewhere near the beginning.

Nothing here is random, and your body is longing to be given the means to repair and restore itself; all you have to do is give it enough fuel to do so. I am currently recovering from bulimia at 24 years old. Originally I wanted to gain weight because I knew it meant kicking my eating disorders butt and it meant I would be getting healthy and having my period return and I would get to live a normal life. But now I am totally unsure what to do.

I guess my weight gain hasn't been too fast since I have been recovered for 6 weeks as of today and have put on about I started at My period returned when I was pounds. Right now I do see a nutritionist and I am consuming 2, calories to 3, calories. I do light exercise but not too much that consists of 50 jump ropes and some light walking for five to ten minutes.

Even though my weight gain has slowed down and my hunger has decreased, I have this stupid fear, coming from my eating disorder voice, that I WON'T stop gaining weight and I'll just keep getting bigger and bigger and it won't ever stop. It's starting to take a toll on me and my recovery.

I can handle being more jiggly than normal and being at an uncomfortable weight. But it's just this fear that I won't ever stop gaining no matter what I do. My nutritionist said the weight gain will stop and that I'll end up losing some weight after a while. But I just don't know what to believe anymore. I honestly thought my weight gain would stop once I reached a healthy weight but maybe I have to become a little over weight before my weight gain stops?

I have noticed since I got my period that my weight gain has definitely slowed and it FEELS like it is getting harder and harder to gain because of my hunger cues even though I still don't under eat- some days I am NOT hungry at all and I feel like if I push myself to eat I feel like I may vomit because I'm simply not as hungry. Other days I can handle eating a lot without any problems. I have never relapsed during this time and still continue to eat 2, to 3, calories even if I don't feel as hunger as the day before.

I refuse to start restricting because this will be a relapse and doing it out of fear plus it will just suppress my metabolism. I want my body to decide when it wants to stop gaining weight but again, I'm just scared and still have thoughts about restricting. But I don't want to give into my ED thoughts and voices. This is the hardest thing I'll ever have to go through, I know this.

I know it will be worth it in the end but I'm becoming afraid now. Does anyone have any light to shed on this or have gone through what I'm going through? Will the weight gain ever stop? I'm sorry for taking such a long time to reply; it's been a bit of a tough year but easier now. I hope you've now found your own way through that fear about weight gain never stopping, and indeed that your bodyweight has now stabilised at a healthy level, but if not, here are a few things to bear in mind.

You yourself say that you'd observed a slowing in weight gain, and that your appetite has naturally decreased as well. In those senses, your recovery is exactly as one would expect and hope, and your determination not to start restricting again is exactly right - that can only lead back to disordered eating, and probably quite quickly a full-blown eating disorder. You also mention metabolism, and this a really crucial factor to take into account.

Ramping the metabolic rate back up to normal seems to be something that happens only after weight has been restored and all the long-term repairs necessitated by the period of starvation have been carried out. Metabolic rate is an extremely powerful way for the body to regulate its resting energy requirements and thereby bodyweight, and there's evidence that individuals have a specific ideal weight which the body will do a great deal to revert to from fluctuations up or down e.

So the metabolism tends to adjust upwards quite significantly as the body gets to where it wants to be, meaning that you end up maintaining a stable bodyweight on the same energy intake as required to restore your weight to that level, i. The other key factor, which you also mention, is overshoot. Reanalysis of the Minnesota Starvation Study data by e. Fat tissues seem to be restored before lean tissue, and the final stage of lean-tissue restoration can take place only if more body fat is deposited, which is what leads to the frequently observed phenomenon of overshoot.

The important thing to remember is that although you can't predict what your final optimal bodyweight will be, you will not carry on regaining weight forever, and responding consistently to your hunger throughout the course of recovery, including a possible overshoot phase, is the only way to restore a healthy ratio of fat-to-lean mass, to bring your metabolism back to normal, and thereby to achieve the physiological basis for a healthy life free of disordered eating. I really hope you're well on the way there by now. Dear Dr. Troscianko, As I've come further in my recovery I can't tell you how helpful it is to read the posts of somebody who has in my mind recovered far more completely than a lot of ED bloggers.

Particularly your experience with overshooting. I suppose I'm writing to ask you if you could tell me more about your process of weight tapering and the timescale it occurred in, or how you felt your body changed? I myself began recovery around thirteen months ago at a BMI of 14, and have overshot my previous comfortable, stable BMI of My body appears to have maintained this for around six months, but with no sign of fat redistribution or tapering down. Although in itself my weight isn't particularly abnormal or outrageously large, it sits very uncomfortably on my frame to the point of actually slightly limiting my range of movement.

I've heard accounts of body fat overshoot tapering off but in every case the excess weight appears to rearrange itself and drop off much quicker than mine is doing. I eat according to appetite and got my periods back as soon as I reached BMI however only recently have they been similar to pre ED in cycle length and premenstrual symptoms. Congratulations, first of all, on your successful weight restoration; I know how much courage and sheer persistence it takes to let one's body determine its own end-point rather than to dictate it with a chart or a mental fixation with some particular number.

I hope you found, as I did, that the eating got easier the longer you carried on with it. My own experience of overshooting was, depending on what you think counts as overshooting, either relatively short-lived or rather extended. My BMI went up to about 26 for a month or two, and then back down to a little under 25, at the end of the weight-gain phase, and then down to around 23 over the following year. I made a slight effort at restriction at the 26 mark, although knowing what I know now, I think that probably wasn't necessary and could have been dangerous , and that it wasn't stopping having quite so many puddings or switching temporarily from full-fat to semi-skimmed milk that made the difference, but my metabolism finally ramping up to healthy levels.

In the subsequent year i. In terms of my bodyweight composition, strength training and subsequently powerlifting have radically increased the proportion of muscle to fat, and will have been involved in some of the ups and downs I describe. But if there's anything really to take from my trajectory, it's that recovery shouldn't be second-guessed, or rushed. Things will happen, and they'll happen in their own time.

You can have positive, constructive input, as I believe the powerlifting has been in my case, but you can't predict anything with confidence, and you need to be prepared to be flexible and not to assume that any given bodyweight is either only temporary or, conversely, permanent. You just never know. Back to you, then. A couple of questions: when you say 'my previous comfortable, stable BMI of If so, would you mind telling me how old you were when your illness began? If you were under 25, you were still growing, so your previous BMI will no longer be relevant. Basically, to judge from the information you give here, I think your bodyweight now is probably just fine.

BMI 25 isn't a magic number beyond which bodyweight becomes unhealthy; BMI distribution is simply a bell curve, and there's in fact evidence that the BMI range is associated with fewer incidences of weight-related deaths than any other weight range Flegal et al.

Please see my reply to another reader above 'Why you won't keep gaining weight forever: metabolism and overshoot' on optimal bodyweight I also hope to write a post about this in the next few days ; there's simply no reason why yours wouldn't be just over As for your remark about feeling uncomfortable with and restricted by your current at least, current in May bodyweight, that's inevitable in the immediate aftermath of weight gain.

Fat takes a while to redistribute; for example, it seems to take around a year for the initial disproportionate deposits of fat round the midsection to even out Mayer et al. It also takes time for muscle mass to be rebuilt the body restores fat first , and getting used to being a healthy size and shape again takes time too. The fact that your periods began again only recently is just one more sign that this is probably where your body wants to be.

Not everyone overshoots in recovery, and you shouldn't assume - or indeed hope - that you have. We can't choose our body's optimum weight any more than we choose our hair colour; the only choice we have is whether to accept that weight and allow our bodies to perform optimally, with ideal metabolic functioning and the ability to eat, as you have been, according to appetite and exert energy according to inclination and need, not compulsion. Be patient with the fat redistribution, and be flexible as regards your body's set-point weight.

I hope you're finding that life is infinitely better at 25 than at 14, and I'm sure that with time, whether or not your bodyweight decreases slightly, you'll come to appreciate your body's ability to find its own way back to health. Hi, I've been struggling with Ana for 6 years now. It started when I was 16 years old and I'm now married and I haven't had my period since I was 16 and I don't remember exactly when it was that it stopped that year.

I'm 5'7" and currently pounds. At the most I weighed pounds! My lowest weight was pounds and I was that weight for a few years. I would fluctuate between pounds, but for the past year I've been right between and I found this site by accident. I want to gain weight to get my periods back and be able to have a baby. I'm so scared of the weight gain and going overboard.

Rachael Farrokh Issues Heartbreaking Plea After Years Of Anorexia | HuffPost UK

I just want to be healthy. I'm eating a lot, but I don't count the calories because I don't want to obsess about it and feel bad about eating so much, I just eat. I gained 2 pounds in a week though going from to , and in that 2 pounds I feel like I'm wearing a tube around my waist!

HOW do I be normal? How long does it take to get your period back? I need someone to tell me what to expect, what to do, and how to cope. Hi, thanks for your comment, and sorry for the slow response. Absolutely everyone in your position is scared of the hunger and the weight gain carrying on forever, but they won't. In the final stage of recovery, once the cellular repair including rehydration and longer-term repairs of major organs have been carried out, your metabolism will increase back to normal levels, which will mean that you're able to maintain a healthy weight on the same intake as allowed you to regain weight.

At your current BMI of about 19, you're precisely where a great many sufferers get to, panic, and then start to restrict again, which means that their recovery can never be complete, either psychologically or physically. You need to be brave at this point, and keep eating. That's absolutely the only way that you'll ever be healthy and normal, the only way your periods will return and having a baby become possible for you.

Your previous bodyweight BMI just over 24 can be used only as a rough guide to what your current bodyweight should be, since till age 25 you'll still be growing, but your optimum bodyweight is very unlikely to be less than that, assuming that was a weight you maintained without dieting or overeating and without excessive exercise. Your menstrual cycle probably won't resume until you reach your body's natural weight, although for some people it does begin again somewhat before this.

The depositing of bodyfat preferentially around the midsection is absolutely normal as one of the body's strategies for restoring protection of the vital organs as early as possible, and you can expect redistribution to happen within about a year e. Mayer et al. So, there's no need to feel bad about eating. On the contrary, you should feel great about it, since it's the only thing that can bring you back to bodily and mental health.

Your bodyweight is still substantially lower than it should be, and your appetite will be elevated while that remains the case, as will the obsessive thoughts about food and body image. Keep going, be brave, keep eating, and it will all get better. Hi Emily, I felt encouraged after reading your blog that my current troubles may be resolved. I developed anorexia after a range of factors including my mum developing cancer left me longing for control and in an attempt to slim down my face after overindulging at christmas.