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Eating too little carbs?


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Hey :) I know that macro-nutrients really don't matter all that much, but I'm trying to get back my periods by eating more fat and omega-3's, as well as upping my total calorie intake. I'm 17, 5'9'', 140 pounds, and eating about 2300 calories a day right now with very light exercise.

Since I'm trying to up my fat, I've been eating about 35-40% fat, 20-25% protein and only around 35-50% calories from carbs. Could this be causing any negative effects over a long time? I really just want to be healthy again! :D

Sorry if this is a weird question :) If anyone could help me out, thanks a bunch!

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So, if you are recovering from anorexia then the most likely culprit for not having your periods yet is that your BMI is still to low (you are at about 20.7 now). I'll explain why that is.

BMI 21-24 is best for reducing the chance of relapse -- the higher up on that scale the less likely a relapse.

The reason it often has to be higher than 20 is because for an ED patient the leptin levels do not return to normal even when weight restored. Leptin is a critical hormone that is directly related to the amount of fat on your body.

If I took a woman of your exact age/height/weight who has never had an ED, her leptin levels will be 12-16. Yours will likely be anywhere from 6-12 which is sub-optimal for having a lot of functions return to normal in your brain and body.

To make up that difference, you need a higher but still healthy BMI. And leptin levels are a gating hormone for the return of regular periods. You need that leptin up higher.

Usually an anorexic must gain until her periods return. So that means, 2500-3500 calories no exercise. Once the periods return, then she goes on a daily calorie intake of maintenance plus 30% for another 6 months.

For you, the maintenance for those 6 months would be around 2700 calories a day. You do not continue to gain weight on this amount. Really. The extra energy is needed to return all the neurological and hormonal functions back to normal. You can exercise modestly during those 6 months too.

If you do that, then your chance of relapse is very low for the rest of your life. Even if you have do have a relapse (often due to life stress) you will recover quickly because you are very likely to seek intervention immediately to get yourself back on track.

The most important aspects of getting to the higher BMI and having the additional 6 months of higher calorie intake are that it will restore regular menstrual cycles and it will quieten the eating disordered thoughts that generate anorexic behaviors.

Hope this helps.

You're right that it's net calories that effect your weight, but the macros can make a difference in what you get out of those calories-

You're right that fat plays an important role in hormones-for brain function and your period. But-

(1) It's positive energy balance needed for your period, all the fat in the world won't help if you don't have more going in than you "should" be using [aka you could be gaining/maintaining on less than this if your body is conservings calories--by sacrificing things like energy and your period!]

(2) CARBS have a role too!  Namely, energy -and even metabolism.

I first learnt this in my exercise physiology class where they showed the effects of the zone type balance [50% carb or less]:  endurance decreased as did metabolism: lack of carbs had similar effects as lack of calories in that it made the body think it was in famine since it didn't have the "preferred" energy sourc.
...so whilst using fat/protein injgested for energy, it also stored fat to deal with this "famine!"

I then read about this in the American College of Sport's Medicine review of studies on sport nutrition.  It noted that the biggest difference in dietary needs of athletes was energy balance and specifically said the extra balance was best to be made up of carbohydrates.

Finally, I experienced it first hand when I was on a low carb diet for medical reasons. The first thing I noticed when I started eating >300g carbs was the huge difference in energy level: not only physically, but just a general sense of zest.

Thus, to get the most out of the net calories you need, meet your fat and protein requiremends, then fill the rest with carbs.

but if you havent had your period naturally due to a long period of anorexia+undereating, even if youre at a bmi of 21 does your period still return naturally?  my gyno said it would not.

Original Post by agruskin:

but if you havent had your period naturally due to a long period of anorexia+undereating, even if youre at a bmi of 21 does your period still return naturally?  my gyno said it would not.

Well allowing for the fact that the female endocrine system is complex and sensitive, there is no automatic concept that normal periods cannot return for a patient who has suffered anorexia and chronic calorie restriction.

It is more usual for periods to return naturally than not, assuming adequate fat stores.

Luteinizing hormone (LH) and follicle stimulating hormone (FSH) are the two principle gonadotropins released by the gonadotrope cells of the pituitary gland. Their levels and ratios are important for the resumption of your regular periods.

Research from 2002 indicates that critical leptin levels must be achieved first and it appears that leptin functions as kind of gate to gonadotropin secretion in adequate levels after weight recovery. In other words, the leptin levels have to be optimal before FSH/LH ratios return to normal.

We also know that ED patients do not return to optimal leptin levels at normal healthy weights. 

So if, at BMI 21, periods do not spontaneously reappear, then leptin, FSH and LH levels should be checked. If leptin is not optimal, then the patient should first be encouraged to gain more weight (up to BMI 25).

Of course, should periods not be forthcoming after reaching a maximum healthy weight, then further tests should be done to determine whether there are other underlying conditions at play.

thank you, ill be going in a month or so for my yealry check up, ive just been taking progestrin and something else 4/yr to "clean things out", i know its not real or anything.

ill ask about leptin, FSH, and LH bc i never got any blood tests done, its just that he said that bc i havent had it for so long, id probly need meds forever.  how can i ensure that these levels are ok? i was btwn a bmi of 18.5-20 for over a yr, and now somehwere btwn 20 and 21, i think, i dont weigh often, for a couple months, i eat around 2000 and gained on 2500.

Original Post by agruskin:

but if you havent had your period naturally due to a long period of anorexia+undereating, even if youre at a bmi of 21 does your period still return naturally?  my gyno said it would not.

 I can't believe they told you that! I think it'd be pretty well known if you "couldn't" get it back.

I've sure known plenty who have!

It's not just getting weight back though, it's about having the proper intake/energy balance in place.

I've also known a lot of people to never get underweight at all and lose their period because they don't eat enough.

-usually they don't lose weight because of what I mentioned in the above post: their bodies are hanging on to calories to keep weight/fat instead of using them for things like womanly function and fertility -and signaling that bone mass.

the doctor said bc its been so long, like 5yrs now.  im eating 2000ish lightly active, more than any of the calculators say, just bc it seems like a "normal" amount.

thanks

Thanks so much to everyone for helping me out! :) I guess I'll have to try adding in some more carbs then, and some extra calories too - hopefully this will work! Also, sorry to hear about your struggles too agruskin! Mine have been gone for like, 3 years, but I've been weight-restored and eating much better/more for about a year or so.

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