When the period comes back...

I just have a general question.. because I have read in places that when gaining, I should gain back to when i lost period.. thing is I lost mine at a low bmi.. so if I gain back to that BMI, does that mean that's when I'll get it back? Or is there still a chance that it might not happen until I gain much more, like not until I reach the healthy range?

Or... is this something that you just can't... determine at all?

I think it's just a 'wait and see' kind of thing. Some people do get their periods at unhealthy weights, too, so it's not a definitive marker for being recovered.

I am recovered from anorexia,  I am 120 and 5 ft 5,  fine weight,  look and feel great,  but still no periods,  my gyno is baffeled because he never saw me at 100lbs. I tell him about this but he is still surprised that now i still dont have my periods,  I have had 3 homrmone injections since september.... still nothing,  do everything you can to get it back healthy.  i totally uped my fats and i dont to any work out at all.

Hi there,

There are a lot of things that come into play and having your period return while in recovery and not just a one-to-one ratio. 

To put it simply, having your period is extremely important while in recovery; but it does not mean the patient is fully recovered nor does it mean they should stop gaining weight.--having a period is a marker [among many] which indicats the patient is getting healthier. 

In other words, try to look at the entire picture of recovery; not just having your period return [although it is a good sign].  Recovery is like a painting...you have to learn to look at the whole canvas of the painting and everything it takes to complete it.

In some rare cases, those who are underweight and/or in recovery from an ED had their periods return--this is most likely due to hormonal imbalance and stress. Not allowing for a full recovery will cause permanent damage to your body and the repair will remain incomplete and set you up for relapse.

Gaining to a very healthy BMI is an important factor to recover and I will explain why.  Leptin is one key element and adipose tissue (fat) is Leptin.

So, on a scientific level let me give you an example of why gaining to a proper weight is vital for recovering ED patients even if you think you are at a healthy weight!

Let's just go through the process of an ED [and EDNOS] to show how it differs from calorie restriction for non-ED people just to give you a proper reference point for why you are being told "eat more", and then we'll get to some of the specifics of how your ED is shifting in expression right now with daytime restriction:

When you dieted for the first time some things that occurred in your body also occur in everyone. Your leptin levels drop quickly. With less leptin in the body, the metabolism is slowed and appetite is increased. When people diet severely, the metabolism is dropped as far as possible to try to maximize what little energy is being provided. While we can survive famine, it is at quite a cost to the body to do so.

Now this is where changes happened to you that don't happen to non-ED people. You had specific genetic mutations that were activated by that starvation. They primarily shift neurotransmitters in your brain to malfunction. We can see this on fMRIs with ED patients. This malfunction creates all the compulsions and anxieties around weight gain and food intake.

If I take two women of the exact same age/height/weight and I starve them (one has the genes for ED, the other does not) and then I stop starving them and I return them both to a BMI of 20 (exact same weight as pre-starvation), there are serious physical problems for the ED person that persist.

And ED person's leptin levels do not return to normal, whereas they do for the non-ED person. This is the critical reason why the low healthy range of BMI (18.5-20) rarelyprevents relapse for an ED patient. The non-ED person will return to an optimal leptin level (that she had before starvation) of about 16. The ED person will have leptin levels of maybe 6-9, despite being BMI 20.

So while leptin is directly related to fat stores, the leptin system is now damaged in an ED person. She has to gain to the higher healthy BMI range to push the leptin back to normal levels. So she may need to be BMI 24-25 to have leptin levels of 16.

As I mentioned before, your body will naturally find its happy weight and eventually you will stop gaining

Why are those leptin levels so critical? Because if they don't hit about 16, then your period is unlikely to return (it can, but odds are against it). Leptin acts as a gating hormone for all the reproductive hormones functioning correctly.

More importantly, optimal leptin levels seem to quiet all those malfunctioning neurotransmitters in the brain that generate the ED thoughts in the first place!That means the chance of relapse is greatly reduced the higher up on that healthy BMI range you are (clinical trials prove that).

First, has the definition of “weight recovered” been determined by experts who have helped you through your recovery process? If so, then it is highly likely that while you may have reached the healthy BMI range (18.5-25) you are still not at your body’s optimal weight.

However, BMI 20 will be a fully-recovered weight for only 2% of all patients striving to recover from the restriction eating disorder spectrum. That leaves 98% of those who have been told to stop gaining weight fighting the body’s absolute necessity that they gain more in order to reach their own optimal weight set point.  Thus why it is critical to reach a higher weight to fully recover, prevent relapse and reverse all the damage done by the ED on a cellular and mental level!

70% of all women naturally rest between BMI 21-27 and half of those will be BMI 23, 24 or 25 respectively. 

Your body will not be the same after you put it through an ED and therefore cannot compare your body to its pre-ED days.  If you are meant to be BMI 24 and you are trying to stay at BMI 20, then the continuing damage from that ongoing restriction is equivalent to being naturally BMI 20 and trying to maintain a weight at BMI 16.

To give you an example: I went from being less than a BMI of 12 to now the higher BMI range. During the weight gaining I gained to a very high BMI--but as I built trust with my body and eating patterns and reached a full recovery I lost some of the post-Anorexia weight naturally and even to this day I consume the same amount of calories.

Everyones body will be different as you heal overall [not just menstruating again] and some need more. For me personally [after putting my body through Anorexia Nervosa, Exercise addiction, and Bulimia] I had to gain to a very healthy weight to have my period return and be regular and to be healthy overall and fully recover. Again, some[most] need a little more TLC to not relapse.

Remember, if you want to fully recover, and heal, you have to go all they way and be willing to do whatever it takes to do this for good and reverse all the damage done.

It was the best decision I made and so lucky to have my period after so many years of not having it but it took some huge challenges that I faced and I am so thankful for being fully recovered from Anorexia and Anorexia Athletica and Bulimia.

 YOU also have to make an effort to be committed to change and recover as well.

I can assure you it is all reversible and you will be fine but it needs a lot more attention and time for awhile to ensure it goes in the right direction.

Best of luck and message me anytime.  Remember to keep pushing yourself.

Here is a link to my post regarding periods and recovery: http://caloriecount.about.com/periods-ft20729 5#13

and this:  http://caloriecount.about.com/body-know-ft207 004#7

snuffles, the leptin levels wont return until a high bmi xxx

thanks dancerqueen! :)

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Original Post by snuffles62:

I just have a general question.. because I have read in places that when gaining, I should gain back to when i lost period.. thing is I lost mine at a low bmi.. so if I gain back to that BMI, does that mean that's when I'll get it back? Or is there still a chance that it might not happen until I gain much more, like not until I reach the healthy range?

Or... is this something that you just can't... determine at all?

Like others have said, it depends on your body, but for me, I lose my period at exactly 102 lbs, and get it back at exactly 102 as well (BMI 16.3) and, (sadly) over the decades, this has happened to me many, many times... The important thing is that if you DO get your periods back at a low weight, DON'T let anyone tell you that you are now 'healthy' and don't need to gain - you STILL need to gain up to a healthy weight. No-one really knows why some of us get our periods at low weights, but it isn't necessarily a sign of good health.

Thank you for the information!!! Thank you dancerqueen for your post too! I love reading them! Missrising, thanks for your links as well, I haven't yet read them but I appreciate it!

dansmum- That's what I'm concerned about, I'm already struggling at the BMI I'm at as it is although I DO have all intentions of going above 18 etc.. but I am a bit anxious over the idea of getting my periods back at a lower idea and falling for the 'well that means you don't need to gain anymore' but I'll try not to :/ I'll try remember that periods doesn't necessarily mean recovered :/ thank you