help.

hey. it's me again. i'm here because i'm panicking.  big time.  my anxiety level is through the roof.  i'm hitting 2000-2600 calories a day, and have gotten very consistently to the higher end of that range.  i am still making super fast gains that baffle even my doctor, and i'm just beside myself.

no longer can i say, "well i'm severely underweight, it'll slow down once things normalize a bit..."

or

"it's probably just a lot of fluid weight"

it's been too long.

 i'm just gaining at a ridiculous pace.

i consume healthy things. i have a nice balance of nutrients going on. 

i get a ton of fiber (like, everything i eat, basically, has a good amount of fiber), but i haven't had a bm in days.  what is that?  has my body learned to digest fiber? i drink plenty of water. i have a lot of yogurt with active cultures to try to regulate things, but to no avail.  i don't understand where all the fiber goes if nothing ever comes out.  sorry.

i walk a lot. i have to. i like the sun and i don't have a car.  is it possible that my body is still in starvation mode? i'm still hungry, all the time, so you'd think that would be an indication that my metabolism is actually functioning quite well, if not even in "hyper" mode, right? i'd give anything to get my metabolism back because this is so tearing me apart. 

please, i know i've posted here before about the same issue, but any further advice anyone has to offer would be sincerely appreciated. i can't keep going on like this.

I don't know what to say about your gaining pace. I know it must be very confusing and frightening. It could very well be that due to all of the walking you do (how much is a lot though?) your body has not actually settled into "restore and repair" phase, and is still fighting to hold onto every calorie you put into your body so it doesn't continue to eat away at itself.

In terms of the BM problem - there is such a thing as too much fiber. Everyone's body is different. Yours may need less for regularity. Also - there needs to be a balance of fiber as well. There's soluble and insoluble. Too much of one without enough the other and you get problems.  Some say lots of dairy can supposedly be constipating. Maybe try to cut back on your dairy intake for a few days and see if that helps?

I've been reading through your back posts to get a sense of where you're truly at...I may be off base, but I think you're on the right track.

You don't mention your weight which is probably a good idea, but I rather suspect that you're not up to a 20bmi yet.  Until you are and manage to maintain it for a while (personally I'd give it a least a week if not a month for every year that you've been struggling with your ed...somewhat arbitrary I know, but it's a goal to aim for) I don't think you're going to get your body back to the normal processing of calories.  15 years is a long time to have been struggling, you really can't expect to overcome 15 years of issues in just a few weeks or months.  You have definitely done some damage over the years and your body needs both time and resources to start repairing the damage just from a the physical point of view.  As your body does recover, that will hopefully help with your mindset, but I do recommend counseling if it's available to you.

Your prior posts mention a thyroid issue that you're not taking medication for, is it a medication that you can adjust the dosage on?  Not taking a medication that you need can cause severe problems just like taking a medication that you don't need.

On the BM, are you getting enough healthy fats?  If you're feeling impacted I'd definitely go see a doctor.  On the other hand, before I started eating as healthily I'd go a couple of days without a BM.

2,000 calories is maintenance for me when I'm not working out so you're probably going to need the higher end of your range consistently.  I know it seems high, but if your doctor is recommending it then you need to do it.

thank you both *so* much for responding.  i have had the worst day ever, and i really appreciate your support.

rebel~

confusing and frightening, yes.  my worst nightmare, in fact...no exaggeration.  i thought i'd have to work hard for this.  i tried to trust the logic and research and what everyone told me about the gaining process.  that makes sense about the "restore and repair" phase...but c'mon, what's it gonna take? i've tried decreasing the walking because i don't want to get compulsive about it (heck this is the least amount of exercise i've done in god knows how long, so my mind will latch onto anything it can get)...so it really varies.  but generally it ends up being maybe an hour or so...sometimes a lot more, sometimes a little less.  nothing outrageous.

funny you should mention the dairy thing.  i was mulling that over recently...how i've probably had more dairy in just this past week than in the entire past 15 years combined (not that it's that much, but i really got no dairy at all when i was restricting...now it's sort of a staple)  i've tried supplementing with magnesium to help balance the increased calcium intake, but it doesn't really seem to help.  i think my fiber intake consists of both the insoluble and soluble.  i eat fibrous and cruciferous veggies, fiber bars, lots of oatmeal (with wheat bran mixed in), fruit, etc. i just don't see where it all goes and even had the thought process that maybe my body has learned to use it as just another adaptation response to prolonged starvation.

thank you for giving me some things to think about <3 

smwhipple~

this would just be so much easier for me if the gaining process were gradual.  people often say it's better to "rip the band-aid off," but i just don't agree.  i think after 15 years of this, it's too much to psychologically handle such rapid changes.  i want to have to work hard for this every day, learn to accept the changes gradually, so i can trust the process and trust my body and remind myself of what i'm doing and why.  i know i've been sick for a lot longer than most, but how can i be the exception to so many rules?  3500 calories above and beyond bmr are still required for the gain of 1 pound...so how can this really be?  not to mention the increased caloric requirements for anorexics and all the research of done on recovery.  i just wish i could understand this from a biological standpoint.  i know i've done a lot of damage, but i really don't understand how i can be defying so many rules.

i'm not taking the thyroid medication because the dr who finally diagnosed me went out of practice.  i don't have the energy to pursue it further right now.  but mainly i want to give my body the chance to heal on its own.  i've done enough research to understand that the reason i probably was diagnosed as hypothyroid was because i was in a state of starvation, whereby thyroid hormones are reduced as the body's way of conserving energy.  so i'm trying to go it without.

you make a good point about getting enough healthy fats. i struggle with this.  i've gradually been integrating more full fat dairy products and things like nuts into my diet.  it's hard for me because i'm incredibly afraid of calorically dense foods...i still always find myself trying to get the most "bang for my buck" haha so to speak.  maybe i'll start taking fish oil.

thank you for your support <3

as a side note, does anyone know anything about venous insufficiency and capillary leakiness?  i've done some research, but i'd like to know if anyone has input here.  i had REALLY bad pitting edema in the beginning of refeeding, which kind of decreased...but now my legs are still really achey and stretched tight by the end of the day, and my veins are realllly prominent.  i like to think that maybe some of this is still fluid imbalances, but it's hard to tell at this point what is swelling and what is just me getting fatter. my doctor hasn't really been all that helpful with this aspect of things - he's mainly just happy to see my weight increasing at ungodly rates. every part of me is growing and expanding and i feel like my head might explode.  

I developed very bad edema when I was in IP the winter/spring of 2008. It started developing mid February and did not fully dissappate for about 5 weeks. I am not joking. This time in recovery, I did develop some (though not nearly as bad) and it took nearly a month for it to go away as well. It takes time for your body to finish repairing those capillaries in your extremities. Your body keeps its most important organs and parts in the center, closest to your heart. The further away from your heart something  is, the less important it is. Following this logic - the capillaries and veins of your lower legs are going to be one of the last things to get fully repaired. Also - having a low heart rate and low blood pressure can increase and even cause edema. It means your heart isn't pumping enough for consistent full circulation of fluids. Its not you getting fatter.  Its that your body has a great deal of damage to undo and its going to take some time for everything to get sorted out.  Something that will help somewhat with the edema is watching how many processed and salty foods you eat, as well as getting more of your calories from healthy fats. There's more out there than full-fat dairy and nuts/nut butters - there's avocado, hummus (depending on the brand), olive oil, mayonnaise, coconut milk or flaked coconut, dark chocolate, whole eggs, even granolas and many soy products that contain a good amount of fat. Eating more of your calories from fats will hopefully lessen the amount of fluid retention you're experiencing. I know its frightening - believe me I've been there. But I can honestly tell you - when I decided to increase my fat %, the edema truly did get better and it disappeared with a week or so of upping my fats.

First all I am about to say I know is easier said then done when ones body makes quick jumps. I remember you posted before but I wonder if you are still very underweight and though you may be gaining quick your body is so malnurished the end result of a healthy weight is still far away? I had severe edema in one of my ip and my legs hurt so much. They had me elevate them when sitting and even sleeping and wear support hose. With time it did go down. I also agree about making sure you are balanced nutrient wise and I did read a study about more dietary fat helping with this in recovery. If you were bulimic too edema is something can be worse in recovery of that then just anorexia alone. As for your calorie level. The 2600 sounds still on the low end for weight gain and 2000 seems like maintance. I would encourage you to be more consistent as maybe the 2600 but then the drop to 2000 could be confusing your body.

i think you are analysing it too much. not everyone has requirements for 3000-4000 cals. it could very well be that your body is gaining what it needs to on the 2500 mark.

i agree you need to be consistent with the calorie level. going up and down is really going to piss your body off. if you are still undeweight then gaining shouldnt b too much of a big deal.

your body may not wish to stop at a weight which you dictate. it may be happier at its own set point and the harder you try to argue with that point, the more painful and difficult life will be

hey rebel~

thanks for taking the time to respond and share your experience.  i'll continue to work on getting my fats up....maybe some of this is still fluid imbalances.  i've reduced sodium as much as possible...i certainly dont add salt to anything anymore (weird how i loaded everything with salt when i was restricting and could eat jars of pickles and not have a problem).  the edema was really really bad in the beginning, and i guess it could still be there, just not as apparent.

abbi~

yeah i'm trying to be as consistent as i can now.  i wavered a lot for awhile and freaked out and started purging some of the calories which i'm sure has confused my body even more.  i've cut that out because i really need to stabilize things for my body and my mind.

fidget~

thanks for the reminder to stop analyzing so much. i like logic and i like to understand what's going on from a physiological standpoint. i haven't fully embraced the "wanting to gain" state of mind, so it's been terribly difficult.  i kind of wanted to "test the waters" and begin to trust my body will work for me, but i guess i can't really control what it does.  there would be something very reassuring about experiencing the metabolic rebound that everyone speaks of. 

thanks for all the support <3

This will settle. it will. sometimes you have to be something before you accept it. eating disorders by their nature are an abuse of control. i put on weight way before i was psychologically prepared to do it and i found it very hard to deal with at first. but i am here now and i accept (usually) how i am and what i am.

i am like you. i need to understand the physiological boundaries and limits so that i feel some safety. but i found after much battles and tears that my body was going to be what it wanted to be and that i was going to waste my life and dreams by fighting it.

this will settle. keep going

HI ,

If you've been diagnosed with a low thyroid that could be your answer right there.  IT would lead you to gain weight at a much more rapid pace than normal. One thing you can do to normalize it is take enough vitamin D...about 1000iu's per day at minimum. Also tyrosine can help normalize your thyroid.  It would probably make you feel much better.  I'd start with the vitamin d first and see if it makes a difference.  I'd probably take 2000iu's per day...that is what my naturopath suggested.  Good luck and hang in there...sometimes you have to feel crappy before you feel better. By the way the thyroid problem would be behind the constipation too.....a sluggish thyroid is one of the main causes of constipation in women. 

thanks, fidget~ i'm pluggin away. i hope you're right and thank you for your encouragement...i hope you're doing well <3

vic~ya know that's interesting.   i have been on this mission to restore my thyroid function with better nutrtion, but i gave up yesterday through frustration and started taking my thyroid hormone replacement again.  i don't know how much of it is psychological, but i feel a lot better already today. i really wanted to see if my hypothyroidism was due to undernutrion, but maybe not.  without analyzing too much, i can see no other explanation for the extremely rapid weight gain...i mean, if the body is supposed to require 3500 excess calories for just one pound....i'm going to see if i experience relief of my symptoms and if things even out a bit now. i've tried tyrosine and iodine (thought controversial)...the vitamin d thing: can i get enough from the sun? i spend A LOT of time in the sun.  gotta run, but thanks for the ideas...hopefully things will start to look up and make more sense. <3

Hi Cruumb....

Hon i don't think it's psychological at all..if were diagnosed with clinical hypothyroidism then you would respond that quickly to the medication.  If you need it..why not take it?  I've heard that the natural dessicated thyroid is the best way to go though.  As for vitamin D...most of us don't get enough from the sun...it depends on where you live actually, how your body absorbs it and if you wear sunscreen etc.  I'll bet you that now that you're about to get your thyroid under control the rapid weight gain will ease and you will gain at a more normal rate.  In fact you might start to lose so you might have to up those calories to keep gaining.  Good luck!

hi again, vic!

thank you so much for your input...i sure hope you're right and things start to ease up a bit. maybe i've been denying the source of my distress. i thought my thyroid issues may have been directly related to prolonged starvation, but maybe not entirely.  i do take natural desiccated hormone because all the research i've done supports it over synthetic versions.  i was taking it for awhile, but stopped when i started trying to recover because i wanted to see if my body would rebound on its own.  maybe i just totally threw it totally into shock.  at any rate, i know it should have to build up in the system for a few weeks before any apparent decrease in clinical symptoms, but maybe since i've been on it in the past my cells know how to process it...i'll be praying that i continue to notice improvement.

i'll look into the vitamin d thing more...i live in new mexico, at a very high altitude, and where it's super sunny, so i'll be taking advantage of the sun as much as i can during these summer months. 

it would be so great if things normalized a bit, so that i can work my way through this process...i know i've done a lot of damage to my body, so it's not gonna be easy.  keep your fingers crossed that this helps, and thank you for your input.