I'm really confused (calorie question)

I've been trying to recover from anorexia and gain weight for the past 4 months and haven't made much progress.  I'm seeing a nutritionist who has worked in eating disorder units before so I've been pretty trusting that she knows what she's doing.  But, as far as I know I've only gained about 2 lbs in the whole time I've been seeing her (I don't see my weight, just go by what she says).  After my appt last week (another week of not gaining) I got kind of frustrated and decided to add up the number of calories that she has me on (we're doing an exchange/food group diet but she has given me guidelines on how many carbs, protein, and fat grams are in each serving.  When I added it up it only came to about 1500-1600 calories.  What confuses me is that everything I'm reading here and on other webpages says that I should be eating a ton more to gain.  This completely freaks me out b/c I don't understand why I'm gaining anything at all or why she's telling me to eat this little and not upping my plan more often (the last increase was a few weeks ago).  I'm comfortable with what I'm eating now but am concerned and confused b/c I don't want this to be any longer of a journey than it already is going to be.  I know I probably need to talk to her about this but wanted to know what everyone's thoughts are on this. 

It is possibe to gain on so few calories - however 2lbs in FOUR months is barely gaining a thing. The calorie level you are eating right now is essentially keeping your body in starvation mode because while it is more, it is still not enough.

Your dietician has probably worked you up in increments over the past few months and is probably trying not to overwhelm you. It is quite common for outpatients to have troubles with eating more, so they do seem to take it a bit more slowly than when working with inpatients.

That being said, I suggest you talk to her about increasing your meal plan up to a steady 2500 calories to promote not only the recovery/restoration of your metabolism, but also to encourage your body to start repairing your organs, muscle tissues and restoring your hormones and brain function.

I definitely realize that a couple lbs is nothing and that's kind of what worries me.  I would probably feel better about it if I knew I was at a "safe" weight health-wise but I know I'm not there yet.  She has increased my diet a bit but nothing recently.  I'm just getting so frustrated b/c I really don't want to be doing this forever.  At the same time, I have been really anxious about upping calories so I could understand why she wants to up my intake slowly.  I guess I'm just being too impatient. 

I don't know where your BMI is at, but when mine was very low last summer, it did take me about 2 months to get myself from eating less than 100 calories a day to eating 2400-2600. When you are tremendously underweight, taking it slow initially is suggested to prevent RFS and edema. After four months though, I'd think it safe to say your body has had time to adjust to food and its perfectly fine and infact  entirely necessary for you to increase your calories at LEAST once a week, if not more often, until you get up to 2500 as a minimum.

I really think you need to talk to your N and tell her that you would be comfortable with eating more. She probably is just afraid of pushing you too much and doesn't want you to take any steps backwards. Something a lot of people, even professionals, fail to realize is that if you don't push yourself now, it will make it a lot harder for you to recover and maintain being recovered in the long run.

Thanks for the feedback and support...I really appreciate it.  I guess really need to be clear with her that even though I'm still having a lot of anxiety I need to keep upping my calories b/c I've started to feel hopeless about gaining....like I'm doing so much work and dealing with so much anxiety and pain but have nothing to show for it. 

I apologize ahead of time b/c this is probably more of a vent than anything....

So I went to see my nutritionist this morning and I was "up" again in terms of my weight.  Of course once I heard this I didn't want to say anything about upping my calories or question why I'm gaining weight while eating so little.  The problem is that this is making me a bit crazy and I'm going back to some ED behaviors like counting calories.  For the past two days I ate about 1350 calories/day and after the physical activity I did (yoga class that my treatment team knows about and has approved) I was at about 1100 for the day.  How can I can eating this little and still gaining?  This is just something that's really confusing and upsetting to me b/c it makes me think that I've completely screwed up my metabolism or maybe b/c I'm older my body doesn't need as much to gain?  While I don't want to eat more I'm almost jealous of all the people here who can eat 2500 calories and not gain at all.  Ugh...I'm just in a really bad place today. 

Ughh I completely sympathise with you as I've been having this problem myself - I gained about 2 pounds a week on 2200 cals despite my doctors and this site telling me I'll need almost 3000 for a 2lb a week gain... then I cut my cals down to about 1800 out of panic and continued to gain! Its so confusing. I feel like my body is doing it to spite me and it just leads me to fall back into ED patterns like you said.

Keep fighting though hun. Good luck :)

I know, it is hard and it is confusing. The thing is - your body has sort of gotten used to being fed right now but it still doesn't trust 100%. By cutting down your calories, you frighten your body and it believes it is being starved again.

I was gaining 1/2 lb a week on 2200 calories a day in January. After some thinking - I realized I didn't want to be ganing on so few calories so I upped to 3600 within a 14 day time span. That SHOULD have resulted in me gaining two pounds a week. I think I gained 1.5 lbs the first week only and since then only gaining every other week.

The body is an amazing thing and it can recover - your metabolism can reboot itself. First you have to take a leap of faith. I'm not saying boost up to 3600 over night. What I am saying is that you need to stop letting your fear if imminent weight gain control you. Because other wise, you will never recover and you will always be caught in this trap of feeling like you need to restrict.

Thanks rebelchick.  I'm in a bit of a better place now....I was kind of freaking out this morning.   And I've been ruminating about it a lot today, but I keep repeating to myself "gaining is good" and it's helped a bit.  I know I jus  need to give up control and trust in the process.  I tend to get way too caught up in the future (what if i can't stop gaining? what if my metabolism doesn't recover?, etc.) and not focus on the moment and the importance of getting to a healthy weight.  I'm still worried about my metabolism and know that I need to bring this up to my nutritionist next week.  I think it would be really good just to get that out there and hopefully she can ease my worries a bit more.