need some advice

hi, im 5'1 and currently 97 lbs.

ive been struggling with an eating disorder and i recently went from 135 to 105 during the summer. i saw a dietrican and have started recently eating again... usually i eat somewhere between 300 and under 500 calories a day... but i stll get my 3 meals in and feel full. ive been told i need to gain weight and my dietrican put me on an 800 calorie target for right now so we can slowly increase... but i find it hard to not stay low with my calories and when i eat something that i know wasnt good or dont know to the calorie ammount to i stress about it and feel guilty and upset.... i have no ideas of what to do!!! does anyone have any advice?

After spending so long in one mindset, it's going to take time to transition.  But be patient.

If you get the internet on your phone, use it to check the calories of everything you eat, if only so you'll feel better.  However, know that you MUST eat at least 700 calories a day.  Tell yourself: if I had enough determination and will power to shrink a 1,500+ diet down to 300, surely I can manage to eat 800 calories a day.

Start a daily journal.  Write down your feelings and thoughts.  Then, make a list of ten things you love about yourself.  Positive things, different everyday.  Consider why you need to change your diet, and write about that too.

Eat healthy foods- it might make you feel less guilty, and you'll be getting more nutrients.  Apples, bannas, yogurt, whole wheat bread, granola...

If you really have problems, talk to your doctor again.

Hi,

First of all, your doctor and dietician are vital resources. It is so much easier to recover when you're not going it alone. Do you have a therapist to work with, too? Ultimately, if and when you are truly struggling go back to your doctor if you feel you cannot get yourself to recover. While it sounds a scary option, sometimes, day or inpatient treatment is the best way to go.

This does not mean it will be impossible for you to recover as an outpatient, but the first thing you have to do is conquer that voice telling you 300 calories is the only way to go. Even 800 isn't enough - an adult female needs 1200 calories minimum, a teenage girl - and by your pictures, you look like you are one - or an adult man need 1500 calories minimum, and a teenage boy 1800 calories minimum. That said, in recovery, calculators will not apply to you.

Your metabolism will likely be shot thanks to undereating. This is what is referred to as "starvation mode".

It is, however, reversable. It sounds hard, but you'll want to get to a calorie intake of 2500 if you really want your metabolism to kick back into gear. At first this may physically be trouble for you as the stomach sometimes shrinks to adapt. As such, both to help you manage your foods, to make it easier to digest and to help your metabolism, I suggest:

1. High calorie, low density foods. These are foods that are as the name says - high in calories but low in bulk. These are not only vital in the sense that they can still easily be broken down by a stomach trying to mend itself but also because they add calories without adding bulk. Examples of these would be whole fat dairy, nuts and nut butters, avocado, oils like olive oil and canola (rapeseed) oil as two examples, oily fish, dried fruit and dense fruit like bananas as just a handful of examples. There are two threads stickied at the top of this forum: Support Recipes and The Official High-Cal Food List. The first of these is a list of example recipes that are tasty, high calorie and helpful in gaining. The second is a more general list of foods that will also help in gaining.
   
2. Eat your meals spaced out over the day - aim for about five to six total. Breakfast, a mid-morning snack, lunch, an afternoon snack, and dinner, or switching one of those snacks for an evening snack would be an example. This is both to make it easier on your stomach and to help rev your metabolism. Do not skip them. If it is easier for you, devise a meal plan routine by yourself or with your nutritionist and stick with it.
   
3. This is an important one: do not weigh or measure yourself for two weeks when beginning refeeding. Why? Because our body will hold to a large amount of water initially. This water shows up on the scale, but is not a true indication of weight gain and will flush out after two weeks. However, seeing any increase can understandably be triggering for a recovering undereater and as such you should find someone to hide your scales and your measuring tapes until two weeks from managing a steady 2500. If numbers trigger you full stop, I highly recommend you steer clear of scales altogether and ask your doctor to blind weigh you.
   
4. If you eat a steady 2500, and then find you are maintaining or even losing weight, you will need to increase. Do not think about this just yet - just get to 2500 first.

The physical dangers that come with undereating and being underweight are numerous. You put yourself at risk of osteoporosis, of loss of fertility if you lose your period, hair loss, electrolyte problems, a weakening of the immune system, low blood pressure, blood disorders such as anemia, heart problems, and even death. From The Body Neglected: Between 5% and 20% of people who develop [anorexia] eventually die from it.

The mental woes that come alongside can be just as devestating. Depression is common in undereaters, as well as distorted perceptions and problems like Body Dysmorphic Disorder. I second aiming's suggestion of starting a journal, or a blog. Instead of using food as a control device vent your frustrations on paper or through your keyboard. Instead of focusing on the things that you hate, focus on what you love about yourself.

Do not worry about nutrition at this point. You will probably have a higher intake of everything compared to others - and really, comparing yourself to anyone else at all isn't the way to go. The only thing I personally think is worth watching in recovery is salt and trans fat, and if you are missing your period make sure you get plenty of healthy fats from oils, nuts, seeds and nut butters, avocados, oily fish, and so on, but any other nutrients and food groups? Don't worry about it. Aim for carbs, proteins, fruit or veg, healthy fats and dairy in all your meals over the day and take a full multivitamin as a buffer, and you'll be fine. Think of food as your medicine to a healthier, happier you.

Do not exercise for the start of this. If you must exercise, weight lift to rebuild destroyed muscle and do light, resistance exercise like yoga ONLY. Cardiovascular exercising is completely counter-productive during weight gain unless you are willing to eat back everything you burn. If your doctor, nutritionist or another professional tells you not to exercise at all, not even weights or yoga/pilates, then listen to them.

As I said at the beginning, if you are truly struggling do not feel you have to do it alone. Go back to your doctor and ask for help if you have to. Sometimes, while some can manage without it, the structure of a day or inpatient program may be the best way to go. If you want some further online support, I suggest going to this website: http://www.something-fishy.org

I wish you lots of luck, and if you have any further questions please ask.

 - Ellie.

No i dont have a therapist yet.

though ive seen the doctor a few times

and the dietrician once.

thanks for all that info.

the whole weighing myself thing is where the big issue is comming from.

i cant start my day or go to bed without knowing how much i weigh.

and if ive eaten more that i would have liked i weigh myself again.

Then lock up your scales. Smash them if you have to. You can't live life based on what a potentially inaccurate machine tells you!

I'd consider inquiring about a therapist, then. Undereating is not just about the physical struggle - it's about the mental recovery as well. Chat to your doctor about it next time you see them.