|Health & Support||-||Jun 13 2012
I am sorry peachybrezel that you feel it was a BIG MISTAKE to pursue recovery, however I would have preferred it if you had shown me the courtesy of communicating your concerns directly on my forums as you are a registered member there.
Your warning to others does not provide all the information they might need to make an informed decision for themselves.
I appreciate you at least put in the correct link to my material, however you misunderstand the concepts of water retention for cellular repair.
Water retention does not turn into real weight. If your body is at its optimal weight set point point now, then the water retention will dissipate when the healing is complete.
If however you are not at your body's optimal weight set point -- I believe you lost 22 lbs. in your 6 month process of getting to being a 'teensy bit' underweight (meaning you were at a healthy weight when you began and given you say you also have a history of 'bingeing' then presumably restriction/reactive eating cycles go back further than the past 6 months) -- then as the water retention dissipates, real weight will slowly replaces it to bring you back to your body's optimal weight set point.
Your body is not interested in staying at a too low weight for you, much as you have determined that you wish to stay at BMI 19. The water retention has shown up precisely because your restriction has damaged your body and water retention speeds cellular healing. BMI 19 is only naturally optimal for barely 1% of the population. If you cannot eat 3000 calories and stay at that BMI, then it is not your body's optimal weight set point.
And that such a significant amount of water retention has shown up in your case is not a situation of "too fast too soon" but rather that there really is that much physical damage that has to be managed by the body.
Whether you have a lot or a little weight to restore for your body to return to its optimal weight, the recovery guidelines are meant to support that effort.
That you currently wish to gain a few pounds is not a recovery effort, and so you should be clear to others that your warning pertains to those who do not wish to recover.
And yes, if you do not wish to recover from having damaged yourself with calorie restriction then following any recovery guideline (including the ones found on my site) would be unwise.
If you choose to use your personal experience as an example of why recovery is not suitable for those who are 22 lbs. below their optimal weight set point (likely more given that you probably have a history of restriction that pre-dates the past 6 months), then it is only fair that your personal experience be spelled out in more detail.
Obviously your decision to relapse is correct for you at this time. You are not ready for recovery at this point. However you have presumed that others who "do not have a lot to gain" will not succeed using recovery guidelines that involve no further restriction of food intake -- that is a flawed assumption. There is also no clinical evidence to support that assumption either.
People only return to their optimal weight set points in recovery and the energy intake is "HUGE" because the damage is "HUGE".
Best wishes, Gwyneth.
|Weight Gain||Recovery and Weight Gain Information: scientific research||Oct 29 2011
Wonderful amalgamation of various studies HouseElf as well as an excellent series of synopses on schools of thought that have been somewhat misguided when it comes to the origins of anorexia and treatment options. I was brought here by a direct message from another user and I'm glad I got a chance to see all of this!
The issues surrounding both hyper and hypo leptinemia (higher than usual or lower than usual leptin levels) still require further study. Generally, we have seen both occur during recovery in transience and, as with many facets of the re-feeding process we can see in the Minnesota Study, it appears to resolve over time.
Hypoleptinemia may be responsible for the necessity of initially needing to weigh more than an optimal weight for a menstrual cycle to return. And, as HouseElf has already highlighted, within the follow-up year beyond recovery, all patients return to their optimal weight (without any restriction or relapse).
A good way to think of it is that sometimes metabolism needs more time to optimize everything yet again in your system. You take the boots to metabolism when you starve. Patience is your best friend in recovery.
However, not all women (about 5%) appear to have their menstrual cycles closely tied to the gating hormone leptin. This is why in some cases, women continue to menstruate through weight loss, or have a menstrual cycle return despite not having yet reached an optimal weight.
Leptin is fat-store linked gating hormone. It is responsible for bone formation, metabolism, appetite, normal hormonal and neurological function and blood formation. When we starve, leptin levels in our system plummets.
Constitutionally lean individuals comprise approximately 1% of the entire population. By definition, assuming an equal distribution of the genetic pre-disposition for the restriction eating disorder spectrum, only 1% of all those attempting to recover are constitutionally lean.
You are constitutionally lean when you eat a larger-than-average amount of food just to maintain your weight and health. Any form of restriction by definition confirms that you are not at your optimal weight set point.
As for severe and enduring eating disorders (SEED), I will not address the specifics of that in detail on this thread, but there are indications that the body makes every effort to adjust to long term starvation to keep the individual alive. It's not a place that any one who is on the restrictive eating disorder spectrum wants to be and I think someone on this thread has already pointed out that the over abundance of clinical data can be both empowering and frightening.
As the REDS shares many facets with anxiety disorders, it's a good idea to keep in mind that there will never be enough data available to assuage the anxiety about weight re-gain, but the huge body of evidence does allow for those of us attempting to support recovery to point out that the guidelines we quote are based on hard facts.
Best of luck to all of you on your continued success.
PS -- I'll be on this CC board again for the last time this coming Monday (Oct. 31) and then you can find me through my journal entries to my new site. Cheers!
|Health & Support||So why will us ED recoveries need to maintain on 2500 (min) while everyone (seemingly) else will only need 2000 max?||Sep 01 2011
Hypermetabolism is not responsible for the approximate 2500 calorie-a-day requirement post-FULL recovery. In fact hypermetabolism (in the absence of an eating disorder -- i.e. the very rare naturally thin person) will usually push the daily requirement to 2800-3500.
The primary reason for requiring about the same amount post-recovery as the minimum required during recovery is that the metabolic rate returns to normal and that therefore means that biological functions that were on hiatus during starvation are now running dependably and require energy.
Almost any adult (beyond age 25) and above 5 feet will require close to 2500 (usually between 2250 and 2650) calories assuming they are very lightly active (desk job) and have no other unresolved health issues.
The calculation used on this site (and almost all other calorie counting sites) is basal metabolic rate multiplied by activity level (BMR x activity level). Double-blind controlled trials have proven this calculation does underestimate the actual energy requirements for adults by about a third.
Total energy expenditure (TEE) is a more accurate calculation (clinically proven) and a calculator for that can be found here:
This site (using BMR x activity level) suggests I need 1750 calories a day to maintain my current weight and height. (no history of ED). In fact I actually consume between 2300-2600 a day and about 3000 at least once a month. I maintain my weight and health on this amount because it is actually very close to my TEE requirement (2484 to be exact).
I have emptied my mailbox if you have further questions, but I may be slow in responding.
During recovery 2500 is a bare minimum. You should actually expect to eat well above that -- around 3500-5000 a day as a recovering woman and 6000-8000 as a recovering man (it can be more than that even on many days and as long as it never goes below the minimum requirement, then recovery continues to move forward).
You have to provide energy not just to regain weight -- starvation creates hundreds of thousands of calories' worth of damage to every major organ and biological system in your body. Calorie is not a fat unit, it is an energy unit. It is normal to eat enormous amounts during recovery and to get overly full and yet still feel hungry. The body has to attend to massive repairs.
And as for hypermetabolism that lingers post-recovery, it isn't a matter of needing to believe or not -- W.H. Kaye's 25 years' or so of research confirms that the vast majority of anorexics do develop hypermetabolism after full recovery.
In those circumstances, 2500 will likely not be sufficient to maintain your health and weight. It will be obvious if you have lingering hyper-metabolic issues because you will feel very hungry if you attempt to restrict.
Thankfully, because the leptin response system is functional in all those recovering from the restriction eating disorder spectrum, you can use your sense of being hungry to ensure you provide enough energy to support your health and weight.
Keep in mind that any restriction or even modest weight loss will usually trigger relapse in those on the restriction eating disorder spectrum. The neurotransmitter anomalies in the emotional center of the brain of those with the REDS are particularly hair-trigger to any sub-optimal levels of energy intake.
If you find you feel hungry but are feeling increased levels of anxiety and acting on thoughts to restrict, then you have all the indicators of an on-coming relapse. Research on this topic has shown that as little as a deficit of 150 calories in a day can resurrect restrictive behaviours in patients who are either in the process of recovering or who have recovered fully as well.
Please check out my journal entries on needing 2500 and why 'bingeing' is not actually bingeing at all during the recovering process (and in fact even beyond recovery excess eating is normal and does not result in continued weight gain).
I will also be updating the following entry and including as a journal entry in the next week, but in the meantime you can review the material on this link as a way of getting some sense of what to expect during the phases of recovery:
Hope this helps those of you on this thread a bit. Best wishes to all of you.
|Health & Support||Diabetes and oatmeal?||Jun 06 2011
It depends on the kind of oatmeal. Steel-cut oats are beneficial in preventing the development of Type II diabetes in a few clinical trials, whereas instant oatmeal not so. Also (rather obviously) don't be slathering it with sugar.
Steel-cut oats are also good for lowering blood pressure and bad cholesterol levels.
If you like your oatmeal sweet consider a lower glycemic index choice (such as agave nectar). And avoid sweeteners that are artificial and possibly dangerous (like the aspartame family etc.).
Not all carbohydrates are the same. Ultra-processed carbs are problematic, but whole grains provide a more timed-release of the sugars and less of an insulin spike.
So, go the steel-cut oats approach and you'll be able to enjoy oatmeal.
|Health & Support||Return to starvation mode?||Jun 06 2011
Glad you have upped the calories further and that I totally misinterpreted your reasons for asking the question too.
It is tough when you don't have much input from your in-person health care providers that's for sure!
And if you find that 3000 isn't enough, then don't be shy and go for 3500.
Is there any opportunity for you to get any cognitive behavioral therapy (CBT) support from a therapist? That can really help shut down how much that ED voice can drain your efforts to keep the recovery process going.
I know I've probably mentioned that already to you but I harp on this facet of recovery so much because it really does short circuit the very high rates of relapse that most REDS patients experience when they focus exclusively on the weight gain part of recovery.
Congratulations on forging ahead and feel free to message if questions come up and I'll try to help answer them. H.
|Health & Support||help me please||Jun 05 2011
Your friends and others who have posted here are all reading this one right -- you are in trouble and the real you knows it.
That's great you have your Mom involved and she knows that your menstrual cycle has been on and off. Be very honest with the doctor when you go there with her.
As a teenager you should eat about 2300 odd calories a day and upwards of 3000-3300 at least once a week. From age 16-25 women should "binge" about once a week and the energy is needed for brain, skeleton and hormone development -- it's not all about weight.
You are starving at 1000-1500 calories a day, especially with your activity level on top of that.
You are on the restriction eating disorder spectrum and while it is easily treated, you need treatment to recover fully and permanently. In addition to seeing a doctor, ask your mother whether you can also get cognitive behavioral therapy with a trained therapist -- that is the clinically proven way to recover from this eating disorder.
You have some good friends that are being honest and a mother who is paying attention, so all the odds are in your favor that you really can just be a normal teenager again and enjoy eating and living without panicking about "being fat".
Best of luck.
|Health & Support||Return to starvation mode?||Jun 05 2011
If you are not steadily gaining on 2500 calories and you are at a low weight, then you already know what you should be doing: up the calories.
If your question is what I think it is, then you are asking whether your body will slowly deteriorate to a point where it can start to gain again on 2500 calories because it keeps dumping biological functions in an attempt to keep you alive, then I don't know where I could even find the answer to that one. It isn't the kind of thing that tends to form the basis of clinical trials.
Theoretically you should be able to get weak and near-death enough that it might work, but I would push back on you to ask why are you not just increasing the calorie intake now?
If you increase to 3500 calories a day and still you are unable to gain any weight, then you see a doctor immediately to identify whether there are underlying conditions that are actually involved.
But first up your calories and see whether you can start to provide your body with enough energy to recover.
|Health & Support||Period Question||Jun 05 2011
Only your body determines your optimal weight and that will be the weight at which your period returns.
At 18, you have not completed development (ages 16-25 is when all the neural, skeletal and hormonal development occurs to get you to adulthood).
While you may have menstruated at 94-96 lbs in the past, that won't have much relevance now because things change constantly through ages 16-25 -- often the body needs to store extra energy at certain points along those years to ensure it has enough to deal with specific development needs.
You have to keep gaining until you do return to regular menstruation and you need to work with a cognitive behavioral therapist to ensure that you are prepared and ready to accept that your body needs what it needs and that whatever weight it decides upon will absolutely be healthy and right for you.
Best of luck on your continued recovery.
|Health & Support||Illness from weight gain||Jun 05 2011
The body is extremely resilient and able to recuperate when we provide it with the environment in which it can do so.
So yes, digestive issues, lethargy and hormonal imbalances are extremely responsive to better life choices and very sensitive to poor life choices.
Damage is completely reversible.
Focus your attention on upping activity levels and removing ultra-processed foods. Don't apply anything more than modest calorie restriction as this can complicate issues and make it harder to achieve healthy and permanent weight loss and recovery of overall health. Keep the calorie deficit at 500 calories maximum (meaning eat 500 calories less than you burn every day at a maximum) -- this helps to avoid suppressing your metabolism and causing all sorts of complications with insulin and leptin resistance down the line etc.
Hope this helps a bit towards your very worthwhile effort to recover.
|Health & Support||Family relationships / attachment issues / ED related||Jun 05 2011
There are various kinds of anxiety disorders: post-traumatic stress disorder, generalized anxiety disorder, specific phobias etc.
Those who develop anxiety disorders often have higher vagal tone from birth, which may suggest a genetic/environmental source that occurs even in utero. Babies with higher vagal tone have more pronounced startle responses to unexpected noises, and a slower return to a baseline heart rate.
Untreated anxiety disorders often eventually lead to depression through the exhaustive nature of anxiety. Unfortunately, many with undiagnosed anxiety disorders seek help at the point where depression has developed and are therefore treated for depression while the anxiety remains untreated.
Given your family history, you most likely have generalized anxiety disorder. It's a particularly sensitive looped system in the emotional center of your brain that triggers all the disparate compulsive, restrictive and avoidant behaviors in an attempt to alleviate the discomfort of the underlying fears.
We honestly don't know enough to determine whether there is co-morbidity or progressive development from a single-source underlying condition. It is always chicken and egg. Is an addict an addict to self-medicate for underlying untreated mood disorders or do addictive tendencies generate pscyho-active substance-generated mood disorders? Likely it is neither and both all at once.
All the traits you express fit under the broad category of Axis I disorders in the DSM IV. And perhaps they will all end up being one disorder when we get to the DSM-VI or VII, who knows?
Given that the genotypes (as far as has been identified thus far) all seem to over lap and that the most successful treatment (CBT) is applicable to depression, anxiety disorders, restriction eating disorders and OCD alike, then it is likely that these are all facets of a broader spectrum of biological functions that have some overall population benefit despite individual variation for its actual value.
Researchers hypothesize that because restriction eating disorders exist in other animals as well, it has overall population benefit to have the genotype persist even if some individuals receive a genetic variation that is fatal (just as sickle cell anemia is deadly, but the sickle cell trait protects against malaria).
The same is true of anxiety-ridden/depressed individuals. In studies, they are known to make more measured and careful decisions and to identify problems and issues where 'normal' people forge ahead without a second glance.
In a family with the anxiety genotype, a dozen will be worriers but otherwise they tick along, but one or two may develop intense phobias that render them house-bound or unable to function in the world independently.
For the individuals where the concoction of genes and environment make for a really reduced quality of life, there is CBT -- particularly successful for the Axis I disorders as a way to take back a quality of life you feel you are owed (and deserve).
In your case, it is likely a generalized anxiety that appears to have two peak focal points: food intake/weight gain/body image (the REDS) and various phobias expressed through obsessive and compulsive rituals aimed to rid or lessen the risk of infection/contamination/impurity.
Purely a guess on my part, but something to definitely investigate further with your involved professionals.
|Health & Support||Therapist does not know what to do with me next...||Jun 03 2011
I am sorry you are at an impasse with your current therapist. This can happen with doctors and therapists just as it can happen with patients -- sometimes things don't work out on one end or the other, or both at once.
What you do in these circumstances is you assess both your part and her part in the breakdown, integrate what you think you can learn and then find the next therapist. In fact you can find the next therapist even while you are processing why the previous one hit a brick wall.
At BMI 14 your therapist is not writing you off, she has wisely assessed that you are so dangerously underweight that without more immediate medical intervention, any psychological therapeutic effort will have little benefit at this point in any case.
Your cognitive function will be drastically impaired at the moment. Cognitive function is a real energy hog and given you are starving, then necessarily the body won't allow for too much thinking to go on because it will endanger other vital functions needing what little energy there is available just to keep you alive.
CBT is needed for complete recovery, but you may need a somewhat more stable physical base from which to apply CBT than what you have at present.
Your anxiety and fear of change will be all consuming when cognitive function cannot really be over-layed to assess actual risks vs. perceived risks.
While your anxieties around contamination drive your extreme desire to remain out of in-patient care, once in care you will find the reality does not match the perceived risk at all.
You need in-patient care to get strong enough to embrace a CBT process fully. And it's completely doable. You are not a lost cause -- far from it.
When you have your medical review, discuss entering in-patient care along with how your contamination anxieties will be addressed (either with pharmacotherapy and/or modifications in how your in-patient stay will progress).
While the desire to avoid any of those kinds of conversations with your medical team will be very strong, worse will be the possibility you will end up in emergency and admitted without being able to feel you can modify the terms and conditions of your admittance at all.
Your underlying fear of change is nothing more than misfiring neurotransmitters creating the illusion that any change will be catastrophic. So there is nothing to really delve into there. In fact, it needs a work-around. But even CBT, which provides work-around training only works when the patient desperately wants to current lack of quality of life to improve.
And to want your recovery you may need to be a bit stronger and healthier than you are now. Get the weight on to a point where you can be released from in-patient care and then you can embrace CBT and recover completely.
Best of luck, H.
|Health & Support||How do you stop?||Jun 02 2011
Your doctors seem not very up-to-date on recovery.
Your weight is only determined by your body, not your doctors and not anyone else including you.
70% of all women should be between BMI 21-27 and of those half will be BMI 23, 24 and 25.
At 5'5" and 130 -- your body has just decided it's not there yet.
Also, your doctors likely don't know that clinical studies show of all fully recovered anorexics only 2% end up above BMI 25. Even more critically for that tiny minority of 2% is that 0% of them are still above BMI 25 one year after complete recovery. That's with no relapse and no restriction.
The metabolic rate and leptin levels will optimize everything for you.
You are still hungry not just because your body may need a few more pounds for everything (especially your metabolic rate) to return to normal, but there is still likely a significant amount of energy needed still for repair.
You damage every major system in your body with anorexia. Your body has to rebuild its bone strength, major organs have to be repaired, the whole reproductive hormone system has to come on-line again... that translates into hundreds of thousands of calories' worth of energy to rebuild it all.
You are not just eating to have it end up as extra weight.
Trust your body and not your perhaps out-of-date doctors on this one.
Have you returned to a regular menstrual cycle as yet? And if you have, has it been 3 months in a row? If it's yes to both of those then use this calculator (below) to correctly assess how much energy you really need and then add 250-500 calories on top (whatever eases the extreme hunger):
If you answered no to one or both of the questions, then you know you still have to gain weight to recover to your optimal weight, and that means returning to a minimum of 2500 calories a day (more if you need it -- 3500+ is fine as long as you never go below 2500 on any given day).
The calculator I provide uses TEE instead of BMR x activity level and clinical studies show TEE is much more accurate at determining actual energy requirements for adults (BMR x activity is too low).
You gain on 2500+ until you hit your optimal weight and then you keep eating 2500 approx (see TEE) for the rest of your life to maintain your weight. The reason you don't keep gaining and gaining is that your metabolism returns to a normal range and biological functions that have been on hiatus due to starvation fire up again and need that extra energy that was going to weight gain and repair.
You are basically at the final phase of recovery -- it's a tough one because there can be that real desire to restrict as there is so much continued demand for extra energy in. Do whatever you can to trust your body and it will reward you in the end.
Congratulations on getting to this point! All the odds are now in your favor that you will recover completely and permanently. And that means all the damage is going to be completely reversed as well.
Best of luck.
|Health & Support||ED recovery-concern||Jun 02 2011
Your nutritionist is not the most suitable professional to lead your recovery process.
You need cognitive behavioral therapy (CBT) from a registered therapist.
Your nutritionist is not trained to determine when you should reintroduce exercise, your physician needs to approve that (confirming the condition of your heart muscle).
Your nutritionist is also not trained in the restriction eating disorder spectrum. While she may even specialize in ED's, that specialization is not the result of education and training in the neurological and physiological elements of the disorder.
Nutritionists and dieticians are also disproportionately on the restriction eating disorder spectrum (REDS) themselves (comparing those with nutritional sciences majors against the overall university student populations) and this leads to conflicting advice and information for a patient looking to fully recover from the REDS.
The restriction eating disorder spectrum includes: anorexia, restrict/reactive eat cycles, bulimia, orthorexia and anorexia athletica.
The enemy is restriction. You cannot binge -- you are reactively eating because you need so much more energy in than you are actually getting.
You need to consume 2500 calories a day every day to recover from the REDS (whether you express it as anorexia, orthorexia, bulimia, etc.).
Orthorexia is the disproportionate focus on eating only healthy foods, having long lists of forbidden foods, watching percentages, nutrients etc. You restrict through this attention to micro-managing intake in these ways.
You may find my post here helpful in understanding the actual phases of recovery:
It applies to all facets of the restriction eating disorder spectrum.
Critically, the anxiety around food intake, body image and weight gain is treatable through CBT. It will be the way you can recover completely and permanently.
Look out a CBT therapist if you can -- it will really help move you forward.
In the meantime, eat 2500 calories at a minimum every day. And if you need more, then you keep eating more. Specifically there can be no forbidden foods and you need to reinforce the fact that you are not bingeing -- your body is requesting more energy.
You need energy for both repair and weight gain and that's why it can be 3500-4500 or 6000 on any given day. As long as you never go below 2500 on any single day, then you are only healing faster which is a good thing!
Hope this helps.
|Health & Support||Recovery - Dietitian, what are you doing???||Jun 02 2011
Unfortunately your circumstance is a common one.
Because a disproportionate number of dieticians and nutritionists are on the restriction eating disorder spectrum themselves (studies comparing those with nutritional sciences majors with the rest of the university student populations), often their guidelines for ED recovery are woefully inadequate.
A professional nutritionist or dietician is most helpful in ED recovery when they develop meal plans in partnership with the patient.
2500 calories a day is a minimal daily amount for recovery. And if the patient is not managing to gain 1-2 lbs. a week, then the amount is increased.
While your nutritionist's style may indeed be to 'protect' the patient by providing minimal information, protection is not necessary for those on the restriction eating disorder spectrum and is more often counter productive to their recovery.
The restriction eating disorder spectrum is a neurological disorder. It is best treated with cognitive behavioral therapy with a registered CBT therapist.
You are also best served in recovery if your treatment team is honest and up front with you, especially as your recovery depends upon you being up front and honest with them. Trust is developed on a two-way basis.
The best way to recover is to have a CBT therapist anchor you in developing non-restrictive behaviors in response to anxieties about weight gain, body image and food intake.
Then you involve a physician to ensure two things: 1) that your vital stats are all as they should be and 2) that any discomfort through the recovery process is monitored and supported to keep things moving along (issues with bloating, aching joints...etc.).
And finally, you can involve a nutritionist or dietician to help develop meal plans that provide you with a minimum of 2500 calories every day, or more if the weight is not increasing as it should.
A nutritionist should probably not be your anchor person for recovery. They are not trained in the neurological underpinnings of the disorder and that is where the lion's share of the work will be done to help your recovery be complete and permanent.
I think your instinct is right in telling you that a vague and circumspect nutritionist is simply not suitable for your needs and your personality.
In fact, anorexics generally do much better if they know exactly what to expect at each point in recovery and can identify and address anxieties associated with those steps in detail through CBT.
Best of luck on your continued progress!
Vagueness will likely only add to the anxiety that is the foundation of the restriction eating disorder spectrum for you.
|Health & Support||Family relationships / attachment issues / ED related||May 30 2011
If I haven't already suggested this to you, Holly Hazlett-Stevens book "Women Who Worry Too Much" is a good quick read that might help.
I suspect you have suffered from an undiagnosed anxiety disorder and that the clinical diagnosis of depression and OCD in your earlier years missed the forest for the trees (not that the trees were not also playing a part).
It's not so much you are a child or even want to be one. You think and act as an intelligent woman of 31. In fact, you are a highly introspective, sensitive and well-adapted 31 year old in almost all respects.
You do however have a "safe person" (which has ended up being your mother). And those with severe anxiety often identify a safe person that, when present, enable them to do things they find too anxiety provoking to attempt alone.
Maybe you could re-frame your living at home not as needing to be looked after and comforted, but as a reflection of the immobilization that occurs with a severe anxiety disorder. Perhaps by re-framing the circumstances you begin to address the root cause rather than get too bogged down in feeling bad about yourself.
If you begin to contemplate a normal existence away from the family home, it's clear you don't dismiss it as too much hassle or just easier to stay put -- instead you likely catastrophize in your mind how it will play out and the various failures you anticipate simply freeze you outright.
Because the REDS span both OCD and anxiety disorders, it is not surprising that you resort to efforts to control all aspects of your life because those efforts are avoidance behaviors built up in reaction to underlying anxiety.
There are rare people who are brain damaged in a way where they cannot register or experience fear. It's a life-threatening condition.
We all experience fear and anxiety because it is necessary for survival. Anxiety triggers avoidance. Makes sense if you hear a rustle in the bushes and move away not wanting to go investigate whether it is a bird or a lion. Anxiety specifically creates physical discomfort sufficient to push us to avoid the stimulus.
Unfortunately what has happened for you is that that the fear system in your brain has gained too much control over all the functions in your brain. You are avoiding a more independent life not so much because the existing life is ideal, comforting, or fulfilling, but because it moves you away from the anxiety stimulus. You are just simply pulling back from moving forward because moving forward triggers massive fear as to what will happen (usually the expectation of failure or catastrophe).
The brain can be retrained and CBT is the best way to do that, that we know of at this point.
Anxiety disorders are at epidemic levels and much more prevalent than clinical depression.
Maybe the high incidence of anxiety disorders is because we live in societies that grossly underestimate our need for inter-dependency and close kinship and communities ties.
Your current circumstances and experiences are common. You are not alone, as you can see on this forum. You are certainly not a freak.
The desire to go back to how you were when things were simple and care free is likely because your own brain can identify there was a time when anxieties did not have such a hold on your interface with the world.
Unfortunately, as anxiety disorders have a genetic component as well as being nurtured through the environmental influences, sometimes parents are unwittingly the kindling for additional anxiety in the child as he or she hits puberty and young adulthood.
And usually this is not that parents ever think or suggest their own child is not capable of handling the world, but rather they speak of their own anxieties and worries associated with all life decisions and that is osmosed by the child.
It is another reason why having a CBT therapist can be useful because you will also have an outside eye on whether you own anxieties that are family-derived as well as ones you've come up with yourself.
These are just observations I have had being surrounded by anxious family myself. They may or may not have much value for you in your circumstance, but I hope some of it might ring true in some way.
Best wishes, H.
|Health & Support||Is it normal to gain two pounds or so when the weather gets drastically warmer??||May 30 2011
2-7 lbs fluctuations within the day, or the week or each month are all normal.
Usually if someone finds such a small shift worrisome, there may be an underlying restriction eating disorder spectrum at work.
You have nothing to worry about, and if you are unable to stop worrying about it despite that assurance, then you might want to investigate cognitive behavioral therapy treatment to address the underlying anxieties around weight gain.
|Health & Support||Acne and weight loss?||May 30 2011
Well you are doing everything as you should. Congratulations on your weight loss!
I am sorry you have experienced both a miscarriage and ectopic pregnancy. I do think it might be a good idea to have a referral to a gynaecologist as there were some hints back when you were 17 but no clinical diagnosis at that point.
It could just be that your reproductive system is particularly sensitive to any change (including modest weight loss and exercise programs) and that everything will resolve in the next few months.
The reproductive system is sensitive in all of us but can be even more so for some.
My best wishes to you on your continued weight loss journey and, when your grieving process completes, I hope you and your husband have a successful future pregnancy and add to your family as you would like.
|Health & Support||Acne and weight loss?||May 28 2011
Well, first of all if you have had challenges with excess weight and acne, then you may want to be screened first for poly-cystic ovarian syndrome (PCOS).
Both ovarian dysfunction and reproductive hormone anomalies in PCOS lead to excess weight, hirsutism (excess hair), and breakouts of acne. It also involves irregular menstrual cycles and lowered fertility levels.
It could be coincidental you have begun losing weight and are now dealing with an outbreak of acne, or not.
If PCOS is not the underlying condition then you may be dealing with reproductive hormone fluctuations that are more a reflection of perhaps too-aggressive calorie restriction.
Fat stores do have and release hormones, but not the androgenic hormone associated with outbreaks of acne.
If you are creating daily calorie deficits of more than 1000 calories then that can be sufficient to suppress your metabolism and will lead to accompanying suppression in your reproductive hormones. And if the reproductive hormones are out of whack, then that could be sufficient to cause an outbreak of acne.
To determine what your energy requirements are use this:
TEE (total energy expenditure) is more accurate than the calculations based on BMR x activity level (which is what this site and most others use). Then from there, if you are clinically overweight right now, then you can eat between 500-800 less than what your TEE recommends. As soon as you get into a health BMI range, then you lower the deficit to 200-400 calories less than what TEE would recommend.
That is the slow and steady way to lose weight and it will help to support your metabolic rate throughout the process. And that greatly improves the chance the weight will stay off permanently as well.
Hopefully these possibilities give you something to work with.
|Health & Support||Bloating||May 28 2011
Given that you have changed the contraceptive implant and that seems to coincide with the problem, then perhaps you and your doctor could start there?
Another outlier possibility (and maybe less of an outlier depending on family history) is that the hormonal changes brought about by the implant were sufficient to trigger celiac disease.
Celiac disease (gluten-sensitive enteropathy) runs in families. If you have family members, and in particular immediate family members, with the disease, then consider being screened.
The genes can lie dormant your whole life, or be triggered by intestinal illness, hormone changes, pregnancies, stress, etc.
But obviously, start with the implant itself as the most likely candidate for the unusual symptoms and see what your doctor might recommend.
Sorry not really offering very much here. Hope others may offer more suggestions.
|Health & Support||Gluten intolerance: how did you recover?||May 24 2011
It can take about 2 years to get good at identifying everything that has gluten.
After about 2 weeks you should have seen a marked improvement in the gastrointestinal (GI) symptoms. If you feel about the same (and you have clearly been diagnosed with gluten sensitive enteropathy aka celiac disease) then you need to revisit whether there is something in your diet you have overlooked.
You can find gluten in ice cream, soy sauce, dried spices (used as filler and to avoid clumping), salad dressings, french fries (as a coating)...you name it. About 95% of all the gluten you can accidentally ingest is wheat. Barley is not used in too much with the exception of course of beer. Rye is of course only found in breads and crackers. Oats are a concern mostly because they are milled along with wheat and suffer cross-contamination. You can get gluten-free oats (Bob's Red Mill is one supplier).
Restaurant visits are challenging and often result in accidental gluten-poisoning if you just go by what you think looks gluten-free on the menu.
Whether you can stand her or not, Elisabeth Hasselback's book the G-Free Diet is well-researched and covers off some good basics on how to navigate the modern world as a celiac disease person. An excellent site for all kinds of information on celiac disease is www.celiac.com.
So, if you are self-diagnosing as being gluten-intolerant, then there's of course a chance that isn't the source of your GI complaints.
About 2/3 of all self-diagnosed celiac disease patients were correct about their diagnosis (in clinical trials where it was investigated how accurate self-diagnosis could be).
As the GI symptoms for gluten sensitive enteropathy (the clinical term for celiac disease or gluten intolerance) can also mimic having an intestinal pathogen (bad bug), if your symptoms are not really improved by being on a 100% gluten-free diet for 2-3 months, then you will want to investigate with your doctor whether there are intestinal pathogens that are actually to blame for your symptoms.
While it can take 2-3 months on a gluten-free diet to see all the physical improvements in the symptoms, you should feel much better after 2-3 weeks on a 100% gluten-free diet and the symptoms should be much less in intensity and duration.
So, first check that your diet really is 100% gluten-free (wheat is everywhere). Second, don't cheat even once as that will set everything off again (not to mention that it causes real serious GI damage and can lead to certain cancers in later life). Then, see if all the GI symptoms start to trend in the right direction. If they do, then continue. If not, see your doctor to confirm what may be the root cause of your GI symptoms (you can be screened for celiac disease as well as tested for intestinal pathogens at that point).
For me, it took a few weeks to feel hugely better. It took 2 years to get good at the diet (I accidentally poisoned myself with gluten on a few occasions just because I wasn't aware of the hidden wheat in certain products), so I fit the norm on that too. And it took 1 final year where I had to actually remove all the gluten hygiene products (particularly shampoo, conditioner and lip balms -- anything that can end up in the mouth) before all my symptoms were really gone.
Also, I am now more sensitive to accidental gluten ingestion. That last time it happened at a restaurant where I was assured the caramelized sugar basket was gluten-free (it was not) -- I was so sick all night. I had a horrendous migraine, vomiting, and horrible abdominal cramps that started about 2 hours after the meal and lasted about 6 hours in total.
My uncle actually collapsed when he was accidentally served a sandwich that was meant to be on gluten-free bread but the order had been switched by accident. He had to be raced to emergency.
It is common for the body to become even more sensitized to gluten once it is removed from the system. It's assumed that this happens because the immune system was overwhelmed and exhausted during the time undiagnosed patient is eating gluten and once it recovers with the removal of gluten, it has a more robust and intense reaction from that point forward (lucky us!).
Hope this helps a bit. H.
The side effects of allergy medications keep some people from using them. Natural remedies can be a great alternative, but some are more effective than others.