Recovery brings with it week-to-week modified meal plans, anxiety to accompany it, a surplus of calories that feels unreasonable, weight distribution that seems to target our stomach in the initial stages, the consumption of more food than what our middle-aged dad eats, and confusion as to WHY THIS IS ALL HAPPENING.
Let me just point my blaming finger to a little (or very important) thing called METABOLISM. In my own words… consistent food restriction over an extended period of time will screw up our metabolism in one of two ways: the hyperspeed metabolism, or sluggish metabolism that doesn’t seem to function how we want it to.
To be honest, it’s hard to predict which way our individual metabolism will go. What I can say is that our metabolism will return back to its “normal” rate (pre-anorexia state) over time… a long time. Easier said than done, but please be patient. Now I will get off of my soapbox and refer to biology, which will make far more sense.
So let me go ahead and break down these two metabolic rates for you:
You have an overactive metabolism
Doesn’t everyone want a fast metabolism? With anorexia recovery, having a fast metabolism can actually feel more tiring and unwanted than appealing. If your experience is anything like mine throughout recovery, then you also ate an amount of calories per day that seemed impossible for your tiny frame. And then the next week the meal plan caloric intake STILL had to be increased.
This is often referred to as “hypermetabolism” during these initial stages in recovery and treatment, and is actually a completely normal (and expected) part of recovery. We all know those people who accidentally forget lunch while at work because they’re too busy, or the people that skip out on lunch after a big breakfast. This feels literally impossible for someone with hypermetabolism during recovery and even post-recovery.
I know it’s frustrating when your dietitian increases your meal plan every single week, and I know eating 3,000-4,000 calories (or more) a day is so uncomfortable; try to remind yourself that this is temporary. Our bodies in these initial recovery stages have been through a lot of damage and there is a lot of repair that is needed (electrolyte balance, hormone functioning, body tissues, mending bones, hair, and nails).
Take this study, for example: researchers looked at the caloric needs of those in anorexia treatment 2-6 weeks after restoring back their healthy weight, and then again at the 6-month mark. The results? The individuals evaluated still needed more than “normal” caloric intake just in order to maintain a stable weight. Even after 6 months, caloric intake was still not back to pre-anorexia state.
When we approach a healthier weight range and we consistently fuel our body, then the hypermetabolic mode begins to decrease. That being said, the higher-than-normal metabolism seems to continue for many individuals, even after recovery. Three years later and I still can consume more than both of my parents combined, and still have room to eat dessert after. This is where I have to constantly remind myself (especially during times of discomfort) that food is a necessity, and I need it to properly nourish my body.
You have a sluggish metabolism
On the opposite end of the spectrum, some individuals experiencing anorexia feel that their metabolism becomes sluggish, or significantly slower. Severe dieting once again gets the blame here (sensing a theme?)
Studies have shown the effect that food restriction and over-exercising has on metabolism. In one such study, it was found that if a 200 pound woman was restricted to just 800 calories a day, her metabolism is highly likely to decrease by 15% after just 3 weeks. Metabolism is further declined when exercising excessively is added to the equation. In general, metabolic rate decreases an average of 0.9% a date when dieting.
This can be discouraging for many reasons, but particularly because it feels like your metabolism is not kicking into high gear when you finally start to restore your weight and eat sufficiently. The best possible thing you can do in this case is to keep consistent with your meal plan, and continue to nourish your body in the way it needs.
In my own words: your body was deprived for such an extended period. Because of this severe food restriction, our bodies literally want to hold onto any calorie and any nutrient we provide it with during weight restoration. It fears that it will once again be put through food deprivation, and therefore is kicked into survival mode rather than high metabolic mode. This is your body’s natural response to keeping you alive and healthy.
Whether your metabolic state becomes extremely fast or sluggish, there are a few reasons WHY your metabolism changes so drastically during and after recovery.
- Healing doesn’t happen overnight. Think about it this way: the damage we have done to our bones, muscles, and organs didn’t happen overnight; and neither will the healing process. While our external appearance is obviously immediately noticeable, our internal functioning is severely damaged. Recovery demands that we give our bodies the fuel it needs.
- Digestion is crucial! Disordered eating and malnutrition over time leads to an unbalanced digestion process. Hypochlorhydria, also known as low stomach acid, can significantly affect digestion considering stomach acid is necessary for digestion. And if digestion is a bit off, then metabolism is sure to be off as well.
- Stress sucks. Living with a background of stress severely taxes your adrenal glands, which are the glands that happen to regulate your stress levels. When going through recovery with added stress (combined with excessive food restriction and/or over-exercise), you begin to run off of cortisol (the fight or flight hormone). This allows you to pretty much just “get by” off of the little food you are giving it and the over-excising you may be putting it through. In short, too much stress on your body reduces your metabolic rate.
- Balance sometimes seems to be forgotten in treatment. Anyone else feel like you’re encouraged to basically “eat anything” during anorexia recovery just to make sure that you hit your daily intake needs. Yes, this is SO important to do. However, this seems to ignore the need to eat balanced, which means proteins, healthy fats, veggies, fruits, and carbs. I don’t know about you, but I felt more encouraged to eat McDonald’s ice cream cones or Wendy’s frosty’s than eating my veggies. While there’s nothing wrong with eating ice cream, the thumbs-down reputation that salads seem to get in recovery isn’t really justified. It’s important to challenge yourself to fear foods, and eat the foods we used to formally be comfortable with; however, it’s still crucial to remember that balance is a part of a healthy lifestyle.
- Maybe you’re weight restored, but still nutrient deficient. Sluggish metabolism may be a direct results of low vitamin D levels and fatty acids. Low levels of zinc are also at play here when you feel like your metabolism has not fully returned back to normal. In this case, lab work can best help provide an accurate picture of what nutrients your body is lacking.
I’ll end this post by giving you one piece of advice: stay consistent with your meal plan. It’ll be hard, anxiety-provoking at times, and definitely uncomfortable. However, consistency combined with balance is your best bet when it comes to restoring the love-hate relationship we have with our metabolism.