Sunday, September 25, 2011

New Dietician

I had my first appointment with the dietician in R's office this week. The verdict: I like her, I think. She, J, is younger than my old dietician and has a much different personality, but is friendly and nonjudgmental and nice and didn't make me feel too awkward. So that's all good.

J spent the first half of the appointment asking questions about my history, current intake, habits, etc. Then she gave me a mini Nutrition 101 lesson, which was semi-interesting but not really necessary. I'm pretty much a nutrition expert - in theory if not practice. She looked over my food records from last week and said - I quote - "Oh good, I can work with this." Her official opinion is that I'm good about eating regularly and not skipping meals or snacks, but that my portions are just too small and my choices are too limited. Which I sort of already knew, but it's helpful to hear it from a professional.

So that was the good part. The bad: she wants to reset my ultimate goal weight to a significantly higher number. Like, SIGNIFICANTLY higher. I think she could tell how freaked out I got because she immediately added that this was a "longterm goal." Which confused me even more - longterm meaning in six months? A year? Five years? Ten? What if I get pregnant? It just seemed like the number J came up with was super high - definitely higher than anything I've ever weighed before. If I gained XX pounds over the next few months to get back to my original goal, why should I have to gain ANOTHER X pounds just to get into the new range?

It all seemed kind of moot at the time anyway, since I was feeling somewhat ambivalent about gaining any weight, much less the XX pounds J wants "longterm."

Anyway, we spent some time going over my food records and beefing up my meal plan. I was reluctant about it for obvious reasons, so J launched into an explanation of BMR and how I'd need a certain number of calories just to stay alive - a concept that I know is true, but that my brain still can't quite grasp. Metabolism scares me because I don't know enough of the science behind it, plus I don't think anyone's metabolism behaves exactly according to a scientific formula. So I don't understand how it works and that freaks me out.

Anyway, my go-to method of increasing calories is usually just adding protein bars. I asked J if she minded me eating multiple bars a day, despite my new commitment to variety. She said something interesting:

"When a patient is underweight, I tell her she can eat McDonald's every day to gain the weight back. The health risks associated with eating fast food all the time are less dangerous than the risks associated with staying underweight."

So...a fast food binge wasn't exactly the recommendation I was expecting from a dietician. Not sure I totally believe her, but she made her point. When you're underweight, it doesn't matter how careful you are to get in your fruits and veggies and whole grains - anything less than a weight-gain diet is not healthy for you.


  1. Yes, my dietician said something like that too: "A calorie is a calorie is a calorie" when you're underweight. Doesn't matter if it comes from ice cream sundaes or all-fruit smoothies. What matters is that you get your calories in so you can ensure optimal health. It's a lot easier for your body to get those calories from things that are more calorie dense (like McDonalds or ice cream sundaes) vs eating low-calorie-density foods all the time but either way it doesn't matter--you just have to get them in. I know you can do this, Kaylee!

  2. The BMR thing always did (and still does) give me trouble too. I think it's easy to challenge it by thinking back to times when you used to regularly consume less than that, and "got by just fine." Or at least that's how I think that time. But the truth is, it's not getting by just fine, it's DYING, albeit so slowly that it's easy to deny it's happening until things are very bad.

    At one point in my recovery I kept a stock of pints of Ben & Jerry's because I needed the calories but my stomach just wasn't up to taking the volumes that I needed of "regular food". I was SO glad that my therapist told me that was fine instead of making me chug Ensures! Any nutrition is better than none when your body is in breakdown mode. And I think our bodies stay in "recovery mode" for longer than we realize. Even once weight is closer to normal range, there is still a lot of repair work going on internally.

    Really glad you like J. Maybe you can talk to your regular therapist about the weight goal she threw at you? Do they communicate at all?

    It's great that even though it's challenging, you're listening to recommendations and agreeing to add in the protein bars or whatever you choose to get the fuel your body and brain need. Really hope your week starts off well. <3