Tuesday, June 19, 2012

Rogue Metabolism

Well, even with the most recovery-oriented intentions in the world, I can't seem to eat enough to put on weight. I saw J, my dietician today, and my weight is down again. I'd like to think J trusts me, but I guess I can't blame her for being skeptical when I promised that I had been following the meal plan and drinking Boost all week. Seriously guys, I did. I don't know why my body has decided to play this sick game with me. Really, the irony is not lost on me. After months of resisting the meal plan and turning up my nose at Boosts, I finally start trying to gain and I can't. Granted, I'm not eating an insanely high number of calories, but enough compared to my previous baseline that I should be gaining, not losing.

So once I persuaded J that I really had been compliant and wasn't lying to her, we had a long talk about funky refeeding metabolism antics. Interestingly, she told me that she often sees overweight patients who are restricting their intakes and can't lose weight - that they actually need to eat more to lose weight, just because their metabolisms have slowed down so drastically. I try to avoid overthinking my metabolism, but I suppose I should be happy that my body is actually waking up and responding to food.  Still, the concept that eating more = weight loss just doesn't seem logical to me any way you slice it.

I was having a lot of mixed feelings about the whole thing. I mean, who wouldn't be thrilled to eat more and lose weight? It sounds like one of those ridiculous diet plan infomercials. And normally, I would be thrilled, except that I signed a contract three weeks ago agreeing to enter treatment if my weight ever dropped below a certain number - which, according to J, I am just barely above. She promised me that if I fall below that number while faithfully following her meal plan, then that's her fault, not mine, and that we would adjust the contract accordingly. Still, I hate that I am genuinely trying really hard in treatment for the first time in, like, ever - and still can't swing it!

To my mind, I'm making huge changes. I've switched to full fat yogurt. I drink X Boost Pluses a day. I cook with butter and oil. In the past week alone, I've eaten pizza and cupcakes and quesadillas. So no, the weight loss doesn't make sense, and it feels like I'm getting cheated. Every time I chug a Boost or scoop out my double-the-fat-and-calories Chobani, I feel gross and guilty but tell myself that it will be worth it. That it will make me better. That it will put an end to the pain and fatigue, to the constant eye infections, to the clumps of hair that come out in the shower every morning. But when I get on the scale, the number tells me I'm getting sicker, not better, and that the anxiety and disgust weren't worth anything.


  1. First off, congrats for sticking with the Boost and your mealplan, and also being adventurous with your food! I'm sure it's frustrating to be losing weight, though, despite all of your hard work. It seems like EDs really mess with metabolism, so those nice little cals in-cals out equations never seem to work. Maybe once your body re-adjusts to the intake, it will realize that you're feeding it more and start gaining. I'm not sure I can offer more advice, because I'm totally at a weight-plateau despite increases in my mealplan. But I wanted to say that I think it's awesome that you're pushing through the nasty feelings about the Boost and non-low-fat foods, and just doing it anyway for your health. That really speaks to your committment and drive to get better. Your body will hopefully catch up soon, and it will be so worth it. Hang in there!

  2. Try to focus if you can on what you're gaining besides weight-- your body is already getting healthier. It's healthy enough to start doing all the maintenance work it turned off when you were underfed. It's healthy enough to start remodeling bone mass, something that requires quite a lot of energy. As your body kicks back into functioning, it'll burn off too much trying to repair all the damage. But even though the numbers don't reflect your hard work, know that your body is already going in the right direction. That always made me feel a bit better.

    [And also, for me at least, it was easier to focus on the life gains vs. weight gain anyhow, even when the weight started going in the right direction. I'm pretty unambivalent about wanting to think more clearly, have more energy, etc... I'm pretty well, sometimes ambivalent, about wanting to actually get to a healthy weight. So focusing on food in=life gained has been good for me.]