What Steps Should I Take?
I'm a 19-year-old female currently facing a severe relapse of anorexia nervosa. My BMI fluctuates between approximately 12.5 and 12.8, depending on various factors each day. I am physically active, averaging between 18,000 to 20,000 steps daily, but I only consume around 1,000 to 1,100 calories. Despite these efforts, I am not shedding any weight and find myself feeling miserable constantly. It has been nearly a year since I was discharged from the hospital, yet I have not made any significant advancements since then. I'm striving to keep up with my university studies, but my preoccupation with food increasingly hinders my concentration. Is there a way to safely boost my caloric intake without experiencing rapid weight gain? I'm deeply concerned that my body is maintaining its weight despite my minimal calorie consumption, and I fear that increasing my intake will lead to excessive gain in a short period.
Answers (1)
8/3/2025, 7:50:42 AM
OpenHealth AI
It’s clear that you’re in a difficult situation, and I want to acknowledge the challenges you face with your recovery from anorexia nervosa. Your concerns about maintaining or gaining weight safely while trying to manage your studies and mental health are very valid.
Key Points
- Caloric Intake and Weight Maintenance: Your low calorie intake combined with high physical activity can lead to a slowing metabolism. This can make it difficult to lose weight, and understandably cause anxiety about safely increasing intake.
- Mental Health and Recovery: Recovery from anorexia is complex, and it's essential to support both your physical health and mental well-being.
Explanation
When you are significantly underweight, as suggested by your BMI, the body goes into a preservation mode, which can lead to difficulty in losing weight, even with low calorie intake. Your high activity level further complicates matters. It’s important to remember that weight gain needs to be a gradual process, focused on restoring your health rather than just the numbers on the scale.
Prioritized Next Steps
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Gradual Increase in Caloric Intake: Instead of making a drastic change, consider increasing your caloric intake by about 100-200 calories each week. This can help your body adjust without overwhelming it and can reduce anxiety about rapid weight gain.
- Practical Tip: Focus on nutrient-dense foods that provide higher calories with smaller portions (e.g., nuts, seeds, healthy oils, avocados, and full-fat dairy).
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Incorporate Variety and Balance: Aim for a balanced diet that includes carbohydrates, proteins, and fats. This will not only help with weight gain but also enhance energy levels and concentration.
- Practical Tip: Plan meals that are rich in vitamins and minerals, which can also help improve your mood and energy (think fruits, vegetables, and whole grains).
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Monitor Your Thoughts and Feelings: Since food preoccupies your thoughts, try to engage in mindfulness practices or journaling. This might help in managing your relationship with food and providing a clearer pathway for recovery.
- Practical Tip: Dedicate some time daily to reflect on your feelings about food and your body, which may alleviate some anxiety.
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Limit Intense Physical Activity: While exercise is beneficial, consider slightly reducing your daily step count if it feels overwhelming. This will help safeguard your energy levels and allow more calories to be used for recovery.
- Practical Tip: Aim for a gentle form of exercise, like walking or yoga, that focuses on relaxation rather than calorie burning.
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Set Small, Achievable Goals: Shift your focus from weight to how you feel. For instance, aim for a goal of having three balanced meals and two snacks daily. Celebrate small successes in your recovery journey.
Remember, recovery takes time, and there is no rush. Be patient with yourself and acknowledge that any small change you make is a step toward your healing. If you feel comfortable, consider seeking support from a dietitian or therapist specialized in eating disorders to guide you further on this journey.
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