Pizza laden with gooey cheese and mountains of pepperoni, olives, and mushrooms.
Chewy chocolate chip cookies the size of my head, the buttery goodness of crumbly goodness literally melting on my salivating tongue.
Chips. Crunchy, salty, oh-so-delicious chips.
I love food. I truly do love food. And yet, when I was at my lowest weight, struggling with anorexia, I did not give myself any leeway to eat any of my childhood favorites: pizza, cookies, and chips were banned from my lips, and even glancing at a slice of pie would keep me awake at night.
I really want to eat that. I really want to eat it. But I can’t. I can’t. I can’t.
Why couldn’t I eat it? No, I wasn’t (and am still not) diabetic. I was not (and am still not) allergic to sugar. Why couldn’t I eat it?
Fear. Fear of having food that was supposedly “bad” and “off limits” pass my lips and then suddenly imagining those carb and fat calories would magically end up on my thighs.
This thought process, these cognitions, are a problem.
Can you imagine, little ole me, brain chemistry going awry because I was about twenty pounds underweight, trying to battle the sinister eating disorder voices in my head? I knew I needed food. I knew I needed to eat. People told me, “Just eat.” But it wasn’t as easy as going to 7-11, buying a spam musubi, and noshing on it. Ignoring the strong DON’T EAT THAT IT’LL MAKE YOU FAT voice and eating what my body physiologically craved was astronomically impossible.
This is where a treatment team is wonderful. A registered dietitian or knowledgeable nutritionist is your best friend. The American Psychiatric Association and the National Institute for Clinical Excellence site that weight restoration for severely underweight individuals with a diagnosis of anorexia is first priority, and that as one begins titrating caloric intake up and weight increases, there will eventually be a need to further increase the amounts said patient consumes. Studies conducted by researchers Kaye and colleagues demonstrate that those recovering from anorexia needed close to 4000 calories a day to gain 1 kg (2.2 pounds) of bodyweight. And this is gaining WHILE DOING NO FORM OF EXERCISE. Throw some jogging into the mix, and the calories needed to gain the same 2.2 pounds increases exponentially to 12,000 calories. Twelve. Thousand.
Those that are struggling with an eating disorder are reading this and probably freaking out. Four thousand calories? A day?! Well, that is where working with a professional in the field comes in handy because EVERYONE IS DIFFERENT. That doesn’t mean you are the exception to the rule and can gain weight on only 1200 calories. No, that means you may need more than 4000. You may need 3500. It really depends on your day to day activities, age, height, and all that good stuff.
I am not extremely old by any means (only thirty-seven years young), but my basic calorie needs will be different than that of an adolescent girl who is just starting the maturation process, and both of our energy requirements will differ from that of an eighty-year-old or a female who just gave birth. Similarly, my current profession requires that I walk around, stand a lot, talk throughout the day, write and read and think. That is a lot of calorie expenditure. Going to school is also calorie burning, and so is staying home with a toddler. There are a variety of circumstances that necessitate an increase of daily calories needed, and that is where working with a registered dietitian or nutritionist can come in handy.
If you are anything like me, you may be curious as to the science behind what happens with all these calories that a person recovering from an eating disorder eats. Similarly, if you know someone or are yourself struggling with an eating disorder but are not technically underweight, you may be wondering if it’s really that necessary to have to eat all those calories. Well, ask you shall receive! In my next post, I’ll discuss some of the science behind the food one eats in eating disorder recovery.
***Note/Disclaimer: I am not a registered dietitian or nutritionist. My information is found from reading and studying medical articles and journals and from anecdotal experience.