I know that sometimes when you are severely energy depleted the materials that I have created are overwhelming. As a result I get a steady stream of questions via e-mail that are answered within those materials posts but may be hard to identify and comprehend for many.
Jason Eppink: Flickr.com
Here are a few I have received recently and hopefully this helps others with some of the basics.
I encourage you to engage your loved-ones in the recovery process. If you find posts on this site overwhelming, then your loved ones can read them on your behalf and give you the point form highlights to help you keep moving forward.
Still Wanting Ultra-Processed Foods
I am currently about 7 weeks into recovery and am still craving snack foods only! I have been eating around 20 granola bars (each one containing about 160-200 cals) and 2 big boxes of cookies everyday on top of my 3 main meals. I'm just wondering if it is normal to still be eating so much snacks since i hear that people on the forums start craving "real" food a lot sooner? and I still feel bloated all the time with a huge belly which is so uncomfortable, may i know when this will get better?
You will hear lots of things about others in recovery that will generate anxiety that you are somehow not trending as you should.
Quoting myself from Phases of Recovery from an Eating Disorder:
“Do not read the Phases of Recovery as though you are reading a recipe or following scientific steps that will realize unequivocal and successful results. Think of it as “individual mileage may vary”.
Do not panic if you find some symptoms are not present, or seem to appear, disappear and re-appear. Your entire recovery process may take you into full remission in as little as 3 months or as long as 24 months or even 48 months. Three months is very, very rare and 18 months is the median time to remission, so be prepared to be patient.”
I sympathize with the impatience that everyone experiences through the recovery process, but try to remain realistic about how long the body really needs to repair all the damage.
When you are unsure about where you are in your process of recovery, then always re-read: Phases of Recovery from an Eating Disorder.
Food Fears I: Food, Family and Fear and I Need How Many Calories?!! can help you reinforce the fact that you need a lot of energy to re-balance the huge energy deficit you have in your body. A preference for ultra-processed foods is explained in the former blog post and the latter blog post provides the clinical data for why the minimum intakes are set as they are.
Amenorrhea and Oligomenorrhea (absent or irregular periods)
I have a question regarding my irregular period. It stopped in September, and I haven't gotten it since then. I'm really worried about what that entails. Perhaps this is a stupid question, but does that mean I'm infertile? Do I really have to eat 3000 calories a day to start menstruating again? I've also heard that once you stop menstruating, you can bleed for two months when you start again. I don't know what i've done to myself and it scares me. I just want to be healthy again, but I don't know how. If you have time, could you please respond to some of these questions? I would truly appreciate it.
Not a stupid question at all. 3000 calories is a bare minimum for those women under age 25 and under 5’8” in height who has never had an eating disorder. You will eat more than 3000 through some portions of the recovery process and that is to be encouraged and normal.
You have created such an energy deficit in your body that, at the moment, it has decided that you cannot survive a pregnancy (nor likely could the developing baby) and so it has shut down the process of a regular menstrual cycle to try to keep you alive by redirecting energy that would go to that cycle for immediate issues like keeping your heart beating.
Your period, and your fertility, will return when you re-balance the energy your body needs. And to do that you have to stop exercising, rest and eat a lot. Nothing about the damage caused by an eating disorder is irreversible thankfully.
It is a serious thing when you stop menstruating and you should talk to your parents/loved ones and to your doctor so you can be monitored as you begin to re-feed and re-balance the energy in your body. Don’t attempt to do this alone as there may be other physical issues beyond amenorrhea (lack of a regular period) that need to be monitored carefully as you restore your weight and health.
Is This Me?
I say all this assuming that I have an eating disorder. Thus far in recovery I've been eating between 2500-3000 calories a day with some days being more like 5000. Yet this hasn't been very difficult for me so I'm wondering if what i'm experiencing is merely gluttony rather than an actual ED recovery situation [emphasis mine]. I also only seem to get extra calories through 'junk' food which I'm not really craving I just know I CAN eat it due to how small I am.
…details omitted…
My mum was worried and we fought about it a lot but I was sure I was being healthy and didn't have anorexia or anything similar. I knew I wasn't and had never been fat so I assumed I was fine. I started university earlier this year and was catered for, but my fear of gaining the 'Freshman 15' led me to under eat. When I finally managed to weigh myself again I was only [severely underweight]. Throughout this time I've been 5'6' and 17-18 years old.
Does this put me in the RED spectrum? Should I really be eating 3000 calories a day?[emphasis mine] I also have lost my period but I've no idea when I lost it due to being on the contraceptive pill for some time.
One of my all-time top questions is “Am I just a gluttonous pig?”
The answer is “No.”
Next in line is “Do the guidelines apply to me?”
The answer is “Yes and No." They actually apply to all people who have never had an eating disorder, so in that sense they are ubiquitous. However, when you have an eating disorder history, then in fact you will need more than those minimum intake guidelines to reverse damage and return to an energy-balanaced state.
3000 calories is an average intake for a non-ED woman under the age of 25 and under 5’8”. Read that one again. That is what an energy-balanced young female eats.
If you are energy deficient, which you will be when you restrict your intake below 3000 and/or up your energy outputs with formal activity and exercise, then 3000 calories is an absolute bare minimum intake during a recovery process where you are attempting to restore your energy balance. Restoring energy balance includes both weight restoration and physical repair.
If any family or friends have ever expressed concern regarding your restrictive behaviors, take it very seriously indeed.
Re-read specifically the Telltale Dozen in Phases of Recovery from an Eating Disorder.
When Can I Exercise Again?
I Know i emailed you a few days ago about not getting my period back yet but I just got it today! Thank you so much for your site, I am so happy! But I would just like to know now if I can resume exercise? I that generally it is recommended to wait until I have 3 consecutive periods but my I am at my pre-ED weight already and it has been quite stable despite eating 3000-4000+cals. I have been recovering for 7+ weeks and have been hungry since the beginning. Nowadays I still eat whenever I am hungry and it naturally takes me to 3000+. does this mean I can stop counting calories now? Can I resume exercise if I am confident that I will not have anorexia athletica because even during my anorexia I was always lazy to exercise, but the past few days I have been feeling like increasing my physical activity (other than walking).
Unless you are over the age of 25 and you also experienced your bout of restriction after the age of 25, then your pre-ED weight is irrelevant.
The resumption of a regular period in no way tells us that you are weight restored or energy balanced just yet. It’s a great sign that things are moving in the right direction.
You are liable to simply shift your eating disorder from anorexia to anorexia athletica. Just because you were not applying exercise to modulate the anxiety around food intake up to now does not mean you are immune from doing so in future. Please re-read Phases of Recovery from an Eating Disorder and specifically search for the sub-headings: No Exercise, Honeymoon, Menstruation and Knowing When You Can Trust Your Hunger Cues.