Anorexic with negative recovery effects and refeeding

I am a 36 year old femalte that suffers from Anorexia (NOS).  I have body image issues and swing between food restriction, exercise bulimia, and laxative abuse.  My lowest weight was 136 pounds in January.  I've had hypothalmic amennorhea (amenorrhea) ( due to weight loss from July 07 through January 08.  In addition I have suffered many medical problems over the past 6 months from constipation to heart valve disease, etc.  I was restricted to 0-600 calories per day AFTER daily exerecising (1200 per day before activities).  During christmas, my family came to visit and in attempt to be "normal" I participated in eating like everyone else. As much as this was anxiety producing, I did it anyway.  In doing this I increased my caloric intake, thus providing my body with nutrients and much needed food that induced my period in January.  Shortly there after I gained a massive amount of weight in a short period of time (36 pounds in a week) and it has been cycling on over the past 6 months.  I have tried many different things as not to go into eating disorder mode.  I've tried dieting and supplements and exercising more and alli....you name it!  just to gain more weight. I have gone from 136 to 200 pounds in 6 months.  This triggers my ED no matter what I do, eat or not eat, I still gain regardless.

I saw an internist at Cleveland Clinic and I lucked out.  She specializes in Sports Medicine and worked with althetic anorexics and exercise bulimics.  She told me my weight gain is due to my ED.  That my metabolism is so messed up from what I have done to it that it needs to reset itself.  She explained that I need to stay on a steady diet of 1500 calored minimum after exercise (2000-2200 before exercise) consistently for about a month straight in order to just reset my body.  I also told her about not ever being hungry and the feeling of fullness and she also mentioned refeeding my body.  She told me that I have lots of "tissue edema"  or tissue fluid and that is a lot of my weight.  She explained that all the testing I have done over the past month or two would not revealed the screwed up metabolism my body is in.  She gave me lots of help and information to get going and she said my body will go back to a healthy norm but will take time and effort on my part.

Is anyone familiary with refeeding of anorexics?  Is anyone familiar with issues with metabolism or metabolism reseting?  What exactly is tissue edema or tissue fluid?  and has anyone experienced this cyclic weight gain being anorexic and did the doctor blow smoke my way to get rid of me.  This experience has been bery traumatizing to me and I don't like who I am and I am trying to notgo into ED mode and seeing my psych once a week to keep me in check.  Any suggestions/information would be greatly appreciated.

[margypops]

I dont know too mush about the refeeding process but I wanted to say Well done" for getting this far ,its a tough road but you sound determined and the fact you are asking for ideas is a sign you are on the right track, Go and click on the Doc site and also put it into the internet and get some ideas about feeding from there. Best of Luck

[lilpea]

I have struggled with anorexia for a long time and am currently in recovery. Your internist isn't trying to blow you off by giving you the answers she did. And don't feel alone - very few people recovering from eating disorders take pleasure from the process. While TV and articles can make it sound like an idyllic and nurturing process, it often feels like jumping off a cliff. Doing the right things feels incredibly wrong because of how you've conditioned yourself to think. It is an emotional fight every step of the way. Just remember that your feelings cannot be trusted to dictate your behaviors at this point. While you should find ways to express what you feel, your recovery plan must be followed no matter what.

As for the physical symptoms and struggles you mention, those, too, are perfectly normal. Your body is in a state of flux and will take time to settle into a normal pattern. Eating more can cause numerous physical symptoms that one must simply learn to cope with; there is no avoiding them.

Edema, or water retention, is a very common symptom of refeeding. Experiencing edema means that much of the weight you gained is water weight. You may notice, too, that your abdomen is bigger in proportion to the rest of your body; this is another indication that it is water weight, which will go away after a while. This can also lead to a widely fluctuating weight. Even though you may not notice it, some days you will be retaining more water than others, leading to a higher scale reading. Don't let the symptoms of refeeding scare you back into your old ways. You have to give it time. Recovery has to begin somewhere, and this process will have to be dealt with at some point, so it might as well be now.

Anorexics often experience false fullness as you are having. Your digestive system has slowed down and food sits in your stomach longer, making you feel full longer. It can also be caused by bloating or constipation. It will simply take time and proper nutrition for these to go away. However, how your brain processes the signals it gets from the stomach will also take time to return to normal. This means that your hunger/fullness signals have been effectively shut off, and only regular eating over time (and relearning to conciously recognize true hunger and fullness) can restore those to normal.

During proper weight restoration many people experience the opposite symptom: constant hunger despite eating. This, too, is related to brain-stomach signals. The constant hunger, which can even be stronger after eating than before, is something that begins to dissipate after about 3 months of regular eating. However, it can take up to a year in some to completely stop.

The hardest part about recovery is that it takes time. There is no way to push your body into recovering and restoring normal functioning faster. Some people's bodies take longer to return to a normal state than others'. With a stable nutrition plan and calorie level, healthy and appropriate amounts of activity (which may be no formal exercise at all for some), and a team of professionals (counselor/therapist, doctor/internist, dietician, etc.) you will recover. Your body won't begin the process until you stop taking "supplements" such as laxatives, diuretics, and weight loss drugs. Most doctors recommend simply a multi-vitamin/mineral and calcium with vitamin D supplements, nothing else. Even herbal and all natural supplements are not a good idea at this point.

Recovery takes tremendous patience and coping with fear. Not only do you have to deal with the psychological and emotional issues, but you have to struggle through the physical changes and recovery process, too. It also takes time. Just like you can't speed up a pregnancy or healing from a broken bone, you can't speed up how quickly your body recovers. All you can do is do the right things every day to help it on its way.

Remember, too, that recovery is something that you do while you are living life - it shouldn't be your life as the eating disorder likely was. Whatever your weight is, whatever stage you are at in the recovery process, begin creating a life for yourself outside of your eating disorder!

[chopperchickie]

Thank you very much for your post.  Your correct, this is a harsh and nasty disorder.  I have probably been suffering from this disorder for many years as well.  I did go to therapy but with this rapid weight gain from incorrectly refeeding has most certainly triggered some ED tendencies.  Since I have been back from Cleveland Clinic, I have manage to loss 6 pounds thus far.  I am starting to feel better and feel successful as I am able to diet and workout without the help of ED.  I would really like to skm off 50 pounds and be happy at that weight.  My therapist reminds me every week of my committment to that number.  

[twiggylou]

Yes, I too admire you for this posting. I am a 55 year old woman who since I was 15 have struggled with anorexia. After two heart attacks and other life threating things, I have been "eating" again these last two years.  My weight goes up and down due to water, my abdomen is swollen and it still freaks me out.  I am a size 10/12 now, from 70 pounds etc. and it is hard. Very hard. But I want to live now, I have a new life and a wonderful loving family who wants me around. So, even though it is uncomfortable, I am alive. Hang in there, life is joyous no matter what size we are, we need to be healthy.