I am a little over 2 months into my first time doing keto, and I find it hard to know when to eat. I suffered/am recovering from the ED (eating disorder) anorexia, so my hunger signals are out of whack, and have been for years. I’m 34 and have suffered from my ED on and off since I was 15. I genuinely do not feel hunger in the same way that most people do. So it is a problem for me to know when and how much to eat. I can go strictly by my macros, but I’m sure at times that I may be eating when I don’t need to. Currently I am 126 lbs, 5’7. I am looking to gain muscle, and I run 3-5 miles 6 days a week. I have my calorie intake goal set to 2200. I urine test my ketones twice a day, morning and evening, and they always run moderate to high. I feel that I am doing everything correctly, I just worry that I may be eating when I don’t need to, or even perhaps not eating when I should.
I was wondering if anyone else has suffered from this same problem, or has any advice on how to know when to eat if you no longer receive signals from your body in the same way that you should due to long term restrictions.
Eating Disorder to Keto
Our standard American diet suppresses the hormones that help us “feel” satiated. On the most recent 2KetoDudes podcast, they interview Dr. Annette Boswell. On her blog, check out: https://bozmd.com/rules-of-the-keto-diet/
Here is an excerpt from that page relevant to your lack of satiety cues:
Step 7: Eat Enough Fat to Feel Full
It is what sets this diet apart-there is no starvation! There is no want for food. I’m not exaggerating. With this approach, there’s enough fat feeding your body that you don’t feel hunger. Your brain receives a powerful chemical message of fullness from your system. This process begins when you eat fat after cutting out sugar or carbs.
Don’t believe me? You have my permission to begin your day tomorrow by eating a stick of butter. Yep. You read that correctly. After not eating anything for several hours (because you were asleep) you can have a stick of butter for breakfast. Add salt for added taste if you like. Pair it with water or black coffee. Still, the only ‘food’ you should eat is butter. Don’t imagine this story. Do it. Listen carefully to what your body is saying. Notice the sensation your brain sends to your body? Your brain detects the signal that you are full when fat fills your stomach.
No wonder, so many of my patients boast about how sustainable and satisfying the ketogenic diet is.
The LCHF diet will return your body’s ability to experience true hunger and satiety, again. It’s not overnight, but it does come, and reliably so.
There is so little value in tracking calories. Your body knows what to do when you stop with the carbs, even with deficient signally. An external app, developed by people whom never met you do not know more about yourself than you do. 
Satiety was a struggle for me as well. At 55, and having ravaged my body’s natural ability to “do its thing” now, nearly 2 years later, I love that I know what true hunger is.
I would slow down on the running (2 miles every other day at most) because the body becomes very efficient at what you do a lot of. Running a lot signals your body to keep the weight low so you are not carrying around a lot of extra expensive (in terms of running) muscle.
Move the extra time you have to strength training to get toned larger muscles.
You mentioned 2 times that you were worried about eating when you don’t need to. This may be left over ED - you don’t need to worry about over eating (which will probably help muscle growth) until you reach something like 135 or 140 pounds - whatever your new goal weight is (i.e. I wouldn’t worry about daily calorie intake estimations - just make sure the scale is going up slowly and it is mostly muscle).
You are most likely correct about this. I’m continuing to break many bad habits that linger from my ED. I will say that this diet (and I hate to call it that because I consider it a lifestyle) has helped tremendously. It has made me see food as a beneficial thing, rather than an enemy - which is what it was for so long. I realize now that so many things were wrong with me due to my diet. Mental disorders such as depression, other health problems (I have epilepsy), and a general feeling of negativity have subsided and I feel better. Not to mention I am able to have the energy to actually go about my daily life without feeling exhausted. ED don’t just affect your weight/appearance. They destroy you from the inside out. But that goes for any bad diet. Which is why I’d recommend keto to anyone. Proper nutrition is a game changer.
I second the idea to curb the running and work on weight training. There is a reason why runners dont look muscled. The body wants to be nice and leaned out for running. I would consider weight training and possibly increasing your calories even more if your going to continue to run.
I often go over my goal of 2200 calories. I should say that I work with a dietitian who knows my workout routine and set that goal. Due to my epilepsy my epilepologist refered me to her, and suggested keto in the first place. An example of my going over my goal is yesterday I had 2536 calories according to my tracking app, and ran 6 miles. I added extra because I was running a 10k. I try to make sure I eat extra when I know I’m going to do a long run, even if I’m not necessarily hungry.
As far as the lean muscle look goes, that’s the look I’m going for. I just want to make sure I’m healthy, and that my body is capable of doing what I’m doing. I should say that I’ve been running for quite awhile. On and off since 2011, but training for a half marathon for about 3 months. Mostly I’m worried about not knowing enough about this diet and the effects it has on lean muscle. I know a lot of runners don’t suggest it due to the idea that carbs are a runner’s best friend. I don’t believe that. I feel like I have more stamina now running off of fat for energy than I did previously.
My recovery from my ED has been going on for awhile, and initially I was eating carb based foods - rice, pasta, with lean meat - to have energy for my runs. Then after my dr suggested keto about 10 weeks ago I switched. I certainly have more energy.
I also swim when I can to mix things up, but it has recently cooled down (we live in SoCal) so I haven’t been doing that anymore.
Sorry for the long reply, just trying to give as much info as possible.
There is some great resources out there…
I have heard of Marathon Runners who have been on Keto and doing marathons so its do-able… how much tougher it is?? I dont know.
If you have a Nutritionist your working with then definitly continue working with them on it.
From what ive read, though slightly altered in macro ratios… Keto is stellar for Epilespy! There is lots of info out there regarding Keto and Epilepsy
If you want to build muscle the scale will go up a bit. Muscle is heavy and dense and has quite a bit of weight to it.
Women don’t look bulky when building muscle so you could keep your lean look while still building lean mass. The suggestion of weight training is a great one. You’ll build the most muscle if you lift fasted. In other words when you get to the point in your ketogenic diet where you’re not hungry for breakfast, go and do a weight lifting routine before you eat your first meal of the day so you’re lifting 12 to 16 hours fasted. The period of time after the lifting when HGH is released will build the most muscle.
If you are able, get a dexa scan. The most healthy percentage of body fat for a woman is 28%. Shoot for that and build lean mass from there.
I’m having my percentage tested on my next visit to my dietician (as she didn’t want to do it immediately due to my ED and possible triggers it may cause if I obsess over numbers and percentages). So I will keep that in mind and work from there once I find out where I am then. I don’t see her again for another month and a half though. So I just have to wait it out.
But I’ll be doing some sort of scan test (???). I know I’m sounding vague, but I honestly can’t remember what she said the name of it was, just that it scanned you, and was the best thing in accuracy next to one that they do in water. You will have to excuse my ignorance, because all of this is new to me.
I posted this in your other thread but will copy & paste here in case you missed it:
I was long recovered from anorexia when I started keto so my hunger signals were pretty good & I had no issue eating intuitively once I’d fat adapted. In your case I’d probably recommend keeping to three ketogenic meals a day to give your body a chance to trust that food will be coming in & to allow it to ‘develop a habit’. Many people trying to fast have stated that they get hungry at certain times just because that is the time they usually eat - you may be able to use this phenomena to your advantage.
As has been stated upthread, I’d also cut back on the running a bit & try to focus more on strength training if muscle building is your goal. I’d also recommend you start at the higher end of the protein recommendations - it’s vital for both muscle and bone building which is an area where both you & I probably need some extra help 
In addition to @PaulL recommendation to look into Dr Georgia Ede I’d also recommend searching for interviews with Dr Tamsin Lewis who is an athlete & recovered anorexic herself. This one might be a good place to start.
EDIT: just a quick PS - if at all possible it might be worth it, in your particular circumstances, to seek the help of a trained Exercise Physiologist to get personalised training advice. You’ll be starting at a different baseline to many.
Likely a DEXA scan. It’s a very low dose xray full body scan. And it is the most accurate for body composition 