Lifelong Effects of Eating Disorders on the Metabolism

(Jenn) #1

Hi Everyone,

I was wondering if anyone has insight or even personal experience with this situation. I was plagued with eating disorders when I was a teenager. I would say I was mainly anorexic with some bouts of bulimia for a good 3-4 years. I would eat MAYBE 300-400 calories a day. I was terrified of food and somehow survived on grapes, a couple cubes of cheese, lettuce and salsa and an occasional small piece of chicken every few days. I was very unhealthy and eventually my family did make me go get help.

The doctors and therapists did help a little at first to help stop my aversion to food and the idea of gaining some weight. Cut to 6 months later and I had gained almost 50 pounds. I had started eating more and more each day. Things like oatmeal, larger portions and yes, even dabbled in fast food junk food. I didnā€™t eat more than any of my other family members during this time and they are all a healthy weight. My original primary doctor retired before my next checkup and the new doc didnā€™t even think twice about the weight gain being too sudden or how unhealthy it would make me the next decade. He just prescribed some metformin after a blood test and said I was insulin resistant. I was so young and already a bit traumatized from everything Iā€™d put myself through I didnā€™t question it or get a second opinion. Over the next 2-3 years I gained almost 100 pounds from my eating disorder lowest weight.

So I went from terribly thin and unhealthy to morbidly obese in under 4 years and not one doctor actually tried to help me. Just told me to eat a well-balanced diet and exercise.

I eventually found keto almost 3 years ago and was able to shed about 80 pounds within the first year. However, I have been stuck at a plateau for over a year now. Canā€™t seem to shake the final 50-60 pounds Iā€™d like. Iā€™m wondering if I somehow irreparably damaged my metabolism?

Quick summary for reference:
Eating disorder weight: 98 lbs
6 mo. Mark after overcoming eating disorder: 150 lbs
3 years later: 250 lbs
CW after 3 years keto: 172 lbs (been this weight since last December give or take a couple pounds)
Iā€™m currently 33 years old and I do moderate exercise and weight lifting 3-4 times a week

I just thought this was an interesting situation and Iā€™ve seen a lot of helpful input from this community so any thoughts on this would be much appreciated.

(Michael - When reality fails to meet expectations, the problem is not reality.) #2

There are lots of people here who can offer specific advice about your weight loss stall. Youā€™re going to need to post exactly what youā€™re eating, how much and when before anyone can help. So, you might like to do that. To respond to your question about ā€˜lifelongā€™ effects, I think there are likely ā€˜long termā€™ effects dependent on just how badly damaged oneā€™s metabolism is and when one finally gets around to trying to stop the harm and fix the damage. Thereā€™s undoubtedly a lot of individual variation. But if you start soon enough to repair and replace, I think the prospects of recovery are excellent. At the age of 33, I think youā€™ll be OK. Just might take a little longer than you hoped for. :slightly_smiling_face:

(Jenn) #3

Good point!
I havenā€™t really changed too much over the last 3 years as far as my food intake goes. A typical day for me is 16:8. I usually have 2 eggs with cheese and 1/3 of an avocado for breakfast at around 10am, a protein and veggie at lunch (lately itā€™s been pork and asparagus with butter), maybe a handful of macadamia nuts around 2, Dinner is always a protein with a good amount of fat (steak with fat trimmings, pork chops, sometimes chicken) and cauliflower mashed or just steamed with butter and saltā€¦ I stopped buying the ā€œKetoā€ treats like quest cookies and keto cups long ago. I try to just keep it real simple.

I have dabbled in IF. I didnā€™t really see a big difference as far as weight loss went. Iā€™d be willing to try it again though.

(Michael - When reality fails to meet expectations, the problem is not reality.) #4

Isnā€™t 16:8 IF?

Doesnā€™t seem like youā€™re eating very much in total. For instance, your ā€˜protein and veggieā€™ lunch: how much pork, how much asparagus? If youā€™re not weighing food portions itā€™s very easy to over/under estimate quantities. Especially vegetables and if youā€™re overeating vegetables, even swimming in butter, that alone could cause your stall. Even so-called ā€˜keto friendlyā€™ vegetables contain significant carbs, plus other stuff that might cause you specifically problems. If you are restricting total calories too much by undereating, that will cause problems as well. Iā€™m just throwing these ideas out there, others with far more knowledge and experience will show up soon enough Iā€™m sure. @Momof5 for one also went through anorexia and bolemia. There are other as well. So I think youā€™ll get useful info!

(Jenn) #5

Sorry! I meant EFā€¦ I havenā€™t been able to go more than 24-36 hours and feel comfortable.

(Michael - When reality fails to meet expectations, the problem is not reality.) #6

Thanks. Other than not eating from mid-evening until next dayā€™s breakfast, which could be anywhere from 8-12 hours and includes 7-8 hours sleeping, I donā€™t fast. Technically, what Iā€™m doing is IF, although itā€™s really just the typical way we all used to eat back in my childhood before eating 24/7 was the vogue.

Jason Fung and a few others are the prime advocates of EF. But even Phinney thinks thereā€™s no particular benefit to fasting more than a couple of days (only occasionally!) and a risk of slowing your metabolism doing so.

(Isa) #7

Jenn, you and I are in the same boat. I wonā€™t go into my history, but a loooong time ago, I went from 105 lbs at 5ā€™7" to over 200 in a year. (Hormonal/metabolic issue). I then had waaaay too many years of eating disorder behavior to try to compensate.

I donā€™t think we can permanently damage our metabolisms with our history. But I do think we can trigger a very sensitive body, who remembers being hungry and starved, and will fight us on weight loss.

I have more thoughts, but I think Iā€™ll end here and just say this: You are not alone. This part of the journey sucks.

(Katie) #8

I was also thinking that you might be too low in calories. A good way to think about it is that if you are too low for too long, your body thinks that it is a food scarcity scenario, and thus holds on to fat to protect you in a famine ā€˜modeā€™. A tool to consider is getting a keto coach to help you to reverse diet. I highly recommend either Robert Sikes or Crystal Sikes (Keto Savage website).

As for your stall, I highly recommend listening to parts 1 & 2 of the April Ihly episodes of @Daisy 's podcast (linked below). She had a major stall and the method that she used to break it could work for you.

Trying non-dairy carnivore for at least one month might be helpful (that was part of April Ihlyā€™s protocol).

I can really empathize with your eating disorder background, and am terribly sorry that you have gone through that. Psychologically I have had a similar experience to yours, but physiologically I did not experience quite the same as you. Nevertheless, please feel free to reach out to me if you want to talk about this more :slight_smile:

https://ketowomanpodcast.com/100-april-ihly/

(Trudy) #9

I have an eating disorder past and am very gentle in using fasting. I agree with this comment.

(squirrel-kissing paper tamer) #10

I have been eating keto for over a year and just last month started eating two meals a day (early lunch, dinner) and itā€™s working out well however I was reluctant to do it for a very long time for fear of triggering anorexic behavior. Since other things in my life are on track I felt safe and while the scale isnā€™t moving, I appreciate the convenience. I donā€™t think Iā€™ll ever be once a day or do any lengthy fasting but who knows where I may be next year.

I think you could skip the afternoon snack for something to try, if you feel like you can. The longer you go in between without snacks, the more opportunity to keep insulin low.

(Bob M) #11

I think Phinneyā€™s wrong.

@Jennc714 Where would you like to be? 150? 145? 155?

What you say you eat doesnā€™t seem bad to me. You could always mix it up, say by going to 2 meals a day (what I do on the days I eat ā€“ most days anyway), maybe throwing in a 36+ hour fast once a week. You could do a 3-5 day fast to see what happens. You also need to ā€œfeastā€ after fasting. That can be tough, as fasting really does cause lower ability to eat more, at least for me. I need to take longer than a day between any type of fast.

(Jenn) #12

Thank you so much! I will definitely check out those links.

(Michael - When reality fails to meet expectations, the problem is not reality.) #13

Hereā€™s his argument:

(Jenn) #14

Iā€™d like to be under 150 for sure. If you go by the stupid BMI chart I should be 97-130lbs for my height of 5ā€™1". That makes me laugh because I was on the low range of that scale while I had the disorder. I think I could do 2 meals a day and shorten my eating window. I do agree with some other comments above in this thread and EF could possibly trigger some old habits I have no desire to relive.

Iā€™ve let food control most of my life and I do feel the healthiest doing keto so I plan to stick with this WOE for the long haul. I guess I was just concerned about the lengthy stall and worried my body may not want to sustain any more weight loss because Iā€™ve stressed my metabolism too much over the years.

(Katie) #15

If you are looking to repair a damaged metabolism, then fasting is the way to go.

Pretty much I do one meal a dayā€¦so I fast 22 hours every day. Whenever I become worried that I donā€™t get enough calories and might slow down my metabolism as a resultā€¦then I do a long fast ( 2-3 days)
That seems to get me back on track every time.

Fasting Simply happened naturally for me. I am just not hungry most of the time. Often I have to make myself eat more cause I know I am eating at a deficit. Maybe if you can up the fat content of your meals you will find you remain satisfied longer and go 18 hours?

(Peter) #16

Of course it is

#17

From what Iā€™ve read around here, when it comes to eating disorders, fasting needs to be approached differently, as there is a tendency towards it triggering old habits of going down to the low energy input in general, or bingeing in place of nourishing feasting on non-fasting days.

So folks who arenā€™t informed about eating disorders and automatically prescribe fasting as the cure may be doing more harm than good.

@Emacfarland has specialization in this area and also about the other subject of hyper-responders to keto, and probably has some good insights/further resources for you Jenn. :sunflower:

(Susan) #18

I have had eating disorders for years; and my metabolism has been severely messed up because of it. I am sure the reason that I have been losing very slowly since June is because of it; as I have tried all sorts of tweaks. I am losing, though, just slower then many others because of all the starving myself, purging, and laxative and diet pill abuse that I did for so many years. I feel the effects are indeed lifelong; but that Keto is healing my body over time and that eventually I will lose all the weight and get to Maintenance, but I am also realistic and realize that it will take a couple more years for that to happen.

(Isa) #19

Thank you for this comment Mary. I cringe when I see people recommend fasting as a fix for someone who has struggled with an eating disorder.

Outside of the health effects, fasting is often a ā€œbehaviorā€ used to meet the eating disorder ā€œneedsā€, often used as a form of punishment for behaviors that are seen as ā€œbadā€ or ā€œagainst the rulesā€.

All this to say: please donā€™t recommend fasting as a first line of action for people struggling to heal eating disorders.

(Windmill Tilter) #20

If you mean that it will expedite the reversal of insulin resistance then maybe, but thatā€™s not ā€œmetabolismā€. If you mean that it will normalize resting metabolic rate, then this simply isnā€™t true. ā€œFastingā€ can mean a lot of things, but taken in the context of your recommendation of OMAD, it still isnā€™t true. Dr. Fung explicitly advises against long term OMAD in his IDM clinic because it impacts resting metabolic rate if done continuously. Not many other folks with an opinion on the subject have an indirect calorimeter and hundreds of test subjects!

Iā€™m not an expert by any stretch, but I donā€™t think extended fasting is appropriate for someone with a serious history of disordered eating without consultation with a professional.

I say all this despite being a big fan of extended fasting for weight loss. Iā€™ve done a couple dozen ( ranging from 48hrs to 168hrs) so far this year and it works great for me. Itā€™s not for everybody though, and in instances of disordered eating, I think the risks generally outweigh the benefits.

Thatā€™s my 2 cents.