Lil Miss Fitness Freak

"And though she be but little, she is fierce"


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Exercise As Part Of Treating Eating Disorders? Fitness Friday 35

Well ain’t that a controversial topic for discussion….

In the spirit of this week being #Eating DisorderAwarenessWeek, I thought I would bring that into our lil regular Friday Fitness chat.

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I knew it would be a big deal. I know that many will not agree with my words, but hear me out, have you ever thought that treatment and exercise could co-exist when looking at eating disorders?

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I know what you’re all thinking.

Exercise is a method to fuel eating disorders

Exercise is a means of dropping weight and burning too many calories

How the hell is exercise going to help put weight on when clearly it just increases their energy requirements?

This is why this topic is a great one to discuss.

The points above are completely valid. In fact, those are the beliefs that many professionals give or yell if the thought of exercise is brought up.

Take me for example, during my short time at the Oakville outpatient program for family therapy, it happened to slip out that I was going to be starting to slowly get into training (this was a few months post-inpatient) and my therapist freaked the eff out. Like I’m not kidding, she actually called my house and my parent’s cells and left frantic messages saying  “Chelsea is not to workout!!!!”

Not that her words stopped it from happening, and honestly, we left that place faster than we came in (not because of that incident, but a bunch of other things..), but I’m just trying to give you an idea of how most clinicians feel about this topic

I.e. They are mostly against the thought of exercising.

no-exercise-today

…or ever…

Like I said, these arguments are all valid concerns and I see where they are coming from…

~I was a compulsive exerciser

~Most use it as a way to burn more calories and loose weight

~Most don’t know limits or when to stop

~Many can let it consume them and take over their lives

So I will say again, I understand their fears, but look at it from another perspective. When you just say NO and/or NEVER AGAIN, where does that get you? It teaches the individual nothing about control or other benefits aside from the superficial ones. It tells them that they have lost a free right to do something many people do. It places restrictions on them, which can lead to them deciding to go and do it anyways. Lastly, it prevents them gaining some of the many benefits you get from exercise that can be critical to the health of a person struggling with an eating disorder (*provided they are stable enough to perform exercises) such as bone and cardiorespiratory strength, helping with psychological disturbances, distraction from nagging negative and obsessive thoughts and potential social opportunities.

There are many people I have seen who have gone from treatment to the gym and are strong, independent people who are in control and did not slip back into old habits. They successfully took their health into their hands and chose to use exercise as a way to ‘come back’ and heal. A way to gain strength when their body was so weak before. A way to build confidence in themselves and eventually find that the gym is more than a place to burn calories. It’s gives them a place to deal with their emotions and re-build themselves physically and psychologically.

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So with all of that being said, I wanted to present you with some research on the topic and how these types of interventions have faired in the treatment of eating disorders. I mean, you have heard my story and I could give you anecdotal evidence of the possible benefits for some, but does it actually show more pros than cons in treatment settings?

Lets find out.

To be honest, I was shocked at the number of articles I actually found. I still believe most are completely dead set on NO EXERCISE but there was a surprising number of studies and pilot programs in treatment facilities exploring the use of exercise as intervention. 

I will stick to the main findings of each study and link each so that you can read more if you desire. I am also going to label them in order of earliest to latest. Lastly, I could have found more, but for the sake of your attention span, I left it to these interesting ones.

Thein et al (1999) –> “Pilot Study of a Graded Exercise Program for the Treatment of Anorexia Nervosa”

Main Findings: With the addition of exercise (amount based on % of ideal body weight IBW), the experimental group (diagnosed with AN) showed no difference in change in BMI or body fat, suggesting that the exercise did not inhibit the primary goal of weight gain. The EXPT group also saw a general increase in quality of life measures while the control saw a trend downward from their initial testing.

Szabo and Green (2002) –> Hospitalized anorexics and resistance training: Impact on body composition and psychological well-being. A preliminary study

Main Findings: Study included a non-AN group (exercise group and non-exercise group) with a group of girls currently in an inpatient facility for AN (exercise and non exercise groups). They were both on an 8-week training program of resistance-based exercises. There were trends found for the psychological variables, however it was speculated that perhaps 8 weeks was not enough. Interestingly enough, there was no decrease in weight of the ED-exercise group but a significant drop in those not in the exercise group.

Lutter and Smith-Osborne (2011) –>Exercise in the Treatment of Eating Disorders: An Alternative View

Main Findings: Exercise was significantly associated with greater improvements in eating disorder and depressive symptoms where the number of METS was associated positively with improvements in the measures of depression (BDI) and eating disorder behaviours (EDI). This study was interesting because the exercise was equine based.

Hall et al (2016) –> Use of yoga in outpatient eating disorder treatment: a pilot study

Main Findings: Adolescent girls (all met the requirements for AN/BN/EDNOS but were clinically stable) in an outpatient eating disorder treatment facility attended 12 yoga classes at one class per week. After the intervention, there was no decrease in BMI and significant improvements in anxiety, depression and body image disturbance scores. 

I did a yoga class or two when I was an inpatient at Sick Kids. This was for the advanced stages only but was a nice change of pace. Definitely saw first hand the mood enhancing features. 

This article by Hausenblas et al (2008) also provides a good overview of 6 further studies showing the benefits of exercise based interventions in eating disorder populations on social, psychological and biological factors if you’re interested in even more reading 😉

Finally, here is an article, Bratland et al (2009), that discusses how exercise based programs are managed in treatment facilities and how many places actually have them! It was limited to a few countries in Europe, but can provide some insight for how they could be implemented and managed here.

So…

To conclude, many articles find that there are benefits to exercise in both outpatient and inpatient treatments for eating disorders. Also, rarely did any study (I didn’t find any) report negatives (such as weight loss or stalling the weight gain process) of incorporating exercise into the programs.

I want to say that, yes I know it may take more work and there will have to be strict guidelines in place, like ensuring they are stable enough to participate, etc, but from what I see from research and from my own experience I definitely think that it would be something to really look into further and do more pilot studies on.

Weight gain is already hard enough, try to make it easier on us all. Plus, by being exposed to it in a controlled setting it can also help to make the transition back to ‘reality’ potentially more smooth.

Something I would like to know is if incorporation of exercise during treatment can lower the risk of over exercising or going back to negative exercise habits when they are discharged. 

What are you thoughts?

-Chelsea

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Guys Need Not Read. Girl Talk

My friends,

A short and sweet post this morning as I have something rather exciting to share. Sorry if this is too much information for you, but to my shock, Mother Nature decided to show her work this morning after about 6-8 months of having amenorrhoea.

To say I was shocked and lost for words was an understatement and although my mind is whirling around all kinds of thoughts, which I’m trying to calm any negative ones, I can say that it is a GOOD THING. No, it’s a GREAT THING. For us females, our cycles really show us that our body is healthy because it’s the first thing to go when the body gets stressed. So to get it back (or at least the first time, as I realistically know that it may be transient as it first starts back) means that my body believes that it’s getting adequate nutrition and it’s trusting me again. It’s not overly stressed and so it feels it can run a body process that isn’t actually ‘necessary’ yet still uses a lot of its resources.

I can say that I was shocked mostly because I’m still underweight, and of course with it’s re-appearance I automatically shifted my thoughts into the negative thinking that the weight I have gained must have all been fat because fat is critical to attaining your menstrual cycle. Give me a day or two and I will fight those thoughts back once again as my rational side comes back to the surface post-shock because those throughs are just that…irrational and eating disorder fuelled.

So yeah, I just wanted to share that lil surprise with you all as this is a big turning point in my journey. Even if I did get it back, this doesn’t mean that my weight restoration stops or that my food will stop increasing because, as I said, the 4 pounds that I have gained is still not enough to make me well and strong. So onwards we continue in the forward direction.

Have a great day my friends

-Chelsea


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Sunday Feelz…Update On Moi

Hiya Friends,

happy-sunday-mind-fresh-no-job-no-stress-cute-baby-graphic

Hope you all are having a great weekend thus far and enjoy a nice lazy Sunday. I’m currently enjoying my first morning at the parents house and I’m  off to the gym in a little bit but I just wanted to give a short lil post about where I am currently as some people have been asking lately.

You know I like to be honest and open with you in my journey and struggles, so I feel as if I need to keep you all in the loop and I want to share! Although I do hate over talking about myself so I will keep it short and sweet.

Just like me…sorry I had to. 🙂

So, what’s been up with me and my health as of late?

Well, it has been officially about 6 months since I started working with my coach and have been increasing my intake. Although I will not post how much I have increased it, is quite a bit and as far as my weight, although many of you may not think this is a large enough amount, but I have gained about 4 pounds in that time.

Yes, I know weight gain is my goal, but keep in mind my frame. Four pounds may seem small for an average person along 6-7 months of eating in a surplus, but I’m 5’0 and under 100lbs so that is actually decent. Especially so because of the way my body works (ie. my fast metabolism) and my training. I just wanted to put that into perspective.

Despite me saying that, I feel no need justify myself to anyone. I’m moving forward in not only weight and strength, but my health is on point for the most part, my psychological health is improving and overall I just feel better.

So in order to keep it brief, I will put some of these things below in bullet form because that ensures I don’t over chat about them. 

…maybe…

~I get my vitals done twice monthly to ensure that inner things are all good. All of them are good and normal for me. Heart rate is in athletic range and my BP is good for me (low, but that has been normal for my whole life).

~I get blood work done along with an ECG also about 2 times a month to check the minerals, vitamins and such. Both are good with one lil issue right now being my urea is too high, suggesting that my intake of protein is quite high and possibly I’m a bit dehydrated because of it. NOTE that this is not going to hurt my kidneys, high protein intake doesn’t cause harm but instead can aggravate if previous kidney problems, which I don’t have, are present.

~TMI for guys, so skip it, but I still suffer from amenorrhea. This is going to come back with time and although I’m going to get major slack for saying this, but I’m trying not to sweat it too much. YES I want it back because it’s important not only for fertility but also for a bunch of other things (hello bone health, etc) and tells me that I’m in good general health BUT I also know that weight gain is a process and over stressing about it is just not going to help. SO, yes I am working to get it back, but I have to let my body determine when it will trust me to that degree again.

~My stomach has been a BITCH. Excuse my language, but my IBS has been the worst it has ever been. I knew going into this ‘bulk’ that it wouldn’t be happy but I never knew how much it would be aggravated and how much that would affect my mood and body image issues. Thankfully, my doctor has given me something to help with digestion (Domperidone) and OMG that has made things so much better. I only take about 1/3 of the recommended dose but that alone has really helped me feel normal to an extent.

NOTE that this is nothing like laxative or anything else that can lead to dependency. You can stop taking it at any time, it has no consequences/side effects and has been said to be one of the most useful tools for those undergoing re-feeding.

What about Training?

I have always been up front and honest with you all about my refusal to give up on my training and I stand by that. My health and weight is improving right along with my training so I’m not planning on stopping or slowing my pace any time soon. I know I may get some judgement for that, but I’m just being honest. Training is my passion and it’s not going anywhere.

It is my mental clarity.

My stress relief

It gives me goals to focus on through the hard times of this process.

It’s just part of me. I’m stronger then I have ever been and if you see me train you can see my love for it (I have been actually told that).

So please, do not tell me I should cut back or worst yet, stop, until I’m ‘better.’ I’m getting  better on both sides. Health and the gym are both improving simultaneously. I’m not being stubborn here, I’m being a realist. I need it to keep me going and, quite frankly, it keeps me happy. This process is hard and somedays knowing that I get that gym time gets me through it.

That aside, I said my strength has increased?

Oh yes, that food has gone to work for sure. I think that my strength has gone up a lot faster then my weight and I’m seeing muscle starting to come back and it’s just further pushing me to keep going.

I want more.

So here are some highlights.

My back squat has gone from 95lbs to 135lbs for equal reps (about 5ish on a good day)

My front squat has surpassed my previous from when I was heavier. (about 105lbs for 5)

My bench is back at body weight. I want to push this further but I also know that bench is very much affected by body weight in most people, so keep trekkin.

Pull-ups have gone from about 5-6 back up to almost 10 depending on grip despite the slight weight increase.

Overhead press dipped down to 35lbs but is now back up to where it was previously at 50lbs. <- OHP is one of the hardest movements for me so bare with me. It’s progress.

The one lift I’m frustrated with is deadlifts. Granted I haven’t done them for a long time (shameful for a ‘gymrat’ I know), but I’m stuck at just above bodyweight right now. There is something I’m not doing right with my form I’m sure so it’s something to look into if I want to improve.

So yeah, in both my mental and physical health, I’m progressing forward. I cannot thank all of my supporters more for what they have done for me during this process and moving forward, I know that things can only get better. I have a sense of mental clarity and peace more so then ever. I’m seeing more and more what makes me happy and branching out to explore more.

So overall I’m happier, have more energy and am just enjoying life much more. It makes me very happy to hear others see that too because hearing that you are glowing is much better then ‘are you okay?’

That is one of the best changes thus far.

And throwing up an end of the post cheesy flex-it pic just because I feel you need to see something and I’m starting to like my shoulders more…

#DontJudgeMe

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Before you say it…booty growth is my biggest goal. 😉

And now I’m embarrassed ha! Signing off! It’s my favourite time. Gyyyymmmin.

Much love friends!

-Chelsea


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Mixed Messages…Thinking Out Loud

Amazing job! You eat those fries and love every moment of it…

How do you eat all those bad foods all the time and not get fat?

It’s okay sweetie, you will conquer that whole pint of ice cream next time.

Hey maybe you should put down that pizza slice, it’s not like you need it..

…..

#YesIAteTheWholePint #RecoveryForTheWin

…..

im confus

Me and you both.

Linking up with Amanda over at Running With Spoons for this week’s Outloud Thinking.

You know my friends I have struggled with this idea for a while. We are very confusing with our messages about food. Then on top of that, when you throw recovery and what we ‘believe’ that those in recovery should eat in there, well **it just hits the ceiling and makes absolutely no sense.

On one side, we have the general public, who demonizes any food they perceive as unhealthy and condemn those who choose to indulge in them even in moderation.

If you happen to not be a size 2, gawd forbid you have that slice of pizza. You might as well prepare yourself for the long, judgmental conversations that may sound something like this…

Hahaha if I eat that pizza I blow up like a balloon…

Oh I don’t eat that crap, do you know how many calories that has in it…

Oh ya know I will just workout an hour longer tomorrow..#balance (<– this is so wrong btw, don’t do this!)

However, take someone who is recovering from an eating disorder and the conversation takes a completely different direction. Think north pole vs the desert.

opposites

That is amazing, you ate fast food twice today! Recovery win!

I feel so over full right now, but I need to get over that because it’s part of recovery…

#PintParty

See the difference?

I’m stuck here though. I see this discrepancy so clearly and that is what makes it so frustrating that I don’t have a clue where to even start. Despite knowing that with most eating disorders come fears and those need to be challenged, I also strongly believe that we taken things too far.

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How has it become okay to push things on those in recovery that we normally preach to those not in recovery to push away from? How are we supposed to show that food is just food when we do this?

We are extremists.

Recovery has become something where you are to ‘challenge’ yourself to eat in a way that we normally try to prevent.

You should feel comfortable with being stuffed if you’re in recovery, but you should feel slightly hungry if you’re not.

You should feel proud of tackling that Mc.D’s twice in one day if you’re in recovery but feel disgusting and bad about yourself if you choose to have a burger once and a while.

We are being completely contradictory with our messages. Food is food and shouldn’t be different for one group of people over another.

Another issue is this also puts pressure on individuals regardless of what “category” they fall into.

If you’re in recovery and you’re not going to those extremes you may feel (or others may feel) as if you’re not progressing. Likewise, further agitation can occur because if you feel that pressure to push yourself waaayyyy out of your comfort zone, it may create even worse association with certain foods.

On the flip side…

Those who do not fall into that category may feel the need to almost hide food when they are wanting or eating something ‘dirty,’ especially if they are overweight.

Apple and hamburger on scales conceptual

You can’t win. Both sides are negative, so then, what the heck do we do about it?

Truth is my friends, I’m tackling a slightly controversial issue here and honestly I don’t know what we can do about it.

I know that we need more consistency somewhere. The same food can not be good for one person but bad for another.

For those in recovery, we still need to challenge food fears so that food can be eaten without second thoughts or guilt. However, this needs to be balanced with not pushing so hard that it pushes them out of normalcy.

Cheering for someone to make them finish an entire pint of ice cream is not normal. This shouldn’t be dubbed a ‘recovery win.’ IMO

If they want the whole pint then thats different because it’s what they want to do but there is also the issue that sometimes with eating disorders comes binge eating….another challenge, another discussion. 

Isn’t the point of recovery to reach normalize eating? 

Again, on the other side, for those not in the ED category, normal eating should include those foods they are craving once and a while and the should be able to eat until they are satisfied. This is regardless of what weight you are at weight status should not dictate whether you are allowed to have certain foods on occasion (Yes I realize there are some exceptional cases but you get my point).

So, to sum things up, we have created a big, hot mess. Our messages about food are wrong and, to be honest, the way that we try to challenge food fears in the clinical population can ultimately lead to further eating issues (like binge eating) or just worsen fears even more because they are just too much.

Just my thoughts.

What do you think?

-Chelsea


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Why Do I Need So Much Food?!?!

My friends,

How are you all? Things are beautiful over here FINALLY! Full sun, 20 degrees and we are all loving life. This is the type of weather I think we are meant to be in all the time because people are just happier. Do you find that too?

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My lovelies. We apparently need a taller friend so that selfies can include all three of us in our entirety. #ShortArmProblems

As for general life, I have one exam down, one to go then I start my new research job next Monday. Student life for ya. Never ending. As for my health, still working away and still making gains in the gym, so a positive direction I would say. Oh and how could I forget…

More and more food. This weekend I actually got another BIG increase and, as normal, my heart began running a marathon in my chest..

Why I red the email before my exam I have no idea… Self sabatoge much?

The increases always do this to me, but this one was rather dramatic and I’m getting anxious for Monday (tomorrow) when I have to deal with it starting.

This leads me into the topic I wanted to discuss today. I don’t know if it was this increase that sparked this question in my mind or if my constant complaining about why my tiny body needs so much food just to even maintain my weight has finally made me want to check things out but, regardless, this was my random question that led me to some journal reading…

Does your metabolism heal fully post recovery?

Is my metabolism messed up and that’s why I can’t gain?

These are what I started asking myself. Maybe I never really went into search because I just assumed it was similar to dieting…

Eat less food…metabolism decreases

Eat more food…metabolism begins to heal, readjust and speed back up to normal.

So given what recovered individuals go through, I just assumed that during the severe restriction that the metabolism would be damaged and then with the re-feed it would just heal itself back to normal eventually provided you kept the weight on.

I was also told by the doctors that post re-feed, those with anorexia tend to be in a ‘loosing mode’ but given that I gained the weight during the re-feed, obviously, and kept it on when I left, I never really thought about things like my metabolism much. I really never thought about this problem at all to be honest.

It also never occurred to me to think about it throughout the years because I was just eating when I wanted to. It wasn’t until I lost (not intentional, I just wasn’t aware in the beginning what I was doing and then being unable to reverse it) and was ‘trying to gain on my own’ that it really hit me that I needed to eat A LOT.

This is when the questioning started.

I’m 5 feet tall.

I’m tiny.

Yes I work out hard but for real, I’m eating more then some guys cutting…

Why?!?! 

This is hard I don’t want to have to eat this much

Now hear me out, I rationally know that everyone’s body is different and that exercise and building muscle leads to an increased amount of food required, but by me being a person who used to look at the diets of others (including competitors), it began to mess with my ability to stay rational when it occurred to me that I was eating more calories then they were.

They work out hard, they are taller then me and eating less?!? 

WTH??

I actually started getting really irrational and thinking that maybe I wasn’t seeing myself right and that I was ‘getting bigger’ because.. how could I not be? I’m eating a house (Or so thought at the time…). It just didn’t make sense to me that I was eating what felt like so much and not gaining anything so every possible theory, no matter how crazy and unrealistic it was, came up.

I’m still working at not comparing and doubting my rational side but I decided to actually look into the research instead of just letting my ED spread it’s lies in my mind and driving me crazy.

As I began to search around, I figured that this information would be quite beneficial to many of your guys, as I know that there are some of my readers that have gone through similar situations. So I hope you can gain something out of it or just at least find it interesting.

Oh the body and it’s workings…

So what did I find?

***Disclaimer. Please note that the research behind post re-feed metabolism is still young and many of the the findings are not in full agreeance but there does appear to be a general consensus that there is a period of “hyper metabolism.” ***

To keep it brief and not too wordy (so I loose you all), I will stick to the main bullets from some studies then sum it up at the end.

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(Tatyana, 2014)

So not only do those suffering with anorexia (AN) have to eat an increasing amount of calories throughout the re-feeding process to start and continue to gain weight at the same rate, they also need it afterwards. Specifically, there tends to be a duration of time post re-feed where a significantly higher number of calories needs to be consumed then what would typically be estimated for an individual of the same height/weight without an eating disorder history just to maintain that restored weight.

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Marzola and et (2013) did a PubMed review and reported quite a few interesting findings:

~The graph above suggested that, compared to healthy weight female controls, patients with anorexia nervosa (AN), both restrictive and binge/purge types, required more calories per day for their body weight directly after treatment. Following one year (the long-term recovered), restrictor types still required significantly more calories for weight maintenance then controls.

~Although studies appear varied, there is a quite a dramatic increase in calories per kg of body weight that has been found to be required for weight maintenance in those with AN. When compared to normal weight female controls, who needed approximately 20-40 cal/kg/day for weight maintenance, those with AN have been found to need 50-60 cal/kg/day or more to keep the restored weight on. Post-refeed the increased calories appears to be required or rapid weight loss is often the result.

Personal Response: Perhaps this is why there is such a high rate of relapse? The fact that patients are no where near psychologically recovered directly after re-feeding and then on top of that have to maintain such a high caloric intake may be too much of a demand for them to handle. Furthermore,  weight loss is even more favourable as the body is slow to fully heal and has this hypermetabolism issue. 

~They did also mention that this tends to normalize itself after about 3-6 months.

~Overall, this suggests that those with anorexia become hyper metabolic during the re-feed process which is actually kind of the opposite of what occurs in cases of calorie reduction for the sake of weight loss in overweight individuals. In the latter case, the overweight struggle to loose weight because as they reduce their calories they become HYPOmetabolic so the slower burn makes it more difficult for them to reach the required deficit. On top of that, if their calories are increased, they rapidly gain because their metabolism is in a less efficient state. Contrarily, for the individual with AN, they need even more calories then before just to gain anything because their metabolism is just hummin too fast. This increase, however, is not that it’s more efficient but rather, that their bodies are simply using more thermogenic processes then normal. In other words, they are just burning off more of their intake as heat rather then using it for building or attributing to new mass.

What about Bulimia Nervosa?

As you saw with the graph above, those suffering with bulimia (BN) may not have the same issue. Directly after treatment, Marzola et al (2013) found a slight increase in caloric needs, but that did not hold true for the long term as it did for AN. Similarly, an earlier study by Weltzin et al (1991) that looked at the difference in weight maintenance requirements in patients with restricting AN vs. BN found that AN requires a significantly higher number of calories to keep the restored weight steady.

Does it last forever?

It doesn’t seem to.

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(Kaye, 1986)

Most studies that I came across gave a range of anywhere from weeks post re-feed to 6 months where the metabolism was generally restored itself and the caloric needs returned to what was considered normal. Although the exact mechanism behind this hyper metabolism during and post re-feed is still unclear, there have been a few suggestions as to why it occurs. One of the more consistent theories is that the endocrine system takes a bit longer to fully recover and return to a normal functioning and so for weight to be sustained post re-feed, the increased caloric intake is required to be sustained (Kaye, 1986, Mazola, 2013). Another contributor to this increased need may be increased exercise. Many studies have found that those with AN tend to have greater exercise generated energy expenditure through behaviours such as fidgeting, pacing, and increased walking (Kaye, 1986). As a result, their caloric needs would increase more then the average person in addition to their already higher requirements for weight stability.

Alrighty for the sake of not boring you too death by having something 40 miles long, I suppose I will end it there. What did you think?

As a final reflection back to my own situation, I suppose some people would call what I have gone through a relapse as I lost a dramatic amount of weight post re-feed back when I was 16. Although it was not intentional and it was so slow that I really didn’t pay attention until it started becoming more of an issue, the point is that I went back to unhealthy body fat and weight levels for my size. As a result, working with my coach is more like a re-feed period once again. Lucky him…

Due to that, it looks like I may have to endure this caloric surplus once again (FML right?) in order to get fully back on my feet. This is also on top of my increased needs from lifting….I can say that I’m thankful that my mind did not relapse, if you know what I mean, but still, the physical gaining process and accepting will not come without dealing with body image issues and dysmorphia. This unfortunately will then promise to make this journey quite the mind fu** for me.

But I just need to…

keep-climbing.jpg

So to conclude, this research was interesting for me to do as many things are making more sense to me, even more things then I shared in this post. I hope you can benefit in some way from this discussion and, as always, hit me up in the comments with your lovely thoughts.

Much love! ❤

-Chelsea

References:

Kaye, W., H., Gwirtsman, H., George, T., Ebert, M., H., Petersen, R. (1986). Caloric consumption and activity levels after weight recovery in anorexia nervosa: a prolonged delay in normalization. International Journal of Eating Disorders5(3), 489-502.

Mazola, E., Nasser J., A, Hashim S., A, Shih P., A, Kaye W., H. (November 7, 2013). Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment. BMC Psychiatry, 2013(13)290. doi: 10.1186/1471-244X-13-290.

Tatyana, (2014). Hypermetabolism in anorexia nervosa. Retrieved April 17, 2015 from http://www.scienceofeds.org/2014/05/07/hypermetabolism-in-anorexia-nervosa/

Weltzin, T., E., Fernstrom, M., H., Hansen, D., McConaha, C., Kaye, W., H. (1991). Abnormal caloric requirements for weight maintenance in patients with anorexia and bulimia nervosa. American Journal of Psychiatry, 148(12), 1675-1682.


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Winding Down This Wednesday

Trigger Warning. For those who are currently struggling or are triggered by the discussion of exercise, psychological struggles, pictures, food, etc please refrain from reading this lil update. The goal here is to ensure everyone remains in a safe place mentally when on my blog!

My friends.

Do you know how much it has hurt me not to be able to chatter with you much this semester? I have my moments where I wonder if you are feeling let down or frustrated with me thinking that I just don’t enjoy or want to blog anymore but please believe me when I say that is far from the truth.

I miss you all and I miss sharing things with you! 

I have tried to push aside the guilt about not blogging and focus on the fact that I’m finishing up my semester hopefully on a high and that I am actively working to bring back up my health status…

My health. How is that progress now that I mention it?

I owe you an update.

I have been officially been working with my coach, Mike, since the beginning of January. I had brought it up before then but we didn’t really gett’er going for real until then. So I suppose I’m wrapping up my third month with him. So what has that brought?

Weight Gains?

Can’t say really because Mike doesn’t want me weighing myself. I will be honest and say that I was initially weighing myself because I felt as if I needed to know when the scale began to tip up. You heard about my lil meltdown I had previously when it did increase a bit and so I have been forbidden to get on it since. To be rational though, that number really truly DOESN’T matter. Your weight tells you nothing about what is going on with your body really. It doesn’t tell you whether you’ve gained fat, water, muscle and so forth. It doesn’t tell you if your organs are repairing themselves. Whether your hormones are regulating. NOTHING. So really, all it does it make you obsessed with a number for no apparent reason.

So with that in mind,  I do weekly progress pictures with Mike and he makes changes as we go…which is EVERY SINGLE WEEK.

Food Gains?

Duh…

I’m not going to say what my specific current numbers are, but to give you kind of an idea…

I’m almost eating my weight in fat (number of grams to number of pounds).

I’m eating triple my weight in carbohydrates.

And around double my weight in protein.

And this is only the beginning. Pretty much without fail, with each passing week, I get another increase. The struggle is real, ya feel? Guys may not (4000+ cals would get their attention), but ladies, do you know how much food that is. Geesh

What I will say is that is just another piece of evidence to show you that you don’t need to be restricting to 1200 calories to maintain your weight or even loose weight! Yes, everybody’s body is different and they all metabolize and respond to nutrients differently but let me be an example to you. Eating high carbs doesn’t make you fat. Eating more then 1200 calories per day doesn’t make you fat.

I may be 5 feet tall but I train hard and so my metabolism is basically a beast…err efficient. I’m truly learning that I need a lot of food just to keep up with it, let alone, make it grow.

BUT! Even if you don’t train, you need to fuel your body sufficiently.

Strength Gains?

Oh yes my friends!

My pride and joy right now is my squat. Since reading week (mid February) my back squat has increased 25lbs! I’m now squatting more then 1.5 times my body weight which is so exciting as that was a lift that really took a hit when my body basically gave up on me (i.e. my strength took a nose dive) in the gym after the weight loss. I’m pushing so hard to reach that 135 ASAP!

Overall though, I’m much more energetic in the gym, my lifts have been feeling amazing and almost everything is just going up. I PR at least once a week in something and it’s just an amazing feeling.

GIMME ALL DEM GAINZ!…

Please…

Mental Gainz?

Lots! Yes, I have had my share of mini meltdowns throughout this process and things may have taken longer then they should have sometimes, but the point is that I not only have to fight the physical but I’m also fighting back the mental as well and that is tough.

I get frustrated with myself sometimes because I wish I could be like everyone else and be happy to be told to eat more food, but I have to take a step back though and realize what significant barriers I have broken down!

~It may have taken me 3 weeks longer then it was supposed to but I managed to add 4 tbsp of nut butter to my day ON TOP OF what I was already eating in my morning oats. This was huge because I had this ‘rule’ in my head that said I was only allowed to eat 1 serving a day MAX (2 tbsp).

~I still have my treat meals (almost still weekly) despite the increases. That was hard for me because I felt that I should stop eating ice cream every Friday due to my already eating more then normal.

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Jays is back open for the season! Let the spoiling begin!! Homemade Reese’s Pieces Peanut Butter gelato (right) and my ultimate favourite, Salty Caramel (left). All their products are made in store. Drools….

~I realized I still get hungry despite eating more. That was another big thing for me. You see, for me, my struggles surround feelings of fullness. I don’t necessarily freak out over calories per say, but I freak out thinking I’m going to feel more full because when I’m more full my tummy will stick out and that’s when I have issues. When you start to feed your body properly after a time of restriction, your body starts to realize that it’s getting more and with that, it can then allow itself to use those additions and ASK for those additions through hunger or other signals. Often times you may think something is a lot but then the next day your stomach will start growling for that extra food because it wants it. It’s proof that your body is efficient. More food or just enough food means that your metabolism is able to be the most efficient and use those nutrients to the best it can, making you an optimal burning machine.

~I haven’t gotten fat. Despite a fairly big increase (in my opinion) to what I’m eating, I have not gotten fat. Instead I have gotten stronger and I have been getting comments that I look healthier (despite the fact that I still really haven’t gained that much). My coach tries to keep me on the straight and narrow about that whole situation but it’s hard for me not to be negative sometimes. That, my friends, is a work in progress.

Any Negatives?

Any change won’t come without it’s share of some not so nice things. For me, the biggest struggle, other then my mind (I’m looking at you ED!), has been my IBS kicking up a fuss with every damn increase pretty much. If any of you have irritable stomachs you know how moody you can get when your stomach decides to screw with you. It sucks, like hard. I’m learning the very weird limits my stomach has and I have had to adapt and try to work with it or else I will just spend all my days with excessive and painful gas, no hunger (because of said gas) and bloating. Sorry TMI but it just doesn’t make this process any easier physically or mentally.

I’m still pushing though and I have so much love and support plus an amazing coach who is backing me up and having patience with some of my irrational thoughts and whining. I will do this and I will come out on top.

….

So, I don’t know if you have been wondering what I look like at the moment as my selfie game has been weak for the past lil bit…

I was super hesitant to post this because I was afraid of what you might think. I was afraid that you would think I looked gross and too skinny. Well the fact is that I am too skinny but I’m moving in the right direction and I should be proud of the gains that I have made regardless of how small they may be. This is my starting point and I’m full speed ahead towards my goals.

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The left was the first progress picture I sent to Mike. The right was two weeks ago. Again, the changes may be small and I’m still small but I’m making progress and he was super happy to tell me about it by putting this shot together for me to compare. 

If you have continued to stick by me during this dry period that is this semester, I appreciate it so much and I cannot say sorry enough for not bringing you the content you deserve. I hope that I can do better now that this crazy semester is coming to an end.

I love you all and lets hope my blog can be a bit more active once again because lets be real, my chattering and random thoughts just cannot be contained!

-Chelsea


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But I’m Not Hungry…

But are you REALLY not hungry?

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My friends, a post I read the other day a la My Little Tablespoon struck something in me. It inspired me to discuss the topic of hunger signals because it has been something I have learned over time as well. Her post was quite interesting for me as it explains some of the weird things that come along with recovery. She spoke about how sometimes you feel as if you are back to being a child and feeling vulnerable and fragile. When you choose to move forward against the ED is when you feel fear like a child who is facing a monster.

You come to realize that as you grow you are bigger then that monster and have to use your voice and your strength to shrink the monster into the small bully it really is. It was quite the thought provoking read to say the least, so, Cora, I thank you for that.

The other thing that stood out to me was this line

I don’t get the typical physical hunger ques of a growling stomach, but I knew I was hungry because I was having the hardest time focusing and felt extremely lethargic.

Maybe this thought hit me harder because of what happened yesterday during my restaurant. Yes, hell day was yesterday (my groups day to run the restaurant at University) and although it turned out pretty good in the end, there was a hiccup for my own health that really just did not sit well with me.

So heres a quick run-down of yesterday.

You see, I’m not allowed to eat during service (i.e. between the hours of 10:30 and 2:30 basically). I asked my prof/chef about eating and he said if you ever need to step out then it’s fine but yet the one time a manager of the restaurant day sat down to have a quick bite after working away for like 7 hours, she immediately got harped at.

You know it doesn’t look good for a manager to be eating while others are working….

Basically us managers don’t eat until everything is done (despite everyone enjoying ‘staff meal’) and if you don’t get up now your mark will suffer. So after one bite and a flush of embarrassment across her face, she ran back in to the kitchen until shift was over which was more then an hour and half later.

This is what happened to me yesterday, except, those feelings of lethargy are so much stronger for someone who is underweight and I actually began to get concerned for myself. Long story short, I had been prepared, I did eat a meal before service (despite it being secretly done in the bathroom and woofed down so fast I don’t think my body recognized it was food..), but after running around the kitchen for 5 hours I was left feeling very hungry around normal staff meal time (1:30)…The hunger pangs stopped but then on came the light headedness and tunnel vision.

I need food, like now…

So this brings me back to the topic of hunger signals others then physical hunger feelings.

So yes, this may be an extreme example to start with to explain my thoughts on this topic, but it was just the other effects that occurred besides the actual hunger feelings that got me thinking about it.

So physical hunger aside, there are times that you think you’re not hungry but your body fails to agree. It is getting low in fuel and is ready for some food and if for some reason it can’t growl at you, other signs begin to surface that show a lack of sufficient energy.

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So what’s with the lack of physical hunger you ask?

In many cases of disordered eating or even dieting, natural hunger signals may become skewed or non-existent and thus cannot be something to rely on. For me, despite generally feeling that hunger almost always, there are times where I don’t feel hungry and instead, I just feel sleepy, unmotivated and unfocused. Often for me, that is the result of gas and such (sorry TMI) due to the increases in food and my IBS kicking up a fuss.

I used to wonder why I didn’t feel this insatiable hunger all day long on some days because I work out so hard. Now I know that perhaps my hunger cues still need time to come back around 100% in addition to the fact that my hunger may be masked by other things. I have also come to learn that there are other obvious cues that I need food and that I just need to be aware when they start to present themselves.

You don’t need the tummy grumblies to signal you to eat.

This hopefully isn’t a forever thing but unfortunately when you restrict at some point in your life, this throws your hormones off balance and thus those triggers may be absent. So instead, it becomes vital that you cue into your other signs in order to keep your body humming away. Some of these include:

Sudden tiredness

Tunnel vision

Unable to process information

Lack of concentration

Sudden irritability 

Sudden cravings

Feeling snacky

Etc.

Etc. 

I say time and time again, your body is smart. If your main cue of hunger is screwed up, your body comes up with other methods BUT most of us are just not in tune with our body enough or unaware that these are cues of hunger.

So what to do if your hunger cues are not so loud?

Listen to your body more. Sudden drops of blood sugar (aka I’m fasting right now and feeling hungry) can manifest themselves in those above symptoms. Try to practice and learn to dissect your feelings rather then waiting for hunger pangs. This takes time and practice, but becoming in tune with yourself will come.

Eat more often. If you’re on the go, have some snacks (remember balance! Not just a piece of fruit here unless you really have no other option) and eat one if you are coming on 3-4 hours after a meal unless  you’re stuffed.

Get on a schedule. I know this seems like a weird tip considering I just said to listen to your body but hear me out. If you have lost your hunger cues then a schedule may be what it takes to regulate your feeding enough for it to start to signal you again. If you actually get hunger signals then by all means EAT but when you are still in the stages of trying to regain your bodies natural patterns, you may need to consider this.

Finally, you need to be patient. Your body isn’t an elastic band that can just return back to normal. If disordered eating (or another disease/illness) had mad those signals silent, give your body some time to come back around. It needs a lil wine’in and dine’in before it will show you some love back.

So think about it. Do you always feel hunger or do you eat sometimes because you know you should?

This is important for me to know especially now that my stomach may put up a fuss more often due to the caloric increases so frequently.

What would you do if you had a very long class but wasn’t allowed to eat. Do you think that is right?

-Chelsea