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Anorexia nervosa is characterized by low body weight and body image distortion with an obsessive fear of gaining weight. Individuals with anorexia often control body weight by voluntary starvation, purging, vomiting, excessive exercise, or other weigh control measures, such as diet pills or diuretic drugs. It often primarily affects young adolescent... more

Bulimia Nervosa is a psychological condition in which the subject engages in recurrent binge eating followed by intentional purging. This purging is done in order to compensate for the excessive intake of the food and to prevent weight gain. Purging typically takes the form of vomiting; inappropriate use of laxatives... more

Binge Eating Disorder (BED) is currently listed under Eating Disorder Not Otherwise Specified in the DSM-IV-TR.  In binge eating disorder, the person does not regularly engage in compensatory behaviors, such as, vomiting, fasting or doing strenuous exercise after binge eating.  Another eating disorder category under Eating Disorder NOS meets all the criteria for Bulimia except that binge eating and compensatory behaviors are less than two times per week or for less than three months.   Often, people with Binge Eating Disorder are overweight or obese.. more

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Ask Dr. Pitts

I am currently recovering from severe anorexia, my BMI is 17.5 up from around 13, nine months ago.  I have been eating regular meals following the advice of a dietician and have had consistent weight gain.  For the past four months however I have been constantly hungry, no matter how much or what I eat I cannot feel satiated.  I am hungry all the time.  I can eat and eat until I feel physically sick but still I feel hungry.  I have no history of bulima or binging but am terrified of this happening.  I have to take sleeping pills at night because I can't bear the hunger pains.  Will they ever go?  What happens if they don't, surely I will become overweight? Please help.
Posted on November 11, 2008 2:32 PM in Continuity of Care, Eating Disorder - Outpatient Counseling, Mind Body and Soul Integration, Nutritional Rehabilitation and Psychological Growth, Therapeutic - Physical Wellness, Therapeutic - Psychological Wellness

Answer

You are doing fabulous!  To start at a BMI of 13 and gradually gain weight to a BMI of 17.5, you have been courageously honoring the needs of you body.  The hunger pains are your ability to listen to the physical needs of your body.  The experience of not being satiated is your body telling you it is still malnourished and you need to continue to a more stable BMI.  The research shows that reaching a BMI of 20 is the best likelihood of successfully moving on from anorexia. 

Speak with your registered dietitian regarding your lack of physical satiation.  Sometimes small meals given through out the day, increase of the amount of food daily, foods with protein or fats can support the physical hunger. 

Emotional hunger can sometimes be mistaken for physical hunger.  If you are not working with a psychotherapist, I would recommend you do so to support your continued recovery.

Best,

Dr Patricia Pitts


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