I am currently recovering from severe anorexia, my
Posted on November 11, 2008 2:32 PM in Therapeutic - Physical Wellness

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.

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

Tags: anorexia nervosa, hunger pains, normal BMI, anorexia, Los Angeles eating disorder treatment, weight loss, Dr. Patricia Pitts, eating disorders, The Bella Vita

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I realize that bulimia, like many other eating dis
Posted on November 11, 2008 2:03 PM in Therapeutic - Physical Wellness

I realize that bulimia, like many other eating disorders and addictions is a way of thinking and reacting - and for me it becomes a pattern that I feel has more to do with my brain functioning, (triggers) than anything else.  When I am not in the pattern of binging and purging I am fine, and don't think about it. But as soon as I start doing it again, it is extremely difficult to break.  Because food is a part of life and something we must be healthy about in order to survive and function properly, I need to start having a better relationship with eating and food.  But first I want to break the pattern of binging and purging.  I want to stop the urge.  Do you have any suggestions as what I can do when I feel I want to eat and then throw up? Any good distractions or ways of thinking?  I feel its like a drug, and once the brain gets the idea that it wants to binge and then purge, food becomes my heroine, and the urge is almost impossible to resist.  Any help would be much appreciated!!   Many thanks...

Answer

There is compelling research that shows both the binge and the purge is associated with low serotonin.  In addition, individuals taking serotonin-boosting medications, i.e., prozac decreased their carbohydrate cravings.  Also, in support of your experience that “food becomes my heroine”, some researchers believe that once the binge-purge cycle is established, drug-like behavior with serotonin 5HT receptors perpetuates this behavior.  Ask your doctor about serotonin re-uptake medications to support breaking the cycle bio-chemically.

In addition, you are on to the right idea by finding ways to not go to the binge-purge behavior.  There are many great distractions and change of thinking to help break the cycle.  The following are a few:  1) practice thought-stopping by seeing a stop sign in your mind’s eyes when you catch your mind racing or going to unhealthy thinking; 2) journal your feelings and thoughts; 3) move by taking a walk; 4)  leave the triggering environment; 5) talk to someone; 6)  breathe – practice being in the moment; 7)  focus on a craft project; 8) have a puzzle you are doing ongoing; 9) focus on making a card or gift for someone else; 10) do the opposite behavior to evoke an opposite emotion, e.g., if sad, watch a comedy and 11) do something with you hands, e.g., knitting or hook rug.

With Joy,

Dr Patricia Pitts

Tags: food cravings, medication for bulimia, binge, eating disorders and depression, Treatment for Bulimia, Los Angeles Eating Disorders, Dr. Patricia Pitts, The Bella Vita, purge

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