Monday, September 9, 2013

I’ve Gained Weight. Now What Am I Gonna Do?

Perspectives for those with bulimia, anorexia and those with no eating disorders at all.

"How much weight have I gained since we started working together?", “I want to know." That was the pressing question.

Ellie has been seeing me for several years, for periods at a time. She presented with severe bulimia, purging 3 times per day, every day, after each of the three times per day she allowed herself to eat. Back then, eating and keeping food in was simply not an option. Over time, her purge frequency decreased and she normalized her food intake, ultimately giving up her bulimia. 

Beyond her initial and modest weight increase, her weight has remained stable within a 2-3 pound range over the past many years. And that initial increase can be attributed to two things—no longer living in a dehydrated state and better nourishment.

To me, the better question for Ellie to ask would have been " how much better off am I since I’ve changed my eating?" In spite of the modest weight increase that she had no interest in, what did Ellie get in return?

When confronted with this question, she appropriately retreats from her disordered thoughts which periodically reemerge and readily acknowledges just how far she has come, how much better she feels. She remembers that there's no way she could've taken care of her newborn grandchildren in the state she was in then, or be trusted driving back and forth to their home. No, the price she paid, the few pounds gained, is nothing given what she's getting in return.

Gaining weight is rarely seen as a positive in our culture. Advertisements fail to praise us for outgrowing our jeans.

But for some, that is exactly what needs to happen. Staying at the weight you were at when you were 12  is hardly appropriate when you are 16, 20, or 40 years old. And even if your weight is objectively 'within the normal range' for the population, it may not be in range for you. It drives me crazy when doctors tell their patients that their weight—a  weight that has never been maintainable without an eating disorder because it's too low—is fine, because they are basing it on the charts for populations. Why the double standard? Because if you've always been a healthy larger size and you've lost weight through unhealthy measures, that 'normal range weight' may be anything but normal. Perhaps given your build, your genetics, your muscle mass, your history of athleticism, your body needs to be at a higher-than-average weight. And fighting it to be at a place you've never been will only contribute to unhealthy ways of eating and thinking. For your mental and physical well-being, weight gain may be just what's needed.

Gaining weight without an eating disorder?

Not long ago—a couple of months, maybe—I noticed that snugness around the middle. No, my jeans hadn't just been dried at high heat for too long. And really it was not in my head. Everything was fitting a bit too tightly. (Yes, even the bras.) Not one to weigh myself with any regularity, I suddenly jumped on the scale. I felt the need to reality check, to verify what I was feeling.

Yup. My weight was up.

Save your rush to judgement, please--it has nothing to do with the cupcakes, the chocolates and my homemade, full fat lavendar ice cream. Ok, let me clarify. No "I told you so's" necessary, because I ate all those foods before. But over the months of summer, the balance wasn't perfect, and so my weight crept up. 

Could it be that I was super active through the end of June, training for my fundraising ride, only to reduce my activity precipitously with the heat wave and awful humidity? Perhaps. Could it be that I've been socializing more, sipping on wine with dinner more nights than previously. Perhaps.  Could I have possibly joined my husband for an after dinner snack—just because it looked good and I thought I'd keep him company—more often than I really needed from a nourishment standpoint? Likely. Like you, I'm not perfect.

But the bigger question is what to do about it. If you were me, would you:

  1. exercise a couple of hours each day to make up for the previous reduction in activity?
  2. reduce your food intake to compensate for the extra calories consumed?
  3. seek the guidance of a Registered Dietitian?

Ok. So I'm the RD so  I'd better come up with a fix.

But if you don't fall into the categories described above--those truly needing to gain weight, or those who've gained appropriately as a result of releasing yourself from disordered behaviors--and you find you've gained some unnecessary weight, here's what I'd suggest. Intuitively, it may seem appropriate to make up for any overeating in the days or weeks which follow. But don't do it! Instead, refocus. Get back to the basics, particularly if you've found yourself slipping into old patterns. Have you forgotten the basics? For starters,

Sit. No eating as you walk around the kitchen emptying the dishwasher. No eating standing at the fridge. And no, don't sit at the fridge; seat yourself at a kitchen or dining room table.
Separate. Eating and distractions,  (other than your family which you can't get rid of) should be separate activities. TV watching, texting, reading--these should be separate from eating. (Unless, I'll add, you are struggling to get food in and find that being less mindful is actually helpful--which it often is!)
Eat with your senses. Are you seeing your food and acknowledging what you're eating? Are you experiencing the textures of what you're eating? Are you tasting your food? Doing so will allow you to slow the pace and to feel more satisfied with what you're eating. You'll enjoy the food so much more!
Choose what you enjoy. Are you giving yourself permission to eat what you like, or holding on to rules about what's allowed vs forbidden, in your mind?
Tune in to  your hunger. Don't wait  until you are at the extremes of hunger--if you're starving you are more likely to struggle to eat as described above, and overeat.
Re-explore fullness. Are you eating until you are stuffed? Might a modest adjustment in portions be appropriate? That said, if you start with smaller portions, do give yourself permission to eat again later--after about an hour--regardless of what you you ate before.
Don't panic! And don't take radical steps to 'fix' the problem. Restrictive eating, denying your body's signals and needs, does nothing positive in the long run. It will only perpetuate an unhealthy cycle and make you feel like c!*P!
Breathe. It won't take long to get yourself back on track. But be realistic--if your eating was off course for some time it will certainly take some time for you to be back to your former, healthy self. Radical dietary changes can have radically negative consequences, so do be patient and appreciate the modest improvements as they happen.


  1. I think I needed to read that. I have such a hard time right now mentally with the weight I gained after increasing my calories and changing my workout to "repair" my metabolism. I worked with a trainer and had this eating plan and well. I feel disgusting. I am eating more and I am determined not to drop calories again, but I look at my photos of when all my clothes looked amazing and now all those clothes don't look that amazing on me anymore. It sucks. But I really liked your list at the end. I will Breathe and continue to do what I do and hopefully the fluff that crept on will go away again. It's tough when you know for a fact that you didn't gain the weight doing any snacking, eating out, partying or drinking or what not but when you were following a rather strict eating plan consitent of cottage cheese and greek yogurt, steamed fish and veg and oats and such, it's just mind numbingly painful.

    1. IN MUCH ACCORD with Lifting What's commentary....I too was instructed to, and I duly implemented my ED' teams program of dietary increase/exercise decrease to "repair" my metabolism...Eating a healthy..normally proportioned meal ...with no over-eating...alcohol consumption...just eating "normally" as I had prior to anorexia...left me with a new "numbingly painful"...well-said by the way...increase of 30 kilos to my hospital a short seven-month period!!!...I was shocked, stunned, horrified.

      To make matters worse...when I went for my annual pap-test, the nurse in the gynecologist's office (who was aware of my anorexia)...weighed me...and felt somehow "obliged" to exclaim.."My!....Is it possible you gained over 30 kilos since we last saw you...not even one year ago?!"....This comment, I am sorry to admit...sent me tailspinning right back to restriction and anorexia....

      So perplexing...Every body is different....but my own body's "confidence" or "trust" in me actually eating on a regular basis...seemed to NOT be yet "established" metabolism simply never "kicked in"....I was so proud of not trying to "compensate" through more restriction...over-exercise....laxative abuse....nor was I hyperphagique....I really, really tried. "Mind-numbingly painful"....THIS.....most definitely this.

  2. Thank you so much for this post. I have been at a healthy weight for several months after recovering from anorexia, but lately I have put on some extra weight around my stomach. I was so tempted to restrict and try to lose the weight quickly and I felt so gross and lazy. But this post made me realize it’s not a big deal to have some minor weight fluctuations and that if I continue to eat intuitively and make time to exercise regularly (a healthy, moderate amount) that my weight will settle at a healthy point.

  3. I slip right into the "I'm not eating and I'm going to work out like crazy" mindset. I mean, I guess I don't eat enough and "work out too much" as it is, but the second I feel like I've gained an ounce, or I see it on a scale, I go right into restriction mode. Not the best thing I guess, but it's what I do. I'm sort of there right now. I feel like I'm 46 months pregnant and I see fat rolls so I freak out and am like "I'm never eating again." It's not fun.

  4. You ask what I gained by gaining weight? I gained my life back complete with a husband I can be fully present with, a job that I actually have the energy to succeed at and enjoy, friends that I can enjoy spending time with because I'm not preoccupied with food and just the ability to truly enjoy all life has to offer. Initially I wasn't happy about the weight gain but now I feel like it was a very very small price to pay for everything I have received in return.

  5. I many not agree with everything you write (re: Yoni's blog), but have to say you provide some interesting points of view!

    1. We can certainly agree to disagree!
      Thanks for reading and commenting.