In anorexia you must gain weight to get healthy. I had anorexia at age 24. With help from my fantastic family and hospitals, I completely recovered and got back to a healthy weight. I then faced a relationship breakup and relapsed completely at 27. I bounced back and gained a bit of weight, but maintained, drifting, underweight in “pseudo-quasi-recovery” for two years, happily eating whatever I wanted and exercising but in denial and thinking I could stay very underweight with no consequences to my health. My wake up call came three years after my initial diagnosis when a routine DEXA bone scan identified that my bones were “Osteopenic” which is the stage before Osteoporosis. My bones were rapidly demineralising. My result was the medical evidence that got to the “bones of anorexia” and made me realise I had to accept that I either gained weight, from BMI 16 to BMI 20, or I would be an runner who wouldn’t be able to run. I either gained weight or would face a future of bone fractures, constant back and spine and leg pain and unable to run, jump or ski without breaking a bone. In no way did I want to gain weight. In no way did I CHOSE to gain weight. In no way did I ENJOY gaining weight (gaining weight was depressing, made me feel incredibly depressed. I felt guilty, glutenous and unworthy). I spent months hating myself. In a world where everyone is praised for losing weight I felt like I was failing. I didn’t want to gain weight. At the end of the day I gained weight for no other reason then because I HAD TO to have HEALTHY BONES. That is the bones of it.
I am, and have always been an athlete. Sport for me has always been completely separate to my eating disorder. It helps me to feel JOY. Moving sets my mind free. It gets me outside and helps me to feel more positive and have sun on my face and pleasurable pain killing neurohormones Endorphins in my brain, making me feel happier and able to conquer anything. My anorexia started as a result of many things, but my love of exercise was never part of it. It was STOPPING running after a marathon that started my anorexia as I found it hard to control my food after eating so much for the marathon. In anorexia, my body fat got too low (I was too fit and too lean) and so I stopped menstruating. Without a period, my bones demineralised as the hormone Oestrogen from menstruation is needed to stimulate bone formation. It acts on both Osteoblasts and Osteoclasts to stimulate bone growth and remodelling. To be me, I need to be active and busy, and having osteoporosis, with bones that fracture easily and unable to run or jump, ski or ice skate or dance, would stop me being me. The only way to get back your Oestrogen, is to gain weight. Sometimes doctors prescribe the pill for those with eating disorders, but all this does is mask the natural period (it induces a period) and gives you a false sense of security but does not include the IGF-1 growth factor that is needed to support bone growth. Either you gain weight and have enough body fat to make Oestrogen or you are slowly demineralising your bones. Taking HRT (hormone replacement therapy) is no fix as it is linked to breast cancer. There is no “magic pill” for this. Even if you have osteoporosis or osteopenia being at a healthy weight can slow demineralisation and reverse some of the consequences. Being overweight and obese also causes fluctuations in Oestrogen and damages bones and joints and so get healthy and then stay healthy. Gain and then maintain or drain em bones.
Oestrogen is needed for more than just bones. It is needed for libido, for fertility, to make the collagen in your skin and to help control your Serotonin (the mood stabiliser in your brain). Too high or low Oestrogen (as many menopausal women will tell you as Oestrogen levels go down in menopause), leads to mood swings (it is fluctuations in oestrogen that causes the mood swings when you are on your period). Low Oestrogen also increases blood cholesterol levels. Without Oestrogen, young girls, teenagers and adult pre-menopausal women, are effectively castrating themselves, depriving themselves of youthful aging skin, denying their joints essential collagen, increasing their risk of heart disease and affecting their mood. Being overweight and obese also affects Oestrogen. Only at a healthy weight can hormone levels work effectively.
The same goes for men. Too low a body weight, or too much muscle and not enough fat (aka bodybuilder “doing weights” look with a high muscle mass but low body fat percentage) can result in reduced testosterone, reducing libido (sex drive) and causing impotence and infertility. Lower testosterone also impacts bone density and can cause hair loss and balding. The big guy with the “perfect body” who you envy at the gym, probably struggles sexually and faces a future unable to run. This is about future proofing your life, the longevity game. Health is for life, not just for a season. Life is a marathon, not a sprint and to run a marathon, you need strong bones.
The hard thing is that then, once at a healthy weight, you must stay at a healthy weight as after demineralising your bones, increased weight and a sedentary lifestyle demineralises bones further. Obesity causes osteoarthritis damaging bones and joints and a lifestyle with no exercise or vegetables strips bones too. Weight bearing exercise (walking, jumping, running) and a diet rich in calcium and vitamin D (found in fruit and vegetables), strengthens bones. You must get healthy and then live a healthy lifestyle to stay healthy! That is the bones of it.
Eating disorders? Get to a healthy weight. That is the bones of it.
Copyright Laura Campbell 21/11/2020