One of the most common questions I get about my recovery is how I forced myself to gain the weight. Without a better answer, I usually just tell people I was in treatment and did not have a choice. With my treatment team watching my every move, I felt as though I had to gain the weight or there would be serious consequences.
If I am being honest here, the weight gain was the absolute worst part of my recovery. I hated every second of it. Gaining the 2-3 pounds per week prescribed by my treatment team was torturous at times. Each day after we finished dinner, I would have to sprawl out on the floor, lay there with my protruding belly, and pray I would not feel that full forever.
Without supervised meals and support from the other patients, I would not have been able to gain the weight. When I hear about people recovering and gaining weight on their own, I am blown away by the amount of courage and willpower that must take. Not only was the weight gain process scary, but the body also goes through some drastic changes that I was not expecting. If my treatment team had not been there to constantly remind me that these changes were normal, I would have easily fallen off the wagon.
First, after a long period of depletion and dehydration, the body begins to retain water. Some patients experience 7-20 pound weight gains within the first week alone, all of which is water weight. After the body realizes it will not be in dehydration mode any longer, it can then properly digest those liquids, relieving the initial bloat.
Before the true weight gain process begins, however, the body uses the first calories it receives to begin repairing the heart, skin, nails, kidneys, brain, ext. After the initial water weight shock, it is actually quite difficult for some patients to gain weight due to excess number of calories needed. Many patients believe that if they up their caloric intake to 1500-2000 then they will start to gain weight, but that isn't necessarily true.
The body goes into what is called hyperactive metabolic state, which means the metabolism works in overdrive around the clock. During this stage I remember having really bad night sweats (actually I was sweaty all the time ha) and I was always hungry no matter how much food I was forced to eat. Although I did not understand what was going on with my body at the time, both the sweating and the return of the appetite are both signs the metabolism is working again - which is a very good thing.
However, it is important to keep in mind that in order to actually gain weight, calories need to be quite high. In my experience, the closer I got to my goal weight, the harder it was to keep gaining. I had continuous calorie increases throughout the weight gain process.
Also, those trying to gain weight on their own go through a period where they experience 'extreme hunger.' No matter how many calories are consumed, thanks to the hyper-metabolic state, feelings of hunger are incredibly persistent. Patients are often unfamiliar with hunger pangs, which can lead to guilt, anxiety, and then binging. It is not uncommon for anorexia patients to go through a period of bulimia during recovery.
The worst part of the weight gain process for me was the uneven distribution of weight. When eating disorder patients begin gaining weight, it all goes to the stomach and face. We always joked about our 'pregnant bellies' in treatment; we all had these tiny little bodies with protruding bellies. With time and consistent eating habits, thankfully, the weight does redistribute more evenly.
Digestive problems are another huge complaint of those in the early stages of recovery. Without going into too much detail of my own digestive issues, let's just say things don't move very quickly - if you catch my drift. Patients experience significant intestinal discomfort and often do not regulate for weeks or even months.
A few other complications I have not mentioned are "refeeding" syndrome, sleep disturbances, nausea, zero energy, and an endless list of psychological disturbances. Again, it is difficult for me to fathom gaining this weight and going through all of these bodily changes without my treatment team. I cannot put into words the level of respect I have for those of you recovering on your own. Hopefully this list won't scare you away from weight gain, but help prepare you.
The good news is, this weight gain process does not last forever. I always reminded myself that if I could get through that phase, I knew I was strong enough to get through the rest of it. My thought processes and mental functions have improved immensely since reaching my maintenance weight. Eventually I began to see the number of positives that came along with the weight gain outweighed the negatives.
It's hard for me to believe that I have been at my goal weight for nine months now. Yes, I do struggle with body image some days, but I know that losing weight is simply not worth it because I would have to go through the dreaded weight gain process all over again.