I’m 22 years old and have been battling with disordered eating for a while, primarily over-exercise and restrictive food intake (also very little fat in my diet). I have not had my period in about 5 months and my hair has thinned out, however I have gained about 5 pounds. I have been to doctors, nutritionists and counselors and they have helped although I’m so busy with college I really have no time/energy to devote to changing my bad habits. I continue to restrict my diet to about 800-1000 calories less than what I should be eating and also use a slew of diet pills. I find the biggest changes I’m seeing in my body are not on the scale but rather in my proportions. I find when I eat something like a salad or some crackers my stomach just balloons out and I look like I could be pregnant, even though my tummy is still very tight and hard. It is just bizarre because I know I’m technically a fairly lean girl but this happens nearly every time I eat and I find it really disgusts and frightens me. I used to have very flat tummy with [distinct] hip bones even when I was heavier than I am now, but now I dread eating even the most low calorie meals (that are on my “safe list”) merely because I despise the post-meal tummy bloat. I just want to know what this is and why is happens! Another thing I have noticed is that I am extremely veiny. Especially in my abdomen and my arms (even my upper arms) my veins are very visible and poke out. Also, I find that I bloat (not just tummy protrusion after eating, but water retension-type bloating) very easily (sometimes I find it almost hurts to smile because my face feels so puffy, or my rings will be loose one day and not fit the next). I am not sure if these symptoms are all connected, but I just want to understand what is going on with my body and maybe get some tips on how to stop this from happening. – anonymous
Dear anonymous,
Thank you for your question. The feeling of bloating that you are experiencing even after eating something light like a salad could potentially be a symptom of delayed gastric emptying, which is a common occurrence for persons who are underweight. When the stomach empties slowly, even the “lightest” food item can cause bloating. This problem is associated with being underweight and the actual hormonal underlying mechanism of it is not fully understood. There are certain medications which can help, but they can also cause side effects and should only be taken under the supervision of a physician. Reaching an ideal body weight and maintaining it will likely reverse the potential delayed gastric emptying, but I understand it is difficult to reach an ideal body weight with this particular problem. “Refeeding” (getting back to a normal weight) should definitely be done under the direct supervision of a nutritionist and physician and could consist of eating more frequent smaller meals. Medications may also help. If you are not already, I would highly recommend consulting with a physician, therapist, and nutritionist who specialize in eating disorders. See “Finding Treatment” for guidance.
Kindly,
Tom Scales, MD
Dear anonymous,
While Dr. Scales has helped explain the physical issues you are experiencing, I wanted to add a little response of my own to your question…
I hear in your words a lot of emotions: frustration, confusion, fear… in fact, the fear you are feeling about how your body is reacting and changing is probably making you even more cautious about your eating, which, in turn, is making your body more confused about how to process food, and is leading to increased physical ramifications of your disordered eating.
Might I suggest something radical? Consider for a moment what it would be like to actually be in charge of food, rather than it being in charge of you.
What if food wasn’t your greatest enemy? What you would think about if you didn’t constantly worry about “safe” foods, “off limits” foods, and the size of your tummy. What great dreams would you dream? What relationships might you invest more in? How might you invest your time, talent and energy in serving others if you weren’t so busy worrying about your body, your food, and your obsessions?
While I can appreciate your desire to understand the physical aspects of your eating disorder, your answers to questions like these are far more important.
Your body has stopped working properly because it is tired of the way you’re treating it. If you want to feel good – not just physically, but emotionally, relationally, intellectually, and spiritually, I encourage you to nourish yourself, body, mind and spirit, and experience a life that is free of self hatred, rigid rules, and food phobias.
This is the life God has for you…
Kindest regards,
Constance