All throughout high school, I weighed between 125 and 135 pounds (I am 5’4”). I started “dieting” when I was a sophomore and an initial innocent attempt to lose a few pounds turned into three years of yo-yo dieting and bingeing. The summer before leaving for college, I weighed 140 pounds. My bingeing had increased senior year due to a lot of anxiety I was feeling at leaving home, etc. College was a drastic change for me because I was in charge of my own grocery shopping, under a lot of stress, keeping really odd hours, and not exercising regularly (as I no longer played a sport like I had all during high school). My bingeing grew increasingly out of control (especially when paired with drinking) and I gained the infamous 15 to round out (no pun intended) at 155. Dissatisfied with my academic performance, my organizational skills, and my appearance, I came home that summer determined to make some changes. I started by curbing my bingeing, exercising regularly, and eating more healthy fare. By the time I came back for sophomore year, I was a lot more focused (academically and otherwise) and continued to lose weight. I steadily continued to lose a pound or two per week. I didn’t deprive myself (I would eat three meals a day and snack throughout the day as well) and I would exercise about 5-6 days a week, varying my activities. I spent my spring semester in a foreign country and anxiety over gaining the weight I had lost back actually led me to lose more weight. When I came home, I weighed *** pounds. I was concerned about my health so I went to see a nutritionist and a therapist as well. I was able to gain a few pounds, but I quickly lost them as soon as I returned to school due to the competitive and anxiety-inducing environment. By January of this year, I was down to *** pounds. Too busy with schoolwork to work on my weight, I continued to exercise and eat as I had been doing. It wasn’t until a few weeks before spring break that I realized that, despite the fact that I wasn’t depriving myself and wasn’t over-exercising, my weight was too low for my height. I was able to put on a few pounds (somewhere between 6-9) but am unsure if I should continue gaining weight. The only physical “problems” I have is that I tend to get cold easily and I haven’t had my period in a year and a half. The problem with using my period to gauge whether or not I should gain weight, however, is that I had irregular periods (at one point during high school I didn’t get my period for 9 months) ever since I first menstruated. I am currently seeing a nutritionist, and she wants me to gain a considerable amount of weight but I wanted to get a second opinion before doing so. Any advice would be greatly appreciated. Thank you! – S.
Dear S.,
Thank you for sharing your history with us. So many girls and women can relate to your story, and we appreciate the opportunity to respond to your concerns. I’m going to address mainly the physical issues you have raised in your letter.
Based on the information you provided, I will start out by saying that I agree with your nutritionist that you are still underweight at this point. Your amenorrhea (lack of periods) and tendency to get cold easily are classic symptoms of a too-thin body. I know you say that you’ve always had irregular periods, but this is most likely related to your restricted eating throughout the years. When girls first begin menstruating, it is common to have irregular periods for the first few years, but you have reached an age at which you should be having periods more regularly. If you haven’t been evaluated by a doctor or nurse practitioner in a while, I would recommend that you do so, just to rule out any medical issues.
Your nutritionist has done a full assessment of you and has analyzed the types and amounts of foods you are eating. If your body is not well nourished, there are detrimental effects that you can’t necessarily detect at this point. One of the major areas of concern is your bone health; you are still at a critical age for laying down calcium deposits to ward off osteoporosis in the future. Also, with inadequate food intake, your immune system is compromised and muscles are weakened, in addition to other problems. You will feel stronger and more energized when you consistently start eating well again.
Your nutritionist is looking out for your long-term health, as well as more immediate concerns. I want to reassure you that she will guide you to a point of reaching a healthy weight; she will not recommend a plan that is unhealthy for you.
Lastly, in your letter you made the comment a couple of times that you lost weight even though you weren’t “depriving” yourself or “over exercising.” This is also something you should be exploring further with your nutritionist. After years of restricted eating, you may have temporarily lost sensitivity to your body’s internal hunger and fullness cues. With professional guidance, rediscovering them will help you learn to trust your body once again to guide you in providing the fuel it needs.
Please continue to see a therapist in addition to your nutritionist. She will help you get at the core of your eating and weight issues. I know that you are very busy with school, but your physical health and emotional well being need to be a priority, so be consistent in seeking and following professional advice.
Take care,
Ann