Calories Needed for Recovery From Binge-Purge Type Anorexia

By August 24, 2012

Currently I’m a 19 year old female, 5’6″ and ***lbs. I’ve been struggling with an eating disorder that has consisted of restriction to about 700cals per day with a few days per week that I’d binge and purge sweets in the late evening. This would only occur once on these days and was typically triggered by high stress situations.   Since returning home from college, I have successfully brought my caloric intake to 1000-1200cals per day and had stopped bingeing and purging for 2 weeks. While home from school, I am not exercising so it has been very hard to resist the feelings of being fat and gluttonous. I relapsed the past 2 days but was determined to stop this behavior today and have resisted the urges despite my binge (I’m currently seeking out therapy at an ED clinic). I took in 2300 calories today and was experiencing much anxiety about this; however I’m also extremely pleased in myself that I hadn’t done anything destructive. I want to stop this and bring my weight up to around [a healthier number] however I’m absolutely clueless as to how many calories I should increase to.   I’m deathly afraid of gaining oddly distributed fat that usually results from rapid weight gain after an ED. With this said, around how many calories should I be taking in per day in order to comfortably gain about a pound per week? I want to gain slowly so that it stays on and I don’t freak out and regress to old habits. Thank you so much for making yourselves available like this. – DP

Editors Note: I inadvertently forwarded your question to 2 of our panelists. As both of them had very helpful responses, however, I thought it best to include both of their perspectives for you here.

Dear DP:

You have made some huge positive strides toward getting better–recognizing your disordered eating along with a determination to change. Your decision to seek therapy in a clinic that specializes in eating disorders is crucial. If you haven’t started seeing someone yet, that should be your highest priority; this is not something simple that you can “fix” on your own. The clinic can also refer you to a registered dietitian, who will help you work through all of your nutrition questions.

Without meeting you in person and doing a full assessment, I can only provide you with some general information. First of all, you don’t have to worry about gaining “oddly distributed fat.” What you may be referring to, however, is what is called “rebound edema.” After a person severely restricts calories, when they start eating again they may experience a temporary phase in which the body holds onto more fluid than it needs. This will resolve in time as you start to establish normal eating behaviors again. So, if you feel somewhat bloated and have noticed a very quick weight gain at this point, it is just water. A gradual increase in total calories and including a lean protein source with carbohydrates at your meals tends to lessen the fluid gain.

I hesitate to prescribe a specific calorie level for you at this time; that is something your registered dietitian can do after fully assessing you. It seems to me, however, that you are on the right track. You gradually increased to one calorie level, and then bumped it up some more. Your dietitian can help guide you more specifically, and decide if you need more than that.

It’s also good for the body once in a while to take a couple of weeks off from exercise, in order to repair all the little tiny injuries and muscle tears. You WILL get back into your routine–with a rested and renewed body. This will not have a significant impact on your body weight, so don’t worry.

A professional will help you take your focus off of calories and weight, and onto healthy eating practices. It is important to start eating three wholesome, balanced meals a day, with healthy snacks in between as needed. In time, you will reestablish normal hunger and fullness signals, and learn to trust your body to eat the right amount for your body type, metabolism and activity level. The freedom and contentment you will experience will be well worth the effort, so stay determined to get better!


Dear DP:

Changing food behavior (as in increasing calories to a healthy level versus severe restriction) demands that one be ready psychologically. Go gently.

Seeking professional help was good thinking on your part. The eating disorder program may connect you with a therapist and/or dietitian for monitoring. They will provide input but you will be in the driver’s seat. You are in charge of learning from your choices.

Understand that dieting, calorie restriction, excessive exercise, binge/purge behaviors, are inappropriate tools. They will trick you in to believing you need them (the behaviors) in order to be “o.k.”. Relying on them will set up an automatic failure complex (I end up doing what I do not want to do), will cause poor nutrition, stop your emotional growth and development and can ignite the flame of self hatred.

To maintain a healthy, proper weight and an optimum energy level you must listen to your body. Do not work at creating another food plan, another revised format for eating, or a “safe” list of foods. Instead, learn how to eat when your body tells you it is hungry. Eat what your body wants and stop when you are full.

You do not have to be afraid of your body. Your body will not betray you and blow up overnight. It was created with an internal process that has worked since the day you took your first breath. Spend less energy attempting to master and control your body’s appearance and learn how to listen to what it needs from you.

I am refusing to write a specific calorie amount for you because I do not believe another “rule” in the Book of Life eating disordered persons subscribe to is what you need. You must stop beating your body in to submission and reach out to it in gentle love.

Stay with the clinic. Do more of what you are doing that has allowed you two weeks of freedom. Do not ever give up. You will be free from the anxiety. You will learn how to handle the inner voice that demands obedience to laws that strip you of free choice. You will recognize that you were created for more then numbers on a scale. You will free your soul from the confines of thinness. And you will live.

Courage to you brave one,