After struggling with restrictive eating for about 2 years, I lost about 35 pounds. My health deteriorated so much that I finally decided to seek professional help. I have started my treatment with a psychiatrist and a dietitian for a month. However, I find it very difficult to follow the food plan. For such a long time, I have avoided eating meat, consuming mainly vegetables and fruits and having only 2 -3 small meals a day. Now I am required to eat 3 meals with meat and drink 2 cans of Ensure a day by my dietitian. I tried to follow her instructions but I felt terribly bloated. I end up modifying my diet plan by eating only 2 meals (only 1 of them includes meat) and drink 2 cans of Ensure. I am quite disappointed with my behavior because I know that I need to gain back weight fast yet I cannot quite bring myself to eat so much. I am afraid that my cheating behavior will hamper my recovery. How can I prevent myself from cheating? Thanks. – Jacelyn
Dear Jacelyn,
Thanks for your question. The bloating feeling you get after eating something more solid like meat is a real phenomenon may people get when they are in a malnourished state. Many people who are underweight secondary to an eating disorder have delayed emptying of their stomach (gastroparesis). This slow emptying of stomachs in people who are underweight has been studied and documented, but the underlying cause of it has not been fully understood. A certain test called a “gastric emptying study” can be done to diagnose it. In this test, you swallow some special food and a series of x-rays are taken to see if your stomach empties properly. A medication called Metoclopramide that you take prior to meals has been used to help with this condition, which you can ask your doctor about. Aside from medication, eating smaller, more frequent meals (like 6 small meals every 3 hours) can also prevent the bloating feeling and help with the weight restoration process. If you have delayed gastric emptying, more solid foods like meat have more of a tendency to not pass through your stomach as easily as liquids. However, I think it is important to try to have some meat in your diet and that eating smaller more frequent meals and asking your doctor about medications such as metoclopramide can help. Consulting with a gastroenterologist to get the necessary test and medication could also be helpful. In summary, I do not believe you are intentionally “cheating”, but may be struggling with a real problem of delayed gastric emptying and there is help for that condition. I hope for the best in your recovery.
Tom Scales, MD