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i don't know if this is triggery or not, so use caution please...

ok so for the last year we've really been struggling with the food thing again.

it starts out with not wanting to eat because we feel sick (med related - damned effexor). the weight starts to fall off and we don't even notice it. then clothes don't fit anymore, and we notice. then some of us (we're a multiple system) will decide that if it was that easy to lose a few pounds, then why not more? eventually we get to the point where we're weak, malnourished, and look like we "need a sandwich" (which is what our sister says when we get too skinny).

but by then, we're addicted to the starving. it's like a high when you don't eat for a long time.

during the initial phase of the "starving" process, what we DO eat is generally unhealthy. lots and lots of sugar. go all day without eating and then eat 4 cookies at nine o'clock, that kind of thing. coffee becomes absolutely essential for energy.

then after the real die-hard members of our system take over, the sugary crap starts to get chucked in the trash. too many calories, they say. so instead of cookies, we end up eating lo-cal yogurt or ice cream, oatmeal, bananas, and occasionally a little pasta all the time. still not enough vitamins. still not enough FOOD - not enough and not in a timely fashion.

we've pretty much convinced the whole system to work on this (now that they've come to their goal of 19 BMI, of course - sigh). we aren't technically underweight, but sitting right on the fence. so the compromise is to STAY at this weight, and nobody gets to pig out on nachos... but nobody's allowed to restrict a reasonable calorie intake, either.

problem is, we don't know how to do this. we only seem to know how to gain or lose, but not stay the same.

whew all that was hard to write. we don't admit this is a problem to anyone. we generally don't like to discuss food or body size. but our health, mentally and physically, is really suffering now. this stomach no longer accepts portions larger than a banana ;) not to mention constantly being tired and weak. and unable to think clearly.

if anyone has gone through this and come out the other side, can you please talk about it a little? about what you did to relearn to eat properly, without abusing food in any way (too much or too little - we have bingers in here too, they just aren't active right now). what helped you emotionally? what helped you with the addictiveness of an ED? what helped you to WANT to eat again? sometimes we actually cry when faced with having to eat something, because it all feels bad now unless it's chocolate :/

titrating lamictal isn't helping (insert queasy face here). also tapering effexor, so maybe we can have an appetite again.

thanks in advance if anyone has any wise words or inspiration :)

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I'm not sure if I'm particularly wise in this area, but I do have problems with binging significant enough to be on minor medication just for that, and a tendency to get addicted to self-starvation as soon as something gets me started. (I am not a multiple, though.)

The most effective way I've found to maintain a particular weight has been to sit down and calculate caloric intake, which can be dangerous for my starvation-equals-purity side. Nonetheless, it makes sense. The relationship between calories and body weight is less magical than most would think. Any given weight requires a certain number of calories ingested to maintain it -- the calories needed to sustain your daily activities plus your body's basic functions (the heart is indeed a muscle, and it's working all the time). Too much more than this, and the result is weight gain. Too little, and weight loss ensues, sometimes at a dangerous rate. It can be difficult for me to accurately assess my activity level, as my self-starving mindset can lead to to choose too low a category when subjectively deciding where I fit (a subtle hint is that walking 5-12 miles per day is not "sedentary"), but if I've done that correctly I will get a good ballpark figure. It can be tweaked if my weight continues to fluctuate.

The next step is to figure out what that number of calories looks like in terms of actual food. My self-starving side often invents fancifully large caloric labels for relatively low-caloric-density foods, like an apple having 250 calories. (Nope, more like 80. And I know it.) Getting a basic idea of what my abstract daily number looks like in actual, physical food makes it easier for me to get myself to eat that amount of food.

If I'm on the high end, I cut out junk food and make a concerted effort to avoid binge trigger foods. If I'm on the low end, I try to eat more, but if that's too complicated to happen I make up the difference with high-calorie nutritional meal-replacement shakes, in the line of Boost or Ensure rather than Slimfast.

I hope that helps a little.

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