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Hi Bret,
As the subject heading suggests,I have been recovering from anorexia for the past 16 months gaining around 20 pounds in that time.I am 22 years old and am 1.81 m tall with a current weight of 58 kilos, or 127 pounds. I am exercising intensively, around 3.5 hours a week using the elliptical and stationary bike, and am eating very healthily, ie lots of fruit and vegetables, whole grains and some protein, however i seem to be gaining weight mainly around my abs which i have also been exercising.I have maintained this exercise routine for a good year now but do not seem to understand why i am gaining weight around my stomach? Also another question if you could please answer for me, is what is the right amount of fruit we should be eating?I tend to consume a good kilo and a half of apples on a daily basis (this is the only sugary food i consume).

Thank you in advance,

Yours sincerely,


Hello Sanja,
I am glad to hear that you are post anorexia.  It is not an easy disorder to overcome, so you must have special strength inside you.  Many times when a body goes from a state of starvation to a state of nutritional rebuilding, as is the case when recovering from anorexia, the body will store some fat around the midsection.  But, some of the bulk around the belly is also the intestines.  When your intestines have not had much food in them, they tend to hold food when it then becomes available.  It is kind of a survival mechanism.  Our body absorbs nutrients through the wall of the intestines.  By holding the food, the body can absorb more nutrients.  

One other reason your abs may be getting bigger is due to the increase in the size of the muscles there.  You mentioned that you have been exercising the abdomen muscles.  Be careful not to exercise them to much or they will grow in size, thus making your stomach area look bigger.  I would not work your abdomen more than once or twice per week.  Any more and you risk building size.

Your diet sounds absolutely great!  I would add some healthy fat, but other than that it is excellent.  Your apple consumption is a bit high, and could be causing some stomach bloating.  Try increasing the variety of fruits that you eat.  I personally eat one or maybe two apples per day, but no more.  I also incorporate bananas, melon, kiwi, berries, and any other fruit that is in season.

You may have heard people say that fruit is bad for your blood sugar, or that it is high in sugar.  The sugar in fruit is not the same as regular table sugar, and the body treats them differently.  The key to eating fruits is to balance the meal with an equal portion of protein and include some healthy fat.  For example, an apple should not be eaten alone, but should be combined with an ounce of almonds.  The almonds provide protein and fat.

As for the right amount of fruit to be eating, I offer this advice; eat a fruit or vegetable at every meal, but combine it with a source of protein.  This will balance and stabilize your blood sugar.  Excessively high glucose - or blood sugar - can be a cause of abdominal fat storage.  The protein is also necessary for you to rebuild your muscle cells which were stripped during the anorexia.

One final piece of advice.  Give your body time to adjust to your new, healthy, nutritional program.  It takes months and years for the body to re-adjust.  You might find that in time the abdominal area starts to reduce down on its own.  You are much healthier now than you were just 16 months ago.  Keep going and don抰 look back!

If I can provide any additional information, or be of further service, please do not hesitate to ask.

Dr. Bret
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