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anorexia & hypoglycemia

QUESTION: Hi my name is Liz. I am 31yrs old. About 20 months ago I had cosmetic surgery after which I started dieting because I wanted the perfect body. At that time I probably weighed about 110-115lbs. I frequently skipped meals and reduced my serving sizes, I cut out a lot of junk food, ate more vegetables, and exercised (cardio and weights) three times a week for three hours.

I was menstruating at the time of surgery, but stopped the following months at 110 lbs. I also started having estrogen deficiency symptoms and eventually rapid heart beat,fatigue, and high cortisol symptoms (although all my labwork is normal) The lowest my weight reached was 93 lbs.(a year ago)
I started eating regularly after that again because I want my health back and my hormones back to normal.

The problem is, when I started eating again I developed a severe case of reactive hypoglycemia. I have been watching what I eat (low carbs, no sugar, fruit, or white flour, etc.)and I quit smoking. With these changes, in the last 5 months I have gained 10 lbs. I am now 107 lbs.

My question is, is reactive hypoglycemia normal recovering from anorexia? Also, am I gaining to slowly? How much should I gain? In what period of time? When will my periods return?
ANSWER: Hi Liz, sounds like you're really trying to do the right thing (good for you!). I've been there, done that. I can promise you that it's possible.  AND there is a life outside of what we look like.  Oddly, once we get a handle on it, the body just does its thing - and does it perfectly.  I can eat whatever I want these days and never bother with a scale.

I guess the question I wonder about most is who diagnosed you with reactive hypoglycemia. Did you sit through a several hour long blood test in order to get the diagnosis or was it made via symptoms?

---------- FOLLOW-UP ----------

QUESTION: I have not been diagnosed with hypoglycemia but I already know I have it because when I eat starchy foods my heart races, I perspire, and have night sweats. I just wanted to know if this was normal with anorexia. I've been eating regularly for a year and I'm still not doing well. My body does not know what to do. Could I have ruined my metabolism?

Having been where you are (anorexic and also bulimic) I recognize the symptoms and for years insisted I was hypoglycemic - found a couple doctors to say so too. I think one of the difficult realizations was that I had to let go of that too. It was a comfortable diagnosis.
 This is from the QuackWatch.com page on hypoglycemia diagnoses and how terribly often it's used (inappropriately): " Real cases of hypoglycemia exist, but they are rare and should be carefully checked by laboratory testing before the diagnosis is made. The diagnosis should be reserved for patients who get symptoms two to four hours after eating, develop blood glucose levels below 45 mg per 100 ml whenever symptoms occur, and are immediately relieved of symptoms when blood sugar is raised. The glucose tolerance test is not reliable for evaluating most cases of suspected hypoglycemia. Low blood sugar levels without symptoms have no diagnostic significance because they occur commonly in normal individuals fed large amounts of sugar. The only way to reliably diagnose hypoglycemia is to prove that blood sugar is low whenever symptoms occur during the patient's usual living pattern."

 What I was really having was severe stress/anxiety (after all, I was eating!).  To this day, even though more than 5 years recovered since my last anorexic episode, I MUST have something 'sweet' after a meal that includes mostly carbs, especially pasta. To be honest with you, I don't know if it's just habit built in after many years (a lifetime!) of eating disorders, or if perhaps I'm now in the small percentage of people who actually have hypoglycemia - so I have something sweet - it goes away and that's it.

 Your metabolism WILL be fine - just don't waiver! Make sure you're eating the right things (whole grains, legumes, 'good' fats, fruits, protein).
 It sounds like you're doing very well - and having been there, I know it's not been easy.  

 I now spend a good deal of time exposing diet fraud, misconceptions, quack products and outlining how we can eat right and GUILT FREE (and not be fat).
 Life is so good when you can have a doughnut and not worry about it for days.

You can email me here or there anytime. I'll do what I can to stand by you as you recover - even if it's to tell you things you really don't want to hear.  You know?

God bless,

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