When anorexic BMI- I never skipped meals. I ate well and lived well and this kept me thin.
When you have had a history of anorexia, people often treat you differently and make assumptions. My ex-boyfriend's mum did a dinner once and served everyone a creamy fish pie and made me a salad, and my aunt (who is a doctor, GPs are the worst as they think they know everything), served up Easter lunch one year and portioned us plates with mine with half the food of everyone else's. Yet I never skipped meals. I ate lots of whatever I wanted. My anorexic BMI was maintained by the perfect healthy diet and lifestyle. Just not perfect for me as I needed to gain weight to be healthy.
When I first got anorexia at 24 it was a result of overtraining for a marathon and getting Athlete's Triad. This is when you get too much muscle and not enough body fat. Hormones like Oestrogen (the sex hormone, mood stabiliser and bone protecting chemical) and Serotonin (the happiness brain chemical) are made of fat and so I stopped producing them. This led to me getting anxious and low and eating less as my anxiety stole my appetite for food and life. The flight and fight anxiety stress mechanism slows gastric motility so you feel less hungry and naturally eat less. This also happens in grief or trauma. You are not being shallow in anorexia, you lose your appetite as a result of deep emotions.
Then in recovery, I rebelled against everyone telling me to eat junk food as it became a punishment. Just like when overweight and being forced to eat salads and told to exercise, when underweight and being forced to eat biscuits and rich creamy foods and not exercise, it makes fattening food far less palatable and exercise far more enticing. Salads became treats as I was not allowed them. However, this all changed when I decided to gain weight to improve my bone strength (at low BMI you don’t produce enough Oestrogen to support bone formation and be fertile) and to one day become a mum. I decided, like the science nerd I am, to “research my way out of it,” and I recorded all I was eating and what I enjoyed and did not, and I learnt about neuroscience and nutrition and why we eat and what to eat. I ate for health and pleasure, sybritically discovering food flavours and becoming a bit of a gourmet cook.
My nutrition educations developed into what I see now as some form of Orthorexia, fixedly obsessed with eating healthy. I learnt all about the role of the gut microbiota and prebiotics and probiotics and about the role of omega-3 and all the micronutrients and micronutrients we need for health. I learnt about the role of stress on appetite and became a yoga teacher and learned mindfulness and stress-resilient techniques. I learnt about CBT and how thoughts are not facts and I learned to unwind the emotions from food. I was put on a meal plan by doctors (who assumed I was not eating) which included three meals a day with protein, carbs, vegetables and fats in each meal, and advised to have a greek or natural yoghurt with every meal. I followed this advice and ate what I was told to. I learnt the value of sleep from Matthew Walker’s book “Why we sleep” and I learned to make it a priority and so got around 8 hours of sleep a night. Sleep decreases appetite by improving blood sugar regulation. You are also more likely to binge eat when tired.
My anorexia partly stemmed from a deep morality around hunger and wanting to help prevent it. It never made sense to me that so many people are hungry and yet 1/3 of the world’s food is wasted. I used to work at an office complex called “WeWork” where they provided office perks like free sandwiches and fruit where so much went to waste, and it used to break my heart as I would read in the news about refugee crisis’s, worked in foodbanks where children were starving and I would see homeless people on my way to work every day. I would see in my own community and family, food wasted every day, with the main thing wasted being vegetables. My brother would buy big packets of salad and chuck it away if it was one second over its sell-by date out of fear of salmonella, despite the food being ripe and delicious still and very much edible. I would eat the food to stop it from being wasted. This meant I would eat a lot of vitamin C, omega-3 and magnesium-containing vegetables. Magnesium increases energy.
I was also advised to eat a lot of fat by doctors to gain weight. One doctor said “just eat a lot of nuts” and so I ate jars of peanut butter, chia seeds (high in protein and omega-3) and lots of high-fat foods like fatty fish (lots of Omega-3) and beef, which is also high in iron and B12. B12 increases energy. Omega-3 fats help reduce omega-6 fats (the so called “bad fats” like trans fats) in your diet and also help you absorb fat-soluble vitamins and minerals so my immune system was strong and I was never ill (illness increases appetite).
Every day I drank a litre of almond milk as it has two times the calcium of milk and I was trying to protect my bones and get as much Calcium as possible to strengthen my bones. The milk was also fortified by B9 and B12 which increased my BMR, basal metabolic rate. My bran flakes cereal was also fortified by B12, iron, B6, B2, B1 and B3, all of which increase energy. I was also eating lots of natural yoghurt which is probiotic, and lots of prebiotic vegetable fibre, both of which feed the gut microbiota, which in turn makes more Serotonin and so I felt happier and had no need to turn to food for comfort. Happiness decreases appetite as your brain releases Adrenaline hormone, like with anxiety, so you get hyper and full of energy.
I have also always naturally been a very fidgety and active person who can’t sit still for five minutes. I had a car crash which made me scared of driving and the London public transport prices went up, so I cycled and walked everywhere. I became a part time-science writer whilst I studied neuroscience and nutrition and a self-employed science tutor and would cycle or walk from each students' house. This kept me very active. I also lived on the top floor of a long thin house (everyone in my family is tall and slim and our house is the same) and had to walk up and down the multiple stairs every day. Even going to the bathroom was a mini-workout. I didn't mean to be active, it just happened and it kept me happy. My best friend is a Zumba teacher and I teach yoga. I went to her classes to support her and see my friends and did yoga to reduce stress and earn money. My family are also very outdoorsy and active and we go on lots of family walks and runs and go surfing together. It was very easy to stay fit in my environment. This increased my basal metabolic rate and gave me more energy to be active and so burnt off whatever I consumed quickly. I could eat anything and not gain weight. I was also young and when you are young you naturally have a faster BMR. As you age your BMR decreases.
Every student I went to would offer me a cup of tea, and as I cut out caffeine based on my strong desire to get lots of sleep, and wanted to protect my teeth from decay after a filling, I opted for herbal teas. This meant I drank a lot of hot water, which increased my energy further and also filled me up. I didn't mean to do this, it just was offered and was a nice treat. When teaching you also talk a lot and get a try mouth, so the fluids were necessary.
My mother also was put on a high fibre diet by doctors, and because of London house prices which priced me out of the market (despite a successful job and good salary) I lived at home and ate the food she ate. The Covid pandemic increased this by making every meal at home. I had the perfect diet to not lose or gain weight and be able to have treats like cakes, chocolate, biscuits and cheesecake if I wanted. My three medically prescribed three meals a day and my high complex carbohydrate fibre, high protein and fat, lots of filling vegetables and liquids and lots of B vitamins and iron (and no menstrual iron loss), kept me full of energy.
We eat for energy. My diet made me full of energy. We eat simple sugars like biscuits and cake for energy when we are fatigued and have low blood sugar. Low blood sugar levels are what trigger Ghrelin (the appetite stimulant) to be produced. Yet my diet and lifestyle meant I never got low blood sugar and so never felt hungry and never craved sweet things. Eating less sweet things made less sweet things like vegetables more palatable, as our taste buds and brains adapt to our diet. The more sugar (and sweeteners as they are up to 1000x times sweeter than sugar and increase your desire for sugar) you have, the less sweet sugar becomes as you need more and more to get the same Dopamine (pleasure brain chemical) high. I cut out sweeteners as they made me hyper and anxious and I cut out alcohol as it made me depressed and stopped me from sleeping (alcohol is a depressant that stops REM sleep) and I need sleep to be sane. I didn't avoid sweet things, I simply non-deliberately didn't desire them. My phone addiction (lots of Dopamine from your phone) and lots of time outside (Dopamine from sunlight and nature) and time doing joyful hobbies and my happy, full social life meant I got my Dopamine buzz from other places than food.
I also had episodes of binge eating in my anorexia recovery which made me very depressed. These were desperate attempts to gain weight after things like DEXA scans where I was told my bones were at risk if I didn't gain weight, or after seeing a friend's new baby and realising I had to gain weight to have my own children. I ate ridiculous amounts in short periods until I felt sick and it was very unpleasant and negative experiences. I lived in fear of these binges happening again and so stuck very closely to mealtimes (maintaining my blood glucose levels) and snack time snacks and researched extensively about binge eating and how to stop it. I incorporated sweet treats into these and allowed myself my favourite indulgences if I wanted them (if you deny yourself something you crave it and binge on it) and developed tools to distract myself when I felt like bingeing on food. By allowing myself to eat whatever I wanted, I never craved anything. I learnt how to stop binges and I was always satiated.
I come from a big family and so home has a big fridge with lots of food in it as everyone (we are all adults now) has different preferences and buys their own food. We are not loaded, but we cope, but I have relatives across the whole of the financial spectrum. My richer cousins are thin and my poorer cousins are fat, and so financial success for me has always been linked to food. I worried about money and this fear of hunger (which I would say has been a great anxiety for most of my life, worrying about being poor or hungry) made me obsessed with saving money and food, hoarding it in my room out of fear of it becoming scarce. I was convinced I was going to land up poor and hungry. My fear of hunger kept me thin as I saved treats for this “future when I wouldn't be able to afford it.” Most of the time my dad, friends or siblings ate the treats before I had a chance to enjoy them.
Overall then I can say that I stayed so thin as I was so active, ate a perfect diet which gave me loads of energy and kept me satisfied so I never felt hungry, slept lots, kept stress low with yoga, exercise, journaling and lots of fun social events (being very busy with a full life and lots on) and by eating well and never denying myself anything (if you deny yourself treats you crave them and binge on them). Being a busy bee stopped weight gain. This enabled me to eat whatever I wanted and not gain weight.
In the end, I know I will gain weight. This is because I will age, have hurt my knee and have osteoporosis so can’t be as active as I have been, and am starting a knackering (and no doubt highly stressful) job with long hours sitting behind a desk and no option to make regular hot drinks or time to prepare healthy meals and snacks. I know low energy will make me gain weight. I also have lots of weddings coming up with lots of food and am moving away from home and the price of vegetables is going up due to Brexit and the Ukraine crisis and my salary will go down. This will impact my eating habits. The weight gain is inevitable. I know what to do to maintain, gain and lose weight and my new lifestyle will change things.
The trick to maintaining your weight is to not diet, to sleep lots and keep stress low, to eat three meals with lots of protein, complex carbs (plant-based) and fat and to drink lots of water. To never skip breakfast as your blood sugar is low first thing in the morning, and to be active, mentally and physically.