Anorexia Recovery, Weight Restoration, and Energy Debt

I published a podcast this week titled, Energy Deficit | Energy Debt | Target Weights | Weight vs State Restoration, and I will explain Energy Debt in detail in this post.


Energy Debt: The accumulation of the effects of long-term energy deficit such as lack of bodily repair and maintenance work caused by chronic energy deficit.


First of all we need to define energy deficit. This is when you are eating less than your body requires on a daily basis. When you are in energy deficit you are not in energy balance. There is a gap between what you need and what you are getting. Demand of nutrients is not being met by supply of nutrients. Hence, your body starts to utilize it’s own tissue for fuel to make up the difference. When energy deficit is long term, or chronic, then the body does its best to keep going by adjusting metabolism.

Energy debt is important to understand when you are in recovery from Anorexia, or malnutrition of any cause for that matter. In the recovery phase we need to eat not only enough to get back into gross energy balance, but enough to reach net energy balance — that is weight restored plus energy debt paid off.

 

Energy debt is like financial debt

I used the analogy of a house in disrepair in the podcast to explain energy debt.

Imagine that you lost your job. You went from a $3000 a month paycheck to $0 coming in. For a couple of weeks you would likely not change your behavior much in the hope this was a short term blip. But after a couple of months of unemployment, reality would set in. In such a misfortune, one would have to stop shopping at Whole Foods and become a lot more frugal. The monthly massage would stop, as would so many other luxury expenditures. In short you would economize. Some outgoings would be less comprisable. Things such as your mortgage payment would have to be made, so in order for this to be prioritized, other expenditures would be stopped. This is what your body is doing when it shuts down systems that are unessential to life — like your period — and slows metabolism. It is economizing.

You may be able to live day-to-day off savings for a while, but there will come a point where you are really desperate. You start having to use credit cards. You build up a credit card debt. At the same time, you are also unable to repair the leaky roof on your house. The plumbing goes and there is no money to fix it. The longer your unemployment lasts the greater disrepair your house gets into.

Then one day, hurrah! You get a job. It’s giving you just enough income to stop using your credit cards, and live day to day. But, you are still in debt. You have years of credit card debt to pay off, and you still by no means have enough money to repair the roof etc. What do you do? You save money. You put it in the bank. You don’t yet feel confident in your job security, so you certainly don’t want to get ahead of yourself and splash out on a plumber in case you lose this job again. You save. You continue to be frugal. It would be daft to go out and start buying luxury items when you have all this debt to save up and pay off.

 

In order to pay off debt, one often has to save

After months of saving, and months in this new job, you may begin to feel more relaxed. You have greater job security. You have accumulated some savings and are thinking that you are in a position to pay back some of your credit card debt. You will want to save a bit more before you tackle any expensive house projects.

So what is the point of this analogy? Energy debt is like monetary debt. You need to save up in able to pay it off. That means, that your income has to be in surplus. i.e you are earning more than you are spending.

When you eat less food than your body needs for a prolonged period of time, your body doesn’t have the spare resources it needs to do repair work. Hence, in recovery, you have to pay off this debt by eating more than you need. Your body, unsure of whether you will continue eat indefinitely, will want to save calories up before it commits to any large healing projects. This is what happens in overshoot/recovery weight. Your body is saving. Smart eh?

Your super smart body is saving when it puts on more weight in overshoot. It doesn’t know that another famine is not around the corner. It doesn’t know that you will keep eating. In the same way you don’t know how long this new job will last, your body doesn’t know how long food will be available. It does exactly what it should do. It saves.

When and how will your body make those repairs and pay off that debt?

Who can tell? We are all individuals.  I would say that for most of us it is a year at least. But don’t worry about that. Worrying about it won’t hurry your body it will only harass your mind. Relax, your body is got this. All you need to do is keep eating — and more than you think you need.

 

But “I didn’t restrict that long,” or, “I was never that underweight”

Same rules may apply. Being in energy deficit is not necessarily the same as being thin. If you have restricted food and lost weight you are underweight — regardless of what BMI you are. You have no idea what state of energy deficit you are in by looking at yourself in the mirror. You cannot tell from the number on the scale. You cannot tell from a BMI chart. There is no calculation that will work this out for you. Err on the side of caution and eat more.

 

In summary:

There is no such thing as too much food when in recovery from Anorexia. You have an energy debt to pay off and amending energy deficit includes eating enough to amend this debt. You do not need to be drastically thin in order to be in a state of energy deficit, and you do not need to have been starving yourself for years to have accumulated energy debt.

Rest and eat.

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What do you think?

  1. If you are drastically thin and have been starving yourself for years (25) is your energy deficit and debt more severe? My guess is yes as more damage has most likely been done to your body. Scary thought!!

  2. Such a great anology! It makes a lot of sense and eases the concern about whether Im eating too much during recovery! I suppose the more I eat, the quicker I will recover because my body will be saving at a faster pace! Damn! You are one smart cookie Tabitha! Mmmm! Cookies! Lol! X

  3. A question. My family member currently does not have access to the internet and prefers to read items on paper. Is there a way to copy this particular post?

  4. Pingback: Defining Mental Hunger - Eating Disorder Recovery for Adults

  5. Again, thank you my dear, this is another excellent post that makes so much sense! I’m still struggling as most of the time I don’t feel like I’m worthy of the food I’m craving but reading things like this help to put a little perspective on things, so thank you! xxxx

  6. Blessings, Tabitha.
    As a retired RN, I see this energy debt in terms of what it takes to restore the inside of the cells. I don’t see that big picture of bones and their coverings: “the body.”
    For me it is the damage to the mitochondria more than anything. A chronic deficit of the building blocks of life leaves everything thinner, poorer, stressed, acidic, systems have been breaking down for a while and not able to be repaired. Chronic and cumulative damage.
    As a person with cancer not being treated with chemo or radiation, I was also put on a very sickening heart medicine that made me extremely nauseous right after weeks of fasting. Then I tried to live on a ketogenic vegan diet with less than 50 grams of carbs per day….
    After over 4 months of that, I got off the bad medicine and could start fighting the cancer.
    I had to get some weight back on, and repay that deficit. Fortunately, I had only starved for about 4 1/2 months, but it was still very difficult, My gut was not working and I experienced refeeding syndrome.
    My mitochondria are certainly damaged, particularly in the cancer cells, which is the real source of the problem I face now. The mitochondria are the source of all cellular energy, I am taking supplements intended to restore them.
    I am feeling pretty good now that I am regaining the lost weight, but it is all coming back on my belly. As you mentioned, Tabitha.
    I was thinking it was because I lost all my muscle tissue from the starvation and had no muscles left in my pelvic floor and belly to hold it in, and I have been working to rebuild with minimal success.
    I also felt there was a connection to high cortisol level because of all the stress I am under. It is expensive (and scary) to try to stay alive with plant-based traditional cancer medicines and healthy organic foods and juices. As we know, cortisol goes up with stress and helps us put more fat there on the old belly.
    I also saw it as a return of Visceral fat, the kind that hides around the belly organs where it can’t easily be exercised off. Which is pretty much as you said, a storage locker for survival after a period of lack. Makes total sense.
    Thanks for helping me see this more clearly. If I keep going to the gym and hanging around on this planet, in a year I could be shapely again! Cool!
    I hope other cancer survivors find your blog so as to encourage them in their journey back to health and feeling good about themselves.