confused about the 'right' intake

[f.jane]

Hi,

I have had an eating disorder for over 6 years now, it started off as anorexia and then became bulimia with an anorexic mindset (or they said something like that, first it was restricting and over exercising then restricting, binging, overexercising and laxative abuse, then binge/purge behaviour and over exercising, now restricting and occaisionaly bing/purge behaviour) iv been relapsing in and out of recovery for the last year and a half and having been through one course of CBT iv now been refurred to a specialist unit at my local hospital but my assesment isnt untill the end of july. (i am currently b/p free for 11 days and my BMI is 22.7). I know that my own judgement about what i should and shouldnt eat can't be trusted but people (including two different councilors and a nutritionist) keep telling me different things about what my intake should be, i know its not 2000, i didnt eat that much before i was ill and my weight was a 'healthy' BMI (22) and im still not allowed to do much more exercise than walking so i dont burn much off. im also not very tall (5'5")

Baisically what im trying to ask is, per day, under what amount of callories is deffinatly too little and above what amount is deffintly too much? For example the boots website BMR calculator says to maintane my weight my intake should be 1460 if im not exercising, is that correct? Im also confused about what a healthy BMI is, the nhs website says under 18.5 is unhealthy but the nutritionist said under 20 and one of my councilors said under 19 but that i should be aiming for 23?

I know its not the numbers that is important and that i shouldnt be counting anyway but the counting is automatic and at the moment im so confused about whats healthy/not healthy that im second guessing myself all the time and its not helping my recovery. Any advice you have would be much apretiated.

thankyou

[Denise Kennedy]

Hi f.jane - thanks for the post. Hey - it is really confusing isn't it!! All these experts with all this different advice!! It sounds as if you are making positive progress though so keep it going.

Essentially we as individuals are all different, and it is impossible to produce rules that fit us all. Body Mass Index is a guage of our body fatness, and we know that for most people if the numbers are too low or too high it can start to affect our health. However these measures should always be used cautiously and there are exceptions to this; for example England rugby players will nearly all have a BMI that says they are obese, but they are very muscular and fit and have a trim waist. We can tell this when we see them, although not just by looking at the numbers.

Similarly - you ask what should your calorie intake be. Nutritionists work from recommendations for groups of people (recommended or reference nutrient intakes) or by using calculations that you mention. These are all approximations. Unless we put you in a lab and measure your metabolism we cannot tell exactly what your individual calorie requirement is.

Where this is leading me is that you must concentrate on what is RIGHT FOR YOU. Focus on being healthy and what you feel is a realistic weight that you wil be happy to maintain near to what the professionals are suggesting. You say your BMI is 22.7 which is so close to the 23 that your councilor is suggesting. This is really good - you should be congratulated for achieving this. Do you feel you can now maintain this?

Regarding your calorie intake - around 1500 calories per day sounds about right. The test will be if you maintain this intake for a few weeks does your weight stay the same? If you lose weight then you need to eat a bit more than 1500 calories; if you gain weight then you might need a bit less than 1500 calories. The numbers are just a starting point.

I know that counting is automatic for you, but try to work towards doing less counting and aim to enjoy your food and meal occasions. Develop your skills in cooking healthy meals, experiment with new recipes, enjoy your creations, try eating with friends or family to enjoy the social element of meal times. The professionals are there to help and point you in the right direction - they are not there to trip you up.

Best of luck.