AdamWW's New Orthorexia Recovery / Bulking Log

[AdamWW]

When was the last time you gave a food blood panel, Adam?

I have been working with a hematologist for about 4 months.

Originally (4+ months ago), I saw my primary doc due to some weird sores on my tongue; turned out to be nothing, just the result of my biting it during sleep when I forget my nightguard.

However, it prompted a referral to the hematologist.

The hematologist then ordered a battery of tests (4 months ago) to rule out blood cancers and rare conditions: nothing on the cancer or rare condition front immediately, but the CBC came back with low White and Red cell counts + low platelets... nothing extreme, but all below normal thresholds. Historically, regardless of my weight, my platelets have always been either low-end of normal but my WBC and RBC were never low...always in healthy range.

During that appointment (still 4 months ago), she said I had the option of either 1) getting a bone marrow biopsy or 2) following up 2 months to see if my counts changed. I opted to wait and retest in 2 months.

2 months later (so, two months ago now), I retested and everything was the same: RBC/WBC/Platelets all slightly low. The hematologist then said the likelihood of anything serious is low given the consistent readings and no worsening symptoms or infections. However, she finds it concerning that at my age and with my history they wouldn't be in range; she also commented on my low weight, Blood Pressure, and pulse.

I asked her at that time (2 months ago) if my low weight could be causing it, and she did not feel it was likely, but that it wasn't something she could confirm. Her recommendation was to gain weight and see if things improved... but it was a loose recommendation and she is not aware of my ED history at all, nor is my GP. I was then told that, during my annual physical (which was today), to ask for another CBC to see if they're still OK.

So, today, during my physical, I requested the CBC as well as a Lipid panel (which I just do every year) and should have the results in by tomorrow to see if my counts are remaining low but stable.

Ultimately, though, I feel confident (like, 99.9% confident), that it is my ED/low Weight causing this.

Looking at my weight alongside my WBC/RBC/Platelet counts over the last 2-3 years (my hospital provides an online member portal will full access to test records), there is a direct relationship between my weight being in/out of a certain range and my cell counts being in/out of the healthy range: when I have been below about 160lb, the counts begin to drop... but when my weight has been at or above 160, they have been healthy. Because every test I have had on these counts in the last 2 years has been during a time where I was at least 155 or below, they have all be flagged as below range. It's kind of crazy how obvious the connection is... it looks like this on the calendar:

test 1 (170lb) - normal
test 2 (165lb) - normal
test 3 (160lb - normal, but approaching low end
test 4 (155lb) - below range, but only slightly
test 5 (148lb) - further below range
test 6 (140lb) - even further below...

And so on and so on until you reach my current weight....

So I have plenty of hard evidence right now to support the medical need for weight gain.

To be honest, I kind of know what tomorrow's tests will say, so it won't shock me... but the hope is, of course, with recovery and weight gain, I can get these back to normal.

On the good side, I haven't experienced any symptoms of low platelets or low WBC (I have zero issues with clotting and I haven't been sick all year), but that could change at any point if I don't get my weight under control.

UPDATE: Sorry I completely misread your post... what is a 'food blood panel'?

[ErikTheElectric]

I meant "full blood panel", autocorrect.

I'm sure it's likely related to your ED, it's very common for Anemia/low WBC and RBC counts to exists in ED's, as I'm sure you know.

If you're open to discussing your numbers, feel free to PM me or post them here. All the best.

[AdamWW]

I meant "full blood panel", autocorrect.

I'm sure it's likely related to your ED, it's very common for Anemia/low WBC and RBC counts to exists in ED's, as I'm sure you know.

If you're open to discussing your numbers, feel free to PM me or post them here. All the best.

Oh ok cool. My metabolic panel was totally fine (electrolytes, liver, kidneys, etc) so there wasn't a reason to check it, just did the CBC.

The low numbers I've been getting recently ended up being about 10% below the low threshold (i.e. The low normal for WBC was 3.5, mine was 2.9) for all the standard cell counts. In particular my granulocytes were the type of WBC that fell and caused the low overall number.

To be honest I think most doctors aren't used to dealing with this kind of anemia due to restriction so they don't really associate low body weight as a cause, but rather a side effect of some other condition which could cause the low body at the same time.

Once I get my results in tomorrow I'm open to posting them here... not a big deal for me.

[AdamWW]

Just got my results in early... things are stable and slightly low... basically no change.

Surprisingly, compared to last year, my total cholesterol and triglycerides went up a little. I was fasted for both. However, I believe being underweight can actually effect your livers ability to regulate lipids properly so I'm not worried about it plus the numbers are still very good, just not as amazing as last year.

But yeah... basically just need to keep going and try to add some weight so I can heal.

My hunger is a mess right now so I am trying to make sure I get enough in during periods where bloating and mixed hunger cues are an issue... otherwise I think simply going with my intuition will add weight naturally.

[ErikTheElectric]

Have you considered seeking help from a registered dietitian to get you on a meal plan? One that has treated EDs before?

[AdamWW]

Have you considered seeking help from a registered dietitian to get you on a meal plan? One that has treated EDs before?

I hadn't, no. Can you do that outside of ED therapy itself? Most of what I've been reading online mentions simply aiming for calorie minimums, etc, in order to gain weight (I'm referring to official medical info and not blogs, etc).


One thing that concerns me about diet plans is that control and overly structured planning tends to worsen the mental component of my disorders, which is why I've been trying to do an intuitive approach without tracking or eating the same things.

[ErikTheElectric]

No. Most ED Dietitians require you be involved in a treatment program.

Something to consider?

[AdamWW]

No. Most ED Dietitians require you be involved in a treatment program.

Something to consider?

Definitely worth considering, I would never rule it out. The treatment center where I did my anxiety therapy has a fantastic ED therapist group that I can reach out to.

The question is: at what point do I consider it necessary or best to go that route? If my weight doesn't go up? Problem there is that I'm not weighing myself, so it would need to be based on visual changes.

My 'relationship' with food is improving, but I have a multi-factor issue like many in that I do need to gain weight to get to a healthy range but I also need to repair my thought process.

For now, I think I am going to continue the course provided I do not start relapsing or getting stuck in semi-recovery mode. Is it best? Honestly I am not sure. I have many unanswered questions.

[ErikTheElectric]

Definitely worth considering, I would never rule it out. The treatment center where I did my anxiety therapy has a fantastic ED therapist group that I can reach out to.

The question is: at what point do I consider it necessary or best to go that route? If my weight doesn't go up? Problem there is that I'm not weighing myself, so it would need to be based on visual changes.

My 'relationship' with food is improving, but I have a multi-factor issue like many in that I do need to gain weight to get to a healthy range but I also need to repair my thought process.

For now, I think I am going to continue the course provided I do not start relapsing or getting stuck in semi-recovery mode. Is it best? Honestly I am not sure. I have many unanswered questions.

How do you gauge this?

[AdamWW]

How do you gauge this?

At the end of each day, in retrospect, I recall far, far fewer minutes/hours spent thinking about food at all.

Additionally, because I am not planning meal times or amounts, it allows me to avoid contemplation which in the past always seemed to make me delay eating times. I would effectively delay calories until evening because it was easier to control it.

Finally, the guilt or apprehension around consuming my fear foods is disspating. Obviously not gone, but I set a goal each day to consume at least 1 food that has caused me anxiety, and the anxiety around each one is lessening.

[ErikTheElectric]

I've been interacting on and off with you for the past few years over these forums and have seen you start many different "logs" and say that statement numerous times, hence why I decided to ask that question.

If you feel that you're becoming increasingly "better" in regards to your overall outlook on food, you're thinking less about it, along with your body (well, which is interesting given your choice(s) of avatars/profile pictures), then by all means.. stay the course. But it may be worth it to check into a program near you in the near future, if your numbers diminish any further.

Cheers!

[Nate118]

Hi Adam,

Recovery the hardest thing I've ever undertaken so I understand how difficult it is. I may or may not be bringing any new information to you, but I feel like I should say this anyway.

My ED psychiatrist taught me that recovery requires two things together:
1. weight restoration; AND
2. changing thought patterns, which ensures that your weight doesn't go back down.

Can't have one without the other. A BMI of 22-23 is most likely required. Note: BMI is only a bad measure for individuals in the 25+ category if they have a lot of muscle mass.

When restoring my weight, it was important for me to track my weight once a week. Before that, I had spent the longest time trying to recover through a heavily subjective self-assessment of thoughts and feelings. I didn't get anywhere because my ED brain was too clever for that. What I really needed was quantifiable data to definitively prove that I was making progress.

I would recommend tracking weight, setting a target e.g. (0.5kg per week) and hitting it because it's the only way to beat this thing.

You can do this my friend!
~ Nate

[AdamWW]

I've been interacting on and off with you for the past few years over these forums and have seen you start many different "logs" and say that statement numerous times, hence why I decided to ask that question.

If you feel that you're becoming increasingly "better" in regards to your overall outlook on food, you're thinking less about it, along with your body (well, which is interesting given your choice(s) of avatars/profile pictures), then by all means.. stay the course. But it may be worth it to check into a program near you in the near future, if your numbers diminish any further.

Cheers!

Noted

[AdamWW]

Hi Adam,

Recovery the hardest thing I've ever undertaken so I understand how difficult it is. I may or may not be bringing any new information to you, but I feel like I should say this anyway.

My ED psychiatrist taught me that recovery requires two things together:
1. weight restoration; AND
2. changing thought patterns, which ensures that your weight doesn't go back down.

Can't have one without the other. A BMI of 22-23 is most likely required. Note: BMI is only a bad measure for individuals in the 25+ category if they have a lot of muscle mass.

When restoring my weight, it was important for me to track my weight once a week. Before that, I had spent the longest time trying to recover through a heavily subjective self-assessment of thoughts and feelings. I didn't get anywhere because my ED brain was too clever for that. What I really needed was quantifiable data to definitively prove that I was making progress.

I would recommend tracking weight, setting a target e.g. (0.5kg per week) and hitting it because it's the only way to beat this thing.

You can do this my friend!
~ Nate

Tracking weight causes me to restrict... I don't feel it is a good idea yet... I learned this the hard way a few weeks ago.

I can tell myself all I want that the number doesn't matter, but seeing it causes me issues. Had not realized it until I observed a very obvious reaction to a short term shift.

[Nate118]

Tracking weight causes me to restrict... I don't feel it is a good idea yet... I learned this the hard way a few weeks ago.

I can tell myself all I want that the number doesn't matter, but seeing it causes me issues. Had not realized it until I observed a very obvious reaction to a short term shift.

This is where a nutritionist comes in handy. You can organise with them to track your weight without telling you the numbers. They can tell you to eat more or less if you need to. They're not there to impose rigid meal plan rules on you. They are there to help make the process easier for you. Most of all, they help you stay accountable. Otherwise, you can just keep yourself accountable by tracking the numbers on your own. Once a week is all you need.

Weight gain is the number one priority. It's the only way to get better.

[AdamWW]

This is where a nutritionist comes in handy. You can organise with them to track your weight without telling you the numbers. They can tell you to eat more or less if you need to. They're not there to impose rigid meal plan rules on you. They are there to help make the process easier for you. Most of all, they help you stay accountable. Otherwise, you can just keep yourself accountable by tracking the numbers on your own. Once a week is all you need.

Weight gain is the number one priority. It's the only way to get better.

I understand and agree, but here's a potential problem I see: if a nutritionist weighs me and doesn't say the number, simply says "eat more", I will know I'm either gaining too slow, not gaining, or losing weight. If they say nothing, or that I'm doing fine, i will know I'm gaining at least at a minimum rate. So whether I know the # isn't necessarily the issue, it's having the concept of weight on my mind and especially if I know it's going up.

I do not see this as being something I have to avoid indefinitely, it may only be for another week for all I know, but I want to see if the lack of weight tracking for a brief period allows me to relax more on thinking about and controlling food. The severe hunger, random cravings, bloating, and many other things are already very taxing at times, and yet at other times extremely positive.

To draw a similarity, not tracking calories, etc, has allowed me to give into cravings and undoubtedly eat way, way more than I would have if I were to track them...

[ErikTheElectric]

I understand and agree, but here's a potential problem I see: if a nutritionist weighs me and doesn't say the number, simply says "eat more", I will know I'm either gaining too slow, not gaining, or losing weight. If they say nothing, or that I'm doing fine, i will know I'm gaining at least at a minimum rate.

There are a thousand ways to rationalize or justify not seeking out help, Adam. These are things that are undoubtedly causing you anxiety and are troubling you. The key to this is FIXING those thoughts and irrational behaviors. FWIW: I can tell you that 99% of this thinking isn't what actually occurs in a clinical setting.

1. A scale exists
2. You step on a scale (usually with your back turned, as I myself do even to this day when I frequent a doctors office)
3. You ask the nutritionist not to disclose your weight to you.
4. You move on.

Whether or not there are alterations to your food intake, is something you should word with that nutritionist first and foremost. But if you are really thinking that it's justifiable to simply not seek help because someone telling you to eat more or less food ---> means weight gain or weight loss.. that simply means that there are even more issues that need addressing here and that you really need to stop attempting to fight this on your own accord. It's just not worth it, my man.

[AdamWW]

There are a thousand ways to rationalize or justify not seeking out help, Adam. These are things that are undoubtedly causing you anxiety and are troubling you. The key to this is FIXING those thoughts and irrational behaviors. FWIW: I can tell you that 99% of this thinking isn't what actually occurs in a clinical setting.

1. A scale exists
2. You step on a scale (usually with your back turned, as I myself do even to this day when I frequent a doctors office)
3. You ask the nutritionist not to disclose your weight to you.
4. You move on.

Whether or not there are alterations to your food intake, is something you should word with that nutritionist first and foremost. But if you are really thinking that it's justifiable to simply not seek help because someone telling you to eat more or less food ---> means weight gain or weight loss.. that simply means that there are even more issues that need addressing here and that you really need to stop attempting to fight this on your own accord. It's just not worth it, my man.

That is not the reason I am attempting this without formal treatment and I am not making excuses. I mentioned before that I am attempting this on my own because having dealt with other clinical settings for anxiety and panic disorder(s) there is some learnings I can leverage which increase my opportunity for success.

Also, like I said, I am not currently avoiding the scale as a permanent solution, I am simply observing whether or not it produces a better result in terms of my mental state and my ability to eat 'freely' compared to weighing myself daily or weekly.

I have zero fear or concern over seeking treatment beyond the time commitment and monetary aspect, but ultimately even those are not more concerning than not recovering at all, of course.

[Nate118]

Waiting one more week will only prolong the suffering. It also makes it harder to reverse the ED's effects on the brain. You don't deserve that, Adam. You deserve a better life.

You'll never feel 100% ready. Waiting until you're no longer afraid of gaining won't work because the only way to overcome that fear is to gain weight. That's why EDs are such vicious traps.

You need weight gain. It's not easy or comfortable, but it needs to be done if you truly want to get better.

[AdamWW]

Waiting one more week will only prolong the suffering. It also makes it harder to reverse the ED's effects on the brain. You don't deserve that, Adam. You deserve a better life.

You'll never feel 100% ready. Waiting until you're no longer afraid of gaining won't work because the only way to overcome that fear is to gain weight. That's why EDs are such vicious traps.

You need weight gain. It's not easy or comfortable, but it needs to be done if you truly want to get better.

I wasn't saying I am waiting a week to gain weight, THAT needs to happen now and it is as far as I can tell. I was simply trying to point out that I am not weighing myself because if I am not seeing a nutritionist or therapist it's impossible to blindly weigh in. The 'one week' was an arbitrary number meaning I might wait approximately a week (could be a day, could be two, or 10, I do not know) longer to see how being without a planned weigh in day effects my thinking. To be clear, I am NOT waiting to gain weight.

Info: https://www.edinstitute.org/blog/201...elf-dont-do-it

[Nate118]

How will you be able to quantify your weight gain without weighing yourself?

[AdamWW]

How will you be able to quantify your weight gain without weighing yourself?

As i've mentioned a few times, this is temporary....

And from everything I have read, if I respond to my hunger then weight gain should happen whether I see a number or not. Is this not true? Every resource I have seen states that such cravings occur to drastically and rapidly restore your healthy weight levels...

[AdamWW]

Turned 32 today. Decided to weigh myself despite not being overly excited about it. My weight is up only slightly, but it is up.

I will be resting today. Yesterday I played 18 holes of golf; did not walk the course, but rather rode on an awesome new thing called a 'GolfBoard':

Disclaimer: no that is NOT me in the photo.




Absolutely loved this because, as I am trying to gain weight and recovery from the exercise purging/compulsion, I do not want to walk during my golf rounds. As it turns out, if you walk 18 holes of golf, on average you burn about 1200 calories during that period. You still burn plenty if you ride a cart, but nothing compared to walking.

The golf board is great because it makes me stay limber without burning as much as walking. Plus it was REALLY fun. (it's motorized)

I also lifted weights on Thursday and Friday, so I had three days wherein I got a bit of activity in, so today I'm just looking forward to resting, taking care of some details around work and a TOWNHOME I JUST BOUGHT!!

Probably going out to eat later to get some freebies, etc.

Happy Father's Day and have a great one.

- Cheers.

[ErikTheElectric]

Alrighty then, best of luck!

[finnyskat]

i'm not as sick as you were/are, but i'm taking so much inspiration from this thread. thank you for keeping it. i hope your recovery continues wonderfully.

[AdamWW]

i'm not as sick as you were/are, but i'm taking so much inspiration from this thread. thank you for keeping it. i hope your recovery continues wonderfully.

Glad to hear.

However, keep in mind that the thought of 'not being sick enough' or 'not being as sick' as someone else who is going through recovery is a commonly held and potentially very dangerous one.

This is, first and foremost, a mental disease, so regardless of my physical state (weight and/or otherwise health-related) you or anyone else could be in a far more urgent position for help.

Never try to compare your ED to anyone else.

For example, you mentioned you're afraid to eat berries because they have sugar. I'm not afraid of sugar... in fact I probably eat well over 100g of sugar every day and over 400-500grams of carbs easily... but does that mean you're sicker than me? No... it has to do with (1) the impact it has on your life and (2) the impact it has on your health/body.

Sadly, you cannot quantify the effect on someone else's life, because everyone thinks/deals/reacts in their own way. It's like pain tolerance: just because you can handle a punch and be 'OK' doesn't necessarily make you tougher than someone who can't, because everyone has different nerves, reactions, and experiences which factor into their ability to tolerate things.

[finnyskat]

Glad to hear.

However, keep in mind that the thought of 'not being sick enough' or 'not being as sick' as someone else who is going through recovery is a commonly held and potentially very dangerous one.

This is, first and foremost, a mental disease, so regardless of my physical state (weight and/or otherwise health-related) you or anyone else could be in a far more urgent position for help.

Never try to compare your ED to anyone else.

For example, you mentioned you're afraid to eat berries because they have sugar. I'm not afraid of sugar... in fact I probably eat well over 100g of sugar every day and over 400-500grams of carbs easily... but does that mean you're sicker than me? No... it has to do with (1) the impact it has on your life and (2) the impact it has on your health/body.

Sadly, you cannot quantify the effect on someone else's life, because everyone thinks/deals/reacts in their own way. It's like pain tolerance: just because you can handle a punch and be 'OK' doesn't necessarily make you tougher than someone who can't, because everyone has different nerves, reactions, and experiences which factor into their ability to tolerate things.

ah.
i reflected on the thing about not being sick enough. i thought about that for a few minutes and realized that, when i was a higher weight but using even more harmful behaviors (purging) i thought the same thing.

i realized that another reason i fear weight gain is that if i gain to be healthy, but still struggle emotionally, i am afraid people will not believe that i am sick enough if i ask for help.

this leads me to conclude that i should ask for help Now. but i can't. i have no money, i look healthy at this weight, and there are no ed specialists in my area.

i feel like i'll just have to keep teetering here between recovering and suffering until i can take the plunge and commit to one side or another.

[AdamWW]

ah.
i reflected on the thing about not being sick enough. i thought about that for a few minutes and realized that, when i was a higher weight but using even more harmful behaviors (purging) i thought the same thing.

i realized that another reason i fear weight gain is that if i gain to be healthy, but still struggle emotionally, i am afraid people will not believe that i am sick enough if i ask for help.

this leads me to conclude that i should ask for help Now. but i can't. i have no money, i look healthy at this weight, and there are no ed specialists in my area.

i feel like i'll just have to keep teetering here between recovering and suffering until i can take the plunge and commit to one side or another.

Why would you entertain the idea of 'committing to suffering'?

[finnyskat]

Why would you entertain the idea of 'committing to suffering'?

i guess because i feel like there's ... nothing else i can do?
which probably confirms that i need help. but it's like--eat enough to support my workouts but not enough to gain, or don't eat at all. two extremes.

[AdamWW]

i guess because i feel like there's ... nothing else i can do?
which probably confirms that i need help. but it's like--eat enough to support my workouts but not enough to gain, or don't eat at all. two extremes.

Very sad you feel this way. I would advise getting help before you spiral more downhill.