to stop trying to eat?

[starvingartiste]

Namechanged. Title is facetious as I don't intend to stop eating altogether.

I am underweight due to a number of factors. These include hormonal issues (endometriosis and menstrual cycle wreak havoc on my appetite, during period and ovulation i feel extremely nauseous and my calorie intake drops massively because i just need to sleep off the cramps). I also have IBS which restricts what I can eat, how often I eat, etc. If I gain a couple of pounds on a good day I'll instantly drop it again the next day from lack of appetite or symptoms.

I am not skin and bones, but I weigh 42kg at 5'4". I have enough energy to get through the day, granted I am fairly sedentary because I deal with chronic fatigue.

Most days I eat breakfast/brunch which is toast and a cup of tea. I then snack on nuts. This keeps me going until dinner, which is things like pasta with chicken and tomato, or a stir fry (veggies and meat), a small roast, or fish and salad. My appetite perks up a bit before bed so I snack on some more toast. In between I have a couple of cups of tea and some dark chocolate. I can't eat fruit due to the IBS and certain veggies are off limits. Eggs make me sick, as does red meat. I can only have milk in tea, not in large amounts.

Before anyone flames me or jumps to conclusions - I do not have an eating disorder. I had one in my youth (now early thirties). I don't want to be skinnier or restrict food. But every time I attempt to add things to my diet, new foods or amount of calories or extra meals, I suffer. If I eat lunch I feel sick and won't be hungry for dinner. Today I tried to eat a chicken salad for lunch - I have low blood pressure that is sometimes affected by eating, and had a massive drop - feeling dizzy, spaced out and shaky. I've spoken to the GP about this sort of thing and she just told me I'm not used to eating extra so my body is just freaking out and to persevere. I don't really want to persevere. I feel like there's no point in adding calories for weight and energy if it makes me feel awful.

The caveat here is I am trying to conceive, and I know my weight is too low for this, or it could be dangerous for the baby. I worry about becoming pregnant and having morning sickness which means I would eat even less (i.e. nothing). I can't really afford to lose more weight. I also worry about needing to eat more when pregnant, but feeling physically terrible when I do so.

This is not a competitive undereating thread, by the way. But there is an element of trauma in how I have to eat, which I'll happily admit to. If you have issues eating stuff for a while, you become scared of trying. FWIW doctors haven't been much help, they just recommend high calorie foods or protein shakes, which also flare up my symptoms.

So, am I unreasonable to just stick to what 'works'? (not necessarily in regard to pregnancy, but I don't really have a solution for that yet).

If the build up shakes aren’t to your liking or set your IBS off they also make them in a juice or as a shot.

Carry on eating little and often if that works better for you, no need to have big meals. Try calorie dense, low quantity foods so you aren't physically eating as much but there's more calories in it. Obviously the ideal would be that they can help with your stomach troubles, but unfortunately I know that isn't easy.

Oh OP that sounds tough. Is it just one or two GPs at the surgery you've spoken to about this? Might be worth trying another one (ask around).
Maybe keep a diary for a couple of days so you can really spell it out in black and white what it's like for you?
If you can't eat enough to maintain even a slim "normal" weight, that does need sorting out , agree with you there - you have so many things, not just conception, that a little more food would help with.

IANAD but a few things to try out while you sort out a GP visit...

A little bread dipped in olive oil
Try a small early breakfast, something bland like full fat cream cheese?
Tiny little bit of extra sugar/fat on anything you can tolerate e.g. in pasta sauce.
More calorific drinks - juice, lattes, hot chocolate, again, start small and see what you can sneak past your body.

Good luck.

you should not TTC until you sort out your eating to be something more comfortable & get your BMI reliably above 18

@Sinkgirl oh it's 'good' to hear that someone knows what I'm going through. not 'good', but you know. Hormones are fucking awful. They've been the bane of my life for over ten years.
I would definitely like another surgery if it would help, but I've had two before. My last was in 2019 and it didn't work as well as the first. I also have a lot of scar tissue around one ovary ever since a cyst was removed in my first surgery, so more surgery might not be great for that (it causes a lot of pain). I haven't had my thyroid checked yet. The combined pill worked very well for my symptoms and I was a slightly higher weight on it, but had to come off due to migraines. I switched to mini pill which has been ok but obviously came off to TTC.

My disorded eating does factor in a fair bit, I have some food issues from childhood and traumatic experiences regarding that (a bit vague, sorry) so food has been a problem my whole life. But I have had many years of enjoying food, not worrying about it, etc - in my twenties I could eat what I wanted as I didn't have IBS (I developed it after an illness). It's honestly crazy what I used to eat compared to what I can eat now. My highest weight then was just under 8 stone.

Thanks everyone else for more tips. Eating smaller amounts between meals seems like a good idea, just throwing things in.

@ragged I appreciate that but my GP advised me not to wait as I'm losing time with my fertility issues. I don't expect to fall pregnant anytime soon in any case.

I would push for a referral to a dietician. There are so many different factors at play here- previous ED, IBS, endo, etc.- that I think you need a specialist to walk you through working out a tailored diet. Especially if you're planning to get pregnant- that's a lot of strain on a body which doesn't have much in the way of reserves.

[quote starvingartiste]@Sinkgirl oh it's 'good' to hear that someone knows what I'm going through. not 'good', but you know. Hormones are fucking awful. They've been the bane of my life for over ten years.
I would definitely like another surgery if it would help, but I've had two before. My last was in 2019 and it didn't work as well as the first. I also have a lot of scar tissue around one ovary ever since a cyst was removed in my first surgery, so more surgery might not be great for that (it causes a lot of pain). I haven't had my thyroid checked yet. The combined pill worked very well for my symptoms and I was a slightly higher weight on it, but had to come off due to migraines. I switched to mini pill which has been ok but obviously came off to TTC.

My disorded eating does factor in a fair bit, I have some food issues from childhood and traumatic experiences regarding that (a bit vague, sorry) so food has been a problem my whole life. But I have had many years of enjoying food, not worrying about it, etc - in my twenties I could eat what I wanted as I didn't have IBS (I developed it after an illness). It's honestly crazy what I used to eat compared to what I can eat now. My highest weight then was just under 8 stone.

Thanks everyone else for more tips. Eating smaller amounts between meals seems like a good idea, just throwing things in.[/quote]
I honestly think people really underestimate the role of hormones in weight - and I know from personal experience how much adhesions screw up your ability to eat and digest.

I had my adhesions removed my a specialist, with a special solution used to prevent more. It was 15 years ago and the bowel ones haven’t recurred. I am sure I have more now thanks to six laps in total plus gallbladder removal and a hasty c section. I would really recommend getting referred to a specialist.

I feel like I’ve mostly overcome my eating disorder now but I live with it rather than recovering. Sickness bugs are a big trigger as I don’t want to start eating again afterwards. But day to day I’m okay and I’m tolerating being overweight.

@SinkGirl i'm so glad to hear you're coping a bit better. Adhesions are just the worst and endo just causes so many wide ranging issues, I think a lot of people think it's 'just' painful periods when it's much more influential on the body. I had a decent surgeon (endo specialist) who did both my surgeries but I had to pay for a private consultation the second time so he would book me in again (not his fault really, the NHS were gatekeeping and I couldn't get hold of him via NHS). He did my second surgery at the private hospital but it was covered by NHS.

As an update to today, my food intake has been 3x slices of toast, handful of cashews, chicken salad, pasta with arabbiatta sauce and veggie sausage, another 2 slices of toast. Might snack again before bedtime.

I'm not trying to diagnose, I just wanted to say that disordered eating doesn't only involve trying to lose weight or restrict food.

I hope you work something out OP.

@MsMD yes, you're right. I very likely have unintentional disorded eating due to past problems and a complex about my health.

Another update: by breakfast time this morning I was absolutely starving and shaky/jittery/weak which is not usual for me. I'm guessing this is because I ate more yesterday and it's boosted my appetite? I suppose it's a good sign if that's the case but it's a bit stressful. It's bad enough figuring out what extra things to eat at the moment, I don't know if I can deal with needing to eat even more!

You're eating a lot more than me and I can't shift a single pound.

I once put on weight in a month just by having toast and butter or toast with peanut butter last thing at night. Maybe you could add in some calories with things like salad dressing/mayo, homemade gravy with your roast, tahini/lemon dressing on green veg, being a bit more generous with oil on the stir fry?

I’d say unless you can sort your thought process out around food you will be unable to eat more. Eating disorders are far from wanting to be skinny I really think you need some sort of help.

@Leshan

You're eating a lot more than me and I can't shift a single pound.

Considering you don't know size of the meal portions, that's just impossible comparison. 🤷🏻 Also just not adding any help, is it.

@Hm2020

I’d say unless you can sort your thought process out around food you will be unable to eat more. Eating disorders are far from wanting to be skinny I really think you need some sort of help.

I agree. It can't hurt to speak to someone.

And honestly look into gut soothing foods. That could help with some of the physical side.

@riotlady

I would push for a referral to a dietician. There are so many different factors at play here- previous ED, IBS, endo, etc.- that I think you need a specialist to walk you through working out a tailored diet. Especially if you're planning to get pregnant- that's a lot of strain on a body which doesn't have much in the way of reserves.

Agree lots of factors. BMI is 17 so only just underweight. Anxiety can stop up you putting on weight or make you lose weight as well.

I'm sorry OP, I feel your pain. Suspected endo here, plus IBS (which I'm 99% sure is linked to Endo). The pain, tiredness, digestive issues all wreck havoc on my appetite. I'm not underweight (BMI is about 20) but would look better with a few extra lbs.

For now, focus on what you CAN eat. So you mentioned toast and nuts. Add a generous dollop of peanut butter to toast.

Can you tolerate banana? A smoothie with banana, pb and oat milk would be calorie dense and delicious.

But I would suggest pestering your GP for a referral to a dietitian.

Agree with others that gut health is good avenue to check. Unfortunately NHS are a bit slow in this area, a naturopath might be a good ‘plan b’ if you don’t get anywhere with the doc. I had fibro for 7 years, diagnosed with IBS and it turned out it was a bacterial overgrowth in my small intestine causing both issues. I got tested privately then went back to nhs for treatment.

Agree with a previous poster about fod map diet - it’s a really good way of working out if it’s a gut health issues e.g. these foods feed unfriendly bacteria causing a flare in symptoms. Good luck

Have you ever been tested for coeliac? “IBS” symptoms, struggling to eat certain foods and difficulty could all be down to a wrong diagnosis of IBS and in fact be coeliac with your body is struggling to get the nutrition you need.