Metabolism and Its Impact on Eating Disorder Treatment
Do eating disorders affect metabolism? Metabolism is impacted by a variety of factors, including diet, lifestyle, hormones, genetics, and body composition, and has a complex relationship with disordered eating behaviors and eating disorder treatment.
By: Mary Matone
Metabolism is a group of cellular processes that, together, are responsible for sustaining life. In simple terms, metabolism consists of the processes required to turn food and nutrients into energy, for use by the body. The rate at which cells convert these nutrients into energy is actually called the basal metabolic rate, but is often simply referred to as metabolism.[1]
Effect of Energy Restriction on Metabolism
Each day, our bodies need a certain minimum amount of energy (food) intake to support the metabolic processes required for life. The specific amount of energy each person needs is determined by their metabolism, or basal metabolic rate (discussed above). This energy is required so the body has adequate fuel to perform vital life processes, such as breathing and maintaining blood circulation.
However, when food is restricted for long periods of time, the body doesn’t have adequate energy to keep life-sustaining processes running, and must adapt.[2] Over time, the body will limit energy use to support only those functions absolutely necessary to maintain life. Ultimately the body will also require less energy to perform required functions. This results in decreased basal metabolic rate, or metabolism.
What Happens to Metabolism During Treatment?
When someone who has restricted their food intake for extended periods of time enters recovery, they may become hypermetabolic. This is a condition in which the body requires increased amounts of energy intake to perform vital functions and/or gain weight, and is related to inefficient processing of foods for energy, and/or storage of extra energy. In addition, increased energy may be required to digest the foods being consumed.[3]
Therefore, in the first steps of recovery, someone may have to consume a significantly greater number of calories to gain weight than would be expected. Further, in order to continue gaining weight, those in recovery may have to continually increase their energy intake in order to avoid plateaus in weight gain.[3]
Given this hypermetabolic response to food intake, it may take 3-6 months, or even longer, for weight to stabilize at a level where a steady energy intake is adequate for weight maintenance. However, it is important to remember that ultimately, energy needs will vary from person to person; in some cases, increased calories may be required for lifelong weight maintenance.[3]
What Does This Mean for Treatment?
The metabolic effects of eating disorders may vary from person to person, and may result in a largely increased caloric requirement. This amount of food may be very overwhelming for someone beginning and continuing their eating disorder recovery, and may result in anxiety and resistance to treatment.[3] As a result, ED treatment should always be specific to each individual, and should have a strong therapeutic component.
Other Considerations
In addition to restrictive eating, metabolism may also be altered by other disordered eating patterns, such as binging and purging. However, the relationship between these behaviors and metabolism is less clearly defined at this time.
At BALANCE eating disorder treatment center™, our team of certified eating disorder professionals is dedicated to treating the spectrum of eating disorders and other disordered eating behaviors and body image issues. We are proud to offer Individual Nutrition Counseling to help individuals move from structured eating to intuitive eating. Our highly trained Registered Dietitians work closely with you to customize a nutrition program specific to your needs. Whether you love to cook, or live exclusively on take out, we can develop a program that works with your lifestyle.
Our Admissions team would be glad to answer any questions you may have regarding our Individual Nutrition Counseling. Book a free consultation call with our admissions team below!
This post was written by BALANCE Dietetic Intern, Mary Matone.
Mary is a graduate student at New York University, where she is completing her Dietetic Internship and pursuing a Master’s Degree in Clinical Nutrition. Prior to her education in nutrition, Mary studied Geology and Geological Engineering at the University of Wisconsin-Madison and later worked as a Geotechnical Engineer in NYC. While traveling across the city for her engineering work, Mary’s interest in food and nutrition continued to grow as she continued to meet many people from varied backgrounds. Ultimately, Mary hopes to help others of all backgrounds develop healthy lifestyles while enjoying great foods from around the world.
Resources
1. Metabolism and weight loss: How you burn calories. Mayo Clinic Web site. https://www.mayoclinic.org/healthy-lifestyle/weight-loss/in-depth/metabolism/art-20046508. Updated 2020. Accessed November 14, 2020.
2. Weyer C, Walford RL, Harper IT, et al. Energy metabolism after 2 y of energy restriction: The biosphere 2 experiment. The American journal of clinical nutrition. 2000;72(4):946-953. https://search.datacite.org/works/10.1093/ajcn/72.4.946. doi: 10.1093/ajcn/72.4.946.
3. Marzola E, Nasser JA, Hashim SA, Shih PB, Kaye WH. Nutritional rehabilitation in anorexia nervosa: Review of the literature and implications for treatment. BMC psychiatry. 2013;13(1):290. https://search.datacite.org/works/10.1186/1471-244x-13-290. doi: 10.1186/1471-244x-13-290.