Restrictive Eating: To Eat or Not To Eat?
 
Robin is a tall, slender young woman with great grades, a great personality, and a great boyfriend. She looks like she has the perfect body (and the perfect life!), but she’s always complaining about how fat she is. She really “watches” what she eats—counting every calorie and fat gram, avoiding all sugars, loading up on lots of vegetables—and now she’s talking about becoming a vegetarian for “health” reasons. Once in a while, she’ll indulge in dessert at dinner. But whenever she does, she feels so guilty and panics all night about how fat she’s going to get. She starts obsessing about how many calories she just ate and how she’s going to make up for it tomorrow with an even stricter eating regimen or a more rigorous work-out. Robin is suffering from restrictive eating, and it can lead to some serious problems down the road. 

Read on to learn…
  • How restrictive eating harms your body, both physically and emotionally.
  • Why eating more will NOT make you fat.
  • What steps you can take to normalize your relationship with food and your body.
Negative Effects of Restrictive Dieting and Starvation
There’s nothing wrong with “watching” what you eat and “balancing” your food choices to maintain a healthy, lean body. But, when taken to extremes –and the “watching” becomes obsessing several hours a day, and the “balancing” becomes rigid policing of every food—the behavior is no longer healthy.

Why do we need to eat?
The most basic reason is for energy. Energy in food is measured in calories. Each of us needs to eat enough calories to meet our resting metabolic rate (the calories needed to maintain all of our body’s internal functions at rest) AND our physical activity (the calories needed to perform all the normal activities of daily living, as well as purposeful exercise). Resting metabolic rate alone amounts to about 1100 calories per day in a petite 110 lb. woman and about 1700 calories per day in a lean 155 lb. man. Add to that, the calories needed for moderate (not heavy) physical activity, and the total calorie needs for that same woman and man amounts to about 1700 and 2700 calories per day, respectively, just for weight maintenance! If you are taller, have more lean body mass, and/or engage in heavier physical activity, you'll need even more calories to maintain your weight.

Three things in food provide energy: carbohydrate, protein, and fat. Carbohydrate breaks down to glucose to provide energy; and fat breaks down to fatty acids to supply energy. Protein breaks down to amino acids, which can also supply energy if needed, but our bodies prefer to use them as building blocks for all our vital cells, enzymes, and hormones. In addition to energy, we need to eat to get the essential vitamins, minerals, fiber, and phytonutrients that food provides.

What happens when we don’t eat enough calories?
Think of the calories in your body as the gas in your car to take a cross-country trip. The car needs a certain amount of gas to get there. To make the trip, you would fill up the tank and refuel it several times along the way. You wouldn’t just fill the tank half way, and you wouldn’t avoid refueling it when the tank became empty. If you did, your car wouldn’t perform well, and you wouldn’t get to your destination. 

Our bodies need adequate fuel too, and our bodies need to be refueled every 3-5 hours to perform well. If we don’t refuel our bodies with adequate calories throughout the day, our body (and all of its systems) will start to shut down. Consider the negative consequences of inadequate calorie intake:

Physical effects
  • Decreased resting metabolic rate. Your body slows down its internal workings so that it can survive with fewer calories. This is why your weight may stay the same despite eating inadequate calories.
  • Loss of lean body mass. If your body isn’t getting adequate calories or protein from food, it will break down your own body tissues (i.e. your muscles, organs, and even your heart!) for energy and/or amino acids. As your lean body mass drops, your resting metabolic rate drops even more.
  • Changes in brain chemistry that increase appetite and food cravings. Serotonin levels decrease and neuropeptide Y levels increase—both of these changes increase your appetite dramatically. This may be why binge eating is so common after periods of restrictive eating.
  • In women, lowered estrogen levels and cessation of menses (amenorrhea). Over time, this can lead to dramatic bone loss and osteoporosis, as well as infertility.
  • Constipation and gastrointestinal upset. Your digestive system (like all of your systems) slows down, so food moves more sluggishly through you. Also, without adequate protein, you can’t produce the digestive enzymes needed to break down food. This may be why it feels so uncomfortable when eating normal amounts of food.
  • Sleep disturbance and weakness. Without adequate calories or carbohydrate, blood glucose levels drop. This results in weakness as well as an increase in stress hormones that interfere with sleep.
  • Hypothermia (feeling cold all the time) due to inadequate body fat levels.
  • Decreased sexual interest. Without adequate calories or fat, your body can’t produce sex hormones (estrogen and testosterone).
Cognitive effects
  • Decreased concentration
  • Poor judgment
  • Apathy
Emotional and social effects
  • Depression and anxiety
  • Irritability and anger
  • Lability (ever-changing mood)
  • Psychotic episodes
  • Personality changes
  • Social withdrawal
NOTE: The cognitive and emotional side effects may be related to changes in the central nervous system during starvation when adequate carbohydrate, fat, and/or protein is not available. Each of these nutrients is critical for optimal brain function. Carbohydrate is the only energy source that the brain can use for fuel (other cells can use either carbohydrate, fat, or protein; but the brain can ONLY use carbohydrate). Fat forms the major material of cell membranes in the brain and nerves (these membranes are critical for normal transmission of chemical messages throughout the body). Protein provides the building blocks for mood-regulating brain chemicals like serotonin (low serotonin levels have been associated with depression and anxiety). 

Effects on attitudes and behaviors towards food
  • Food preoccupation. Your body desperately wants to eat, so all of your thoughts and interests involve food.
  • Collection of recipes, cookbooks, and menus. Again, your body is fascinated with food because it is so hungry!
  • Increased consumption of coffee, tea, and diet sodas. As your energy levels plummet, you turn to stimulants in these beverages to keep you going. What you really need is food energy (from carbohydrate, fat, and protein).
  • Loss of body’s natural mechanisms for regulating hunger and fullness. When you let a diet dictate what and how much you should or should not be eating, you lose touch with your internal cues that normally regulate hunger and satiety. This can lead to overeating in the future because you can’t tell when your body is physically full.
  • Binge eating when food is finally available. After all, your body doesn’t trust that food will be available again later. So, it desperately tries to hoard as much food NOW as it possibly can.
  • Dichotomous thinking about food (i.e. “good food-bad food” mentality). Diet books love to put foods in these two categories. And when they do, two things happen:
    1. Your cravings for the so called “bad foods” increase (after all, whenever something is off limits or forbidden, we seem to want it more).
    2. Your risk of binge eating on the so called “bad foods” increases (after all, if you eat one cookie, you’ve already blown your “diet,” so you might as well eat the whole box and then restart your diet tomorrow).
As you can see from this list of effects, restrictive dieting negatively impacts not only your emotional, social, and academic life, but it also can directly contribute to binge eating and weight re-gain (as mostly fat) later. Consider this: there are more diet books, diet centers, diet supplements, diet drugs, and diet foods now than ever before. And, there are more people dieting now than ever before (an estimated one half of US women and about 1/4 of US men are on a diet at any given time). Yet obesity rates have increased 50% over the past decade! And, eating disorders are more prevalent than ever! Just a coincidence? No. Dieting helps contribute to both obesity and eating disorders.

Overcoming Fears (if you are a restrictive eater):

If I eat more, won’t I gain weight?
Not necessarily. As you increase your calorie intake to a more appropriate level, your resting metabolic rate will rev back up to normal. So, even though you’re eating more, you will be burning more, and your weight will stay the same. 

NOTE: If you previously lost a large amount of weight rapidly through very restrictive dieting and now you are underweight, it may be in your best interest to gain a little weight back. But, most of this weight gain will be due to the reconstruction of your lean body mass. Consult with a Registered Dietitian or other qualified health professional for help with this.

How many extra calories does it take to gain 1 pound? 
It costs about 3500 extra calories to gain 1 pound. In other words, if you need 2000 calories per day to maintain your healthy weight, you would have to eat an extra 3500 calories per day (5500 calories total!) to gain one pound a day. It’s very unlikely that you’ll eat that much or that you’ll gain that much weight that fast. 

NOTE: It’s important to realize that your weight may fluctuate 1 or 2 pounds each day depending on when you weigh yourself. Whether or not you’ve just eaten, drank something, or gone to the bathroom can cause your scale reading to fluctuate. But this does NOT mean that you have gained or lost 1-2 pounds of FAT each day. The weight change is simply due to normal shifts in fluid levels and digestive tract contents. Don’t let the scale numbers scare you.

To gain one pound a week (which is much more realistic), you would have to continuously eat an extra 500 calories per day for 7 days. So, for a person whose maintenance needs are 2000 calories per day, that's 2500 calories per day for weight gain.

NOTE: If you have been eating a very restrictive diet for a while, and you have lost a lot of weight, your metabolism may become super revved up (above normal) when you initially increase your calorie intake. Because of this, it may take many more extra calories before you see a healthy gain in weight. As your weight gets closer to a healthy level, and as your body becomes more accustomed to the more normal calorie intake, your metabolism will return to normal and you won’t have to eat as many calories.

But, whenever I eat more, I can see my stomach getting fatter!
When you first start eating more, your stomach may appear more distended, but it is NOT fatter. Your stomach may be distended because…
  • There is more food in it (but it settles once the food has been digested).
  • You are retaining a little water (but that goes away after your body adjusts to the new eating routine).
  • You are constipated (but as your digestive tract gets used to processing more food again, it will speed up and your bowel movements will normalize).
Positive Steps For Change

1. Discover what purpose restrictive eating and dieting is serving in your life. Is it your way of asserting control? Dealing with an underlying anxiety disorder? Boosting a damaged self-esteem? There are many reasons why people develop disordered eating behaviors. Take advantage of the caring and confidential counseling services on campus to help you make this self-discovery. Click here for more info on why eating disorders develop. 

2. De-code your “fat feelings.” When you say you are feeling fat, is there a feeling underneath? Are you feeling insecure, sad, overwhelmed…? Learn how to express your emotions without abusing food or your body. Again, take advantage of the caring and confidential counseling services on campus to help you with this.

3. Determine what weight is a “healthy weight” for YOU. Each one of us has a healthy weight based on our genetics, muscle mass, and body type. Being under your healthy weight is just as damaging to your health as being above your healthy weight. Sometimes it’s hard to accept the weight that is healthy for you (especially with the media’s ideal body in mind). But, learning to love (or at least accept) your body is key to treating it with the respect and care it deserves. Click here for more info about “How Much Should I Weigh?” 

4. Learn the basics of good nutrition so you can fuel your body with optimal energy and nutrients. After months (or years) of restrictive dieting, you may not know what normal eating looks and feels like. And, you may be scared to adjust your eating plan on your own. Seek the guidance and support of a Registered Dietitian to help you. And, be sure to check out the Nutrition 101 section of this web site.

5. Take baby steps towards your goals, and be patient with your progress. If you have learned that your body needs about 1800 calories per day (but you are only eating 1000), start by trying to add 200 calories to your usual plan. Start by adding more foods you are comfortable eating, and then gradually challenge yourself by adding some of the “forbidden” foods you have previously avoided. No food needs to be strictly forbidden. Balance and moderation are key to health and happiness. Get help with this if you need to. 

6. Listen to your self-talk. That “little voice” in your head is your self-talk. Positive (or negative) self-talk can be very powerful. If you go into an exam thinking “I can do this. I’m totally prepared. I’m going to ace this thing!” you’re far more likely to be successful than if you go in, worrying “I’m not ready for this. I’m going to fail!” In addition to affecting your academic performance, self-talk influences your athletic performance, your ability to overcome personal crises, and your eating and physical activity behaviors. Click here for more info on self-talk.
 

Sheri Barke, MPH, RD
COC, Student Health & Wellness Center
Rev. 2005