Hungry like the wolf, or like someone who's been starving herself for years...

July 1, 2010 3:23 PM

A few weeks ago while I was clicking around a bunch of size acceptance/health at every size blogs, I came across a comment from someone claiming that most if not all recovering/recovered anorexics require more food/calories than someone else of their relative same size who hadn't been anorexic (or maybe it was that they are hungrier? I do not remember exactly). I can't find this comment again, and my Google searches for any kind of study or explanation have not been fruitful.

This seems slightly weird to me, since people need different amounts of food (and different types of food) anyway; bodies are so different. How can anyone tell if one person is really hungrier than they are "supposed to be"?

Does anyone know if this has been studied, or if there's any further information?

I'm not particularly looking for your own personal experiences, although I'm definitely interested if anyone wants to share.

(n.b., I am not looking for any fat hate, anti-size acceptance/health at every size, or pro-ana comments or stories. Thanks.)

posted by shamash to Health & Fitness (6 answers total)

Here is the primary source that asserts what you cited.
posted by halogen at 3:35 PM on July 1, 2010

RESULTS: After weight restoration, restricting anorexic patients required significantly more calories per day to maintain weight than did bulimic anorexic patients, as measured with corrections for weight, body surface area, and fat-free mass. Previously anorexic normal-weight bulimic patients required significantly more calories per day to maintain weight than never-anorexic normal-weight bulimic patients, as measured with correction for weight but not with the other factors used to correct caloric intake.

Notice that the paper compares women with a history of anorexia to women with bulimia (or history thereof), not anorexics and healthy women. The comment you cite must be either incorrect or referencing a different study.
posted by halogen at 3:41 PM on July 1, 2010

I've heard that, too, and always been quietly skeptical. The problem is that - if I understand the study correctly - it relied on self-reported data. With all the perils that entails.

Asking ANYONE to report the number of calories they consume is just asking for an unreliable data set. Much less people who are undergoing psychological treatment for eating disorders.

But I have also heard it explained as "anorexics break something in their body's metabolism," which sounds plausible at least. In other words, it's not that they burn more calories, it's that they go through more calories because their bodies process the energy inefficiently.
posted by ErikaB at 4:20 PM on July 1, 2010

i'm a former anorexic. i was never at hospitalization level, but i was at a very unhealthy weight and looking to go lower. this is all anecdotal, but here it is:

my body doesn't relay "hungry" to me in the same way as it used to. i had to pretty much stop trusting it at all and try to eat on a schedule. the closest thing i have to something i recognize as "hunger" is "blood sugar crash" which is a message delivered too late, if you ask me. i have no idea on the more/less calories, but on the more/less hungry question i define more as i'm either always hungry or never hungry because there's no sign my body gives me that relays that information effectively. also, i grew more "peach fuzz" around my face and i feel that my body stores fat more than it used to (but, that again might be my own fucked up perceptions).

i'm inclined to agree with you that bodies are too different to say "this subset of people need this many calories", but being anorexic absolutely fucks with more than just your head, even more than a decade later.
posted by nadawi at 4:51 PM on July 1, 2010 [1 favorite]

This NY Times article mentions it in passing but doesn't explain why.
posted by unannihilated at 5:55 PM on July 1, 2010

I'm sure that it's that recovered anorexics need more food (as in the study cited above), not that they are hungrier. I've never heard the hungrier thing - though, like nadawi said, hunger signals can get messed up, though usually in the opposite direction, where people don't realize they are hungry.

You might also be interested to know that anorexics who are in the process of restoring weight (gaining their weight back) often, though not always, need huge amounts of calories to gain weight. I'm recovering from an eating disorder, and was in the hospital for it, so I saw this firsthand. In order to gain 1-2lbs a week, with no exercise at all, the people who were a little bit underweight to start usually needed about 2800-3000 calories per day. The anorexics who were very underweight, however, often needed more like 4000 calories per day, and sometimes even more than that.
posted by insectosaurus at 6:46 AM on July 2, 2010