2/6/2019 1 Comment
One of the major causes of hypothalamic amenorrhea is under eating and low energy availability. This isn’t necessarily intentional. Some ladies don’t eat enough without knowing it and end up with missing periods, a condition called hypothalamic amenorrhea (HA). That being said, a huge portion of women who lose their periods due to under fueling (and/or over-exercising) do so because they have a bad relationship with food and their bodies. Learning to love your body and truly enjoy food is a huge part of healing hypothalamic amenorrhea.
Replace Restriction With Permission
Think about it. One of the major causes of HA is under eating. It’s logical to think that one of the major solutions to this problem would be to eat more. Unfortunately, in most cases it’s not that simple. For those who have a bad relationship with food and their bodies, eating more can come with a lot of guilt and other negative feelings.
It can be scary to let go of all of the food rules and allow yourself to relax and simply enjoy eating. Don’t let fear stop you! Your goal is not just to heal your hypothalamic amenorrhea. It’s also to heal your relationship with food. It will take a lot of hard work and commitment, but eventually you’ll feel less out of control around food.
Why & How You Need To Be Eating More
It is important to understand that while working to recover from underfueling, you have to be intentional about eating more. Over time, you have likely either trained yourself to ignore hunger and fullness cues, or if your underfueling has been unintentional, your hunger and fullness cues have not naturally led you to eating adequate amounts – likely due to not adequately fueling your exercise. To start with, you will probably have to plan your eating – making sure to eat first thing in the morning even if you don’t feel hungry, having at least a snack every couple of hours, and mindfully increasing your overall calorie intake during the day. This can mean larger portions or incorporating different food choices that contain more energy.
You may have heard of the idea of Intuitive Eating. This is a way of eating that encourages you to respect your hunger and fullness cues, but as we just discussed, until you have reset those cues from the time of restriction/underfueling, IE is not necessarily appropriate. However, overall Intuitive Eating is a great way to help heal your relationship with foods as mentioned in my blog post about Intuitive Eating in the link above.
Eating enough is absolutely crucial when you’re recovering from hypothalamic amenorrhea. Recognizing that your hunger and fullness cues aren’t firing properly and working with a non-diet dietitian to make sure you’re properly nourished can be monumentally helpful. Traditional dietitians are often telling woman they need fewer calories than they actually do and are not familiar with HA. Eating more (calorically dense) food and eating more frequently probably won’t come naturally at first, but as your body and mind get used to the new amount of fuel and types of food, both the physical sensation of hunger and fullness signals, and the emotional aspect of going against many food rules you had in place before, will get easier.
Eating “Too Much”?
It’s common for ladies who want to heal their relationship with food (and their hypothalamic amenorrhea) to feel like they are eating large amounts, and to put the negative label of “binging” on this behavior, once food rules and restrictions are out of the equation.
Eating more (and eating enough, and even eating more than you “need”) is not the same as binging.
When you first start adding more food into your routine it might feel a little hectic and out of control, but that’s to be expected. Most of us find that food restriction leads to eating larger amounts when the restrictions are removed. Giving yourself permission to eat more foods (and foods that you enjoy) is what will ultimately improve your relationship with food and lead to more consistent eating.
At first, the feeling of fullness might deter you from eating enough and meeting your energy needs. This is because your body needs a little bit of time to get used to what eating enough feels like.
As you’re letting go of your restrictions and start eating more, you might need to eat past your initial feelings of fullness. It can be as simple as enjoying foods that you have been afraid of in the past, having a second helping of dinner even though it feels like you’ve had enough, or eating when you’re not necessarily hungry.
It is also important to realize that what you see or experience as a large amount of food is what your body needs to recover. It can feel scary to eat a lot at one time when you haven’t allowed yourself to eat enough for so long, because you wonder if you will be able to stop, and how often this will occur. Again, it comes back to restriction. If you continue to restrict in the times after you feel as if you have eaten a lot, the same pattern will repeat. This is another area where giving yourself permission is helpful – even if you ate more than felt comfortable at one meal or snack, it is okay to eat at the next meal time, whether that be breakfast, snack, lunch, or dinner – in fact, it is strongly encouraged to do so. The more safe your body feels that you will supply nutrients and energy that are needed, the less you feel the need to consume physically and mentally uncomfortable amounts at the times when you have given yourself permission to eat.
In addition, as far as the physical feelings around eating go, remember that having undereaten for however long means that you probably experience feelings of fullness more quickly when you eat what is, to most people, a “normal” amount of food. Pushing through these signals, for the time being, is often needed to get enough food in; over time your signals will readjust to encourage you to eat amounts that will truly fuel your whole body.
That being said, if you feel like you need a little extra help when it comes to eating more, what to eat, or the emotions that come along with eating more, reach out to a qualified medical professional. It’s all a part of the journey (especially in the beginning) but eventually you’ll feel less out of control around food and food will be just that… food. Think of it this way, for a very long time you have been following a certain “diet” or way of eating. You can’t expect to feel comfortable overnight once you start eating more or differently. This takes time, patience with yourself, and practice. I’m not saying it’s going to take years to do this but it will certainly take time. The more you “practice” this new way of fueling your body the easier it will get!
In the meantime, check out this post for a list of calorically dense foods designed to allow you to eat more without necessarily eating a larger volume of food. (Eventually, you’ll want to start increasing the volume of food you consume (however, it is possible to eat enough with calorically dense foods). This list is just to get you started by eating enough calories!)
“Bad” vs “Good” Food
There is no such thing as a “bad” food. Society and other medical professionals (that often have no experience with woman that have HA, body image disorders and all the other “fun” stuff that comes with HA) have deemed foods “good” or “bad”. Yes, as a Registered Dietitian I can agree that there are some foods that have more vitamins and minerals in them or other things that are beneficial to the human body. However, what your body needs right now is FOOD. Your body wants to be fueled with adequate calories through calorically dense foods (your body doesn’t know you’re eating a kit kat instead of kale, only your mind does. Right now you can’t necessarily listen to your mind). This includes but is not limited to candy, cookies, mac and cheese, chips, etc. All the foods society deems as “bad” or “unhealthy” are SO good for your body during recovery. If you eat an entire package of Oreos, there’s nothing wrong with that. This is not a binge, this is giving your body what it wants. This behavior of eating “lots” will diminish with time, especially with regular adequate fueling from the time you wake up until the time you go to bed (and even in the middle of the night if you’re hungry).
Remember all this out of control feeling and craziness is temporary (and normal). You can do this!
Who Needs a Period? They are a pain in the a** anyway !