Here's how I ate to gain weight to recover from anorexia and bulimia. I ate a largely whole-food plant-based, vegan diet. I gained over half my body weight back.
I gained weight on a calorically-dense WFPB vegan diet twice as fast as I had gained weight on an omnivorous diet.
Regaining my weight was the second time in my life I had to recover from anorexia. The first time was done under conventional medical treatment, so the diet was meat and dairy heavy. Weight restoration took twice as long on this diet. And the physical consequences of eating the the Standard American Diet were immense.
Disclaimer: I remove exact calorie counts here because they can be triggering. There is no one diet or way of eating that's best - I share what I did for informational purposes. I am also just barely 5'1", which also affects how much I intake versus someone else.
Table of contents
Sample meal foods
General meal composition
This is a real entry from 1 day of eating. It gives an idea of how I ate on all days. If I were to model an “ideal day of eating” for anorexia recovery, I would decrease the protein and fiber intake (while increasing fat).
This is because protein is the hardest-to-digest macromolecule, and protein and fiber make one feel fuller. This is the opposite of what an anorexic person needs.
The Carb:Fat:Protein ratio is about 40:50:10.
So, I ate a majority of fat, some carbs and minimal protein.
I aimed for at least 4,000 calories daily.
Reasons for the calorie and C:F:P ratio:
The average female needs at least 2,500 calories to just maintain body weight. And a starving female, to gain weight, needs to eat much more. I tried 3,000 calories for many months but my weight kept dropping.
Carb and protein were not helping me gain weight. Eating large amounts of fat finally got me to gain weight. It was eating an 80:10:10 ratio that made me lose a significant amount of weight in the first place.
I ate every 2-3 hours, never letting myself go hungry. My eating schedule began with 3 meals 2 snacks, and eventually evolved into 4 meals spread throughout the day. I don’t think it especially mattered as long as I got my calories in at regular intervals. Making my biggest meal my final meal (at least not tapering off my eating throughout the day) helped me gain more weight – more on that explained below.
Sample meal foods
Every one of the meals I had about the same proportion of calories, such as this breakdown from breakfast.
2.5 tbsp nut butter
2.5 tbsp flaxseed oil*
2 cups white rice
1 cup cooked leafy green vegetables
General meal composition
Each meal, I included at least:
2-4 tablespoons nut butter
Processed carb (e.g. white rice, flour)
2 tablespoons flaxseed oil*
This is the one non-WFPB part which may be controversial. I don’t think eating oil was necessary to my recovery, but I eventually tried it to because I was at BMI 11 for months. I was desperate, and oil finally got my weight to move up and minimized digestive discomfort.
I believe that for severely underweight people, oil is more health-promoting (given the extreme circumstances) than harmful.
The digestion of a severely underweight person is broken. Just as one would administer potassium to someone with severe hypokalemia rather than give them pounds of bananas to consume (arduous to digest and not quickly enough assimilated given the situation), a person in dire need of more fat in the body can benefit from oil.
I do not consume oil now. I stopped eating oil once I got my period back.
I chose flaxseed oil because it’s shown it can be beneficial for female hormonal health
Protein I limited the most on purpose. I tried to eat no more than 1 cup of beans (in the form of tofu most often) daily. I knew protein is the hardest to digest and already I felt bloated from eating such a large amount of food.
To gain weight, I reversed all weight loss advice
Again, many plant-based eaters, and especially WFPB eaters, are trying to lose weight. I read books like How Not to Diet by Dr. Michael Greger in order to apply all the advice in reverse, to gain weight instead.
Here's how I ate on a mainly WFPB, SOS-free diet to recover. The only part of my diet not compliant with WFPB was oil, which was actually a key addition which helped me finally gain more weight. I don't believe oil is necessary to recovery but it can be extremely helpful.
I ate calorically-dense, processed, all cooked food only
In Chef AJ’s language, it was food all to the right of the red line
I ate just as much at night as during the day
From my readings of books like How Not to Diet by Dr. Michael Greger (which I read to apply the advice in reverse), I knew my body would convert more of what I’d eaten at night into fat and body mass than what I ate during the day. What people eat during the day is burned more throughout the day than stored in the body.
I limited fruit and leafy vegetable intake
I still had vegetables, at least the minimum recommended amount, but it’s very easy for an HCNC to especially overemphasize them. I’d remind HCNC’s on a WFPB diet that all the carbs they’re consuming are vegetables too (like potatoes)
Before I figured out the diet which finally got me to gain weight (shown above), I made the mistake of eating too many fruits and veggies. They only filled up my stomach with more water and fiber, and used up digestive energy, without giving me the caloric density and fat I needed.
Fruit is mainly water and carbs didn’t help me gain weight. I ate some berries daily and otherwise did not eat much fruit.
Liquid meal replacements were helpful
I found the liquid meal replacement Nourish (made by Functional Formularies) useful. It was the one vegan whole foods liquid nutrition brand I could find. The one ingredient it has which is not 100% WFPB is flaxseed oil. Each Nourish serving is 400 cal. Functional Formularies makes a similar formula called Liquid Hope, but that has much more protein, so I didn’t choose that.
Liquid meal replacements are advantageous because they are:
Both aspects are key. Reducing channel factors (i.e. making the healthy choice convenient) makes it easy to eat well. When I was too busy or stressed to cook much, I would end up drinking lots of Nourish throughout the day to help make sure I got my calories in. I drank up to 4-5 Nourish packets daily, averaging more around 3 daily during some phases during my recovery.
I do not drink any liquid meal replacements or ingest oil now that my weight and period are stably restored. I think there's no issue with continuing to eat these, especially if one has trouble maintaining weight.