Written to a client about the importance of decreasing stress, reducing exercise, and eating more fat in order to get a period:
The most stressful part of your life right now is trying to recover from anorexia and deal with all the hunger and food thoughts, the wonder of if you’ve eaten too much, the fear of weight gain, etc. If you let that all go and just follow the rules we’ve established [the meal plan, rules to not exercise, etc.], then you’re going to be much less stressed. And therefore get menses back sooner.
Hypothalamic amenorrhea is not having a period due to too much stress on the body (physical + mental). Mental stress causes people to miss their periods, lose their periods, etc. all the time. That’s why you have to decrease mental stress too, which you could if you just followed the plan and gave up trying to worry about everything and predict what you can’t predict. Focus on the present.
You have ALL the power to influence when your menses returns.
I keep repeating that you need more dietary fat not just because it’s the most calorie dense, but because physically, to have menses you HAVE to have that minimum body fat % at least. Menses is linked to body fat, not overall body weight. Body weight higher just correlates with body fat % being higher. But if you attempt to increase your body weight without increasing body fat % (as you have been doing by trying to avoid fat), you will not get menses back sooner. Rather, you’ll have to increase your bodyweight to HIGHER and HIGHER, and likely be wondering why your period hasn’t returned.
If you hit at least 11% body fat sooner and got menses back sooner, then you wouldn’t have to increase your overall weight as much
This is why I just thought it was so painful to watch you stuff yourself on low-fat food, to the point of being uncomfortably overstuffed. I did that too and there was no point in any of that because it wasn’t helping me gain weight nor body fat. As you know, as Dr. Goldhamer says, “The fat you eat is the fat you wear.”
If I were you I’d be eating ALL the fat. Yeah it could cause temporarily more oily skin, breakouts, whatever. But your hormones will fluctuate and need to restore to normal levels, and this is all the process you have to go through to finally recover. If you have to go through it anyway, might as well do it faster.
And you can tone down how much fat you eat once your period comes back for at least 3 cycles, aka your body is feeling happy finally.
If you are X lb and still like 5% body fat, no way you’re going to have a period. If you keep eating your current diet, you might go up to like Y lb and still be around 5% body fat, and you still won’t have a period.
I even started eating oil for a reason. I needed to get the fat and calories in. I’m not saying you have to eat oil, but even oats for example, nobody considers a “high-fat food.” Fat is the most healing food for you right now. The fat you eat is the fat you wear, and you NEED to wear more fat.
If you’re too scared of nut butter still, just add seeds or your favorite nuts. Just try a handful. It’ll help you absorb more nutrients from all your food anyway, the fat-soluble nutrients.
I still eat fat at every meal, like I said, because I know how important it is for nutrient absorption. I add nuts, seeds, avocado to everything.
I had flaxseed oil cause people (including Dr. Csilla Veress) say that’s very good to help the period come back. Also as you know it’s loaded with those good omega 3’s, which I know you have a good amount of, but more is always helpful.
You getting your period for at least 3 cycles is the real point when you can say you’ve physically recovered. So if you eat lots of fat, you could get it sooner than overshoot like you said, and prevent having to overshoot at all or as by much.
And part of de-stressing is NOT looking at your weight #, because as you know, every time you look at it you get panicked.
Too high cortisol = no period. Hypothalamic Amenorrhea.
And cortisol is highest in the morning, naturally.
So getting super stressed in the morning (checking your weight) and doing stressful exercise in the morning... that can keep your menses from coming back, forever. Some people get their menses back JUST from stopping all exercise.
To get my period back sooner, I should've decreased my mental stress more
I’d decrease my mental stress WAY sooner. That was huge for me because I was already eating so much fat.
I personally wasn’t stressed over weight gain or trying to avoid overshoot, my stress came from other sources.
It's all about the cortisol, getting that down.
And again cortisol is highest in the morning, so please don’t overstress yourself in the morning especially by checking your weight + freaking out over it, or exercising at all.
If I had minimal mental stress going on then for sure I would’ve gotten my period back WAY earlier and probably wouldn’t have gone up to X lb, which isn’t even that much.
Actually, the first time I recovered from anorexia too (under conventional treatment), the mental stress kept me at my peak weight for months, but no period coming back.
When I calmed down more and stopped being so stressed out about recovery, it was way easier to get my period back. I just trusted that eating and resting would bring it back, and it finally came back.
Yours will come back too when you get physically and mentally healthier :)
All that extra stress and cortisol on the body does you no good. Yes, moderate exercise can lower cortisol and boost dopamine, but only those who are ACTUALLY at a healthy bodyweight. Right now exercise just harms you more and spikes your cortisol, telling your body you’re still in a famine.