To someone struggling with an eating disorder, the concept of weight gain can be utterly paralyzing. There is so much stigma and judgement surrounding the idea of weight gain. And while yes, there is the basic meaning of actually restoring weight that has been lost, it's also so much more than that. As eating disorder recovery clinicians, some of our goals for you include:
Resuming a menstrual cycle
Decreasing preoccupation with food
Normalizing sleep patterns
Normalizing metabolism and basal metabolic rate
Normalizing digestion -> gastric emptying -> decrease early satiety -> poop normally and decrease constipation
Regulate body temperature on your own -> increase your energy
Reduce stress/allostatic load on the body
Improve your mood
Reduce anxiety and depression
Reconnect your gut/brain to hunger/satiety cues -> Help hair growth, skin and nails
Reconnect socially and reduce isolation
So many of my clients ask, the very black and white questions, "How do you know when I have reached my goal weight if you can't tell me for sure what that even is?"
The answer is very gray and lies in the details. Typically, once children have resumed their normal growth trajectory and the medical complications listed above have started to decrease, that is a good indicator that set point has been attained or is close. For adults, since we don't have the luxury of growth charts, we look at weight trends over time. A decrease in the above complications and a willingness to add flexibility and imperfection to their meals (among other things).
Weight restoration in eating disorder recovery means so much more than just "gaining weight". It involves the slow but dire process of bringing all metabolic and physiologic functions back "online".