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A friend of mine has obviously brought her metabolism into starvation mode by performing strict low-calorie diets (without any exercise) for over ten years. This has resulted in a yo-yo effect where she can hardly eat more calories than her basal metabolic rate without gaining weight, so she diets again every few weeks.

What is the best way to break this vicious circle of dieting and gaining weight again after eating normally? How can she bring her metabolism out of starvation mode?

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This is a situation where she needs to take a step backward in order to move forward. The worst thing she could do is lower her net caloric intake again via diet or lots of exercise, as that will just reinforce "starvation mode" to her body.

I would suggest she starts by eating natural whole foods to fill for a few weeks. Its probably best to avoid tracking calories or scale weight during this time, because of the potential psychological impact. She isn't likely to gain any "bad" weight with these foods and it sounds like her body could really use the nutrients.

Progress can be measured by trying to determine her basal temperature; it's probably quite low now (almost nobody on the planet actually has a 98.6 deg. temperature). I'd suggest measuring this first thing each morning. As she eats well, per above, her temperature should slowly rise. Somewhere in the upper 97's might be a good target to shoot for, but some significant gain is a good sign that her body's state is improving.

Regarding exercise, the Body By Science workout might be a good choice, as the workouts are infrequent and burn few calories, while still encouraging muscular growth and cellular cardiovascular efficiency.

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    I concur that her situation will definitely need to take a step 'backward' to get anywhere. A starvation diet like that will often shed more muscle than fat. When she starts eating properly again, she will definitely gain weight, but it will likely be more muscle than anything else as the body attempts to right itself. It might look like fat, but that's probably because the muscle is being built underneath existing fat that isn't visible otherwise. I also concur with not tracking calories; the top priority is to get her out of that frankly life-threatening cycle.
    – tmesser
    Commented May 29, 2011 at 16:52
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If she's been on a low-carb diet than it's likely the immediate weight gain is just water and glycogen being replenished by the consumption of some carbohydrates. If you start a low-carb diet in the first few days you'll likely lose around 1.5kgs which will just be water and using your glycogen stores. Same will go back on when you reintroduce carbs into your diet.

as long as she understands this is just water and not fat, she should be ok. if she's eating the number of calories as her BMR suggests, then she shouldn't be gaining weight.

encourage a diet based on veges, fruit, meat and nuts. as less processed as possible. she should stay healthy and lean.

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To bring out the metabolism to normal you can follow these steps:

  1. Give small amount of food at 2 hour interval.
  2. First increase cereal servings gradually at the interval of 3-4 days. Start with easily digestible ones like soft rice, porridge, etc.
  3. Then add high protein foods like milk and milk products. Give fermented milk products like curd, yogurt, and buttermilk. Soft pulses e.g. green gram. Fish, chicken etc.
  4. Then add fats like cream, toned milk (3%), Cottage cheese, soft cheese etc.
  5. Then add soft fruits like banana, papaya.
  6. Then add blanched vegetables-green leafy vegetables like spinach, cabbage, celery, lettuce etc.
  7. Also stewed fibrous fruits & vegetables like apple, carrot, and radish.
  8. Depending on how much weight you want to increase incorporate other high calorie, fatty foods. Also the protein intake will depend on the same.
  9. Thus you have to increase Calorie & protein intake, cereal servings on 2-3 hour interval, give at least two liter water per day.
  10. All these things will help to maintain the normal metabolism & will help to gain the weight.
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One word: Exercise. (Strictly speaking, your best option is diverting that unspent energy to something more useful than fat gain.)

Ideally not some silly cardio regimen; aim for resistance training, preferably with free weights. It's good for the body, and some modicum of muscle mass looks great on everyone. More lean body mass will also increase your BMR. I'd recommend Stronglifts 5x5 if she can manage the empty barbell, perhaps some dumbbell program if she's a tiny ana.

Do keep track of calorie intake. 'Normal eating' doesn't mean anything, and people tend to focus a lot more on metabolism than warranted..

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  • This advice is outright dangerous. If someone's body is in a starvation mode, increasing exercise to reduce the number of net calories is the last thing you want to do. There are hordes of reports on how the extreme cases, anorexics, literally die of starvation doing this. Eating under starvation levels does grievous damage to your body, especially when it's done over the long term like this. Much like working out when you're sick is not a good idea, working out when you're starving is not a good idea.
    – tmesser
    Commented May 29, 2011 at 16:55
  • @YYY: The OP does talk of increased calorie intake...
    – eevar
    Commented May 29, 2011 at 18:00

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