I am 26, female with anorexia. How to feel better?

Question

Hi doctor,

I am a 26-year-old female, and my height is 152.4cm. I have been dealing with anorexia, amenorrhea, ulcerative colitis, and anemia. Of these, I had anorexia as a teenager and went to rehab eight years ago. Since then, I have had weight regulation issues.

TSH is normal, but that is all my doctor tested me for. I lost my periods for years until rehab and have had them back since. I shot up to the overweight range after rehab on a diet of calories. I gain weight on a diet calories and my body does not work normally. Currently, I am taking medication Inflectra.

Need advice

Answer 1

Hi,

Welcome to icliniq.com

Thank you for sharing this. Given your history of anorexia, amenorrhea, ulcerative colitis (UC), and anemia, it is understandable that your body may still be in a state of metabolic dysregulation.

Even though your thyroid stimulating hormone (TSH) is normal, a full thyroid panel, including free triiodothyronine (T3), free thyroxine (T4), and reverse T3, along with cortisol, insulin, fasting glucose, leptin, and sex hormones (estrogen, progesterone, luteinizing hormone, and follicle-stimulating hormone), would give a clearer picture of your metabolic and hormonal status.

Years of malnutrition can cause the body to downregulate metabolism as a protective mechanism, which may persist even after weight restoration. Additionally, chronic inflammation from ulcerative colitis and medications like Inflectra (infliximab-dyyb) can affect weight, water retention, and how your body processes food.

You are not alone in feeling like your body does not respond typically to “diet calories.” I recommend working with a registered dietitian who has experience in eating disorder recovery and chronic gastrointestinal conditions, alongside an endocrinologist for a deeper hormonal evaluation.

Focus on gentle nutrition and movement you enjoy (not punishment-based), and continue monitoring your UC and iron levels closely. Your body may still be healing, and it deserves compassion, not blame. There are ways to help support it medically and nutritionally without going back to restriction.

I hope this answers your query.

Thank you.