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Following my fascination with what is commonly referred to as 'metabolism,' I realized that I know a few "recovered anorexics" (please let me know if there is a better term), all of whom maintain normal weight on a normal lifestyle, and one of whom has decided to become a dietician to help others with the condition.

It occurred to me that while these individuals now eat basically normally, they also don't seem to have a propensity to gain weight above that which would be expected of others of their ages, genders and backgrounds. This would seem very odd considering some only a few months earlier had BMIs below 15, eating under 500 calories a day.

The question is, therefore:

Do metabolisms, or more specifically the normal ability to process "normal" amounts of food for energy while maintaining "normal" weight, of individuals with anorexia nervosa recover, and in what way?

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    For the "& in what way" part of the question, are you asking for the biological mechanisms behind changing metabolisms? The studies I know off hand are from people who were starving due to circumstance (not anorexia), but I think it will be generalizable. I'm going to start a lit review to be sure, but if the case is similar to say, a starving child, then the answer will be yes, though if growth has been stunted the delay will often persist. – Atl LED Sep 21 '15 at 0:00
  • @Atl That's definitely a good part of what I'm looking for. Would you mind providing sources? – TheEnvironmentalist Sep 24 '15 at 5:08
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They appear to.

In Caloric consumption and activity levels after weight recovery in anorexia nervosa: a prolonged delay in normalization, researchers looked at anorexia patients 2 to 6 weeks after what is called "refeeding", and patients 6 months after.

Patients with anorexia nervosa, in the weeks after achieving target weight and terminating refeeding, have elevated levels of activity and caloric intake, compared to normal controls. In contrast, caloric intake and activity in anorectics who had maintained weight for months after weight recovery were similar to controls.

So they were maintaining weight at the same amount of calories that people without a history of anorexia were also maintaining their weight at.

The same was found in this study: Resting metabolic rate and total energy expenditure in acute and weight recovered patients with anorexia nervosa and in healthy young women

No significant differences were found between the weight-recovered anorectic women and the healthy controls in RMR (1,330 ± 131 kcal/day [weight-recovered]; 1,419 ± 197 [controls]) and in TEE (2,602 ± 637 kcal/day [weight-recovered]; 2,596 ± 493 kcal/day [controls]).

RMR = Resting Metabolic Rate; TEE = Total Energy Expenditure

Both studies had small sample sizes though.

During recovery, patients recovering from anorexia need more calories than expected for weight gain, which is called hypermetabolic, but that period ends at around 4 to 6 months.

Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment (figure 2)

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