In today’s blog post, nutritionist Elaina Efird, RDN, CD, CEDRD, CSSD discusses a case study that shows the impact of bingeing and purging on your metabolism.

Case Study: Bingeing and Purging

In this example, the individual is 5 feet, 3 inches tall and weighs 150 pounds. She understood that her binge and purge behaviors were disordered and needed to be addressed, but she didn’t think it was that big of a deal. She didn’t believe they were truly impacting the way her body functioned. In fact, she initially came to The Kahm Clinic with a goal of weight loss. Elaina soon realized that she was bingeing and purging, and the focus shifted to correcting these behaviors. “That’s what’s really insidious about eating disorders,” says Elaina. “It’s normal to convince yourself that you’re okay, even though you’re not.”

This patient was bingeing three to four times per week. One binge often included 2,000 to 3,000 calories worth of food. She would then purge after every binge. Additionally, she was purging on days where she hadn’t binged but instead had a perceived binge. For instance, she would eat something that she didn’t think she should — like a single cupcake — and purge afterwards.

The Impact of Bingeing and Purging on Your Metabolism

Of course, we wanted to correct these disordered eating behaviors. To start, we completed her metabolic testing and found that her metabolic rate was fairly normal. She was burning 1,560 calories per day — 100 calories above the expected 1,460 calories per day for someone her age, height, and weight. “When people binge, the density of those binges helps to maintain their resting metabolic rate (RMR) and keep it nice and high,” Elaina explains. “That’s not to say the behaviors are okay! But it does explain why her RMR appeared normal in this instance.”

One red flag was that her carbohydrate metabolism was slightly too high. She was bingeing late at night, at a point in the day when her digestion was slowing down. It was taking the body a long time to process that food, which caused this number to be high (despite her fasting prior to this test). In other words, at the time of testing, her body was still breaking down too much food from a prior binge.

The Kahm Clinic’s Treatment Approach

This individual was eating 1,300 to 1,400 calories during the day and then bingeing and purging at night. To start seeing positive results, we worked on ensuring that she increased her intake in the earlier part of the day. Remember: Her RMR is 1,560 calories; that’s how many calories she burns if she does absolutely nothing throughout the day. We needed to adjust her intake based on her RMR, her daily activity level, and her exercise habits (at least an hour per day, five to six days per week). 

At first, she was only comfortable consuming about 1,800 calories a day. We stressed the importance of front-loading those calories, meaning she ate a majority of her food at breakfast. “This approach helps to set you up for success later in the day,” Elaina shares. Oftentimes, if you binge late at night, you wake up either feeling full or sick and decide to start fresh by delaying your first meal. A big breakfast helps to break this binge-restrict cycle by ensuring that your body is adequately fueled throughout the day, which in turn helps you manage those emotions that trigger a binge.

We slowly progressed her to 2,400 calories a day, which she is maintaining to date. We completed a second metabolic test about seven months later. Her RMR increased to 1,790 calories per day, which means her body is functioning even better than before! Additionally, her protein, fat, and carbohydrate metabolisms are all within normal range. 

It’s important to note that her bingeing didn’t just “go away” by eating a well-rounded breakfast in the morning. However, by front-loading her calories and working through her emotional triggers with a therapist, she slowly decreased the frequency of her binges and purges. Her body was better fueled, but she also learned how to better control her emotions.

To talk to a professional about eating disorder treatment, please reach out to our staff or schedule an appointment at The Kahm Clinic today.