Healing Your Metabolism After an Eating Disorder 

Written By


Expert Reviewed By

Dr. Lauryn Lax, OTD, MS

Dr. Lauryn, OTD, MS is a doctor of occupational therapy, clinical nutritionists and functional medicine expert with 25 years of clinical and personal experience in healing from complex chronic health issues and helping others do the same.

Different Kinds Of Food, Healing Your Metabolism After An Eating Disorder 

Eating disorders, chronic dieting and overexercise wreak havoc on your metabolism. 

Even once you’re in recovery, it can take time to heal your metabolism after an eating disorder. From unwanted weight gain, fatigue, digestive issues, thyroid and hormone problems, or catabolism (unwanted weight loss), you may wonder…Will I ever have a  “normal” metabolism after an eating disorder again?! The short answer: Yes. 

Here’s all you need to know about healing your metabolism after an eating disorder—including:

  • My Recovery-Metabolism Story
  • Metabolism 101: What Your Metabolism Is
  • 7 Reasons Why Your Metabolism is Not Working After an Eating Disorder, and
  • 3 Steps to Start Healing Your Metabolism After an Eating Disorder

Why Is My Metabolism Not Working?!

Woman Confused About Her Metabolism

“Will I ever have a normal metabolism?”

 It’s a question I am often asked by my clients and individuals in recovery from eating disorders, and it’s a question that I, at one time, often asked myself!

After struggling with eating disorders, including anorexia, orthorexia, exercise binging and purging, and ARFID, for nearly 20 years, my metabolism was a wreck—weight issues, digestion issues, mitochondrial cell issues and hormone imbalances galore!

And if there is ONE thing I’ve learned from both my clinical and personal research and experience, it is that your metabolism is definitely NOT the same as a “normal” person after going through a battle with an eating disorder or years of chronic dieting and overtraining. It goes crazy!

For some individuals: Your metabolism becomes super fast. Your body needs a lot of food as the metabolism goes through the roof! You struggle to keep weight on without necessarily trying. You struggle to build muscle or see progress in the gym.

For others: It becomes super slow. You have no real appetite. You can get by seemingly just fine on what others may consider a diet. You may even just look at a piece of pizza and seemingly gain 3 pounds. You struggle to tone up or see progress in the gym. 

In both cases, you may no longer struggle with eating disorder behaviors or even thoughts, but for whatever reason, your metabolism and your body composition seem like they are working against you—not for you.

Research supports this. For example: one study (Newman et al, 1987) evaluating the calorie requirements to maintain weight in recovery for women with a history of anorexia or bulimia found that energy and calorie needs varied significantly based on their former habits. 

For the test groups, researchers recruited anorexics who were 4 weeks into recovery at 95% to 100% of their normal body weight; comparing their metabolism needs to women with a history of bulimia who were 1 to 4 weeks into recovery and at a normal body weight. The findings? Even after weight restoration, the formerly restrictive anorexic patients required significantly more calories per day to maintain weight than did the women with a history of bulimia. In short: Your history and type of eating disorder may determine your metabolism in recovery.

My Recovery-Metabolism Story

I’ve been there. Got the t-shirt.

After 15 years of struggling with various eating disorders, chronic overexercise and trying every diet under the sun (even “healthy eating” diets), my body and metabolism were a mess:

  • IBS, bloating and constipation
  • No period
  • Low T3 (thyroid hormone)
  • Spinning my wheels in the gym—difficulty building muscle or improving my fitness performance
  • Autoimmune issues galore
  • Food sensitivities 
  • Cellular fatigue—feeling like everything in my body moved slower
  • Dulled hair and skin
  • Weakened, brittle bones 
  • Cold hands and feet
  • Weight management difficulties —a hard time maintaining and gaining weight (despite eating a diet fit for a healthy, active 6-foot-four-tall guy!). 

Over those years, my body was forced to adapt and survive off frozen Lean Cuisines, Crystal Light, keto bars, carb-less or protein-less meals— whatever “health kick” I was on that time. However, once the process of recovery began, and I began reintroducing adequate fuel to my body, it soaked it up like a sponge, and kept going and going and going (Energizer bunny style)—fast and furious. 

All of a sudden, I went from seemingly needing very little food to get by (despite 6 to 8 hours of exercise per day! , to needing upwards of 3000 to 4000 calories per day in treatment in order to barely gain or maintain my weight. A night and day difference!

Although my “hyper-metabolism” eventually slowed down in the years following treatment, today, although I have been in recovery for nearly a decade, my metabolism continues to be a fiery furnace! It is highly sensitive to any vast changes in its daily eating or workout routine, and can easily lose weight, as if it reverts back to the “set point” it knew for 15 years in my eating disorder. 

For others I’ve counseled in their recovery, they experience similar, but unique, metabolic challenges after years of chronic dieting, binging, purging, overtraining or other unhealthy stressors on their bodies too.

  • Their metabolism is seemingly “shot”—under-functioning and sluggish
  • They easily gain weight without trying
  • Their hormones are all over the place—crazy PMS, infertility, spotty periods 
  • Their skin breaks out constantly 
  • They can’t poo without working out or running 5 miles 
  • They need coffee or lots of caffeine to function
  • They simply don’t feel like their best, most vibrant self

If you’re in recovery and have ever wondered: Why is my metabolism working against me?!…It’s important to first understand what your metabolism is and 7 common reasons why your metabolism stops “working” after an eating disorder. 

Metabolism 101: What it Is 

By definition, “metabolism” means: the chemical processes that occur within a living organism in order to maintain life.

Metabolism is divided into 2 main functions:

  • Catabolism (breaking down molecules to obtain energy things down, including digesting your food, burning body fat, or in some cases wasting away bone or muscle)
  • Anabolism (stimulating growth from the energy released by catabolism to “build” and create new molecules, such as forming new muscle and tone after you break your body down from a tough workout) 

In laymen’s terms: Your metabolism is all about energy! Your metabolism basically means the energy that your cells require to thrive.

Every individual has a BMR (Basal Metabolic Rate) which equals to the amount of energy your body uses in a given day for all life processes (such as digestion, hormone balance, tissue and cellular repair and recovery, sleeping, brain power, working out, dealing with stress and more). Your BMR also equals the amount of energy (food, calories) you need to consume in order to keep a steady fuel supply for all bodily functions to work properly.

A slew of factors determine your individual BMR and metabolic rate—including:

  • Your genetics 
  • The types of foods you eat
  • Your pre-disposition for gaining muscle/losing weight (i.e. a hard gainer vs. an easy gainer)
  • Your workouts and activity levels
  • Your digestion—how well you absorb food and use it as energy
  • Your age
  • Your gender
  • Your environment (higher heat vs. cooler temperatures)
  • Your internal body heat
  • Your stress levels (does your body need more energy to deal?)
  • And…eating disorder recovery


Hence, the slower your metabolism, the lower your BMR, the less energy you have and the less efficient your bodily processes work. Your digestion is slower. Your thyroid is slower. Your brain feels fuzzy or slower. You feel sluggish or tired. You require coffee to function.  You struggle to see results in the gym—tone, muscle, anything. 

On the flip side, the “faster” your metabolism is, the more efficient your body is at using foods you eat and energy stores for all life processes—at least if you are healthy. Your body’s functions of nutrient digestion and absorption, hormone balance, immune balance, detoxification and cellular energy production work better…as long as your metabolism is not too fast. 

Woman Frustrated Because Her Metabolism Work Too Fast

If your metabolism is working too fast, you can fall into the trap of a “catabolic” metabolism. Your body is constantly in fight or flight or “break down mode”. It struggles to keep up with your functional and cellular demands balance for optimal digestion, hormone balance, brain health, detoxification, immunity and more—requiring more food and calories to repair, rebalance and function. (a.k.a. “hyper-metabolism”). 

Above all: An optimal metabolism is all about balance—not too slow, or not too fast.

For an optimal metabolism to occur, you need all systems of your body in shape: Your digestive tract is able to digest and absorb your nutrients, your liver is able to detox out toxins and pathogens, and the mitochondria in your cells are able to metabolize or break down carbohydrates, proteins and fatty acids in order to generate energy (ATP). (Things we will discuss momentarily). 

Unfortunately, eating disorders disrupt metabolic balance! Here are 7 reasons why your metabolism may stop working after an eating disorder.

7 Reasons Why Your Metabolism is Not Working After an Eating Disorder

#1 Disrupted Gut Microbiome

#2. HPA Axis Dysregulation (Stress) 

#3. Sluggish Thyroid 

#4. Poor Detoxification & Liver Health

#5. Undetected Nutrient Deficiencies

#6. Your Intuition is “Off” 

#7. You’re Undereating, Under-Sleeping or Overtraining

#1. Disrupted Gut MicrobiomeYour gut microbiome is the key to metabolism (Martin et al, 2019). The pathways of metabolism rely upon nutrients that your gut bacteria breakdown in order to produce energy that the body cannot create on its own. Gut bacteria determine things like how many calories you harvest from food, what kinds of nutrients you draw from your food, and what hormones are created to facilitate metabolic processes, such as GLP-1, PYY, GIP, 5-HT, and CCK, which influence key metabolic processes including glucose metabolism, insulin response, body fat accumulation, and feeding behavior (cravings, meal timing, likes and dislikes). 


Hence, if your gut microbiota are balanced, your metabolism is more balanced. If your gut bacteria are out of whack, then you can guess what happens to your metabolism and nutrient utilization? From malabsorption (food goes “straight through you”), to seemingly storing every calorie you eat (a “slowed metabolism”), indigestion (sluggish digestion), blood sugar imbalances (hypo and hyperglycemia), nutrient deficiencies (your gut bugs are unable to process and digest nutrients) and discombobulated feeding cues (confusion over hunger-fullness, eating at odd times, lack of appetite or insatiable appetite)…your gut bacteria play a bigger role in your metabolism and complete recovery more than most treatment professionals and programs give ‘em credit. 

Copious research reveals that, if you’ve had an eating disorder, your gut is probably not in balance. 

The brain-gut connection is a perfect example of gut imbalances in eating disorders. It is well-established within eating disorder treatment world that individuals with eating disorders have low serotonin levels—your feel good brain chemicals. For this reason, SSRI’s (anti-depressants and anti-anxiety meds) are often prescribed as part of recovery therapy—aimed at increasing levels of serotonin in the brain. However, do you know where your body’s serotonin levels are produced in the first place? More than 90% of serotonin is produced in your gut microbiome by Enterochromaffin (EC) cells lining the gut—pointing directly to the bigger piece of the puzzle (poor gut function and dysbiosis—an imbalanced gut flora), often overlooked in the treatment and healing process. Moreover, very few psychiatrists tell you about the long-term side effects of SSRI’s on the gut microbiome and more specifically your metabolism. High circulating levels of superficially elevated 5-HT (serotonin) is positively correlated with metabolic and weight imbalances (Young et al., 2018) and poor blood sugar control (Takahashi et al., 2002). 


Other studies clearly demonstrate dysbiosis (low bacterial diversity, variety and imbalance) goes hand-in-hand with anorexia, binge eating, purging and obsessive food behaviorsMany disordered eating behaviors wreak havoc on gut balance itself—laxative use, overexercise, binging, purging, restricting, yo-yo weight gain and loss, and nutrient deprivation (Ruusunen et al, 2019).

For example, enterobacteriaceae overgrowth (a “gram-negative” bacteria) is commonly overgrown in the gut microbiomes of individuals with anorexia, orthorexia, bulimia and binge eating disorder (Fetissov & Hokfelt, 2019), and is a precursor to the development of immune related conditions often experienced by individuals in their post-recovery years—highly connected to gut inflammation (Wu & Wu, 2012). 


Researchers also believe that the re-feeding process and nutritional strategies for women in recovery from chronic eating disorders  should differ from standard weight gain diets, primarily because eating disorders patients’ gut microbiota is completely different than “normal” people—particularly those with history of anorexia. Traditionally, many recovery and treatment diets are higher in fat and sugar, and low in fiber, sparking an increase in  Firmicutes and decrease of Bacteroidetes bacteria phyla  (Murphy et al. 2015)—associated with an altered metabolism in post recovery years.  The researchers further suggest that recovery diets should be more balanced, incorporating prebiotics, fiber (vegetables) and gut-friendly foods during treatment as well, in conjunction with the common treatment foods often considered ‘unhealthy’ from gut microbiome’s perspective, such as foods high in saturated fats or sugar, but considered ‘healthy’ from psychological perspective (Ruusunen et al, 2019). 

Unfortunately, the evolution of treatment and the acknowledgement of gut health restoration for former eating disorder patients is still poorly understood by many treatment professionals. Although patients with histories of anorexia and bulimia report extremely high rates of GI symptoms, in conventional treatment settings or gastroenterology offices, testing focuses primarily on assessing and addressing structural imbalances (ie. scans, scopes, gastric emptying). In many cases, measurable pathology—IBD, is often not demonstrated, and ED patients are often told they just have “IBS”, they need to “just get used to eating Pop-tarts and pizza”, or to “take a Tums, Lactaid or Miralax” to supress GI symptoms (Norris et al, 2016).

However, what is often present (but not assessed or addressed), is dysbiosis and functional gut pathologies. Common gut pathologies I’ve experienced and see in my clinical practice include:

  • Disrupted gut microbiota
  • SIBO (small intestinal bacterial overgrowth)
  • SIFO (small intestinal yeast overgrowth)
  • Candida 
  • Intestinal permeability (leaky gut)
  • Fungal and mold overgrowth
  • Bacterial infections (Lyme and lyme co-infections)
  • Parasites


No, you won’t have “everything”, but it can be helpful to work with a practitioner who gets eating disorders and specializes in gut health to help you identify your root causes behind metabolic and gut imbalances. 


In short:  if you’re in eating disorder recovery, but did not address your gut microbiota during your recovery or treatment process, then you have a big answer as to why your metabolism may not be “working” after an eating disorder. 

#2. HPA Axis Dysregulation (Stress)

HPA Axis Dysregulation is a fancy word for “stress.” 

If you come from a background of chronic dieting or over-exercise, you come from a background of STRESS. The constant state of stress you lived in during your eating disorder taxed your HPA Axis (your hypothalamus-pituitary-adrenal “stress regulatory” system), and consequently, your cortisol balance. 


Cortisol in particular is often linked with weight fluctuation. Both an excess and deficiency of cortisol can impact blood sugar levels and thyroid function, trigger weight fluctuation and symptoms of low metabolism. 


During an eating disorder, cortisol gets hijacked (Misra et al, 2017). Major stressors that may lead to cortisol imbalances during chronic dieting and/or eating disorder include:


  • overtraining
  • under-eating
  • over-eating 
  • binging and purging
  • laxative abuse
  • a (loud) inner critic and perfectionist 


The “Biggest Loser” study is a perfect example of this (Fothergill et al, 2016). Researchers followed contestants from “The Biggest Loser” tv show six years after their dramatic weight loss , finding that most contestants had regained the pounds and their metabolism had significantly slowed, burning at least 500 fewer calories every day than they did before the show began—not because they were overeating or no longer working out, but because their metabolism had been overly stressed from chronic dieting and training


Hypercortisolemia, higher-than-normal levels of cortisol, have been reported in persons with anorexia, bulimia nervosa, binge eating, and obesity (Gluck et al, 2014).


More than likely, in your eating disorder, you were running off cortisol (your stress hormone)—and lots of it—to keep up.  Your body felt like it was running from a bear at all times. 


Elevated cortisol helped you (and your metabolism) “survive” —you were able to ‘get by’ and function in your extreme dieting and exercise ways. However, eventually, your body, your hormones and metabolism get tired and confused. Just like what would happen if you were to keep running and running and running from a bear…eventually, if you did not escape, you would probably become bear food. 


Recovery aids in the improvement of many, but not all, hormonal changes, and deficits may persist despite recovery. For some individuals in recovery, their cortisol levels eventually tank—an “adrenal fatigue” presentation. For others, their metabolized cortisol is low, but their “free cortisol” circulating in their tissues is still super high—presenting with a fast catabolic (body breakdown) metabolism. For others, they experience significant swings in cortisol throughout the day.  


Hormone urine, saliva and bloodwork testing with a practitioner is the best way to clearly see where your hormone balance is at; while realizing that if your metabolism is “off” in recovery, your hormones probably have something to do with it as well. 


#3. Sluggish Thyroid 


We can’t talk gut and HPA Axis (cortisol) without talking thyroid—your body’s metabolism’s “master gland” that is regulated by your gut and HPA Axis.  


Your thyroid is a small butterfly shaped gland, located in your throat region, that produces thyroid hormones (specifically Thyroxine (T4) and Triiodothyronine (T3) which act on every cell in your body to increase cellular activity or metabolism. Thyroid hormones play vital roles in regulating the body’s metabolic rate (calorie burn; nutrient uptake and utilization), digestion, weight, heart functions, muscle control, brain development and bone health. 


 If there is too much (hyperthyroidism) or too little thyroid hormone (hypothyroidism), metabolic function slows and/or becomes impaired. 


Approximately 1 in 8 women will develop a thyroid condition in her lifetime. Hashimoto’s—an autoimmune condition in which your body attacks its own thyroid—is the most common cause of hypothyroidism, most often triggered by impaired gut health, nutrient deficiencies, and stress—including starvation, purging, laxative abuse, overtraining and/or binging (Frohlich et al, 2019; Zhao et al, 2018).  Furthermore, cortisol—both from increased gut inflammation and stressors—inhibits the conversion of T4 hormone to active T3 hormone, and increases the conversion of T4 to reverse T3, consequently affecting metabolism. 


Common signs and symptoms of traditional hypothyroidism (under active thyroid) include: 

  • Fatigue
  • Sleepiness
  • Mood swings
  • Forgetfulness
  • Weight gain
  • Depression/irritability
  • Muscle cramping and aching
  • Weakness
  • Decreased perspiration
  • Changes in blood pressure
  • High cholesterol
  • Swelling in legs
  • Blurred vision
  • Cold intolerance
  • Hoarse voice
  • Heavy menses
  • Coarse, dry hair and skin
  • Hair loss (on head and/or body)
  • Constipation


There are approximately 26 shades of hypothyroidism. Unfortunately, conventional medicine only looks for a couple of them—high TSH hormone and/or low T4 hormone levels on bloodwork—easily missing or misdiagnosing patients who have a thyroid problem. 


For example, aside from traditional hypothyroidism (high TSH above 4.5), “low T3 syndrome” (characterized by “normal” TSH” levels, but low T3 hormone) is often not tested for by doctors, despite being common in women with histories of anorexia, bulimia and chronic stress (restriction, starvation, overtraining). Decreased T3 levels are associated with imbalances in bodyweight, body fat, impacted hunger-fullness cues, and higher circulating cortisol (Spalter et al, 1993; Croxson et al, 1977, Kiyohara et al, 1988)


A functional blood chemistry thyroid workup should include the following markers:


TSH: TSH is the most common screening test for thyroid disease. Levels of TSH rise when levels of thyroid hormone decrease. If your TSH is at 4.5 or above, you would be diagnosed with hyperthyroidism; however, functional blood chemistry is aimed at catching disease before it progresses, and a TSH above 2.0 is considered “subclinical hypothyroidism.”


T3 and T4 levels: T3 and T4 are your circulating thyroid hormones. If they are low, thyroid function is low. 


Thyroid antibodies: Since Autoimmune destruction of the thyroid gland is the most common cause of hypothyroidism, if your metabolism is “off”, it’s important to look at antibody levels, including thyroid peroxidase antibody (TPO), thyroglobulin antibody (TgAb) and thyroid stimulating hormone receptor antibody (TRAb).


#4. Poor Detoxification & Liver Health


Your liver—your body’s master detoxification and filtration organ—plays a role in virtually every metabolic process in the body, including turning nutrients from food into substances your body can use, breaking down fats and carbs, storing sugar as triglycerides, balancing blood sugar, creating energy and, perhaps most important of all, getting rid of toxic substances.


Eating disorders take a toll on your liver. 


For example, complications from bulimia, like dehydration, vitamin deficiencies, and low blood pressure can lead to liver problems and damage. As for anorexia, stress from starvation and restriction can lead to elevated liver enzymes, non-alcoholic fatty liver and liver autophagy—literally “self eating” (Bridel et al, 2014, Keloufi et al, 2014). Undermethylation—a genetic mutation reducing the liver’s ability to efficiently detox toxins and process and absorb nutrients and supplements by 60%—is also common in individuals who struggle disordered eating (Steiger et al, 2019). 


Consequently, subpar liver health means a subpar metabolism. 


Despite the promises of both body restoration in recovery and trendy fad diets, Instagram fitness routines, it’s often your gut, hormones (especially cortisol and thyroid hormones), and your liver that hold the answers to your questions about mystery metabolism and weight imbalances. If you’re gaining or losing unwanted weight (without trying), a sluggish liver is often somewhere in the mix—unable to process nutrients, toxins and hormones with ease due to both former and current stressors that wreak havoc on the liver.


Not only did your eating disorder habits force your liver to function harder—from laxatives, to processed diet foods and artificial sweeteners, birth control pills and SSRI’s, and simply not taking care of the body—but, once in recovery, if you’re not supporting your gut and liver health directly, then the burden of daily liver troublemakers (that most people face) further stresses your liver out, including:


  • viruses and bacteria
  • toxic heavy metals like copper, aluminum, or mercury
  • mold and mycotoxins (air quality) 
  • toxic chemicals in cleaning, hygiene and beauty products
  • pesticides and GMO’s in our food supply


Even the healthiest babies are born with livers that aren’t functioning at 100% because of these liver troublemakers. 


It’s like running with a gimpy leg. Your liver was already gimpy from the eating disorder, and since most nutritional and treatment protocols don’t take this into account, your live struggles to keep up with the race—becoming more congested internally. Liver overload result in toxins being pushed back into the blood, causing fatigue, skin problems, poor memory, immune dysfunction, overall irritability and metabolic/weight issues.


#5. Undetected Nutrient Deficiencies


Energy to power the body’s metabolic processes is derived from the food that we eat. Hence, nutrient deficiencies are a calling card for metabolic imbalances.

Just because you are in recovery, does not mean your body is nourished—even if you are eating “normally” and regularly. You can still be eating, but starving at a cellular level.

We see this commonly in the U.S. as whole—where the average American consumes 3,000 calories per day, but over 90-percent of the population is suffering from at least one mineral or vitamin deficiency based on the Dietary Reference Intakes (Bird et al, 2017; EWG, 2014). 

This is especially true if: 

(a.) your gut microbiota are out of balance (unable to absorb your nutrients)

(b.) you’re eating the same things every day, and/or 

(c.) you’re missing out on key nutrients in the diet

Common signs of nutrient deficiencies include:

  • Anxiety—low B12, zinc
  • Brain fog—low B12, choline
  • Candida, SIBO, bloating—low B1 & B2
  • Constipation—low potassium, magnesium, Vitamin D, fatty acids
  • Feeling tired/sluggish—low zinc, B vitamins, iron, magnesium, fatty acids, chromium
  • Hormone imbalances-low Iodine/Selenium, B vitamins, omega 3 fatty acids, folate, manganese 
  • Immune issues—low glutathione, Vitamin A, Vitamin C, Vitamin D
  • Osteoporosis—low Vitamin D, Vitamin K2, minerals (magnesium, sodium, potassium, calcium)
  • Poor liver function—low ALA, glutathione, B vitamins
  • Skin problems—low Vitamin A, Vitamin C, K2, omega 3 fatty acids, zinc 
  • Unintentional weight gain or weight loss—low Vitamin D, B vitamins, magnesium, manganese 

#6. Your Intuition is “Off” 

Dieting, binging, starving and restricting alter your eating intuition—even after your eating disorder has ceased and you no longer are actively pursuing your “old ways”. 

For example, patients with anorexia, even after acute treatment, consume 300 to 700 fewer calories each day, compared to healthy controls. While intake increases with weight restoration, it remains significantly reduced relative to controls.  Other dietary features like macronutrient intake, energy-dense meals, and diet variety also differ between former anorexia patients and healthy controls, with women in recovery more likely to eat the same things every day and opt for lower calorie meals (Mayer et al, 2012).  

In women with bulimia, over 60% fail to fully abstain or break free from core bulimia symptoms, urges or thoughts—be it the occasional bing or purge, feelig guilty over their food choices, carbohydrate cravings, or urges (Linardon & Wade, 2018). 

And research shows that when a history of dieting alters your built-in intuition mechanisms.  Impaired serotonin levels (remember, your “feel good” brain chemicals), for instance, can confuse you about your body’s hunger-fullness cues and alter your reward and mood cues—making certain foods or odd diet preferences seem more appealing (Laney et al, 2007). Ghrelin (hunger hormone) and leptin (fullness hormone) levels also get out of whack in eating disorders. Physiologically, ghrelin is elevated before a meal and decreases after food consumption; whereas leptin (fullness) is decreased before a meal and increases after eating. 

During an eating disorder, women with anorexia generally experience increased ghrelin (hunger cues) in their body the majority of the time, however, when presented with food at meal time—both for favorite and unfavorite foods alike—they experience decreased ghrelin (hunger cues). Their appetite turns off (Monteleone et al, 2016). Interestingly, both during and after treatment, as the body and health restore, research shows many patients may continue to experience  elevated ghrelin levels, and sometimes even greater ghrelin levels than before treatment—as if the body is still hungry to make up for “lost time” (Nakahara et al, 2007). 

As for those who struggle with bulimia, it is well established that ghrelin (hunger cues) levels do not significantly decrease after food ingestion, whereas healthy controls do, even though both groups experience increased leptin levels (fullness hormones) after a meal.  The blunted ghrelin response to food ingestion may support the occurrence in bulimic subjects of an impaired suppression of the drive to eat following a meal (Monteleopne et al 2003). Although more research is warranted for hunger-fullness hormones in women in recovery, this data suggests there may still be more work to do—in your gut health, hormones and liver—in order to establish intuition again. (Fun Fact: Ghrelin is a hormone that is produced and released mainly by the stomach with small amounts also released by the small intestine, pancreas and brain—your HPA Axis). 

The bottom line: When your intuition is affected, our metabolism is affected.

Your body’s metabolic processes rely on your built in mechanisms and hormones that tell you when you’re hungry or full, and what nutrients (if any) you’re missing. Although both intuitive and mindful eating after an eating disorder do not magically happen overnight, if you never learned or practiced intuitive and mindful eating in your treatment or recovery, this could explain the roadblocks you’re hitting in your metabolism as well. 

Interestingly, new research shows patients who receive eating “cue” exposure therapy during treatment—basically relearning how to eat again (ie. how to chew, enjoy, taste food; how to check in with their hunger-fullness cues)—experience significantly greater outcomes than those who just received CBT therapy emphasizing thought and food “normalization.” This suggests that relearning to eat does not happen overnight or magically once in recovery without a little practice and thought (Garcia et al, 2017). 

#7. You’re Undereating, Under-Sleeping or Overtraining 

Balance, balance, balance. 

If these three essentials for human needs—nutrients, sleep and movement—are out of balance, then you can say one word (over and over and over again): Stress. 

Accidental dieting (chronic under-eating), neglecting your full 7 to 9 hours of shut eye, or pushing yourself a little too hard in the gym can all have “push back” for your metabolism. 

We already briefly chatted about this when we talked about the thyroid, but when we under eat, overtrain or under sleep, this ultimately impacts the “master metabolic regulator” – your thyroid gland. 


Remember: Your thyroid gland produces two hormones called T4 and smaller amounts of T3. It’s the T3 that is the active form of thyroid hormone. In response to increased T3, your metabolic rate speeds up.

If your body is malnourished, calorie restricted, tired, overtrainined or otherwise stressed, however, active T3 decreases and a portion of your T4 is converted to another form called reverse T3. This form is inactive. Because you don’t have enough active thyroid hormone, your metabolism slows. In turn, due to the “starvation” or “work (too) hard” response, your body holds onto what it’s got (body fat). In some cases, it also starts breaking down its own muscle, tissue and energy stores—resulting in fitness plateaus, unwanted weight gain or weight loss, and metabolic mayhem. At the same time, your cortisol levels also shoot through the roof, driving more inflammation, lower libido, hormone imbalances, lowered mood or increased anxiety and typically the opposite of the healthy, fit, strong and vibrant body and energy levels you’re going for (Cadegiani & Kater, 2018; Fothergill et al, 2016). 

Simply put (and contrary to popular belief), in order to have a revved (high) metabolism, you actually need to eat more nutrient dense, quality fuel more often; move your body with a “Goldilock’s approach” (not too much, not too little); and get plenty of beauty sleep—the time where your metabolic processes restore, repair and work the hardest.



If you actually now have a “higher” (fast) metabolism, this is the reason why (you actually—finally—started feeding your body!).

3 Steps to Start Healing Your Metabolism After an Eating Disorder

So now that you know the 7 most common causes of a slow metabolism in eating disorder recovery, how do you actually heal your metabolism after an eating disorder?!

In my 20 years of clinical and personal experience, I’ve found these 3 essential steps make all the difference:

Step 1. Establish a (Healthy Metabolism) Baseline

Step 2: Identify Your Root Cause(s)

Step 3: Don’t Go it Alone

Step 1. Establish a (Healthy Metabolism) Baseline 

Given the fact that gut health, liver health, hormone balance and stress levels play the biggest roles in metabolic mayhem, establishing a baseline for these factors is critical.

A baseline is the foundation upon which good gut health, liver health, hormone health and decreased stress is built (preventing any desperate measures like Dr. Google prescribed liver cleanses, Orange Theory treadmill slavery or old ED habits included).

The good news?

You can have a thriving metabolism without falling prey to the diet mentality!

I call the baseline essentials for a speedy metabolism your “7  superpowers” because they are 7 metabolism healing habits that you already possess inside yourself.

Your 7 metabolism healing superpowers include:

(1.) Oxygen
O2 is the #1 nutrient for cellular function and energy. This superpower entails proper breathing throughout the day to signal “chill out” to your stressed out metabolism. Literally: Just breathe—in through your nose, out through your mouth; upright posture; 5-7 breaths per minute at rest. No need to meditate for hours on end—simply, continually send signals to your brain (and metabolism) to relax. Not stress. 

(2.) Hydration
Water flushes toxins and wastes, carries nutrients, and keeps cellular and metabolic processes revving. Drink half your bodyweight in ounces of clean filtered water per day (ie. If you weigh 140 pounds, drink 70 oz.).

(3.) Nutrients
Nutrition is key to metabolism. The pathways of metabolism rely upon nutrients that they breakdown in order to produce energyDespite blogosphere claims, there are no magical “metabolism boosting foods”; instead healing your metabolism after an eating disorder is all about 80/20 balance (non-perfection) and nutrient-density. Include real whole foods the majority of the time, including fat, fiber and protein at each meal; and 20-percent of the time, let life happen. Think:

  • Essential fatty acids—coconut, ghee, grass-fed butter, extra virgin olive oil, olives, raw nuts and seeds
  • Dark leafy greens, colorful veggies, some fresh fruit and prebiotic fiber
  • Pastured, organic, wild-caught proteins—fish, chicken, turkey, beef, bison, duck, wild game, lamb, seafood, eggs
  • The occasional chocolate, meal out with friends, week of travel, morning cup of coffee—basically imperfection  

Additionally, variety is king. A healthy microbiome thrives upon a diverse, nutrient-dense diet in order to balance your gut bugs to better promote better digestion, less inflammation and a speedy metabolism. No, you don’t need to eat or cook something completely different for every meal—but establishing 2 to 3 rotating breakfasts, lunches and dinners each week can be helpful for mixing it up. Lastly, are you eating enough? If not, consulting with an expert to ensure you’re feeding your metabolism appropriately could be helpful to ensure you’re on the right path.

(4.) Absorption
Stomach acid, digestive enzymes and proper GI function ensure you’re actually absorbing your nutrients to run your metabolic processes. Unfortunately, many folks with histories of an eating disorder do not have these basics in place. Boost your GI function with digestive enzymes and/or digestive bitters, taken with meals; chew your food until fully liquified; and if you ever experience bloating, try adding 1 tablespoon of organic apple cider vinegar to water after meals and/or taking Atrantil—an herbal formula aimed at minimizing bloating.  

(5.) Elimination
Metabolic detoxification is your body’s natural process of removing toxins from your cells, ultimately eliminating them from you body. Your body has 7 channels or pathyways by which it detoxes toxins out, including: your lymph system, your skin, lungs, colon, kidneys, liver and blood stream. To rev your metabolic detox process, assist your elimination channels naturally by sweating, moving and ensuring you are pooing daily (no laxatives needed). Consider trying an infrared sauna—just 10 to 20 minutes per day (with plenty of water and minerals of course); varying your workouts (remember: overtraining equally destroys your metabolism) and getting fresh air; and assisting proper bowel habits with digestive bitters, peppermint oil capsules and Smooth Move tea as needed. 

(6.) Rest
Your metabolism is optimized during rest—not work. Particularly sleep (enough of it). Sleep loss and sleep disorders have a significant impact on metabolism. Studies clearly show that sleep deprivation alters blood sugar balance and hormones that regulate metabolism, like leptin and ghrelin levels. Aim for 7 to 9 hours of sleep each night in a pitch dark, cool (68 degrees or below) room. Bonus: up the ante by cutting the screens within 1 to 2 hours before bed, and within the first 1 to 2 hours of waking; instead, starting your day with an energizing morning routine and then a bedtime wind-down routine (instead of newsfeeds, social media scrolls or email checking). 

(7.) Connection
Oxytocin—your connection and “love” hormone—also regulates a wide range of physiologic processes, including eating behavior and metabolism. It is produced by your hypothalamus and its release into your body is controlled by your pituitary gland (a la the HPA Axis) when the electrical activity of neurons in the hypothalamus is excited. What “excites” your hypothalamus? Connection! When you are “connected” to hobbies, passions, pursuits, daily activities and people that make your heart come alive and light you up, your oxytocin is released into the bloodstream. Interestingly, elevated oxytocin is associated with reduced weight in overweight subjects, increased energy, regulated hunger-fullness cues, enhanced fat burning, and balanced blood sugar.

Step 2: Identify Your Root Cause(s)

Test, don’t guess, is the name of the game. Instead of shooting darts in the dark, trying to figure out what’s “wrong” with your metabolism, testing is a direct way to get answers you’re looking for. Possible helpful “root cause” tests may include:

  • Functional blood chemistry lab work—including a complete thyroid panel
  • Comprehensive stool analysis + parasitology
  • DUTCH cortisol hormone test
  • SIBO breath test
  • Mold & mycotoxin urine testing
  • Heavy metals 24 hour urine testing
  • Cyrex food sensitivity testing

You can find some of these tests at Direct Labs, here

Step 3: Don’t Go it Alone

Overwhelmed? Don’t be. There is strength in numbers. Working with an experienced clinician, trained in both eating disorder recovery and functional medicine can help expedite the process of healing your metabolism after an eating disorder. 

Book a complimentary consult with Dr. Lauryn today to find out if our virtual clinic is the best fit to you.


This article was scientifically reviewed by Dr. Lauryn, PhD. She is a Doctor of Occupational Therapy, Nutritionist, & Functional Medicine Practitioner with over 20 years of clinical and personal experience.  

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