Anatomy of a hot flash

One of the most annoying parts of regaining lost pounds (even just a few!) is the hypermetabolism and accompanying hot flashes. I feel like a woman in menopause.

I've come to find the hot flashes appear on a regular schedule.  I eat, and then...wait for it...wait for it...I suddenly want to find an ice bath.  They only come after eating, usually within 15 or 20 minutes.  My therapist tells me it's a good sign, that my body is frantically burning up all of the calories (errr, nutrition) to repair itself. Personally, I just think it's the weight gluing itself to my ass really, really fast.

Which might be true, but it's annoying and frustrating to deal with several times a day.  I wish it would just stop.

And I'm kicking myself because I should have known better than to let the ED back in, even just a bit.  That I shouldn't have been this stupid.

I know that hot flashes will eventually pass.  That my body will adjust.  That (gulp) the pounds will go on, and the return to homeostasis is one of the benefits to weight gain/health/whatever positive spin you want to put on it.

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hm said...

Is the hot flash thing singular to you, or common among recoverers? Do you know?

Anyway, you're not, not, not stupid. You just have an ed. And you moved. And you changed jobs. And therapists. And got a boyfriend. That's a helluva lotta changes in what... 6 months??? Most people would have had a nervous breakdown. You didn't- but you relapsed. Sounds reasonable.

And you are smart, smart, smart, for catching it before it got painfully serious and disrupted your life significantly (significant disruption is relative, I know- but you're still independent, at home not hospital, have the boyfriend). You're a GENIUS for grabbing tight hold on your treatment team and leaning on them full force to help you pull up out of it. AND for giving yourself perspective that this will pass and there will be benefits. That's some serious smarts.

I think you're amazing. I think you're wonderful. I think you're darling.

But I am sorry you are stressed right now. :(

PJ said...

My hot flashes have all but stopped - just occasionally now, I think it now depends on how much I have to eat...
And totally agree with hm - so not stupid. Don't listen to your brain when it says that! Otherwise I'm stupid too, and I don't think I am. I just think I have an eating disorder that I'm fighting :)

Cathy (UK) said...

Hot flashes are annoying and I'm sorry you find them distressing :(

However, what you are describing cannot be termed 'hypermetabolism' in the clinical sense. An elevation of metabolic rate starting 15-30 mins after the consumption of a high calorie meal (especially a high protein meal) occurs in everybody, whatever their nutritional status. It is not caused by rapid or extensive tissue repair, but by the digestion and assimilation of food. At approx. 15-20 mins post meal ingestion much of the ingested food is still in the stomach, or has emptied into the duodenum (depending how long it took to consume the meal). The complete digestion and assimilation of a large, high protein meal can take a good few hours. Factors such as the heat and spiciness of the ingested food, alcohol consumption and the level of anxiety associated with eating will also influence the potential to experience hot flashes during and soon after eating.

Therefore, your therapist is incorrect in stating that a hot flash that occurs 15-20 min after meal ingestion is caused by the body frantically repairing itself. And, of course, you would be incorrect if you believed that the meal you had eaten 15-20 min earlier was glueing itself to your ass! That food is still in your gut!

Clinical states of hypermetabolism usually occur during or after severe tissue trauma. Hypermetabolism does occur in AN, but it's usually during re-feeding from very low weights and it contributes to re-feeding syndrome. Re-feeding syndrome occurs as a consequence of a rapid increase in carbohydrate metabolism in a starved, glycogen depleted body that is surving primarily on fat and protein stores, when there is high insulin sensitivity. A sudden increase in intracellular ATP synthesis draws in serum phosphate, causing the latter to fall. A cascade of electrolyte disturbances ensue.

So all-in-all, I don't think you're experiencing some clinical hypermetabolism, but merely a post-meal elevation of metabolic rate associated with eating larger than normal meals to regain lost weight. It is a horrible feeling though, and can cause distress. It will be over soon though :) Take care!

Katie said...

I don't think I ever got hot flashes - I used to get freezing cold after meals, as if all the blood had rushed to my digestive system! About half way through weight restoration I started feeling warmer than the rest of my family, but that was a constant thing. It was funny because I'd although thought I was just a cold person, and it was a bit of a family joke, so when my metabolism started working much faster than theirs I got to laugh at them instead!

I'm sorry you have to deal with the hot flashes. Hope they don't last much longer!

Angela said...

Mine happen during the night. They aren't really flashes, but more like all night. It drives me crazy, so I know how you feel. My nutritionist told me the same thing about my metabolism kicking in, which I definitely think is better than it slowing down. I thought the extra calories would make me continue to gain even after I was at a healthy weight. I never believed her when she would tell me that my metabolism would actually work better when I increased my calories. I hope like you that the sweating stops soon! Take care:)

HikerRD said...

Thanks, Cathy. The metabolic explanation made little sense to me. Admittedly, I've not read the explanations about hot flashes in recovery, but assumed they were hormonal (given changes in hormone levels with ammenorhea it seemed like a likely explanation).
Great to see this addressed, Carrie. I'm sure many in recovery have questioned it.

Abby said...

This will sound odd, but I'm jealous of your hot flashes. Granted when I was in treatment and experienced them myself, I wanted to claw my eyes out. However, it was a sign that I was seriously taking the right steps and my body was finally responding. I'm finding it hard to push myself to that point again right now, hence my desire for hot flashes. It would mean I was seriously taking the rights steps and that my body was responding.

So while they might stink, keep that feeling in mind the next time you want to take a short cut or a step back. Remember that you don't want to go through this crap again. Recovery stinks, but it's worth it. Hang in there!

CJ @ said...

I was wondering if you could answer a few questions.
I have been in recovery before and had been hypermetabolic but this time dont seem to it possible that it comes later in the process? or is it that sometimes you just arent hyper metabolic?
Thanks! sorry if this is kind of a random question.

Anonymous said...

Cathy..She may not be hypermedabolic but hotflashes are probably coming from adjusting to food again. Even if you're not hypermedobolic, your metabolism is kicking back in and hotflashes occur. I'm definantley not a Dr but I have been in inpatient treatment 8 times and many people who recover have this experience. And this is what Dr's that are specialist in the field have told me many times.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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