BY: Katherine Schaumberg, PhD

DATE: 16 March 2017

Fear of weight gain is a common experience in individuals who have eating disorders. Indeed, in a new paper from our group, fear of weight gain lay at the center of bulimia nervosa symptoms.  Even when a person is motivated to recover, she or he may continue to restrict food intake, exercise at high levels, or purge, in part because a fear of gaining too much weight looms large. For some individuals in recovery, thoughts like, “If I start gaining weight, I’ll just never be able to stop,” can be difficult to set aside.

A research study published this month in the International Journal of Eating Disorders provides new information about the long-term weight trajectory of individuals in recovery from anorexia nervosa and bulimia nervosa – over the course of 22 years! (Murray, Tabri, Thomas, Herzog, Franko, & Eddy, 2017). Results from this study suggest that the likelihood of continuing to gain  weight after recovery from anorexia nervosa and bulimia nervosa is actually very low – lower than the rate of weight gain in people without histories of eating disorders in the population. Body size and weight will stabilize at a place that is right for your body after a period of time with regular eating patterns.

While some people may find evidence from this study reassuring as they navigate recovery, other people may find that no amount of reassurance from scientific studies can convince them that they are not at risk for continuing to gain weight at the same pace as during their recovery.

Working with a therapist to discuss fears of weight gain can be useful, as therapists can help people to work towards recovery not just in terms of physical health, but also towards their psychological wellbeing. The best way to deal with weight gain fears are not be one size fits all. Here are some things that might be helpful to know as you or someone you love moves through recovery:

• Fears about weight gain are a common in people with eating disorders

• Continuing to gain weight after eating disorder recovery is unlikely

• Discussing fears about weight gain with a therapist can be helpful as you try to figure out what to do when these fears come up and what a fear of “fat” plays in your life.

• These fears often decline as eating patterns normalize. Often patients are surprised at how much they can eat with no changes to their weight. For example, contrary to what the eating disorder might say, eating a cupcake won’t immediately cause a five pound increase on the scale. As weight stabilizes and nutrition is restored, obsessive thoughts about food and weight often become a less central part of one’s life.

• People live healthy, productive, full lives, pursuing goals and values at a range of body sizes, shapes and weights. When fears are stubborn, try shifting focus towards goals and values that are precious to you—you may find that you are able to work towards recovery in the service of things that are most important to you, even when stubborn fears of weight gain rear their ugly head.

Murray, H. B., Tabri, N., Thomas, J. J., Herzog, D. B., Franko, D. L., & Eddy, K. T. (2017). Will I get fat? 22-year weight trajectories of individuals with eating disorders. Int J Eat Disord. doi:10.1002/eat.22690