[Highwave Vortex]

A few questions on handling long-term malnutrition

Hello everyone!

Got a few related questions so I'll give some context to start.

I'm a woman in my early 20s who's been struggling with eating enough and getting decent nutrition in for around 10-15 years now. I've got my suspicions that I'm struggling with a slightly better case of ARFID (I'm able to eat at least a few foods from each food group but trying new food and cooking is still a big uphill battle) but my main issue is getting enough food in. I've been functioning on about 45-48kg at 170cm for years and persistently have low energy and hoped that doing a bit of training would help get my energy up, maybe improve my appetite, and also stave off the joint pain I was getting from a very sedentary lifestyle (real bad for early 20s I know (ᵕˆヮˆ) ).

I've been sticking to bodyweight exercises with a warmup, one day of a program/easy level workout and a bit of stretching afterwards every day. Over 3-ish months I progressed to starting on the Momentum program but started feeling excessively exhausted day after day and decided to drop it and go back to what I was doing but even a few weeks later of scaling down training, I'm feeling more exhausted, anxious, and I've been getting dizzy quite regularly this week in particular.

I've been to see a dietitian, a counselor, and two hypnotherapists with varying levels of success so I'm trying more of an anxiety management angle next to see if that clears some of the "fog" (for lack of a better term) to eat better.

It's been hard to find information about functioning around being underweight since most research is around weight loss or muscle gain so I feel like I'm wandering around in the dark a bit for this and I've got so used to how I feel that I'm not always sure what's just a regular Tuesday and what's a warning sign.

So finally for my questions:

• Should I be training at all? If I'm eating at a permanent deficit, then is exercise just putting more stress on my body and the sedentary pain is worth tanking to not make things worse?
• I've been training at easy primarily but should I be stepping it down to light even if I can do the movements for easy workouts or even medium?
• What actually counts as warning signs for being underweight? I've been through the How to Listen to Your Body guide and haven't been getting any sharp pain but some lightheadedness can often just be a regular day so I'd just be skipping way too often and that doesn't sound right.
• Are there any exercises/categories (e.g. cardio) that I should be avoiding to minimize the stress on my body?

My goal is to feel better and have energy to finally get a job or do something more substantial with my life. And I'm more than happy to be patient with things. It's taken me over 10 years to get to where I am now but I seem to just go in circles and want to break out of the loop.

Thank you for any help, this site and community has given me what little motivation and strength I possess, and I hope to keep it going!

 

[Laura Rainbow Dragon]

Welcome @Highwave Vortex !

Firstly: I am not a medical professional. And I think you should be under the care of one. At least please keep in contact with your dietician. And a GP too, if you can. The symptoms you describe could be entirely attributable to a deficiency in a single mineral, and a general practitioner may be in a better position to order the necessary tests to diagnose this, and prescribe the necessary medications to overcome it than a dietician. Ideally it's best if you're able to acquire all of the nutrition you need from eating real food. But when this is not possible, supplementation can be life-changing. But to address symptoms as severe as the ones you describe, you want to consult with a physician to determine safe and effective supplementation levels.

A sedentary lifestyle is almost never the recommended course of action. But yes, working out too much can be a problem if you are not ingesting sufficient calories. When I taught group exercise classes at a gym I had a student who struggled with anorexia. The direction she received from her doctor was that she was allowed--recommended even--to take my class, which was yoga based, but that she should not be doing cardio-focused workouts. But please understand that this is but one anecdotal account. And I was this person's fitness instructor. Not her medical doctor. Please do consult with your own doctor re: the best course of action for you.

 

[Lhin]

Welcome!

First of all: I'm also not a medical professional, but I've got some underweight friends and can try to tell you what helped them. Please take into account what Laura Rainbow Dragon said and check with your doctors or dieticians whether the advice that helped my friends might also help you.

Training with malnutrition is indeed not easy because as you said, your body burns more calories while it runs on deficit. On the other hand, some light movement can help with appetite and mental health. For my underweight friends light yoga and stretching or some light walking (especially outside, if that's an option for you) was recommended by their therapists and generally helpful for them. But, as said above, please consult with your doctors or dieticians and if you feel unwell or dizzy it is generally a sign of something you should do slower or avoid.

Another thing that helped them when they were severely underweight were drink meals. Generally, they are only a stepping stone to healthy eating and you shouldn't rely on them too much because they can encourage unhealthy eating habits but if the choice is between a drink and a skipped meal, the drink is often the better choice. However, drinks should never replace real meals. In Germany, you can get specialized drink meals for underweight people in the apothecary. Again, this is something that helped my friends and might not work for you, so please consult professionals.

I wish you best of luck and strength on your journey!

 

[Neffie]

I agree with every advice already given. Light yoga is an excellent choice for movement and mobility. Instead of strength workouts I would personally choose short walks outside, in the nature - until your body gets better with the help of professionals.