How Much Should I Eat During Hypothalamic Amenorrhea Recovery?

In this post I walk you through how much you should eat during Hypothalamic Amenorrhea Recovery. Actually, this post does not only apply during recovery. It describes mindset and behaviors that holds true for the rest of your life.

I'll start this post off with an analog. Imagine you have a bank account. Every month you withdraw 2500 EUR and insert 1800 EUR. This means after one year you have a balance of negative 8400 EUR. Continue live like this for 12 years, and your debt is over 100.000 EUR.

Now exchange bank account with body and EUR with kcal. Of course the numbers are fictive, but the example gives you a feeling of how much deficit you have built up over years of restriction. It will take a lot of inflow (in form of energy) to reach break even. So how much is much?

2500 kcal is the bear minimum

If you are completely sedentary and doing no exercise whatsoever you need to consistently hit AT LEAST 2500 kcal every day in order to recover from Hypothalamic Amenorrhea. Do not let your restrictive mind twist 2500 to the maximum, this is really the bare minimum needed for your body to be able to repair and restore functions (such as menstruation) parallel with breathing, pumping your blood and make your heart beat. If you lack your period, more is always more. If you are engaged in some kind of exercise or movement, have an active job or are still hungry, you will have to eat more. What you eat is secondary to how much you eat (in my post What Should I Eat During Hypothalamic Amenorrhea Recovery? I provide some guidance on the what part).

Listen to your hunger is better than counting calories

I have dedicated a separate post to Hunger, Cravings and Extreme Hunger but the short version is: take every occasion to eat! If you are hungry, feel dizzy, wake up hungry, think about food, eat eat eat.

In the first week of Hypothalamic Amenorrhea recovery or so, counting calories might be a good tool to make sure you hit your minimum. Once you allow yourself to eat and embrace your hunger, you will most probably be hungry for way more than 2500 kcal. Many can find it triggering or appealing to see black on white how the daily intake climbs above this number. So my advice is to stop calorie counting as soon as possible and feed your body according to your hunger cues, whenever they might occur (In my post When Should I Eat During Hypothalamic Amenorrhea Recovery? I go more into detail on meal timing).

To find true freedom for both body and mind is the overall goal. To learn to trust your body will serve you throughout all stages of life, including during pregnancy if this is something you strive after.

There is no upper limit

Remember that Hypothalamic Amenorrhea origins from a relative energy deficiency. Or starvation if you like.

Once again I'd like to mention the Minnesota Starvation Experiment. In this experiment, the daily caloric intake for thirty-six young men (thoroughly vetted for physical health and mental soundness) were intentionally restricted to only 1800 kcal. This was done to study the effects starvation has on body and mind (I intent to do a comprehensive post on this experiment in the future).

One of the psychological changes observed was that the men became obsessed with food. Physical changes observed were among others neurological deficits, a lowed basal metabolic rate (it dropped 40% compared to normal) and decreased strength (muscle mass). After the starvation followed a twelve week re-feeding period. Here the men were split into five groups (the men did not know in which group they were in). One whose calorie intake was gradually increased by 400 kcals, one by 800, one by 1200 and one by 1600. The men in the lower calorie groups did not shown any improvement. They were still extremely hungry, were thinking about food all day and did not show an increase of their basal metabolic rate. Even providing them with extra vitamin and protein supplements did not help. The researches eventually concluded that in order to recover from starvation, a person needs around 4000 calories a day.

So how does this relate to you? I am sharing this study to take away the fear of "too much". There is no such thing for you. Maybe you need 4000 kcal in order to recover! Just as for the men of this study, the only way for you to regain an uncomplicated relationship with food and to heal your body (restoring your period) is for you to allow yourself to eat unconditionally.

If you are eating restrictively in the name of health, and realizes your period is missing and bone density is low, you have proof that what you’re doing is not healthy. That whatever you’re doing is not done in the name of health, but that you’re in fact trapped into fear. I know how overwhelming it can be to go through Hypothalamic Amenorrhea Recovery on your one. But you don't have to be alone. I am here to support and guide you on your journey.