When a person begins recovery treatment for anorexia nervosa, they may need to initiate a process known as refeeding. The refeeding process is a controlled period during which an individual with anorexia nervosa can slowly and safely reintroduce more calories and higher nutrient levels to their body.

Hypermetabolism is a relatively common condition that can affect people during the refeeding and recovering phases of anorexia nervosa. In this article, we’re going to dive deeper into the causes, symptoms, and treatment options for hypermetabolism in people with anorexia nervosa.

What is Hypermetabolism?

As the name suggests, hypermetabolism is a state that causes the body to experience an abnormal increase in its basal metabolic rate. Put simply, hypermetabolism makes people expend a higher rate of energy while at rest.

What Causes Hypermetabolism?

For the purpose of this article, you don’t need to have a comprehensive understanding of the biological reactions and chemical processes underpinning a hypermetabolic state.

However, if you’re still curious about what causes hypermetabolism, here is a simplified step-by-step guide to the process:

• People recovering from anorexia are usually coming off a period of severe food restriction.
• Prolonged food restriction can disrupt the efficiency of the body’s natural metabolic responses.
• After sustained caloric and nutrient deprivation, the body may enter starvation mode by dramatically reducing resting calorie expenditure.
• When the body is in starvation mode, the reintroduction of food can lead to irregular basal metabolic rate responses.
• When a person recovering from anorexia nervosa begins refeeding, the uptick in their basal metabolic rate is often high enough to classify as hypermetabolism.

Symptoms of Hypermetabolism

Remember, hypermetabolism is itself a symptom of the body’s underlying response to refeeding. Unfortunately, if someone recovering from anorexia doesn’t know what to look for, they may not even realize they are suffering from hypermetabolism.

To ensure this doesn’t happen to you, we’ve listed some of the most common external signs of hypermetabolism:

• Inability to gain weight when eating in a caloric surplus.
• Sudden weight loss.
• Anemia and blood problems.
• Tiredness and fatigue.
• Irregular heartbeat.
• Episodes of insomnia.
• Shallow or strained breathing.
• Excessive sweating.

Treatment Options for Hypermetabolism

Fortunately, treating hypermetabolism in people recovering from anorexia is remarkably simple. As long as the patient maintains a regular recovery diet, hypermetabolism will usually cease towards the end of the refeeding period. If hypermetabolism persists past refeeding, we strongly recommend reaching out to a dietician or doctor.

Sources: Science of Eating Disorders, Body And Soul Heals, Not Your Average Nutritionist, National Eating Disorders

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