Underweight, need help regaining health

Question
I'm a recovering anorexic, been underweight for three years due to stress, loss of appetite and physically demanding jobs. Despite being in recovery for a year I've never fully maintained a healthy weight. I am 21 years old, female, 5' 5'' and 110 lbs now. I've always had a pretty fast metabolism but now I'm starting to feel things spinning out of control a little. Even though I probably won't get fat sometimes I feel "skinny fat" and get symptoms of hypothyroid and hypoglycemia. When I regain weight it tends to go right to my stomach or lower body and it's getting harder to keep it off. I'm determined to gain weight the healthy way and rebuild my muscles, I just need some guidance.
My nutritionist put me on a 2,500 calorie diet, told me to decrease my protein intake and eat more carbs (I was eating equal carbs and protein and moderate fats before, but she was worried about me getting too much protein). While following this advice hasn't caused me to noticeably gain weight, it seems to make my hypoglycemia worse. What should I do to fix my metabolism and gain muscle without gaining much fat?
I already work out 4-5 days a week with 10 lb dumbbells, a resistance band and treadmill. I also do pushups, situps, squats and sometimes go jogging.

Answer
#1 congrats ion your progress beating the illness you have is hard. I have worked with a lot of individuals how never get past it. Remember body fat is NOT evil! and it is essentially life do whatever it takes to get you to a healthy body weight and then simply maintain and if you eat well train your will transform your body.

I would tell your old school nutritionist that seems to be reading off the food pyramid to go back to school, open her mind and get some education. For you I wouldn't limit the carbs but I sure would not make them the forefront, nor would I for anyone.

IMO diets should be based on first on your protein and fat needs and then carbs added ion to fit your goals. To get the point of the importance of protein across, there are at least 3 essential fatty acids and at least 7 essential amino acids. meaning we must eat them to live and sustain a healthy life. In turn there is NO such thing as an essential carbohydrate. That's not saying not eating any carbs is optimal, but that its possible and 100% healthy if needed.

I would get checked for hypoglycemia if you feel you have a problem. Id look into getting 1 gram protein per lb of body weight thats plenty and should allow some extra, and maybe consider soemthing Like a 40P, 30C, 30F diet.


As far as your training I would drop the joke Pink DB's and isolation moves and start a real training program. One that uses your body as the beautiful machine is it. Remeber the moves that make men big and strong make women hot and toned.

I would train to perform. Train like an athlete, seek performance not pain. Pain is not an indicator of a good workout, progress is. Pain happens, it should not be a goal of training. It's better to make progress and have NO pain.  Aim NOT to go to failure. failure happens don't seek it. Aim to kick the weights butt not them kicking yours, Aim to make progress, make something that was hard easy. Start slow, even deep body weight squats and work up. Learn proper form.

BIG compound free weight moves. Squat, lunge, deadlift, overhead and bench pressing, pull ups rows etc. get in hit it hard make progress then move on to strength endurance work. hard fast hiking intervals, strongman training, hill sprints,dragging things, carrying things, playing soccer, football, basketball, racquetball, or other brief HIIT like work. what ever we found you to enjoy and work hard at.

I would stay in the 1-5 rep range for 3-10 sets, crisp and fast concentrics, a nice controlled eccentric, focusing on performance over pain.  
If you perform better you by default will look better.

Start with 3-4 days and then on the off time rest recover and eat, remember progress is made out of the gym not in it. The harder you train the harder you must rest. Add on a few fun activities a few times a week, go hike go play a sport, something go have some fun. You have NO need to run long distances unless you dream of being a marathon runner, there are better ways for us to look good than run distance. I don't know anyone who aspires to look like a marathon runner :).

Phil Stevens

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