Weight restoration is often a vital component of eating disorder recovery, especially for individuals who have restrictive eating disorders. It may seem counterintuitive that healthcare professionals focus on a number-based factor, especially when a primary goal in recovery is to move away from a focus on body shape and size.

However, weight restoration is critical to improving physical and mental health symptoms and allowing a life of food freedom. Without weight restoration, a person may face significant mental and physical health risks that do not allow for full recovery.

What Is Eating Disorder Recovery Weight Restoration?

In eating disorder recovery, weight gain, or weight restoration, is essential to restoring health, especially when a person is considered clinically underweight. Those who are underweight from a lack of adequate nourishment throughout an eating disorder may need to restore weight to improve physical and mental health symptoms.

“Weight restoration” is generally defined as 95% of a person’s expected body weight (EBW).¹ Expected body weight is often calculated by a number of factors, including a person’s age, height, and more. There are several methods healthcare providers may use to determine this.²

Weight restoration will be specific to each individual — remember that even if we all ate the same foods and engaged in the same kinds of movement, our bodies would still be different!

However, on the whole, weight restoration is when your body is restored to a weight that allows it to function as it naturally wants, and as it supports you to think, move, and feel through the world!

When going through a recovery journey, your team — including your dietitian and your doctor or other expert healthcare provider — will use a wide range of factors to define what eating disorder weight restoration means for you. It may be challenging to restore after weight loss, especially since eating disorders often tell us lies rooted in thoughts that thinness is better. However, embracing a body neutrality mindset can be helpful.

Learn more about embracing a body neutrality mindset here.

What to Know About Weight Suppression: Symptoms, Risks, and More

In eating disorder recovery, weight restoration may not be a recovery goal for each individual. However, for those who have weight suppression — meaning their weight is below what is healthy for their body — not being fully weight restored may lead to partial recovery, and put them at health risks.

Weight suppression also puts individuals at risk for future onset eating disorders, according to research.³ This may be especially prevalent in restrictive eating disorders, including anorexia, bulimia, and avoidant/restrictive food intake disorder (ARFID).

Those with higher weight suppression following discharge from treatment also saw more symptoms.⁴ If a person in recovery does not gain adequate weight to achieve weight restoration, they may experience physical symptoms including:⁵

• Abnormal heartbeat
• Irregular menstrual cycles or absence of periods (amenorrhea)
• Blood pressure problems
• Dizziness
• Loss of bone density (osteoporosis)
• Tiredness and fatigue
• Unbalanced electrolytes
• And more

Weight suppression may also contribute to mental symptoms including:

• Increased focus on body image
• Focus on thinness
• Body dissatisfaction

Walking the line of partial weight restoration in recovery may also not allow a person to enter the mindset of full recovery. This can make them more likely to engage in behaviors. If they are still weight suppressed and experiencing physical and mental symptoms of the eating disorder, this may make it more difficult to step into a full recovery mindset.

The Benefits and Importance of Weight Restoration in Recovery

Weight restoration is crucial for eating disorder recovery, and provides many physical, psychological, and mental health benefits.

Overall Recovery Benefits

A number of individuals cited weight restoration as the point in their recovery journey when it really began to “take off.”⁶

When individuals are weight restored, their bodies are no longer fighting to keep them alive, and they can begin to focus more on the mental aspects to achieve holistic recovery.

Physical Benefits

Weight restoration can significantly improve many of those physical symptoms individuals may face.

Experts note that weight restoration — especially early in recovery — has a “greater impact on symptom improvement.”⁷ From helping regulate blood pressure to restoring hunger cues, weight restoration is critical for physical health recovery.

Research has found that individuals with anorexia have deficits in the gray matter of the brain — a type of tissue that plays a vital role in many functions, including memory, emotions, and more.⁸ Recovery — including weight restoration — was found to help the brain repair itself.

Psychological and Mood Benefits

Research found that individuals undergoing nutritional rehabilitation and psychotherapy in an inpatient setting had a “significant” reduction in depression symptoms, and with weight restoration, their mood symptoms significantly improved, as well.⁹

With partial weight restoration, the study’s authors noted that an increase in mood could not be explained simply due to anticipation of discharge. This highlights the profound, positive impacts weight restoration can have on mood!

Long-Term Recovery Benefits

Research shows that individuals who fully weight restore have more long-term recovery outcomes and are less likely to relapse.

One study found that for each “unit increase in normative eating self-efficacy, patients were 4.65 times more likely to be weight restored at follow-up.” Individuals who reported a higher frequency of normalized eating behaviors were also more likely to be weight restored.¹º

The study concluded that “normative eating self-efficacy and normalized eating behaviors” could be “vital treatment targets” to prevent relapse and help individuals fully recover.

You Deserve a Life of Full Recovery

While it can be uncomfortable to have your body change through eating disorder recovery weight restoration — especially because that’s the last thing the eating disorder wants — it often plays a critical role, especially in the case of restrictive eating disorders.

Having a qualified team who can support you through your journey can make a world of difference. At Life Cycle Nutrition, our dietitians are experienced in navigating the various challenges you may struggle with during eating disorder recovery. You deserve to live a life of recovery and food freedom.

Schedule an appointment today to get the nutritional support you deserve.

Citations

1. Perry, Taylor R., Kelly Cai, David Freestone, Dori M. Steinberg, Cara Bohon, Jesse E. Menzel, and Jesica H. Baker. 2024. “Early weight gain as a predictor of weight restoration in avoidant/restrictive food intake disorder.” Journal of Eating Disorders 12, no. 27 (February). Accessed December 1, 2024. https://doi.org/10.1186/s40337-024-00977-2.
2. Le Grange, Daniel, Peter M. Doyle, Sonja A. Swanson, Kali Ludwig, Catherine Glunz, and Richard E. Kreipe. 2012. “Calculation of Expected Body Weight in Adolescents With Eating Disorders.” Pediatrics 129, no. 2 (February): 438-446. Accessed December 1, 2024. https://doi.org/10.1542/peds.2011-1676.
3. Stice, Eric, Paul Rohde, Heather Shaw, and Chris Desjardins. n.d. “Weight suppression increases odds for future onset of anorexia nervosa, bulimia nervosa, and purging disorder, but not binge eating disorder.” The American Journal of Clinical Nutrition 112 (4): 941-947. Accessed December 1, 2024. https://doi.org/10.1093/ajcn/nqaa146.
4. Gorrell, Sasha, Erin E. Reilly, Katherine Schaumberg, Lisa M. Anderson, and Joseph M. Donahue. 2018. “Weight suppression and its relation to eating disorder and weight outcomes: a narrative review.” Eating Disorders 27, no. 1 (July): 52-81. https://doi.org/10.1080/10640266.2018.1499297.
5. “Anorexia Nervosa: What It Is, Causes, Symptoms & Treatment.” 2024. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/9794-anorexia-nervosa.
6. Barko, Emily B., and Sara M. Moorman. 2023. “Weighing in: qualitative explorations of weight restoration as recovery in anorexia nervosa.” Journal of Eating Disorders 11, no. 14 (January). https://doi.org/10.1186/s40337-023-00736-9.
7. Accurso, Erin C., Anna C. Ciao, Ellen E. Fitzsimmons-Craft, James D. Lock, and Daniel Le Grange. 2014. “Is weight gain really a catalyst for broader recovery?: The impact of weight gain on psychological symptoms in the treatment of adolescent anorexia nervosa.” Behaviour Research and Therapy 28, no. 56 (February): 1-6. https://doi.org/10.1016/j.brat.2014.02.006.
8. Sheehan, Sidney T. 2022. “Groundbreaking study shows substantial differences in brain structure in people with anorexia.” USC Keck School of Medicine. https://keck.usc.edu/news/groundbreaking-study-shows-substantial-differences-in-brain-structure-in-people-with-anorexia/.
9.  Meehan, Katharine G., Katharine L. Loeb, Christina A. Roberto, and Evelyn Attia. 2006. “Mood change during weight restoration in patients with anorexia nervosa.” International Journal of Eating Disorders 39, no. 7 (August): 587-589. https://doi.org/10.1002/eat.20337.
10. Cooper, Marita, Angela S. Guarda, Felicity Petterway, and Colleen C. Schreyer. 2021. “Change in normative eating self-efficacy is associated with six-month weight restoration following inpatient treatment for anorexia nervosa.” Eating Behaviors 42 (August). https://doi.org/10.1016/j.eatbeh.2021.101518.