Overcoming Two Decades of Dieting To Recover From Hypothalamic Amenorrhea
A past client of ours, Nicole, shares how an interaction with her primary care doctor caused her to dive deep into the diet world at the age of 10, which led to her trying to shrink her body and diet for over two decades. During this time she not only developed osteopenia but also high cholesterol. Nicole is now recovered, ovulating, and living her life...free from diet culture.
If you prefer to listen to her story, her episode is 209 on the podcast.
Nicoles HA Recovery Story:
Growing up, I was always known as the chubby tom-boy with a bowl-cut that chose to play with guns over barbies. My best friend and I, were both of Filipino Descent and both on the more pleasantly plump side. We would take turns pretending to have stomachaches in PE class to get out of running laps and presidential fitness testing, was always a thought that conjured fear in our hearts. However, all that changed during a doctor’s appointment in the 4th Grade. My pediatrician at the time, Dr. Kwon, uttered three words that would ring in my ear for all my remaining days to come. “You’re Too Fat.”
Who knew, a simple routine physical would shape the course of my life for decades to come.
Almost immediately after that appointment, I followed Dr. Kwon’s orders to stick with a 1,200 calorie diet. I exercised daily, and measured all portion sizes of my food. I gave up fast food, I chose vegetables and fruits in place of all sources of fats and oils, and I continued to restrict and over-exercise even after I was in a healthy weight range. These “Healthy” habits gained me the praise and positive reinforcement I sought from my peers and family members. However, little did they know that I would continue to hold this regimen tightly as a coping mechanism in times of stress throughout my teenage and young adult years.
In high school, my father developed a heart condition and went into cardiac arrest at an all-you can eat buffet. To this day, I cringe at buffets, and can still remember him being given CPR on the Chinese Restaurant floor. That was also around senior year of high school, when I was getting ready to turn 18 and have a “Debut”- it’s the equivalent of a quinceanera for Filipinos and serves as your “coming of age” party. I wanted to fit into the dress for the big day, and took up running with one of my girlfriends. It was funny that the activity I hated as a child became my source of joy as an adult. The endorphin rush and adrenaline high, was now something I would gladly choose in place of fear and worry. It helped me shed the pounds I needed to fit in my beautiful Debutante Ball dress, and when my dad was in and out of the hospital, running helped distract me from feeling the pain I felt when I watched his health continue to decline over the years. I refused to end up the same way, so I made it a point to eat clean, and exercise daily. These habits also annoyed my mom, who would get upset when I turned down her decadent Filipino dishes, thus fueling my autonomy and making me want to continue to restrict in rebellion.
Going away to College at UC Berkeley and coming back for Dental Hygiene School all brought about times of trials and tribulations, not to mention, more than a few relationships and break-ups along the way. And when things got stressful, I turned to a new physical activity. At first it was just doing a few themed-5K’s for fun (I always loved having an excuse to dress up in a costume and celebrate after the run). But after Dental Hygiene school, I broke up with my college boyfriend, and that spurred the urge to complete a triathlon. The next boyfriend got me into hiking, but once that relationship ended, I took my physical feats even further. I realized I really liked hiking, and kept doing it as a form of therapy with one of my coworkers who was part of a hiking group. Each hike got a little longer, and I always felt stronger after even if my legs would be sore AF. Before the age of 30, I managed to Hike Machu Picchu in Peru, Conquer Yosemite’s Half-dome, and the Grand Canyon, Rim-to Rim. Then at 31, in 2019, I completed my first half marathon. It was at this time I reached one of my lowest weights. I remember one of my close coworkers was concerned for me, and mentioned that a mutual friend who was an Eating Disorder therapist thought I might show signs of an ED. It was also at this time I had a routine physical along with a Dexa scan that diagnosed me with Osteopenia. This was the wakeup call that got me to start seeing an ED therapist and a nutritionist that helped me gain weight, but never enough to start my cycle.
During the pandemic, I used my stimulus to buy myself a Road Bike. Cycling with a new partner led me to completing my first 50-mile bike-race in Mexico. I was so proud of myself for accomplishing these feats, but when I look back, there was always a part of me that realized, the drive to continue to push further would never really satisfy the hole I was trying to fill. I’d run the extra mile, swim extra laps, cycle longer distances even when my body started to show signs of degradation, not to mention I was under-fueling and always teetered between the line of skinny and scary skinny, you know the kind you worried about, but still got praise for your discipline and “hard work”.
Little did I know, losing my period along the way, was a clear indication that I was not in a healthy state.
I should mention, I was misdiagnosed with PCOS by my OBGYN while in College, around the age of 20. I was placed on birth control to help elicit a pseudo-period. My OBGYN at the time assured me that it was “healthy to shed the lining of your uterus every month” and the Estrogen from the birth control pills would keep my bones healthy. Hearing this allowed me to remain blind to what was really going on with my body. I chose to stay on birth control, rather than try to get my period back naturally. My OBGYN at the time would comment that I was “a little underweight” and could try to gain some weight to get my period back, but every time I tried, the few pounds I would gain did nothing to elicit a period. Even the progesterone challenge did not work to “jump start” my cycle. (She never once diagnosed me with HA, but when I look back at it, the signs were clear.)
In addition to all of this, my cholesterol was always high, which I thought had more to do more with genetics than diet/exercise, but it definitely reinforced my habits. Now I come to find that lack of estrogen, which is a regulator of cholesterol, is more likely to be the culprit of my elevated cholesterol.
Fast Forward to Post-Pandemic. At the age of 35, I am now in the most healthy, nurturing relationship I have ever been in. My partner and I have talked about wanting to get married and have children in the future. I finally made a change to a new OBGYN and in the beginning of the year that Doctor was the one to finally diagnose me with HA. She debunked my PCOS diagnosis with an up-to-date vaginal ultrasound and blood tests. Not so shocking news would show that my hormone levels were all shot- LH/FSH/ Estrogen, all showing signs of someone in a pre-menopausal state. She recommended that I cut back on exercise to try to gain enough weight to be at a healthier BMI. Hearing this diagnosis was scary but at the same time a relief. I finally had a diagnosis that made sense. And this time around, I was determined to face my fears and address the skeletons in my closet.
I joined The HA Society and signed up for one-on-one coaching with Ashley. The process was painstakingly slow. I decided to give my body a rest and gave up my gym routine pretty much all together, except for walking and yoga and very easy-going hikes. For the past 10 years, I would wake up at 5:00am so I could hit the gym before work, mind you I never had breakfast until a few hours later at work and it would definitely not constitute what a real breakfast would suffice for me now these days. Ashley can contest that the food piece took a while for me to fully go “all in”. It had been decades since I had eaten like a normal person. My closest friends and family members would often get annoyed with me because I constantly had to alter my meals when I would order food at a restaurant. Choosing the low-fat, no-cheese, not-fried options were habits I had to work to break. It took months before I could let go of celery or “water sticks'', as Ashley would call them. But Finally, Salads got swapped for the French fries I had deprived myself of for so long.
It took 6 full months to recover my first period. It came right after a vacation with my boyfriend, and I think just letting myself be on vacation with no restrictions, really helped my body respond in a way it needed to. My second cycle was delayed, but it felt like more of what I would consider a “real period” to be. I am now 30lbs heavier, and I have good days and bad days. I still struggle with being in a bigger body. But I am so much happier, knowing that I finally faced the biggest fear that was instilled in me at such a young age. I know I am not Fat, but I am truly in a healthier state. I am no longer constantly cold, I don’t have to use lubricant during intimacy, and I find myself able to sit in stillness more easily than before. Friends and Co-workers have mentioned that I am more present and alert, and most importantly, my partner has even commented that we have better conversations and connect on a deeper level. It’s like now that my mind isn’t as preoccupied with thoughts about food or hunger or when my next meal will be, I can finally focus on the person in front of me, and the conversation I’m having.
On the down side, I had to give up my thigh gap, things jiggle when I attempt to run, and my endurance has definitely decreased. But I am slowly working to get to a stronger physical state. I recently began working with Liv, a former HA-er and personal trainer that focuses on health outside of the scale. Instead of Cardio, I am now trying to take up weight lifting in order to gain strength and improve my bone health . It’s a unique experience to finally approach fitness from a healthier mindset that promotes keeping my nourished body size, and maintaining my period over weight loss.
The physical changes of my body were not necessarily accepted by all quite easily. While my partner remains my biggest supporter, claiming he’s more attracted to me now than at my underweight state, I did get some comments from my family. Relatives who hadn’t seen me in months, said that I looked healthier and were happy to see me gain weight, but the comments took getting used to. I should mention, I’m half Filipino and my mother’s culture can be a bit blunt and lack a filter. After attending a funeral just recently, my mom yelled across the room, “Nicole, everyone says you look better now that you are fat again!”- my heart sank and it took a minute for me to compose myself. It’s been a battle to speak up to her along this journey, and make sure she understands that comments about my body are not appreciated. In her own way, she means to show support but lacks tact. I realize if I ever want to get it through to her, I have to make a point to call her out on it. Because at the end of the day, whenever I do have kids, I am choosing to break the cycle, and want nothing more but to create a safe space for my child to grow up in with a healthy mind-body balance. While we grow up learning to “respect your elders”, I’ve learned that sometimes they don’t warrant that respect, so all you can do is Transcend them.
If you would like to connect with Nicole, you can find her inside The HA Society.
Ready to make big recovery moves?
If this story moved you and you're ready to not only get your period back, but do some deep healing work, consider 1:1 coaching with us. If you're not ready for coaching consider joining our community support group, The HA Society. We'd love to help you on your journey.
