Healing/resetting metabolism - can it be done?

[newgirl]

I will try to keep this somewhat short...

When I'm pregnant I suffer from hyperemesis - extreme vomiting and nausea that results in weight loss, hospitalization, a shitload of medications, and getting nutrition through a feeding tube or PICC line. I had this in my first pregnancy and I'm currently pregnant with #2 and going through it all again. This will be our last baby, I'm getting my tubes tied before we leave the hospital.

Now that I'm pregnant again I'm realizing that I did not put enough thoughtful effort into truly healing my body after #1. It takes a while to get back to optimal even with a normal pregnancy, let alone a pregnancy where you LOST 40 pounds and had to be on feeding tubes to survive. After delivering I gained a TON of weight, even while breastfeeding. I didn't really care much because OMFG I could eat.

Now I am reflecting though, and I'm realizing that I should have done more to actually restore and re-strengthen my body than I did. Objectively my hyperemesis is milder with this second pregnancy, but in some ways it actually is hitting me harder and I feel that it's because rather than me starting off from a position of strength, it found essentially a weakened shell of a body to attack.

I struggled mightily to lose the weight that I put on after delivery, but could never move more than 10 lbs off. I've never had difficulty dropping pounds before. What I fear is that the extreme starvation that I experienced for the 9 months of my first pregnancy has permanently changed my metabolism - like my body is in permanent starvation mode and it just hangs on to every bit of food it takes in.

Is there merit in any of this thinking? And if so, is it possible to "re-set" or heal a metabolism that has gone out of whack from extended starvation? I'm literally thinking it might be more akin to what an anorexic person goes through, just on a physiological level. Carbs have never been my friend, even pre-pregnancy, and I always leaned out better on a high fat/high protein diet. I never tried anything formal like keto dieting or paleo.

Does anyone have any similar experience or advice they can offer? I'm planning to work with a nutritionist during this pregnancy, but I'm concerned the textbook knowledge they get isn't really the most cutting edge or that they won't really get the connection that I feel there is between the hyperemesis and the struggle to get back to a normal weight...

[Sibley]

Not in your position, however I am interested by history. It is my understanding that there are long lasting effects of starvation or deprivation. In some of my history reading, you can pretty clearly see generational impacts (at a population level) of famines and other events. Now, that's a population level, so you're talking millions of people. At an individual level I don't know what research may have been done.

My best guess, based on common sense, is that you're putting massive amounts of stress on your body. Being pregnant is hard enough on the body, but adding starvation into the mix is a whole 'nother ballgame. Your body is going to react to that by demanding calories and packing on the pounds as soon as it can. The "matronly" figure has roots in biology - it has to, otherwise it wouldn't be so darn widespread in mothers but not in non-mothers.

Probably the best thing you can do going forward is to work with the nutritionist to make sure that when you can eat, you're feeding your body a balanced diet that will provide the nutrients and calories that you need. Your body is probably going to demand a lot of food (especially if you'll be breastfeeding), and I don't know how much you should try to fight it. Biology has a way of winning despite our best efforts, so the more you can accommodate what your body is naturally trying to do the more likely you'll be happy with the results.