Sam is a registered sports dietitian in Massachusetts who battled amenorrhea for 10 years.  She battled disordered eating and excessive exercise under the guise of health for years. When she finally sought out help for period recovery, she was assured by doctors that she was on the right track. She was told she needed to give her body more time. 

Sam stopped all intense exercise and tried increasing her intake to recover her period. As a dietitian herself, she thought this would be rather simple, but after 10 months of trying period recovery on her own she finally got help. She joined Lindsey’s program and restored her period in just 5 weeks! She is confident that the accountability from the FFF was the key to her period recovery plan, and is so grateful for the lessons that she’s learned along the way. 

In this Episode:

• When doctors assume period loss is normal for athletes
• How to recognize when your recovery plan isn’t working 
• Overcoming mental barriers as a dietitian on seeking support 
• Understanding how much food you need to recover 

Lindsey Lusson  00:00

Welcome to the food freedom fertility podcast. Here we discuss the challenging, rewarding and life changing process of recovering your period and finding freedom with food and exercise. Whether you’re hoping to regain your cycle to get your health back on track or you’re ready to become a mama, this podcast is for you. While the recovery process isn’t always rainbows and butterflies, it’s my hope to bring you both information and inspiration during your own recovery journey. I’m your host, registered dietitian and fellow Hypothalamic Amenorrhea woman Lindsey Lusson. 

Hello everyone. We are so excited to air a new episode of the food freedom fertility podcast Hypothalamic Amenorrhea recovery and beyond. I am stoked to bring on a fellow dietitian and friend and past client of mine, Sam!

So Sam is a registered sports dietitian in Massachusetts and she experienced period loss with Hypothalamic Amenorrhea for over 10 years. She battled disordered eating and excessive exercise under the guise of health for years. When she finally sought out help for her missing period she was assured by several doctors that she was on the right track. She was told she she just needed to give her body more time, Sam decided to stop all intense exercise and tried increasing her calorie intake to regain her period. As a Registered Dietician herself, she thought this would be pretty simple.

But after 10 months of trying period recovery on her own, she finally decided to seek some support and joined Lindsey’s program. It took same just five weeks to see her period return. Sam is confident that the accountability from the food freedom fertility society was key to getting her period back. And she is so grateful for the lessons that she has learned through recovery along the way.

Welcome to the podcast, Sam.

Sam  01:41

Thank you, Lindsey.

Lindsey Lusson  01:42

Yeah, I’m excited to chat with you a little bit more! I think that your story is going to resonate with so many listeners is both past athletes and registered dieticians alike. And so just to kind of jump in and let people kind of understand your story a little bit better. Do you mind sharing a little bit about just your background as an athlete. And losing your period and kind of what you were told and what that experience was like for you?

Sam  02:07

Yeah, of course. So my story started about 10 years ago, I was extremely active, I was on to pretty competitive soccer teams, and then also running track. And at that point in my life, I really ate whatever I wanted, I didn’t really have any concerns or rules. I was just extremely, extremely active. And I definitely didn’t understand how much I needed to eat. So at one point, I lost my period, I went to my OBGYN, and she was like, you know, like, you’re super active. This is just like a byproduct of that. Plus, I was a pretty late bloomer, so I really hadn’t had a cycle for all that long before that.

So she was like, You know what, like, this just could be natural irregularities, but it’s probably from sports totally fine. Give it time, come back in a few months if you still don’t have it. So months went by period was still missing. I went back to her. And she’s like, you know, fine, like, let’s do the Provera challenge. I did it. And I got to bleed within like 10 hours based on the science of the Provera challenge. It doesn’t work that way.

Lindsey Lusson  03:09

Right.

Sam  03:10

So she was like, total coincidence? Like, what were the odds of that. So happy that you have your period back and healed from Hypothalamic Amenorrhea. Let’s regulate it with birth control. So knowing no different I was just I agreed. And I stayed on that for years. But my junior year of high school to not get too ahead of ourselves here. Last week of school broke my foot, rehabbed over the summer, first week of senior year tore a few ligaments in my ankle, it needed surgery to fix that. And that process alone was 11 months. Between the two injuries, I kind of gave up on the whole playing sports in college. Went off to my freshman year, and honestly at first didn’t really miss being all that active. I think I had kind of burned myself out. 

Then probably midway through my freshman year, I realized that I had put on what I thought was a significant amount of weight. So my mind kind of switched gears. I was like, Okay, I used to be super active. And I was I liked how I looked. Now I’m doing nothing. I felt like, I don’t I have to go back to the way I was. So I just went all in. I would work out every morning before class, I became a fitness instructor, I became a personal trainer, and honestly became my identity in college.

Yeah, during college, I decided I wanted to be a dietitian. So I started working for another sports dietitian as like a virtual assistant. Whoa, yeah. And I was actually making like canva posts and helping her out. And a lot of the symptoms of Hypothalamic Amenorrhea really resonated with me. I knew my history, and I knew what I was dealing with it my habits and my hair loss and all these things. So I went to my doctor to get off of birth control and get on a copper IUD because I wanted to take all the hormones out and see. That’s when I realized that my period was missing first like in time.

Lindsey Lusson  04:53

It’s so interesting that with your background and we learning about things in sports. Do you feel like you learned more about recovery, like working in the sports field as a dietitian, than what your doctor what advice your doctor gave you? Or do you feel like you got any good direction from the obese or any specialist that you saw,

Sam  05:19

I was fortunate that all of the obese and the specialists I saw knew about Hypothalamic Amenorrhea. And agreed that that’s what I had. So I’m very fortunate that I wasn’t misdiagnosed in any way. But beyond that, their main advice to me was just like, okay, like, exercise less, eat more and wait. Yeah. I was, in my mind already doing those things. But nothing was changing, and nothing was happening. And I have a pretty type A personality. So when they told me to be patient, I was like, okay, like, I’ve heard that before in other areas. So I thought that was just what I had to do at this point.

Lindsey Lusson  05:52

Yeah. But I mean, you know, being a dietitian, and having gone through, like really similar coursework to people who go pre med, and eventually go to medical school and become doctors. So like, knowing some of those people, like, we know that they actually don’t get a ton of nutrition training as part of their medical training. 70 like some, I’m sure some programs are better than others.

But you know, the advice that they’re giving you to eat more and exercise less, if there were more specific advice that would come down to dietitians. So in a lot of ways, in some ways, they’re kind of staying within their scope. It’s good that you’re able to get that actual diagnosis, but tell us like, what happened next. So you’re going through it, you’re assisting a sports dietitian at a university and you’re learning more about HA, you’re checking some boxes. And so where did you go from there?

Sam  06:41

Yeah, um, so the sports dietitian I was helping was actually she was doing like virtual work similar to you. So I, again, like I was seeing all of her like social media posts, and all of her reels and all of her content. And it just like kept resonated with me to the point where I couldn’t ignore it. So when I originally came off birth control, I again was told like, no, it can take your body up to six months to regulate.

So again, another waiting game, I started to get impatient. And I started to believe that there may be more to it. It was hard for me to accept the diagnosis at the time. I’m so partway through my recovery, I made took it upon myself to cut out all forms of exercise except walking. I went cold turkey, which, if you knew my routine before, would be a pretty drastic change. And after I did that, I did that for nine months before I reached out to you. So at that point, the exercise variable was out of the question. Yeah. And it, I had to sit with the fact that like, it was just a dietary thing. And I felt like I had the tools to figure it out. But it obviously wasn’t coming together.

Lindsey Lusson  07:58

Yeah. And, you know, I feel like that can be hard for any person to do. Because I work with a lot of people who have HA, who work in health care. I’ve also worked with a handful of dieticians, like yourself, and it can feel like kind of intimidating and on some level defeating to reach out for help. I know that when I was struggling with an eating disorder, I was in a really dark place. But I was not very kind to the dietitian that I worked with, because on some level, it was hard for me to accept that I needed help. Do you feel like you had a hard time coming to terms with the fact that you might need to work with someone? Even somebody who has very similar training and education to yours?

Sam  08:41

It definitely was a challenge. I really couldn’t wrap my head around the fact that I couldn’t do it by myself.

Lindsey Lusson  08:48

Yeah, yeah, I hear that so often from people that I work with. And I get it like that’s hard to, to reach out for help. And I think a lot of us are very type A, and it’s not necessarily that we maybe couldn’t do it on our own. But the fact that sometimes we just need somebody else to be a different set of eyes. And a different perspective. And ultimately, some support along the way, right? Like somebody’s saying that this is the right thing for you to do. And we’re going to make sure that we are filling in the gaps for maybe what you’re missing on your own. So you said that it wasn’t until about nine months into your own recovery, that you decided you were ready to get some more help.

Sam  09:38

It was nine months of no exercise. So I would say I spent probably three months before that trying to limit my exercise. And what I thought was increased my intake. And when that didn’t work again, I thought I had the whole nutrition thing under control. So I was like It must be the exercise. It’s gone. And like I said cold turkey. I just stopped and it First, that was extremely difficult. But over time, I just kind of fell into a routine of not doing it. And I waited through that phase for nine months. So it was more like a year.

Lindsey Lusson  10:11

Yeah. And that’s a long time to do recovery on your own. It’s interesting to, to me that the exercise. It sounds like it was easier for you to really go all in with in the food. And then exercise was kind of a later piece to fall in. More often than not, I hear the opposite. But for most people, it’s like, kind of like a give and take relationship between the two. What do you feel like before you joined my program and started working through some things? What do you feel like the last bits of food restriction? that were there that you were kind of hanging on to?

Sam  10:45

And that’s a good question, because for a long time, I just like ignored it. I would say, I was very particular about the ingredients. The things that I ate and not like, oh, you know, I wasn’t analyzing oil types and things like that. But you would have never seen me pick up like a bag of goldfish. That just like wasn’t ever something I would consider. And if like I was around sweets, it’s a bit communal thing, like maybe I’d have a bite. I was very, very aware and cautious of what I ate.

Lindsey Lusson  11:21

What do you think that that awareness and caution and I guess, structure? Or rigidness? Rather better word? What do you think that that rigidness? How did that play into like your relationship with food? And the amount of times you thought about food and stress? And do you feel like there was some mental stuff going on? Even beyond the calorie deficit that you were kind of still operating in?

Sam  11:47

Definitely, I again, when I was in high school, like that was never a thought for me. The job was always felt like I had a hollow leg because no one knew where I put all the food. And then when I went to college, and I kind of went on this, like health kick.I just slowly one by one. And it wasn’t necessarily a conscious decision. But like the things that I would eat got narrower or narrower. And I didn’t even realize the restrictions I put on myself until I was put in a situation where that food was in front of me. And then I would like feel how I felt.

I remember going with my mom to visit my great uncle who was in the hospital. We didn’t expect them to be there as long as we were. My mom went down to like the great little cafe in the hospital and she got like hummus cups with pretzels. And I was like, dipping the pretzel on the hummus and then like eating the hummus and not the pretzel. Yeah. And she was she was just like, what, like, what are you doing? And at the time, I didn’t even realize I had an issue with pretzels until I was put in that situation where it was the only thing to eat.

Lindsey Lusson  12:52

Yeah. I think that that’s like a really good example of how disordered eating and eating disorders can thrive in isolation is because your habits are always going to seem very normal to you. But if you’re missing your period, something’s off, right. Whether it’s the exercise the food or the mentality around food, you know that that’s a great example. And that’s a rather extreme example. Do you feel like you had kind of gotten better than where you were at that point in time? What what types of things? Did you notice coming up as you were going through the six week program?

Sam  13:33

Yeah, that’s a great question. I think I realized that your program, not just like, what foods I wasn’t eating, but when I wasn’t, wasn’t allowing myself to eat them. And so I remember like, I would eat breakfast in the morning. And before your program, I would just wait until lunch. But then I was, again, being the black and white person that I am. I was like, okay, like every three hours. So then like, nine 930 would come around. And I’d be like, this is a foreign time for me to eat like this is not in no world. Do I eat anything substantial at 930 in the morning, like this is smack in between breakfast and lunch. So that was eye opening to me.

Lindsey Lusson  14:14

And it’s funny, and I hear that time on a lot, right? Like it’s not time to eat, and having these predetermined times in our heads that we’re allowed to eat and times that we’re not allowed to eat. I’m curious, Sam, I’ve talked about this with another registered dietitian on a different podcast. You mentioned that over time. It sounds like in college, the list of foods or the types of foods that you would allow yourself got smaller and smaller and smaller and smaller. How much of your education as a dietitian, do you feel like played into some of the restrictions that developed?

Sam  14:53

Um, it definitely made things more black and white. Because a lot of what you learn any college is geared towards like heart health or renal how? Yeah, which they preach a lot of like the whole grains, fruits, vegetables, like they don’t, they don’t recommend like, honor your cravings. Like that’s just not part of the curriculum. So I will say that what I did to get my period back wouldn’t be found in any textbook. But obviously, that was the healthiest thing for me. I think nutrition education has a tendency to, to paint recommendations with broad strokes. And not acknowledged how individualized that needs to be morally, and there’s so much nuance with nutrition.

Lindsey Lusson  15:41

And I think especially, you know, you’re talking about textbooks. So we’re talking about, you know, things that are founded in research. Things that are applied to populations and you know, things that are have a lot of merit behind them. But I think that it gets even scarier whenever we start, like venturing out of things that are not research based. So like, if, for instance, someone is listening to this podcast, and you really struggle, a lot of food rules because you read a lot of things on social media, or you Google things about food all the time, and you’ve got these thoughts in your head as a result of those things, it can be really hard to break away from those things. 

But on another level, you know, Sam and I were taught these things, this is our profession. And so I know a lot of people that I work with in health care. They seem to have this hard time breaking away from fear of being “overweight”. Saying that’s not healthy. It’s not healthy to eat processed carbs. So how could eating processed carbs or sugar, or goldfish or whatever the food is right? How could that possibly be healthy for me to be able to get my period back? Do you feel like you had any of those thoughts? And if so, what helped you in working through this thoughts?

Sam  16:50

Yeah, they were definitely there. I think the hardest part for me was that I didn’t fit the exact mold. I know a lot of people who struggle with Hypothalamic Amenorrhea like hate going out to eat because it’s stressful. Like I loved it. Even when I have these restrictions, people probably didn’t know how much I restricted. I was just flexible enough that there was always something I would eat. So like, it wasn’t a glaring problem. But over time, when I was in your program, and I was eating things that I wasn’t used to eating. I didn’t even understand how I did it before, it was a very eye opening realization.

Lindsey Lusson  17:30

Yeah, yeah. And I’ve heard that too, that there are people who feel like their relationship with food is actually very good. But then whenever they’re pressed a little bit, they get defensive. Or they start to have their eyes kind of open to maybe they’re more restrictive with food than they realized. You know, one of the things that I do in my program are those food challenges, right.

So I’ll say, it’s Friday, you do not have to participate in these food challenge if you don’t want to. But if you want to push yourself a little bit further into recovery, especially if you have a very rigid relationship with food, it can be a good challenge. And so I’ll say everybody go have pizza and share a picture for accountability. Do you feel like the food challenges were helpful for you and uncovering some of those hidden food rules?

Sam  18:17

Definitely. Oh, I remember the first week in your program, your challenge was bagels. And I was again, like I don’t think I was afraid of bagels at the time. Like if I were have gone to, you know, an event at work. And that was the only thing that was their breakfast, I would have eaten it. But I could not have told you the last time I had had a bagel. Yeah. And it’s funny, because from that point forward, I think I had a bagel every day of period for covered.

Lindsey Lusson  18:45

It’s a great fit. It’s a great period of everything. But I think that that also highlights to how ha could so easily be missed. It’s so great that you actually got that like stamp of approval on diagnosis. Because I think a lot of times physicians are looking for an eating disorder.

They’re looking for somebody who jumps off the paper at them because they’re underweight. Or they clinically look like they don’t have an eating disorders. Even though we know EDs don’t have have a look. But what we are told they’re supposed to look like, and the behaviors and the attitudes with food? So like, what I hear you saying is: I didn’t have extreme restrictive behaviors with food, until you start looking at it under a microscope. And so, what did recovery look like for you? Like, what do you feel like was the easiest part of recovery? Like what do you feel like you just knocked out of the park?

Sam  19:44

I would be hesitant to say any part was simple. I think your program was the push I needed to jump into the eating side of things. Like I said before, I had already stopped the exercise. But I could not see fathom the amount of food I needed to eat on my own. Having your support and then the support of the group, I could sit down and feel daunted by my plate, but know that it was the right thing.

Lindsey Lusson  20:14

Yeah. Yeah. So getting some reassurance was really helpful for you. And so being able to be in a supportive environment, it sounds like was the piece. It made some things click. But it sounds like you also had a hard time accepting the fact that you needed more food than the minimums. Like, where do you think you kept getting hung up with? I can’t possibly need more food?

Sam  20:40

Yeah, I, I think seeing the minimums in front of me. I just couldn’t imagine that that was what my body needed. When I was doing it on my own, it was so easy to justify not filling half my played with carbs. I just couldn’t understand why that’s how much food I needed. And I guess that does go back to my nutrition education, like nowhere in any of my classes. Did they talk about someone? My age, my height, my size, needing that much?

Lindsey Lusson  21:09

Sure. I think that’s interesting about how much emphasis our training that height and body size, go into calorie requirements. And while that’s one factor, I personally feel that that’s like an overstated factor. Especially for somebody who’s starting at an undernourished status. And so what helped you to like, was there a lightbulb moment? Or do you think it was more of like a progressive push and recognizing the role doesn’t stop turning? If you’re eating more, like, where do you feel like things really shifted into high gear? And how did that allow you to get your period back in five weeks?

Sam  21:50

I really, I did not want to waste my time or your time. I was like, Lindsey has a limited group. There isn’t room for everybody. It’s only a certain amount of time, like I’ve come this far on my own. And what I’m doing is not working. So I kind of made a commitment to myself, like, I need to throw myself into this 100%. Because as much as I want to believe that I can figure this out on my own. I’ve, I can’t, and I’m going to trust that she can.

Lindsey Lusson  22:18

Yeah, so knowing that there was a date and program start date and end date. It sounds like really kind of lit a fire under you to say I am I’m going to do everything that I’m told to do. And I am going to address areas that maybe I haven’t addressed just yet. Do you feel like you’ve knew deep down that there that you did need to eat more? Or do you feel like it was more surprising to you? That was probably in your case, more of the missing pieces? There wasn’t a lot of exercise going on?

Sam  22:47

I think I knew deep down that I needed to eat more, but not that much more.

Lindsey Lusson  22:52

Yeah. So what would you say back to someone Sam, who’s like listening? And cuz I hear this so often from people? I’ll say, Do you feel like you’re eating enough to have a regular cycle? And so often I hear from people, they say they feel very calm, feel relatively competent in their answer. And so what would you say to somebody who feels like they are eating enough for a period recovery? Yet? It’s been, you know, nine months, a year, nine years since having a cycle. Like what would you like to say to that person or say to yourself in the past?

Sam  23:28

Yeah, I would tell them to trust that they’re not the exception. I’ve done a lot of reflecting on this. And I think two things that held me back one, I believed that I was someone who could get my period back without gaining weight. I kind of put myself in like a special box. I don’t know why I thought I was like, deserve a spot there. But I did.

Lindsey Lusson  23:49

Everyone thinks that! I remember one of the first post I made in a support group when I was working on period recovery is “has anyone been able to do this without gaining weight? “So I think that it’s probably wishful thinking on a lot of our parts. So you’re definitely not alone in that.

Sam  24:06

Yeah. And then the second thing that held me back, I think, is I believed that I could eat more, I would gain weight, my period to come back. And I still wouldn’t have that like, food freedom that everybody talked about. I was just like, there’s just no way that people can like, decide at 1pm they want a cookie and like not care. I was like, like, I may get my period back at the end of this but that’s just not who. I’m going to become like I didn’t think that I could get the full package. So I think that held me back a little bit. So if I just like got out of my own head and like I said trusted that I wasn’t the exception to these like made up rules. I think I would have been able to jump in sooner.

Lindsey Lusson  24:53

Yeah. What I think is so interesting about your story too is how well educated you are on nutrition and in particular, on this topic. Because there are a lot of dietitians who work in renal or in heart health or work in peds, right? And so they have really great nutrition training, and they work with very specialized populations. And they may not completely understand the actual issue. But you did. And you even still struggled with some of these issues. And I can only imagine, having walked a similar story, how hard it is to come around to those things. What do you think made you feel that you wouldn’t mentally have that food freedom that I always talk about?

Sam  25:36

I think I was just so used to it for so long. Like feeling the way that I felt, I just couldn’t imagine. I don’t know why I limited myself. And like my ability to recover as much as I did. It just seems so far fetched to me. I just assumed that I wasn’t going to be one of those people.

Lindsey Lusson  25:53

Yeah, I hear that a lot from people on the period recovery side of things. They understand the process, and they understand that it works for other people. But somehow they have this thing in the back of their mind thinking they’re the exception. They’re going to be the one person that it doesn’t work for. So it’s interesting to hear the flip side. You understood your you felt like your body was capable of recovery, but you thought you would kind of always be stuck with these food rules.  Do you feel like also the like desire or need to exercise and kind of earn your food? Or do you feel like you were kind of already past that during period recovery?

Sam  26:28

I was, I was scared that the second I got my third period, I was going to run into things way too quickly. I vividly remember at one point, during your program, I like said to myself, I was like after my third period, because I’m gonna wait until I’m like fully recovered, I was like, I’m gonna get in the gym, and I’m going to become like the strongest version of myself I can possibly be. And slowly throughout your program, I just realized that I didn’t need to be in that big of a rush to get back.

Now, I’m five cycles out. And I’m still easing my way back in because I never want to feed into those thoughts again. For instance, last week, I was at my desk at work, and I was eating like fried food. I would have never done before. And my mom texted me like, oh my gosh, like, have you seen what a nice day it was outside. I had my gym bag next to me because I was gonna go to the gym after work. But I ended up like packing up my stuff. I took my gym back home, and like went and sat outside and read a book.

So that is just something I would have never done ever. Like, sit there, eat fried foods, skip the gym and go sit outside. I was sitting out there in the sun. And they just like hit me how big of a change it had been. So that was very, very, very satisfying to realize how far I’d go.

Lindsey Lusson  27:47

I think that those what you just described are like the moments that we don’t really realize we’re missing out. We don’t realize it until we’re on the other side of recovery. And so I think your story is incredibly inspiring. And hopefully is speaking to somebody today who maybe feels a little bit stuck in their recovery journey. If they’ve been doing on their own for so long and you know, having a hard time really wrapping their head around maybe needing more support or immediate needing more food. Is there any like last words of encouragement you would want to leave listeners with? Especially somebody who is battling the idea that wow, I really do need more food? And thinking Oh, not me, I’m the unicorn, I’m the exception to the rule. What would you say back to that person?

Sam  28:31

I would just encourage that person to really think about what they want. Not just like in that moment, but like five years from now. It’s really easy in the moment to think that like your clothes or your your identity is like the most important thing. But five years from now, I think if they’re really honest with themselves, they’re going to want something bigger than that. And life doesn’t just boil down to clothing sizes in your identity as the fit person.

Lindsey Lusson  29:01

Yes, yes, I could not agree more. And I think that that is a great thing for anyone listening to reflect on. So thanks so much for sharing your story and for sharing your wisdom and your experience. We appreciate you coming on today. Sam,

Sam  29:13

Thank you so much for having me!

Lindsey Lusson  29:20

Absolutely.