Is This an Eating Disorder or Something Else?

Reader’s Question

For the past three years, I’ve been experiencing what I assume to be an eating disorder. I’m 5′ 1.5″ and have weighed anywhere from 142 down to 105. So, I’ve never weighed enough to be obese and never low enough to be considered anorexic. I’ve mostly kept it to myself about my weight fluctuations, afraid to be told either that something or nothing is wrong with me. The one friend who knows of my problems insists I have an eating disorder.

I’ll go months eating four hundred calories or less a day, drop weight, exercise madly, suffer many physical health problems. Then I’ll move or return home from school, and I’ll be “normal.” At worst I’ll spend a few months binging and purging, or purging after eating normal amounts of food. I recently tried to be more “healthy,” gained up to 142, and found myself triggered into another bout of extreme calorie restriction. In all these instances, I’m plagued daily by a driving force to diminish myself. I want to be less. Thinness is not the goal, just a measurement of progress. Instead, I aim to quiet my presence, to take up less space, less money. I strive to speak softly, to keep myself in check. I laugh too loudly, I speak to boisterously, I’m excessive in my needs. Somehow, shrinking my body shrinks the burden I am to others.

In the past two months, I’ve come from 142 down to 119 lbs through not eating. It always seemed hard before, but now it’s different. I don’t eat, and it’s not difficult. I’ve considered seeing a doctor about this, but I’m afraid I’m not actually sick. Maybe I’m just one of those chronic “yo-yo dieters.” I don’t look sickly thin; I’m not all bones. For all intents and purposes, I may as well be a healthy young woman. But I’m scared of the way my heart flutters and how the world spins, and by the increasing thoughts of suicide and depression. I’ve isolated myself from friends and my family, and I’m at my wit’s end.

I just need to know, do I have a problem? Is it an eating disorder, or is it just a bunch of dramatics and regular behaviour for women? Is my health in jeopardy, or am I fine? If I see a doctor, will I be demeaned and laughed at and sent away, or will I be given help? I almost feel I have to be a 70 pound skeleton before I can ask for help. I’m scared my concerns will be deemed invalid, my worries nonsensical, and I’ll have spent money for nothing. I just need some answers and guidance. My head feels so cluttered and my nerves so high-strung, I can’t think rationally half the time. All I know is I scare myself sometimes, and I could use some answers to the questions that have been riding me for three very long years.

Psychologist’s Reply

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(Please read our important explanation below.)

Not all eating disorders fit textbook definitions. Even relatively recently a certain “qualifier” diagnosis was added to Anorexia Nervosa to include atypical binge and purge features (as opposed to the features that more commonly accompany Bulimia Nervosa). And the link between eating disorders and anxiety and depression has long been known, as have the potential long-term physical complications of irregular and problematic eating patterns.

Don’t be afraid to seek help. There are professionals who specialize in eating disorders and their complications. And don’t be surprised by any resistance you might have not only to seeking treatment in the first place but also to continuing treatment if things become difficult. You seem already to have some insights into the various psychological issues that often accompany eating disturbances. So, there is every indication not only that you should seek help from a qualified professional but also that you will benefit from the effort. Take hope in the notion that with time and appropriate therapy, you can work through all the issues necessary to be at greater peace with yourself and the impact of your presence on the world.

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