Expert: Meg - 1/21/2008

Question
Hi. I have struggled with my self esteem for a long time. I remember as far back as 4 yrs old, when I refused to swim because I didn't want anyone to see me in a bathing suit. I thought my parents were ashamed of the way that I looked, even though I have been underweight or at the low end of healthy all my life.
The first time I was anorexic was when I was 11 years old-I lost ten pounds and ate only carrots for months.
It took me 2 years to recover, and my parents never found out.I didn't even know what anorexia was.
Now I'm sixteen, 5'8. 6 months ago I weighed 115 pounds, and began to hate myself. I decided to diet, by eating 1,200 cals a day. My goal  was 105, but I went further. It took me less than 3 months to lose 25 pounds-I was 90 lbs. I knew I had a problem, but thought that I was too fat to be anorexic.
Then my hair started falling off, my skin was peeling, my hip bones covered in bruises from sleeping on them, I could barely move or think. I froze. If I cut myself, I couldn't heal. I couldn't sleep. I stayed awake for 48 consecutive hours. My heart felt funny-slow and hiccuping.I had my fat percentage analyzed-4%.
My dad made me gain 10 lbs-now I'm 100, with 10% body fat. Is this OK? He wants me to gain 10 more, but right now every part of me is struggling not to lose it all. If I go back to normal, I'll just hate myself again, and who knows how I'll end up this time. If I eat healthy, and exercise, is there any harm in being 5'8, 100 lbs, 10% body fat?

Answer
Hi Anna,

Thanks for your question and I hope that I can be of help.  It sounds like you have been struggling with your eating disorder in some form for much of your life and I'm so sorry that you've had to deal with this for so long.  

It sounds like at least a part of you is wanting to recover and get healthier, and of course, there is still a part of you that wants to lose and is still pretty in the grips of your eating disorder.  These conflicting feelings are normal and something that I would say most everyone who has dealt with an eating disorder can relate to.  The key is to find a way to let the healthy part of your brain (the one that knows something is wrong) be the part that is in control and the sick part (the part that feels you have to lose more to be happy/okay/etc) not have as much power.  This can be difficult, especially when someone has been dealing with feelings related to this for quite some time.  I don't know if you have considered talking with a therapist who specializes in eating disorders or if that is something your parents can help you out with, but I really think that it would be beneficial in helping you find ways to let go of some of the eating disordered thoughts and learn to like yourself based on who you are rather than the "feeling" of control that your eating disorder provides.  

Here is a link that has a lot of referral information-when you are ready to consider that, it might be of help:

http://www.something-fishy.org/treatmentfinder/

I am a little worried about you (and partly because I remember myself when I was at a similar point, feeling pretty stuck between people wanting me to get better and gain weight and fearing that doing that would make me unbearable to myself) and feel like you are really concentrating a lot on your weight right now rather than the bigger picture.  Now, I don't blame you as I'm sure that weight is pretty high on your list right now-which is understandable as it still sounds to me like you're in the midst of your eating disorder-though its great that you have gotten a little bit healthier.  To be fair, I have to say that you are still very underweight and have too low body fat, and I don't want to say that to upset you but just so that you can hear (from an outside perspective) that you are still not in a healthy range.  I know that you probably can't "see" that right now, but this is one of the problems of an eating disorder, your self perception is most likely very distorted right now.  

I hope that you can take a look back over what you wrote and try to look at it from an outsiders perspective.  Some of this stuff is pretty scary (not sleeping, your heart feeling funny, the bruises, the peeling skin, hair falling out) and I think that if you see this as a friend who is going through this stuff, you'd be terrified for her.  Now, I don't think being terrified is the key, but seeing that perhaps its time to at least think about getting help and getting your life back is a good start.  

I don't know how to advise you on your weight.  It really does depend on your frame size and body structure, but I still think that 100 pounds for someone 5'8 is going to be too thin and not let you be healthy.  However, my recommendation is to find a healthy diet (if you don't know what that would be for you, talk with a nutritionist-as its easy to forget what healthy is when one's thinking is messed up with the anorexia) and focus on taking good care of your body right now.  Learn WHY certain foods are helpful for you and how nutrients benefit your body by giving you energy.  Focus, instead of on weight gain, on getting your energy back, on not feeling that scary sense of sickness all of the time, of reconnecting with your friends and finding out what you love to do (other than diet/exercise/think about weight/food) and then put even part of the time that your eating disorder takes up into the stuff that you love.  The stuff that will bring you even more happiness and fufillment that your anorexia.

Also, here is a question for you.  Pretend you woke up tomorrow and you were at your goal weight (whatever that is)...what would happen?  What would your life be like? What would be different than it is now?  Once you are able to answer these questions, then write down the stuff that your life would contain and these are some of the things that you want and are trying to get by using weight as a means for control.  Knowing this stuff can be helpful (actually, knowing yourself can be helpful too-which is why therapy can be great) in learning other ways to get what you want that don't hurt your body and don't deplete your energy and take away your life.

Sorry to go on a little tangent there, but I really believe that the key is not in hitting or staying at a certain weight, but at learning to be okay with you (and "you" meaning all of you, not just your body).  I hope this helps at least a little and I also wish you much strength as you continue to fight this.  I can hear so much intelligence in your message and I know that you have lots of wonderful things ahead of you.  Please keep fighting and feel free to write again if there is anything else that I can help with.

Take care,
Meg