Expert: Joanne - 10/7/2008

Question
well, first of all i want to say thank you ssooo much for helping out so many people, you just make the world a better place to live in!!

so here is my story...

I always thought that my eating disorder started out about 1 and 1/2 years ago, but in fact I realized that I once went through an anorexic phase without knowing it, so I tell you what happened when it hit me first...

I actually have been an exchange student, but was very unlucky with my first host family I stayed in, I felt lonely, because she (it was one single person...) was only at home at 8 PM, and I felt so misplaced (the neighbors were preachers, so I couldn't really relate to them)... The only thing we did together (me and my hostmum) was going to church, and I just hated it, because there was no one i could relate to... (4x a week) ... It took me some time to find friends at the highschool, but we couldn't meet that often, because most of them didn't have their drivers license or no car (and we lived to far from each other to just meet by going there...)

i also had to go to church, i had no choice... (i would have wanted to go to another church, because there would have been my friends, but my hostfamily didn't allow it)

so i felt so miserable, because my parents paid a lot for the organization and I just feared then when I would come back home, that this half year would have been a complete waste... my second fear was that the only thing I would gain there was weight (at that time I was 16 and being 5.35 I weighed a good weight of 117 and I had to never worry about what to eat...) I didn't want to go home be fat and miserable, so I restricted heavily which means no breakfast only eating salad at school and hardly anything for dinner... when I was waiting for my hostmum to come home, I was basically in front of the TV and just challenging myself to go another hour , and another before finally eating an apple or two or three crackers...
the next thing was I thought that one pound equals 0.5 kilogram, so when the scale read 122, i was thinking that I weighed 61 kg, which completely terrified me, so I started restricting and got down to 105 which i thought was 52.5 which was ok for me... it left me feeling great because, from the uncontrollable things in life, this was one thing i could control (i also was a little bit chubby as a child, but not overweighed, and got bullied when i was 10-11 but not for my weight though... another thing you should know is that i got sexually abused when i was 6 or 7 years old [i kind of pushed this away for a long tim] this left me feeling of being abnormal and that probably why i got a little bit chubby, my parents and sister do know about it, but i just can't tell it anyone else, so there's always something between me and my friends, because they don't know my dark secret... I also didn't go to a psychologist and we never talked about it at home which left me dealing with it all by myself...) at that time i just felt like a complete failure... and i have a bigger sister who always got straight a's a boyfriend, and i also considered her prettier than me...

when i had to tell my hostmother that i am not going to stay with her it broke my heart (because she wasn't mean to me or anything, it was just because i felt sooo lonely...) she brought home some fast food and a milkshake, i ate the burger, (crying) and then drank the milkshake, after that i felt so guilty for making her sad, so when she went to sleep i got to the bathroom and purged for the first time the milkshake, which made me feel better (how selfish is it from a person to worry about her weight, when it comes down to meeting new people and being abroad... :( i am a horrible person...)

my second host family was much better, and there i also started eating normally again, and (i starved myself for 3 weeks--> is this enough to go into starvation mode??) this was mostly due to my hostdad because he was a great cook and i also felt much happier (when I'm happy and with friends i can eat a lot easier...) so i gained everything back and anorexia was completely gone...

when i got home i realized that i put some weight on, but that was fine with me, until my last year of highschool it all went well, but when my finals started and the final trip was about to come, i felt fat and was stressed because of the exams that i started working out and not eat much at all and also throw up sometimes, i lost weight very quickly and got down to 103 which left me feeling great being skinny and everything (from 120 to 103 within a month) because on that final trip i wanted to look the best to make up for things i have missed in my life (i never had a boyfriend) and thought maybe the guys would start recognizing me (why am i so fucking selfish??) and they did, so i didn't change my eating habits when i got home from that trip...

then i went for 3 weeks to Norway and was eating normally there again (because i dindn't want anyone to see that something was wrong with me...) although i still took more vegetables, more salad than from the rest, and gained about 7 pounds so when i got home i restricted again (sometimes purged although this happened maximum 1-2 times a month)

a half year went by like this and i got down to 108 the following half year i then didn't throw up for 5 months, but did chew and spit instead (which caused 3-4 cavities in my back teeth :( as i had to find out later on) because i would spend a half night like that...

so when we had dinner i often spit into the napkin, or got up pretending i had to fetch something from the kitchen or set an alarm of my cell saying oh my friend is calling (gross :(  ) but we don't really eat together very often in my family, because we all come home at different times...

in February my mother thought that something might be wrong with me and watched me closely when we went skiing so i was forced to eat... i hated it and i never admitted i had a problem... this lead to guilt so i threw up because i couldn't control the amount i was taking in...

then i did the first course of being an skiing instructor (i love skiing!!) and there i pretty much ate normally (but still taking more salad, vegetables, or leaving out the dessert of fear of weight gain, just eating extremely healthily, because i didn't want anyone to know that there was something wrong with me... and it was easier for me too, because i did sport (i stopped the extreme working out after Norway... because i got to tired, i actually didn't work out at all)... so when i got home i was restricting again, but the pounds crept up till i was at 110, which was still ok for me... then the following summer i was in another exchange program (i love to discover new worlds) where i worried in the beginning about my weight but dismissed these thoughts very quickly, and gained up to 120, so when i came home i was terrified, i restricted, but nothing really changed, i stayed at about 118-120...

i hated it because when i was eating healthily i was about the same weight and now with eating just a little, or a tiny bit every few hours i had the same weight, and after going to the dentist (where i found out about the 3-4 cavities, i was so sad, because my smile and my nice teeth had always been something i was really proud about... so this was my wake up call, but at that time, i was so mad at myself, that i didn't keep up the healthy eating from the summer, because this could have been a true change for recovery...

so right now i am at 116 which is healthy i now but i am restricting really much trying to get down to 105 or something, because i really want to recover now, because when i reached my old weight without eating normally i thought ok, i can deal with it, if i could maintain it when i eat healthily, but eating not much and being the same weight as before, really told me that something has got to change...

why i want to get down to that 105 is, because then i feel like i have a little puffer, then it would be ok for me if i gain 15 pounds when i recover, because if i would get over 125 or even 122 i would probably start restricting again, so i really need this 15 pounds bonus!!

all i want is, having my life back, not worry about anything when i eat something, be healthy get muscles back again and start loving my life and myself for who i am not how i look...

i really fear that i have completely messed up my metabolism, because now i am restricting and it is soo hard to loose a pound, and with that metabolism i fear that (i now eat about 150 - 600 cals a day although over 400 or 500 is an exception) how will it be when i start eating healthily again...

i am now turning 19 in 3 weeks is it to late for my metabolism to get ok again?

i really want to recover (i first have to loose something to do so) please help me... how should i start out without gaining to much (i haven't thrown up since a half year and i probably threw up all counted together about 15 times, so i am not really what you would consider a bulimic person, because i normally never get into binging...)

if i would be underweight i would be willing to gain some weight, but i am not, so i don't wanna get overweight... what is the best way to keep myself from being so? should i start making my intake higher for about 200 cals a week or immediately start by 1200 or 2000 or 3000? oh and what about the anorexics developing a super fast metabolism in recovery, how does it work? do i have to eat 3000 cals a day... i would love to have that sort of metabolism, because i actually love food... irony isn't it... :(

or is it just because they were severely underweight? how much do people normally gain in recovery, or a person like me, what do you think? i really need your advice, i know i can do it, i just need a push into the right direction... how easily do you become overweight as an anorexic person? how much damage have i done to my body (because my bmi was never lower than 17 and most of the time it was 18) ... i wanna be healthy, i want to start liking myself again...

(i forgot to mention i have a lot of fights with my mum in general, she is never content with me, often says something bad about me, i just feel that compared to my sister, that she likes everything about her (my sister and my mum are almost the same and my sister also always critizes me or yells at me for leaving some of my stuff around or stupid things like that) and that she just fears when i am going to make my next mistake, she also often yells because of the smallest things, like when i cook or something, she mostly is pissed off, by the "mess" instead of saying thank you for cooking and things like that, or it could be when i left my jacket in the wrong place...)

thank you so much for your patience, if kept reading till the end... i now the text is way to long, but i haven't and couldn't and can't talk to anyone, so you are my last straw i cling on!!

so i hope to hear from you, if not also thank you i know that you probably don't have the time to answer me, but that's alright, because you help so many people here!!

greetings from europe ;)

Answer
Claudia

It is great that you are getting to see so much!  I wish that I had travelled a bit before I started at medical school, I feel like I am missing out on so much!

I think that you just need to try to eat as normal a diet as soon as possible again.  When people with anorexia are put on meal programmes, especially inpatient ones, they tend to be fed quite considerably more calories than the recommended 2000 or so a day.  This is to try to build their bodies back up as quickly as possible, taking their body out of as much physical danger as possible at the time.  From a lot of what I have read and seen, it isn't very common to increase calories slowly!  Also, the quicker you are eating a more 'normal' diet again, the quicker your body should recover and your weight stabilise.

Claudia, I think that you seriously need to think about counselling or therapy of some sort.  This is the only way you will truly be free of the eating disorder.  You need help to discover the reason you have an eating disorder, and then aid in finding better coping mechanisms.  You need to talk to someone about your relationships with family members and why you feel the way you do about them and yourself.  I really think that you may need to address the sexual abuse, which seems very very scary and probably something that you don't really want to drag up again, but I would say even now, 12 years later or so, it is still impacting on your life most likely, even if it is only subconsciously, but it needs to be addressed and laid to rest properly.

I would ask that you visit a doctor as soon as possible and ask for a referral to people who specialise in eating disorders, or even just a therapist/counsellor/psychologist and possibly a dietician or nutritionist in order to get some advice as to what you should be trying to eat on a daily basis.

Joanne