Expert: Joanne - 3/14/2008

Question
i'm 17 and i know that i have a pretty severe eating disorder ive had it for quite a long time now and its gotten to the point where i cant even eat some lettuce without throwing it up or compulsively burning of the calories and much more i just i cant take it any more i actually feel like im about to die its not just the usual feeling weak thing..its taken me so long but i, i think i need to go to a doctor. my anorexia and bulimia has completely distroyed EVERYTHING in my life to too much of an extent. i just need to breath again. but im so scared of getting help..thats an understatement im petrified. and half the time i dont want to let go and when i do i try to but just cant..so my question is after all that rambling..i need you to tell my what they will do to me if i go to a doctor and get admitted to a clinic or hospital or whatever they admit you to. i need to know what the routine will be..i know i cant leave without my parents or doctors consent until im 18..but what kind of foods will they try to make me eat..at least do they try to feed you in small amounts of healthy foods to begin with? what happens if i dont eat when im there? can i phone home if i want to? can i have visitors if i want to? at the momment id rather die then go into hospital and not be allowed to walk outside or have phonecalls or see my parents if things are too much and i want to go home..im sorry ive gone on but please just tell me what you know because i find even thinking about going into recovery petrifying and well pathetic to be honest but going in wihtout knowing what they'll do to me is so much worse.

Answer
Jo

It sounds as though you need to get help now!!! Please!!!

Your best bet would be to go to your Dr and just tell them absolutely everything!  From there, you will most likely be physically assessed.  If you are extremely underweight, or your health is suffering badly, there is a huge chance that you will be expected to receive inpatient treatment.  If your health isn't too bad, sometimes, they would rather try outpatient treatment first - but this depends where you are from and what is available in your area.  I know that there are places out there that will admit anyone with an eating disorder out there as you are paying for the treatment yourself, and then other places like here in the UK, where they really only admit the most serious cases simply as there aren't the facilities available, so use outpatient care in as many cases as possible.

Different clinics have different routines.  Some are very much like a hospital set-up and run like a hospital, others tend to be more homely and may be slightly more relaxed.  Usually, your treatment (inpatient) involves not much other than refeeding and getting you to a healthier weight.  During this time, you most likely won't get a lot of say in what you eat, you will be given what they recommend is necessary depending on the weight you need to gain and your physical health.  As you begin to eat better, you may be given more a choice.  When you are at a low weight, many places won't start therapy with you as they don't feel that it is constructive until you are healthier.  From this point, you will receive individual therapy, group therapy, and many places will have family therapy sessions as well.  In order to treat you, they need to establish the reasons you developed an eating disorder, which can involve small/big things from your past which your family may be involved with, plus it is helpful that they are supported and taught how to deal with the eating disorder as well.  You will also receive help from nutritionists to help you make better food and eating choices in order to help prevent relapse.  This will all continue for as long as your treatment team thinks it is necessary.

You will most likely then be moved into an outpatient maintenance programme.  This will involve you still meeting with a therapist and possibly weigh-ins every so often to ensure that you are coping when you return to your 'normal' life.

If you don't eat in the treatment programme, it can go 2 possible ways.  They may discharge you seeing as there may be other people out there that are needing the treatment place and have a better chance of recovery at that point in time, providing you are not at a dangerous weight or have any major health complications.  If they do think that you are too unwell, they may tube-feed you.  This is very easily said and a lot harder to do, but I do recommend making every effort to eat as much as possible when you are being expected to eat - being tube-fed is not nice!!!!

A lot of treatment programmes involve you being there voluntarily.  I would recommend trying to get into that sort of programme as soon as possible.  If you allow this to continue, by the time you actually get help, this may no longer be your choice!!  If you become too ill, you risk being committed, which may involve a lot more intensive treatment, and can also impact on the rest of your life.  Here in the UK, being committed can put future employment in certain jobs at risk.

I urge you to get help as soon as possible!  I would recommend talking to your parents and then visiting your Dr as soon as possible as it does seem your situation is becoming extreme, and therefore, possibly more and more dangerous!  Eating disorders can be deadly!

Joanne