Expert: Joanne - 4/17/2008

Question
Hi Joanne,

I have suffered from Anorexia, Bulimia and Compulsive Overeating for about 20 years now with periods of being healthy in between sometimes for years at a time.

In 2005 I had another relapse due to overwork and stress. Also, I was on Prozac for Depression Treatment and the medication made me nauseous a lot of the time so I literally couldn't eat.

I have put on 10 kgs since that time and am working hard on recovery. I didn't deliberately put on the weight but have been experiencing bouts of overeating due to depression, hence the weight gain. Everyone says I look better but I am tired all the time, demotivated, hate looking at myself in the mirror and hate the fact that my clothes are too small and I have to buy bigger sizes.

How do I start feeling positive again, love my body and generally feel OK in my own body? Also, how do I get rid of this chronic tiredness? Secretely, I would love to lose 2 kilos to see if I feel better again. While it does my ego good to recieve complements, people don't seem to understand that just because I look better (to them!) doesn't mean I feel better on the inside, quite the opposite - I hate the way I look at the moment and while I never want to be that thin again, I would love to just be a bit lighter and to gain some measure of control over my eating and weight again.

What do you suggest I do?
Also, when will I be able to say I have recovered?  

Answer
Ann

Did you ever receive any treatment for the eating disorders before?  If you did, try to contact the people that provided this again.  If not, then I suggest that you try to get that professional help - visit your GP, or self-referral if it is available in services in your area.  I would recommend finding someone with eating disorder experience, but if that isn't possible, then just someone that can provide therapy may be of great help.

It sounds as though there are underlying issues there that have never been dealt with properly, and your way of dealing with them is to abuse food basically, in way or another.  In order to have a healthier relationship with food and your self-image, you really need to work on the underlying problems and resolve them, or at least have help developing better coping techniques.

When you were put on prozac for depression, did they offer therapy or counselling alongside?  If not, I think that you need to demand it.  It is very easy for them to hand out pills, but without psychological work going on at the same time, it is quite hard to overcome it.

I would guess that your tiredness is linked to the depression, but could also be nutrition problems, and would get that checked out by your Dr.

I think to be truly recovered, you have to be able to eat without being fearful of eating anything.  You should be able to eat what you want, when you want, but this should be done within a proper meal time structure for the most part, but without guilt for having the occasional snack, drink etc.  But it is also about knowing when enough is enough, and knowing the difference between eating because you are hungry, or want to have something on impulse, but not eating for the sake of eating, and not eating in order to deal with emotions.

Joanne