Expert: Joanna Lhulier, Psy.D. - 7/31/2008

Question
QUESTION: I am 20 years old, and I have never had a problem with eating.  However, once I attended college, that changed.  During my sophomore year, I started getting really nervous and throwing up.  It wasn't my choice.  At first, it was just when I had a big test or something.  I tend to stress out easily during school.  Lately, it's become more frequent.  Now, almost every time I eat I have to focus on getting the food down and keeping it down.  I even skip out on hanging out with friends because I don't know when or if I'm going to purge. Sometimes it happens before I even eat.  Other times it happens while I'm eating or right after.  I went to a doctor once during school, and she checked my thyroid and blood work.  She said everything was fine and that I was just stressed out.  However, it's summer now, and I'm still purging.  I'm NOT stressed out now.  I never wanted to throw up, it's just happening.  I'm hungry, but it's like every time I start to eat, I can never finish my food because my nerves kick in.  What do I need to do?  Do I need to see a doctor? If so, what kind of doctor?  Thank you for your help!

ANSWER: Hi Karen-
I have to admit your symptoms are somewhat unique.  Do you worry about food or gaining weight?  Have you lost a lot of weight since this "purging" began?  

Regardless, I do think you need to see a specialist.  I would start with a therapist that has experience with eating and anxiety disorders.  I would also make an appointment with a gastroenterologist who has a specialty or at least experience with eating disorders.

I am glad that you are addressing this now before you go back to shcool.  I wish you the best.
Take Care,
Dr. Joanna Lhulier

---------- FOLLOW-UP ----------

QUESTION: I do want to gain a few pounds.  I used to weigh about 125 pounds.  Now I weight about 120.  So I've lost about 5 pounds since this began. Any ideas on what this could be?

Thanks again!

Answer
Hi Karen-
I really can not give a professional diagnosis in this context, but it sounds like you are struggling with an unusual type of eating disorder that is mostly provoked by anxiety.  In other words, underneath the eating problems might be an anxiety issue that needs treatment.  Then again, you may have a medical condition which is why I suggest that you see a gastroenterologist to rule this possibility out.
I wish you the best.
Dr. Joanna Lhulier