Expert: Joanne - 1/26/2009

Question
QUESTION: Hi I am Leah. Okay, so now it has been about 4 months now and I think I may
be becoming bulimic. I am 14 years old. I NEVER eat lunch or Breakfest. I eat
dinner because my parents expect me to. When I do happen to eat lunch I
usually go in the bathroom and well, try to throw it up. I only do that when I
eat something I know I shouldn't have, like fat foods. My friends and family
tell me that I am not fat and that I am very average built for me age. I talked
to my guidance counselor about it and she didn't say much. Sometimes I will
eat a lot and then go in the bathroom and throw it up. I guess, i really don't
feel like eating much because I feel guilty when I do. Please don't tell me to
eat more, because people tell me that all the time. Also, sometimes when I
eat something and I don't throw it up I work out excessively and i will go and
run 10 miles or 5 miles depending on what I ate. I am not constantly throwing
up my food. It usually happens about 4-5 times a week.
If you can, please give me some advice or suggestions on what to do.

Thank you very much, Leah

ANSWER: Leah

It definitely sounds as though you are developing some disordered eating habits, which is not good to say the least!  It sounds as though you are developing habits belonging to different eating disorders, so would most likely be looking at a diagnosis of EDNOS (eating disorder not otherwise specified) as by starving yourself, you have some anorexic tendencies combined with bulimia, involving both self-induced vomiting and excessive exercise.

I would never tell you just to eat more as I know that there is much more to this than just what you eat.

I think that you really need to sit down and talk to an adult about this.  The best people would be your parents, but some people are not comfortable with this, and that is understandable.  Sometimes it is just easier if they are aware of what is going on to provide support, and also if you are from the states, it may be hard to get medical help without them being aware due to insurance (I'm from the UK, so don't understand fully whether or not you can speak to a doctor and receive treatment without them being slightly aware of what is going on!)  If you are from the UK or anywhere with a national health service, then visiting a doctor without your parents knowledge shouldn't be as much of a problem, but I would recommend telling your parents as you may find that you need their love and support while trying to recover.
Your parents and doctor are good places to turn to first, but I would also have suggested the guidance counsellor or a teacher at school.  You mention that you have spoken to her, and she didn't say much, what actually happened during that session?  Were you entirely open and honest with her?  Is she completely aware of your situation?  It seems quite shocking that you have confided in her of having such problems, but she has not offered you more in the way of help, or pointed you in the direction of professionals that can help.

You could do recovery by yourself, but you really will need people around you to support you as it is not easy, and if you choose to do this, then I would recommend looking at buying yourself a good self-help book, however, I would still prefer that you dealt with this with professional input.  You may not need to go on an eating disorder programme, but I would definitely try to get an appointment with a trained counsellor or therapist as you need to work on your self image, and also any underlying issues that may have led you to an eating disorder.

Eating disorders can kill, I can't stress that enough, and those that survive an eating disorder can suffer horrible health problems in the future if they allow their eating disorder to go on untreated.  By vomiting, you are putting yourself in danger from ruptured oesophagus, you are potentially rotting your teeth, etc.  There are so many things that can go wrong, please don't let them happen to you!

Joanne

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

QUESTION: Alright. Yeah i am from the states. =] When I spoke to my counselor I mentioned that I was throwing food up and not as much starving my self. All she really was saying is that I have bulimia and that it isn't severe but I should stop. That was mainly it. So it wasn't very help ful. She has been there a lot for me considering I have been SI for 3 years now and I have Adhd. (sadly) I don't have 2 much of a connection with my parents, i don't know who they are. I have never meet them before. =[I live with people who took me in when i was three. My parents left me. =[. The main reason I started throwing my food up is because I feel so out of place. The family that I will with is skinny and a lto of my friends are. I think I am skinnier i will fit it. I don't know. what I shold do. ?

ANSWER: Leah

I'm sorry to hear that about your parents.  Do you feel able to talk to the family that raised you?  Do you love them and trust them as though they were parents?  If you feel that you can trust these people, then speak to them.  Are they aware of your SI?  I have little doubt that the reasons behind your SI and your eating habits are most likely linked and possibly something to do with the fact that you feel out of place.

I think that you need to talk to your counsellor again, and let her know how much this is affecting you.  Whether or not she sees this as severe is not the point!  I do not believe that there is such a thing as 'mild bulimia' or 'mild anorexia', although they may not seem so bad compared to the people that you see on tv or read about in the news, there is a huge chance that the person who only has mild eating disorder habits will be someone that falls down the slipperly slope and becomes so deeply involved in an eating disorder that it becomes very hard to treat, and meanwhile they are becoming seriously ill!

I think you should let your counsellor know that you want to address the eating habits now before they do become much more ingrained, and if you still aren't taken seriously, then maybe you should visit a doctor or try to see a professional counsellor or therapist.

Are you making much progress with your SI with this counsellor?  Do you believe that this is helping?  If it is, then great continue with that, but if not, it may be worth looking into someone professional that can address your eating issues as well as the SI as I do think that you will find in the future that both are self-destructive behaviours, and are likely to have developed for the same reasons.

Joanne

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

QUESTION: I love my parents, but I never really connected with them. Yes my parents and counselor at school are both aware that I SI and only my counselor is aware that I may have bulimia. Think is, when ever I talk to my mom she never really listens. SHe just acts like my life is perfect and nothing is ever wrong.  I gave up last year on trying to tell her things. When I told her that i SI she just started to cry and then she just walked away. I tried to talk to my dad and he got super mad. He always seemed to be frusturated with me. One time he got so mad that he left me and he was gone for quiet I while. My ex boyfriend. Start to realize that I have eating problems and went and told guidance. I have been talking to a therapist out side of school and I CANNOT stand her. My mom can't even stand her. So its like I am at the end of the rope because it feels like I have no one to talk bout it. I talk with my best friend but she gets really upset with me and forces me to eat, which then u know what happens. =[. I am all out of options. =[ I dont know what to do. What do u think?

Answer
Leah

Therapists are likely everything else - some you'll like and others you won't.  I'm not suggesting that you should have to put up with that though.  As therapy is such a important, but highly personal thing in your life, it is completely acceptable to try and find someone that you do get on with and feel you can talk to.

Basically, I'm saying that maybe you should sit down and talk with your parents about how you feel about this therapist.  You need to have them help you to find someone that you can confide in comfortably. CHANGE YOUR THERAPIST!

I also think that you need to sit down and talk to your guidance counsellor at school again.  I think that you need to make them listen, as that is their duty.  If you don't think that the counsellor is helping you, then you are quite within your rights to complain about them!  This is part of their job and what they are being paid for.  Yes they are responsible for the welfare of loads of other students, but if they are unhappy to help you themselves, feel that you need more specialist help, or just simply don't have the time, then they are obliged to help you find a suitable alternative!

Failing all this, then speak to your medical doctor.  Have them make a referral to someone that can provide you with the support you need!

You need to get help, and you need to be trying to talk to people that are in your 'real life' and not just on the internet.  Yes, come here for support, but you really need someone that is there in person to really help you and provide you with the attention that this problem requires!

Joanne