Expert: Joanne - 1/8/2009

Question
Hi joanne

I'm scared I've made myself become anorexic or something similiar and need some advice. I'll start by telling you my history. I've had poor eating habits since 2001 when I started uni, when i would miss out lunch and often breakfast inorder to save money. I taught myself not to eat untill 5pm, going all day without food. i used to tell myself its mind over matter

This behaviour subsised when I got a bulimic (now ex) girlfriend who made me eat so that i would weigh more than her. but my habit was still there and i would always lie to her about what i had ate when she wasn't around. But at this time it wasn't a problem i just didn't eat much.

After uni i did a ski season and ate better than i ever had, as it was my job to cook great food and I loved the cooking and the eating, i would always give myself the biggest portion and always had a massive breakfast although i rarely ate lunch, again in the aim of saving money. however i was fitter than ever before and as a result happier than ever before.

after my ski season i returned to uni to start a PhD which has been very stressful and has made my eating habits very very bad and as a result my health, fittness and happiness have declined vastly. My typical day is to wake up and go straight to work and make myself a super super super strength coffee, which allows me to function untill lunch time which genrally ends up being about 3pm or sometimes even 6pm. I then eat my dinner at about 9-10 or sometimes if lunch was late miss it out completely. the reason for this poor habit is no longer money but pressure to get work done that comes from my supervisor and then materialises in my head as 'you dont have time for lunch,you need to get this done'.

now i'm in a mess and the thought of eating often makes me feel sick, I wish i didn't have to eat and i think its all down to my poor eating history and coffee addiction. I have just given up coffee for the new year and now realise i was using it to replace food.

Now I know i need to eat more but I struggle to do so, food is no longer appealing to me unless its free, in which case i always eat a stupendiuos amount from free buffets etc but even in these cases i still dont want to eat the food i just force myself to cos its free. genrally i dont like food anymore, despite being a great cook with a love of gd food i cant be bothered to prepare it and so when i do begrudgingly  eat its usually crap like a microwave tesco lasange or a takeaway. As a result I'm unhealthier than ever, thinner than ever, my immune system is very weak, i ache all over, find it hard to concentrate, have mood swings, ofetn feel depressed and often feel sick when i wake up and after meals and i dont like to eat food, its getting harder and harder to eat and at the same time i get weaker and weaker, i even think its starting to effect my vision on some days. I eat so little now that I feel hungry even after a big meal, it seems impossible to make myself full (although its often a battle to actually swallow) for example today I woke at 9 had breakfast (ceral bowl) at 10:00 and lunch at 13:30 which was 2 big bake potatoes, tin of beans and chesse and i'm still hungry for more! i think i might be on the brink of stravtion or malnutrtion and am starting from yesterday to form a proper eating habit but I'm scared I'm not strong enough and that the damage is done and it will be impossible to put things right.

Does it sound like i'm suffering from a known eaing disorder and what advice do you have?

thanks very much

(ps sorry if spelling is poor i cant get spell check to work and sorry if this question is too long to)

Answer
Scott

I can't tell you whether or not you have an eating disorder, only a qualified doctor can do that, but I definitely think that you have disordered eating patterns.  From reading your e-mail, I definitely think that there is something emotionally going on regarding eating and food, and one of the parts that worries me most is the bit about having an ill girlfriend and lying about your eating habits to even her.  It is common for someone with an eating disorder to be obsessed with what and how much people are eating around them, and so I understand your girlfriend's thoughts, but worry about your reasons for not eating and lying about it to her.  Was there a reason for this?  Do you still believe it was simply about money, or was there even a sense of rebellion against her, or even competition with her?

You are aware that you were healthier, fitter and happier when you were eating, which is good, I'd be much more worried if you believed that you would only be happier when you weren't eating or thinner.  I think you need to look at the real reasons that you are like this with food.  Do you still have a requirement to spend as little as possible?

I think that you need to start thinking about food as a necessity and something that isn't free, but is necessary to spend money on.

I would recommend visiting your doctor and asking them to run blood tests, etc, just to make sure that you are not malnourished, and that your body isn't at risk of lasting damage, and when you are there, talk about your eating habits.  Ask for a referral to a dietician.  If you have someone sit with you and construct a meal plan to follow, possibly taking into account cost if that is still something that is an issue for you, you may find it easier to make yourself eat.  Once you begin to follow a meal plan like this, your body should become used to eating again, and your hunger/full signals should begin to 'work' again.  It is just going to take time.  You may find that initially you want to eat a lot, and that is natural as it is your body trying to get all the nutrients that it has been missing, and then it should settle down.

It may also be worth talking to a counsellor or psychologist, even just one appointment to connsider whether or not this runs deeper and is more of a deep-rooted eating disorder rather than just a 'bad habit'.

When I think about it more and more, I would be worried that you may have eating disorder-Not otherwise specified (EDNOS) which basically means that you don't fit neatly into the 'anorexic or bulimic boxes', however it seems as though you may have some anorexic behaviours thrown in with binge-eating.  Go to your doctor to be fully assessed.  There are questionaires that you can fill in (can even find similar things online!) that will indicate whether or not it is an eating disorder.  Much of diagnosis relies on the thoughts and feelings that go with eating as well as the actual behaviours.  Possibly do one of these online and then print off your results and take them to your doctor to decide whether you may need treatment for an eating disorder, or whether help to develop a daily meal plan should help you sort out your eating problem.

I wish you the best of luck, and please feel free to get back in contact if you have anything else you would like to ask.

Joanne