Expert: Joanne - 2/11/2009

Question
I was diagnosed with anorexia in september last year although it had been a very big part of my life for about a year. I overdosed at the beginning of september, and it was whilst on an adolescent ward I was given the diagnosis. I was then transferred to a adolescent psychiatric unit. I had been to the unit twice before for suicidal thoughts/attempts.

I spent 2 and a half months in the unit, though the last half of my stay was mainly on leave as i be-littled by ED and convinced them I was fine. I should probably not have been discharged when i was.
I am 16years old, and 5 foot 7. My lowest weight was around 44kg and my all time highest is 59kg. I currently weigh in at 49kg though it varies, and feel I would like to set my final goal as 53kg maximum.
My diet plan is as follows:
Brekkie-porridge and two slices of toast with jam
Lunch-sanwich and muller corner yoghurt (i alternate between a fruit yoghurt and a choc one)
tea-main meal of around 400-600 calories and rice pudding
supper-galaxy hot choc made with milk.

I can pretty much deal with this, though it does seem an awful lot compared to what a normal person would eat. The thing i struggle with it i often wander into my kitchen to get a drink and will just stick my hand in the cereal box and eat maybe 3-4 cheerios or something like that, and when i do this i get upset and angry and i think its going to make me fat because i didnt have to eat it. Its not on my diet plan, and then i start wanting to cut out things like my puddings. I know the simple answer is try re-strain from getting those 4 cheerios, but i cant really, and surely its okay too? i need to learn to be okay about it, but i cant :/

my second main problem is that i feel i wont stop gaining weight. My counsellor said when i reach a healthier weight they wont really want to reduce my diet plan that much (crazy! i know!) so how will i stop gaining? will i just gain forever and ever? and how can i ever learn to live without a diet plan?
Im so scared that all these fears I have about the future are going to send me into relapse, again.
please help
thankyou

Answer
Natalie

FIRST AND FOREMOST, PLEASE TAKE THE ADVICE OF PROFESSIONALS INVOLVED IN YOUR CARE!!!

I'm so sorry that I have taken too much time to get back to you, something unavoidable came up and I couldn't get internet access.  Again, I apologise profusely.

Believe it or not, I hardly think that what you are eating is more than 'normal', in fact I'd argue that I probably eat more than that!  You need to try and work on that.  You need to make sure that in your mind you know that you aren't eating too much, and stop beating yourself up about it.  As for the handfuls of cereal, I wouldn't worry too much!  I was actually going to suggest adding snacks to your diet plan, if your counsellor is happy with that.  Those cheerios can be your snack.  You need to discuss this all with your counsellor.  You need to let her/him know exactly what panics you so that you can address that and learn to lessen that fear.

As your body recovers and repairs itself, it will become used to being fed well and regularly.  As this happens, your body's metabolism will increase, which means that your body will begin to burn more calories while carrying out its normal functions, so your weight will begin to stabilise and then you should be able to maintain a healthy weight on around 1800-2000 calories per day.  You will not gain forever, but in order for this to work and happen soon, you need to make sure that you eat every day and do not skip meals - this requires you to fed your body at regular intervals.

You need to speak to your counsellor about all of your concerns and be completely honest about them.  If you think that you need more support at all with this, it may be worth trying to get back in touch with people at the adolescent psychiatric unit or something as this is much easier to treat sooner rather than later, and sometimes it can be hard to get the right treatment when relying on adult services.  Paediatrics and adolescent services, although sometimes may be over stretched, but once you get into the adult services, it can become easy to 'get lost'.  I don't know about different parts of the world, but do know that here in the UK, your care is much better taken care of as an adolescent or child as much of your care falls into the lap of only one or two doctors.  Once you are an adult, it is easy to be shoved around from one person to the next.

I didn't accept help until I was 17, so only had a few months working with the adolescent services, but they were worth it, and I regret not asking for it sooner!

Please come back if you want to talk or have absolutely anything else you would like to ask!
Joanne