Expert: Joanne - 2/15/2009

Question
hi,i have battled with my weight most of my life,in the past 2yrs ,my weight has fluctuated from 37kgs to 43.6kgs i am 5"6 tall small framed, so not that thin .i have looked a pictures of anorexic girls and i don't look like them.im not that thin, i have all ways managed to stop this from been a really big deal. till as i say the last 2 yrs. i now have people in my life that. seem to get on my case about it.i do realize that I'm not like every one els, i don't eat all the time, i can go 2 or 3 days with out food. that's just the way i have always been  for as long as i can remember. i only want to eat when I'm hungry. to keep the pease i went to the doctors about  a year ago . and have been going every 4 week since 4 a weigh in, not that I'm weighed as i proffer to do that on my own i just tell the GP my weight.i have kept it up to 43kgs for a few months now. i have had a very low iron level and have been on iron tablets for 4 months and its still very low. i am struggling to keep my weight down at 43kgs its been going up to 43.6kg. and I'm just so stressed with this. i feel so uncomfortable. don't want any one to see me feel very self conscious. i have started exercising again on the quiet, stopped taking the iron tablets, because i think there making me fat.im restricting my food, and lying to people around me. because i cant be honest with them, they just get mad. i have got my weight back down to 42.3kgs , desperate to get back at least to 40kgs, but i feel and know every one close to me is watching me. i gave up caffeine and made a promise not to take it. so badly fell the need for it, is there anything that's not bad 4 me that i can take to give me energy and help to speed up my metabolism. i need the caffeine to run and give my a feeling of energy. i just cant get the people around me to understand.im seeing my psychologist again next week and i don't want to tell her that I'm failing to do as I've been asked. as she may tell my doctor.i feel trapped. please can you give me some guidance. i have some great friend but i just don't want them to know how I'm thinking, i don't want the stress of this with my friends or my husband any more. we have got back to an ok place.but i just cant maintain what's been asked of me, and no one can understand me. thanks

Answer
Liz

Firstly, for your height, you should be at least 55kg!  At your present weight, your bmi is only about 15.5, and it should not be below 18.5.  At the weight you are, you are risking seriously damaging your body in the long term!

Are you telling your doctor your honest weight?  I find it surprising that they do not find this low weight worrying and do more to deal with this!

You need an energy boost?  You need to try and address these eating behaviours!  This will dramatically increase your energy levels, as will correcting your iron levels.  Anaemia causes you to have a lack of energy as it means the ability to carry oxygen in your blood is affected, and oxygen is necessary for cellular respiration to create energy.  I would recommend taking the iron tablets again, but ultimately, increasing your iron levels would be better done with a diet rich in iron.  I can not recommend taking anything to increase your energy levels as these are only makeshift solutions and I think that your efforts would be better put into trying to beat this eating disorder.

You need to be completely honest with your psychologist, otherwise they are unable to help you properly.  They need to know exactly what they are dealing with and what you need to work on.  There is no point in only telling them half the story, or they are only able to treat part of the problem!

Has anyone explained possible health complications with you?  Just look anywhere online, the list is long, going from bad hair, skin and nails right through to kidney failure and cardiac arrests!  When you are not eating enough, your body will find other sources of energy, and usually breaks down muscle to do so - your heart is a muscle, and when it needs to, your body will break it down!  Ultimately, your body will do all it needs to to protect the brain, and does this at the expense of everything else!  Your brain can be affected by anorexia though, and you are likely to have noticed the lack of concentration and problems with memory as your brain shrinks, with the possibility of things like strokes and seizures!  Eating disorders can be deadly, and they do not spare any part of the body!

You mention a husband.  Do you have kids?  I think that you need to think about the effect that this could be having on any family that you do have.  Although you should not recover for your family or feel guilty about it, you should be recovering for yourself, it is hard to maintain relationships through this, and sometimes it is easy to push people too far away.  Please talk to your husband about what is really going on!  If you don't have kids, is that something that you want in the future?  If so, at the moment you are risking the ability to have a family of your own.

Please think seriously about what this is doing to your body and possibly your relationships.  Surely your health and happiness are worth trying to resuce - please tell your psychologist and doctor the truth!

Joanne