Expert: Jeanne Rust, PhD - 7/10/2009

Question
Hi Dr Rust,
 Here's my situation: I just took the EAT-26 test and scored a 35, a 7 on the shorter 5-question test (SCOFF or something), and I'm still not sure if what I'm dealing with can be considered an eating disorder.  I'm 5'7", currently 133 (I was 150 on January 16, 2009 which was when I started tracking my weight and calorie intake), I try to restrict my calories to 1150-1350 calories each day, I work out vigorously at least 6 days/week (usually cardio where I attempt to burn upwards of 350 extra calories, and then weight-lifting and ab work), though I occasionally have to stop because I feel light-headed and tired.  I don't sleep well at night (my doc prescribed Lunesta a couple months ago but it didn't work).  I am on birth control so I do have a monthly cycle, however in the last 4-5 months my cycle has been extremely irregular (it'll start a few days early or just be really really light).  I don't purge but i have attempted to on numerous occasions, especially after eating over 1900 calories in a day.  I get so frustrated with myself that I can't activate my gag-reflex, it almost brings me to tears.  I am ashamed to eat in front of my family though I'll still go out and eat with my friends but i do a TON of research into nutritional information on the menu of whichever restaurant at which we're eating.  I am obsessed with measuring out my food (though I eat quickly at each meal and don't cut food into small pieces), and am EXTREMELY organized when it comes to my meals.  I can plan my calorie intake for an entire week, if I really wanted to (a path towards which I'm heading) and suffer from serious anxiety when I don't know how many calories are in a food or how many calories i've burned from an activity. I think about calorie burn and food all day and stress over it.  However, I'm very aware of my behaviors and because I love working out I'll never be anorexic, but I do make a conscious effort to eat the bare minimum in order to remain active.  I have to eat, but when I over-eat (i.e. over 1900-2000 calories in a day) I stress out to the point of wanting to throw up, and have tried, though I can't seem to make it happen with my fingers.  I'm about to start trying laxatives to further the weight-loss...
Do I have an eating disorder NOS?? Or am I just on the brink???  I'm ashamed to even submit this question because I know in my heart that I have some sort of problem, but I don't quite know what to call it.

Answer
Dear Beth,

I'm so glad that you wrote!  You seem to be a self-aware young woman -- and unfortunately self-awareness doesn't keep us healthy!

You do indeed have Eating Disorder Not Other Wise Specified or EDNOS.  You have all of the symptoms other than the very low weight.  Your calorie intake is quite low considering your level of activity.

You haven't had any real medical consequences yet because you're young, but the body can only put up with so much stress.  I see many women in their late 20's and 30's who have become severely ill because they have abused their bodies for so long.

Would you believe that it is possible to become completely well from an eating disorder and still be slim --being well does not equal fat!  It means being vibrant, healthy, being free of obsession, and able to live life as wonderfully as you would like!

Warmly,
Jeannie Rust, PhD
www,mirasol.net
www.edrecovery.com