Expert: Jeanne Rust, PhD - 9/1/2009

Question
QUESTION: Hi,
I am a 20,female from uk.I don't really know how to type this email, because discussing my weight is never really something I've done. I am 8 stone and 5"11. Last time I spoke to my doctor about my weight he said for my height I should be 12 stone.

I have always been slim but recently I visited family after not seeing them for a while and every single one of them commented on how much weight I'd lost.
I look back at pictures from only even months ago and see a much larger verson of myself, and it gets me down, but I feel better now that for a few months ive almost cut eating out.even tho i no i'm not overweight.I've lost quite alot of weight quite quickly.

My mum approached me and said she thot I have an eating disorder.This was a total shock to me,And i was very upset. She is now tryin to get me to gain weight.
Which is the hardest part.
I dont think I'm mega thin, even tho everyone else says otherwise. My mum says if i keep eatin the way i am i will make myself very ill.
But everytime i think of approaching the problem my head says "Yes but to fix this problem u have to gain weight"
And that just makes me feel down and cry, so I avoid eat. I am also avoiding any kind of help becoz I know all I'm going to b told is I need to gain weight. But I will lose all my self eestem to put the weight on.

I feel very weak, and tired, very cold and generally just a frailer version of me.And I'm having panic attacks and passing out. My whole mood had dropped.I feel very very full after a very little to eat and if i "force" it I am sick. I never make myself sick tho.

I have one month to prove to my mum i'm trying to eat, even tho im not, she wants me to gain weight, not me. and I have to be reweighed.
I can't win ethier way:
If I've gained weight my mum will be happy
I will be heartbroken

If i've lost weight I'll b happy
My mum will b even more convienced I have an eating disorder.

But I just don't think I do. I just want to b thin and not eating alot keeps me thin, and if i start to eat more i'll put weight which i just dont want at all.

I cant accept I have a problem.
Because I don't know if I really do.

What do you think?
Thank you very much


ANSWER: Dear Emma,

I'm so sorry to have to tell you that you do have an eating disorder -- anorexia nervosa.

One of the unfortunate things that happens with anorexia is that we never feel like we're thin enough no matter what parents or doctors tell us.

The body works like a little stove.  Food is the fuel for the little stove -- what keeps the engine running.  When the body doesn't get enough food as fuel to keep the heart, lungs, and brain working (in other words to keep you alive), the body begins to feed off of itself.  It feeds on your muscle mass, on your heart muscle, and on your brain.  This is why anorexics will usually die of heart attacks.  The heart muscle is actually depleted and can't work any longer.  

The body feeds on your brain mass as well.  When you get thin enough, your cognitive ability (your ability to think clearly) becomes more and more impaired.  You make not only bad decisions but you can't see what everyone else around you can see -- and that you're on your way to an early death.  I can tell that you're already affected cognitively because you can't see what your other friends and family can see!

Many people with anorexia have their brains literally become smaller and reach a point that if they decide they do want to get well, their brain won't regenerate.  Many people who have anorexia also won't ever be able to have children.

No one, your doctors, parents, friends, etc., can make you eat or want to get better -- unfortunately.  But every day you're making choices --

I really hope you get some help and get somewhere where they can help you realize the beauty in life, the excitement and joy that is out there for you when you don't have an eating disorder any longer.  You won't have to live a little gray life focused only on what you're not going to eat!

Let me know how you do!!

Jeannie Rust, Phd
www.mirasol.net
www.edrecovery.com




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

QUESTION: Thank you so much for your quick reply. My weight issues are all i am able to think about and it means alot you replied quickly to me.

I want to no how to start to accept the problem?
Everytime i think about it i just cant stop crying.
I cant say I have a problem and believe it.

Wot should I do first?  

Answer
Dear Emma,

It is so sad when we realize that we have such a serious condition.  There is such a big part of us that says, I'm not that sick, I'm not that bad!

The first thing to do would be to go to your doctor, talk to him/her about your difficulties.  You'll also need to see a therapist who specializes in eating disorders.  It's possible that you can do all of this on your own and tell family members when you feel it's time!

You'll want to gain weight slowly -- only 1/2 - 2 pounds a week.  Not more.  This is not about fattening you up (although it feels like it) but this is about you being healthy.  You need to work on the food with a professional like a nutritionist or dietitian and on the issues that are underlying the eating disorder with your therapist.

Go to www.mirasol.net and then to the Learning Center -- Read the section on what causes eating disorders -- let me know what seems to describe you!!

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