Expert: Ryan Hale - 3/2/2010

Question
QUESTION: hi i am 15 and am 160 and weight 45kg. i'm am obsessed with Calories and fat, but recently it has become much more of a obsession i have reduced what i eat and even vomit up food atfer eating. look at my self and think i'm fat and i feel fat. i feel very cold. i do a lot of sport and and obsessed with excising after eating.
also after eating i feel ashamed and anrgy for eating!
i am to afraid to talk to my parents about how i feel

please can you help me? thanks Antonia

ANSWER: Antonia-  from what you've described, it sounds like you do have an eating disorder.  Your description meets much of the psychological criteria for bulimia.  I am wondering what kind of feelings you have, especially when you are going through the eating behaviors.  I am also speculating that you may feel bad about yourself, to the extent that you are trying to block out those feelings with the pains of hunger.  Is this due to something in your past or a family situation?  People with eating disorders often have a history of major stress in their lives with work or school, have been abused at some point, have very strained relationships with friends or family, or are very perfectionistic (or have others in their lives who demand perfection).  If any of these apply to you, it may be necessary to work through these issues with someone, since they can contribute to the disorder.  Often, people think they can just try to change the behavior, but is there areas of your life are still bothering you, the eating situation really hasn't gone away.  I know it seems like a lot to launch into all of these areas of your life at the same time you are going through an eating disorder, but you'll find that by going through all the hard work in all areas can make things better in each area.

A great place to start is your school's psych or counselor.  I know it sounds corny, but they can be really good resources.  If they can't help, they are required by law to help put you in touch with someone who can.  In many states, they can even see you for a few sessions before they have to let your parents know that they've seen you.  It is important to talk to someone.  Thank you for contacting me, but I am not able to do therapy with you over the Internet.  I'm happy to answer questions along the way though.  If you can't talk to your school counselor or psych, your family's physician can be a good place to start as well.  Give it a try and see where you get.

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

QUESTION: thank you for your help
i don't vomit up all my food only sometimes but in the last few days have only eaten about 500-800 calories.  
should i approach my parents about how i feel?

ANSWER: Antonia- I don't know what your family dynamics or relationships are like, but generally, it is good to include your parents on important issues like this.  At some point, you will need to include them, the sooner the better.  With what you've told me, I still think you have an eating disorder.  When you talk to your folks, let them know what's going on.  If there is anything that could be inflammatory, that can all be discussed in counseling.  Counseling for eating disorders often and needs to include family therapy.

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

QUESTION: Thank you for your help it has helped me a lot! what type of eating disorder do you like i have
thanks again
Antonia

Answer
I think you may have anorexia nervosa purging type.  This means that your behavior is like an anorexic's but that it also included vomiting.  Bulimics are more often closer to a low normal weight and engage in purging more often.  This is just my best guess from what I know over the internet.  What matters though is that you take a step forward and tell someone who can help that you think it might be a problem.