Expert: Ginger - 8/9/2010

Question
I am not sure if I have a “problem” or not. I know most people would say that is the first sign there is a problem but I think people also tend to overreact. I just have a few concerns and am not sure where to start. Go see a doctor?  A physiologist? Or just ask online?



The only reason I am concerned is because I am getting tired of my thinking and the overwhelming concentration on food and what I eat is starting to get to me. I also have noticed that I am obsessed with the way others look and constantly compare myself to others (even others that are larger than I am). I like that I can stay fit and control what I eat etc, and I like keeping my weight under control. I don’t want any of that to change. I just want to be able to be happy when I’m out doing things and enjoy activities instead of constantly comparing or constantly thinking of how I could be better. I haven’t wanted to talk to anyone about it because I am afraid that my husband or family will try to make me eat more or eat unhealthy foods and I don’t want to end up putting on more weight. I don’t feel that I am underweight and I know that I am not “fat” but I am not satisfied with the way I look so I don’t want them to think that if I have a “problem” then that means they need to make me eat certain things. I eat a small salad with vegetable and a touch of fat free dressing every day for lunch,and i will have a peice of fruit for a snack. Sometimes mornign sometimes lat eafternoon, never both. Dinner is usually something more normal,like pasta or subway or something. I try to keep it smaller. On occasion i do vomit after i eat and feel too full. THat is very rare though b/c i don't like the feeling. I feel really disgusting and "ashamed" or disapointed if i feel full after i eat or if i feel i've eaten too much. im 5'2 1/2 and weigh about 96-97 pounds. I got to 95 the other day and would like to stay at that weight or a tad smaller



I guess I don’t even know what to ask or anything….I just don’t know what to do. Is there something I can look at that will help me to know if I have symptoms of an eating problem? Or someone who can tell me?


Answer
Hi Jen,
Thanks for your question- I'm glad you asked!

Even if you had only told me that you sometimes vomit after you eat because you don't like feeling full, and that you feel disgusting, ashamed or disappointed if you feel full, I'd tell you that you have signs of bulimia. Add that to your obsession with food and weight and all the other things you've told me, and I'd say you should definitely see a professional before things get even more out of hand.

Doctors use the Diagnostic and Statistical Manual (DSM IV) to diagnose mental disorders, including eating disorders. This manual gives the criteria/symptoms a person must have in order for a diagnosis to be made. The DSM IV gives the criteria for anorexia, bulimia and EDNOS (eating disorder not otherwise specified- a combination of disordered eating symptoms that don't quite fall into anorexia or bulimia categories. I would guess this is where you'll find you fit the most). Here's the criteria for EDNOS (if you look on the left-hand side of the screen, you can click to see the criteria for anorexia and bulimia, too):

http://www.eatingdisorders.org.nz/index.php?id=836

I think your family doctor would be a good place to start in getting some help. He/she will want to monitor you physically, and they can point you to a counsellor or psychologist or nutritionist if needed. This isn't a good road to be on, and the further you go, the more dangerous it is, the harder it is to get back, and the longer it will take. The first steps, though, are acknowledging the problem and wanting to change, which you've already done!  

E-mail me any time you think I might be of some help.

Good luck,
Ginger