Expert: Jeanne Rust, PhD - 1/21/2011

Question
QUESTION: Dear Jeanne,
I think I am anorexic, but I'm not certain. I try and eat as little as possible, absolutely never more than 800 calories per day.  I don't think anyone notices because I cover my skipping meals and no-snacks with lies about having already eaten or having forgotten lunch money, etc. I've attempted to make myself throw up, honestly tried, but I can't. I feel like I have two voices in my head; I call them 'me' and 'her/she'. She constantly tells me how fat and ugly I am, and she yells at me (in my head) when I eat. She is constantly reminding me that every calorie I eat is making me a worse person. Even when I go 10 hours without eating anything, she isn't pleased. If I eat a big dinner, she forces me to jog and do push ups and sit ups and jumping jacks for hours. There's another voice too, 'me'. I tell myself that I'm not fat, but I don't get to talk often. I only hear my own voice in my head when I'm around my friends. My friends are really amazing people, and being with them makes me feel like I deserve to eat. Then, once they're gone, She starts yelling at me again. My parents know I have a bit of a problem, but they don't know how bad it's gotten. They told me that if I want to improve the flab on my stomach, starving won't help. They asked me why I want to be skinny, and I honestly had no answer. She just has so much power over me, and there is nothing I can do to stop her. I don't know why she wants me to do this, or what she thinks will happen if I keep doing it, but she's forcing me. Can you please give me some advice? Is this normal for anorexics to hear a voice in their head? I don't think it's someone else inhabiting me, I know that 'she' is actually a part of who I am, but I identify her as an outside force because it just seems easier to understand. Should I talk to someone? Is this just an eating disorder, or something more? How can I get her to stop?
Thank you so much,
Me

ANSWER: Dear Anna,

Yes, Yes, Yes -- you do have an eating disorder and from what you're telling me, it's pretty serious.  Did you know that when people were in the concentration camps in Germany in World War II that they were only given 800 calories a day to eat.  Look up some pictures of concentration camp victims and see if they look thin enough and if that's how you want to look.

You have definitely an anorexia/eating disorder voice and a healthy voice.  Definitely two voices.  The anorexia voice is gradually consuming who you are.  It really wants to kill you, make no mistake about this.  The anorexia voice is not a part of you -- I know it feels like it, but it is separate from who the real Anna is.

Where do you live in Japan?  Let's see if we can get you to a therapist and/or doctor who specializes in eating disorders.  I'm quite worried about you!

Let me know how you do!

Warmly,
Jeanne Rust, PhD
CEO/Founder
Mirasol, Inc.
www.mirasol.net
www.edrecovery.com
888-520-1700

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

QUESTION: Jeanne,
Thanks so much for your information. I ended up telling my parents about what's going on, and I am seeing a therapist. One question I still have though is why I'm actually not losing much weight. I'm 5 feet 8.5 inches and 53 kilograms. I know that's supposedly skinny, but I really am not. My therapist says that my metabolism has just slowed down so much, but if that's the case then why do most anorexics lose more weight?
Thanks,
Me

Answer
Hi, Anna -- the more you don't eat, the more your metabolism slows down.  A person can lose weight quickly at the beginning -- then weight loss slows -- a lot of weight loss is about the reduction of muscle mass rather than loss of fat.

Our bodies are made so that when we go into starvation mode (as people used to do when there wasn't enough food available), our metabolisms slow way down as a way of preserving our very selves -- It is not natural to starve -- so our bodies compensate so we don't die -- at least not right away.

You are still quite thin, Anna.  I'm so glad that you're in therapy!!  Please keep in touch with me and let me know how you do.  I wish I could answer the metabolism question more specifically but there is really no definitive answer!

Warmly,
Jeannie