Expert: Jeanne Rust, PhD - 3/19/2011

Question
QUESTION: Hello,

I don't have a eating disorder (or somehow I just can't gain weight, so I guess it's sort of a disorder).
However I only weigh 120 lbs and I'm 5'10 tall.

I've been this weight and height since I was 12, for some weird reason I just didn't gain weight or get hungry.
I went to the doctor and asked if he could help me with a diet to gain weightm, but nothing came of it.

From I was 13 I used to stay up all night playing video games, I was too lazy to make any food so I just drank soda all night.
Then I ate once or twice during the day and that was about it.
Cigarettes and soda kept my appetite at a incredibly low.

Everyone pointed out that I was very skinny and I was always extremly tired, but I just couldn't gain weight.
I tried but lost motivation after a short while, time after time.

Luckily I did have a handsome face, so I never developed any mental or emotional problem with my weight, but when I turned 15-16 I decided I wanted to start bodybuilding.
However I did never manage to gain wight, I was never hungry and had to force feed my self.
I was very bad at disciplining my self, so I just postponed and postponed.
Now I'm soon 22 years old and I don't want to be this skinny anymore and I'm starting to fear that being underweight all my youth may have given me any permanent damage?

I once managed to reach 130 lbs when I ate 4000 calories a day, but I lost motivation and went down to 120 lbs.
I have no energy what so ever, which means I dont even have the energy to make food, so it's a raelly really weird and hard cycle to get out of.

I've now got a good diet though, but I want to know if I have damaged my body in any way for life?
I've read that your heart and brain can shrink ?

ANSWER: Dear Dave,

I'm felt so sad when I read your letter!  I'm wondering where your parents or caregivers were when you were growing up?

I don't believe that you have permanent damage at this time -- but I want you to see a therapist who specializes in eating disorders.  She can help you find out what your underlying issues might be, the ones that keep you from gaining weight and maintaining it.  The lazy, no motivation, lack of hunger doesn't fit.  Underneath all of this are reasons why you might be subconsciously choosing to be in an anorexic state.  There are always sexual issues -- It's just one of the possibilities.  Some men want to keep themselves very thin or very fat so they don't have to be in any kind of sexual relationships.

No energy is to be expected when you're not eating.  The body is like a little stove --food is the fuel that keeps the little stove working -- no food, no energy.  Yes, when you're body is not getting the fuel it needs, it will feed upon itself including the major organs in the body such as muscle mass, the brain (causing cognitive impairment), and the heart (which could cause a heart attack).  And yes, these organs do get smaller --

So now is the time!  You've needed a wake-up call -- and this is it!  Please let me know what you do and how things go for you!

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

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

QUESTION: Thanks a lot for responding to me.
You said you don't believe I have permanent damage yet, but at the same time that the body starts to feed on it self, how can I know if this has happened or not?

I understand that in your field there is usually some other component than lazy and no hunger, but to be 100% honest, that's the whole reason.
I've never wanted to be skinny, it was just what I was.

I always found it weird I never got hungry, I never ever ate breakfast and I never ate lunch, my first meal used to be dinner.
For some crazy reason my body didn't make me hungry, eventhough my stomach hurt.

It sounds absurd, and it is, I know.
I quit smoking cigarettes and drinking soda purely because I wanted to gain weight and I realized these 2 were the main culprits in why I never got hungry.

There is no underlying subconscious cause for this, it's just the fact that my body doesn't tell me I'm hungry, and when it does I've been to lazy to make food so I just drink soda with empty calories.

I never had sexual issues, because I was lucky enough to be what girls considered handsome, so I had very high self confidence.
Also I've been in sexual and emotional relationships since I was 13, I never had a problem with either.
This is no passive agressive more, nor does it have anything to do with my self image, it's just the way I've always been.

Answer
It would be interesting, Dave, if you went to a therapist who specializes in eating disorders and get an assessment.

The following is quite long but definitely worth your while.  It's called the Johari window --


1. Known to Self          2. Not Known to Self          Imagine a square divided into four parts -- one part is known to self, etc.
3. Known to Others      4. Not Known to Others   


  
The Johari Window, named after the first names of its inventors, Joseph Luft and Harry Ingham, is one of the most useful models describing the process of human interaction. A four paned "window," as illustrated above, divides personal awareness into four different types, as represented by its four quadrants: open, hidden, blind, and unknown. The lines dividing the four panes are like window shades, which can move as an interaction progresses.

In this model, each person is represented by their own window. Let's describe mine:

1. The "open" quadrant represents things that both I know about myself, and that you know about me. For example, I know my name, and so do you, and if you have explored some of my website, you know some of my interests. The knowledge that the window represents, can include not only factual information, but my feelings, motives, behaviors, wants, needs and desires... indeed, any information describing who I am. When I first meet a new person, the size of the opening of this first quadrant is not very large, since there has been little time to exchange information. As the process of getting to know one another continues, the window shades move down or to the right, placing more information into the open window, as described below.

2. The "blind" quadrant represents things that you know about me, but that I am unaware of. So, for example, we could be eating at a restaurant, and I may have unknowingly gotten some food on my face. This information is in my blind quadrant because you can see it, but I cannot. If you now tell me that I have something on my face, then the window shade moves to the right, enlarging the open quadrant's area. Now, I may also have blindspots with respect to many other much more complex things. For example, perhaps in our ongoing conversation, you may notice that eye contact seems to be lacking. You may not say anything, since you may not want to embarrass me, or you may draw your own inferences that perhaps I am being insincere. Then the problem is, how can I get this information out in the open, since it may be affecting the level of trust that is developing between us? How can I learn more about myself? Unfortunately, there is no readily available answer. I may notice a slight hesitation on your part, and perhaps this may lead to a question. But who knows if I will pick this up, or if your answer will be on the mark.

3. The "hidden" quadrant represents things that I know about myself, that you do not know. So for example, I have not told you, nor mentioned anywhere on my website, what one of my favorite ice cream flavors is. This information is in my "hidden" quadrant. As soon as I tell you that I love "Ben and Jerry's Cherry Garcia" flavored ice cream, I am effectively pulling the window shade down, moving the information in my hidden quadrant and enlarging the open quadrant's area. Again, there are vast amounts of information, virtually my whole life's story, that has yet to be revealed to you. As we get to know and trust each other, I will then feel more comfortable disclosing more intimate details about myself. This process is called: "Self-disclosure."

4. The "unknown" quadrant represents things that neither I know about myself, nor you know about me. For example, I may disclose a dream that I had, and as we both attempt to understand its significance, a new awareness may emerge, known to neither of us before the conversation took place. Being placed in new situations often reveal new information not previously known to self or others. For example, I learned of the Johari window at a workshop conducted by a Japanese American psychiatrist in the early 1980's. During this workshop, he created a safe atmosphere of care and trust between the various participants. Usually, I am terrified of speaking in public, but I was surprised to learn that in such an atmosphere, the task need not be so daunting. Prior to this event, I had viewed myself and others had also viewed me as being extremely shy. (The above now reminds me of a funny joke, which I cannot refrain from telling you. It is said that the number one fear that people have is speaking in public. Their number two fear is dying. And the number three fear that people have, is dying while speaking in public.) Thus, a novel situation can trigger new awareness and personal growth. The process of moving previously unknown information into the open quadrant, thus enlarging its area, has been likened to Maslow's concept of self-actualization. The process can also be viewed as a game, where the open quadrant is synonymous with the win-win situation.

Much, much more has been written on the Johari window model of human interaction. The process of enlarging the open quadrant is called self-disclosure, a give and take process between me and the people I interact with. Typically, as I share something about myself (moving information from my hidden quadrant into the open) and if the other party is interested in getting to know me, they will reciprocate, by similarly disclosing information in their hidden quadrant. Thus, an interaction between two parties can be modeled dynamically as two active Johari windows. For example, you may respond to my disclosure that I like "Cherry Garcia" by letting me know what your favorite ice cream is, or where a new ice cream shop is being built, kinds of information in your hidden quadrant. Incidentally, it is fattening, so be careful on how much you eat!

I wish I could draw it our for you here -- but you can also Google Johari window and you'll see the drawing.  A very interesting way of looking at oneself or someone else!

Let me know what you think!

Warmly,
Jeannie