Expert: Jeanne Rust, PhD - 4/5/2011

Question
Hi,
I have never been diagnosed with an eating disorder but have been increasingly obsessive and controlling over food since I was about 13.  I started restricting but never lost control at about 15 (not eating anything for a few days at a time to loose weight)

At 23 I started restricting more severely and couldn't stop, I was forced to eat in order for noone to find out, but whatever I would eat I would purge. and went through a period of bingeing and purging.  However, if I had the choice I would have just avoided eating all together. This went on in varying degrees for the past two years, during which time my periods nearly stopped (and possibly did for awhile).

I have stopped making purging (possibly aided by fluox, rx'd for minor depression) but cannot stop thinking about food and weight.  I currently weigh 102 and am 5 ft 6. (i have lost around 13 pounds since new years, due to illness and restricting.) I am still unhappy with my weight, but understand logically, from an outsiders view (thanks to several comments) that I am not fat. I also think I am nowhere near small enough for treatment.

I was wondering, do I have an eating disorder? And if so what it would most likely be?  I am under the impression that I do not met the criteria to be diagnosed and therefore could not get treatment? Is there any at home treatment you could recommend. Or any other advice you would have for me?
If you need any more info please ask.
Thanks :)

Answer
Dear Addison,

You currently have a Body Mass Index of 16.5 which is very low.  You're in the anorexic range.  I felt sad reading your note because you've struggled for such a long time.  Yes, you definitely have an eating disorder.  Anorexia combined at times with bulimia.

I have frequently talked with many people like yourself who don't think they're thin enough for treatment.  This is such a misconception -- you definitely are thin enough for treatment.  In fact around 50% of our patients at Mirasol are of a normal weight.  This is all about how preoccupation with food and weight interfere with your everyday living.

Most people I know with eating disorders get to be pretty miserable.  When their weight gets low enough, they begin to develop cognitive distortion -- in other words not thinking clearly because of the anorexia.  If the body is not getting the food it needs, it will feed off of the major organs in the body such as the brain, the heart, muscle mass, etc.  I've seen anorexics sitting in wheel chairs weighing 65 pounds and trying to move their arms and legs so they can exercise because they think they're fat.

Here are some statistics you'll find interesting:

Physicians need to know that eating disorders have the highest mortality rate of any mental illness.  Research reports that 5 – 10% of anorexics die within 10 years after contracting the disease; 18-20% of anorexics will be dead after 20 years and only 30 – 40% ever fully recover.  The mortality rate associated with anorexia nervosa is 12 times higher than the death rate of ALL causes of death for females 15 – 24 years old.  20% of people suffering from anorexia will prematurely die from complications related to their eating disorder, including suicide and heart problems.

Seeing a therapist twice a week along with seeing a dietitian would be the first step.  Of course seeing your doctor for a good check-up.  I suspect that you'll need some kind of residential treatment.  Why not come to Mirasol?

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