Expert: Jeanne Rust, PhD - 4/17/2011

Question
Before I ask let me point out that what the info I am about to describe is NOT current. At present my wt to my knowledge (I'm on blind wts) is entirely stable. So no worries. The biggest thing I am struggling with atm is obsessive thinking that is ED related, mostly thinking missing what I used to be as twisted as that is. And I've started wondering... clinically/medically speaking what are the indications for bed rest in treatment?

I was wondering this because last time I went to tx a residential level of care was recommended but for financial reasons it was also an impossibility so I ended up doing a partial hospitalization program. During that time I took a brief week long hiatus when I ended up in the hospital with dehydration and other issues. I am just rather curious if in all reality I should have been in a more medical setting. I know all my vitals at time of admission to the partial program.
HT: 5'1"
WT: 88
BP: 80/60
Pulse: 60 (my "normal" is 84)
Temp: 95
EKG: Showed normal sinus arrhythmias with S and T wave abnormalities

I know its after the fact and medically irrelevant at this point its just that at the moment I'm kind of in that "I was never that sick/sick enough" mentality and I'm also very medically minded so I've started obsessing about this stuff and I'm trying to get an answer so maybe I can get it out of my head.

And a vaguely related question. As mentioned to my knowledge wt is stable at a place my nutritionist is comfortable right now. I make the occasional bad choice but am working on intuitive eating and have been doing pretty well. Next Fri. will mark 1 year in recovery. So physically speaking I am really doing quite well but in the last month my thoughts have become SOOOOO ED obsessive, I've been obsessing more about my meals and what those around me are eating, using food rituals (but I AM eating)... My analysis is that it is most likely due to the fact that I am preparing to make the first move of my life, alone, several states away, to grad school, in a school where I don't know anyone. Consciously I'm not really stressed about it but I don't know... is this type of transition a common trigger for AN to creep back in to ones life? It hasn't effected my food behavior much yet and I don't want it too I just want the ED voice out of my head!

Any feedback on either concept would be much appreciated. Especially the first one so I can stop obsessing about it. Thanks!

Answer
Dear Sam,

I am not a physician but it sounds to me as if you were certainly "sick enough!"  Your electrolytes could certainly have been another factor.  In regards to bed rest, that's the doctor's call.  It's a very individual thing.  As you're telling me about how you're obsessing again about the eating disorder, wondering if you were really that sick, it sounds to me like the eating disorder voice is speaking to you!  Loudly!

Also the eating disorder thoughts creeping in again, food rituals, what others are eating, etc.  You know all of the signs -- and I'm so glad that you are telling me about this!

Eating disorders are stress related conditions, so as long as your obsessing if you were really that sick, obsessing about food and food rituals, you don't have to think about what you're feeling about going away.  It would be very normal to be scared about living away and on your own!  It is very normal for anorexia to pop up it's ugly little head.  Do you have a therapist?

You can also check again with your nutritionist.  This is really a gift to you -- this will come up again.  The idea is to find ways for coping that don't include an eating disorder.  Do you have any ideas about what you could do?

Let me know what you think?

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