Expert: Reverend Abbott - 9/10/2007

Question
hey, thanks for taking the time to do this work.  i had some questions about metabolism and body issues-- i'm 29 and dealing with a relapse of anorexia; i was anorexic in high school but i've struggled with eating and body issues since i was really young in an unrelenting way and i suppose i'm back where i started.  i'm exhausted from all of it but have a really hard time moving through the world if i'm not unequivicably really small--it's like i don't feel entitled to take up space unless i barely am; it's so frustarting to me to be such a staunch feminist and watch me do this crap to myself, arg, anyways-- i was eating 650 calories a day (less than 5 grams of fat) and exercising religiously (compulsively) from december to about july and dropped a bunch of weight.  i'm not sure, i think i'm 5'1" and 90 pounds--maybe a little less, but i have a kind of hefty/thick frame naturally.  i don't have a scale, which drives me crazy, but i know it would really further exacerbate my obessesions.  besides, my clothes keep getting looser and a friend who i endlessly badger swears i'm losing and starting to appear sickly. i find this oddly reassuring.  so here's my question(s): i bumped my calories up to about 1,000 to slow my weight loss (still eat little to no fat) and also to perk up my metabolism, but i also do some small bingeing (500-700 extra calories), mostly when i drink, which i do like 3 times a week.  it's so crazy, but it seems to work-- i'm losing *more* weight, which baffles me.  is it because my calorie intake is fluctuating between like 950 and 1700 and i'm successfully tricking my body into releasing its fat stores?  i'd say i eat about 950 4 days a week, 1500 one day, and the other 2 is more like 1800.  i also purge a little when i binge.  i feel like such a cheat or something.  can this weight loss be medically possible or is it in my head and my friend is just lying to me?  also (and i really do apologize for such an intensely long series of questions)-- i feel pins and needles and chest pains all the time now.  i take l-glutamine, a multi vitamin, and an extra shot of c, plus green tea extract daily.  i eat 5-8 servings of fruits and veggies a day.  i haven't stopped my period. is there anything i can do to prevent a heart attack short of stopping my behavior right now?  i know i'm a total freak show.  i'm in therapy and going to see a nutriotinist after i get insurance clearance by going to my ob-gyn next month so i *am* working at it but it's hard to not obsess about what's going on with my body in the interim.  what do you think? and thanks again.

Answer
I know how you feel and all the angst. How you think you want to stop and be different, but how this is somehow comfortable. "The devil you know is better than the devil you don't".  That's how it is with anorexia and you're right, there is so much more going on than food or weight. It's feeling "unworthy" and little and out of control. You probably suffered abuse of some sort, whether physical or emotional - or both.
 Yes, when someone says we "look well" it can trigger a further dive into self starvation.
You're not unusual and you're not alone.
All the numbers are overwhelming aren't they? The calories and the calculations - the studying body functions and trying to determine what's going on (fat coming back or going away; losing bone, organ tissue or muscle?).
 Anorexia is the number one most fatal of all psychological disorders.  Number one.
 I'm here and I have a site you can look at. When you're really ready, just let me know.  I WILL try to support you through this, but you do know - you have to be ready.

 www.GetTheReal.info