Expert: Meg - 6/30/2006

Question
Hello.
My name is Ally. I've struggled with eating for a while now. I joined a support group online for EDs, but I guess I'm still a little unsure if I really have a problem. I'm 16, 5'1", and around 133 lbs. Obviously, I'm overweight. For the past several months (and several month periods before in my life before some sort of intervention) I have been on calorie restriction. Usually I average 400-600 calories a day. For the last 2 days I have gone up to 700 in an attempt to get my metabolism back up (consuming that much is very difficult for me emotionally). After intervention, I usually find a way to keep my intake to 1,200 calories or less, which as you can see is much more than I normally eat. I have no idea what is reasonable for a girl of my size to eat. I feel I eat a lot when I get in 500 calories or so, while others say it's nothing. The last time I hit the 800 calorie mark recently, I completely lost it, purged for the first time, and almost went on a binge of self injury (which I also struggle with). Feelings of fullness make me paranoid a lot, and sometimes I have issues where my stomach feels full, but my body is still showing signs of hunger (light-headedness, headache, etc.). I don't know...I'm not underweight, and have never been underweight in this situation, although my highest weight was 173 lbs, and through these periods I sit today at 133. But, isn't it beyond reason that I'd be starving or anorexic when each pound of excess fat I have is equal to so many calories? Thanks.

Answer
Hi Ally,

Thanks for your question and I'm so sorry that you're struggling with this and hope that you can find some help or at least some ways to start working on this.  

Everything that you mention above would lead me to conclude that you have an eating disorder.  I absolutely understand that feeling like your problem isn't serious or 'bad enough' to warrent help/treatment/concern is actually very common and many people who are struggling from eating disorders feel this way.  I know that I certainly did, and feel like this is actually part of the eating disordered mindset that tells you that you're 'not good enough', 'not thin enough', 'not pretty enough', etc.  This is why eating disorders can be so tricky to beat as they tend to become insatiable and always dangle that carrot that tells you you need to be a little thinner and then you'll stop.  Sadly, the carrot will always keep moving and most people never feel like they've reached their goal-even when they are deathly ill.  

The behaviors you are describing are certainly indicitave of anorexia even if your weight is not as low as think it should be.  First of all, depending on your body composition (how much muscle you have, structure) your weight might already be low for you.  Regardless, you are definitely not eating nearly enough calories for someone who is 16 and since you have lost 40 pounds from your highest, it sounds like you are probably on the way to full fledged anorexia.  This is why its good that you're aware of this now and can hopefully stop this from happening as there are plenty of healthy ways to have a body that you are happy with and they don't have to involve severe restriction (as you are doing now).  My guess is that if your weight loss is tapering off, despite your barely eating anything, it is because your metabolism is slowing down and going into starvation mode.  This happens mostly as a means of survival and will continue to occur until your body gets enough calories/fuel to function normally.  Even fairly strict diets rarely prescribe under 1500-1600 calories and its possible that you need even more for your basic body funtions to work at their optimal level since you are 16 and growing.  I don't know if you have any way of talking with a nutritionist or dietician, but that might be helpful in terms of figuring out specifically for your body what your needs are and how you can meet them without feeling like you're overeating.  

It worries me a little bit as you sound like you are very engaged in not only the physical aspects of an eating disorder (ie: the behaviors of restricting, occasionally purging, 'feeling fat' even though you technically are not) but also the emotional aspects (like having trouble with feeling too full, even when your body signals are dictating that you need food, guilt over eating, the obsessive thoughts).  I feel that the emotional parts of this are generally the most difficult to overcome and usually requite getting some sort of treatment in order to move past them.  Because you also struggle with self injury (and don't feel alone, a lot of young women struggling with eds also SI) I especially think that reaching out to someone who can help you deal with all of the feelings that will come up as you begin to increase your caloric intake is really important.  A lot of times, some of the same overwhelming feelings that can lead someone to restrict can be channeled into behaviors (such as SI) when you stop the original behaviors.  Please keep reaching out so that you can have as much support as possible to fight this.

My heart really goes out to you as I remember being in that same place where I knew on one level that something wasn't right-but also felt that an eating disorder was something I'd read about and one could only have one if she was 60 pounds and skeletal.  The truth is that eating disorders can occur at all weights and the damage they can inflict doesn't discriminate.  

Here are some links that might be of help to you:

http://www.something-fishy.org/isf/questionnaire.php

http://www.something-fishy.org/dangers/dangers.php

http://www.something-fishy.org/dangers/dangers.php

Hopefully, I've answered your question and this will help you at least think about taking some action so that you don't get any sicker.  I know that its not easy, but you are worth it and you don't want to waste any more time getting sicker and feeling bad about yourself.  

Please feel free to write again if anything in this note is unclear or if there is anything else at all that I can help with.

Take care, okay?
Meg