Q. Lately I’ve been gaining weight, due to treatment for long standing Anorexia Nervosa, and it’s been devastating to my self esteem. I have been unable to find any sort of psychological treatment in my area specific to anorexia, so I’m pretty well on my own as far as body image issues are concerned. My treatment consists of medications for depression, nutritional counseling, and general psychotherapy, with a new therapist whom I like, but who has never before treated an anorexic. After months of nutritional counseling, I had finally gotten to where I could usually meet my meal plan goals — which are still about half what it will be in the end — but now I’ve gained a lot of weight, and I just can’t stand it! My self-esteem, which was reasonably good when I was thin, is through to the sub-basement; I’m hardly accomplishing anything in my life, little as I have to do in the first place; and my depression is back with a vengeance, despite the medications. I know that chronic anorexia is not known for having a good prognosis, but I can’t believe that I am just plain stuck with a choice between being actively anorexic, or “normal” weight and feeling miserable because of my body. There must be some sort of hope, mustn’t there? Can you offer any sort of advice?
A. Anorexics typically believe that other anorexics look much too thin. When they see themselves in pictures or in the mirror; they think they look much too heavy. When anorexics look at each other, they see someone who looks too thin. The problem is a self image problem and that’s what appropriate therapy can successfully deal with.
I don’t know your exact height and weight but you have been diagnosed by a qualified mental health professional as being anorexic, so it’s hard for me to comment specifically about this matter. I would encourage you to continue with your therapist. It is a good sign that you like your therapist but never hesitate to try another therapist if this one is unable to help you. Don’t give up.
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