Hi, my name is Michelle and I’m 19 years old. I’ve had issues with food since I was a child, but they got worse 2 years ago. I’ve been in treatment for an eating disorder for 1 year now (diagnosed first with Anorexia, purging subtype, and then with EDNOS).
The thing is I can’t seem to make significant progress because I’m not convinced I’m “sick enough” to be receiving treatment. I’m in a normal weight range but I have all the other characteristics of Anorexia…. so because of this I want to keep getting sicker, just so I can say: Ok, I’m underweight and sick now, I can receive treatment.
What should I do? How can I understand that I don’t have to be skin and bones to need treatment? Do u think I have to have ALL the characteristics to have Anorexia?
And my family is always saying things like: You don’t have an eating disorder. You have other issues… not that! I’m sick of trying to convince myself that I deserve help and treatment.
How can I handle these comments? Thanks!
A. Dear Michelle, I am glad you’re open and willing to address these serious issues. As I have mentioned in this forum on many occasions, eating disorders are very dangerous. They are one of the most deadly of all mental health disorders. Not eating properly can be physically damaging to the body. Psychologically, starving your body of food means you’ll likely be tired, irritated and moody, among other unpleasant feelings.
If I understand your letter correctly, you think that because you are not “sick enough” treatment is not necessary. You believe that you should wait until your condition worsens before you can justifiably accept treatment. You further explain that making yourself sicker might either give you the motivation to receive treatment or it will give you the feeling that you are worthy of help. By your logic, the only time you’re deserving of help is after you’ve experienced a certain amount of suffering and only then are you worthy of being a recipient of treatment.
There are many problems with your way of thinking. You are essentially torturing yourself. Your thoughts and behavior are self-destructive. By your standards, for you to receive help the prerequisite is suffering. In your mind you may have even created an imaginary “suffering point” that must be reached before you feel that you’re worthy of help. But how much suffering is enough? Is it when you reach 75 pounds and a feeding tube is necessary? How about after you’ve fainted from dehydration or exhaustion and need be to be rushed to a hospital? How much suffering is enough to make you worthy of treatment? How sick do you have to be to be deserving of treatment? I hope you can see how self-destructive and illogical this line of thinking is.
You seem to lack a high opinion of yourself. Low self-esteem is most likely related to your eating disorder. Both of these issues can and should be corrected with therapy.
Realize that your thinking is illogical. You do not need to suffer to be worthy of help. There is no amount of suffering that you must endure before you allow yourself to enter treatment. You don’t have to get worse before you can get better. Suffering is not a prerequisite for treatment. You are worthy and deserving of help. Believe in this truth. Anything else you tell yourself is inaccurate and is the result of distorted thinking.
What sort of advice would you give a good friend if this were her problem? Would you say she was right, that she was so unworthy that only increased suffering could render her deserving of help? Would you tell her to wait until something bad happened to her before you’d advise her to get help? I highly doubt you’d make that suggestion to her.
I cannot determine whether you “officially” have an eating disorder. That’s because it’s too difficult to diagnose an individual over the Internet. But what I can determine from your letter is that your thinking is illogical and needs to be corrected. You can do this with effective therapy.
I would strongly recommend that you do not wait to seek help. Therapy can help you to correct the low opinion of yourself and teach you to believe in the truth, which is that you are worthy of help now and in the future. Give yourself permission to believe this. Thanks for your question, Michelle. I hope that you seek help now and not later.
Last reviewed: By John M. Grohol, Psy.D. on 12 Jan 2009
Randle, K. (2009). Am I Deserving of Treatment?. Psych Central. Retrieved on February 27, 2015, from http://psychcentral.com/ask-the-therapist/2009/01/12/am-i-deserving-of-treatment/