Eating Disorder Has Returned

By Kristina Randle, Ph.D., LCSW

I am falling back into the depths of my eating disorder and I can’t tell anyone. I have suffered with an eating disorder since I was 13 (I am 18 now). It started out as bulimia/binge eating. I would binge and sometimes purge. I was overweight from the time I was a kid and I was always self conscious about my body. Over the years I began purging more and also experimenting with laxatives and diet pills. During my junior year of high school my eating disorder morphed into anorexia/bulimia. I wouldn’t eat all day and sometimes after everyone in my house went to sleep I would binge and purge or sneak out to run a few miles. I am 5’6″ and my weight went from 165 pounds to 115 from September to January. I started regularly bingeing and purging again and I gained about 15 pounds by the end of February. In early March a teacher found out that I was taking diet pills and called my parents. (This teacher had been questioning me about my weight loss for a while). My parents had suspected an ED and eventually I wound up in residential treatment. I was there for 5 weeks, went home, relapsed, attempted suicide and was sent back to residential for another two months. I was discharged to a outpatient program in July and spent July and half of August doing the OP program as well as seeing an outpatient therapist twice a week. When I was discharged from residential my weight had gotten up to 145 pounds. I started binge eating again and my weight rose to 155 over the remainder of the summer. I was too embarrassed to tell my treatment team about bingeing because I felt so disgusting for doing it. In September I went back to school for my senior year and started heavily restricting and exercising again. After a few weeks I landed in the hospital dehydrated and was sent back to residential for a third time. I spent a month there and then the following three months in an Intensive Outpatient Program because my insurance would not cover partial. I also so my individual therapist twice a week. Since then I have graduated from high school (I completed all my classes at home with a tutor) and got accepted into a top boarding school for a postgraduate year.

However, in the past month things have really taken a turn for the worse. I am so unhappy with my weight and I can’t stand the way I look. I feel so fat and disgusting and the thought of wearing anything other than baggy sweats scares me because I dont want anybody to see my disgusting body. My body has maintained a weight of 155 pounds and I am extremely uncomfortable with that number especially because I KNOW that my “set point weight” is between 140 and 145. I desperately want my weight to get back to 115 where I was in the depths of the anorexia phase of my eating disorder. Although I know this is an unhealthy weight for me, I cant seem to stop thinking about how much better I would look and feel at that weight.

In the past month my eating disorder has been all over the place. It started with severe restricting. I ate about 500 calories over a 7 day period and my weight immediately dropped to about 145. This sever restriction however was followed by a week of severe bingeing where I gained the weight back (and then some) Then I went away for a week to a sports camp where I was playing 9 hours a day of intense volleyball and eating maybe 1200 calories at most. I came home and hadn’t lost any weight which sent me into a week of severe bingeing and purging, followed by a family vacation where I felt pressured to eat foods I was uncomfortable with (it was a week of indulgence… I wouldn’t say bingeing because I wasn’t consuming massive amounts of food) After I got home my weight had climbed yet again and I started taking 10 laxatives daily. My weight has gone down and is now hovering around 155 again but I am still really unhappy with this number. Today I started restricting and purging again. Meaning I am not eating but anything I do eat is being purged.

I feel awful. I cry myself to sleep almost every night and I feel like a fat, disgusting failure. I am still seeing my outpatient therapist twice a week but I cant bring myself to tell her. I am so afraid that if I am honest she will tell my parents that I am not mentally stable enough to go away to school, which I have been looking forward to for over a year. However, most of the time I dream of going away to school because school distracts me so much from food and I can lose weight a lot easier when I am wrapped up in academics and athletics. Although I am a high achieving, top tier school-bound student I feel as though my only goal in life is to reach a weight I am comfortable with- an emaciated body. But at the same time, I really do love school and learning and the school I am going to will be a great opportunity for me. I don’t want to give it up because of my eating disorder. I can’t miss out on another year of my life because I am in treatment.

There are few days when thoughts of pursuing an education and becoming a successful doctor excite me but the majority of the time the only thing I want to achieve is a perfect body.

I don’t know what to do. My thoughts are so extreme, so black and white. No therapy technique (mindfulness, thought stopping, DBT, CBT, relaxation, etc) has ever worked for me. Sometimes journaling helps me get my thoughts out but my journal entries usually end up as some twisted plot to lose a ton of weight.

I really need someone to talk to. I love my therapist but I feel so self conscious around her because I am bigger than her. I feel like I don’t deserve to talk about how I “feel” fat when my BMI proves that I am overweight. I am embarrassed to even bring it up in a session because I know that my therapist knows what my weight is and I cant bear to hear the number aloud.

I don’t know what to do. I feel so alone with my thoughts and I feel like recovery will never be possible because I am so ambivalent about it. –Pam

A. A recent article/ blog entry in the New York Times entitled Is Anorexia a Lifelong Illness? featured Dr. Kathryn Zerbe, an expert on eating disorders. In this article individuals were able to ask her questions. One response was particularly insightful. An individual by the name of “DJ” wrote this about her battle with bulimia “…ironically, in an effort to avoid obesity and to be attractive, I have ruined my appearance further.”

With that statement she was referring to how she ruined her teeth and had to spend large amounts of money on dental work. Not to mention, as she goes on to say, the fact that her health is at great risk because of her eating disorder.

You are likely in the same position she is with regard to your health. In addition, because of the eating disorder you also face the possibility of not being able to achieve your lifelong dream of wanting to become a doctor. Your obsession with finding the “perfect weight” is essentially ruining your life.

You are keeping your ordeal a secret and I strongly discourage this. You are in treatment with a therapist but are unable to reveal the truth about your situation. I understand that you feel ashamed about certain aspects of your behavior. I would encourage you to try to move past these feelings, as difficult as it may be, and talk about them with your therapist. You have the opportunity to be treated, but fear of what others think of you is standing in your way. Your therapist knows already that you’re struggling with eating issues. She’s not going to think any less of you because you’re having difficulty. Her job is to help you when you are having difficulty but she can’t if she doesn’t know you’re having a problem. You’re not helping yourself by withholding the truth from the very person who is attempting to help you.

I also noticed you’re overly critical of your behavior. It’s a common characteristic among individuals with an eating disorder. In your case, it leads you to believe that your therapist will also be critical of your behavior. There’s a very good likelihood that your perception of how you believe your therapist will react is inaccurate. It is important for you to tell her the truth no matter what you think her reaction will be. You need help and you need it now.

I recognize that you’re frightened but you can be helped. Many people have sought treatment for eating disorders and it has saved their lives. The same can be true for you but it begins with you not keeping the reemergence of your disorder a secret. I wish you luck.

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Last reviewed: By John M. Grohol, Psy.D. on 12 Aug 2009

APA Reference
Randle, K. (2009). Eating Disorder Has Returned. Psych Central. Retrieved on November 27, 2014, from http://psychcentral.com/ask-the-therapist/2009/08/12/eating-disorder-has-returned/