Eating disorder?

By Dr. Marie Hartwell-Walker

I’ve been in treatment for an eating disorder for almost 3 years now. It started when I was 17, and now that I’m 21 i’ve been better, but i’m not completely recovered yet. I used to go to weekly appointments with my psychiatrist, now I see him once every 3-4 months, i also went to equine therapy twice a week and then left it a year ago, plus i went to individual psychotherapy and nutritionist once-twice a week. This has been my life for the past 3 years and I’m also a psychology student and will be graduating nexo year.

I was diagnosed first with anorexia, purging subtype, and then my treatment team changed the diagnosis for ednos (eating disorder not otherwise specified). I used to starve myself, restrict my food intake and i tried to induce vomiting a lot, even though i only succeded 2 times but felt relieved and guilty at the same time, so i stopped trying. Instead, i restricted and when i felt i had eaten too much and felt guilty, i skipped meals or excercised.

But recently (like a year or less from now) i’m not using a lot of eating disordered behaviors, i restrict sometimes and skip meals, but not as bad as before. I left one of my treatment team therapists like 5 months ago, and on our last session she told me she didn’t really think i had an eating disorder (this came out after 2 and a half years of treatment with her), and she said it was because i wasn’t as bad as other girls with ed’s.

When i told her 2 different psychiatrists had diagnosed me with an ed (eating disorder), she said,well, ok, you do have an ed. Now that i’m going twice a week with my other therapist, last session she told me i was more functioning than most people with ed’s and that she didn’t think i really had one, cause i wasn’t that sick.

I don’t really know what to think or believe about this whole situation, it’s just making me more angry at them, cause i feel decieved by them cause then they lied to me all these years, and it also makes me mad at me for not being “sick enough” to deserve treatment, and i thought that phase was over.

Hope you can tell me what do u think or what should I do. Thanks!!

A: There is no sweepstakes on trouble. It doesn’t matter in the least whether your problems with eating are better or worse than other people’s. You were diagnosed with an eating disorder 3 years ago. Period. To your credit, you had the courage and the perseverence to get treatment. It sounds like it was largely successful. You still don’t have an absolutely healthy relationship with food but you are getting there. You are not endangering your life or health anymore and you’ve developed other ways to handle anxiety. Good for you!

Rather than being in an argument about diagnosis, I think it would be more helpful for you to give yourself credit for how far you’ve come and then refocus your treatment. i worry that your identity has become somewhat tied up with having the diagnosis. I’d like you to instead be redefining yourself as a person who has done good therapeutic work and who has developed positive ways to manage stress. Can treatment now focus on building your self-esteem and self-confidence so that you can truly put the eating disorder behind you?

I suggest that you talk to your therapist about setting treatment goals for the present and near future and that you leave the past where it belongs — in the past. Of course you deserve treatment. But at this point treatment may take a new direction so that you can eventually terminate therapy.

I wish you well.
Dr. Marie

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Last reviewed: By John M. Grohol, Psy.D. on 30 Sep 2010

APA Reference
Hartwell-Walker, D. (2010). Eating disorder?. Psych Central. Retrieved on October 31, 2014, from http://psychcentral.com/ask-the-therapist/2010/09/30/eating-disorder-2/