Q. I think I might have an eating disorder, but I am really not sure at this point. This past summer, I lost some weight and was quite happy because I finally seemed to be getting rid of my excess adipose (I was 110lbs and I got down to 97lbs); however, when I went to my doctor for my annual physical she was very concerned about the amount of weight I had lost and told me I needed to gain ten pounds. I have gained eight pounds and I now feel quite lost. . . I am 5?5? tall and weigh 105lbs. I feel that I must eventually weigh 90lbs. I know that, for my height, that is a low weight, but I completely hate the weight I am at right now. I have very irregular periods (and even skip a month or two sometimes) but I think that because I am still getting them (and because of how fat I currently am) I cannot be quantifiably anorexic . I have had been using periodic self-induced vomiting as a means of controlling my weight since I was 15; however, it was not until last summer that I actually lost a good amount of weight. I know that I have irregular eating habits- I am a college student and I skip breakfast and lunch every day. I live at home so I have to eat dinner each night, but I know that if I were in a dorm I would not eat at all. I try to ?eliminate? whatever food I do eat- and, in the past, I have thrown up to the point of seeing blood. To tell the truth, I experience something of a dichotomy in regards to my perception. When I look in the mirror, I usually perceive myself as fat; however, this last time, when I was at the doctor, I happened to see my reflection and I thought, literally, ?My God, you are thin!? By the time I got home, this solitary reflection had been overridden by my frenetic desire to lose ten more pounds- but, still, I think that if I really had an eating disorder I would not experience such epiphanies. Now that I am fatter, I occasionally find myself looking in the mirror and thinking ?you look healthy,? but, for me at least, ?healthy? is synonymous with ?fat? and I honestly hate the idea of being fat. I miss my previous figure and am determined to get it back, then surpass my previously low weight. I do not care what my doctor says, and I do not care about what it will do to me. I think that, on the one hand, my weight has become the predominate force in my life- my grades in school have slipped and I cannot focus on things as well anymore because I am always, constantly, thinking about how fat I am and how much weight I have to lose. Sometimes, I feel that I am sacrificing everything in my life to a quest for thinness, but I think irrationally, yes) that if it will make me thin it will be a fair tradeoff. I feel so lost right now and I really do not know what to do. I am obsessed with my weight. Still, I do not want anyone to know how I feel because then they would stop me and I do not want to be stopped- actually, I cannot fathom being stopped. I feel I am obese at the present and if someone told me I had to stop losing weight I would be inconsolable. Still, I worry about what I am doing to myself- yet I am so much calmer when I do not eat. I really don?t know what I am doing anymore, or what to do anymore. To put it simply, I hate my body and I will always hate my body until I reach the (seemingly unattainable) ideal of thinness. Does this sound like an eating disorder to you?

A. Yes, this definitely sounds like an eating disorder to me. The rigidness in thinking about your weight, the fact that you know you are being illogical and irrational despite what you know to be right, believing 105 lbs is obese, not listening to what the doctor says, throwing up blood, and the willingness to sacrifice everything in your life is evidence that you are on an extremely unhealthy path. Eating disorders are less about losing the weight and more about wanting to gain control over some aspect of your life that is uncontrollable. In other words, it’s about something deeper than just wanting to be thin. The path you are on poses a serious threat to your physical health, ranging from problems with dental problems, cardiac and gastrointestinal problems to death. Eating disorders are said to have the highest mortality rate of all psychiatric disorders. I know you do not want to stop what you are doing; as you said you could not fathom being stopped-but you need to be stopped. I strongly encourage you seek help with an experienced and trained therapist that specializes in the treatment of eating disorders. Please do seek help and do not put this off.