Tag:

Anorexia

I Want to Talk to People But I Don’t Want to Be Friends

by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP January 12, 2021

written by Daniel J. Tomasulo, PhD, TEP, MFA, MAPP

I have always very self-conscious but after I got a boyfriend it became worse. I was terrified he would leave if I remained “fat” so I then limited myself to 320 calories a day until I plummeted from 120 lbs to 80 in about 3 or 4 months. I was then hospitalized for anorexia nervosa. I managed to convince my dad I was well enough to leave in a week when doctors insisted I should stay for a month. I hid most of the food they gave me in my purse…I still battle with anorexia but I have upped from 320 to 1200 and am still upping my intake (I know this is nowhere near the amount I need per day but I will get there soon!) but I am not here for eating disorder related talk. Ever since I started my restrictive tendencies tendencies I became a “recluse” of the sorts. I love talking to people if I am in a classroom discussing a learning topic but if it gets personal I become petrified. This has escalated to the point where I do not respond to any text messages and I reject most invitations to hang out unless it is in a big group or a loud party where I will not have to go into personal or one-on-one interaction because I feel as if I may say something stupid or weird that a normal person would not say. I hate giving out my number because when I ignore people I feel horrible and wished they understood why. I sincerely like people and enjoy talking to people and people generally like me. People try to become close to me but eventually I ignore them to a point where they stop trying. I can handle conversation but if it lasts for longer than 10 minutes or becomes personal I become extremely stressed and anxious which also applies to hanging out. I Am also extremely sensitive and can not deal with change (just happened the last year),for example, If I plan on going to the mall or going to the store and plans change I usually tear up and even cry for a bit if it is a bad day. I used to be a social butterfly…what happened?

I know you don’t want to hear about the eating disorder, but we need to review the situation. The eating problem began as you developed a more intimate relationship. This means that they are connected.

Leaving after a week at the treatment center only gave you some of the tools, but not all of them. The social concerns you have are directly related to the eating problems. They are not two separate things.

I would recommend you take care of the eating concerns first. What you will learn is that your relationship to food is intimately connected to your relationship with others.

See if it is possible for you to get reevaluated by the program you were in. If not, you’ll want to talk to your general practitioner or psychiatrist. You will want to ask your family for help in setting up either of these appointments.

I know as a freshman in high school it may be hard for you to imagine that all these things are connected. I admire your courage for asking this question here, and hope that you will follow through on the suggestions.

Wishing you patience and peace,
Dr. Dan

January 12, 2021 0 comments

Mom Pressures Me To Be Thin & It’s Making Me Relapse

by Kristina Randle, Ph.D., LCSW August 14, 2011

written by Kristina Randle, Ph.D., LCSW

For the past two years I was diagnosed with anorexia. I went into recovery at 5’8 and 113lbs. I was terrified of food and gaining weight and treatment really helped me get back up to a healthy weight and allowed me to eat again. Since I restricted for so long I put on weight fast I’m now 135 which is a healthy weight.

My mom keeps commenting on my weight, asking me if I worked out, harassing me about everything I eat. Ive confronted her and told her that she needs to stop because it’s triggering and she doesn’t. She hangs around the kitchen at night to make sure I don’t get something to eat after 8. I ate an apple and a cup of air popped popcorn for dinner tonight and she said good job. I was just in the kitchen getting a bowl of oatmeal and she said ” do you really think you need that” and stuff like that is triggering me to lose weight again. She makes me feel self conscious to eat anything around her. When she goes to grocery store she buys me separate groceries all mine being sugar free/fat free fruits and veggies, which I don’t mind I eat a lot of that stuff but I don’t ask her for it, it’s almost like she is trying to say something without saying it. I just don’t know what to do…..she literally won’t let me live normally and eat what I want….What would you do?

Congratulations on your recovery. I am very encouraged by your success despite living in what seems to be a challenging home situation. I hope that you take pride in this major life achievement.

Having said that, recovering from an eating disorder might be a lifelong battle. Eating disorders do not simply “go away” even if substantial recovery takes place. There may be remnants of old thinking patterns or behaviors that occasionally resurface. That is to be expected.

Your current challenge is dealing with your mother. Her behavior is unusual, out of line, and you are correct to be concerned. It will be a difficult task but try not to let her behavior affect you. She may have her own untreated mental health issues. I believe that might be the case, though I have a limited amount of information to make that determination. The fact that you confronted her, and it had no effect on her behavior further supports the premise that she has untreated mental health issues.

Perhaps the reason she has not altered her behavior after the confrontation is because there was a miscommunication. Confrontations do not always lead to the desired outcome. You might want to try a different form of communication. One idea is to write her a detailed letter expressing your concerns. That might help you better achieve your desired outcome.

I noticed that you are in college. College, for most students across the country, reconvenes in a few short weeks. I am wondering if you will soon be leaving home and moving to college. If so, it would be advantageous to your recovery.

Moving might solve the problem. If that is not an option, then I would strongly suggest family therapy. A family therapist can help to change the relationship dynamic.

In addition, the therapist can assess how you interact with your mother and determine if changes are necessary. The therapist might also speak to your mother, on your behalf, about her behavior. Furthermore, the family therapist may be able to teach your mother a new way of interacting with you that is less likely to trigger negative eating patterns.

The “find help” tab at the top of this page, can help you to find a family therapist in your community. If you choose therapy as an option, which I would highly recommend, pick a therapist with a successful track record of helping individuals with eating disorders and their family members. I hope this helps. Please take care.

Dr. Kristina Randle

August 14, 2011 0 comments

OCD in Place of Anorexia

by Kristina Randle, Ph.D., LCSW March 19, 2011

written by Kristina Randle, Ph.D., LCSW

Just when I thought I’ve won the seemingly endless battle against my OCD by triumphing over my eating disorder (anorexia, to be specific), common symptoms (checking the switches countless times, washing my hands forever, hoarding) and gotten a hold over my rampaging thoughts, I had a severe panic attack a few days ago.

I’ve been frequenting a beauty spa for microderm abrasion for a few months ever since I had a severe acne outbreak due to my anorexia. And here’s the root of my panic attack. Two weeks ago, my esthetician changed the treatment without informing me of what the new treatment detailed. It was only after I had (what I now know is) Intense Pulsed Light (IPL) did I return home and researched on it.
OCD sufferers always have to keep ourselves well-informed to clear any lingering doubts in our mind, ie. checking the switches to fulfill the remaining 99% of doubt, with 1% fulfilled when we first switched it off. However, I had a panic attack precisely because I didn’t even have that 1% to rely on. What I found out about IPL is this: there are hundreds of people who’ve suffered from fat loss, indentations, wrinkles, fine lines, orange textured and saggy skin ranging from a few weeks to months after their IPL.

I went ballistic, trying to find the cause of their fat loss. I knew I couldn’t cope feeling like this for a few months if I tried to eliminate my worry by following CBT. I cried for three days straight, after which I felt so empty and light-headed, I didn’t want to think anymore. From what little information I’ve gathered, there are two groups of IPL victims: ones with severe burns directly after IPL because the setting was too high and the ones who didn’t have any visible side effects until weeks to months after their IPL.

Of course, there are countless people who’ve gained much from IPL and didn’t suffer from any negative side effects, but being plagued with OCD, my mind seems unconvinced I’m going to be all right. I spent quite a sum consulting a professional doctor the other day and his reassurance that “IPL can’t cause lipoatrophy (fat loss) because it doesn’t penetrate deep enough,” and “The IPL machines used at beauty spas aren’t lasers. Only certified doctors can utilise them, and only lasers can cause fat loss,” only served to further my agony because from what I’ve read from the victims’ accounts, the doctors always deny their injuries and claims they’ve never had a victim in their years of IPL practice.

Just what am I supposed to do? Worry incessantly for six whole months before I’m fully convinced my fat cells aren’t damaged? I would have gone for a scan to check the state of my fat cells, but the doctor says that’s impossible, says you can’t miss lipoatrophy because your face will look sunken and hollow. I’m aware of what my mind’s going through due to the load of information I crammed into my brain when I first realised I had OCD: this is an obsessive thought and I’m compulsed to seek the answers to all my questions before I’m convinced.

My cheeks have been feeling numb these past few days, so I’d like to ask if it’s possible my brain’s sending signals to make them feel numb because this problem has been weighing itself on my mind 24/7. Like those people who lose their voices momentarily due to an extreme shock. Is it possible? I feel my face is getting thinner since I’ve been checking my face obsessively, every day. Has my view become distorted due to my persistent train of thought?

My mom thinks I’m ridiculous because I’m not relieved even after I’ve the doctor’s reassurance and there’s nobody else I can turn to. I’d really appreciate a reply, some comfort or advice; anything. I can’t stand feeling like this for the next six months (it’ll take a total of six months for myself to become fully convinced I’m not suffering from lipoatrophy). Please, and thank you.

Among OCD sufferers, specifically among those with health-related anxieties, often no amount of reassurance is ever enough. In fact, the act of seeking reassurance can make OCD worse. It temporarily decreases anxiety but it reinforces the seeking reassurance behavior. OCD sufferers should resist the urge to seek reassurance and endure their anxiety. If an individual usually seeks reassurance when they feel anxious then not doing so will increase their anxiety, possibly to very intense levels but those levels cannot be sustained. Anxiety always decreases. In that way, anxiety is akin to the law of gravity: what goes up must come down. Individuals with OCD are unwilling to endure their anxiety. They do everything in their power to escape it. This is a mistake. Anxiety avoided in the short run, only intensifies it in the long run.

You may be overreacting to the IPL treatment. Your level of concern in any situation should match the most likely outcome. The professional advice you sought supports the idea that your level of concern should be minimal. You minimize the doctor’s advice but focus intensively on the outcome that frightens you the most. You must get in the habit of basing your reactions on the reality of a situation, on the truth. This is essential to overcoming OCD. What one feels to be true may be very different from what actually is true. I understand that changing thought patterns is not an easy task. It is a skill that you can learn with practice and professional help.

Congratulations on working through anorexia but OCD can be equally as problematic. Both anorexia and OCD are control disorders. Sufferers are attempting to gain control of their lives but no one with either disorder effectively achieves this outcome. If you haven’t done so already, please seek counseling for your OCD. Very effective treatments exist for OCD, one of the best being exposure and response prevention therapy. The find help tab at the top of this page can help you locate a therapist in your community. I wish you well. Please take care.

Dr. Kristina Randle

March 19, 2011 0 comments

Scared to See A Therapist For My Eating Disorder

by Julie Hanks, MSW, LCSW March 12, 2011

written by Julie Hanks, MSW, LCSW

I started out with anorexia but now am bulimic/anorexic and have been this way for about 3 yrs now. I am on a binge/purge cycle and have purged everyday at least since November. One person knows about my ED and I am so scared to get help even though I know that I need it. I am fully aware of the dangers of bulimia. I am being treated for one of the symptoms of bulimia, which is passing out because of malnutrition. However, the doctors did not figure out that it is due to an ED. I’m 18 so I can get help without my family knowing which is a big deal for me because I can not let them know. They have a lot to deal with right now plus my mother does not really understand how to deal with things. Shes Bipolar and every once in a while has a Schizophrenic episode. I am scared of my father and stay away from him so I can’t tell him either, my whole family dynamic is screwy. However, I am considering getting help for my ED. What should I expect if I do decide to go to a therapist? What kind of questions will they ask me. Thanks for your help.

First of all, I’m so glad that you are considering eating disorder treatment because the fact that you are passing out means that you are not only suffering from psychological problems but that you are in physical danger too. Please disclose your eating disorder to your physician so he or she can be a resource for you and can help you find a psychotherapist or eating disorder treatment center.

While every therapist is different, I can give you a general idea of what to expect on your initial evaluation session. The initial session is an assessment where you’ll sit down in the therapist’s office and talk about what brings you to therapy; you’ll get a feel for the therapist’s style. This session will include filling out some paperwork – a mental health and family relationship history, rating scales or a brief checklist to establish a baseline to track your progress, and a release of information so your therapist can communicate and coordinate care with your physician and request your medical records, if needed. After gathering this information, the therapist will give you a diagnosis and make treatment recommendations. The recommendations may include outpatient psychotherapy, intensive outpatient psychotherapy, or inpatient treatment.

As you seek a therapist, make sure you find one who specializes in treating eating disorders. A great resource to find a therapist is available at the top of this page by clicking the Find Help link. Another excellent resource is EDReferral.com and they have several eating disorder therapists listed in your state. It can be helpful to meet with a few different therapists so you can find one you feel most comfortable talking with and you feel most confidence in. Just like any other relationship, you’ll click with some therapists over others. Consider your physical symptoms as warning signs telling you that you need to address this problem now. Please, don’t wait to get help.

Take good care of yourself!

Julie Hanks, LCSW

March 12, 2011 0 comments

Body Dysmorphic Disorder is making her miserable

by Dr. Marie Hartwell-Walker February 19, 2009

written by Dr. Marie Hartwell-Walker

I’m 22 now. When I was younger I was very overweight, I topped out at 160lbs at around 5ft 3in when I was in middle school. Everyone always made fun of me for being so fat, but at the time, although it hurt, it didn’t really seem to affect me so much. However, towards the end of middle school I became obsessive about my weight and weened myself down to eating barely anything. Over 200 calories was deemed unacceptable to me, and I dropped down to 120lbs and was now 5ft 8in. I still was absolutely disgusted with myself and wanted to be as skinny as possible, so much so that I envied those who were labeled anorexic. I even joined a pro-ana website.

Eventually, I started eating a little bit more, but i would force myself to puke it up. I always felt disgusting and fat. I hated myself so much that I resorted to self mutilation.At this point my parents finally got worried and I was put on antidepressants and taken to a therapist. I stopped taking the medication and only went to about 3 or 4 sessions with my therapist because we couldn’t afford it and I hated it anyways. Again, I eventually started eating more, but now I’d only eat “fat free” food, and I’d still purge. For the sake of my parents, I forced myself to stop purging because they knew I was doing it. It was hard to not recognize the smell of puke lingering in bags in my closet, and stuck in the drains in the bathroom. It was hard to stop but I did it. In the process, I joined a gym with my mom and I became obsessed with working out. I worked out at least 2 hours a day 5 days a week. I still hated my body though. I started training with a trainer to lose more weight though he said I was already skinny, I wasn’t to myself and that’s all I wanted. Unfortunately with the diet plan he gave me I gained 10 lbs which was supposedly from muscle, but to me, 10lbs was 10 lbs. I finally got fed up with it all and had liposuction at 19 years old. I was convinced it’d make me happy, but $9000 later I hated myself even more. Now I swear it was a botched liposuction and hate how uneven it is and the bumps it left on my stomach and how it messed up the shape of my butt. Needless to say, I am now 22 and I hate my body more than ever. I hate my bumpy stomach, my rippled jiggly thighs, my flapping arms. I hate the size and shape of my butt and breasts, I hate my fat wrists, I hate my nose, the size of my eyes and lips, the shape of my face, and the length of my toes. I don’t think there’s anything I don’t hate at this point. I have MANY crippling issues but this is by far the worst of them. I cry all the time even though my boyfriend always says I’m skinny and beautiful. Everyday is torture to me, its all i think about and it consumes my whole life and all of my energy. I spend my days wishing I was other girls and feeling like I’m nothing. I’ve been suicidal many times, and though I don’t believe I would ever try it, I can’t say I don’t ever think about it anymore. Noone even knows any of this other than my boyfriend. I guess the front I put up is so good that everyone thinks I grew out of it, and my god I wish that were the case! I am now eating somewhat normally, almost compulsively actually and I absolutely hate myself for it. I am 155lbs and still 5 foot 8 which is supposedly healthy but I feel like a blimp and can’t stand to even look in a mirror. I still have feelings of wanting to stop eating or to purge. I just don’t know what to do, and why this is happening to me!!I hate my life so much because of this. I don’t know if it has anything to do with this, but even when I was around 130 lbs my mom always had comments about my weight and told me I couldn’t fit into the clothes I wanted to wear. If I picked up a small, she’s pick up a large. She always made comments about my body like my but being flat or my toes being freakish or my top lip being smaller than my bottom one, and many others. She makes comments about what I eat..even the rice cakes, she says I need to watch what I eat. A few years ago my brother also admitted he said he didn’t love me when I was fat, and he laughed like it was a joke. It hurt…ALOT. Especially because it was coming from my older brother who I always looked up to. He even has his own issues with his weight, he too was very overweight and crash dieted when he was in high school.I just don’t know what to do with myself, I feel beyond help.

I’m very, very glad you wrote. You’ve been in pain around body issues much, much too long. Yes, it makes sense that family members’ comments would make you feel self-conscious. And middle school is traumatizing for many people. It sounds to me like maybe you developed what’s called body dysmorphic disorder in response to all that negativity. You have an unrealistic idea of what your body looks like and it’s been making you miserable.

It’s time for you to have what I call a healthy rebellion. You’ve apparently taken old messages from middle school and family members to heart and accepted those opinions as your own. It’s time to reject those ideas and to decide for yourself what is good for you. My guess is that those same individuals have been wrong about many things. Why would you think they were right about what you look like?

Yes, I know. A healthy rebellion may sound good to you but feel too hard to do on your own. In that case, having the support of a sympathetic and experienced therapist would probably give you quite a bit of relief.

I’m sorry your first experience with a therapist didn’t work out. But maybe you didn’t have the right therapist for you. Ask people you trust to recommend someone and look for a therapist you feel you can work with. Research has shown that cognitive-behavioral therapy is probably the most helpful for this problem so look for a therapist who has that training.

You are most certainly not beyond help. But you have to accept some help to get it. You made an important first step by writing. I hope you will take the next step and give therapy another chance.

I wish you well.
Dr. Marie

February 19, 2009 0 comments

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