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Am I Anorexic?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Hi I’m 15, female, 5’2 and 87. I’m completely obsessed with food. It literally rules my life. I stay up all night thinking and planning what I will eat the next day. I love making food for others but I never eat it. I find it hard to eat over 400 calories a day. I am on my feet every minute I am awake, I never sit down. I workout and exercise also. Not as much as I should. I cancel plans with my friends because I’m afraid they will make me eat or I will be confronted with food. I have constant urges to throw up but I never have. I also self harm by cutting.
I cancel all plans with friends also because I hate being social. I’m a nice person, I just get nervous around other people. I hate staying the night at other peoples’ houses because I have certain routines that I do every day.

I’m constantly sad. Nothing makes me happy. Not even going on vacations or “fun” trips to the mall or amusement park. Being with friends doesn’t make me happy, it just makes me freak out. I constantly think people are judging me. What the heck is wrong with me?? Eating disorder? Anxiety? OCD? Depression? I’ve taken many online quizzes and I’ve scored high on all of the above disorders. I haven’t been to a doctor in over a year, I’m afraid they’ll force me to gain weight and eat. I have insomnia also. Please help. I feel suicidal all the time but I’ve never attempted. I feel like I’m constantly bothering people.

I am sorry that you are suffering. You asked about whether you have anxiety, OCD, depression, or an eating disorder. I cannot know with certainty. What fundamentally seems to be driving your behavior is anxiety and fear.

You also seem to lack self-esteem. You are constantly worried about what other people think of you. You worry that you are “bothering people” which may indicate that you consider yourself unimportant.

You are not functioning well. Your eating or sleeping patterns are unstable and you are experiencing significant mental health symptoms, all of which are disrupting your life. You need help. Receiving help at this time is especially imperative because you admitted that you are considering suicide. People often consider suicide when they feel as though they have no other option or they don’t know what to do.

I would advise you to see a mental health professional. You should also have a physical evaluation by a medical professional to determine what damage your body has sustained. Undergoing those evaluations will help to determine your psychological and physical health status.

Accessing professional mental health treatment is the wisest and most efficient approach to your problems. Asking for help may be difficult but force yourself to do it anyway. There are many people who have had very similar problems, received help and their life has significantly improved. If you are willing to seek professional help, then you can expect the same, positive outcome. There is a great deal of hope if you are willing to seek treatment. Please take care.

Dr. Kristina Randle

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Still Facing Eating Disorder

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

Last year I got influenced by an anorexic friend and I started experiencing eating disorder symptoms. I binged & starved & eventually ended up purging as well. I went to therapy for 6 months & got over all of it. I was eating fine for 3 months, and then I finished therapy. Now I’m having thoughts about eating disorders, calories, all my problem areas, etc. I don’t eat more than 1200 calories, & there’s lots of days where I eat way less. I don’t know what to do, because my parents and everyone else think I got over it already. I can’t tell them that it started again. I also can’t go back to therapy because I can’t afford it. I really don’t want to have this again, especially because I’m only restricting this time around and not binging, and I don’t want to end up in the hospital. I just can’t seem to eat normally though. My head is definitely playing games with me, and I don’t know how to stop it. I don’t have most of the symptoms for anorexia either, besides for restricting. I’m not underweight or feeling cold, etc. So it’s not dangerous, yet. I am totally normal besides for this. I hang out with friends, go to school, work, etc. I am pretty happy with myself, which is also why I don’t understand why I’m doing this to myself.

You had previously gone to therapy and it was successful. Try to think back to what about the therapy helped you. Perhaps what you learned in those sessions can assist you now.

Part of why you are not returning to therapy is because you can’t afford it but you also don’t want to go. You also don’t believe that your eating disorder is “dangerous [enough] yet” and thus therapy, in your mind, isn’t required yet. I would disagree. Any time you deprive your body of its proper nutrients, it’s being damaged. It’s always dangerous.

If you’re a college student, then you can utilize the college counseling center for free. Many college counseling centers provide high-quality services. Utilize those services, if they are available to you.

If your parents have health insurance and you’re under 25, then you may be covered under their policies.

Community mental health centers are also an option. They offer low-cost or sliding-scale fee psychological services. Sometimes, services are free depending on your level of income.

Finally, another idea is to contact your previous therapist and ask for his or her advice. The therapist might be willing to see you temporarily, free of charge, or refer you to a clinic that provides low-cost or free services.

Therapy worked well for you in the past. If the problem has returned, then it would be wise to repeat what has proven to be successful in the past. Eating disorders have the highest mortality rate of all mental illnesses. They are very serious disorders which require treatment. The sooner you seek treatment, the sooner you can eliminate these symptoms and minimize the damage to your body. Please take care.

Dr. Kristina Randle
Mental Health & Criminal Justice Blog

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Depression, Isolation, Counting Calories, Pressure To Be Skinny & Ways To Cope

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I know I am very young, but I feel so hopeless, out of control, and desperate that this was my last resort. I have come to realize that I have depression. One of my family members suffers with Bipolar disorder and depression and is currently on medications to keep them under control. I hate myself. Although people would specify me as “popular” in school, I feel like a loser. All my popular friends could EASILY live without me so what is my point in this world? I used to have one very good best friend, but she ditched me for someone else. We stay on speaking terms, but hang out rarely. Since summer has started, I’ve completely isolated myself and spent all my time alone in my room on the computer. I’ve began to obsessively exercise and become obsessed with counting calories. I’m at a normal weight now (5’5 and 114 pounds) but I look so fat that I’m surprised I’m even a normal weight. I still eat, but I only eat half of what I used to and only healthy foods. I exercise SO much. But there is one thing that keeps me going. My hope that someday this will get better. You see, I went to a performing arts high school camp where I was completely accepted for who I was. I made friends instantly, but the camp was over in 2 weeks and we all had to depart. The only thing to keep me going is the hope that in 2 years when I audition for that performing arts school is that I will make it in. I’ve made friends with all the teachers and am currently taking the ADVANCED ballet and modern classes (I’m going into seventh grade and am taking a class with college students). I really want to be a dancer. I just love how I feel when I’m there. I feel like I belong, like I’m part of a family. Everyone is accepted and loved. I just LOVE that feeling! The school is full of talented people, and I’m afraid that if I’m not skinny enough I cannot make it in. I also just want to stand out. My school now is HUGE like GINORMOUS! No one really stands out unless they are massively popular. In this school, everyone stands out in their own way. I just want this so bad, and it’s the drive to keep me going. But I feel like if I’m fat I can’t do it. I feel like I NEED to continue this diet and exercise regimen for an entire 2 YEARS before I make it in (NO DESSERTS, NO WHITE BREAD, ONLY SMALL PORTIONS OF RICE AND PASTA, ABSOLUTELY NO CANDY, AND NO EATING OUT). But I know that’s impossible to keep it going that long, but I just need to do it. I feel like I can’t, but I really want to. How can I cope with being extremely pressured to be skinny, with my depression and isolation, and with my friend problems? Please please please please help me. i’m desperate.

The pressure you feel to be thin is a major concern. It is driving your obsession with being thin. It is an unhealthy obsession. In your mind, you “need” to do it. You have given yourself no choice. Your ability to limit your weight has become paramount.

In addition, your body, its size and shape, has become your primary vehicle for success in life. A thin body, in your mind, has become the one and only pathway to popularity, attention, belonging, and to professional dancing. It is everything. The pressure you feel to be thin only makes sense in the context that you have placed on the importance of body size.

You wrote that you are desperate. I can understand why. All of your hopes and dreams depend on your ability to limit the size of your body. The idea that being thin is the key to your happiness is an illusion. For those who believe this illusion, no amount of weight loss is ever enough. More is always better even when it isn’t.

This problem is further complicated by the fact that your view of your body is distorted. As you mentioned, you are a “normal” weight but continue to see yourself as “fat.” That one line from your letter to me, shows you are no longer able to see the reality of your appearance. If the scale and the charts show that you are a normal body weight, in the normal range, you can not appear to be fat, not to others, not to trained professionals. You can see yourself looking fat in the mirror but that is an illusion. Almost everyone with an eating disorder sees an illusion staring back at them in the mirror. A fat illusion.

It is important to recognize the incorrectness of your thinking. If it continues, it can lead you down a dangerous road. Some individuals who feel extreme pressure to be thin ultimately develop eating disorders.

My recommendation is to discuss this matter with your parents as soon as possible. Don’t be afraid to ask for help. Ask your parents if they will take you to counseling. Counseling could help you to develop a healthier relationship with your body. It could also help you to manage your weight in a healthy, controlled manner and address your depression and feelings of isolation.

Now is the time to seek help. You may or may not have an eating disorder. Counseling can eliminate the possibility or stop it before the problem becomes unmanageable. The “find help” tab at the top of this page can help you and your parents locate a therapist in your community. Please take care.

Dr. Kristina Randle

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Do I still have an eating disorder?

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

I’ll be 26 next month. I used to be bulimic. I’m not sure when it started but I know in the 7th grade I picked up smoking specifically because I heard it was an appetite suppressant. So it had to be before that. Through high school I would exercise compulsively before and after school vomit abuse laxatives and even went through a period of straight binge eating. Then I did nothing to compensate. I would hoard food all over my room and from the moment I got home from school I’d just sit in my room and eat until it hurt like hell and I fell asleep. In my first and second year of college I was still actively bulimic. Getting up in the middle of the night when my roommate was asleep to eat stashes of food and throwing it up. Periods of over exercising or compensatory strict dieting eating nothing as long as possible. I reigned myself in and stopped for the most part with a few periods on and off.

To bring it to the present. There are thoughts and behaviors that I have always continued weather I am eating normally or not. I have never stopped weighing myself countless times a day. I keep the scale in the living room so that I can easily do it over and over again. I always count calories and know the calories that are in what I am eating even if it is a normal intake. I am constantly displeased with my body uncomfortable in my own skin comparing myself to other females desiring to be thinner weather I am engaging in it or not. These things and others have never stopped even if and though I am eating normally.

Last year at 5’4 I was 135 last month I was 110 last week I was 114 now I am 117 shooting for 110 again and in my mind, though it is a desire I don’t think I will act on, Id like to be 100.

Being actively bulimic for so many years the running train of thoughts in my head and certain compulsions are permanent. But now I don’t know weather I still have an eating disorder or not as besides these left over things I go through periods of time where I compulsively exercise, severely restrict my food intake 1000 calories or under with or without binging depending on the time. Where I binge with or without compensation. Where I binge and purge or chew and spit so I don’t have to purge. But generally most of the time periods where I do nothing abnormal. Where I eat like any other average Joe and do not care to do anything about or because of it despite the regular thought processes the calorie counting and the number on the scale.

These times are rare now. They run the gambit from binge eating to bulimic to strictly anorexic. They last for weeks to a month or two or three and I stop. Overall I am relatively speaking a normal eater. And I don’t know if I should do something about these “flare” ups or even classify myself as having an eating disorder still because although I have no control over when it rears up I can reign it back in and act and be normal with food for long periods too. Currently I am coming back out of normal ie 110 back to 117 and about to start “managing” again to get back to 110. People can’t turn these things on and off like this and still have an eating disorder can they. Can you have an eating disorder and be relatively normal most of the time?

Do I still have an eating disorder? If so, what? Is this just unresolved thoughts from the years of being bulimic? What do you make of this?

I think it is a good thing to question yourself about your behavior around eating. Your history and struggle with food and body image and weight are the classic problems with eating disorders, and I think it would be safe to say these issues are still active in your life. One way to appreciate what happens in any recovery process is that the frequency and intensity of the symptoms are reduced. This seems to have happened in your situation, but the struggle still remains.

My experience in working with people with eating disorders has followed a two-fold process. First is to establish a foundation of support for the individual. This often means for them to be involved with Overeaters Anonymous, Food Addicts Anonymous and learning more about their condition. Ongoing support and knowledge are the two biggest weapons against these disorders.

The second part has to do with redirecting their concerns toward positive thought and behavior patterns and developing more joy and interests — in other words, developing a plan for a direct counterbalance to the obsessive thoughts surrounding food, body image, and weight. Some places to start with positive behavior change can be found here, as well as a list of therapists who may be able to help.

In the words of Julia Child, “Life itself is the proper binge.”

Wishing you patience and peace,
Dr. Dan

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Something Wrong With Me?

by Kristina Randle, Ph.D., LCSW
written by Kristina Randle, Ph.D., LCSW

I don’t know wat’s wrong with me. i am only 16 and yet i feel so stressed out and depressed. i don’t know wat to do or wat to think.

for one, im not happy with myself. i feel like im so fat when i know im not at all 91lbs 5 ft. if i lose a lb i became upset and over eat to gain back that lb. but if i gain a kb i ‘d starve myself so that i can lose that extra lb. i just hate that feeling of havign to count calories and not be able to read wat ever i want and b so upset if i eat too much.

i let this get to me so much, it changes my mood and everything. it can make me from being happy to upset. im so sensitive that i let everyhting gets to me even if the little thing. i just feel so stupid for get mad at the little thingd but then i just can’t help it. i’d feel happy in a sec then all upset and give ppl attitude the next. in school my friend asked me y am i smile and laugh all the time. but then when im in my room at night, i’d cry so much n sometimes i just cry for no reason.

i look at everything so negatively idk how but everyone around me said that i do. i’ve always thought that i ahndle thigns pretty good but somehow ppl don’t like it. im just guessing it was my fault then .idk. lately i just see myself as a very selfish person. i love receiving but i hate giving out wether its money or just a faovr or being nice. i feel like my family don’t give me enough attention and care. bbut yet i know for a fact that i don’t to them neither. so y does it bothers me so much. i know it is not right to b selfish n u much give b4 u can recieve but how come i just don’t want to give any.
i jsut feel so much pain right now b/c i just got so much comment on pple telling me that i done somethign wrong n have been disresprctful. but then how could iwhen i get pissed off at them b/c they didn’t do wat they promise to me. i just feel so wrong n jsut want to get out of this world. i feel so much pain in me n i can’t let it out. i often wanted to b alone b/c i don’t want to upset the ppl around me n dislike them b/c i know they will piss me off somehow. so i tried to sty away from them n just get some peace time. but then at the asame time, im seperating myself from them which me im not as close anymore. but if im close, i’d hurt them somehow n i just don’t know wat to do. help me.

You seem to be dealing with many confusing thoughts and feelings. Sometimes you feel that you’re overweight and this upsets you. It leads you to starve yourself which of course is unhealthy for you. You must realize that being 5 feet tall and 91 pounds in no way means that you are overweight. According to the Body Mass Index (BMI) chart you are actually underweight. You seem to be viewing yourself in a distorted way.

There are studies of individuals with eating disorders conducted in hospital settings. Those studies have shown that it’s not uncommon for individuals with eating disorders to see themselves as being overweight but view other individuals in the group as being too thin. They are able to correctly determine that others are too thin but they’re unable to accurately perceive their own weight. I’m not suggesting that you have an eating disorder but you do seem to have a distorted view of your weight.

You have also described feeling emotionally unstable. This is a lot for an individual to be dealing with alone.

I’m wondering if there’s anyone you can talk to about what you are experiencing. If you haven’t done this already please go to your parents about these issues. They will likely be able to help you, either by offering you advice or perhaps by making you an appointment with a mental health professional. If you don’t feel as though you could go to your parents then I would ask you to think about who else you could speak to. Is there a guidance counselor or clergyman you would feel comfortable speaking to?

I think overall the best place for you to start is with your parents and to let them know what you wrote about in this letter. All the issues you mentioned can be properly dealt with but it begins with you openly and honestly talking about what you’ve been experiencing. Please take care.

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Body Dysmorphic Disorder is making her miserable

by Dr. Marie Hartwell-Walker
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

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