I never had a "normal" relationship with food. Nobody knows when how how it started - but when I was 3 my sister came and I was neglected. That was when my weight began to increase and by the time I finished highschool at 17, I was obese with a BMI of 30+. So I can only guess that it was the pressure of having to compete for my mum's attention, having to be the "good girl who doesn't make mummy angry", and the intense fear of abandonment that led me to turn to food for comfort. My mum is also someone who is very concerned about weight and body image, and of course my weight did not sit well with her. I used to hear things like "I'm ashamed to have a fat daughter like you", "Why can't you be like so-and-so" etc., and I was also not allowed to have long hair or wear skirts/dresses because Mum said that fat girls look ugly in them.
Upon entering college, I went on a slimming programme losing 20kgs (approx. 44 pounds) in 6 months. The whole thing was quite gradual - it wasn't like I forgo all carbs in a day. And because it was so gradual, it was also deceptive - I mean what is 25% lesser rice than yesterday? I was also told to toast my bread, avoid even cereals, eat vege sticks when I'm hungry, and once a week I would have only vege (cabbage, tomatoes, capsicum, onions and celery) boiled without salt and oil. I also went on "detox" twice - during which I was given laxatives and told that it will "cleanse your body before the real thing".
My menses went off after 2 months into the diet, became very irregular. Hormone pills don't work at all and they only made me gain weight. When I started gaining the weight, I was frustrated and started to binge. I would be so obsessed with food during lectures and would always end up barging into the cafeteria alone to eat even though i know that I have food at home. I would also sneak snacks into my room, hide them under the cupboard and eating behind locked doors before throwing wrappers underneath other rubbish. I also started to do "lemon detox" - drinking concentrated lemon juice the first thing every morning.
When I came to another state to study, I decided to go back to "diets". This time, I didn't care about "safe foods". I had proper b/fast and lunch, but then have whatever that I would for b/fast - during dinner. So dinner would be 2 pieces of bread, or a packet of hot cereal, etc. Whenever my friends asked me for a movie I would usually decline. If I go along, I would have to plan ahead on how to compensate with the "extra meal". Hence, my weight would always fluctuate tremendously between study times and holidays.
In february, I learned the "art" of counting calories and using fiber products to "purge". It started when I saw a clinical psychologist with a background in nutrition. She insisted that I only had "weight management issues" and refused to hear about the psychological reasons behind my struggle with food. Hence, she counted calories in front of me and told me it's okay to use fiber. I stopped seeing her after a while.
Professional help for EDs in my country is almost non-existent. There are no ED clinics. One of my lecturers is a health psychologist specializing in EDs but she isn't a clinician.
Now I think my health is suffering. Besides my menses (which can go up to 5 weeks in a cycle), I also have low blood platelets (suspected to be autoimmune).
Even though I don't fit into the description of anorexia or bulimia, I think that this is more than just poor eating habits. Am I right?
To be diagnosed with Anorexia, Bulimia or EDNOS there has to be psychological distress. If the clinical psychologist that you went to refuses to discuss anything but nutrition then your best bet would be to go back to your doctor.
1) Before you go to your doctor, take and print out a self-assessment or an eating disorder screening. Most of them are available free online. (It's OK if the online screening doesn't suggest an Ed.)
2) Make a list describing your "behaviors." How long you have been doing them and how often etc..
3) Ask for another referral to see another clinical psychologist.
Don't rule out seeing a new one because the other one was not that great. Right now, i am seeing one that does not specialize in Ed's and I am making progress!
Sometimes, eating disorders or disordered eating occur because the person has self-esteem issues or because they feel like the Ed gives them a sense of control. These are issues that a regular therapist can assist you with.
Although, technically you might not fit the bulimia or anorexia criteria, some of the behaviors you described are beyond disordered eating. Have you considered that it might be Eating Disorder Not Otherwise Specified (EDNOS)?
That diagnosis is usually left up to the discretion of the individual doctor or psychologist.
Do you think that your doctor will be able to give you a referral to see a new psychologist?
Thanks for your reply. I've done those assessments before - including EAT-26. Recent score was 27. I was told by professionals that I "don't have an eating disorder yet, but am ON THE WAY." I do wonder about EDNOS, but I think it doesn't appear in a professional's vocabulary. Or so it seems. I hate being thought of as wanting attention or diagnosis.
I have real body image issues. I hated the way I look, and it took so much to get me to even wear a skirt - more so a dress. I have long hair now and will not cut short because it reminds me of the days when I wasn't allowed to grow my hair because I was fat. Even after losing 44 pounds, I was never satisfied. In fact, the slimming center had expected me to lose at least another 20 pounds. But I stopped.
I'm seeing a doctor for low platelets (otherwise called thrombocytopenia). Have not discussed with her about whether it may be due to malnutrition. I really don't want to be referred to a psychiatrist
I'm a psychology student, so technically I should be able to find professionals in my faculty. But it's hard, especially when EDs are usually overlooked. I used to chat with the only ED professional, but she is very busy. She was the one who upon hearing my symptoms, alerted me to the fact that I'm at the brink of a "full-blown ED".
Maybe, the professionals can't bill for EDNOS and that's why they haven't brought it up?
I can completely understand not wanting to be referred to a psychologist. In my case, I ended up in the hospital several times and i've been very close to not making it. I had no other choice but to seek help.
I lost 6 years of my life to this disorder. Once you do develop a full blown eating disorder it is very rare to recover on your own. So please don't put off getting help even if it's to a non-specialist. There are certain gradual changes in the thought process that occur in Eds.
Try speaking to someone in the faculty to see what they suggest about EDNOS.
Hmmm, the only professionals I saw were those in my faculty so I don't pay them actually. I think "EDNOS" is a term that appears only in the DSM...to the professionals, I'm simply "on the verge of a full-blown ED aka AN or BN". I don't want to make it look as if I'm using ED as a "crutch" for attention, because I'm beginning to feel like it is what people see - especially when to them, I don't have an ED yet. I did actually see a psychiatrist twice - for psychosis, and when I told him about my food issues, he listened and changed topics.
So yes, I'm pretty much resigned to struggling on my own. I'm surprised that I had battled with food for more than 20 years and it didn't fully explode. I find this hard to let go because I never knew what it's like to eat well. It's like I have to unlearn and relearn everything.
Can't believe how EDs work - whether I have a "diagnosable" ED or am just "on the way", they're just so deceptive. When the brilliant therapist started counting calories in front of me, I found myself doing it immediately. Now, on most days I'm surviving on 800kcals and usually does not go above 1000kcals. And I still think that I need to cut down on it even more.