To ask my GP for a referral to an eating disorders clinic?

[Some0ne]

I'm obese. I'm 5'8'' and weight 18.5 stone. I can't stop eating, I never feel full. If there's something sweet in the house, I have to keep myself constantly distracted or I'll eat it. If there isn't, I'll keep going back to the kitchen, looking in the presses to see if I've missed something. I have diabetes but I still eat crap. My portion sizes are insane.

I hate myself, I'm ashamed of my body, I hate how much power food has over me. I feel disgusting. I'm ashamed to eat in public. Sometimes I'm afraid to go out in public. I try to avoid going out alone because I feel too self conscious.

I don't want to be like this as my kids get older. I'd be a terrible example to them, and an embarrassment.

But I just can't seem to get a grip on the problem. I want to go to my GP and ask for help but part of me feels like that's a cop out, and I should just get over myself and eat properly, and stop navel gazing. I said it to my DH last night and he looked at me as if I had ten heads; he doesn't seem to think my problem is serious enough to warrant help or support.

WIBU?

There is no harm in asking, but you might not meet the referral criteria for your local eating disorders service, it will depend on what they are.
Your GP practice may have access to a dietician that you could see? Or have you considered mainstream things like weight watchers? Where I work they have made this available free to certain catergories of people because they feel it is more effective than standard dietetic advice.
Thats not to try and minimise your difficulties, but just the way that things are set up you may not be able to be referred to an eating disorders clinic.

I can't help but I felt a huge sense of relief on reading your post that I am not the only one.

I've seen a dietician. I know pretty well what I should be eating. That's not the problem. And there isn't a Weight Watchers meeting anywhere near me.

letasongcarryyoualong, tell me more. Please.

I was referred for a similar issue with food, the called it binge eating disorder, which actually had deep roots in my abusive upbringing. I think you might find it useful to speak to their counsellors, I certainly did. I was referred to a support group, but didn't attend as it was not the right time in my life to cope with something like that.

I think it's the right time for me.

There's certainly no harm in asking.

But in most areas there is a lack of specialist provision and ED clinics tend to be geared at those with anorexia and bulimia nervosa. Places can be like gold dust and often accessed based on referral from a psychiatrist following a mental health assessment.

However your diabetes may get you rapid access to different specialist services, such as a specialist dietitian and potentially counselling.

You sound like me last summer. I'm also 5'8'' but I weighed 24.5st. I was just the same, life was for eating, all I thought about was food.

I joined Slimming World in September and have lost 6st so far, so I weigh the same as you now :) so still a long way to go. I still have my odd binges but now I kind of accept it and move on, and I think my attitude towards food is a lot healthier. I also run most days and am much more active, and instead of just opening the kitchen cupboards when the DCs go to bed, I put my boots on and take the dog for a walk, or read a book instead.

Anyway, it's been the support of SW that has got me this far, I always stay for the talky bit after getting weighed and that's what's really helped I think. You need to just decide you want to change and then do whatever you need to do to achieve that. If the gp can't refer you, maybe look into sw or perhaps a local therapy group?

Long post which has taken me ages to write, but I wanted to say I understand how you feel and to encourage you that it is possible to get out of that way of being. Let this be your first step.

I have always been miserable around food. My eating habits are dreadful. I was painfully thin all through my childhood and absolutely hated meal times.

After I went to university I started to enjoy eating a bit more. Ever since then it's been a spiral of binging and starving. I try very hard not to let anyone else see this and certainly wouldn't admit it in RL.

At the moment I'm very fat and can't stop eating. It's a horrible feeling and I know it's very, very wrong. I don't know why I'm posting this other than to tell you that you're not alone.

Of course Yanbu. You have an eating disorder, sadly as already in evidence on this thread, it is not a recognised one by the ignorant. Good luck!

Who is ignorant? No-one has said that the OP doesnt have an eating disorder, only that she may find that she doesnt meet referral criteria for her local eating disorder service.
Or are you saying that the people running eating disorders services are ignorant about eating disorders

There isn't an awful lot more to tell you I'm afraid, like you I often feel I can't stop eating but if there is help available it certainly doesn't exist around here.

have you thought of a psychologist? if they help you understand why you eat constantly and how to deal with it, you might get it under control. I had hypnotherapy for weightloss and it worked really well for me.

I had the same problem and was referred to an eating disorders clinic in the UK. It didn't help, it was all CBT and self asteem classes. Then I moved to Sweden and asked to be referred here. It was amazing. Their approach is that it's all down to blood sugar levels and if you can get those evened out, you will be in control of your eating.

They gave me a eating schedule, not a diet plan. Within a fortnight of following it, I felt like a different person. It was hard to follow because the amounts earlier in the day were much higher than I was used to, but this controlled over eating later on.

The rules of the schedule are:

• 2000 calories a day - the purpose is to take control of your eating, not lose weight (although slow weightloss will be a side effect)

• calories split as follows 3 x 500 calories meals, 2 x 250 calories snack, 1 x fruit snack. (ie 6 'meals')

• timings: breakfast is always 500 calories when you first get up. Then arrange the others to suit your timetable but never more than 3 hours without a 'meal' and never more than 5 hours without a 500 cal meal. EG 8.00am breakfast, 10.30am snack, 1.00pm lunch, 3.00pm snack, 6.00pm meal, 9.00pm fruit.

• that 5 hours should be 6 and should be where ever possible not never

If you had cirrhosis because of alcohol addiction, or were abusing drugs, there is a clear referral path to services. But because you're presumably functioning in every other area of your life and not harming anyone other than yourself, you can go sing for support. I know exactly how you feel.

I don't think anyone would come on a thread started by any other form of addict and advise them to go it alone or try a commercial programme (like WW)

Given that if I do get a referral it'll take months to see anyone, TheUnMember, I might give that a go and see what happens. At least it's something concrete to focus on.

It's good to know I'm not the only one! It does feel like it usually.

If you do go to your GP, ask for a referral to a counsellor rather than to an eating disorders clinic. For one thing, as others have said, ED clinics tend to be geared at undereating rather than overeating. Also I've known some people who've worked in ED clinics and they hated it and reckoned the "treatment" was all geared at getting the patients to a healthy weight so they could be discharged rather than actually solving their eating problems. One woman I used to live with was an OT in a clinic and when I asked her what her job involved she said "Sitting with the patients and making them eat fishfingers." She hated the job.

It sounds like you would benefit from counselling to get to the bottom of why you eat so often. If you could afford it, it would probably be a good idea to try private counselling because you can be waiting forever for a referral on the NHS.

TheUnMember:I am interested in this way of managing my food intake. Pardon my ignorance (truly) but, can you give me an example of what a 500 calorie meal may consist of. I've never been on a diet in my life but am just continuing to get fatter and fatter as the years go by. I'm not particularly miserable about it but am very concious that it's not healthy and feel I should take some steps towards addressing this.

Example day:

Breakfast could be:
a 30g bowl of cereal with milk +
1 slice of toast with butter (1tsp) and jam
1 small glass of fruit juice

Snack:
2 digestives and a banana

Lunch:
Cheese salad sandwich or a mcdonalds hamburger

Snack:
bowl of muesli with fruit yogurt and a chopped apple
or a mars bar

Dinner:
3 egg sized potatoes
half a large chicken breast (approx 90g)
big pile of carrots, broccoli and cauli
bit of bisto gravy

Fruit:
a small portion of grapes

The important thing is to eat something of approximately the right number of calories. Ideally something healthy but anything is better than nothing. Missing a 'meal' is what causes the drop in blood sugar and your body's response will be to drive you to overeat later to compensate. If you don't feel like eating, because your still full from the last one, eat it anyway. Your body will gradually adjust to this new eating routine. If you do over eat at some point, don't skip the next one because you're too full or to compensate. Eat something.

I used to sleep in the afternoons because I felt totally exhausted. Doctors told me this was depression. This disappeared completely immediately I started following this schedule.

Oh, and don't weigh yourself more than once a week. Noticing a weight loss will encourage you to try harder and reduce your intake a bit, and then you're back to the beginning. Noticing a weight gain will discourage you. If you want to lose weight once your eating is stabilised and under control, you do it by increasing your physical activity not by reducing your calories.

Good luck

I've got very similar issues to yours and I would strongly urge anyone in the same position not to go down the weight watchers/slimming world/ lighter life etc route. Dieting is really not the answer and can lead to a cycle of depriving yourself which leads to more bingeing and overeating. It's not easy but it's the root causes that need to be tackled, and we need to learn what 'normal' eating is in response to hunger. I've found the following first steps useful:

• eating in a planned way every 3-4 hours
• structuring eating ie. no more chaotic eating but having 3 meals and 2-3 snacks
• aiming to eat when you're hungry and stop when you're full (obviously a little easier said than done!)
• keeping a food diary and noting circumstances/feelings when you have eaten compulsively or when you're not hungry to try and see what the triggers are

I must admit that I have been not bold enough to go to my gp so instead have paid privately to see a counseller specialising in eating issues and more recently a nutritionist with experience in helping people who overeat. Both have been really helpful and I do feel on the road to recovery.

There's also a really good 6 week course with a Christian perspective (but also suitable for non christians) run by some churches called 'new ID' aimed at helping people with eating issues.

I've never been myself but I know some people find Overeaters Anonymous Helpful. I've also found a number of good books on the subject - post if anyone wants the details of these.

I hope this is helpful, I know how desperate it can make you feel and how much energy it takes up, but really you are not alone and you are not just weak or undisciplined, it's not your fault and not something you can sort out on your own, but freedom from food issues is possible I believe!

"I don't think anyone would come on a thread started by any other form of addict and advise them to go it alone or try a commercial programme"

There are no reputable commercial programmes aimed at substance addiction?

My point was that the OP may not qualify for an NHS eating disorder service in her area. That is the reality, and whether you like it or not, it doesnt change the way things are.

Ok, i work,in this field, nhs,
I would commend you for being ready to address this problem,
Definately go to your gp for referrel.
Eating disorder services are NOT mainly for people with anorexia nervosa,mainly because it is a serious condition that is thankfully rare.
The bulk of work at eating disorders is for people with binge eating problems,,
Bulimia, which is where people binge; ie lose control with eating, and then compensate by vomiting, taking laxatives, exercise or restrict eating which all leads to more binges.
Or binge eating disorder, where people lose control and eat large amounts but don't do the compensation bit.
Eating disorders are about how life issues have become entangled with eating and eating disorders services are very much into helping regulate and normalise eating, maintain a healthy weight, and find other,ways to manage life issues.
A gp will assess if u seem to have an eating disorder and refer you, if it seems it's more an obesity issue; ie a tendancy to overeat as opposed to actual loss of control, gp may refer to obesity clinic, eating disorders services don't currently tend to tackle obesity
But don't be put off from second hand info.. Here as to how crap eating disorders services are, they are generally, highly specialist, good teams that may well be just what you need,
Best wishes xx

P.s.
I second what purinelli said,
Ww slimming world etc etc... Whilst can be really helpful For some, can be expensive, soul destroying experiences for many.

I would say there are a few things you could try for self help.

You say your portion sizes are far too big. Ok, dish up your portion as you normally would, then split it in half. Tell yourself that you can have the second half in an hour. Eat the first half, and you will know in the back of your mind that there is more if you want it, but chances are in an hour, you will feel fuller and not as keen to eat it. Our stomachs do take a bit of time to tell the brain when we are stuffed.

Another thing is to just be really really strict when shopping, and dont buy the stuff that you know you will pig out on. Then if it isnt in the house, you cant eat it. I had to do that, and it takes a bit of time to get in the habit, but again it does work.