Is it possible to restrict food intake without developing anorexia?

[airforsharon]

Just asking for advice/perspective please.
I've had a difficult few months for several reasons, including sudden, messy long marriage breakdown, and I've completely lost my appetite. For about 6 weeks i've had, at a guess, around 500 calories a day. I stopped eating dinner earlier in the year, and tend to have a snack at breakfast or lunch, with maybe a bowl of cereal before bed.

I've lost about a stone in the past 6 weeks but i'm not underweight, currently at the low end of 'healthy' on the BMI scale.

I feel very low in myself and that's manifesting as absolutely no interest in food. I know if i don't eat more i'll continue to lose weight but i had a look on the NHS website and bar emotional/stress reasons for restricting, i don't have any of the main 'drivers' for anorexia. So i think if i went to the GP and explained what's going they'd just say 'eat more', but i genuinely can't. I feel sick and stressed at the thought of it - and I'm not feeling unwell in any way. I actually feel quite clear headed and 'light'.

So basically, is this something to bother the GP with or, can i just ride it out and hope appetite improves when i start to feel less shit about myself?

I think you're eating quite a dangerously small amount even if it's not with intent to lose weight and you should definitely see your GP. BEAT are also good and have a phone line if you wanted to chat it through with someone first.

I think it would be a good idea to see your GP. They might hopefully be able to offer help with your low mood, which you have identified as being the cause of your lack of appetite. I hope things improve for you soon.

Certainly a restrictive diet, if not anorexia it might yet be an eating disorder brought on by your stress.

You are depressed (or have depressive behaviours) rather than anorexic. Please go to the doctor, if you can afford to see a psychologist that will probably help you more quickly than going via your GP.

Try to eat communally when possible.

My first H tried to kill me, my boss sacked me because he said he didn't want the embarrassment when it got in the papers. 6 weeks wait for benefits (this was mid 1980s, DKs got free school meals, decent cooked ones. I couldn't eat,then I couldn't afford to eat. Did what used to be called "living on the breadline". White toast 3 times a day for me. I lost a stone, emergency accommodation, ugly divorce,housed and picked up.

Loss of appetite can be a common symptom of depression so it might be a good idea to see your GP about your mood generally. Be sure to mention your reduced appetite and how you can't face much more.

Are you drinking plenty of fluids? Vitamin and iron tablets?

Rather than trying to force down bigger volumes I wonder if you could try and make the most of your current habits- maybe add a banana to your cereal at night, a piece of cheese or dark chocolate, or a few nuts to your lunchtime snack? Sorry if that's tantamount to suggestions of 'just eat more', just in case you'd tried to reintroduce whole meals straight off. Hope you're feeling better soon xx

It sounds like depression to me. Please have a chat with your GP and see what s/he says. Loss of appetite is a very common symptom of depression. Do not let it drift into a more serious eating disorder.

As you say you just don't feel like eating, sounds to me like you are never in the MOOD for eating which is common enough at stressful times, but don't let it drag on too long or your general health will suffer. GP appointment today. Wishing you well.

I got like that once, it's depression so please see your GP.

In the meantime, I found I could manage a cup of thin soup or one of those meal replacement drinks as you don't really need an appetite to drink. Also take a vitamin/mineral supplement.

If you can don't lose good habits, as it's hard to pick them up again. So, 3 meals a day, with veg or fruit, sit down and take time to chew and digest. Then you can up the overall intake a bit as you go along.

I'm a MH nurse. 500 calories is the point where things start getting potentially dangerous. Now, when you say 'around 500' is that a bit more than 500 or a bit less? When people aren't eating properly it's very easy to over estimate the amount that's going in- and eating less than 500 calories a day for more than a few days can lead to heart failure, amongst other things, due to electrolyte imbalance. You have to be very very honest with yourself here. If you think it's actually less than 500 calories or you feel physically unwell (nauseous, shaky, lightheaded) you have to go to A&E.

Beyond that, I would suggest getting your GP to refer you to ED services. While you may not currently identify with an ED psychologically, anorexia is actually a very biological illness that can be triggered through a period of restricted illness. It's likely that you're going to need ED support to help you with your eating and then other MH support to help you with your mood.

It's good that you've identified you need help now, while things are still at an early stage. I do hope this advice is useful ❤️

I've been through exactly this in the past 18 months. Through stress my appetite has almost completely disappeared and I could happily eat just once a day - mostly soup which I make myself, or a fried egg on one piece of toast, for example.

I do think I'm disordered over it, but at times I simply cannot put food in my mouth.

I'm still slightly overweight so I don't worry too much about it, I had plenty to lose, but it doesn't sound like you do.

When I have been very anxious/depressed I have struggled to eat as I just don't feel like it.

I don't think it's anorexia as my focus isn't losing weight I just don't feel like food as I am so sad.

I think you would probably benefit from support more generally (as I did - I got any anxiety drugs and therapy) but I didn't have an eating disorder.

Meant to add, I really identify with that description of feeling clear and light if I've eaten very little - I do think that's sort of tempting, if not addicting.

Anyone eating less than 500 calories a day for more than a few days is at risk of a medical emergency. While low body weight makes things more dangerous, a low BMI isn't necessary for serious medical complications, including heart failure, to occur-this includes people who are overweight.
Regardless of the actual classification of the mental illness, disordered eating can, by default, cause physical health problems which are potentially life threatening, and mental illness is secondary to that, and I say that as a MH nurse.

My DD had anorexia..anorexia is caused in those with a genetic predisposition by weight loss. The weight loss can occur for any reason, not just a desire to lose weight. In your case depression. The weight loss itself triggers anorexic behaviours and patterns, not the other way round.
My DD didn't mean to lose weight, but once past a certain point she developed AN, and was then a typical anorexic, scared to eat. Once she gained weight those thoughts disappeared (and that is a gross simplification of the hell we went through getting there)
To me the red flag in your post is 'I physically can't, I feel sick and stressed at the thought of it'
That's not depression or lack of appetite anymore.
Yes go to the GP and as a previous poster said if you have been eating less than 500 cals for a while you are in physical danger. So get physically checked out. Ecg, BP, HR and blood tests.

Scared to eat: yes, I get that!

Sometimes I know I should eat but I stare at everything in the house and mentally assess all of it as too calorific. And I've started to love the feeling of going to bed hungry.

This thread is making me think...

Thanks for all your replies, and kindness.
To answer a few points -

@Telomeres it sounds like we're treading a very similar path :/ It's surprised me how quickly the weight has come off, if i lose another stone i will be underweight

@Nannyfannybanny that sounds like hell. I'm sorry you went through all that, and glad things are better now

@Lottsbiffandsmudge I know my mum is concerned (and keeps trying to force cake into me) that i'll reach a point where an ED is inevitable. I honestly thought that unless you had those 'classic' traits such as obsessive calorie counting or binging etc then you couldn't or wouldn't develop an ED.

@JennieTheZebra I'm not keeping tabs on the calorie content of everything, so 500 is a guess. I'm sure some days it's less but others slightly more. I didn't realise the health implications of that could kick in so soon.

@GailPro thank you for the links, i'll look at them this evening

@Avastmehearties yes, i'm drinking plenty, i'm fueled by strong tea, 6-8 mugs a day. I do also take cod liver oil every day, and a berocca when i remember

I think i probably do need to see the GP. beyond my complete shit of a soon to be ex i also have teens going through tough times (2 with SEN), animals to care for and have recently moved house. Mum has some significant health problems too. I think i might have reached my 'ffs world, what now?!' point. I do feel completely overwhelmed at times.
Thanks again.