Anxious about first GP appointment for eating disorder concerns

[groovejet]

Finally admitted to myself, my husband and a colleague that my eating has become disordered to the extent that it is affecting me physically and contacted the GP and have my appointment tomorrow. I am incredibly anxious about the GP phone call, that they won't take me seriously and that the advice will be just to eat more.

BMI is 17.4, however, that is taken first thing in the morning, it goes up during the day. Started some minor restrictions in September but things have gotten worse over the past month and have been restricted calories further each week, so am also worried that GP will think that because the more serious issues have only been going on for a month they will dismiss me as a time waster.

Does anyone know what the GP is likely to say (it is a phone appointment) and what I should say if they are dismissive. It was a big step for me to admit that I have a problem and I am worried about what will happen if they do dismiss me.

I hope you GP is receptive. It is fine to tell them it started in September. It can take time for an ED to develop. There is no hard and fast rule. And it now appears things are accelerating, which is your body and brain reaction to the restriction.

If the GP questions the severity of what you’re going through, you can tell them you feel out of control. And you feel compelled to restrict. And you tell them about the acceleration and that you don’t feel in control.

Tell them about your physical symptoms. I presume amongst other things, it could be lack of energy, having difficulty maintaining your current life / lifestyle and feeling cold all of the time.

You can tell them that you want to be referred to ED services as you feel unable to turn this around alone. You can also say this is a big step for you to admit that you have issues with eating.

Do you know how much you’ve lost this last month? And do you know what your starting weight and BMI was? If you’ve been noting it down or have a rough idea, that would be useful.

It sounds as if your weight loss is probably accelerating, which should be of concern to the GP. You BMI does sound low. You know you are now underweight and it sounds as if you fear that if you don’t get this under control you’re going to be significantly underweight soon. Tell the GP this as well.

The anxiety that you’re feeling will also be linked to the lack of nutrition. If you do tell the GP you’re anxious, do ensure that you are clear the anxiety is not what is driving this lack of eating. And therefore they anxiety is a symptom rather than a cause. That is important as you may be treated very differently if ED services think anxiety is the cause.

Well done for booking the appointment and for admitting it to yourself. That’s really hard and so brave. Try not to worry, however you may be asked to self refer for therapy and you may not receive a diagnosis any time soon - please be aware that this is because the NHS has some very bizarre rules around when and how to diagnose and not meeting these doesn’t mean your condition isn’t serious or dangerous. It just means the NHS is cash strapped and so they’re refusing to help lots of people who need it.

If you have the money I’d recommend some private therapy with an ED specialist as you are likely to be waiting a long time with the NHS.

There are also some work books online that you can progress through alone at home which can help you reconsider how you think. They can have some effect if you want to get better and are cash strapped.

Resources can also be found at BEAT and they have a chat system in place. https://www.beateatingdisorders.org.uk/

Remember the opinion of a singular GP in a system that doesn’t cater well to psychological conditions doesn’t mean you aren’t valid or that your condition isn’t dangerous, serious and health threatening. It just means one GP (they are NOT ED specialists) had an opinion.

Write everything down prior to the call - all of your symptoms, worries and behaviours. Politely explain to the GP that you would like to run through your list, so that they have a full understanding. Hopefully they will then be able to refer you to the ED Service.

Thanks so much for your replies, reading them has helped. Not opposed to going private but would rather avoid it if I can but will certainly consider it.

Good idea for me to write things down that I want to say, I do record my weight and calories so I have that information if they ask.

Not going to be a fun day tomorrow, it is a mixed feeling of knowing that I need help and need to be fully transparent but also concerned about that receiving help means my weight will increase.

Thanks again

Would it help to have your DH at the appointment with you? Another pair of ears can be helpful to remember what has been said, especially in stressful and overwhelming situations like this.

The appointment went well, the GP was very calm and understanding and he let me run through what I had written down before asking questions.

I have to got to have blood tests and he is doing a referral to ED services, not sure what that involves or how long it will be but feels like a huge step taken today.

That’s good the GP is taking this seriously. It is a big very step. Hopefully it won’t be long before you get an appointment.

Just an update, my referral has been rejected because of lack of blood tests which were meant to be done this week but have been delayed by 3 weeks. Feeling frustrated as I was feeling optimistic that I had accepted I have an issue but the more time I have the more my mind starts telling me things aren't that bad and regret reaching out, the word rejection is a bit of a focus.

I have been able to self refer for 6 sessions of private counselling through work, which, whilst they are not specialized in ED's I am hoping they will be able to provide some support for lack of self worth and other anxieties.

They'll refer you to an eating disorder clinic

The eating disorder clinic will work with you / refer you to a dietician and a CBT counsellor.

The CBT changed my life. It really helped me understand that I don't have to believe everything my brain tells me and that sometimes our brain isn't our friend.

My BMI went to down 15.4. I look back at pictures of me and I genuinely looked like a skeleton. I weighed less than what my 9 year old weighs now.

Get the blood tests sorted and get the GP to re refer you.