Advice on anorexia - any help/comments appreciated

[LudwigvanBeethoven]

Hi, I am new to Mumsnet and I'm only sorry I'm posting on this subject as my first posting.

I'll be as brief as poss - I'm in my mid 40s and have two daughters aged 6 and 3 - I was anorexic, not too badly so, in my early 20s but it has now returned. I am concerned at the distress it causes my husband, who is the light of my life, and my two beautiful girls - I fear that at some point soon they're going to pick up on it, but I really cannot force myself to do the evening meal thing any more - it is causing me so much distress and panic. In my view I am pretty overweight - all this BMI stuff is only a guideline, as is the weight to height ratio - I am 5ft 8ins and weigh two pounds under 8 stone in the morning and 8 stone 2 in the evening. Seriously, if you saw me you would say that I am not underweight and really I am overweight - I carry too much weight that really is not necessary.

Yet, my views on my weight are at odds with my family and it's this distress that concerns me. At the moment I feel that I am condemned to a life of being fat just so that I don't cause any problems. Needless to say this is doing my head in. I am booked to see a specialist counsellor next week but I have to say that my dealings with counselling in the past has not been great, so I have warned the counsellor I'm seeing of that.

It was the visit to my GP that gave me a bit of a shock. I went to him recently and said that another issue I had was related to the fact that I carried too much weight. now, a while back he had asked me if I had always "been that slight" and I had told him about the anorexia of 25 years ago. So, on this recent visit he got incredibly upset and said "what are we going to do? are we going back to the anorexia again?" I wasn't really able to give a coherent reply other than that it might help to get a psychiatric assesment rather than "prescribe something to lift you out of this" which is what he offered also.

I'm in a bit of quandery here - so any advice or comments would be so much appreciated. This is unbelievably selfish, but all I want to do is to be thin and all I can see is how fat and pathetic I am as person and frankly a really rubbish mother if being thin is more important than their well being.

you need to see a specialist Eating Disorder team, is the counsellor you are seeing an ED specialist?

Yes, this person is an ED specialist and recommended by my GP - but to be honest, at the moment my GP is the only person I trust. However, I understand that he is trying to do the right thing by sending me to her - he has also faxed off a request for an appointment at the local psychiatric hospital, but as this is a public service it will be a good long time before I get an appointment I guess.

have you spoken to BEAT? your GP should be able to rush things through.

You are quite badly underweight wether you 'believe in' BMI scales or not, and I'm sure you know that to be the case. Sadly anorexia nervosa tends to warp reality and often includes body dismorphia i.e. the sufferer believes they are fat when they are very thin. How is your health otherwise? (Be honest) Do you still get regular periods, for example?

Counselling is a good start but, like any other talking treatment, it won't have any effect unless you embrace the therapy and want it to succeed. This is clearly not the case at the moment. So I would say that the best route for you would be to ask to be referred to a specialist clinic. The reason I say that is because, as well as the fundamental mental illness, many of your symptoms are being prolongued and exaggerated by simple malnutrition. In a specialist eating disorder clinic they are able to correct the malnutrition as a first step and I have known many people who tell me that once they came out of the fog and delusion of starvation, they found the psychiatric counselling far easier to cope with. Good luck

cogito is right. when my weight is low it warps everything. the thinner i am the less reasonable. this is very common. i will post a proper reply later when ds is at school.

OP, are you sure about carrying too much weight? Obviously build and so on makes a difference, but I'm 5 ft 8, size 14, and weigh closer to 12 stone.

Having been anorexic myself in the past though, I realise that logic doesn't really scratch the surface, any more than all the people telling you you're alarmingly thin when you feel all horrible and fat.

For me the trigger for my ED was my parents' divorce in my early twenties - my food intake felt like something I could control, even when everything else was going to shit. And that horrible sick feeling I constantly had in the pit of my stomach could be replaced with a recognisable feeling of hunger, in roughly the same place. So I think for me it was a way of dulling or ignoring what I was feeling, in favour of something that at least had a clear cause (ie not eating).

Is there anything else in your life right now that could be triggering a return to your anorexia?

Cogito - thank you so much for that reply - I think that is the one that has made the most sense to me so far. I think I probably should ask to be referred to a specialist clinic as you suggest - I just have this feeling that I'll be going over old ground in terms of seeing a counsellor and will end up doing a few sessions and giving up, as i don't think I'm on the same page as these people. The only problem is is that I fear the clinic will make me eat..

OThe Huge - I don't think there is anything that has triggered this return to the anorexia, although I wouldn't view myself as being anorexic to be honest, other than I had this original injury to my ribcage and made me think about my body and the fact that it has been taking a while to heal which I think is due to carrying too much weight.

I just wonder if I should wait and lose a bit more weight so that I get as far down as possible in order to want to put on weight again? weird kind of logic I guess, but it seems like an idea worth considering.

Thanks for these replies - any other comments would be much appreciated. I feel a bit isolated and confused.

I seriously doubt that your rib injury is taking too long to heal because you are carrying too much weight. it is more likely because you have sustained a minimum weight for a long period of time. my bones are very weak and I heal very slowly thanks to years of low weight. your body is focussing on day to day rather than using up calories to heal.

anorexia warps everything. you are ashamed of it and you know that people dont see what you see. I call it my evil twin, because she sits on my shoulder and whispers in my ear. i use it as way to purge myself and its so, so easy to fall back on. but the more weight I lose, the fatter I feel.

my husband hates it. he doesnt find me attractive when Im spiralling, but I dont really care because to have sex means taking my clothes off. i manipualte people and lie about food. I hide my meals and eat at odd times so that I can get away with starving. the best time was when dh worked nights and I could not eat for whole days.

but it has compromised my fertility, I have (as i mentioned) problems with my bones, I am always ill and the worst thing is, I dont care. because my twin becomes such a burden and I want to listen to her.

ADs help, just to regulate my seratonin, helps me see clearly. but, seeing a proper EDT is vital. BEAT are agreat support. please give them a call. you arent well at the moment, but you can make yourself better.

how are you op?

Hi Lissieliou - thanks for being in touch and sorry it's taken so long to get back to you. It's all a bit weird at the moment - have just started with this new counsellor and she is proving to be helpful in a way I didn't expect. she is very non-judgemental which is a nice feeling. Have only had two sessions with her so far but I think I will continue seeing her for some more sessions. mind you, I couple this with the fact that I am happy to have lost some weight, so I'm now at 7stone 10lbs and I'm hoping to get down to nearer 7st if I can which for my height of 5ft8ins I think is OK. I also know what you mean about avoiding meals etc - I do find that hard as I know how much it is upsetting my husband and I really do feel awful about that as he is such a great guy. It makes me feel so selfish - but then I don't think I'm a particularly nice person...

Can I ask what kind of treatment have you had and whether it has helped at all on a long term basis?

An update! I have had about 8 counselling sessions now and generally it is going OK. It is giving me a greater understanding of what my problem is and we have discussed the various reasons for it - some of which are more serious than I had realised.
But, at the last session I sensed some distancing by my counsellor from me and I found this really unnerving and upsetting. I'm probably being over sensitive. I wonder if it is part of the strategy in treatment, like it has shifted a gear.

Does anyone have any experience of this or have any advice to offer?
I'm finding it really tough - tougher in a way that I didn't expect.
Thanks.

I have weight issues. No anorexia, but serious weight issues. I exercise fanatically 5 times a week at times, and eat very little, and only healthy food. I talk about it all the time, without realising. I think about it constantly and am on cloud nine when I am under control and eating little and losing weight. It scares me rigid that I can't get below a certain weight, which for your information is hugely more than you and your very tiny 7st something. I could only dream and have no idea how you get so low! My point of this post is not to ask questions or dwell on these issues, but to tell you that I have three little boys of 7, 5 and 3 and they are all hugely fattist. Its horrible. They hate fat people. They ask me constantly if their thighs are fat and how they can get muscles. I have done this. By talking about it. I have done this to my boys. And let me tell you, if I have done this to mine, I dread to think of the impact you have had on your girls. They absorb every little detail. Think of them, and stick with your counselling, it will be worth it. I am here if you want to talk. x

Sometimes the relationship you have with a therapist or counsellor is designed to make you feel uncomfortable/unpleasant emotions, it's part of the process that they try and take you to a difficult emotional place and guide you through coping with it, to help you let go of a coping strategy like anorexia. I know when I saw a therapist for a similar food issue (for 10 months) there were times I absolutely hated her, and couldn't bear the thought of going back. But that was part of the learning process, I could feel anger, and hate even and fear, and it didn't kill me, or hurt me even. Losing weight or controlling food doesn't change hard emotions, it aneasthatises them.

Have you ever thought of going to a support group like OA? www.oagb.org.uk/ Many, many people have overcome an addiction to restriction/exercise there as well as to overeating/binging. The most powerful part of a support group is that everyone in the room - no matter what they look like - understand the intense obsession with food, and can relate to where it has taken you. Unlike a therapist, who has to be distant from you, OA members will laugh and cry with you because they know how you feel. Sometimes, that's enough to change how you feel - I know for me, part of anorexia is the isolation that comes with it, not eating with anyone means you miss all the opportunities to talk, to be with people, to feel intimacy. You don't have to be on your own though. Trusting people may be hard, but if you let the fear out of your head and talk it through, you might find it's not being 'fat' you're afraid of, but being lonely, or being rejected, or being not good enough at your job, or being financially insecure... or whatever you're hiding underneath the fear of 'fat'.

The worst thing about anorexia is it's a self-fulfilling prophecy. Being afraid of not being 'good enough' becomes being afraid of being 'fat' and it leads you to make yourself ill, so that you can't actually do anything to the best of your ability... which seems like 'proof' that you are worthless, and yep, you guessed it, fat. But you can get through it! you've done amazingly to ask for help. I hope you stick with it, because you obviously love your family and they love you :) there is so much you have done really well, and can be proud of and part of. Life is out there, just waiting for you!

Hi OP,

I just saw this. What helped me was realising how long I'd wasted worrying about food when my life was slipping past. (and away at one point, as I was dangerously thin)
The difference was I didn't ever think I was fat. Yes I felt more in control when I wasn't eating and when I was thin, but actually in a different way it terrified me as I couldn't reverse it, and I desperately wanted to. I was so stressed that eating made me feel sick and so I couldn't do it - I was terrified I'd be forced to eat, as well.

I had some counselling which at the time, well I liked her but I didn't get any better. Maybe it had a longer term effect though. Eventually everyone said they couldn't do anything else, and I knew it was down to me and actually I bloody needed them all to just leave it and stop trying to make me eat.

I could only feel safe enough to try (experimental eating, see how much I could manage, without feeling too full) if I knew no one was watching and waiting. I made everyone leave me alone, begged them not to talk about it and finally I got the space I needed to allow myself to eat.

It took four or five years. I damagd a lot of my body, different aspects. I learned a lot. I survived, and I have been a stable weight (give or take the odd stone when I fall in love or get worried about something big) ever since I got 'well'. I still eat badly and I still have issues but I regained control in a way that didn't involve food.

I did feel the more pressure I was under the less I took responsibility and got angry with everyone else, and to take my own problems in hand was the only way I found to get past it. It's been 10 years since I got better. I miss it sometimes, I miss having no friends, not being too fat for my jeans (well I'm slim now but not as slim as I'd like to be!) and I miss the total insular introversion and introspection. I think I went back to being a baby again and hiding in a rented room without any real life contact. I had to disappear, well very nearly, before coming back.

Hope you are doing okay.

Thank you, thank you all for your incredibly helpful replies - you guys are great and I really appreciate this. It really is so much hard than I expected it to be and yes, I understand what you say, Overcameana (great name, btw) that the counsellor has to make me go through these emotions and therefore some distance. In the session before last she said that what she wanted to do was to put her arms round me and give me a big hug but that she wasn't going to do that, and then in this week's session she was pretty distant - I was going to ask her if she would sit next to me rather than opposite me but I was afraid to.

I was thinking of asking her in next week's session if she would indeed sit next to me - I just feel safer somehow. Do you think it would be inappropriate?
Gloria - am interested that you still miss aspects of the illness - I know from talking to people with depression that they say that whilst they are over it they still fight it every day. Is this what it will be like overcoming and ED?
Thanks again everyone - I can't tell you how helpful it is. I'm just back in from a walk where I cried for the entire hour, having just had a row with my husband, so feeling pretty rubbish - all of you have made that not so bad!

p.s. Overcameana - thanks for that suggestion re support group - I'll check that website out, sounds good.

My mother was anorexic for most of my childhood, and until I was 30. Her eating disorder caused me huge emotional problems, leading to several years of counselling, and my own eating disorder. Please continue with your therapy and if you are ever at the point of giving it up, stop and consider the effect of your eating disorder on your children.

7 stone is a dangerously unhealthy weight for someone of 5 ft 8. My mother spent many years at this weight and it has damaged her health permanently.

Well done for seeking help.

Thanks Littlefish - I really do think about the effect on my children. Whilst my target is 7 stone, and I'm currently 7 stone 5lbs my counsellor says that the weight is never low enough. It's a dreadful state - being torn between my children and not wanting them to worry about eating or their weight and myself not gaining weight.

Can I ask what damage it did to your mother's health? I'm in my late 40s, so no spring chicken and need to think about this...

Osteoporosis
Pancreatitis
Rotten teeth
Scarred knuckles

I know that my mother thought that she hid her behaviour from us. We were always aware, but never really understood. We saw the self harm, heard the vomitting, the crying etc. Our main role model for food was showing us that food was something to be feared, controlled, used as a weapon, a reward, something to be both despised and craved. Most damaging though was the emotional withdrawal. When in the grip of anorexia, it took all her focus - there was no room for us. I felt completely rejected. My mother thinks that she hid her behaviour from us. She didn't.

thank you for being so honest. I recognise the issue of the lack of focus - I think at the moment I'm still convincing enough to not draw attention to it but I know it's only a matter of time. My children are 7 and 5 so smart enough to figure things out. At the moment they have a very positive attitude towards food and we make it together, so I hope I can keep this aspect going...

Well from my own experience I;d say you're going down the right route with the counsellor. Doctors, including GP's and psychiatrist in general know f-all about eating disorders. this is not surprising as, imo, eating disorders are not real medical illnesses.
They mimic illnesses because you LOOK sick and probably feel sick, and loads of people even encourage you to see yourself as being sick, and therefore needing "treatment". But I would say the first step is to see that there is nothing wrong with you. You might need some help at the moment but you're not ill.

Check out something called Dialectical Behaviour Therapy. It wasn't orginally designed for eating disorders (more for self-harm but what's denying yourself food except self-harm?)but is amazingly helpful. Even if you want to keep going with the counsellor you're seeing now, you can do a lot of the DBT stuff on your own.
It's based around four areas: mindfulness , interpersonal effectivness, emotional regulation and distress tolerance. Books by its founder, Marsha Linehan, have worksheets etc, that you can work through on your own.

Another things that worked for me is Susan Jeffers's "Feel the Fear and Do it Anyway." Feel embarrassed recommending this book. It was recommended to me years ago, I picked it up, took one look and said "this is a load of crap". Now an awful lot of it is crap, and very simplistic, but have rediscoverd it lately and much of what she says makes sense to an anorexic person. I have the CD's and play them when I'm driving on my own. You might find them useless but for the sake of a few pounds (the book'd be even cheaper) I'd say they're worth a go.

You might need some help at the moment but you're not ill - really? I'd say any sort of dysmorphia is illness, as is the need to control things to such an extent as to risk your own death.

I think when I was around 6 stone I was ill, because my body couldn't function properly. If someone has said there was nothing wrong with me, I would have asked them why I could not eat in that case. I was mentally and physically ill.

'what's denying yourself food except self-harm?)' I'd disagree with this also. I never wanted to harm myself. I just had trouble managing the alternative.

Throwing around these generalisations isn't always helpful to everyone, though of course they may resonate with some. I just had to take issue with those two things.

Thank you Gloria - I was finding it difficult to respond to lovetomatoes' message as I disagree with some of her comments so completely.

Of course anorexia is an illness - more than that, it is a life-threatening illness.