Anorexic but not thin?

[NorkyButNice]

Does anyone have any experience of anorexia? I could do with a friendly yet knowledgeable ear to natter to.

I've had a rather messed up relationship with my weight and food all of my life and (as a result) was 15 stone in November. I fell ill from a completely unrelated condition and as a side effect of one of my medications, lost the feeling of hunger - unsurprisingly the weight fell off.

When the compliments started coming it was a bitter pill to swallow, as I felt so crap from my illness, but as usual with my diets, it became addictive. I've lost 4 stone in 6 months and need to lose more. My weight is the only thing I feel like I have control over - I've had to stop working, I'm not allowed to have another baby at the moment, I'm too tired and sick to play with DS half the time.

Anyway, I saw my GP to get my prescription this week. I mentioned to her that whenever I get up from lying down I feel faint. She asked me about my weight loss, saying she'd noticed it but hadn't known just how much it was. I eat less than 500 calories a day and that's only because DH is there - I serve myself and my 20 month old the same size portion. I know that sounds stupid.

She says I'm suffering from anorexia but my BMI is still 22.5 and I have regular periods so is this the case? She wanted me to take anti depressants or be referred to the eating disorders clinic at the Maudsley but I can't or DH will find out. She's given me a month to sort myself out.

Sorry this is so long but has anyone been here?

anorexics dont start out super skinny. You have issues with food. Im not saying you are deff anna but i would listen to your doctor and get help before you loose too much and cant get out of the pattern.

Difficult one as it's a side effect of the medication that means you are not hungry rather than deliberately not eating, covering up the fact you are not eating, exercising to excess etc. However you know you are not eating enough and you are not doing anything about that fact you could have meal replacement drinks etc if you didn't actually feel like eating which would ensure you are getting the vitamens/minerals/calories you need. Whether you have anorexia or not you are harming your body.

To be honest the first thing I would do is tell your DH, I am sure he is your DH for a reason and therefore will want to support you in everyway he can. The second thing is to accpet the GPs offer of the referal to the Maudsley who should be able to help you.

Good luck.

P.S yes anorexics can have a normal BMI and periods, there are different stages to anorexia.

As you say yourself in your first sentence you have had problems with your weight and food for a long time. The word "anorexia" really only means "no appetite", so anybody who has "gone off" their food for any reason (pregnancy, chemo, stomach bug etc etc) could be described as "anorexic".
The fact that you are eating that little and that you feel your weight is the only thing "you have control over" makes it an eating disorder = anorexia nervosa, to give it its full name.
I agree with starshaker, take this seriously and go for any offer of help and support you are being offered.

Norky, please take up your doc's offer of a referal.
I am a former anorexic and like most ed sufferers, only got help when I was near death and had a tube up my nose.
By getting you some help now, your doc is trying to get you well before you get too far down.
One third of anorexics recover, one third have it on and off forever and one third die. The sooner you get help, the less dangerous it is.

I do not mean to scare you, but this a serious, serious illness. Get help now and you will be able to make a full recovery with no long term side effects. I have bad joints and immune fuction problems due to my ed. Others have worse.

Good luck.

Several things in your OP would raise my suspicion of anorexia.

Have a very good friend who's teenage daughter was diagnosed last year and what you have posted was so typical of how she acted in the beginning.

Lost weight, received compliments, boosted her low self esteem.
Started exercising a lot more, so lost even more weight.
Cut out meals, would only eat once a day.
Restricted her calorie intake severely.
Refused to eat anything that contained fats, sugars, carbohydrates.
The feeling of control she had over her eating became very important to her, as it was the one area of her life where she had complete control.
She developed rituals around food as well.
Induced vomiting after eating.
Periods stopped several months after first becoming anorexic.

as I said earlier, there are a few things you have mentioned, that she also did.
You don't need to be 5-6 stones with a dangerously low bmi to be classed as anorexic.

I really hope you get help soon and don't slide further down this route.

Strictly speaking, anorexia isn't always the conscious non-eating of food - it can be just a lack of appetite leading to significant weight loss, like you seem to be in the throws of.

If you are concerned that you are not in control of your weight loss, you could try adding calorie supplements such as ProCal to your normal food to you boost your energy intake, but particularly your nutrient levels, as this is what will be suffering most. You need to be taking in your vits and mins otherwise you will be in bother. Take supplements if you are not already doing so - if you explain to your doc what is going on you should be able to get calorie and vit supplements on prescription.

Much of your future health depends on whether you feel so good about your weight loss that you have stopped having perspective on it. If your BMI is 22.5, you are currently deemed healthy physically - do you honestly think you can stop there? If that's where you want to stay and feel confident about your weight and shape, then make up for your appetite loss with ProCal until such time as your appetite returns to avoid losing any more and becoming 'ill'.

If, however, you feel like you could continue losing weight happily because of control issues, or you think you will look better if you are perhaps a bit underweight, or even that were you to be underweight it would give you more 'leeway' to eat when your appetite returns, then you may have the start of a problem - seek help or support before it becomes a way of life.

Good luck xx

Also wanted to add that a bmi of 22.5 is right bang where you should be, so you don't need to lose any more weight but you said that you "need to lose more" in your op.

I would tell your dh, you need support from a lot of people at the moment, I would take everything that is offered,

good luck

Unfortunately I know that I am now choosing not to eat, even though I am assisted by the meds making me "not hungry".

When I eat breakfast or lunch it's the same meal each time - 2 spoonfuls of muesli with 6 raspberries and 3 strawberries cut into quarters. All day I drink water like it's going out of fashion along with peppermint tea and coffee.

I started running and doing pilates 3 months ago and that's become equally addictive.

All I get is compliments though - I can't stop now when I've never been this thin before. Surely if I'm nearer 25 than 18 on the BMI scale it can't be an issue.

DH would not understand. He'd just watch me eat which is not acceptable.

I should have said thanks for all the replies - I really appreciate it.

DH has said that I can lose another stone then he thinks I'll be too thin but my BMI will still be over 20.

How can anyone know when to stop? There's got to be a point where everyone is happy with how they look?

You have an eating disorder that you need help for. You won't ever feel happy with any weight you reach whilst you are ill because the unhappiness comes from within- not the mirror, the scales, the tape measure or your clothes. Get help please.

Well, I think that is the trick: to be happy with how you look, no matter what weight/shape/state of wrinklieness you are, IYKWIM. Without counting calories, staring at scales, cutting strawberries into quaters etc etc. It is well established that people who have a v stable normal weight are those who do not think much about what they eat, only eat when they are hungry and stop when they are no longer hungry.
BMI is a tricky measure anyway: lots of rugby players have huge BMIs but are v fit and their wt is mainly muscle, not fat. Equally there are naturally thin people who may have low BMI but do not have an issue with eating.
Anorexia nervosa is NOT about eating or food, it is about control, or a lack of control over other aspects of life and that is how controlling food/weight becomes so important to the exclusion of everything else.
BTW, I have recently lost a stone (by cutting out the crap eating sensibly) and according to my BMI I could do with losing another 2. I know if I did I would feel too skinny, I do not like bony knees , although another 1 stone would be nice, not likely to happen though, as I just found out I am pregnant ...

Stop concentrating on numbers, look after yourself and be kind to yourself and take up the offer of help.

Diagnostically your illness would be classified as 'EDNOS' (Eating Disorder Not Otherwise Specified) because of the very specific criteria written down for Anorexia Nervosa, but make no mistake it is JUST as serious, and amounts to the same thing - most people with serious eating disorders are 'Ednos' because the diagnostic criteria don't actually fit the path of the illness very well. The risk is people - including GP's - don't take it seriusly and do the same blood tests etc. Losing weight fast is very serious. Have you had blood tests? You should have them, and an ECG, please request them if you haven't. (To check out if there are any immediate prolems to sort out with liver function, heart, potassium etc). The Maudsley are good, I would take the referral. If you want to do it yourself, try to start maintaining your weight by introducing six small meals a day, however much you can manage at first - increase the portion size and variety of foods until your weight loss stops. Try to weigh once a week and remember your weight won't ever be completely static, so learn to cope with the ups and downs but adapt your food intake in a logical way to aim to maintain rather than lose (if this is well under your 'normal' adult weight, your body will cope and perform better if you let your weight go up a bit). No anorexic I've met has ever got to a weight where they feel happy with how they look - except those in recovery who have restored to a healthy weight and moved away from the illness into life again. Hope you're OK, I know it might seem a fuss about nothing, but take a step outside the Eating Disorder and try to listen to the voices of the people who care for you (not just the ones who are jealous/admiring of the weight loss) and put your trust in them because the eating disorder will trap you otherwise. Imagine where you want to be in ten years time. Will more weight loss really get you towards your goals, or is it just an easy excuse to keep putting off the real challenges of life. Sorry to go on.

^ sound advice

Thanks again everyone.

Being fat hasn't made me happy so being thin had to be worth a try.

When my GP said she was going to weigh me again in a month I was excited at the thought of having a goal to lose as much as possible in that time - not the effect she was hoping for I think.

Don't think I can do it by myself as I don't want to stop yet. Even on days where I try to eat more I still only have 800 cals or so and feel sick I'm so full.

Trying to buy a house at the same time as well as being ill and stopping work - all too much.

But will being thin really make you truly happy, deep down happy in yourself? Compliments are transitory - after a while people stop complimenting and start looking at you askance and making derogatory comments about how 'drawn' or 'emaciated' you are looking and that makes you even less confident about yourself. Food and eating takes over your life - all you think about is food and calorie content. It becomes THE most important thing, overtaking your relationships, your kids, your work, your friendships... it is a mental disorder that takes YEARS to sort out. You are potentially in a position to talk some sense into yourself before you spiral out of control. Take that opportunity for your loved ones sakes. You want to be in control of your eating because you feel you lack control in other areas of your life? Believe me, it will control you.

You have the full force of medical opinion saying you are healthy at the weight you are. If you have issues about self-esteem and self confidence that you are linking to your weight loss, trust me, it isn't further weight loss you need, it is rational discussion with a trained psychotherapist.