Do I have Anorexia Nervosa?

Hi Samsam,

Sorry to hear about your difficulties, it must be hard for you. I must start by stating that I'm not medically trained and unable to make a diagnosis, but hopefully can offer some good advice based on my own experience and treatment.

I'm really sorry to hear about your GP's response, it is unacceptable and unfortunately demonstrates the lack of training amongst the medical profession on eating disorders. Unfortunately your case is one that is far too common. You've taken a really brave step talking to your GP, and you should be incredibly proud of yourself for doing this. I understand that your experience was difficult, but I would really encourage you to visit your GP again to chat this through. Is there someone else at your surgery who you can see? If you do decide to go again, check out Beat's (the UK's eating disorder charity) website as there are some really fantastic resources on there including a leaflet to take with you to a GP appointment with guidance on what they should do. There is actually official guidance by an official NHS body called NICE who provide guidance on pretty much everything health related. In the eating disorder guidance (published last year) the wording is that "if an eating disorder is suspected, patients should be referred to appropriate services without delay", although difficult it's something to point out to your GP. 

Your experience regarding needing to be a lower weight to be treated seriously is also very common. I can completely relate to this too. Can I ask if you are under or over 18, it does make a difference in terms of your next steps? Under the same NICE guidance, BMI should not be used as a sole criteria for providing treatment and the guidance also informs what type of treatment a patient should be entitled to, based on their diagnosis. When I was told that my weight wasn't low enough to receive treatment for my eating disorder, it fired me up and I put in a formal complaint. I also got my MP involved who to this day hasn't forgotten my case and turned up at a key Parliamentary event on the subject to learn more about eating disorders because she'd been inspired by me, so it's definitely worth raising this issue with them.

I want to make you aware that eating disorders aren't about being thin, in fact many sufferers can be very very poorly and be at a healthy weight. Not being underweight (although the measurements you've provided would indicate that you are) doesn't mean your issue isn't as serious as someone who is, your struggles are real and you deserve to have treatment.

One thing which is worth considering is why you are feeling this way, and if anything has happened that might cause you to want to do this. Everyone is different, but there is often some kind of psychological and/or sociological cause. It may be worth keeping a mood diary which tracks how you are feeling and what action you take. For example, some people (without eating disorders as well!) might have had a rubbish day at work or school and come home and eat a bar of chocolate, or have a large glass of wine etc. For me my struggles really started as a result of struggling to fit in at secondary school. I had also started my period so arrived at school larger than the other girls who were pre-adolescent. When you feel excluded you blame stuff and I blamed me and my weight. This was made worse by a boy who I fancied calling me fat. I then (completely unrelated) was diagnosed with epilepsy and my initial medication caused me to gain a lot of weight, making things even worse. I hid my eating disorder from my parents for years, which I thoroughly regret, because I lost so much of my life as a result, and by the time they did find out, I required hospitalisation and nearly died. Trust me you do not ever want to be on an inpatient unit. It's hell. I find triggers to be situations where I feel out of control/can't escape a situation and usually it's because of people being manipulative. Knowing my triggers is extremely helpful because it means I'm prepared for things to be difficult so then can put in place my various positive coping mechanisms and ensure I utilise the reasonable adjustments for me at work e.g. I will work from home. Thankfully my work is really supportive, but I have had a complete contrast in a previous job.

It's great that you've pointed out weight fluctuations around time of the month. I have horrendous fluctuations which I've grown to accept. My target weight band includes a 1kg extension because of this, and it helps me feel ok that I'm not over my weight band. But weight fluctuates all day, every day, so it's good not to weigh yourself too often. It's also great to hear you mention bingeing. It took me years to come to terms with the fact that happened and when eventually I did broach it with a dietitian he said to me "of course you do, it's a biological survival mechanism". My diagnosis is anorexia too, and your body's natural response to starvation i.e. danger is to protect itself. In the past that would be hunting down the nearest food source, now of course it is accessing energy as quickly as possible through snacks like chocolate and crisps. We wouldn't be alive as a race if we weren't programmed to do this. Hard as it seems, eating balanced meals consistently will help this (especially including carbs and fats!!!), but I know you this is easier said than done and this is where support is valuable.

Beat (mentioned above) are a fantastic charity and provide amazing support services. Their helpline is open every day of the year and is free and confidential. If phoning someone is difficult they have 1-2-1 online chat, email support and twitter support. They also run themed online support groups every day.

I hope some of this helps. It does sound like you have an eating disorder, but I'm not a medical professional. Either way, something isn't right and you deserve to get the help you need. Recovery is possible and is easier the sooner it happens. Here if you want to chat.

Dear Samsam,

I'm so sorry to hear you're struggling with this. Unfortunately, there is a lot of weight bias when it comes to support for eating disorder recovery. However, I would have hoped your GP would have given more helpful advice for your mental wellbeing.

A wonderful resource that can help you understand whether or not you are suffering from an eating disorder is NEDA's online screening tool; https://www.nationaleatingdisorders.org/screening-tool.

BEAT is the UK support charity for eating disorders. They have a helpline that you can call.  https://www.beateatingdisorders.org.uk

You've taken the first bold step in asking for help. 

Let us know how you get on.

Best wishes,

Kaysha