How do I tell if a patient has an eating disorder?
How do I tell if a patient has an eating disorder or “I“ have an eating disorder? What are the main signs to look for in the way they talk about food, weight, control, etc. or “I” speak about these same topics?
I am going to start with the basics, so I will address what you need to pay attention to. I have seen patients both inside of an inpatient unit and in my office for many years who continually say to me - I don’t have a disorder, I have just found the best way I know to keep my weight the way it is. I like being a size one. I used to be a 12 and now I am a one. Let me be. I am fine. If someone says that to you (or you say that to yourself), know that you are talking with someone who is in denial (or minimizing) the truth, that she in fact does have an eating disorder. By the time they get into my office, of course I know that they have a disorder, but I also know they are going to refuse to admit it or even to allow themselves to take this opportunity to explore the possibility in depth. How come they are even in my office, at a presentation I’m giving or inside of a hospital? That’s a great question, many are only there because someone forced them to be. I have one right now who said that her husband would divorce her if she didn’t get some help. What help she keeps asking herself? She is so embedded (and I use that word advisedly) in her disorder that she finds it impossible to imagine not having the chance to eat whatever she wants and then vomit to get rid of it.
I am going to begin with bulimia and then turn to discussing anorexia.
You have an eating disorder if you are using either laxatives, vomiting, diuretics, or all of these to get rid of the food, most often an immense quantity, that you consume. Now, that doesn’t mean you do it every day, you may do it twice a week, only on week ends, or periodically, but, if you are doing it as a way to control your weight, you have a disorder. Let me say that a “disorder” means that you have a distorted view of food, a distorted perspective of what use it serves for you and a distorted perception of how much you are focused on it throughout the day (and night). Some have bulimia and are overweight because they have stopped vomiting or taking laxatives (or rarely ever did), yet still binge.
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I am going to start with the basics, so I will address what you need to pay attention to. I have seen patients both inside of an inpatient unit and in my office for many years who continually say to me - I don’t have a disorder, I have just found the best way I know to keep my weight the way it is. I like being a size one. I used to be a 12 and now I am a one. Let me be. I am fine. If someone says that to you (or you say that to yourself), know that you are talking with someone who is in denial (or minimizing) the truth, that she in fact does have an eating disorder. By the time they get into my office, of course I know that they have a disorder, but I also know they are going to refuse to admit it or even to allow themselves to take this opportunity to explore the possibility in depth. How come they are even in my office, at a presentation I’m giving or inside of a hospital? That’s a great question, many are only there because someone forced them to be. I have one right now who said that her husband would divorce her if she didn’t get some help. What help she keeps asking herself? She is so embedded (and I use that word advisedly) in her disorder that she finds it impossible to imagine not having the chance to eat whatever she wants and then vomit to get rid of it.
I am going to begin with bulimia and then turn to discussing anorexia.
You have an eating disorder if you are using either laxatives, vomiting, diuretics, or all of these to get rid of the food, most often an immense quantity, that you consume. Now, that doesn’t mean you do it every day, you may do it twice a week, only on week ends, or periodically, but, if you are doing it as a way to control your weight, you have a disorder. Let me say that a “disorder” means that you have a distorted view of food, a distorted perspective of what use it serves for you and a distorted perception of how much you are focused on it throughout the day (and night). Some have bulimia and are overweight because they have stopped vomiting or taking laxatives (or rarely ever did), yet still binge.
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