Overcoming an eating disorder – diagnosed with high insulin levels – what to do?

A reader writes:

i’m a fat girl who just got diagnosed with high insulin levels. i’m sorta freaking out. i’ve spent the past 2 years working really hard at rebuilding my relationship with food after a bout of bulimia. i’ve been following “the fat nutritionist” & using a lot of her tips about normal eatting & now it’s all fucked. what do i do? are there any other fatties with this medical issue? how did you guys treat it & still be okay with your body? i feel like my dr looked at me & saw fat not a person. hhhhhelp!

Psychiatrist vebally attacks patient over weight gain caused by anti-depressant

Julia writes:

I’m 22 and I have multiple mental illnesses – complex PTSD, OCD, social anxiety disorder, depression and a sleep disorder – most of which are the result of surviving rape and sexual abuse. I’ve had disordered eating for most of my life, which is currently manifesting as compulsive overeating disorder.

I had lap-band surgery in 2007 and lost a lot of weight, but my doctors kept telling me I needed to lose more. My psychiatrist told me that she thought my social phobia would go away if I achieved a ‘nice figure’. Since my metabolism has been affected by the various medications I’m on, as well as years of yo-yo dieting, it is exceedingly difficult for me to get to a BMI below 28.

My psychiatrist decided to adjust my medication 8 months ago, which caused me to start regaining weight. Since the new antidepressants didn’t work, bingeing was the only way for me to regulate my emotions in order to stay alive. I am now back on the original antidepressant, but it hasn’t been as effective since then.

I saw her a few days ago. Within the first 10 minutes she started attacking me about my weight. It started with the usual spiel about the supposed link between high weight and various diseases, but she seemed angry which was out of character for her. I calmly told her that my weight gain was mostly due to a higher dose of anti-psychotics (which I take to get to sleep). I admitted that I had been eating more, but said that if I didn’t binge I would probably kill myself. She responded by saying, “You are killing yourself” (meaning I would give myself diabetes or hypertension). I told her that I didn’t wish to discuss it any further. When she persisted, in an increasingly censorious tone, I got up to leave and told I wasn’t there to be lectured about being fat. She told me that I was being irrational and making ridiculous accusations. I have low self-esteem and am very sensitive to criticism, so this made me feel as though I’d been struck.

At this point I was sobbing and feeling like I was watching myself from outside my body. I now realise that I was having a panic attack. I thought the gate was locked and I was waiting for her to unlock it (she works from her home and has a locked gate in front of the door for security). Feeling trapped is especially triggering for me because I was raped in a locked house when I was 13. I was struggling to breathe, and being ordered to “stop hyperventilating” wasn’t helping matters. I told her, between sobs, that my problem was my trauma and not the fact that I’m fat. I also kept saying that I wanted to leave. When she asked me why I didn’t just leave, I told her that I couldn’t get out. This seemed to enrage her, and she said, “You’ve been coming here for 6 years and you know you can always open the door, you’re being ridiculous”. I didn’t know this because she is always the one to open the door and the gate and I hadn’t thought to check whether the key was in the lock (which it was).

I left feeling like my stomach had been ripped open. I don’t think I’ve ever felt so betrayed in my life. I’ve told her every detail of every trauma I have, and I trusted her completely. It’s very hard for me to trust anyone, and I’m so angry with her for making it even harder. I don’t know how she can justify what she said when she knows that I’ve been struggling with suicidal thoughts and that I’m not able to handle any more stress at the moment. I’m scared that I’ll have to either stop taking my medication when my prescription runs out or go through the hell of trying to find another psychiatrist, who most likely will turn out to be just as ignorant and judgmental as she did.

Binging? Purging? Vomiting blood? Try dieting…

Katydid writes…

Two years ago, I landed myself in the ER at around 2 AM. I’d been puking my guts up multiple times per day, every day, for months—binges, meals, mere snacks all found themselves subject to the perverse First Law of Bulimia: what goes down must come up. The night of my ER trip, as I paid homage to the porcelain goddess yet again, I found that along with my stomach contents, the toilet was filled with blood.

The doc in the ER was compassionate and thorough, if somewhat clueless about eating disorders. Aside from being somewhat anemic and dehydrated, all my tests were clear, and as I coincidentally already had an appointment with a new internist in the morning the doc apprised my internist’s office of my situation and released me.

Three hours later (approximately one of which was spent sleeping) I made my way into my new doc’s office. I explained that recently I had lost about a bunch of weight starving and puking nonstop and that now I was restricting much less but still bingeing and throwing up constantly; I told her that I’d had an active eating disorder for about four-five years and I filled in the details of the previous night’s ER episode. She asked about my highest and lowest weights—despite several times losing dramatic amounts of weight quickly and unhealthily, I’ve never been “thin,” and when I told her my highest weight, she said it was “great” that I’d lost the weight, even though I told her I’d only lost it restricting and purging.

Then she put me on the scale. I told her I didn’t want to know my weight, and that she at least respected, but then I got off and she said to me, “well, you’re overweight, but I’m sure you knew that. What are you, like five-two?” (I’m five-four, but telling her that didn’t seem to give her pause at all though it would most definitely change the point at which “overweight” came into play. I’d also now been sitting in her office waiting for about three hours, mainlining water—as per the ER doc’s stern instructions—to the point where I thought my bladder would explode and she decides to weigh me fully clothed including my SHOES and then acts like the number she has is real.)

She goes on to tell me that what she wants to do is put me on a modified Weight Watchers plan and have me come back in a month and weigh me again. (I am 5’4” and 145 pounds—which is 30 pounds less than I weighed six months ago, though I lost the bulk of it in six weeks—and I am so sick with an eating disorder I am barfing up blood and she’s talking about a DIET?!)

I tell her that I’m really not interested as I’m already working with a nutritionist. She then asks me, in a hostile tone, what exactly I want from her; I’m at a loss for words since I figure it’s pretty self-evident that, um, she’s a doctor and I want her to…monitor my health?

She takes my stupefaction as a sign that perhaps I’m looking for an amateur psychologist, as she then asks why I have an eating disorder—“were you raped or abused or something, or is this just kind of a going-off-to-college/growing up thing?”

She did not do a physical exam other than weight and blood pressure; she did not discuss the ER incident. She did not bring up the possibility that, given that I was puking blood, more tests might be necessary, nor did she discuss that though I seemed fine I was fairly anemic and had just barely avoided spending the previous night hooked to IVs. I’m not sure what level of insensitivity or stupidity you have to reach to actually think that the most important thing you can tell a 21 year old with an eating disorder is that she should lose weight. Clearly those few extra pounds I was carrying were FAR more threatening to my health than whatever other damage I was inflicting on my body.

The medical community needs a serious wake-up call: not only can there be health at a range of sizes, there can also be illness at a range of sizes. WEIGHT IS JUST A NUMBER!!!

“Of course you’re a binge eater — you’re fat!”

Michelle writes…

Once, I had a therapist for depression who assumed that I had binge-eating disorder because I am fat. It took me over a year to realize this. From the beginning of therapy, I made it clear that I was not there to talk about my weight, and it was off-limits as a topic. So, for over a year, I paid her lots of money and we never talked about my weight.

Then, while I was still in therapy for depression, I began to see a dietitian who specialized in Health At Every Size, and treated people with eating disorders. My eating was all chaotic and out-of-whack years after a bout with food restriction (aka “dieting”), and I was unhappy about it. She assessed me and told me that I did not currently have an eating disorder, binge or otherwise, though she agreed that my dieting episode, years
previously, had been on “the slippery slope” of anorexia nervosa.

Crippling pain? Try strenuous exercise!

Contadine writes…

5 years ago, at 230 pounds, I decided to go on a diet. It started off typically: planned meals, calorie journal, joining the gym. Before long, I was restricting myself to no more than 500 calories a day, and exercising upwards of 3 hours a day, 7 days a week. I was biking, running, lifting, doing yoga. I dropped 70 lbs in 5 months. Down to 160 lbs and a size 12 from a 20.

At about the 6 month point, I started having all these aches and pains. First in my wrists, then my shoulders, then my hips. Pretty soon, I was in horrible pain all the time, all over my body.

I went to the doctor to check out what was wrong. I got around 10 seconds to describe my pain. Her response? “That’s what happens to people your size. You’re putting too much pressure on your joints. Try eating less, and start exercising.” We hadn’t talked at all about my food intake or exercise routine. She handed me a flier for an Overeaters Anonymous group that met at the hospital and showed me out of the room.


Once again, an eating disorder is no excuse for not dieting

Nemohee writes…

After years of taunting and teasing by the other kids at school (who always seemed to assume that being fat also made you stupid, in addition to being ugly), I developed an eating disorder. It started out innocently at first: cutting down to 1500 calories a day, keeping a food journal, increasing my exercise, but soon it got out of hand. I was consuming NO MORE than 500 calories a day, and my poor dog nearly collapsed from the long, arduous walks I was taking him on (after which I would put him back in the yard, and proceed to exercise MORE). I was fairly proficient at hiding my low calorie intact from my parents, so they thought I was eating a healthy diet, though somewhat reduced in nature.

Naturally, I started losing weight. I lost three pounds in my first week. The next week it was four. My doctors, who had always chided me for being overweight (even going so far as to insinuate that my mother, who is heavy due to thyroid problems, was overfeeding me), were thrilled.

“Keep it up!” one responded joyously as I stepped off the scale. Never once did they stop to tell me that losing more than a pound and a half in a week was dangerous.

Three months later, I had lost enough to take me from a size 16 to a size 8. (more…)