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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 13 of 13. This is the beginning of the thread.
Posted by need2change on April 22, 2006, at 16:30:34
I have been struggling with anorexia and some bulimia for several years now. I have been inpatient five times, and I continually go back to my illness. Sometimes I'll do better for a while and then I fall back into restricting, purging, and losing weight. It has become my whole life, identity, and has cost me so much of my life. How do any of you get motivated to get well and stay well? How do you move on with you life? I have tried and tried with little or no success.
Posted by Racer on April 22, 2006, at 16:51:49
In reply to How do I get motivated to recover?, posted by need2change on April 22, 2006, at 16:30:34
I don't know. I do know that there are more times now when I want to eat, when I question why I still go back to restricting, but I can't say that I eat even nearly normally -- and I certainly can't say that my weight isn't making me nuts. (I'm within normal range right now, and can't seem to lose any weight. It's horrible, and I go through periods I just want to stop eating altogether until I'm thin again.)
Therapy helps, with a therapist who has training and experience in eating disorders. Mine is a Certified Eating Disorders Specialist, with a lot of years of experience with this. That helps.
How old are you? How long have you been in this maze? And what sort of treatment have you had, besides just the hospitals? Any outpatient treatment, especially therapy that is NOT CBT? (not that I have an opinion about that...)
Some support groups can be helpful -- I really liekd the ANAD group I went to. You can search at ANAD.org, and see what they've got going in your area.
I'm sorry I can't help any more than that.
Posted by need2change on April 23, 2006, at 19:15:50
In reply to Re: How do I get motivated to recover?, posted by Racer on April 22, 2006, at 16:51:49
Racer,
Thank you for your response. I am 26 years old. I have been seeing a psychologist who is well-known in the eating disorder field for eight years, and she is wonderful. My condition is not due to her lack of knowledge or skills. I know it is all me. I haven't been to an e.d. support group in about three years, because I get too competitive and triggered by other anorexics. I think a lot of people with anorexia are like that - feeling the need to be the thinnest and sickest.
Although CBT has been shown by much research to be very effective for people with anxiety, depression, bulimia, etc., it has not been shown to be very effective in helping people with anorexia. I have tried and tried to change my negative and irrational thoughts, but they still haunt me everyday. I have tried numerous medications for my OCD, but it hasn't ever helped my anorexic obsessive thoughts. It is so frustrating!
I think that the best thing is to find things that you value outside of your eating disorder. Sometimes it works for me. I must have something that I truly care about each day that "trumps" my e.d. There isn't too much that does, though. I want to find passion for life!
Racer, tell me more about you and what kind of support you need.
Posted by Racer on April 23, 2006, at 20:30:23
In reply to Re: How do I get motivated to recover?, posted by need2change on April 23, 2006, at 19:15:50
>
> Although CBT has been shown by much research to be very effective for people with anxiety, depression, bulimia, etc., it has not been shown to be very effective in helping people with anorexia.LOL! It's actually been shown, in a couple of studies I've read, to be LESS effective than other models in AN...
I've seen a couple of CBT types, and each time have started restricting more. There's something about the whole, "It's entirely up to you, if you work hard enough, you'll feel great!" thing that just sets me off. And I'd bet you understand that. Several women in the ANAD group I went to had been in CBT and gotten "better" -- only to relapse, badly, not long after ending therapy.
Anyway, you asked about me? What do I need? I need to lose 20 pounds, or I swear I will never leave the house again. Other than that, which probably tells you something about where I am in recovery -- my weight is up, but my brain is still stuck -- I'm middle aged, been seeing my current T for nearly a year now, and really like her. She's CEDS, which was important to me when I was looking. (I'd been trying out Ts from the various ED referral lists, and just NOT having good luck, so my RD told me to look for CEDS, and it has worked out well for me.) I'm also in one of her ED groups, which is very helpful. I'm the only restricter there, though, which is weird. Everyone else talks about the shame involved in being bulimic, in purging, and I can't share that with them. I've still got that "AN made me special, I showed I was stronger, had more willpower, whatever" voice going on inside me. I miss a lot of things about it -- mostly, the energy. I hardly get anything done anymore, and I feel quite ashamed of that.
But, with my weight back, I can do some things I probably couldn't have done before. I've registered for some classes, and am rather enjoying them. (It's weird, though, because everyone is SO much younger than I. The instructor of one class is younger than I am!) It's also a problem, though, because I still get obsessive, and grades are a problem for me... (As in they have to be Good Enough...)
Oh, and I have two cats and am married... (naw, don't read anything into the order there... ;-) )
Posted by cloudydaze on June 25, 2006, at 19:44:59
In reply to How do I get motivated to recover?, posted by need2change on April 22, 2006, at 16:30:34
What helped me to recover from anorexia was the fact that I wanted so much to be healthy - for myself, and the ones I love. I had to force myself to eat when i was pregnant with my daughter, because i loved her so much. I wanted a healthy child, and i got one VERY healthy 8 lb baby!
The first step for me is realizing I wasn't fat. A size 2 is far from fat...but i saw myself that way. It took lots of other people telling me I was NOT fat for me to believe I had a problem. I remember when I was in inpatient treatment, my doc told me to draw a picture of myself on the dry-erase board. I drew a plump girl. Then, the doc asked another person in the class to draw a pic of me. They drew a stick figure. It was a revelation for me, for some reason.
Eating disorders are often a lifelong struggle, but they can be beaten, with willpower, and a good support system.
I went to a support group for awhile, and it helped, because I saw other people twice my age there who were very obviously anorexic. I then made a decision that I didn't want to be like that,(sick) years later. That's really when my recovery started.
The best thing to do is to eat small meals, several times a day. If you've had an ED for a long time, it's gonna take awhile to work up to eating normally. If you try to eat 2000 calories a day right away, you could end up making yourself ill.
Posted by ElaineM on June 26, 2006, at 15:55:52
In reply to Re: How do I get motivated to recover?, posted by cloudydaze on June 25, 2006, at 19:44:59
Hi, I'm in my twenties too, and have been inpatient three times. (which I sometimes think made me worse - competition) Also, I tried a self-help group before "official" treatment. The problem I found with that was that I was the thinnest there. This particular group consisted more of people who were not emaciated (though a few were very sick otherwise), and people more like myself now. That is, people who either weren't well below the minimum medically safe weight, or (like me now) those who had gained weight back and were trying to lose it again. It seemed very counterproductive to me then. But it works well for some.
I was caught in the cycle of forcing the weight on, and madly taking in off after. I spent most of the past five years of my life in hospitals. The thing that made me recover was, after all this assult on my body (or mind, or both) I got sick with a medical illness (sorry, I don't like naming it) that made it virtually IMPOSSIBLE to exercise and restrict. So, whether I wanted it or not, the weight came back full force. I'm not big now (maybe a six or eight) but I can't stand knowing that I didn't get to choose to get rid of the anorexia myself. It feels like it was taken from me.
I have known a lot of people who got healthy because they were pregnant. And one woman got a job that she was really wanting, and fell inlove with that, instead of needing to be smaller. I kept alot of weight on before to get back into university.
I realize that I may be speaking with a hypocrite's voice but, I wish I had known then that other things I was taking for granted were so much more important than wearing kids clothes. Right now I'd rather be able to do everyday functions properly. But then, who's to say that I wouldn't break out old habits if my health suddenly became normal and stable.
I do think that if you can fill your life with as much other happiness, you won't need to rely on weight control to take the place. (but that's me) I've rarely been happy, but the times that I was, my weight stayed relatively stable.
I also think putting weight on slowly helps. (And I think moderate, safe amounts of muscle building exercises would've helped with the distribution, and confidence, the times I had to weight-restore in hospitals. Though if exercise is a symptom it'd probably be better not to). I think it's most important to slowly increase your tolerance to new ways of controlling symptoms, and new foods.
I wish I knew the answer to your question. I guess I'd just say don't give up. It sounds stupid, but keep trying. I found that despair is toxic, and there's alot of that with EDs. (At my sickest, I lost my heart and will long before my body gave out.) And then just know that others have done it. True, they seem few (and I didn't believe it ever happened until I saw some women a few years after I'd been in treatment with them) but they exist.
The fact that you're even wanting to find the motivation you need, is a good step.Good luck, Elaine
Posted by need2change on June 27, 2006, at 5:24:08
In reply to Re: How do I get motivated to recover?, posted by ElaineM on June 26, 2006, at 15:55:52
Elaine,
Thank you so much for sharing your story. I do agree with you that it is important to find other things in your life that you enjoy and are more passionate about than your e.d. I know that each and every day I must find something, whatever it is, to "trump" my e.d. behavior. Sometimes I actually do find something. I just wish that I had passion for life. I feel like I have lost interest in most everything.
I do truly appreciate everybody's feedback. This is something I keep struggling with and need as much encouragement as possible. Hearing from others who have been there is more helpful than anything.
Thank you.
Posted by cloudydaze on June 28, 2006, at 14:22:08
In reply to Re: How do I get motivated to recover?, posted by ElaineM on June 26, 2006, at 15:55:52
> Hi, I'm in my twenties too, and have been inpatient three times. (which I sometimes think made me worse - competition) Also, I tried a self-help group before "official" treatment. The problem I found with that was that I was the thinnest there.
* This was the opposite for me...I was probably the youngest in my support group, and probably the "healthiest" - that is, my ED was not in it's advanced stages. Lucky for me, I was treated early.
I say that now - but I was angry at my parents for forcing me into inpatient treatment. The treatment itself was problematic. First of all, they forced me to gain weight, which really wasn't needed ( I was far from skeletal). And they prohibited me from exercise, because I might burn calories. At this particular hospital, everyone was required to get up in the morning and do aerobics as a group - I was left out of that. I thhink the exercise could have done me some good. Also, when I gained 5 pounds, they decided i was healthy enough to go home - before i felt emotioanlly ready. As a result, it took me a lot longer to fully recover than i think it should have.
> It feels like it was taken from me.* be careful of that feeling. I felt that way too at first. It almost caused a total relapse. In fact, I think that if I hadn't gotten pregnant, I'd still be anorexic. Maybe things happen for a reason?
Need2change - i wish you the best of luck - hang in there and don't give up.
Elaine - you give good advice - sounds like you've really been there.
Posted by ElaineM on June 30, 2006, at 22:37:34
In reply to Re: How do I get motivated to recover?, posted by cloudydaze on June 28, 2006, at 14:22:08
Cloudy, It was very good of your parents to step in in the early stages. (My parents were in denial, and angry with me for a long time - they've never been a support that way.) You only get deeper and deeper into the disorder the longer treatment is delayed. I get flashbacks of the "refeeding" rules when you mention that you had to gain weight even though you "weren't skeletal". So many women had problems with that. Usually they make sure everyone is at the minimum "low-end" of their weight range. It's maddening to see how closely they stick to rules like that, but that is where the power of behaviour modification is found I guess. The rules have to be stronger than the disease, and what-not. (You're probably sick of hearing that one, right) Though I have my criticisms of B.Mod., I can understand it theoretically now, at least.
One of my biggest critiques was the not allowing a small amount of monitored muscle-building exercises. It's a tough line I guess cause exercise is a slippery slope, especially when it's a symptom. Three times I've had to gain 35lbs, and I strongly believe I would've done so much better upon discharge if I had even the smallest bit of confidence in my new, "healthier" body. They say all the weight re-distributes throughout the body with time, but to a scared, newly weight-restored person, expecting them to bravely wait it out, is often too much. Recovery doesn't even get a chance.
I do take what you said, about there being a danger in missing the disorder, very seriously. I think it will always be something I fight. My perception of food and my body has been tinted permanently. It took a long time for me to get over the despair that I "ruined my logic", that you "can't go back in time". I've stopped mourning the presense of thoughts like that, and just try to fight them whenever they come up.
What a blessing that you were able to have a child. I too think I would've probably relapsed again, if I hadn't become medically ill (ironically enough, with something completely unrelated to the anorexia).
It's nice to hear that you've been able to fight the disorder.
Take care, Elaine
Posted by cloudydaze on July 16, 2006, at 22:46:37
In reply to Re: How do I get motivated to recover? » cloudydaze, posted by ElaineM on June 30, 2006, at 22:37:34
Yes, i am glad now that my parents were there for me.
Right now i'm at the opposite end of the spectrum, struggling to lose lots of weight, because i am now clinically overweight, to the point it's affecting my health (high cholestrol being one problem). Sometimes I think Behavior modification worked too well? I guess my eating disorder has been reversed! I know that medications caused some of the weight gain - I can blame about 40 pounds on Depakote and zyprexa...but honestly i have no clue how i ended up overweight. Well technically i know it was from bad diet and lack of exercise, but being depressed helped it along.
But now i'm faced with the biggest struggle of all - losing weight without starving myself. It's new territory for me, and i know it would be really easy to slip back into my old habits...but i know i can't. Problem is, right now i'm not so sure i'm going to succeed. I don't know if its possible. I suppose i will find out.
> Cloudy, It was very good of your parents to step in in the early stages. (My parents were in denial, and angry with me for a long time - they've never been a support that way.) You only get deeper and deeper into the disorder the longer treatment is delayed. I get flashbacks of the "refeeding" rules when you mention that you had to gain weight even though you "weren't skeletal". So many women had problems with that. Usually they make sure everyone is at the minimum "low-end" of their weight range. It's maddening to see how closely they stick to rules like that, but that is where the power of behaviour modification is found I guess. The rules have to be stronger than the disease, and what-not. (You're probably sick of hearing that one, right) Though I have my criticisms of B.Mod., I can understand it theoretically now, at least.
>
> One of my biggest critiques was the not allowing a small amount of monitored muscle-building exercises. It's a tough line I guess cause exercise is a slippery slope, especially when it's a symptom. Three times I've had to gain 35lbs, and I strongly believe I would've done so much better upon discharge if I had even the smallest bit of confidence in my new, "healthier" body. They say all the weight re-distributes throughout the body with time, but to a scared, newly weight-restored person, expecting them to bravely wait it out, is often too much. Recovery doesn't even get a chance.
>
> I do take what you said, about there being a danger in missing the disorder, very seriously. I think it will always be something I fight. My perception of food and my body has been tinted permanently. It took a long time for me to get over the despair that I "ruined my logic", that you "can't go back in time". I've stopped mourning the presense of thoughts like that, and just try to fight them whenever they come up.
>
> What a blessing that you were able to have a child. I too think I would've probably relapsed again, if I hadn't become medically ill (ironically enough, with something completely unrelated to the anorexia).
>
> It's nice to hear that you've been able to fight the disorder.
>
> Take care, Elaine
Posted by need2change on July 17, 2006, at 20:17:10
In reply to Re: How do I get motivated to recover?, posted by cloudydaze on July 16, 2006, at 22:46:37
I know that Depakote and Zyprexa cause about the most weight gain of any of the psych. meds., because I also work on a psych. unit and see it all the time. So being on both at the same time probably would cause a lot of weight gain. I haven't ever been on Depakote, but I did take Zyprexa one time and it made me binge all day long. It was awful, and I felt totally out of control. That is why I only took it once. Have you talked to your doctor about trying some other meds.? Seroquel and Abilify are similar to Zyprexa and don't typically cause as much weight gain. Trileptil (spelling?) is similar to Depakote, and I don't think it typically causes as much weight gain.
I'm sure eating healthier and moderate exercise could help also, but I do know that those meds. in particular make it difficult to keep weight off. Either way, I hope that you can get and stay healthy and realize your intrinsic value whatever your weight is.
Amanda
Posted by cloudydaze on July 18, 2006, at 17:51:43
In reply to Re: How do I get motivated to recover?, posted by need2change on July 17, 2006, at 20:17:10
Oh i'm not on those meds right now...in fact i quit all my psych meds about a year ago (i think its been a year).
But I gained a lot of weight when i was on those meds, and never lost it. I am on a diet & exercise program now, and have managed to lose 15 pounds, but haven't lost any in a few weeks.
Right now my problem is that I am so out of shape that I find it difficult to get the exercise i need to lose more weight. I started having pain in one of my legs, and I think it may be a circulation problem linked to my high cholesterol (the reason I HAVE to lose weight). Now that my health is in danger, there's a lot of pressure to lose the weight. It's no longer about how i look, because I actually feel better about my body than i did when I was anorexic....
> I know that Depakote and Zyprexa cause about the most weight gain of any of the psych. meds., because I also work on a psych. unit and see it all the time. So being on both at the same time probably would cause a lot of weight gain. I haven't ever been on Depakote, but I did take Zyprexa one time and it made me binge all day long. It was awful, and I felt totally out of control. That is why I only took it once. Have you talked to your doctor about trying some other meds.? Seroquel and Abilify are similar to Zyprexa and don't typically cause as much weight gain. Trileptil (spelling?) is similar to Depakote, and I don't think it typically causes as much weight gain.
>
> I'm sure eating healthier and moderate exercise could help also, but I do know that those meds. in particular make it difficult to keep weight off. Either way, I hope that you can get and stay healthy and realize your intrinsic value whatever your weight is.
>
> Amanda
Posted by ElaineM on July 18, 2006, at 20:40:42
In reply to Re: How do I get motivated to recover?, posted by cloudydaze on July 18, 2006, at 17:51:43
> Oh i'm not on those meds right now...in fact i quit all my psych meds about a year ago (i think its been a year).
>
> But I gained a lot of weight when i was on those meds, and never lost it. I am on a diet & exercise program now, and have managed to lose 15 pounds, but haven't lost any in a few weeks.
>
> Right now my problem is that I am so out of shape that I find it difficult to get the exercise i need to lose more weight. I started having pain in one of my legs, and I think it may be a circulation problem linked to my high cholesterol (the reason I HAVE to lose weight). Now that my health is in danger, there's a lot of pressure to lose the weight. It's no longer about how i look, because I actually feel better about my body than i did when I was anorexic....
Something I've found myself, is that when I was emaciated, I lost almost all of my muscles. Then force-feeding on the weight in an environment that doesn't allow exercise, made nearly all of it come back as fat. Which is what they wanted -- what I needed (to a certain degree). Yet, depending on how many times you cycle, more muscle is lost, and none regained.I got to a point where I was still thin, but had a high percentage of body fat. Now, (although I also have an additional medical problem) I find it hard to do very basic exercise. I'm severely out of shape.
The tough thing is, if you look at it from purely a weight perspective, they would consider me healthier now, than before -- though it's anything but.
It will be difficult, but I think it's really great that you're approaching your weight loss from a health, and not appearance perspective -- You must've worked hard while recovering from your AN episode.
Keep fighting, EL
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