Gosh, quite a bit has happened over the past couple of days. As I mentioned on Monday, I was having an appointment later that day with a specialist eating disorder dietitian. With the appointment booked for 90 minutes, I assumed we’d run out of things to talk about but no! We covered a lot.
Reflecting back, I guess there were 3 parts to the appointment:
- How I’ve got to the point of being diagnosed with atypical anorexia
- What impact is this having on my body
- What plan can we put together towards recovery (the scariest part!)
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The first part was quite straightforward and, in some ways, it was helpful to hear that my need to exert some control over my intake makes sense when I deal with a very challenging carer situation at home day in day out.
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The second part was a massive eye opener and the main things that have stuck in my memory are:
- If menopausal, this is the time a woman is most likely to have a heart attack. And if I’m eating very little, that’s going to put more strain on my heart
- If I’m not eating anywhere enough, that’ll explain why my trips to the loo are weeks apart! Yes, she asked me about poo! That’s not a conversation I thought I’d be having and oh was I embarrassed!!! But she said that eating very little means the food is just sitting on top of what’s already in my system whereas I need a good amount of intake to work like a plunger and clear me out. I know, TMI!
- If my body is holding onto things that should have passed through, eating is going to feel uncomfortable. So, there’s even more reason to clear myself by eating a lot more as the uncomfortable feeling will stop at some point.
- If I’m contemplating horse riding, I need a DEXA scan as I’m at risk anyway with a family history of osteoporosis otherwise a break could be more serious. I did have a DEXA scan 10 years ago when I last had an eating disorder but I freaked out back then when I was asked to get on the scales. The dietitian said that when asking for a referral, I can ask that there’s a note about not being weighed.
- My body will stop at some point. She said that, yes, I’m functioning but I’m not going to stay in this functioning zone for much longer…. and she said that as I’d mentioned my BMI is in the healthy range, my focus should be about maintaining though she also said I’m bound to still lose more until I get my calories up more. She said there’s no reason to be trying to lose weight (especially if I’m carrying so much excess skin) and this is all about being healthy and not putting my life more at risk.
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The third part was hard (I knew it was coming) though she struck the balance between being supportive and very direct with me … and that’s what I needed. She said the aim should be to increase my calories by 300 a day for the next week and that I need to start this straightaway. She asked if I’d like some ideas about what to eat as she could see from my food diary that what I eat is very healthy (loads of salads and vegetables) but I need to eat more. So, the plan for this week is to eat: a Nak’d bar, a portion of Greek yoghurt and 3 tablespoons of raspberries. Now, I’ll admit that I freaked out a bit and when I bought these items last night, I went for the 0% fat yoghurt rather than the one she suggested and I looked for the lowest calories Nak’d bar on the shelf…. and that’s the anorexic voice feeling very scared. And I did eat more yesterday. I did get my calories up by 200 (to 585) but I felt horrible. My body felt so uncomfortable and it’s the sense of having to do this every single day that feels overwhelming. My first instinct is to cut back today… so this is going to be a battle for a while…. but that 90 minute appointment was so much more useful than I could have imagined.
So, I feel like I’m at the beginning of a very long journey but at least I’m on it and I’ll have another appointment with her in 3 weeks’ time. She was truly worth every penny.
Right, back to work for me but hope you’re all doing okay and I hope to check in over the next few days to see if I’m still managing to stay off the scales. My therapist said to me the other day that I’m brave confronting all of this. I don’t feel brave at all but I guess when there’re competing voices wanting to restrict versus wanting to recover, perhaps I’ll see that I’m having to dig incredibly deep to make progress.
Love Erika xx