Atypical anorexia. Are you ready to recover?

Hey guys

I guess today’s post is to help me think through the concept of recovery from atypical anorexia although it can probably be applied to many other situations, not just eating disorders.

The thing is…. my current situation isn’t really about the food. Sure, the thought of food, how to avoid it, how I’m going to knock off another pound consumes almost every waking moment but things like eating disorders, alcoholism, self-harm and OCD are just the outward behavioural signs of inner turmoil.

As I’ve eluded before, I ‘get’ the logic about my situation as it links to being a carer. Focusing intently on my weight loss takes up a lot of mental space and helps me avoid focusing on the harder things. So, it serves a purpose. What I’m going to do is to look at the pros and cons of recovery. Even as I write that, I’m thinking “Erika, why wouldn’t you want to recover?!!!!” but let’s see how I get on with these lists.

The pros of recovery

  • I can become physically healthy again. I hope this is possible as I know that my organs are starting to be affected but I could possibly prevent them from at least deteriorating further
  • I can reclaim the mental space this is taking up
  • I can then refocus on adopting healthy eating patterns and fully embrace how I’ve lost over 160 lbs
  • I can stop panicking at the thought of meeting up with friends over meals as I love being with people!
  • I can take on the physical demands of things I’ve been looking forward to (which I don’t feel I can right now) like abseiling, adrenalin-filled rib boat experiences, etc.
  • I can get on with the therapeutic work that I’m mentally partly trying to avoid

The cons of recovery

  • It’s scary! If I don’t have this intent focus on all things food-related, I’m more likely to think about the painful stuff
  • I’m worried about increasing my calories in case I then can’t stop eating
  • If I can’t stop eating, I could put on all the weight
  • I don’t know how to recover

So, let’s challenge those cons:

It’s scary! If I don’t have this intent focus on all things food-related, I’m more likely to think about the painful stuff

Yes, it is scary and that’s understandable Erika. Thing is that those feelings about being a carer need to be processed and masking them isn’t going to make them go away. Talking about this stuff might be really hard but you’ve an amazing psychotherapist in place who you know you can tell anything to. Just think back to what it’s like when your mind feels free and you don’t feel trapped. You can do it, girl!

I’m worried about increasing my calories in case I then can’t stop eating

Isn’t that understandable?! You’ve lost all this weight, you’ve got a new body (including the excess skin but, meh, a small niggle). But you’ve also been doing the Noom program for 4 months and actually, despite the anorexia, you’ve been learning lots about healthy eating even if you’ve not been able to put it into practice. You’ve actually got a mental tool kit of strategies to now use. Yes, when you recovered from atypical anorexia 10 years ago, you did then put on a lot of weight but this time feels different. Apart from the carer issues, you’re in a good space overall.

If I can’t stop eating, I could put on all the weight

Check out what you wrote above, Erika. You can choose a healthy range to stay between which allows for normal fluctuations. You’ve already set this up as your body weight is 2 lbs away from being in the healthy range but you’d like to lose another 9 lbs overall so that you have some wriggle room.

I don’t know how to recover

And you don’t have to know. ‘Just eat more’ might sound SO simple but you don’t have to do this alone. You know that things have been escalated by your therapist and GP because of their concerns over physical risk so you need to pass over the control. You can’t do this any more. Keep an open mind. Listen to the eating disorder service people who have their area of expertise and work ‘with’ them. Don’t see support as something being done ‘to’ you but work with them like you’ve done with other professionals in the past. They’re just part of Team Erika and will want you to rediscover your true self.

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Gosh, that felt quite intense to write but I hope the above helps at least one person reading this, whatever their situation. In fact, the structure of pros, cons and how to challenge cons is perhaps a format for a range of ‘What shall I do?’ situations. I’m going to record myself reading the above in the next couple of days and then play it back… because I’ll then be able to hear an external voice talking to me which can feel very different to the inner one. Well, let’s see how that goes.

I’ll be back on Friday or Saturday but, until then, take care

Love Erika xx

Where am I right now with atypical anorexia?

Hey folks

So, I thought I’d give an update about where I’m at with an eating disorder that I’ve been really trying to avoid over the past 15 months whilst on this significant weight loss journey.

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For those who haven’t come across my blog before, firstly welcome! I’ve lost about 160lbs since February last year and I’m now just a matter of a few pounds away from my BMI being in the healthy range. In fact, if my excess skin was removed (and I have a LOT!), my ‘real’ weight is probably already securely well within in the healthy range. However, finding myself within the anorexic grip is impacting my heart and kidneys so things aren’t great.

Although I’m having twice-weekly psychotherapy which is just incredible for dealing with some issues around being a carer to my son (and wow do I have the best therapist!), we know that I need some intensive support to avoid ending up in an eating disorder unit or medical unit. I don’t ‘do’ hospitals at the best of times and certainly not right now with Covid. I found a place in London but they said my eating and the weight loss aren’t stable enough to access their evening programme of meal support and therapy. They feel that I need their day support to get this under control…. but I couldn’t do that until late August / early September. Referrals to eating disorder services on the NHS are an all-time high so whilst I sent an email to my GP surgery last week about being referred, I would think that support will very likely be limited unless they wanted to admit me (which I don’t want!). .. but we’ll see. I was thinking this morning that another private option would be finding a dietician with expertise around eating disorders and there’s someone not too far from me who sounds experienced and personable. But when I see my therapist later on today, he may have some news about support from another professional he works alongside.

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I’ll be really honest here. I’m really scared about where I’m at and it feels like the eating disorder has a very tight grip on me as my calories have lowered from before (it’s gone under 400 calories in the past few days). It’s not that I don’t want to eat more. I do! I look at restaurant menus and think ‘yum” whilst simultaneously mentally calculating how many calories are in the photos and how it’d be so ‘wrong’ to eat it. And it’s not the case that I won’t try to eat more. The anorexic voice is loud, making it that I can’t eat more. Eating disorders are complex, very complex, but I know that whilst I went through this 10 years ago, I had many years enjoying food, enjoying socialising so I have to hold onto the hope that I’ll beat this… but I’m struggling to hold onto the hope right now.

You know guys, let’s see what support can be put in place and perhaps maybe, just maybe, I’ll be able to blog one day with excitement that I managed to go over X number of calories in the same way that I’ve celebrated moments over the past year like no longer being morbidly obese or getting into those jeans. I’m sure there’ll be many positive posts ahead as life is good and I need to get things back on track.

I’ll be back either tomorrow or Saturday but hope you all have a good day

Love Erika xx

Coming out of lockdown… coming out to comments about weight loss – HELP!

Hey folks

My mid-week post coming a day early as it’d just be good to ‘chat’!

You know, I guess there are parts of this post that could also relate to those who’ve perhaps put on weight during the last year. Much of my life has gone remote with seeing clients online where just my shoulders and head are on show. I feel SO protected like this! I like the fact that others can’t see what lies beneath and I guess I could get very comfortable with being here…. perhaps a bit too comfortable. Virtually everyone I have seen face-to-face are either clients who see me as a one-off anyway or just random strangers if I’m out walking.

I shared last week that I’ve already had comments in the past 10 days from people who have seen me before (i.e. a pharmacy assistant and a builder) and have exclaimed “HOW much weight have you lost?” the moment they’ve laid eyes on me. The thing is that I know (or I guess) that such comments are very well intended and come from a really good place so I certainly don’t begrudge them. Even if I didn’t find myself currently battling an eating disorder, I think I’d feel some sense of awkwardness. Do I like compliments? Sometimes but not about my body. But when the two people have then gone on to ask how I’ve lost it, the last thing I want to say is “Well, you know, I’m battling atypical anorexia right now and I’m actually very poorly and my heart and kidneys aren’t doing great but, apart from that, yeah, just eating less and moving more“! People don’t need to know the truth and I don’t need to tell them. 3 friends, other than professionals, know what’s going on for me. But I feel that that once I crack the anorexic grip that’s dictating how many calories I’m eating, I will be in a better place. My understanding of eating and health have actually improved since the start of this journey. My mind has really changed in many good ways so I’m feeling positive that the weight isn’t going to go back on.

In the next few weeks, I’ll be back to a voluntary job I’ve done for 3 years (but they haven’t seen me since I was 158 lbs heavier last year), I’m bound to see family and I genuinely can’t wait to see friends. Yes, I want to reconnect with people but, you know, it would just be great if they could skate over the whole weight loss thing. But the reality is that I’m just pounds away from losing half my original body weight in 15 months and perhaps they think that I’d love a compliment! No!!!!! Please just ask how I am. Please just ask what I’ve been up to. Please just give me the choice about whether I even mention the whole body shape / weight thing… which I’m very unlikely to! But being able to blog about all of this and talking to my therapist (whom I’ve never met in the flesh since the world went remote last spring) over the next few weeks will be an enormous help. Just articulating how it leaves me feeling and processing that.

I’ll be back on Friday (I’ll try not to forget this week!) about where I am with my eating disorder. My therapist told me on Monday that there is a plan to offer me some additional support with another professional which will run alongside the work I’m doing with him. I have to say that even over the past few days, my calorie ‘limit’ has gone down further…. I won’t go into details right now and in fact I’m waiting to hear a bit more myself about this potential support but I’ll give you an honest update on Friday about where things are at.

Right, off shortly to watch the first semi-final of Eurovision 2021!

Take care all

Erika xx

Atypical anorexia… the medical results are in…

Hello guys

I think I need to take a bit of deep breath before I blog today as I’m trying to process a conversation I had with my doctor yesterday.

So, the upshot of the conversation is that I may have a problem with my heart, my kidney function is reduced, my vitamin D levels are extremely low and my folic acid levels are also extremely low. She said about prescribing tablets to increase my vitamin D and folic acid levels and the first thing that came to my mind (and which just feel out of my mouth) was “How many calories would be in those?” She said it would be next to nothing but I don’t know if I can ingest something without knowing the calories involved. My doctor seemed really concerned that I’d even have this thought and said that it’s the first time she’s come across this with anyone with anorexia or bulimia. In fact, she seemed commented about my comment a couple of times and said that this alone raised significant concern from her perspective.

So, she said that perhaps I need to be referred to the eating disorder service and the local mental health team…. but I don’t know what to do. Do I need support? What would be achieved when I’m already seeing a psychotherapist privately as I come to terms with being a carer. I’m feeling extraordinarily stuck about what help would look like. She did ask about what I felt I needed but the one thing that could potentially help me get out of this situation is something that’s not easily obtained through the health service or even privately…. meal support. Someone to help me break out of the trap of staying within so many calories… but, simultaneously, I feel really in control and I don’t want that control to be taken away. I don’t know, guys. I’ve never had physical health issues before so I’m trying to process all of this. I’m seeing my therapist on Monday so it’ll be good to talk it through.

But I’m focusing right now on drinking lots of water for the sake of my kidneys. I drink way too much Diet Coke but I’m really cutting this back to one can a day with the aim to stopping altogether. So, I suspected the results wouldn’t be okay and, unfortunately, I was right….

We’ll see what happens over the next few weeks when I undergo some more tests and try to decide if I am willing to accept help.

I’ll be back on Monday but wishing you a lovely weekend

Love Erika xx

Anorexia in the UK headlines… Nikki Grahame’s death

Hey

I guess I need to talk. There’s a news story breaking right now in the UK about Nikki Grahame, a reality TV star who first came onto the UK television screens in Big Brother series 7 (2006). She openly told her story about how she’d been fighting anorexia since she was a very young child and she bore a scar in her abdomen from when she was fed directly into her stomach. Apart from singer Karen Carpenter, gymnast Christy Henrich and singer Lena Zavaroni, Nikki’s was the one name that was synonymous with anorexia. Over the years, she sought help from many treatment providers and she was back in an eating disorder unit. But she’s lost her battle, aged 38. So much to give. So much more life to lead.

I know that my calorie intake is low right now. This isn’t some intentional crash diet. It’s not a ‘very low calorie diet’ that’s being medically supervised but there’s a huge part of me that’s being drawn to reducing, reducing, reducing, part of me that feels like it’s being controlled. That part is also feeling totally invincible because I’m functioning. I’m walking, talking, working. But there is a logical part of me that knows I’m going to crash at some point. I know I can’t survive on what I’m eating, even if a large part of me feels that I’m perfectly fine. But, yes, I’m sitting here really tearful about Nikki. She may not have thought that anorexia would eventually take her… I watched Emma Wants to Live on Amazon Prime the other night about her fight and eventual death from anorexia…. she so wanted to live too….

Although I’m not underweight, that logical part of me knows that atypical anorexia carries the same medical risks as anorexia yet my internal anorexic voice feels that risk doesn’t apply to me. I’m meeting up with my therapist on Monday (the one who’s helping me come to terms with being a carer) and I need to talk to him. I really need to cry. He’s asking me very direct questions about my eating as he can see I’m losing weight and my doctor, who knows everything, has ordered various tests for me, such as an ECG which is in just over 2 weeks’ time. Just pretty conflicted in my head right now: the invincible anorexic voice versus the one who’s worried about me….

Sorry, guys. I just needed to write about how I’m feeling. Feeling rather lonely right now…..

Love Erika xx

Week 48 weigh-in: the doctor’s made a diagnosis…

Hello folks

Here in England, today is a good day! It’s the first day for months that we’re allowed into other people’s gardens (but no more than 6 people or two households) and it’s wonderfully sunny. Definitely a good start to the week where tomorrow and Wednesday will be warmer. With a quiet week work-wise, I’m going to head out on a walk along a disused railway line through a forest which is very popular with dog walkers, cyclists and horse riders. Yes, I’ll be heading out again during daylight where I don’t feel the need to hide as much 🙂

What’s happened this week?

  • I lost 4 lbs
  • My weight’s now in the 180s
  • My BMI’s is in the lower 28s
  • I’ve now lost more than 10 stone in all (that’s more than 10 x 14 lbs)
  • I got brave in Saturday’s post and shared how the old anorexic voice is back… but hopefully I have enough insight and determination to catch this early.

What could Erika improve on?

  • Increase my calories. A large part of me feels I’m eating way too much (more about that in the moment) yet I know cognitively from experience that this is dangerous.

Erika’s next target(s) along with the big ones!

  • 1 lb until my BMI’s apparently the average for where I live
  • 3 lbs until my BMI’s in the 27s
  • 4 lbs until I’ve lost 85% of my excessive weight
  • 22 lbs until my weight’s in the healthy range (that’s just over 1.5 stone to go)
  • 29 lbs until my ultimate goal so that I have a 7 lb buffer to stay in the healthy range!

So, where am I right now with what I’m eating? I don’t know why but, in my head, I’ve become very obsessive about how many calories I should be eating and the self-imposed limit is reducing quickly. Right now, I’ve a strong need to stay under 500 calories a day. Of course, there are ‘very low calorie diets’ (VLCDs) out there where people will typically eat 600-800 calories a day or perhaps do intermittent fasting where some days are cut back drastically…. but it’s usually advised that people do these under medical supervision, such as if they need to lose weight very quickly for something like surgery. When I was in this situation before, that calorie limit reduced and reduced until I’d eat no more than 250 calories a day but my heart was affected when I was eating no more than 600 a day. So, this is where I’m at and it’s like this strong voice has a tight grip on me. But something struck me yesterday. I was thinking about my aim to get to a ‘healthy’ weight and, wow, the word healthy is really important. It’s far more than what the scales show. Whilst the anorexic voice is feeling pretty good right now as I keep my calories low, my other (much more stable) voice wants me to reach my target weight with a healthy mind and body, and is telling me to see if I can first aim to raise my calorie limit to 550… one step at a time. I hope that what I’m saying makes sense! Two competing voices in my head, each trying to dominate the other!

I had a call this morning from the doctor who’s now officially diagnosed me with atypical anorexia. She’s asked me to have an ECG and a blood pressure test taken lying down and then immediately standing up because of some symptoms I’m getting relating to postural hypotension. That’s not until April because things at the surgery are so busy right now but she wants me to have a blood test this week. Whilst my weight is the one thing I couldn’t tell her, I did tell her my clothes size which felt scary but I did it. Small steps 🙂

I’ll be back on Wednesday about plotting our dieting histories on a time line so if you’re someone who considers themselves to be a yo-yo dieter, this post might be particularly pertinent.

Take care

Love Erika xx

Recordable weight loss since blogging:Still to lose:Current weight:BMI:
121 lbs29 lbs187 lbs28.3
Plus 21 lbs lost prior to blogging

An eating disorder or strict dieting?

Hey folks

So, since Monday at my latest weigh-in, I’ve gone a bit quiet on the blogging front. I’ve always promised to be really open with you as I venture through this rather large weight loss journey but, as my blog tag line says, it’s been a case of trying to keep it a healthy diet rather than slipping into previous eating disorder behaviour and mentality. Goodness…it’s a fine line between the two! I mean, can we be super focused on the calorie counting, the exercising, etc. whilst keeping a healthy mindset and without it becoming obsessive? Up to now, I’ve had times when it’s been really hard but I’ve been slipping in a rather large way more recently.

Where am I right now? The anorexic voice is dominant in my head and I find myself becoming terribly fearful of eating, of not having larger losses on the scales, of not exercising enough. I find myself planning how to miss meals, how to get rid of food (not in a purging way but basically not consuming all the food I’m dished up). And I guess I have two voices in my head: the side which is probably an anorexic voice (all consuming, obsessive, berating, etc) and then the other voice that’s caring and knows I could end up ill again like 10 years ago. And, as I’ve said before, it’s possible to have ‘atypical anorexia’ when your weight is average or even above average if all the other DSM5 diagnostic criteria are met. Am I there? Yes, it really pains me to admit this but I think that my strict dieting has turned the corner. 10 years ago, things got really serious when I started to have abnormal heart tracings and I’ve noticed two things recently: I can get dizzy when I stand up and I can also find my heart racing some mornings when I wake up and I’m getting out of bed. Of course, it may not be heart-related but I’ve done something that I didn’t think I’d do. Despite my intense fear of doctors, I contacted my local surgery yesterday to explain the situation and I’m waiting to hear back.

The last time I struggled with an eating disorder, I lost so much weight but I then put it all (and more) back on. And I’m worried that this will happen again. However, a difference this time is that I have therapy to help me come to terms being a carer to my child and talking things through with my therapist will hopefully help me find a way to get that healthy mindset back and be able to eat in a less restrictive, less dangerous way.

So, I feel embarrassed admitting all the above but I owe it to you readers and I owe it to myself to be upfront. How do I overcome this? I need to allow my caring voice to quieten the anorexic voice so that I stop heading down this destructive route, find a way to regain a healthy mindset, find a way to eat healthily so that I can still get to an average weight and use my story to inspire others

Hope you have a great weekend everyone and I’ll be back on Monday

Love Erika xx

When does a strict diet tip over into being an eating disorder?

Hey folks

There really seems to be a fine line between the two. A close friend has expressed concern that I’m in the grip of an eating disorder having lost a lot of weight this year and knowing that I had what would now be called ‘atypical anorexia’ in 2011-12. You can read about this (here). So, am I just super focused…or is something else going on?

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In the UK, the acronym SCOFF is used by medical practitioners to screen for the presence of possible eating disorders. Answering ‘yes’ to at least two of these questions would suggest possible anorexia or bulimia so here’s me being honest in answering each one:

1. Do you make yourself Sick because you feel uncomfortably full? No.

2. Do you worry you have lost Control over how much you eat? No.

3. Have you recently lost more than One stone in a three month period? One stone is the equivalent of 14lbs so yes…but my starting weight was very high? At the same time, I’ve lost more than the recommended 1-2 lbs a week and I’m jumping on the scales probably far more than is recommended.

4. Do you believe yourself to be Fat when others say you are too thin? No…as I’m still in the obese range. I feel far bigger than my clothes size would suggest but can’t that be the case for many people going through a transformation? Does the mind need time to catch up with what’s going on with the body?

5. Would you say that Food dominates your life? Yes! All day, every day. I wake up thinking about food, I think about how to avoid situations where others, like my husband, will expect me to eat more that I want to, I take ages to go to sleep because I’m thinking about calories and, well, my Google history is full of food-related searches. So, this is a resounding yes.

So, okay, I can say ‘yes’ to two of these.

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When I was ill in 2011-12, the mental health team said that I had all the features of anorexia as I’d gone from a BMI of 43 to 27 very quickly….but I was still actually overweight. They could see that day-to-day life was consumed with all things food-related and almost this obsession about losing that next pound on the scales. They could also see how my heart QT’s interval was becoming prolonged with regular heart tracings. The term ‘atypical anorexia’, which was added when the DSM-5 was published in 2013, basically means that the criteria for anorexia is met except that the person can be ‘normal’ weight or even overweight. So, I think it’s safe to say that this would have been my diagnosis at the time if it existed.

As some of you know, I do have a lot of pressure at home as I’m carer to one of my adult children and so, whilst I’m always the one with a huge, beaming smile, I know there’s a lot of sadness going on right now. So, am I struggling to sometimes eat enough because I’m tired and perhaps struggling as a carer or have I turned to being rather strict because eating and losing weight is something that I can control in life? I’ve decided to pursue some therapy to explore this so I’m hoping that will start in the next few weeks. But returning to my original question ‘When does a strict diet tip over into being an eating disorder?’, I guess this can happen when thoughts about food and losing weight permeate into almost every aspect of life. I’m having days when I feel almost scared of eating so I know I need to challenge my thinking around food to stay well. So, in answering this question, I’m going to have to get back to you. I’ve always been (and I’ll continue to be) open with you.

I hope you have a super weekend. I’m seeing my parents this weekend which is the first time for about 7 months due to Covid so I can’t wait. And I’ll be back on Monday with my next weigh-in

Love Erika xx