Please take this with a grain of salt. This is my personal opinion and experience. I have a lot of issues, I'm an older person (at least for what it's considered old in the ed community) who presents female while being neurodivergent. I currently sit at an overweight bmi post pregnancy and attempted recovery on my own, and I have been sick for many many years. I do not present like the majority of cases.
I want to emphasize I did NOT feel shamed by my weight. She did not make any remarks about my weight at all. She did not mean any harm at all. I simply don't know how to explain what happened. So I will talk about weight and numbers. Be warned.
EDIT: edited name out for privacy
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B is a very sweet person. However we were not a match. It might be my case is a bit complex. I feel she needs more training in eating disorders beyond what's on the books. I was a little... baffled at her attempt to diagnose me with something. For some reason she was very insistent on diagnosing me with bulimia despite being told I do not binge or purge. Ever. Maybe she thought I was lying? Maybe she thought I have binge restrict cycles (I dont). When I reminded her of this she... told me it was restrictive bulimia. without binging. yeah... Quiz time! What does the word bulimia mean? 3 2 1 oops, time's up! The answer was "ox hunger", as in, nervous over eating. Your bonus prize for not knowing is pain. Just kidding! It's knowledge. Nobody knows everything. Better luck next time! (I felt bad for this, she looked like she felt bad for what she said. But... what if I had been a susceptible teen, and someone insisted I actually have a disorder that involves binging when I'm quite literally starving? Translates to "you need to starve harder" in disorderspeech. These illnesses kill people every hour. Yes it's always that serious. From the beggining to the end.)
She says she worked on a treatment center, so she probably saw the worst of the worst, the ones that fit the exact dsm criteria and are medically compromised in an obvious way. You really don't have to assess the risk. You know they are dying. They are at the end. But people of all sizes, colors, gender and social status have eating disorders. Anorexics not only eat healthy food either. At my lowest adult weight I lived off instant ramen and red bull. Fat red bull. I was also severely underweight. Why choke down nasty food when you're eating so little? lol
An anorexic patient should not be declared cured once they weight restore. Maybe their diagnosis can change. But would you diagnose such a person with BED while they go through extreme hunger after literal starvation? Not everyone experiences the "fog lift" people get when they weight restore. Some people weight restore fast and their psyche lags behind. It's unfair to call these people cured. Why, I ask, do we need to get so sick we're on the brink of death to receive appropriate help? Why then and only then do professionals get shocked and frustrated EDs have such a high rate of relapse? Why are we labeled difficult after this like it's our fault? It's hilarious how they go and publish academic papers wondering why relapse is so common and why SEED becomes a thing, and like AN is sooooooo treatment resistant. Big mystery we got here, folks! Solve it to win the big prize! (spoilers: it's more anorexia. It's tube. feeding. time!)
And yes, people who are bigger or healthy weight can have restrictive eating disorders (not necessarily anorexia. osfed is a thing. arfid is a thing though it's debatable if it counts as restrictive). The times in my life I've been weight restored (few) are because... I was happy, and let go of my illness. It was not binge eating. I kept eating my balanced meals. Just ate more. That's how weight gain works. Anything over your tdee will make you gain weight. Yes even vegetables. "You can't eat 1500 calories worth of veggies and fruit a day" lol watch me ;) (my tdee is tiny for years of muscle loss. I do not have the confidence to increase my intake. I'm aware I eat too little. No way my tdee is under 1200. But it's around there. I just can't stop restricting. Plus I'm short)
Assumptions about people with eating disorders are incredibly damaging and so are misdiagnoses. It's less damaging to give a generic osfed diagnosis that insists someone has bulimia or bed if they do not binge or purge. frankly even just a depression diagnosis or something is less damaging if we're talking about insurance demands.
Again this isn't personal, just the thoughts of a tired person. Don't get me wrong, she is a very kind person, and she seems to care deeply. I hope something could be learned from our interaction. Or maybe she thinks I'm a nutcase or a diagnosis seeker ana butterfly (no offense to butterflies). I kid I kid. I don't like assuming things. I hope all of you the best.
I'm sure she'll be a great match for other people. She really is a lovely person. nobody is perfect. read more