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Re: Totally Busted... » CareBear04

Posted by Racer on April 12, 2008, at 14:30:25

In reply to Re: Totally Busted... » Racer, posted by CareBear04 on April 11, 2008, at 23:39:33

> if your T claims to have noticed your weight loss, why didn't she point it out? i'm wondering the same thing about mine.

I think a big part of the difference between out situations is that my T is a Certified Eating Disorders Specialist, and I'm seeing her with a diagnosis of Anorexia Nervosa; your pdoc and pcp are probably not nearly as familiar with all the issues and nuances involved in eating disorders, which would be my guess for why no one has made that diagnosis for you. Or, at least, no one has made that diagnosis yet.

What you've described sounds very much as though there's a great deal of cause for concern in your case. The DSM criteria for AN includes a certain amount of ambiguity -- "refusal to maintain a minimally normal body weight," for instance, is variously defined as a BMI of 17.5 or a weight of 85% of normal. For me, the difference between those is about 7 pounds -- meaning my diagnosis would change based on which one you used. The consciousness of the intent is another one -- and most eating disorders specialists at this point don't worry about intent anymore. Amenorrhea is another issue that comes up often: no psychological differences have been found between women who experience amenorrhea and those who don't. It's one of the criteria which is most likely going to be dropped from DSM-V, according to the working group. (Some women lose their periods before they've lost a significant amount of weight; some women continue to menstruate at weights below 70% of normal. So far, no one really knows why.) The fear of becoming fat is another one -- for many anorexics, it's much less a fear of becoming fat, as an unaccountable drive for thinness. That may not sound all that different, but it is.

Anyway, sorry -- I get onto a jag, you know?

The bottom line for you, though, is that something's wrong, and it's worth working on figuring out what it is. What is behind your weight issues? I'd say you probably qualify for EDNOS, so whether or not every criteria fits for you is maybe not as vital as all that...

Good luck, whatever the outcome.


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