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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by Dr. Bob on March 11, 2005, at 11:29:30
Hi, everyone,
I'm pleased to announce that Elizabeth Steinhauer, MD, Assistant Professor of Psychiatry here at the University of Chicago, has volunteered again to be our guest expert on eating disorders for a week (until March 18).
If you have any questions for her, just post them here with "Steinhauer: " at the beginning of the subject line to flag them.
Discussion about the how this works -- or doesn't -- is welcome, but should take place at Psycho-Babble Administration.
OK, any questions? :-)
Bob
----
The participation of a guest expert is intended to provide information and not advice. Her responses should not be considered diagnosis or treatment. She may suggest an option to consider, but do not infer that her professional opinion is that you personally should choose that option.
During the past 24 months, she has not been a full-time employee of any commercial organization that had an interest in the topics she will be commenting on, and neither she nor any immediate family member has had a significant financial interest in or affiliation with one.
Posted by B2chica on March 11, 2005, at 17:55:51
In reply to Steinhauer: Guest expert on eating disorders, posted by Dr. Bob on March 11, 2005, at 11:29:30
they've tagged me with an ED label.
i agree in a sense that yes i have issues. but i don't think i'm fat, i don't have loosing weight in mind. no body image issues.
of course there are control issues but mostly if i restrict or abuse lax it's because of this 'process'.
1. it disgusts me to see people shovel this "matter" into an orafice of their body, heck why the mouth-why solid foods why can't we drink with fluidity our sustanance?2.the design of the human body is so intricate, everything has it's purpose. but it seems that we should be self sustaining.
3.is eating the fatal flaw of humanities design?
4.everything that should go into this whole in my head feels so unnatural that i want it out as soon as possible. due to some medication i stumbled onto use of laxatives and soon started abusing them finding that this eased this pressure and hatred of this 'flawed' function.
FYI-i just finally started therapy with a hopefully great psychologist.
we just talked yesterday and he and i discussed this feeling that i have-actually we had a great conversation and he 'understands' where i'm coming from (can't believe it-others view it as only a weight issue-not my case).i guess i'm not sure there's a question here. but i wanted to state in writing what was going on in my corner.
due to the results it's been categorized as an eating disorder...logically it is.
But have been very suicidal and recently hospitalized because of it. i'm not sure i'm past that but moving to this issue that i'm sure has caused some permanant effects to my body, i view my labeled 'disorder' as my struggle with needs of humanity and my lack of wanting to be a part of it.would appreciate any comments regarding my view.
(oh, and welcome to babble!)
b2c.
Posted by Maxime on March 12, 2005, at 16:09:46
In reply to Steinhauer: Guest expert on eating disorders, posted by Dr. Bob on March 11, 2005, at 11:29:30
Dear Dr. Steinhauer:
Thank you for volunteering to answer more questions regarding eating disorders.
I am a 36 year old female who has suffered from anorexia since I was 12. I have always restricted, although I have abused laxative in the past.
Right now I am a normal weight. Yet I am only consuming 500 calories a day. I can't lose weight.
I don't understand how my weight stays the same when consuming so little. I do know that I have ruined my metabolism with my restricting over the years. I also have hypothyroidism ( I take Synthroid).
Is it common for people with eating disorders to develop thyroid problems? Is it possible to eat 500 calories a day and not lose weight? I wish I understood what my body is doing? I also exercise daily.
I am now tempted to start using things like Ephedra and anything else I can get my hands on to lose weight.
I am not asking you to tell me how to lose weight. But if you could explain what you think my body might be doing I would appreciate it.
Kind regards,
Maxime
Posted by Dr. Beth Steinhauer on March 12, 2005, at 16:24:32
In reply to Steinhauer-ED or not, posted by B2chica on March 11, 2005, at 17:55:51
> they've tagged me with an ED label.
> i agree in a sense that yes i have issues. but i don't think i'm fat, i don't have loosing weight in mind. no body image issues.
> of course there are control issues but mostly if i restrict or abuse lax it's because of this 'process'.
> 1. it disgusts me to see people shovel this "matter" into an orafice of their body, heck why the mouth-why solid foods why can't we drink with fluidity our sustanance?
>
> 2.the design of the human body is so intricate, everything has it's purpose. but it seems that we should be self sustaining.
>
> 3.is eating the fatal flaw of humanities design?
>
> 4.everything that should go into this whole in my head feels so unnatural that i want it out as soon as possible. due to some medication i stumbled onto use of laxatives and soon started abusing them finding that this eased this pressure and hatred of this 'flawed' function.
>
> FYI-i just finally started therapy with a hopefully great psychologist.
> we just talked yesterday and he and i discussed this feeling that i have-actually we had a great conversation and he 'understands' where i'm coming from (can't believe it-others view it as only a weight issue-not my case).
>
> i guess i'm not sure there's a question here. but i wanted to state in writing what was going on in my corner.
> due to the results it's been categorized as an eating disorder...logically it is.
> But have been very suicidal and recently hospitalized because of it. i'm not sure i'm past that but moving to this issue that i'm sure has caused some permanant effects to my body, i view my labeled 'disorder' as my struggle with needs of humanity and my lack of wanting to be a part of it.
>
> would appreciate any comments regarding my view.
> (oh, and welcome to babble!)
> b2c.Dear B2chica,
My work with people with eating disorders has taught me that there can be endless variations on why people feel uneasy about food or eating. You are not the only person with an eating disorder whose primary goal isn't weight loss or fear of fat.
I'm gratified that you've started working with a psychologist, and hope you will continue. It sounds from your description as though you feel repelled by a process that, like it or not, is built into being a human being. You are feeling embattled against your own irrefutable biological need for survival. It's analogous to someone deciding that the human being's need for sleep is loathsome, and resisting it with all their might, when sleep is simply necessary for survival and has no moral currency. Needing food for survival, like needing sleep, is neutral, neither ennobling us nor degrading us. It's a given of the human condition.
I think you are very insightful when you say that your disgust with natural bodily functions has more to do with your struggle with what it means to be alive and your uncertainty, at times, about whether you want any part of it. I believe that therapy can be helpful for you in resolving these questions. My hope for you is that, as you become more accepting of yourself, you will also feel more committed to remaining alive and healthy.
Please make sure that your psychologist as well as your medical doctors (internist/psychiatrist) are aware of your laxative use. Laxatives can cause serious medical complications, such as electrolyte imbalances, cardiac arrythmias, dehydration, and so on.
Good luck with your recovery--Dr. Steinhauer
Posted by B2chica on March 14, 2005, at 15:11:01
In reply to Re: Steinhauer-ED or not, posted by Dr. Beth Steinhauer on March 12, 2005, at 16:24:32
thank you for the great reply. i know there is a part of me that wants to be healthy, and i'll take all the info i can get.
-and yes they are both aware of the lx abuse...i feel quite comfortable and able to be open with both of them.
thank you.
b2c.
Posted by Dr. Beth Steinhauer on March 14, 2005, at 17:35:36
In reply to Steinhauer: Thyroid and metabolism with EDs, posted by Maxime on March 12, 2005, at 16:09:46
Dear Maxime,
Our bodies are biologically programmed to maintain a healthy equilibrium. This is why in response to starvation your body's metabolism slows and you are prone to conserve energy (and weight). The reverse is also true. Studies have shown that male inmates who consume significantly MORE than their usual caloric intake will gain less weight than might be expected, as their metabolism speeds up, they sweat, their heart rate speeds up, etc., in the body's automatic attempt to maintain equilibrium. This is related to "set point theory", which has been explored by many scientists.
The reason that you are not losing weight despite exercising and despite eating so restrictively is that you are being met by extreme resistance by your body, which instinctively knows better. It is defending your set point and vigorously defending against your efforts to starve yourself. Laxatives and Ephedra carry additional serious medical risks of their own, and I would strongly recommend that you avoid using them. Laxative and Ephedra abuse can be life-threatening.
Maxime, 500 calories daily constiitutes starvation. At the concentration camp of Treblinka during World War II, the Nazis determined that 800 calories per day was the MINIMIMUM needed to sustain "life" (and life, as they defined it, consisted of susceptibility to disease and infection, infertility, extreme weakness, and so on).
Your question about the relationship between hypothyroidism and your eating disorder is a good one, but an internist or endocrinologist would be more knowledgeable about this than I would.
If you are not already getting help for your eating disorder, I hope that you will do so. There are many good therapists and internists who could be of great help to you. Anorexia Nervosa can be a fatal illness in up to 20% of cases, and sufferers also are at higher risk of suicide. I hope that you are able to enlist the help that you need from family, friends, and clinicians so that you can begin to enjoy and appreciate your body, and have a more peaceable relationship with food. Best of luck--Dr. Steinhauer
Posted by montella on March 16, 2005, at 11:45:17
In reply to Steinhauer: Guest expert on eating disorders, posted by Dr. Bob on March 11, 2005, at 11:29:30
What is the difference between overeating and bingeing? Is one more of a problem than the other?
Posted by Dr. Beth Steinhauer on March 18, 2005, at 10:20:49
In reply to Steinhauer: overeating vs bingeing, posted by montella on March 16, 2005, at 11:45:17
Dear Montella,
Everyone overeats at times, whether because they're at a party with wonderful food, or vacationing in Paris, or for any other festive occasion. Overeating becomes problematic when it's done for emotional reasons or feels compulsive or out of control. While some people generally overeat at meals or snacks, i.e. consuming more than they need for nutritional purposes, binges are typically thought of as discrete episodes in which the eater feels driven and out of control. It is not uncommon for people who binge to consume 3,000 calories or more in a single episode. This may or may not be followed by attempts to purge through vomiting or other means. In other words, while overeating and bingeing can both be problematic, it is the intensity, severity and time-limited quality of a typical binge that distinguishes it from overeating.Hope this is helpful. ES
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