Sunday, 26 October 2014

Does Size Matter-I am not "skinny"..can I be anorexic?

Does Size matter?
I am not skinny......can I be anorexic?

For some of you it might sound unbelievable, but eating disorder sufferers come in many different shape and size. 

Yes, you can be suffering from anorexia even if you do not look skinny. And you can appear to be over weight and still fighting with anorexia. You can look "normal" (whatever normal is ) and struggle with bulimia, anorexia, orthorexia, night eating syndrome...just to name a few. 

According to DMS-V ( Diagnostic and Statistics Manual of Mental Disorders) some of the characteristics of anorexia in relations to weight is : "restriction of energy intake relative to requirements, leading to a significant low body weight in the context of age, sex, development trajectory and physical health.  Significantly low weight is defined as weight that is less than minimal or for children and adolescents less than that minimally expected.

Just examining the meaning of, the significantly low weight is obvious that it is not clearly defined and somewhat vague. 
However, professionals do follow the manual and those who suffer from anorexia but do not fit the "significantly low weight box", are not considered ill enough to be treated...that means they are put into the competing realm ( in this case competing with the DSM-V definition)... Badly enough anorexia is a competitive illness...even if the person does not compete with another person, they compete with themselves. Because the "anorectic voice" tells them that they are never thin enough, never starved enough...basically, nothing is ever enough for anorexia.

I remember back in my days when I was living with anorexia, that I was asked by my therapist to name the person I follow as an example. The person I want to look-alike.
I could not named one. I have never been interested in fashion, nor was I ever interested in anybody's look. I have always been a thin person and it was more often annoying than anything else.... My therapist who was, of course, treating me from a text book, was startled and even looked uncomfortable as I did not seem to fit the "box". I could almost read the question on her face :"Can she be really anorexic?" 
As a matter of fact I didn't fit most of the boxes...at the beginning of my illness, I didn't count calories, nor did I exercise excessively, nor did my  diet went wrong...etc.

I truly believe that the expectations of fulfilling the criteria for anorexia is making matters worse...and those sufferers who for example made some progress in their recovery, on their own, and reached a "normal weight" but are desperate for help because they don't know how to achieve complete freedom. Nor do they know how to deal with the "anorexic voice".These dear people are left alone. And if they want to be taken seriously, the only choice they have is to achieve a significantly low weight.

On my journey towards recovery, I have experienced hopelessness many times, and I I would have wished to have some help. I clearly remember the day when I was maintaining, a "healthy weight" but the anorexic voice did not seize to torment me. Every minute of my existence was filled with anorexia's endless demands. My head buzzed, I felt dizzy....confused and exhausted up to the point that I have contemplated taking my own life. However, I have pulled it through alone, but that is exactly, why I do not want others to have to go through this alone.

You can have a "normal weight", but still being tormented by anorexia. And the truth of the matter is, no matter what size you are, anorexia is no joke. Living with this illness is debilitating, devastating and very lonely.

Therefore, size does not matter in determining how anorexic you are, there is no level. If you have anorexia, you have anorexia.

Here is a question for us professionals who are here to help sufferers. Should we wait for those clients who fit with DSM-V characteristics of anorexia? Should we wait and only help those who fit into the "box". Or should we let our clients to be our teachers and teach us about how uniquely they experience the illness, regardless of shape and size and how many boxes we can tick, and help them at the stage where they are at? 

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