Give us some credit

To treatment providers:

Give us sufferers some real respect- especially when you tell us our "target weights." People with eating disorders tend to fixate on numbers, so consider it an occupational hazard. Whatever number you tell us, chances are, we won't like.

It's the nature of the disease. Any weight is too high.

You can fall back on formulas (the stereotypical 100 lbs for someone 5 ft tall, and 5 lbs for every inch over 5 feet), but those are imprecise and were originally used for target weights for runway models. It's not uncommon to find that weight a lowball target.

Instead, look at our growth charts, our behaviors and thoughts as time passes. Be honest that this is a guess, that things may change. That health is more important than a number. That we're not silly little girls and boys who need to be coddled and treated with kid gloves. We're sick, yes, but we're not stupid and we're not as frail as you might think.

And don't lowball a weight to make us "comfortable." Because that comfort will be short-lived, and the disease will continue to torture us. As someone who has been there, I can honestly say that you are doing us no favors. If we're going to freak out about weight gain, we may as well freak out on the road to ultimate health, rather than that precarious road between recovery and relapse.

If you were a surgeon, you wouldn't take out 90% of a tumor because removing the other 10% would cause an uglier scar. You'd take out the tumor and refer us to a therapist if it really bugged us. So why do you so often settle for 85% ideal body weight? Or 90%? Or 95%?

Our health and lives are at stake.

We can handle the truth.

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mary said...

This post is gold Carrie!
This is such pertinent information yet all too often ignored. Even caretakers and parents are treated with kid gloves, as if we can't handle the truth, so we really can relate. So many parents and even treatment teams think playing it safe, or giving the lowest number will make it easier. In the long run it can be quite harmful and it does something even worse, it implies that there is reason to fear that another 10-20-40 lbs.over the low target weight will be too big a burden, when fear and anxiety is what needs to be released. As you said, it's not about the number but about health. A low number often leaves the patient sick, often in secret, for a much longer time. When we are afraid of upsetting ED we are giving "it" power to decide what it wants, not allowing the person to reach a stage where their own body and mind can function well again.
"Are you feeling cozy yet, less anxious, and have you got the high pro glow and energy?" type of medicine needs to be an integral part of treatment. "Is ED still trying to voice his ugly and unwanted opinion?" These things will matter and we'll help you fight this message. Flexibility is so important and some folks are meant to be bigger, in order to be truly well, than a standard chart might indicate.
It does take practice allowing ourselves to be where we belong and mostly it's about acceptance and self love and also about forgetting oneself so we don't become our own obsession. A good sense of humor doesn't hurt.
And I know just how strong you are even when you don't. I believe *you can not only handle the truth, *you need it to recover and stay in recovery.

*(meaning anyone who's recovering or still struggling)

Gaining Back My Life said...

Hmmmm, sounds oddly familiar.

My nutritionist (who is an ed specialist) has a goal weight for me that is 10 pounds higher than what my PCP tells me I need to gain.

PCP has admitted lack of ed knowledge, so I guess I just go until my body is hapy, huh?

Carrie Arnold said...

I think, Mary, you hit the nail on the head. The lowball weights just play into the idea that there is something to be feared about health and weight.

And don't get me started on insurance companies that discharge at 85% IBW. But that's a different story.


Your best bet is to dig out some old growth charts from when you were young, and just start tracking your weight. It will give you a pretty good idea of where your weight wants to be at now.

I was lucky in a sense, that I didn't get sick until I was 19-20. I had been at an adult height and weight for almost 6 years, so my dietician just needed to take my initial weight and add a few pounds of "relapse insurance" (like 2 or 3), and it's pretty much my healthy weight.

I still don't like it, but there you have it.

Cynical Nymph said...

"gaining my life back," that sounds reeeally familiar.

By height/weight charts my doctors have used, my "ideal weight" is a full 10 lbs. under where I am now. I've fluctuated up or down about 2 pounds in the last 4 years... so... you tell me which one my body naturally wants to be at: the 10 lb. higher weight, or that chart's weight (at which point I still felt like hell warmed over)? My nutritionist was the only one to point out, over and over again, that my body would find its own set point; a magic BMI chart wouldn't do it for me.

Not that intellectually accepting this makes it any easier (ha! right!) to not castigate myself over not weighing *exactly* ten pounds less, like the chart (and my former GP) said I should.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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nour·ish: (v); to sustain with food or nutriment; supply with what is necessary for life, health, and growth; to cherish, foster, keep alive; to strengthen, build up, or promote


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