u/econroy

33F, anorexia binge/purge type for 25 years, chronic and severe. I am seeing a therapist who specializes in EDs, and today is our 4th session. So far she hasn't offered much of anything. She advised I see a dietician, which is not financially feasible even with insurance. Aside from that, she does a lot of nodding. The most feedback I've gotten out of her was a long pause and "wow, this eating disorder is a beast." She parrots back what I say with no actual point. She has yet to offer guidance toward anything tangible.

I get that I have to do the work myself but I'm going to her for help getting to a place where that feels possible. So far she has left me feeling worse and even more hopeless against the illness.

I have reached a point where my life is in shambles, I'm medically compromised, I can't differentiate between reason and delusion. I need help. Is it rude or unreasonable to ask her tonight if she has an action plan? How she helps long term, what she can offer, etc?

Thanks. Sorry if this is unreasonable.

Title, basically. I'm so far in it I've completely lost any concept of "end" or "goal." It used to be I relapsed because I wanted to be thinner. Ok, cool, got thinner. Then I kept it up because I wanted to feel safe when I decided to eat a little again....I was losing weight to create a cushion for when I decided to "ease up." Great, not unusual. Then I got to a weight I haven't seen in a while and I didn't want to immediately give it up. Right on, fair enough. Etc etc. For a while there was something every week that I had to keep the weight loss going for - not even to be thin, just to keep my body and mind in check so I could physically get through whatever function or appointment or responsibility it was. But now there aren't any more reasons. I've run out.

Now I'm just....in it to be in it. I don't like how I look, it's embarrassing. I don't like how my boyfriend looks at me or touches me - he body checks me as we watch TV. Not maliciously, and he tries not to be obvious. But it's not caressing, or petting, it's feeling. Feeling for edges and gaps and "how much has she lost since the last I saw her" kind of checking.

My mom cried yesterday. She sat across the table and cried because she said she has to watch me die. She can't separate herself from me like she did her mom and dad before they passed.

I hate using the bulimic behaviors every day. It's a routine that is very strict and I crave the first hour of it, but the rest is hell. The rest terrifies me.

My future in this disorder terrifies me. I'm 33. I don't want to be 40 or 50 or 60, emaciated, binging, vomiting. I want to be a woman with a partner and a life who cooks and gardens and reads and has interests. The problem is, I don't think even recovery will make that possible for me. I've tried before, many times. All recovery leads to for me is binge eating and a fat body and the inability to leave the house out of shame.

I'm not just addicted to the weight loss, although that's a huge factor. If I don't see that number go down every day, it's a bad day.

I'm also addicted to malnutrition. I'm addicted to my obsession with food content - tiktoks showing recipes, wieiad, "food porn" (nothing sexual, just photos of food), etc. It itches my brain in the best way. I hunker down with my phone at my desk and it gets me through the tough or slow moments at work. It would be a huge loss to gain weight and suddenly not find any of that so enamouring. It's one of the only coping skills I have.

I'm addicted to the exhaustion and the peculiar pain of not having enough fat on the bottom of my feet anymore. I'm addicted to the bruises that appear from nothing and the big vein that has been uncovered running down my left upper arm. Thats not there when I'm heavier.

I don't like how I look but I'm also convinced it's better than any alternative. Striking shock and concern is better than inspiring disgust or being off putting in appearance, which is what my body would be if I were healthier.

Idk. Round and round it goes. I keep saying I have to make changes, I have to stop, I have to get healthier. I want to get healthier, I want to eat, I want to rest. I want to do things like get ice cream with the man i love and have dinner with my mom. I dont want her to die and have this be all she ever knows of me. It's just that the reality of those last things isn't nearly as rose tinted as the concept of them are. The reality of healthy is sitting in silence and boredom and self disgust for hours in the evening, with an over full stomach that makes me want to rip my skin off and fling it out the window.

Idk how to fix any of this.

Probably not the best way to word that title. Im just not sure i should continue seeing her.

To start, I'm 33 and have had anorexia-BP type for 25 years. I have been through many inpatient programs and one brief PHP, but due to insurance/circumstance I've never had lasting treatment. Mainly just medical stabilization in hospital for a month or so at a time then back to the real world with no follow up.

I made some headway in recovery on my own from Fall of 2025 through Winter of 2026 before relapsing again. I briefly weight restored and would go 8 days a time without using the purging behaviors, before using them once then going another 8 or so days, and so on. However, I was never able to stop entirely and I binge ate on almost a daily basis. It was not healthy. Aside from this recovery attempt my use of bulimic behaviors has been daily for decades.

I relapsed around April of 2026 and it's been a real rough one. I eat 3 crackers a day, have one strict b/p cycle in the evening where I don't actually swallow the food, I just chew/spit for a while then purge whatever managed to get swallowed. I am severely underweight but not so severe that I'm walking around looking like Eugenia Cooney. My blood work isn't great but the electrolytes are stable. There are markers of significant ketosis, kidney strain, severe anemia and my glucose is average mid 50s at any given time. But of course, none of this will make me drop of a heart attack in the immediate, so my doctor was unconcerned.

To avoid another inpatient stay, which is no longer an option I'm willing to entertain going forward, I'm trying to build a treatment team outside of hospital. I finally found an outpatient therapist who specializes in eating disorders and OCD, my two most prominent issues. It took a while - most specialists aren't accepting new clients, or won't see me because my weight falls below the line they draw for medical liability.

I've met with this specialist 3 times, for an hour each. She is underwhelming. She has yet to offer guidance, advice, guidelines, anything (other than "get a dietician," which I can't do financially). Yesterday during our 3rd session I went on a brief vent about the past week- my relationship, my job, the eating disorder and how living with it is suffocating me, about how stuck i feel and how badly I want to change but there are so many reasons I can't.

She was silent, then said "wow.....this eating disorder is a beast."

That's it. Thats the feedback I got. For the rest of the appointment she remained mostly silent, or just parroted back what I already said.

I'm spending over 100 dollars a session here. It's so hard to find a specialist but I'm wondering if this is worth it, or if I'm just doomed to deal with this on my own forever because I really am too "complex" of a case that it's basically terminal.

Is it too soon to draw that jusgement? How long should I keep seeing her if I get nothing out of it?

Thanks

Venting.

(Behaviors mentioned, no numbers)

Every week or two I crack for a night and keep down almost an entire (normal person's) days worth of calories, consumed in one sitting. I'll scarf stuff then go straight to bed. I did this 3 nights ago and my body is holding on to that extra X lbs for dear fucking life. If I hadn't have done that, I'd have reached my next goal by now. But it threw my weight loss in reverse and then stalled it.

I'm not getting any confirmation from anywhere that I'm thin. My doctor was less than concerned. My bmi is barely into "severe," which let's face it, isn't really severe. When you think of a severe anorexic you think Eugenia and the like. If you don't look like them you're "fine."

My boyfriend broke up with me in the middle of my workday last week, over text. "You're too sick and it's effecting my mental health." Then he came over that evening and said he never planned on going anywhere, he just wanted to make a point. It threatened my job - I had to leave early after having the mother of all panic attacks. This is after taking PTO all over the place to keep appointments with a specialist and a doctor, per his request. Because he's constantly issuing ultimatums - "Do better or I'm leaving."

Last night, 8pm, he showed up no warning. "Come downstairs, I want to give you a hug." I was at the end of a rough >!chew/spit/binge!< cycle, about to >!purge!<, mess was everywhere. I was disgusting. I absolutely could not go downstairs. He knew why. I've asked him not to just stop by in the evenings for specifically that reason, but he does it anyway every once in a while.

Now I'm terrified he's going to decide he wants to break up again today. I can't even text him for reassurance. He doesn't like messaging much during the day, I usually don't actually hear anything tangible from him until 3pm or so (even though he sits at a desk with a phone and gets plenty of breaks and checks Facebook all day....I digress.)

I have no ground beneath my feet. My job no longer feels stable. My boss behaves like a mean girl, treating everyone else warm and me like im a lesser creature. My boyfriend and only support is flaky and selfish. I'm killing myself to be thin and I'm not even that thin. The boyfriend said it himself - "Well you definitely don't look like Eugenia Cooney."

And I'm not even getting the consistent weight loss I should be, because I fucked up the other night.

I'll never fucking be good enough.

I'm 33 and have had anorexia for 25 years. This is the first relapse that I've noticed the ketosis smell in a very bad way. It's also the first relapse that I've noticed significant hair loss.

I will admit that my bmi falls under the "severe," but it's not well into the "severe." Ive been thinner. Still, when i was thinner I was younger. I wasn't as damaged, nor was I going as hard at it as I am this time around.

I can't escape the rotting smell coming out of my throat. It's awful. Nothing fixes it. I also notice whiffs of what can only be described as a "bathroom" smell coming off me, even if I haven't used the bathroom in that way in days. I try to be fastidious with my hygiene, I wear deodorant, my clothes are all clean....I don't know what else to do.

It feels a lot like my body is decomposing while I'm still alive. And it's so frustrating, not only because it's embarrassing but because I've been thinner before. I think I've just hit an age where the damage can't be denied anymore.

I got labwork done last week, the markers of moderate to severe ketosis are prominent. That kind of confirmed it for me, that there's nothing I can do. It's so defeating.

I ate a bunch of stuff. I don't even know the caloric value, there was peanut butter involved, I can tell you that. Instead of >!purging!< I took some benadryl and immediately slept for 11 hours.

I have never felt worse in my life.

I'm too mentally ill for him, he said it's effecting his mental health. And as he has reiterated to me many time, his health comes first always.

I had the mother of all meltdowns in my car. Took 40 minutes to get myself normal enough to go back in. Cleaned up in the bathroom, sat at my desk, the panic and general despair hit all over again. I was hyperventilating and couldn't stop shaking so ultimately I had to go to my boss and excuse myself for the day before more people saw me in thar state.

No hope. That's all. That's all this post is. No hope.

This relapse has taken me down some weird fuckn roads. I've had an-bp for 25 years, I'm 33 now, and I've had more relapses than I can count. This one is a little more extreme and a little more long winded, feels more like it's happening to me rather than by me, so maybe that's why.

I know food hoarding has never been a rare thing for anorexics, but it's never been something I've done. Until now anyway. I have a drawer at work packed with snacks I'll never eat. I add something new every day - today it was a fruit cup. There's like 6 packs of pb crackers in there, a to go cup of pb, packs of fruit snacks, a bag of drizzlicious rice cakes, 2 ziplock bags of popchips, a package of pop tarts, 2 rice crispie treats, belvita biscuits, a granola bar, and some suckers.

Imagine if someone went looking for something and opened this drawer, God.

I just like knowing they're there. Just in case.

I spend the bulk of my work day watching food related tiktoks, like "wieiad" and "90s dinners," etc etc. It scratches my brain better than even eating would. I didn't used to do this either, regardless of how low my bmi was.

I'm just thinking out loud I guess. I'm so enmeshed in this.

I've been referred to two ED versed dietician clinics in my neighboring city. The specialist I'm starting treatment with has made her treatment contingent on this, as she's not comfortable having her weekly apts being my only support right now.

The concept of actually seeing one of these dieticians makes my skin crawl.

I've met with many dieticians in all my inpatient stays. They give you unrealistic meal plans that no one in a normal healthy mind and body would ever follow. They teach you about exchanges, which I never used because they are trivial and infantilizing and you might as well just count calories, the values of which are seared into my brain anyway.

&gt;! Every dietician I've met is either extremely thin or extremely overweight !< - none of them actually look healthy. These clinics also tote themselves as HAES, which I find insufferable.

It all vibes as hypocritical, immature, and geared more toward teenagers than a grown woman with a 25 year history of ED bullshit. I've been there done that, seen it all, and know how to feed myself. I just can't. Having a dietician tell me what I should and shouldn't eat won't fix that, ultimately it'll make it worse.

It's further complicated by my wrecked digestive system - I have Gerd, lactose sensitivity, and I can't eat most things like raw fruits and vegetables because my body simply cannot digest them. For example, I bloat up for 7 or 8 hours and have to stay horizontal in crippling pain every time I try to eat an apple. That kind of destroyed. A dietician will call those "ED excuses" and slap a meal plan on me I can't follow even if I wanted to.

Has a dietician actually helped anyone here? If so, please share. I'm trying to change my perspective but i have no evidence it would be reasonable. I don't want to spend money on yet another apt convinced it's just going to be more bullshit.

Thanks

I finally got scheduled with a specialist. I'm meeting with her today at 2pm. Her protocol is 2 hour long evaluation apts and then go from there.

I was up most of the night worrying about outcomes. Part of my brain is desperate to stay sick- these habits are my routine. They keep me safe. Restriction and weight loss keep me functional and employed and comfortable among people, and then the evening bp cycle gives me something to look forward to/something to fill the empty hours.

I'm also not as thin as I could be. My dumbass googled the medical line between significantly uw vs severely and I'm RIGHT on that line. One day without behaviors and id be back over it. I feel invalid for that. I also keep comparing myself to what I once was - I used to look like a "real" anorexic. Now people look at me and think sure, she's a little too thin, but they wouldn't guess anorexic simply because I'm only a little corpse-y vs full corpse-y.

"Not sick enough." You know how it goes.

I'm also very concerned she will recommend inpatient before seeing me regularly. Not only to get my weight up but to "prove myself." This has happened to me several times before and I've been told that this weight I'm at is the line drawn by most practices. "You hit this number, you have to complete an inpatient stay before seeing us." So should I lie? Probably, but again, I'm so desperate to be seen as valid.

I'm worried I'll be too honest and describe my behaviors to her, because ultimately I do want help with them, and she'll section me or something. "A danger to herself" my ass, but that's happened before too.

I'm worried she will demand an inpatient stay that I won't be able to do. Not only because I work full time and can't afford it, but because I will NEVER put myself in those environments again. I've been in more times than I can count. Doesn't matter the location, it's all horrible and perfectly conducive to ultimately making me sicker in the long run. And if that happens, my boyfriend is apt to leave me. "You know what to say to get them to deny you, you do this on purpose." He accuses me of that often.

I'm worried she will agree to work with me despite the numbers and I'll get lenient with myself and gain weight. Let's be realistic- despite any therapy I won't be able to cope with it and then I'll be even more miserable than I am now. Recover a little/relapse. I've done it more times than I can count. I can't put this job at risk and weight gain directly puts my job at risk because I cant cope with it and start calling in.

I'm worried she will agree to work with me and I won't feel safe being more lenient on myself if I choose to, because then I'll have gained weight by my next apt and thus I will be seen as a failure/invalid. I like to at least have the option of eating if I want to. Another apt would mean I can't for another week.

Gibberish. All gibberish, 50 different lines of concern convoluted at the base of my brain and I can't untangle any of it.

I'll go, but it'll be a waste of time. She's already demanded I see a dietician which I refuse to do. They're just as delusional as we are.

Thanks if you read this.

I'm 33. I've had anorexia binge-purge subtype for 25 years. I am in the middle of a bad relapse and I am severely underweight. My behaviors are extreme. I'm scared - it feels like this relapse is happening to me, not by me.

My boyfriend is distant and feels neglectful. He used to be supportive, now he's just mean and not there. He's the only person in my life other than my mom, who lives across the street from me and is complicated.

I'm at work right now. I have a good job with good people but I will always be on the outside looking in. I'll never be "one of the girls," even though all of us working in the office are the same age and unmarried without kids. I was isolated for a long time, and thus do not have the social skills and sometimes I feel like I vibe as weird, or wrong somehow, but not tangibly enough for me to know what to fix.

I get to eat (and keep down) 3 peanut butter crackers a day. That's half a pack. 105 calories. The arbitrary rule I live by is I have to wait until my office mate goes on break around 1pm to eat them. I don't want anyone to see it. It takes maybe 45 seconds to eat these 3 crackers.

I spend my mornings white knuckling chest pain, dizziness, low blood sugar, waiting for cracker time. Today when that time finally came I had eaten 1 and a project manager came in and started yapping at me. He saw me eating. He interrupted my only minute of relief in the day.

It was the last straw. I threw the rest of the crackers out - they're contaminated now - walked right by him and have shut myself in the bathroom. It's been 15 minutes. I sobbed for the first 10. Now I'm typing this.

I am doomed to this illness. I've been inpatient more times than I can count. I've tried to recover so many times and even if I were to try again, it's not worth it. I'll just end up back here. I'm unlovable, I'll die alone regardless. I'm so fucking lonely. I'm so fucking scared.

Thank you if you read this.

This is a vent. Thank you if you stick around to the end.

It's all so cliché it makes me want to puke, but it's true.

I'm 33. I've been struggling with an-bp for 25 years. I have had so many relapses I lost count. I couldn't tell you how many times I've been inpatient since I was ten. Always short term - a month, maybe a month and a half. Necer lasting residential with follow up treatment. Never anything outpatient, although I did have a therapist for 6 years who didn't specialize in anything. She was county funded and just kind of sat there each week, nodding and "mhm"-ing while I slowly died in front of her.

My weight has been all over the place over the years, but the average has been uw. Right now I'm right on that line between what's classified as significantly uw vs severely uw. Right on the edge of it. Give me another day and I'll have tipped it into severe category.

The issue I'm running into is I've been thinner. Significantly so. This relapse has carried me into some dangerous and scary territory and my boyfriend is threatening to leave, he has withdrawn all emotional support because he feels like it's a waste of breath trying to support someone who can't even feed themselves. "I can't be your guardrail, just fucking eat, or don't. " That's what he told me a month ago, on the rare occasion I texted him in the middle of a bickering match I was having with myself over if it would be ok to eat something that night or not. My voice alone wasn't cutting it against the ED logic, so I asked for his as a voice of reason. He came back with that.

I took it to mean he doesn't care, because I wasn't thin enough yet.

I take his lack of support to mean the same thing now, even several sizes down from there.

I'm exhausted, despite having been much lighter before. I've been doing the legwork trying to find a specialist to actually help me, before I'm inpatient material again. The issue is I've hit that bmi mark where it's a medical risk based on weight alone, and outpatient specialists are not likely to see me. It is incredibly frustrating.

And yet I still feel invalid because I cant help comparing myself to the "real" anorexics out there. And to my former self, the Emily in her 20s that was a "real" anorexic. I looked the part.

I get that I'm old and damaged after decades of abuse, and my body can't handle what it used to when I was in my 20s. But that feels like a cop out.

I'm so tired. I wish I didn't care.

We are both in our 30s, which somehow makes it all that more inappropriate. It was fucking weird. We were just watching TV and suddenly he had his fingers around my bicep. He jiggled it a couple times too.

"Just wanted to see if I could fit my fingers around it, " he said.

He didn't mean any harm by it, I'm just so embarrassed. I'm >!5'5, 96 pounds,!< I get that I'm not a billboard anorexic or something but why the fuck did he do that. He knows fully well what I struggle with, knows fully well I'm mid relapse.

I'm so uncomfortable, it's a discomfort that stays with me always. His tangible judgement of my body has gotten under my skin and I can't shake it off.

This will probably get deleted. Yall know who I'm taking about, you can't escape it. It's all over every feed, no matter what your algorithm was prior. It's like her emaciation is being promoted.

She knows exactly what she's doing, and so do her designers. They dress her in a way that flaunts it. She uses bigger dancers as props in her show to make herself look smaller, under the guise of inclusivity and body positivity. Takes one to know one - we all see right through that.

I would pity her but frankly I don't think she is a good person in general. Again, she knows exactly what she's doing and how she triggers her younger and more impressionable audience. She's is my age, and she knows better but does the opposite.

Idk why it bothers me so much, it feels immature. But christ, she's everywhere.

I finally got through to a specialist that's willing to meet with me. I have an evaluation scheduled for next Thursday.

I spoke with her on the phone today for 20 minutes- a free consultation. She primarily just discussed pricing. With insurance, the fees are as follows : $105 for the 2 (apparently there has to be 2) initial evaluations, and then $98 for each weekly session.

She also wants me to see a dietician. I told her close to nothing about my eating habits - just that I restrict and bp daily. "You have to see a dietician, ill send you names."

She sent me two designer nutrition clinics in my city and that's just more money out the window. I've been at this 25 years - I don't need another unrealistic meal plan shoved in my face that I could download off Google. They also tout themselves as "HAES," and I have opinions about that that I won't voice here.

I'm discouraged. In the brief consultation today she gave the typical disclaimer that she will refer me to a higher level of care if I fall below a certain bmi, because that will make me a medical risk. Or if my behaviors make me a medical risk. I already know I check both those boxes, so should I really waste the $105? Maybe, if only to get my bf off my back about it. I've been to higher level more times than I can keep track of. It doesn't do jack shit for me except medical stabilization and then back to the wolves.

I'm just so disgusted by the whole thing. Treatment is a big cash cow. There's no actual help out there.

I'm in a bad relapse. My brain is torn between leaning into it and trying to recover, and unfortunately because of that I kept down a >! 1530 !< calorie binge last night. I just went to bed on it like a dumb ass.

I can't go into the dreams I had. Disgusting, disturbing, traumatizing body horror. I was obese in all of them but that's the only detail I'm comfortable sharing. It was so bad. Usually when I wake up from dreams where I'm bigger I'm relieved and just move on but these were so disturbing I can't shake it. It's visceral.

I'm a pragmatic person. Dreams are just dreams. They don't mean anything. But I can't help but blame the fact that I ate so much and kept it down.

I read this whole book today and I'm wondering if anyone can recommend anything similar? Just please for the love of christ don't recommend Wasted. Iykyk.

Thanks

I'm going nuts. I swear to god I'm defying the laws of thermodynamics.

My weight has been plateau'd going on 3 weeks now. It's still a very high weight for me when compared to my history - I'm relapsing after being briefly weight restored during a self imposed (stupid) recovery attempt.

Tw for lots of numbers. I'm not holding back here, I gotta get this out somewhere or I'm gonna lose it.

>! I eat 105-210 calories a day. I binge and purge once an evening, but my binging is very strict and I don't swallow actual mouthfuls, I just chew and spit and then purge after a routine of items. My purging has steps too. It's exhausting. It's through this that I have always lost weight reliably. I'm locked into this routine and it's part of my DNA. !<

>! 3 weeks ago the weight loss stopped. Boom. Just like that. I've been stuck at 100 pounds on the nose. Sometimes it wiggles between 100.4 or 100.8, then it'll go back down to 100.0. Or it'll stay the same for a day or two, then wiggle again. But it hasn't gone below 100.0. !<

I'm five ft five inches. This is fucking killing me. I feel like I'm going insane.

I worry I'm doomed to this and if I eat anything more to try to break the plateau I'll never be able to get that weight off either.

When it's all you have to hold onto to get through the day, this kind of thing is like hell. You put yourself through so much suffering and pain and it's for nothing. No results. Fucking zilch.

I'm exhausted.

My boyfriend is giving me until September to change. We are in our 30s - his many ultimatums have never had a date set to them and now that one does it feels all the more silly and immature.

He told me yesterday he can't stick around to watch me kill myself but then also told me he doesn't care about the restrictive aspect of my disorder, just the bulimic. So if I can manage to somehow be a "clean" anorexic that would be totally acceptable for him.

I'm so tired of people not understanding the cycle. To stop bp you have to eat enough. I can't eat enough because my body is wrecked and I also look like a fucking monster at a healthy bmi.

He told me to find a healthy way to maintain this unhealthy bmi. That doesn't exist. He didn't care - he just told me to figure something out.

Go to therapy, figure something out. He doesn't want to accept that my diagnosis doesn't have the resources his does (he's 4 years clean of drug addiction). It's 10x more complex. 10x more insidious. I don't have the money for therapy. Even if I did, my weight is low enough and habits extreme enough that any therapist would refer me to higher level care. This has happened time and time again in the past. He laughed at me when I said that. "That's not true, and even if it was, just lie."

So let's say I lie to get them to see me. What's the point of lying in therapy to get help for the issues I'm lying about?

I don't understand. I'm so frustrated and angry. Jesus.