I would never argue that I am normal about eating. I will argue that very few women are, but not that I am. But I have never been comfortable with the label bulimic. It's been the go to diagnosis because if you throw up then you must be bulimic. It's very hard to take therapy seriously when everyone is treating you for a disorder you don't have. I don't binge, period. The only time I come close is after a very long period of restriction (auto pilot as I think of it) and even then calling it a binge is more my perception than diagnosable.
Under the DSM IV I'm not anorexic either. I don't meet diagnosis (even purging type) because I have never been and am not underweight. In fact they say 85% or less of minimal weight for size and age. I'd have to weigh 85 or less to be diagnosable. I also would have to stop having my period (which would be perk).
So I've always technically been EDNOS which most people don't know much about and is the catch all 'I think you have a problem and need help' diagnosis. It's like there are these two exclusive clubs and you're not accepted into either.
DSM IV
It stands to reason that if my behavior is not medically and psychiatrically significant enough to get a real name and a real set of criteria, then how bad is it? I mean realistically I'm not even at the bottom of my weight range, I function fine physically and mentally, have completely normal blood work every time, and my blood pressure is better now than it's ever been. So I've got some maladaptive self destructive behaviors, but who doesn't. Show me one completely normal person and I'll show you a liar or someone really good at hiding their quirks. Mine just happen to be about food.
I'm not saying that restricting oneself to 800-1000 calories a day and purging anything over that is okay. I definitely needs to work on some new ways to deal with the stress of life. I'm just wondering if it's worth thousands of dollars a year in therapy and treatment and people treating you like your broken.
I have been keeping track of the revisions they have been considering for ED in the DSM-V due to hit your local psychiatrist in 2013. It not that I thought there would be a disorder that was the perfect fit (like the elusive pair of perfect jeans), but I did think I'd fit in somewhere since I keep getting told 'it's a big deal' and 'beating this is going to be the hardest thing you do in your life'.
DSM-V ED thus far
First of all, they want to change the section to be titled Feeding and Eating Disorders. Really? We are now going to go from ED to FED? Was that some psychiatric humor? Not only in 2013 will I become FED, but I get to switch from the subtitle of EDNOS (eating disorder not otherwise specified) to Feeding and Eating Disorders Not Otherwise Classified or FEDNOC. If you really wanted a new verb you might as well have gone with something like tagged so it could be FEDNOT. At least it would have had some matching humor. Next I get to go to all the subtypes in FEDNOC and get cross listed as Atypical Anorexia Nervosa and Purging Disorder. More bang for my buck I guess... two for one special. Oh except that these aren't actually classified as disorders, they are conditions. But it says that only one condition should be assigned to patients so I guess I'll have to pick one.
I do think they are suggesting sound and needed changes. I'm just beginning to think that if the diagnostic world doesn't think I have a disorder then I shouldn't either. I have a condition. Sounds much better than I am ED, EDNOS, or bulimic. Some people eat too much salt, red meat, sugar, fried and processed foods. The average american woman weighs about 30 lbs more than a 'healthy' range which means to me there are a LOT of over weight women out there. A lot of women that eat too much and many that don't watch what they eat at all. They don't have a 'condition' for that. No one goes to their friend that is 30 or more pounds too big (very much putting them at more risk across the board medically) and tells them they think they have a problem. When they eat when their not hungry or are never not hungry no one freaks out. In fact no one really even bats an eye until someone is grossly overweight and well past simply obese.
So it's a double standard really. I'm not hungry as often as many and sometimes I don't eat even if I am. I watch what I eat very closely and when I feel that I need or want to drop a few pounds, I eat less. I have a purging disorder (but classified as a condition) and I am working on it. It's not surprising that it hasn't been an issue of late since I'm not stuffing myself on someone else's meal plan and idea of how much I should consume. You can argue that I'm increasing my health risks (what doesn't), but I've had everything checked routinely over the past few years and I am 100% healthy. I can continue to work on better stress management and continue the treatment that has my depression in check without treating a disorder that I don't have. Now if I drop to 85 pounds, start losing my hair, and put myself in serious danger of heart failure then I'm just in denial now (and the past 14 years?) and you can tell me you told me so (and I'd qualify for treatment under my insurance for once).
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