Struggling with Body Image: The Dangerous Desire for Anorexia

I really want to have anorexia!

I am 167 cm tall.
Two years ago, I weighed 78 kg, and now I weigh 46 kg.
Even though I am already too thin, I still constantly want to lose weight and feel that I am fat.
This summer, I developed binge eating behaviors, going to all-you-can-eat cake and barbecue buffets four times alone over two weeks, and then I would induce vomiting.
I am feeling a bit better now, more normal.
Due to my obsession with my body shape, I struggle with calories every day; food has become just calories to me.
My mind is consumed with thoughts about eating, and I envy others who have no appetite or eat little or nothing.
I think I want to have anorexia so that I won't have any appetite and won't want to eat, right? My roommate often has little appetite, and I envy her so much.
How can I lose my appetite? I realize this is already a pathological thought, and I understand, but I just can't control my desire to lose weight.
Classmates, roommates, and everyone around me, even though they are all slim, ask me how to lose weight.
Seeing them motivates my desire to lose weight even more.
My parents are very worried about how thin I am, but I just can't help it.
When I am out, I have to eat out for every meal, but I find outside food disgusting, greasy, and unsanitary, and there are no clear calorie labels, so I don't dare to eat it.
I only eat simple foods that are easy to calculate calories or meal replacements.
Sometimes, when I eat out, like a large spring roll, I feel guilty and scared, and then I exercise a lot.
I also hate and refuse to eat with others because I am afraid they will know what I eat.
I actually have a large appetite; two lunch boxes are just right for me, but I have to restrain myself and can't do that.
So when I eat with others, my plate is often the only one that is empty, and I feel that others eat so little and waste food, which makes me feel like a big fat person and that I must be fatter than them.
Therefore, I really dislike eating with others.
I truly envy people who eat less.
How can I become someone with a smaller appetite or develop anorexia?

Da Pang Zi, 20~29 year old female. Ask Date: 2005/11/12

Dr. Cai Xiuwen reply Nutrition

Hello, based on your height, your ideal weight should be at least 55 kilograms.
Your current body mass index (BMI) is 16.49, which indicates that you are underweight.
I believe you need psychological support; stop calling yourself "chubby." Every day, remind yourself, "I am great, and I want to be healthier." Your weight goal is 55 kilograms.
Consider yourself a foodie; you can enjoy everything but remember to do so in moderation.
Eating is not something to feel guilty about, just remember to maintain a balanced diet that includes all six food groups.
Occasionally, if you eat more, increase your physical activity.
Your appetite didn't suddenly increase; keep a few things in mind: 1.
Eat regularly; don’t have days where you eat a lot and others where you don’t eat at all.
2.
Maintain a balanced diet; eat a variety of foods (preferably fresh foods and limit processed items).
3.
Exercise regularly; daily outdoor activities not only burn calories but also help relax your mind and improve your mood.
4.
Remind yourself every day that you are great and can be healthier.
Wishing you health and beauty.
This message is from Dietitian Tsai Hsiu-Wen at Nantou Hospital, Department of Health.

Reply Date: 2005/11/12

More Info

Struggling with body image and the desire for anorexia is a serious issue that requires immediate attention and understanding. Your situation reflects a complex interplay of psychological and physiological factors that can significantly impact your health and well-being. It's crucial to recognize that the thoughts and behaviors you're experiencing are often associated with eating disorders, such as anorexia nervosa or bulimia nervosa, which can have severe consequences on both mental and physical health.

Firstly, it's important to understand that body image issues often stem from societal pressures, personal experiences, and mental health conditions. The fact that you feel the need to constantly lose weight despite already being underweight indicates a distorted body image, which is a hallmark of eating disorders. This perception can lead to dangerous behaviors, such as extreme dieting, binge eating, and purging, as you mentioned with your experiences of overeating followed by vomiting.

The desire to be thin or to have a smaller appetite is often fueled by societal ideals of beauty, which can create a cycle of negative self-perception. You mentioned feeling envious of your roommate's lack of appetite and wishing to have the same experience. However, it's essential to recognize that this desire is not a healthy or sustainable approach to managing your weight or body image. Instead, it can lead to further disordered eating patterns and exacerbate feelings of guilt and shame associated with food.

Moreover, the behaviors you've described, such as calorie counting, avoiding meals with others, and feeling guilty after eating, are indicative of an unhealthy relationship with food. This relationship can lead to nutritional deficiencies, physical health problems, and emotional distress. It's crucial to understand that food is not just a number or a source of guilt; it is essential for your body's functioning and overall health.

If you are experiencing binge eating followed by purging, this could be a sign of bulimia nervosa, which is characterized by cycles of binge eating and compensatory behaviors to prevent weight gain. This disorder can lead to severe health complications, including electrolyte imbalances, gastrointestinal issues, and dental problems due to frequent vomiting.

To address these issues, seeking professional help is vital. A mental health professional, such as a psychologist or psychiatrist, can provide you with the support and tools needed to address your body image concerns and develop a healthier relationship with food. Therapy approaches such as Cognitive Behavioral Therapy (CBT) have been shown to be effective in treating eating disorders by helping individuals challenge and change their negative thoughts and behaviors related to food and body image.

Additionally, working with a registered dietitian who specializes in eating disorders can help you learn about balanced nutrition and develop a meal plan that supports your physical and mental health without the focus on calorie counting or restriction. They can guide you in understanding the importance of nourishing your body and help you find joy in food again.

It's also essential to involve your family and friends in your recovery process. They can provide support and encouragement as you work towards healthier habits and a more positive body image. Open communication about your struggles can help them understand what you're going through and how they can assist you.

In conclusion, the desire for anorexia and the struggles with body image you are experiencing are serious and require professional intervention. It's crucial to seek help from mental health and nutrition professionals who can guide you towards recovery and a healthier relationship with food and your body. Remember, you are not alone in this journey, and there is support available to help you overcome these challenges.

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