BMI

This is something that’s been bothering me for a long time, and I’m going to attempt to put it into words without sounding like I want to be more sick than I already am.

As an anorexic/bulimic who is cripplingly aware of every pound in weight I carry, my ‘aim’ I suppose is to be thin. As thin as I can be. And it’s never thin enough. I know that. I could kill myself trying to lose an extra stone or two and I still won’t be thin enough. The reality at the moment is that I’m sitting at a BMI of about 17. In the world of eating disorders, this BMI is not really seen as a problem. Certainly compared to where I have been, I am thought to be doing ‘well’ (or better than I was, at least). I am ‘healthier’ apparently. This baffles and irritates me all at the same time. I don’t feel like I’m doing well, and I don’t really feel like I’m doing better either. My ED behaviours are still as consuming as they were with a BMI of 15 and a BMI of 25. I still binge, vomit, restrict as much as I did at my lowest and highest weights. My potassium still takes dips and I feel just as exhausted.

When I reached the point where I really wanted help (about 18 months ago now) and really battled hard to be listened to, I was about the same weight I was now, perhaps a little less. I seem to remember my BMI was about 16.5. I had an initial consultation at my local mental health unit, where I was told that while they’d find me some help, I wouldn’t qualify for the specialist eating disorder service because they didn’t consider anyone with a BMI higher than 14. More realistically, it was explained, I likely wouldn’t be considered for specialist help unless my BMI went under 13. I felt defeated. And fat. Fatter than I had done in a while. I was sick, I knew that. My life was controlled by my eating disorder and I was thoroughly miserable. I didn’t feel good enough at anything, and now I learned I wasn’t ‘good’ enough at my eating disorder either.  I dropped almost a stone in weight very quickly from that point.

I’m in two minds even now about why I did that. Losing weight was what I was trying to achieve, that was the whole ‘point’ of having the eating disorder, or at least in my mind then it was. I suppose that on one hand I was trying to meet the criteria. I wanted help. I had gone years without admitting to anyone that I was sick. I wasn’t going to go through explaining my situation over and over to get nowhere. I was quite sure that this was the only way I was ever going to get better. And I had to get sicker in order to do that. Then of course there was the bonus of also being thinner, I’d be lying if I pretended that wasn’t the case.

So that brings me to now. My sessions recently seem, to me at least, to be very focused on trying to prepare me for ‘life after SEDCAS’. Yes, I have problems with paranoia, but I’m also not stupid, and there have been too many hints to ignore that this care, the specialist help I fought for, is going to be withdrawn soon. Not only am I too big for their service – for the record, no one has said that but given what I was told back then and where I am now, this is the conclusion I’ve come to – but I’ve also made nowhere near enough progress within the system. Their time could be better spent on patients who are really going to benefit from their help (and have a lower BMI than I do). I don’t blame them, their resources are stretched and I suppose they consider that a patient with a critical BMI deserves help/care more than I do, I’m just not sure where that leaves me. . .

 Why is it that someone suffering with an eating disorder needs to become deathly thin before they ‘earn’ the right to recovery, especially when the statistics prove that early intervention is so important. Yes, I have a higher BMI now. I do not agree that I am healthier because of this. I do feel that I’ve failed in every way possible. I’m not better, I’m not any better, but I’m also not thin. I don’t want to lose the care I have in place but I’m also not sure how sure how to use that care in order to be able to move forward. . .   But without it, I don’t know where I’ll be. . .

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