Question: my friend told me that she made herself throw up and she stopped eating for two days cause her sister called her fat but she told me she's going to stop and knows it's unhealthy for her. What can I do to help her and would exercising with her help her stop?? She also seems really stressed out lately, is there anything I can do to help her get through this??

Katie Brooks Says...:

Hello there-

I'm
glad you wrote.  Eating disordered behaviors, like restricting and
throwing up, have a lot to do with unprocessed negative emotions and, in this
case, self-esteem.  It seems to me that your friend had hurt feelings with
her sister, which triggered insecurity.  She chose to cope with those feelings of insecurity by using unhealthy coping methods. In regards to helping her, I'm not sure exercising with her
would send her the right message right now.  I think it might validate
that she is fat and that she needs to do something to fix it.  Sometimes
exercising can become part of an eating disorder as well.  Even though it
is healthy to exercise, it can be done to excess if it is done for the wrong
reasons.  For instance, if my self-esteem is low and I am trying to lift
it by exercising, then my self-esteem will be contingent upon being thin.
 I will never learn how to love myself unconditionally.  

I believe that it
would be more loving for you to help your friend cope with the hurt feelings.  Send her the message that she is beautiful inside and out and that she does not
need to change a thing in order to be loved by herself or anyone else.
 Help her to stick up for herself by encouraging her to ask her sister not
to call her fat because it is hurtful.  Teach her to love herself and her
body by striving for health rather than being thin.  Tell her that she
will feel better if she was eating healthy foods regularly and staying active.
 In addition, teach her that purging and restricting will not bring her
health and wellness.. it will only bring more pain and stack a problem on top
of a problem.  I hope this was helpful.  If you have any more questions
please contact me at goodtherapysandiego.com.

Warmly, 

Katie Brooks, LCSW

Director of Good
Therapy San DIego

GoodTherapySanDiego.Com

(760) 525-9565

Question: I am not trying to diet but sometimes I can’t help it but do the tricks I know. I am too skinny already (I know this so I don’t have any false body issues) but when I actually do lose a pound or two I get so happy even though I know that I actually don’t need to lose weight. I think it’s probably a bit of an eating disorder that I have but mostly I am in charge. If I can pick a weight that’s OK and stick to that weight does that mean I don’t have to worry about how I think about eating? I don’t do any purging or binging.

Katie Brooks Says...:

Hi Anonymous-

I
know that it can sometimes be very confusing diagnosing yourself.  I think
it depends on your weight and age.  If you are an adult and your BMI is
under 19 then you are underweight and that can be dangerous for your health.
 You can calculate you BMI here: 

BMI Caluclator

Anorexia is the most
dangerous mental disorder at this time.  If eating, food, and weight control become
obsessions, or are already, you may need to seek treatment. People with
anorexia nervosa typically weigh themselves repeatedly, portion food carefully,
and eat very small quantities of only certain foods. Some people with anorexia
nervosa may also engage in binge-eating followed by extreme dieting, excessive
exercise, self-induced vomiting, and/or misuse of laxatives, diuretics, or
enemas.  At this time it seems that you do not engage in this behavior,
but you may want to watch yourself.

Mostly,
it's up to you to get treatment.  You will know when the time is right.
 Keep an eye on your behaviors.  If you continue to feel that you are
having trouble maintaining a normal weight because you engage in behavior that
interferes with weight gain and / or if you notice that you continually minimize
the seriousness of your low weight, call for extra support.  Here is a link to my website that will give
you further information on signs and symptoms.

GoodTherapySanDiego.Com

Question: I am a 32 year old binge eating male. I have been binging for 6 years. I do not purge. I am dangerously overweight. I am sick of living like this. I want to get treatment. Diets do not work for me. Nutrition plans do not work for me. I have a compulsion that is beyond my control. I understand this now. I have never had any kind of therapy or psychiatric treatment before but I suspect I also have borderline clinical anxiety and depression on top of the BED although I think that much of my anxiety and depression gets mixed up with the tension and shame of the eating. I feel like I want to really get away at a rehab type place but most of these places seem to be for people who already have a treatment team and all that. How do I get started with treatment? Is a residential facility going to be an appropriate place for a male of my age? Can you recommend a good facility for someone with my types of problems?

Katie Brooks Says...:

Hi there-

I'm glad you have decided to take the step to get treatment.  It sounds to me like you have an unhealthy coping skill rather than a dieting problem.  It seems like a weight loss program would have worked if dieting was the issue.  You do not have to have a treatment team to go to a residential facility.  Because I do not know appropriate details like where you live or the severity of your disorder, it is very difficult for me to refer you to a specific treatment center.  It would probably be a good idea for you to see a therapist in your area so that you can be properly evaluated.  You may not need to go to such a high level of care in order to effectively treat the BED.  Once the therapist evaluates you, he or she can then refer you to a local treatment center that treats men and fits your needs.  If you have any further questions please don't hesitate to contact me at goodtherapysandiego.com. 

Question: So I stopped drinking like 6 months ago and I have lost 30 pounds since then. I am close to rocking a 6 pack which is something I never believed I would ever see grace my portly-since-i-was-a-kid body. SO this is good. But what’s weird is now that I am all of a sudden in good shape I am feeling obsessed with counting my calories and exercising and trying to get to that body I have always wanted. I think about it all the time. All the time. I am always checking myself out in the mirror and making plans to exercise and reading about health and fitness a lot. So my best friend was anorexic in her teens and she says I am starting to scare her because I am getting weirdly obsessed. SO this worries me. But if anything was the matter I would be feeling anxious about how I look, not feeling great about it, right?

Katie Brooks Says...:

Congratulations on your
weight loss and abstinence from alcohol.  I'm sure that you feel great!
 It sounds like you are just really excited about your new body and health
status.  Word of caution though...  becoming "obsessed"
with weight, food, and exercise can turn into an eating disorder over time.
 It is progressive.  Right now you feel great, but it can easily turn
into a terrible cycle if you are not mindful about your habits.  If you
spend most of your time and thoughts on any subject it can be unhealthy.
 Getting exercise and eating healthy foods are really important for a
healthy life style, but they should not take over your life.  Focus your
energy on health rather than on appearance.  Try to limit the time you
spend on appearance and balance your life by developing other areas of
strength.  

My concern is that sometimes
weight loss can become a goal driven activity that never actually is satisfied.
 Make sure your goal weight attainable and is within the normal BMI range
for your weight and size.  I have been
witness to numerous women who will go to extreme measures to hit their “goal
weight”, only to gain it back because it is not a realistic goal for their
body.  This is how the cycle starts and
more extreme measures/ punishments are taken to reach the unattainable goal.
Once this war with the body develops numerous health risks can occur.  Be
aware if you start to engage in any of these behaviors:  restricting your
food over long periods of time, ignoring hunger signals, excessive exercise
(regardless of fatigue, injury, or weather), bingeing, purging, using diet
pills/ laxatives, obsessively checking the scale and body, avoiding social
activities associated with food, and the development of food rules and rituals.
 Please visit my website for more information on the signs and symptoms of
eating disorders:  GoodTherapySanDiego.Com .  If you have any more questions you are
welcome to schedule a phone session or visit. 
Good luck!