Things are not great

Had my appointment with L. I was pretty much the same weight as I was on Monday. It worked out to a gain of 2.9lb.

I cried for half the session.

I can't do this. I can't. My mind is screaming at me to starve, that this is exactly what they want. They want to make me fat.

L says it gets better. Does it? Does it really? Because it sure feels worse to me.

When recovery triggers a relapse

I've been 'in recovery' for a little over a month now. I put it in quotes because a lot of the time I feel like my heart's not really in it. I know that if I continue down this path that I'll die, but my disordered brain keeps telling me that that's just scare tactics, that I'm still horrendously fat and I have a long, long way to go.

Outpatient, Day Patient and Inpatient - What's the difference?

OP - Outpatient
Outpatient treatment can take a number of forms. The most common is a weekly appointment with a qualified therapist. There are a multitude of therapies that are traditionally used for treating eating disorders, but the options offered differ between NHS trust. Outpatient treatment is the most common form of treatment for eating disordered patients, and you can expect to have between 20 and 40 appointments over the course of your treatment. If outpatient treatment is completed, but you have not progressed to an expected level of recovery, your care team may consider an alternative, higher form of treatment.

I broke my purge-free streak

I had made it 9 days. 9 days without purging, and I was feeling very good about it.

But something about my dinner today made the choice between continuing on with the streak of purging all too easy a decision.

Now, physically, I am exhausted. I am drained and I've got a headache, and I look pretty damn awful. Emotionally, too, I'm impacted. I feel like I betrayed my therapist and my boyfriend and myself.

I know that this is a normal part of 'recovery,' but god, if it doesn't suck.

What it's like to have an eating disorder and have a normal BMI

“There’s nothing that we can do to help you at your BMI.”

I turned to leave, but before I reached the door, I’d turned around. “You know what this means, right?”

She knew. There was nothing that she could do to help me. Not until I was thinner.

I want to eat, but I just can't

I've read so many things about recovery: how it won't be anything like you expect; how it will be hard; how you'll fail at points - but my lord, I didn't really anticipate this.

It's lunchtime at work. I walked in to the supermarket and wandered through the aisles. I looked at the salads, I looked at the sandwiches, I looked at the smoothies, and yet, I couldn't find anything. There were plenty of foods that fit my normal criteria: vegan; low cal; cheap, but nothing I could eat.

MARSIPAN - Management of Really Sick Patients with Anorexia Nervosa

The Management of Really Sick Patients with Anorexia Nervosa working group came out of concerns that a number of patients with severe anorexia nervosa were being admitted to general medical wards, and sometimes deteriorating or dying there, due to either (or both of) medical complications or psychiatric problems.

The full MARSIPAN report (second edition) is published by the Royal College of Psychiatrists, and can be found on their website.

DSM-5 and ICD-10

So, you may have come across references to either the DSM-5 (or the DSM-IV) or the ICD-10. These would most likely come up in conversations or articles relating to diagnosis or criteria for mental illnesses.

I thought it would be useful to break down what these actually are, what the listed eating disorders diagnoses are, and how they are different.

Eating Disorder Acronyms & Terminology

You will come across a huge number of acronyms and terminology when discussing or researching eating disorders. I've decided to aggregate them here, and in time, I'm hoping to include full definitions of each term, or a link to a page where the term is discussed in greater detail.

This page is continuously updated.

Inpatient NHS Eating Disorder centers

There are many different centers and inpatient facilities across the UK that treat eating disorders on an inpatient basis. I've collected some of them here, and I'm working on a much more comprehensive guide, which I'll hopefully publish very soon!

Accessing Eating Disorder Services in the UK

Sadly, the quality and experience of ED services across the UK depend entirely on which area you live in. I'm in the process of writing up more detailed information on things like NHS trusts and CCGs, but for now you'll unfortunately have to do that investigation yourself.

A large percentage of people who access ED services will do so via their GP, be it of their own volition or dragged along by a concerned parent. The GP will do a brief assessment and likely refer you to a specialist eating disorder service. If you are a minor, you will likely be referred to CAMHS - this is the Child and Adolescent Mental Health Services.

At your first appointment, there will be more assessments. Again, this is very  dependent on the process that your trust follow. The likely assessments you'll have to complete are (some, or all of):

Lily's Eating Disorder History

I'm going to tell my eating disorder story. Unabridged. In order to do that, though, I have to go back over a decade.

The first memory I have of disordered eating was when I was about 12. My mum had cooked dinner, and we planned to eat it on trays in front of the TV. It was chicken. I cannot remember exactly how I achieved this, but I managed to hide some of my food in the bathroom. After the meal, I disposed of it. That is the first real event I can recall.