Does my friend have anorexia?

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Chechani
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You see, my friend says they has anorexia. Well, more like brags about it? I've heard that anorexia can be confused and people think you must be really skinny to have it and all, which makes me not actually sure if they have it and if I should worry and support them.

They commonly say they have anorexia to many people also commonly saying they don't eat, they never eat or "I haven't eaten for a week!" to nearly everyone they know, including teachers. But, I do also see them eat despite their words. They also say they've lost a lot of weight when me personally haven't seen any change at all. But its hard to notice changes unless drastic by just looking. They also refuse or try to avoid to do P.E. while also complaining about their weight and how overweight they are. And in not a rude sense, they are overweight, not saying it's a bad thing. And even though I know I'm gonna feel bad for saying this too, but I also think they're attention seeking as I can't see how they have Anorexia, but then again I don't have a great range of knowledge about that subject.
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Trust Orang
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You don't have to be underweight to be anorexic, but due to the thermodynamics of restricting, people tend to drop weight at such a rapid speed it's unhealthy. Restricting a little bit is just a bad diet, but can't be sustained so it's nothing to worry about.

Due to the surrounding circumstances, I think your assessment might be correct and she is attention-seeking.

On the other hand, bulimics often don't lose weight. They restrict for a while and then snap and binge. Some variations of anorexia involve binging and purging as well. If she's going to the bathroom every time she's eaten, it might be time to start worrying about her.
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londonmyst
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Might have said anorexia when they actually meant bulimia.
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Pathway
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I mean, eating disorders are complicated and no one here can diagnose her. Talk to her, ask her if she's getting help.
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Anonymous #1
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(Original post by Chechani)
You see, my friend says they has anorexia. Well, more like brags about it? I've heard that anorexia can be confused and people think you must be really skinny to have it and all, which makes me not actually sure if they have it and if I should worry and support them.

They commonly say they have anorexia to many people also commonly saying they don't eat, they never eat or "I haven't eaten for a week!" to nearly everyone they know, including teachers. But, I do also see them eat despite their words. They also say they've lost a lot of weight when me personally haven't seen any change at all. But its hard to notice changes unless drastic by just looking. They also refuse or try to avoid to do P.E. while also complaining about their weight and how overweight they are. And in not a rude sense, they are overweight, not saying it's a bad thing. And even though I know I'm gonna feel bad for saying this too, but I also think they're attention seeking as I can't see how they have Anorexia, but then again I don't have a great range of knowledge about that subject.
I'll begin by saying that the advice that I'm about to offer is based on my experiences with eating disorders. I developed anorexia about two and a half years ago, then I developed bulimia and stopped my anorexic behaviour about 9 months ago, and since around June I've yo-yoed between anorexia and bulimia with some orthorexic tendencies thrown in. The advice I offer is based on personal experiences not medical expertise so it's possible I too may make some errors - I apologise in advance for them.

Firstly, you don't have to be skinny to have anorexia. I actually developed my anorexia when I was overweight/obese. The idea that you have to be skinny to be anorexic is based on the media focusing on high profile cases of anorexia where someone is really thin. I know that this idea is also based on the diagnostic criteria which state(d) that you had to be underweight to be anorexic whereas now there is increasingly a move away from this model of diagnosis.

From my experiences and from speaking to others with anorexia, it is extremely rare for those with anorexia (I refer to myself as an anorexic, but I concede that this is not an acceptable term to some) to be so open with being anorexic. Now I am open with many friends about my eating disorders, but I only started doing that this June, over two years since I developed my first eating disorder, so that seems a little odd. Those with anorexia will avoid food, however, but that doesn't mean that they won't eat at all. In my current relapse into anorexia, for example, I do eat, but not very much. Again, it's a myth that those with anorexia don't eat - we do, but we don't eat enough to maintain any kind of healthy weight. In terms of losing weight, that can take time to notice. I read somewhere that it takes around a stone's difference in weight for someone to notice a weight gain/reduction. That said, what seems a little off here is bragging about weight loss and noticing weight loss when others around you don't. I never really bragged about my weight loss nor did I recognise at the initial stages that I was losing an unhealthy amount of weight. Similarly, many with anorexia will go to lengths to hide weight loss, wearing, for example, baggy clothes. The reason that we do this is so that we can hide our weight loss and make ourselves appear bigger than we are. This means that we can continue to lose weight because we seem bigger and so have weight to safely lose and also can, in some cases, be triggering: if we appear bigger than we are, we must have weight to lose is what our minds can think. Avoiding P.E. is also rather odd - most people with anorexia will compulsively exercise as it's a way of burning off the calories that we have eaten that our mind tells us we don't really need. On some days, I've burned off more than I've eaten.

So while this may not seem like anorexia to me, I can't conclusively say that because I think it's wrong to invalidate how someone feels. It's clear that your friend is, however, unhappy with their body, so it may be worth offering them a chance to speak to you or to point them in the direction of people who can help them. It's also worth getting them to stop with their behaviours as soon as possible. If I had my time over, I don't think I'd have started down this path of eating disorders, but once you're ill and on this path, it's so difficult to stop and I can say now that part of me questions everyday whether I really want to recover from anorexia. Your friend doesn't want this illness, I can tell you that.
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Chechani
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Thank you for so openly sharing your experiences!
Even though it isn't based around 'medical statistics' It definitely opened up my eyes and helped me understand Anorexia a lot more. I'm going to nudge my friend to people who can help (-- carefully since she tends to get violent if people try to help or talk to her about any mental illness they've said they had.)

Once again thank you, your answer really helped!
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Chechani
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(Original post by Trust Orang)
You don't have to be underweight to be anorexic, but due to the thermodynamics of restricting, people tend to drop weight at such a rapid speed it's unhealthy. Restricting a little bit is just a bad diet, but can't be sustained so it's nothing to worry about.

Due to the surrounding circumstances, I think your assessment might be correct and she is attention-seeking.

On the other hand, bulimics often don't lose weight. They restrict for a while and then snap and binge. Some variations of anorexia involve binging and purging as well. If she's going to the bathroom every time she's eaten, it might be time to start worrying about her.
Thank you for your answer. She doesn't go to the bathroom after eating so I guess I shouldn't worry as much as I am. I'm probably going to still talk to her about it though.
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Anonymous #2
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(Original post by Anonymous)
Firstly, you don't have to be skinny to have anorexia...
(Original post by Trust Orang)
You don't have to be underweight to be anorexic...
You have to be thin to have annorexia. Its literally the top line of the diagnostic criteria, and BMI is how you guide severity.

There is no movement away from this - that would completely ignore all the very dangerous aspects of annorexia - electrolyte imbalances, bone density, etc - which manifest at very low body weight only.

There are a variety of other diagnostic labels for people who have disordered eating but don't lose weight. Its fundamentally far less dangerous though - pretending it is is not helpful..
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Trust Orang
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(Original post by Anonymous)
You have to be thin to have annorexia. Its literally the top line of the diagnostic criteria, and BMI is how you guide severity.

There is no movement away from this - that would completely ignore all the very dangerous aspects of annorexia - electrolyte imbalances, bone density, etc - which manifest at very low body weight only.

There are a variety of other diagnostic labels for people who have disordered eating but don't lose weight. Its fundamentally far less dangerous though - pretending it is is not helpful..
Adhering to the culturally relative diagnostic criterion above the principle is to ignore the lived experience of thousands of overweight people who develop anorexia. Are you seriously suggesting that anorexia, the mental illness anorexia, starts as the bones begin to demineralise? That is self evidently idiotic.

Props for knowing the criterion though, go you!
Last edited by Trust Orang; 6 months ago
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Anonymous #2
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(Original post by Trust Orang)
Adhering to the culturally relative diagnostic criterion above the principle is to ignore the lived experience of thousands of overweight people who develop anorexia. Are you seriously suggesting that anorexia, the mental illness anorexia, starts as the bones begin to demineralise? That is self evidently idiotic.

Props for knowing the criterion though, go you!
Do you think being rude will make you move believable or..?

There are substantial differences between those that have disordered eating with low weight, and disordered eating without weight loss. The psychology is fundamentally different. Which, to use your own terms, is pretty self-evident given that one results in catastrophic weight loss, the other doesn't.

A nice illustrative study on this was the Minnesote Starvation Study - ordinary people forcibly starved go on to demonstrate many of the psychological traits seen in anorexia, including obsession with food, distorted self-image and low mood. It demonstrates the clear relation between starvation and psychology.

As I stated quite clearly too: physical ramifications are very very different. Generally speaking, when you are creating different diagnostic labels you are doing it to guide treatment. And anorexia nervosa has vastly different treatment goals, including frequently admission to inpatient psychiatric units. Eating disorders with no weight loss just don't need this.

They are fundamentally different diseases. Eating disorders are complex and need complex treatment. Its not just 'that person no eaty good too it must be the same thing', as is your view.
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CarolinaBlack
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Your friend is dumb. If you want to help him, then talk to him separately why he does it and give adequate arguments that this is bad. If you do not want to help him, and I would have done so, then encourage him to continue in the same vein and pretty soon he will begin to experience tangible problems.
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Anonymous #1
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(Original post by Anonymous)
You have to be thin to have annorexia. Its literally the top line of the diagnostic criteria, and BMI is how you guide severity.

There is no movement away from this - that would completely ignore all the very dangerous aspects of annorexia - electrolyte imbalances, bone density, etc - which manifest at very low body weight only.

There are a variety of other diagnostic labels for people who have disordered eating but don't lose weight. Its fundamentally far less dangerous though - pretending it is is not helpful..
There is a move away from that school of thought though with BMI now only being used to determine the severity of anorexia. I admit that it's still at the top of the diagnostic criteria, but there is a call to remove that diagnostic criteria in terms of reaching the conclusion that someone has anorexia.
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