Content Warning: Disordered thoughts, talk of weight changes (no numbers)
My dietitian brought up the idea of a higher level of care a couple weeks ago. I pointed out that some of my recent trouble was medication-related, but she said that even my baseline thoughts from before then warranted a higher level of care.
At first, I felt like I was too much trouble for her to deal with anymore. I’d been feeling that way about most of my relationships—I’ve leaned on so many people so much, and I’m afraid of losing everyone. I was also afraid she’d say that if I didn’t go to a higher level of care, she wouldn’t work with me anymore.
Fortunately, I’m very transparent about these things (in case you, dear readers, hadn’t noticed!) and I brought them up. She explained that her professional opinion was that I needed more help, but that she was willing to work with me regardless. She wants what’s best for me, however, and she feels like I’d make more progress at a higher level of care.
I’m planning to have a good talk with my therapist tomorrow, and it’ll be good to get his thoughts on things. He certainly sees the thoughts I have, but maybe he won’t think it’s as crucial to get a higher level of care. I’m making progress, and maybe outpatient is enough.
I did virtual intensive outpatient last summer and last winter, and while I got some things out of it, I had a lot of trouble with the program. My relationship with them basically ended when their dietitian told me that I didn’t need her help and that I could come back when I had figured out my “gender issues”.
Back to the present, or close to it. My current dietitian and I started looking into programs, just to see what’s available. Even if they recommend treatment, it’s ultimately my decision, so it doesn’t hurt to look into options. I couldn’t find virtual programs that could practice in my state, so my dietitian said that in-person programs should be “on the table”. We continued looking, trying to find a place that would accommodate a non-binary vegetarian, much less one with a variety of other things going on!
I have phone assessments with two different places scheduled for next week. I thought about canceling based on some wording on their websites, but my dietitian convinced me to hear them out. Anorexia used to require a low weight, but it doesn’t anymore, and that’s my diagnosis from my psychiatrist. The website still lists it as such, however, and would instead diagnose me with OSFED, Other Specified Feeding and Eating Disorders.
People with any eating disorder deserve help. I know that the website not diagnosing me with anorexia doesn’t mean my problem isn’t severe, and it doesn’t mean I don’t need help. But that voice in my mind tells me that they think I need a low weight to be sick enough to go, even though I know that isn’t the case. It feels invalidating, and I’m already trying to invalidate myself without that added stress!
They’re also asking for a number of medical tests. These tests make sense for someone at a low weight or who’s really restricting, but neither is the case for me. I’m ashamed that these tests won’t show anything. I guess that’s also a sign that I do have a problem in my head, at least! I’m thinking most non-eating-disordered people don’t wish they were physically sicker than they are.
I’m also confused about my weight now. My dietitian said I’ve lost some weight, though I keep thinking I’ve gained it back. The shorts I’m wearing were snug enough at the beginning of the summer that I could wear them, but I didn’t want to. I wore a larger size instead. Then these ones became comfortable, and then I needed a belt, and now they’re even looser. I’m torn between thinking I’m losing more weight and thinking my shorts are just getting stretched out. The latter seems like a disordered thought, but I just don’t feel like I’m actually losing weight.
Even if I am, I know I’m still at a much higher weight than my usual, and if there is weight loss, it seems slow. I feel like my weight might settle down eventually and hopefully get somewhere lower than it is now. If I go to a higher level of care, though, they probably won’t understand. I’m worried they won’t let my body recover and get to a weight that is right for my body. I realize losing forever isn’t good, but I’m nowhere near needing to stop. I just hope that if I go, they see that!
I’m hoping that the assessments will help with some of these concerns. I have quite a list of questions to ask, between those issues, whether they can handle my other medical issues, and whether the patients will all be young, thin, cis girls and women. It can be hard to be the “other” in so many ways!
I’m also concerned with the practical stuff. How could I leave my family for long enough to get help? How could I miss work? How could I manage “on my own”, even with support? How could I get by without having enough control over my food?
I’ll keep looking into things, even though it’s scary. I’m sure I’ll know more soon!