I have a question. People have asked me “why aren’t you in the hospital?” or “how do you not have a feeding tube?” I am 5’5 and weigh ** lbs and have had anorexia for 6 years since I was 14. Am I not sick enough for my doctors or family to want me to get help? What has to be wrong with a person with an eating disorder for them to be put into the hospital? Do you have to stop eating all-together to be put into the hospital or given a feeding tube? When should a person get a feeding tube? – anonymous
Dear Anonymous,
The body learns to adapt to a state of starvation and keep itself acutely stable. That doesn’t mean that your body is not being harmed. With today’s health care and insurance situation, to be hospitalized requires a person to have a problem which needs immediate treatment and generally can be corrected in a day or two. Much health care is performed as an outpatient. This means that many people with anorexia will be told that they don’t need to go to a hospital to be admitted. If your body has lived in a state of starvation for a long period of time, chances are that your labs are relatively normal. Again, this doesn’t translate to “you are fine.”
If you are having great difficulty in taking in the calories you need to restore weight to a healthy level, you may benefit from a feeding tube. Many people use a feeding tube from home, with the assistance of home health care nurses. Talk with your doctor and explain your difficulty. Try to find an MD that understands the ED. My usual practice is to work with the patient so that they eat weight maintenance calories, but then use the feeding tube to supply the calories needed for weight restoration. This way, you are not “overeating” to gain your weight.
It sounds as if you are looking for help. Unfortunately those close to you may not recognize how much of a problem you have; as they may think it is just “normal” for you to be so thin. Ask for help. Share your struggle with someone you trust. See “Finding Treatment” for more guidance.
Brenda K. Woods, MD, FAAFP