How Can I Be Anorexic, But Not Visibly Underweight?

By November 16, 2012

I am 19 and have been diagnosed with anorexia and bulimia, just this year. I have struggled with both for many years now, but have only recently found someone whose help is actually working. Although my behaviors are typical of those with anorexia, I question that I even have an issue, because I am not visibly underweight. In terms of my height, I am hovering JUST under the lowest point for my weight range/age/height etc. Most people tell me I look healthy. The people who know what I am going through want me to put on weight, and maintain that I actually am underweight. Why would they be the only ones saying that? It seems like they just want me to eat more. It is hard – when most people think of anorexia, they think of extreme thinness. I do not fit that description, and so often doubt how much of an issue this is for me. I know the diagnosis is clinical, and that ED’s are not all about weight, but I struggle to understand how I can be anorexic, and yet not visibly underweight. – Advice? E.

Dear E.,

Your question causes a couple of thoughts to come to my mind. I want to start with what is essential. You have been diagnosed with anorexia and bulimia, and write that “I have struggled with both for many years now…” Yet later you question the label of anorexia. It is my belief that that is the disorder talking. Do you hear its silent seduction? The small, soft voice that says: “are you sure you have that? You don’t look like _________ or like _________. “

It is a scheme of the disorder to make you question the therapy that is working. It is meant to make you question whether the professionals and other people in your life that supposedly care about you really do. It is the voice of temptation.

No one defines anorexia as just emaciation. Anorexia is not just a description of a physical appearance. It is a term that describes a cluster of symptoms. Decreased weight (BMI) is just one factor.

There is no trophy or badge for anorexia/bulimia. There is no perfect way to be anorexic or bulimic. Are you suggesting that the diagnosing clinician does not know his/her stuff? Or do you not believe you are worthy of such a diagnosis? What has to happen for you to believe you are experiencing anorexia? Would you have to lose more weight, be officially underweight and noticeably emaciated? If so, that is the disease talking. It is enticing you to not accept help.

Scripture portrays the schemes of evil. Particularly, how the serpent, when it approached Eve in the garden, was really whispering to her: “are you sure God meant you shouldn’t eat from this tree?” Those of us who believe the biblical accounts of history know that this seemingly innocent questioning of how true God’s word was changed the course of history.

I hear you questioning what someone has told you. Are they telling the truth with that diagnosis? Should you just accept it and believe it and trust them? Consider performing a little experiment. Decide that you are undecided about your diagnosis but you are willing to accept the diagnosis as being some thing in your best interest. Like any good scientist, act as if you agree with the diagnosis for at least 90 days. Make a mental note of what differences you experience as a result of being an active, recovering, anorexic/bulimic. Examine after 90 days the fruits of having accepted what you were told and living beyond it. I will be anxious to hear what happens.