I am 22 years old, and I have been seeing a counselor who only treats eating disorders. The reason I began to see this counselor is that I knew I had some disordered behavior, but I don’t feel that it is even affecting my physical health. I mainly am seeing her because I am sick of being obsessed and depressed all of the time. She has suggested that I see a nutritionist, and the only way my insurance will cover the cost of a nutritionist is if I get a physical first. I have been really worried about all of this for a number of reasons. 1) I don’t live at home (I’m a student living far away from home) and I don’t have a primary care doctor. I don’t know who to make an appointment with that would fit with my insurance and that understands eating disorders. 2) I don’t really think this has affected my health. Maybe I am just in denial, but I am afraid I will go to a doctor who will think I am wasting her time. My counselor has given me the letter that she sent to my insurance company, asking them to cover the cost of a nutritionist. She gave it to me so I could give it to the doctor I see so that they will know what I need them to pay attention to and inform the insurance company about. I was horrified to see the symptoms next to a diagnosis of bulimia nervosa. I really didn’t think it was that serious. When I went home and read it, I cried because it scared me. Is it normal to feel this way? Is it normal to really not believe that this is a serious problem to my health? And how do I go about finding a doctor and explaining my situation to them? I just need some advice. Thank you so much! – g.
Dear G.,
We’re glad that you took the time to write us. Your fears and concerns are completely understandable and you are definitely not alone in having conflicting feelings. As you have experienced, people struggling with eating disorders often deny or are unaware of the physical risks they are taking. I sense that you are at a very important turning point, so press on!
It’s wonderful that you are seeing a counselor who is concerned about your physical health, in addition to your emotional well being. Referring you to a nutritionist shows that she cares, and is also being thorough in your treatment plan. Sometimes in the process of recovery, we have to trust that others—especially professionals—know the best course of action.
As you have discovered, bulimia is very hard on the body, and can cause multiple medical complications. I know it is difficult for you to face this reality, but accepting it is a positive step in moving forward. Getting a thorough physical exam at this time is like a gift to yourself, to identify if you have any problems and ensure your future health. Of particular concern in the short term are the electrolyte imbalances that can occur from purging, which can cause heart problems and seizures. As you now also know, bulimia can result in damage to your gastrointestinal tract and erode teeth enamel. In addition, your eating patterns can contribute to mood swings and feelings of depression. All of these complications have nutritional ramifications, so seeing a nutritionist will be a valuable use of your time and resources.
Regarding your question about finding a doctor, the simplest solution would be to call your counselor and ask for a referral. It would be ideal to see a health care provider who specializes in eating disorders, but if that isn’t feasible, a general doctor would be able to do the assessment. Since you are living far from home, another avenue is to ask some local people—be it friends or professors—for the names of some good, caring doctors. Another option is to see someone at your school’s health clinic. You might also consider seeing a nurse practitioner or physician’s assistant. Not only are their fees more reasonable, but they generally are able to spend more time with patients. When calling to make an appointment, you can tell the receptionist what type of insurance you have and often, they know right away if your visit would be covered.
At times, we need to take action despite our feelings. You are well on the road to recovery, and paying attention to your body is an important step. It’s the only one you have and it deserves respect and care. I encourage you to move forward in getting a medical evaluation and a nutritional assessment. Keep working with your counselor, and you will soon start to feel so much better—both physically and emotionally.
Keep in touch.
Ann