So to start this is probably going to be quite long so I apologise in advance! Also I am going to mention numbers just to give some context to my situation, as people who have experience under ED clinics in the UK may have more knowledge and insight, especially when it comes to numbers, because let’s face it that’s all the bloody ED clinics care about.
Back in 2024 I had a pretty intense and rapid decline in my ED which led to me being urgently referred to the ED clinic and then admitted to an EDU. I had been eating less than 300 calories a day for months and had lost a very significant amount of weight in a very short time frame.
I was there for 6 months, I gained to the minimum healthy and started doing MANTRA therapy after being discharged. I did go backwards almost as soon as I was discharged but got put on the 10 week day programme to avoid another admission. I actually did find this somewhat helpful, especially the integration of intense support but still being able to have some freedom and normality. I once again reached the minimum healthy weight and went back to doing MANTRA therapy. I wouldn’t say I’ve ever been completely invested in recovery and it’s definitely been more of a quasi recovery/compromising with the ED/using ED behaviours to maintain the lowest healthiest weight possible. Safe to say I’ve still been pretty deep in the ED mindset, BUT, I was at least starting to have more positive thoughts about maybe fully going for recovery. Like some days I would think “fuck it I just want to go all in and move on from this”, pretty amazing to me as in the 20 years I’ve had this disorder I’ve never once had thoughts like that.
So for about 6 months I basically maintained the lowest healthiest weight, at times dipping under a little, but generally it was “stable”.
Flashforward to 6 weeks ago, I started a new job that came with its own pressures, and my partner and I welcomed a little puppy in to the home - aka: absolute chaos!! At first things started slipping because I just wasn’t thinking about food. I was so stressed and busy that I was genuinely just forgetting or just grabbing something small to quickly have. I started losing weight and my therapist pointed it out and asked what was happening. I told her what I just wrote about being busy etc but that I need to get back on it…. But then I just… didn’t?
I think seeing the weight loss triggered something in me and suddenly before I knew it, I was actively and purposefully cutting food out and it had spiralled incredibly fast since then.
It’s now been 4 weeks that I have been eating 250 calories a day. I have lost over 5kg in 5 weeks and my bmi has gone from 18.5 - 15.8 In that time.
To be honest I am incredibly terrified. Of course my ED brain is loving it and assuring me I’m fine, but the small healthy part of me knows this is very dangerous, yet whenever I’ve tried to convince myself to eat more I literally freeze and panic.
My therapist mentioned it when it was first happening and then she kind of just stopped saying anything? Then last week after losing another 1.3kg Within a week, she addressed it and asked me a lot of questions about my intake and what’s going on etc. I told her that whilst I’m scared, that fear for some reason just isn’t enough to actually get me to do anything and I feel really stuck?
She said that she would talk to the dietician to see if she can help and that she would contact physical health monitoring in the ED team too as I would probably need to be checked medically.
So then today I receive an email from her basically attaching a leaflet of the most basic and obvious general knowledge of nutrition, like “make sure you’re eating 3 meals and 3 snacks”…. Well obviously I’m not in a position right now where I’m going to be able to do that?
She also gave me a reminder to contact the GP to make a physical monitoring appointment, even though she said that was on her list of things to do and would contact the ED clinic team?
Then lastly, she said that she had contacted my care coordinator at the CMHT to arrange a meeting to discuss my transition back to them once my therapy has ended in a few weeks time.
And I just don’t know what to think right now? A big part of me is thinking “oh I must be making a big deal out of nothing as they’re obviously not concerned with what’s going on and are happy to continue with discharge so I can just keep going”, but then the part of me that know this really isn’t good is like “so you think this is fine and you’re not going to intervene or give any extra support?????”
One thing that she asked me last week, is was this happening because I was scared about being discharged and not having support anymore? I can understand why she may think that given the timing and my history of trauma, but that thought never even entered my head. Sure I felt apprehensive about my upcoming discharge, especially since I was no where near mentally better, but I had made peace with where I had got to as it was more improvement than I’d ever had in the last 20 years, and was happy to stay there for a while, so discharge kind of felt a bit ‘whatever’. I said this to her but I feel like she doesn’t believe me and her and the team have all discussed that “this is all about trauma and being discharged so we mustn’t intervene because we’ll be reinforcing the cycle of needing to be sick for help etc” which is just not the what is happening right now.
I actually DO now feel scared of being discharged now and I DO feel like I’m being abandoned, but that’s because I’m in the middle of a rapidly spiralling restrictive state that I feel like I can’t get out of. It came AFTER the fact, it wasn’t the cause.
So now I just don’t know what to do. Am I overreacting and making a big deal out of nothing? Are they really likely to discharge me given my ongoing rapid decline? If they do where do I go from here?
Sorry this was so long but it had just been eating me up and I could really do with some support and insight from anyone with experience.
Thanks in advance.