QUESTION: I want so badly to be forced into a doctor's office - or to even just go, without force! Problem is, my family has inadequate health insurance. My mother will cry to me to please gain weight, but she has never even mentioned seeing a doctor. I have responded to her in the past, in denial, saying - if you think I am so sick, why don't you bring me to a doctor? We have no family doctor and I seriously believe any medical expenses incurred from an eating disorder will be looked at by mother and family as a selfish burden I have imposed (we're poor!) since, after all, I am 'smart enough' to 'know better' than all this. Help. I just want a doctor to set me on the right plan and help me believe I'm going to be okay - I fear death, sometimes.

ANSWER: Hi dear – believe me, I understand. I hear your cry for help. And I understand why you fear death sometimes – eating disorders can be deadly and you are right to take your disease seriously. I want to suggest that you read my answers to all the other questions in this volume, but especially read my answer to the question about why I never sought professional help. My personal belief, which I realize is controversial but for which I have copious personal evidence to back it up, is that if you want recovery badly enough, just like anything else you want badly enough, you will let nothing, not even a lack of medical insurance, stand in your way. You will find a way.

However, having said that, in ‘reading between the lines’ of your question I am sensing some assumptions you may be making about your family’s education level when it comes to eating disorders. And I am also sensing some assumptions you seem to be making about their willingness and ability to help you. One thing I always urge the women I work with to do is to communicate their needs clearly to their loved ones. If you need to go see a doctor, then simply tell your mom that you need to go. Your mom may not have any understanding of eating disorders, and she may not know that there are treatment options available to help you. If she tells you that your family doesn’t have money for you to see a doctor or have treatment, then ask her if there are any other options. Can you visit a local hospital that makes provision for those without insurance coverage? Can you arrange for a payment plan with the physician of your choice? Would the doctor or hospital possibly be willing to see you even if you cannot afford the payment, or be willing to reduce the payment to something you can afford? Can you take out a short-term loan to afford medical care?

If she remains unwilling or unable to help, or shows signs of being too afraid or overwhelmed by what you are facing to be able to offer the help you need, then seek out another adult who can understand and offer help. This may be a family friend, another relative, a spiritual leader, a school teacher or counselor, a coach or a friend’s mom….brainstorm to think of people who may be able to offer help. There are also so many excellent web resources out there that may lead you to help, and in one of the other questions I give a link to a page on the Key to Life website with my favorite weblinks. You may also want to check out Mercy Ministries and the FREED Foundation online for options.

Unfortunately, one of the side effects, and often one of the root causes, of an eating disorder is an unnaturally low self-esteem. I remember all too well the intense shame and horror I felt inside as I watched my disease, and the unwillingness it generated in me to speak up about what I needed, tear my family relationships to shreds. But the fact of the matter is, eating disorders are 50% genetic and 50% environmental, and saying you should be ‘smart enough’ and ‘know better’ than to develop one is like saying a cancer patient should have been smart enough to avoid leukemia. It simply doesn’t make sense, especially since the DNA that created you also contributed to your vulnerability to the disease you suffer from now.

What it all comes down to is this. You cannot be passive – you must take an immediate, proactive role in beginning your recovery work. You cannot rely on your mom to ‘get it’, or a doctor to ‘set you on the right plan'. In order to win your battle against your eating disorder, you must recognize the complicated reasons why the eating disorder began and why you continue turning to it now, and slowly but surely begin to turn your own mind from your enemy into your ally.

I liken the part of your brain that is overtaken by an eating disorder to a cancer that must be rooted out so that your mind (and body) can be restored to health again. You have a part of your brain that is actively working against you right now, whispering to you that you are unworthy, that you are a burden, that you don’t matter, and that help is out of reach. None of those statements are true. You may have to get creative to find the help you seek, but if you look for it, you will find it. You may also have to accept, as I did in my recovery journey, that a partial or full do-it-yourself recovery program is your most immediate source of care. This will involve reading self-help books, finding places in your community that offer medical and psychological care at reduced or no charge, and teaching yourself to fight like a dog against your disease until you convince your own mind that winning the war over ED is in its own best interests. This is how I did it. And, regardless of the method employed to get there, every successful recovery from an eating disorder involves a totally changed mind. You must work with your mind and educate yourself about your disease, nutrition, health, recovery, and other people’s recovery stories, and you must cultivate patience, courage and perseverance in order to achieve your goal. As your mind changes and heals, your body will follow. You can’t get there from any other direction.

I will say this, however. You sound very clear about what you want and need. So your next step is to communicate what you have shared with me to your family, and take it from there following the steps I have outlined above. Please keep in touch and let me know how you are doing.

Much love,

Shannon

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