Assessing the Consequences of Undiagnosed Disordered Eating
At 19 years old, I identify as male (ftm), stand 5'6" tall, and currently weigh 163 lbs. My mental health treatment includes a dosage of 150mg venlafaxine along with Nebido injections. I have a history of Borderline Personality Disorder (BPD), Post-Traumatic Stress Disorder (PTSD), complex trauma, depression, and anxiety. Additionally, I’ve previously experienced a heart murmur and am undergoing evaluation for Postural Orthostatic Tachycardia Syndrome (POTS). Last year, my psychiatrist added 45mg mirtazapine to my regimen alongside venlafaxine. I initially weighed 136 lbs but saw a jump to 195 lbs within just three months. In May, I decided to discontinue mirtazapine abruptly, after which I lost 30 lbs. Food has always been a source of struggle for me, exhibiting disordered behaviors since childhood—such as fasting starting at age 8 to lose weight, excessive exercise, avoiding food, and vomiting after meals. Since halting the mirtazapine, my daily caloric intake has been alarmingly low, ranging from 300 to 800 calories depending on my emotional state and daily obligations. I had one week during a holiday where my consumption was significantly higher; despite my intent not to restrict, I found myself refusing food even after I vowed to avoid doing so. That was in June. While I once adhered strictly to my eating patterns, I've recently noticed a shift. Over the past three weeks, I've had one or two days each week where my caloric intake has spiked to between 1200 and 2000 calories without any prior planning. This deviation often triggers feelings of guilt, shame, and anger, leading me to compensate through the use of laxatives and further dietary restrictions. Since May, I've been relying on laxatives about once to twice a week. My physical activity levels are quite limited; I walk my four dogs, averaging 6000 to 10,000 steps three days a week, whereas on other days, I may only clock around 2500 steps. When I do walk, I maintain a brisk pace, typically uphill. My aim is to reduce my weight to around 125 to 130 lbs ideally by Christmas, after which I hope to stabilize my weight and assess how I feel. I am concerned about the possible health risks associated with my eating patterns. Although I haven't encountered the common symptoms yet, I have recently experienced an increase in chest pain and heart palpitations over the last three days. Based in the UK, I am aware that health guidelines vary by location. Any guidance would be greatly appreciated. Thank you for your support.
Answers (1)
8/14/2025, 2:40:54 AM
OpenHealth AI
It's important to acknowledge that you're facing a complex situation involving your mental health, disordered eating behaviors, and physical symptoms. These factors can significantly intersect and require careful management. Your concerns about weight, caloric intake, and the physical symptoms you're experiencing, such as chest pain and palpitations, are valid and deserve attention.
Key Points:
- Disordered Eating Patterns: Your history and current behaviors indicate disordered eating, which can have serious health consequences.
- Physical Symptoms: Chest pain and heart palpitations are concerning and should not be ignored. These could be related to anxiety, dietary habits, or other health issues.
- Focus on Nutritional Health: Prioritizing a balanced and adequate caloric intake is essential for your overall well-being and mental health.
Explanation:
Disordered eating often leads to a cycle of restriction, bingeing, and compensatory behaviors (like using laxatives), which can have harmful effects on your physical and mental health. The drastic changes in your caloric intake can contribute to nutrient deficiencies and may exacerbate your existing mental health conditions. It's good that you are mindful of your weight goals, but aiming for a healthy relationship with food and body image is equally important.
Next Steps:
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Monitor Symptoms: Keep a log of your physical symptoms, including chest pain and palpitations. Track when they occur and any potential triggers (dietary, emotional, etc.). This can help highlight patterns or correlations that may need further evaluation.
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Gradual Dietary Changes: Instead of severe caloric restriction or extreme fluctuations in intake, aim for gradual changes. Focus on incorporating nutritious foods that you enjoy into your meals. Aim for at least 1,200 calories a day as a minimum, ensuring it's from balanced sources like fruits, vegetables, whole grains, proteins, and healthy fats.
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Hydration and Rest: Ensure you're drinking enough water throughout the day, and prioritize good sleep hygiene to help with your overall mood and energy levels.
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Limit Compensatory Behaviors: Reducing the use of laxatives is crucial, as they can disrupt your electrolyte balance and heart function. If you feel the urge to use them, try to find an alternative coping mechanism like journaling or talking to someone.
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Establish Support: Consider reaching out to a registered dietitian or a therapist specializing in eating disorders. Professional guidance can help you find a healthier relationship with food and address underlying emotional issues.
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Seek Immediate Care If Symptoms Persist: If you're experiencing persistent chest pain or heart palpitations, it's crucial to contact a healthcare professional right away to rule out any serious conditions.
Your journey is significant, and taking these steps can help you navigate your challenges more safely and sustainably. You're not alone, and it's essential to prioritize both your mental and physical health equally.
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