Dear Alice,

Last year I was Teetering on the Brink and this year I've fallen off of it. The teetering individual who was worried about how much she thought about food and her weight has turned into a very scared person who has fallen off the brink, with little on her mind but what she eats, when she eats it, and how she looks. I haven't had my period for almost a year and exercise compulsively until I can't anymore, when my legs simply hurt so bad and my knees won't hold me up. Worse, I seem to be losing bladder control—several times when I've been very tired, I've wet the bed at night or been unable to wait until I got to a bathroom. I can't live like this anymore and every morning I promise myself I'm going to change but then night rolls around and I've not changed a thing. Please tell me something that will help — I never knew desperation's face was this thin.

— Needing Help

Dear Needing Help,

Thank you for writing. Reaching out can be intimidating, even online. You've taken the first step towards regaining your health by admitting that you have a problem and asking for help. First of all, it is important to get support from others throughout this process. The reality is that anorexia nervosa (whose symptoms you describe perfectly) is a very complex disorder, and it will take time, energy, and the help of multiple health care professionals to untangle the components that got you into this state. Whereas last year you may have been teetering on the brink, it is now safe to say that this year you've crossed the line.

At this point, it is imperative that you see a health care provider. Some of the long term physiological effects of anorexia are irreversible, so the faster you get help, the better. Your health care provider may recommend that you start a comprehensive treatment program for eating disorders.

If talking out loud about your problems seems daunting, you can start by simply making a list of your symptoms (as you've done here) and telling them to a counselor or doctor. Your health care provider will be able help you move forward from there. Together you will be able to work out a plan of action — whether this leads you to an in-patient treatment program, an out-patient program, or group and/or individual counseling. You can make the decision based on both your personal needs and your insurance plan. You can also find more resources and information from the National Eating Disorders Association website.

Please talk to someone soon. You're worth it!

Alice!

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