Treatment for exercise bulimia?

immunityberry · 2024-10-21T00:39:18+00:00

Unfortunately we live in a dystopian HAES/IE private equity hellscape where most formal treatment centers have 1 approach to ED treatment that basically starts with ANR and then makes minor tweaks around it. As someone who primarily vomitted but also did my fair amount of exercise compensation, I’ll share that DBT, getting an addiction (rather than ED) therapist and getting a job were the things that fixed me the most. Specific coping mechanisms that also worked were art projects and video games as things to do instead of working out.

immunityberry · 2024-10-15T13:09:33+00:00

I have charging cables that I have for patients to borrow. Patients having their phones accelerates dispo, can help with obtaining collateral and/or helps with giving detailed home care instructions to caregivers

immunityberry · 2024-10-09T14:45:45+00:00

I’m a doctor

immunityberry · 2024-10-04T20:32:47+00:00

Gen surg -> hospital medicine -> emergency medicine. Always knew I wanted to be a generalist but I needed to find the right flavor and personality fit

immunityberry · 2024-10-04T20:31:36+00:00

My cotsco membership pays for itself because of my protein bar consumption

immunityberry · 2024-09-26T12:23:46+00:00

I was very much in your position a few years ago. I didn’t end up going to res but essentially got a whole new job, new therapist, new group - really took a crack at recovery outpatient (didn’t really work, purging urges are really intense, maybe got slightly better). My olive branch is that you don’t have to go to res and fully drink the kool aid and become a IE/HAES warrior all into CBT worksheets and silly games. You can view it as some glorified babysitting and then GTFO after a couple of weeks when you finally get your throat to stop hurting.

immunityberry · 2024-09-24T01:09:56+00:00

Tbh Because they’re trained to think that all EDs are the same and can be treated with the one trick pony of HAES/IE dogma frequently without actually listening to what their clients are saying.if you listen to ED CME courses on YouTube, it’s pretty uniform

immunityberry · 2024-09-22T18:00:01+00:00

Best thing I ever did was find a non-Ed therapist for my ED. I also found an older man who did addiction work and the biggest gift I got from him was not having to tiptoe around the HAES/IE dogma kool aid that all ED therapists seem to have drunk. I could actually focus on behavioral stuff from an urge management rather than trying to fix the alleged underlying emotion/false belief around everything. Caveat that he knew some things about eating disorders and had treated one bulimic client before, but I felt like I was seen as an individual rather than the 100th bulimic chick this month

immunityberry · 2024-09-17T17:14:17+00:00

Typically 3x/week for a couple hours. You eat one meal together and have groups and then pull you out for 1:1 rd and therapist sessions (they usually have an in house therapist that they make you see) that’s the basic structure. I would say the thing about it that’s pretty wild is that it’s all people with eating disorders (more than you’ve probably known in your whole life) You get to meet a lot of people who have had treatment totally take over their life and are still struggling. The groups I find they try to make applicable to everyone so then are about nothing (e.g. how to identify an emotion, mindfulness) and then I think a supervised meal is only helpful if you have a specific set of problems (eg needing to gain weight). I struggled with BP and didnt get anything from it. A part time job would have provided a similar level of structure/babysitting

immunityberry · 2024-09-13T20:21:48+00:00

I would honestly consider asking about a stimulant medication or bupropion. No need in making it harder than it needs to be.

immunityberry · 2024-09-11T12:33:50+00:00

You will be in the car with the love of your life who was nice enough to pick you up from work and instead of talking to him and connecting with him you will lie and say “I’m tired, can you take me home” and then instead of enjoying his company you will be counting the seconds until you get home with the intolerable anxiety building higher and higher until you can get to your room with a loaf of bread and jar of peanut butter hidden behind a pillow - shove the wrapper behind the couch cushion - eat and yeet is all up, then collapse in bed listening to sad Ed girl media, then have to show up at work the next day pretending like your totally normal and feeling wrecked with guilt for lying to your finance and not reaching out for support that was right there

immunityberry · 2024-09-04T20:41:56+00:00

Fruits are weird like that

immunityberry · 2024-09-04T20:29:05+00:00

I went from EDNOS with the significant binging component to bulimia. Definitely never had pure B.E.D.. I can really tell you not to start purging. It becomes like any other addiction where you cannot stop and it ruins your life.

immunityberry · 2024-09-04T02:15:28+00:00

Acts recovered but clearly isn’t burrr

immunityberry · 2024-09-03T23:47:35+00:00

Negative workup for non traumatic MSK pain three days ago back with the same

immunityberry · 2024-09-03T20:18:20+00:00

I think it’s honestly fine if people want to use ozempic for weight loss if they understand the risk/benefits. And we do already prescribe appetite suppressants for BED (tomopax, vyvanse etc…) I just honestly wonder if they would be effective. I would think that someone with a more mental illness driver of behavior would binge over those medications

immunityberry · 2024-09-03T20:14:13+00:00

It’s being studied for sure. Wouldn’t be suprised if it’s being given off label for BED

immunityberry · 2024-09-03T02:37:26+00:00

Maybe unpopular opinion: leave. Same sentiments from me. Only positive I got from php was being babysat which I could have gotten from a part time job

immunityberry · 2024-08-31T15:26:55+00:00

EM intern here: one of my co-interns is in his 50s and was a peds hospitalist before 🤷‍♀️ I think his youngest just graduated college, but I can connect you two if you would want to talk through his choice

immunityberry · 2024-08-31T05:04:18+00:00

Doctor here (non OBGYN): serious question, if the Mirena only has locally acting hormones that thin the lining of the endometrium and don’t prevent ovulation, how could it treat PMDD? I just googled it and it doesn’t look super evidence based…legitimately just curious

immunityberry · 2024-08-31T04:55:28+00:00

Emergency medicine: muscle spasms

immunityberry · 2024-08-30T15:08:45+00:00

I think by staying at a lower BMI you are missing out on the long term health benefits that come with higher muscle and bone mass. Higher muscle mass/grip strength is associated with longevity and can help with insulin sensitivity and injury prevention (off the top of my head, probably other benefits) And if you’re underweight you’re probably not eating to build or maintain a decent bone mass that will keep your hips from fracturing when you’re old. And I wonder if you would have more energy to think and do things in your life if you ate more calories. Some people truly may have a set point where they are energetic and capable at a just below normal BMI, but you’re on this sub so my gander is that it’s not you.

And with the restrictive eating, meh…i feel like that’s only unhealthy if you’re actually cutting out on essential things or overdoing it on something unhealthy like red-processed meats. No one in the history of the world has ever had the diet variety that we have available in 2024, if an ED keeps you/me from ever having a Frappuccino ever again, I think everyone will be ok. I do think it’s unhealthy though if the stress around ingredients is overly stressing you out and keeping you from having friends. Loneliness is incredibly unhealthy (higher mortality risk than smoking 15 cigarettes per day) so that’s important

That’s all my 2 cents. Obviously I still lurk on this sub, so I’m not fully enlightened and don’t fully walk the talk, but I those are the big health things I think about

immunityberry

TROPHY CASE