More ED stuff (from someone with a psych degree who’s very familiar with the DSM criteria) – I technically didn’t qualify as anorexic either back when I was as a teenager, because my BMI never dropped into the underweight category. But I was eating less than 800 calories a day, often significantly less. And fit all the other diagnostic criteria, except for the bit where I have the body type of my stocky muscular Scottish and Welsh ancestors, and I don’t think it’s even possible for me to get to a BMI under 20…if eating under 300 calories a day for months at a time didn’t do it, I really doubt anything could.

Ironically enough I’m actually about 20-30 pounds lighter as a non-ED adult who never goes hungry (and is no longer hypoglaecemic, which I also was when I wasn’t eating properly). That’s part of how I came to FA, looking at my own history and seeing what happened when I tried to defy my natural body type. Dieting didn’t make me skinny, it just made me really really sick and incapable of getting anything productive done.

Fuck you dieting industrial complex. I want my mid to late teens back.

RE Dodai’s post…it really is a shame how that sort of “but you’re not fat, I think you’re pretty!” thinking seeps into mentality of even the most progressive people. I sometimes wonder if the people really mean what they’re saying, ie. “you actually do not look fat to me, therefore I do not believe that you are”, or if what they really mean is “but you’re not (insert list of negative qualities here), therefore clearly it is not possible that you are fat”. It’s really wierd how hard it seems to be for people to uncouple the physical state “fat” and the negative stereotypes associated with it, even people who’re actually thinking about it and trying not to be prejudiced assholes.

PS Tea Marguerite – OK, I’ll be the one to say it explicately – the DSM criteria need to be revised. Not just for anorexia, for bulimia too. Because the problem with eating disorders isn’t just that they can make people terribly thin, it’s that even if they don’t make people terribly thin they still make them sick. I have a good friend from high school who’s bulimic and has always been chubby. And her teeth are totally fucked up from the bulimia anyway. These are psychological diagnoses, the person’s weight at any given time isn’t and shouldn’t really be the key issue.

- ED trigger warning-

I had an eating disorder at 215lbs. I still have one at 155. I purge after meals, but, because it’s not a binge then purge, I don’t qualify for bulimia. I restrict what I eat, but because I’m not underweight, I don’t qualify for anorexia. I’m not upset to be diagnosed ED-NOS. It doesn’t mean my disorder is any less real or painful because I’m on the not otherwise specified spectrum.

In a similar manner, I don’t get upset when people tell me I don’t have GAD. I have anxiety problems. I get treatment and medication for my anxiety problems, and I’m not at all bothered by the fact that I don’t fit the diagnostic criteria for one specific disorder subset. That’s the whole reason that NOS exists, from eating disorder to dissociative disorders to bipolar and more.

I agree that the conversation about eating disorders needs to change to include people of all shapes and sizes, but I don’t think attempting to rewrite the DSM is the way to do it. Perhaps a website like the BMI project– “This is what an eating disorder looks like.” Only, I don’t know anyone besides myself who would feel okay posting their picture.

*possible ED trigger following*

Anecdata: my mom has been anorexic/bulemic for easily 10 years, but because she weighs ~140 and is 5’2″, would be considered “overweight” according to the BMI.

However, she eats once every other day, and often takes laxatives or vomits afterwards. Her hair and teeth are falling out from nutritional deficiencies, she sleeps constantly, and her mental health issues (net of the eating disorder itself) are *probably* made worse by constant hunger. What’s worse is that she has had doctors give her bullshit about needing to *lose* weight :(

I’m not trying to jump down your throat, TM, but this very phenomenon is rendered INVISIBLE by the very diagnostic criterion you are pointing out, and that I’m assuming the original commentator was snarking on.

I get what you’re saying, but you’re a little off in saying it.

Not to be nitpicky, but the diagnostic criteria for anorexia nervosa from the DSM-IV clearly states that the person must refuse to maintain a body weight at or above a minimally normal weight for age and height. So technically, a person with a BMI of 20 cannot be diagnosed with anorexia nervosa because she’s not underweight.

ED-NOS? Eating disorder? Unhealthy? Yes, but not technically anorexic.

Anyway. All the time people tell me I’m not fat, or maybe “not that fat” as in, some acceptable level of fat that is less than The Obese. Friends have been shocked that I have to shop at plus-sized stores. Even some of my doctors refuse to call me fat or obese, despite obese being the appropriate BMI category for me, and call me overweight. Occasionally I object and even though they know my exact height and weight and in most cases BMI (from my chart and without having to calculate it in their heads), they’re always shocked that I’m “obese.”

I wish the BMI Project would open up again, actually, and with the option of us providing exact heights & weights & BMIs as well as the basic category.

Very well said.