Why you are already "sick enough"

Sometimes people feel as though the diagnosis OSFED means that they do not have a “serious” eating disorder or that they are not “sick enough”. This can result in people not seeking treatment, criticising themselves for their struggles, or not asking for support from family and friends. In some cases, it can lead to people deliberately trying to lose more weight or engage in more eating disordered behaviours in an attempt to be “ill enough”. Unfortunately, sometimes services can feed into this narrative. Some services are only able to offer treatment to people below a certain BMI or who are engaging in a certain amount of eating disordered behaviours. Whilst this is often an artifact of how the services are funded, it can leave people feeling as though they are not ill enough.

OSFED is an eating disorder

It’s important to remember that OSFED is an eating disorder - just like bulimia nervosa and anorexia nervosa. Although it is not talked about as frequently, it is actually the most common eating disorder with a recent research study suggesting that OSFED accounts for about 47% of eating disorder cases (Hay et al., 2015).

“You look fine, you can’t be ill”

Many people fear that they will be judged if they are not significantly underweight - that people won’t believe they have an eating disorder or won’t see how much they are struggling. However, being ill is so much more than being underweight. People can be a healthy weight, but be eating very little, exercising a lot, or purging. People can appear healthy, but can be battling voices about food or their shape or weight 24/7. There is no link between weight and how strong that self-critical voice is.

Sometimes it can be the people who care about you who say that you are looking well… and that can feel like such a criticism. However, this may be their way of trying to encourage you, or of trying to reassure themselves that you are ok. But the best measure is the impact your eating disorder is having on you. If it is causing you distress and is affecting how you function (whether or not it is obvious to other people) then you need to get help.

Early intervention

People typically have eating disorders for a long period of time before they get treatment - even if they are trying to access support. However, there is a lot of research to indicate that earlier treatment can improve the likelihood of recovery in both anorexia (Treasure & Russell, 2011) and bulimia (Reas et al., 2000) and reduce the risk of relapse. Early intervention can also minimise the physical impact of the eating disorder on your body.

So if you are struggling with issues around eating, shape, or weight, ask for help. The chances are that you will never be sick enough or light enough for your eating disorder - the goalposts will keep changing. As hard as it can be to challenge that eating disorder voice, a little support now may save a lot of distress and damage down the line. You do not deserve to be ill.