coming to terms with an ED

Okay so I am starting to come to terms with the fact that I may have an eating disorder. However I don't believe I do (which may be the denial part). I eat a maximum of 300 calories a day which will consist of salads and stuff but I just put it down to 'healthy eating'. I am nearly underweight (apparently) however I refuse to believe that as I still have fat!.

This is why I refuse to admit I have a problem.. Because I don't look thin and I still look fat! When I am weighed in a professional environment I feel like the scales are lying or they are rigged because my scales at home say I am 1 stone heavier (my mum did warn me that shop brough cheap scales are not reliable as they can't be checked like ones in the dr).

Does any of this even sound like an eating disorder? Because I admit it don't seem like one to me, I can't believe it although yesterday I went over 300 calories and threw it up (which I would NEVER do!). When shopping I look at the numbers on the food, avoid bread, potatoes, pasta and rice. What mores left to eat?! But I can't help it as I have these voices that tell me how nasty I look or am.

What can I do? What does it sound like? Just a phase or something more? Any answers greatly appreciated

That amount of calories is not enough to really sustain a person. We can't diagnose you here, but it does sound like you have an eating disorder. I would go to my gp and tell them what you told us here. Purging is not good for you in so many nuber of ways. It can ruin the enamal on your teeth for one. I hope you are able to get the help and support you need to over come this.

There is a whole world of food outside these items that you are - I think, prudently - avoiding (except that rye bread - whole rye - is OK and very good for you, but wheat bread is better to avoid). There is oatmeal with fruit, berries or dried fruit for breakfast, there are cheeses in moderation paired up with more fruit, there is an untold number of vegetables, there is chicken, lamb, lean beef, then there are nuts and seeds, beans and legumes, and yogurt and kefir which, I imagine, are a must for you given the digestion need at such a low caloric intake. Plus you need protein - eat plain greek/strained yogurt to get maximum protein for minimum calories. Finally, you absolutely must have oils which are high-calorie foods, so when you write that you eat salads, I infer that you do not dress them, and that is not a good idea. As for fat on the body, everyone especially women should have some, but if you absolutely must have the leanest body possible, your best bet is to significantly up the calorie intake with an emphasis on protein and undertake serious strength training coupled with endurance exercise.

As for diagnosing, of course we cannot, but just in the ballpark I would say that anyone eating fewer than 1000 calories a day consistently day in and day out should at least be evaluated.

Oh, and I forgot - there is another thing, called "skinny fat". These are low weight women who are not fit and whose body composition includes a high percentage of fat. A higher weight person can be fitter, more muscular, with firmer bones. If you can afford them - about $100 stateside - buy high tech scales. They will display your body composition to you (and show correct stones, to boot). You should shoot for healthy fat (look up the numbers, they are higher for women than for men), enough bone mass, and as much muscle as possible provided this is what you want. High bones mass at your age is critical to preventing osteoporosis later in life. High bone mass is a product of weight bearing exercise (even walking - against the force of gravity - works, but biking does not) and calcium in the diet. Calcium is available through dairy and some vegetable sources such as chard, but you have to eat a lot of chard if you want to limit yourself to this source. Much easier with yohgurt etc. With 300 a day, you must be deficient in dairy. It is very hard to think of the future, especially when you are so young, but try to imagine and choose - do you want to be a frail little lady with a crooked posture or a more robust elderly woman who can stand upright? Your decisions now matter. I hope I make sense. Good luck.

Please describe them - how often do you hear them, are they metaphorical or real, are they loud or not, male or female, inside your head or outside, always critical or sometimes, resembling the voices of someone you know or complete foreign to you?

This sounds eating disordered to me. Your brain alone consumes more than the three hundred calories you said you ate. Can you think of nothing but the next time you get to eat? Are you often cold? Do you get dizzy? All these can be further signs.

When I was in my ED I felt the same way. The scales were telling me I was underweight but I wouldn't believe it- I still looked so fat. Then I was hospitalized for five days because my organs were consuming themselves from lack of energy. That's just one of the things an ED can do to you. At the very least I recommend getting checked out by a medical doctor if this has been going on for long. A psychological diagnosis would probably also be advisable. Better safe than sorry.