[cka87]

So this past week my dietitian gave me an ultimatum, said if I don't go into IOP she won't work with me any longer. She gave me the contact information and said I could make another appointment with her when I got into their program. So...obviously this kind of devastated me. I emailed my therapist and she never wrote back. She always back emails within 24 hrs so now I'm worried she doesn't think she should work with me anymore either. Feeling pretty abandoned right now.

on a side note..i dont want to do IOP, have no insurance that pays for mental health, barely can afford my T and dietitian. I mentioned that I dont want IOP in my email to T and told her I was struggling and had no idea what to do next.

[kaliope]

so how is IOP connected to your diet? is it going to benefit your diet issues that she has given you this ultimatum? if you are that dead set against it, find a different dietician.

[clairelisbeth]

I think the OP probably sees an ED dietician and the dietician feels she needs a higher level of care for her ED (IOP)...is that right?

I've been in the position of my team suggesting a higher level of care and my not wanting to go. What I later learned is that they were usually right. I can understand that this is hard and definitely scary, but if your dietician and/or T could help you find an IOP program that your insurance would cover, would you be willing to think about it?

It doesn't sound like your dietician wants to abandon you-more likely, she can't ethically continue to treat you if you're in a bad state. She's probably hoping that your desire to keep your relationship with her might motivate you to choose treatment.

I've been in recovery for several years and I know how hard it is. Feel free to pm me anytime.

[cka87]

yeah she says since I am continuing to lose weight that she can no longer enable me. i really have no interest in the IOP. It is the only ED treatment center in my city. I looked into it and since I would keep my own dietitian and therapist the only thing they can offer me is their groups. I have NO interest in groups, and they sound like BS. And i'm 27 I don't want to be stuck in groups with what are probably teenagers. Im just irritated and lonely right now.
secondly...i emailed my T 5 days ago and she usually answers the same day. Is it okay to email her back? what if she didn't answer because she wants me to quit too? i really need her right now but i'm afraid to email again and seem needy. I dont' have another appointment until dec 3 :/

[callisto711]

I'm a dietitian but I don't work with eating disorders. She probably doesn't feel like she can adequately treat you at the moment and is trying to practice ethically. If you trust her, I would do what she says. She really knows best about this.
I don't really know what to say about your T. When is the last time you saw her?

[cka87]

Originally Posted by callisto711

I'm a dietitian but I don't work with eating disorders. She probably doesn't feel like she can adequately treat you at the moment and is trying to practice ethically. If you trust her, I would do what she says. She really knows best about this.
I don't really know what to say about your T. When is the last time you saw her?

i understand why she's doing it. thats the worst part, i know why she said that and i know its all my fault. i last saw my T on nov 13.

[Lauliza]

I agree with all of the above. It sounds like your dietician is spot on if you are continuing to lose weight while zou see her and your T. This pretty clearly shows that you need more help than they can give. Have zou contacted your insurance to find out what kind of alternate program they will cover if not the one in your city? I know there aren't always a lot but I am just wondering if there is some kind of treatment they will cover or some kind of loophole. Plus perhaps Obama care will cover something? Often times for mental health issues state or now federally subsidized insurance will offer supplemental coverage in addition to your own insurance.

As for groups, they can help you find one that suits your needs. There are lots of women with EDs out there. Not all them are teens- there's just more in treatment because their parents force them to. But you are an adult and make the choice to either treat your disorder or not. How can your current therapy and dietary counseling change so that you achieve different results? My guess is they cant offer much more, but what is it you want?

[cka87]

i have no idea what i want. I know they can't help me if I'm not willing to do any work. But i think i want so badly to hold on to my eating disorder that i refuse to change...in which case theres nothing else either of them can do.
I hate myself for not wanting to change but...I JUST DONT KNOW. 5% of the time i want to change and 95% of the time I want to hold on to the only identity i have. the only thing that makes me feel safe, the only way i know how to cope with life.

[Lauliza]

I'm sorry, this must be so hard for you. It's easy for people to give you advice or suggest strategies for helping yourself, but there has to be an internal motivation for you to really make a change (which you probably are aware of). What is the 5% of you that wants to change driven by, do you know?

[cka87]

well I'm 27, this started when I was 13. So basically I look back and see 14 wasted years. My friends have all grown and matured and been in relationships and gotten married and had children and I'm still stuck in the same cycle of restricting and isolating myself. So that's really my only motivation to recover. But my ED is safe, it's my identity, it's my way of coping, it's the only thing I know. And even though it's lonely, I hold on to it because I don't think I'm anyone without it.

[AncientMelody]

Well...I respect the fact that at least you are owning your responsibility. That you realize that they can't help you unless you want to change and put in the work. I wish you well and hope you can learn that there IS value to you as a person without an eating disorder. Because there is.

[Lauliza]

Maybe you feel like you have wasted 14 years, but at 27 you so young! Try not to feel the pressure to get married and have kids because your friends have done it. Maybe those things don't motivate you enough because it's not really what you want. At 27 you don't need responsibilities like that, not until you are ready to take care of yourself. You can't overlook your own needs which is what you have to do when you start a family. So maybe those things can wait and you can focus on finding and/or redefining yourself. You have no one else to focus on now, it's the perfect time and you have not wasted anything. You can go to school, train for a career, travel, take care of yourself and be healthy. You don't want this to rule your life and keep you isolated for years on end. There are a lot of women out there in their 40's, 50's and beyond finally being treated for eating disorders after 20 or more years of unhappiness. I really hope you are able to get the help you need and take that first important step.