Discharge from outpatient ED program?

Eating wise, things haven’t been going well these past few weeks. My daily diet has been consisting of a protein bar, a bowl of diet yoghurt, a bowl of vegetables, sugarfree jelly and half an apple, and I haven’t been able to bring myself to eat and keep down anything else apart from this group of safe foods. My weight hasn’t dropped by more than 4kg so far, however, as of this morning my BMI was 15.98 which it hadn’t dipped to since being discharged from hospital. Part of me is pleased that I’m losing weight, the other part of me is thinking “Why am I doing this? I just want to recover.” But maybe I’ll feel more comfortable maintaining if it’s between a BMI of 15-16? That way my weight would still be underweight but on the higher end of underweight, it’ll give me ~2kg leeway between being a BMI of 15-16, and I’ll be able avoid being put into hospital under the Mental Health Act.

I’ve been seeing my psychologist at the outpatient ED program weekly. However, because they’re an outpatient service, they have a duty of care and won’t see clients if they’re medically unstable, keep losing weight or are below a BMI of 14. I’ve lost weight three appointments in a row now, and I’ve been warned by my psychologist that she is not allowed to continue seeing me if I continue to do so. I’m meant to at least maintain my weight at my next appointment which will be in a week’s time, whether I do or not remains to be seen.

The day after my appointment I did try. I had a bread roll at breakfast, but then once I started eating I felt like I couldn’t stop, and it led to a binge/purge. And now I’m afraid to try again because I’m afraid I won’t be able to stop eating and it will lead me to binge and purge again, and I’m afraid of the feeling of fullness, and gaining weight.

If I’m discharged from the service, well I guess that’s that. On one hand I know that they can’t have clients declining under their care and you have to be committed to recovery, on the other hand, it sucks that they may discharge clients for struggling. It’s hard to be able to turn things around by yourself, and it’s unfortunate that there’s no day program and/or outpatient meal support to help people to be able to do so.

14 thoughts on “Discharge from outpatient ED program?

  1. In mental health I find it very odd that people are discharged when they are struggling, even suicidal. All that does for some is make them deteriorate further. Vulnerable people do not need this. It is sheer madness in itself.

  2. There is a lot of help here in the US with free support groups that meet regularly. I attended one on depression that helped me quite a bit.
    I believe that you have searched all over for help, and I don’t wish to be a pain by telling you what you already know, but neither do I want to leave out something that may help, so: http://www.b-eat.co.uk/get-help/get-support/support-groups/ seems to me to be an organization that would have groups near enough to attend. I have found in using AA that there are helpful groups, and ones that had little for me. After a long search I finally found one that did have help, but it took me a while to be accepted fully. I was determined, and eventually made good friends and became very involved with the group. It helped me to become involved with planning and making coffee – I met people. That is the key – if you meet enough people you will find someone who understands YOUR problem, not just a generic version.
    My best to you!

  3. What an evil policy. When a person needs care most, the authorities drop you by the wayside. A system designed to fail.

    I hope you are able to tame this monster. It must be hard to keep up your studies when busy battling such an issue.

    Good luck! Thinking of you.

  4. Ugh, frustrating to say the least… I really hope that things work out for you. I wouldn’t want you to be discharged from the outpatient care but I also want for you to be the healthiest weight you can be in accordance with what you are prepared to be.

    Take care.

  5. hospital never helped me. Self-help groups and/or counselling are the best. Hospitals see people as ‘patients’ not as equals in care. With ED this matters!

  6. The hospital and my outpatient team never helped me, but it’s still stupid that they have a policy like that.

    And, just saying, real progress won’t come unless you are uncomfortable. It’s not fun, obviously, but being comfortable won’t give you any real progress.

  7. I hate that they do that. Had a friend at the same (I think) clinic and she struggled in the same way and was discharged. I’m thankful I moved states to access treatment which really turned my life around. I still struggle, but less so.

      • Yep, same one. Definitely don’t approve of how they run it, but given it’s a public program and there’s very little funding for it, I get where they’re coming from. In saying that, there should be much more money invested in ED treatment.

        I had to spend my savings (and my parents) on private treatment. No regrets, but 10 years on I still struggle off and on. I’m not “cured”, but life is better.

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