A young friend of mine, C. is in hospital and I am extremely anxious about her. Her weight has dropped to a dangerous level. She (and I don't often see her and get this information from a mutual friend, S.) denies that she is anorexic, however, as she knows she is too thin and says she wants to eat, but she gets stomach cramps after eating most foods and so is afraid to eat - she associates anorexia with a mistaken body image. She has been tested for many allergies and illnesses, with negative results.
It seems to me that accepting her assertion that she is not anorexic is not helping her at all. It seems self-evident to me that she is suffering from an eating disorder, however you categorise it. She was in hospital a few months ago, but only because she collapsed; until then she had never been to the doctor at all about this problem. S. is much more comfortable with calling it a food allergy than anorexia, but I don't see why. It is an illness, there is no shame in it. If I had a nervous breakdown or suffered from bi-polar disorder, I should not be shunned because my illness was more of the mind than the body.
C's mother has tried to take the pragmatic route, which would be the way my mind works too - look, you may feel pain after food, but it is still nourishing you, just eat little and often and it will be doing you some good. But she can't, won't - and weighs about 4 stone. Which is 56 pounds. 25 kilos. If it drops more, she will die.
She is on a drip in hospital now, as she is so low in various vitamins, and on a fairly strict regime, told she has to eat 1500 calories a day and then build up from that. But until she understands the problem, she is not capable of breaking away from it.
My mother developed anxieties about foods and all I could do was try to accommodate her wishes as much as I could, while making sure she took in as much nutrition as possible. But she was in her seventies, and physically ill too.
C. is only thirty, strong willed, intelligent and independent. Can you help someone who denies that she needs help?