Posted by Dr. Beth Steinhauer on December 22, 2004, at 17:34:31
In reply to Steinhauer: treatment difficulties and depression, posted by Racer on December 22, 2004, at 1:30:50
Dear Racer,
I'm relieved to hear that you're getting treatment, even though your motivation may feel tenuous at times. The fact that you've experienced medical complications (e.g. osteopenia, cardiac arrythmias) underline the importance of making treatment a priority, as you are.
Implicit in your question is a consideration of pregnancy in the not-too-distant future. I would strongly urge you to make certain that your eating disorder and depression are both solidly in remission before you undertake a pregnancy. The hormonal fluctuations and bodily changes of pregnancy can truly wreak havoc for women with histories of depression and/or A.N. If you are having trouble accepting your perceived "excess weight" now, when your R.D. is so concerned that you are underweight, you can imagine how challenging and stressful it would be for you to gain the 25-35 lbs appropriate for a normal pregnancy! Please take good care of your own health--both psychological and physical--before taking on pregnancy.
I agree with your wariness about the gym membership idea. For women with A.N., while weight-bearing exercise can help with ostepenia, it may need to be more limited and supervised, at least at first. It is very easy for women with E.D.s to get involved in compulsive exercising that results in excessive weight loss, stress fractures, overuse injuries, etc.
As for your medication regimen, I think you would be best to address this with your own doctor. I've had little experience with Duloxetine (Cymbalta) since it just came on the market, though it ought to be helpful. Wellbutrin, as you know, can be problematic for women with ED, and can cause appetite suppression and weight loss. Provigil might be possibly aggravating your anxiety. It is a great medicine, but some people find it makes them feel nervous or "wired." Also, be sure to address with your doctor any plans for future pregnancy, as this may guide her/his choice of medicine.
Hope this helps. Best of luck--ES
poster:Dr. Beth Steinhauer
thread:432726
URL: http://www.dr-bob.org/babble/eating/20041128/msgs/433010.html