I'm thinking BULEMIA---do you agree?

My best girlfriend has gotten skinny lately. And when I say skinny, I mean she is about 5’7", never was even chunky to begin with at her originating weight of 148, and suddenly she is down to less than 130 lbs in just a couple months. Without significantly increasing her activity, and without seeming to be dieting much.

Here’s the story, tell me if I am off base to worry about an eating disorder, specifically “binging and purging”:

She and I have dieted together over the last couple years, successfully. She is about 4 inches taller than I am, and built a bit differently, and never was even chubby in my eyes, wearing a size small or medium top and size 10 slacks or skirts even at, as I said before, around 145-148 lbs. Then suddenly in October, she decided to try and step up her weight loss goal to lose around another 10 lbs or so, just to see “if she could do it” (she is age 35, so no worries about the slowdown of weight loss that occurs after 40 for many women who are trying to diet). I am around her a lot, and she isn’t increasing her physical activity much at all (maybe 2 30-minute walks a week, but usually just ONE, beyond being the active mother of 2 young girls, ages 3 and 7). She doesn’t belong to a gym, and she doesn’t accompany me on my hour-long brisk jogs in the evenings, either.

I thought maybe she was starving herself, skipping breakfast and lunch, and this still could be true, but I see what she eats for dinner, and it ain’t just a few crumbs, my friends (three hefty portions of homemade sausage/pepperoni pizza the other night, plus she had nibbled on the ingredients as she cooked–and had had several glasses of wine)! Plus she tells me via email nearly every day what she has had for lunch, and while I cannot verify that she is actually eating her lunches, she often goes to lunch with her hubby who works in the downtown building next to her, and I KNOW he’d say something (both to her, and to me, as I work for him one afternoon a week) if she were in fact declining lunch altogether.

Nevertheless, she has now got to be below the 130-lb mark, her clothing is just hanging off her, and I know she recently bought size 6 slacks. She thinks she looks grand, and for now she still looks good enough not to set off any serious alarms with her husband, altho he has told her within the last couple weeks that she’s lost enough now, and should just try and maintain without losing any more.

What alarmed me is this: I had an episode of throwing up, myself, a few nights ago from sheer stress at an event in my life, and I was telling her about it. Her first and ONLY comment was: look at all the calories you lost by throwing up, that otherwise might have gone to your hips! She felt I was “lucky” to have emptied my stomach in such a way that it would keep any extra weight off me, and said as much. A field of red flags went up before my eyes.

What would YOU think under these circumstances? I intend to keep a close eye on her and see if I can detect any more behaviors that might indicate a serious eating disorder. She does seem to talk about weight loss chronically, but then since we have both encouraged one another for the last two years, that hasn’t bothered me up to now.

And did I mention she is taking anti-depressants as well, & has been for a few years? Many of those can slow down weight loss or even prohibit it, in some cases. She’s not using Wellbutrin, which I know from personal experience CAN reduce appetite, but is using Prozac. I can’t speak for her dosage, however. She could be on reduced dosages, which might not interfere with her metabolism in any way.

Without alarming her, what other things should I be watching for to ensure that she isn’t bulemic? Or am I off base to even consider that at this point?

WWDD? (What would Dopers do?)

–Beck

Sudden unexplained weight loss can be the sign of a serious health problem, so a doctors visit may be a good idea.

It could just be the prozac though, from the FDA website…Weight loss: Prozac can cause weight loss. Children who take it for a long time should have their growth and body weight measured regularly.

I wouldn’t automatically think bumelia, though she might want to schedule a visit with her doc.

The Prozac is a possibility, but speaking favorably of throwing up is a huge red flag in my mind.

Express your concern at her weight loss, remind her that weight loss, particularly when eating habits have not changed, is a symptom of several illnesses, some serious, and see what she says. If she’s bulimic, she’ll slough it off, I’m thinking where if she is losing weight inadvertently she might react with concern and agree to see her doctor.

I would not be unduly concerned unless she continues to lose weight. The loss of eighteen pounds in nine weeks is a reasonable pace considering that prozac can inhibit the appetite.

If the weight loss continues, you might mention to her husband what she said to you about throwing up.

At the moment, however, I would concern myself with why I was throwing up because of stress. That’s not appropriate either, you know. I’m sorry that you are in such a stressful situation. You may not be “in a place” emotionally where you can take on the responsibility of “fixing” your friend’s problem. It’s kind of you to care though. Take better care of yourself.

If she’s new to being bulimic, there WILL be signs around the house- and hubby will definitely notice, unless he’s completely oblivious. Speaking as a bulimic for 7+ years, I tend to doubt that an actual one would have even made that comment about vomiting- it’s too obvious, especially if it’s new to her, she’ll be trying to hide it as completely as possible. Things to look out for: red marks on her knuckles, her making excuses to go to the bathroom or somewhere else immediately after eating, and coming back to the table with wet eyes, looking like she was just sneezing, her skin/eyes will start to look worse from the vomiting, she’ll start to eat what seems like an excessive amount of food (i.e. more than her normal portions). When you’re in her house, check out her toilet and the area around the toilet.

The impossible to ignore clue with an ex GF was that on returning home from a resteraunt, she would turn on the stereo, go into the bathroom, stay for a bit, and immediatly turn the stereo off after exiting the bathroom. She never would admit to it until after we broke up. (we remained friends for a few years)

Maybe her metabolism has speeded up for some reason. IMO, 130 is a perfectly reasonable weight for her height, perhaps a little thin, but it wouldn’t scream eating disorder in my eyes.

I’ve lost about 5-7 lbs. in the last month or so just because of depression and stress. No eating disorder, I’m just not hungry. It happens like that sometimes.

I don’t get it. What do red knuckles indicate? And what are you expecting to find in/around the toilet?

:confused:

I’m guessing teeth marks from putting fingers down the throat and dried up puke around the toilet.

The red knuckles and/or red cuticles are an indicator of bulimia because the stomach acid in vomit will essential burn the delicate skin in those spots.

As to the OP, I think you are over-reacting. Her weight isn’t even remotely in a danger zone, 148 lbs is on the larger side, and 130 is just about what she should be. The rate of her weight loss isn’t out of the realm of normal crash dieting (think New Years Resolution).

Leave it alone and focus on your own issues. Hell, maybe her and hubby have just been doing some vigorous sport humping.

Encourage her very strongly to get a work up by a primary-care doctor.

It could be bulimia, a medication side effect, hypethyroidism, or a hundred other things, and no matter how much time you spend on The Dope, you won’t get a good answer from us. Furthermore, if it is bulimia, a medical professional will be able to refer your friend to a psychologist or other specialist in the treatment of eating disorders that will likely be more effective than your attempts to stop her unhealthy behavior on your own.

Good luck.

Not necessarily. I think my “ideal weight” is around 130, but if actually weighed that much, I’d be a coat hanger, and it would probably not be healthy for me. Body type has a lot to do with it.

One way to open the door, in a deceptive way is to go with her statement that ‘ok at all the calories you lost by throwing up, that otherwise might have gone to your hips!’, perhaps show interest in this form of weightloss. Pretend that you were sick all weekend and found that you have lost some weight and see why some people would do such things intentionally.

I’m not saying this is a good way to do it, just a way that came to mind

148 lbs is emphatically NOT “on the larger side” for someone who’s 5’7". 130 isn’t necessarily an unhealthy weight either, but according to the OP, the woman was a size 10 at 148, which hardly qualifies as “large”. Thanks for encouraging pukers everywhere, though.

That said, I don’t think that there’s any good reason to assume she’s bulimic. Anytime I’ve ever had a stomach bug I’ve joked about all the calories I’m not absorbing. You mentioned that she’s stressed out and that she’s on Prozac, which kills appetite. Right there are two reasons she might be losing weight, so why immediately jump to the conclusion that she’s bulimic?

148 at 5’7" is on the larger side? Wow.

I’m 5’ 6.5, and weight around 145 in my early 20s. In pictures, I look slim and healthy. Who knew I was on the larger side!

And at 5’9.5", being 190 must make me morbidly obese! Strangely enough, I don’t look that big in photos.
To the OP: I think the only thing that’d worry me muchly is her reaction to you vomiting, as I don’t see that as a normal reaction to someone getting sick. If you think that she’s starting to look unhealthfully sick, then I’d look for other clues or talk with your friend’s husband about this to see if he’s having the same concerns. After all, he does live with her, so he sees more of her behavior.

Could she be abusing laxatives? If she is puking to lose the weight, her breath would show it. Has her usage of mouthwash/breath mints/gum gone up lately? As others have said, 148 pounds at five seven is NOT on the heavy side. Not even with the new BMI! Her BMI at 148 was 23.2, and the ranges are:

At 130 pounds her BMI is 20.4, so still normal.

Knee jerk much? I never implied that she was overweight or fat, just that 148 lbs is at the top end of her expected weight for that height. Say what you will about BMI and other “target” weights, but my comment was not loaded with any implications or judgements.

It’s always a goddamn minefield discussing weight on a message board loaded with people who spend too damn much time in front of a computer.

Thanks, folks, I just worry about the girl, is all. I’ll let it be for a bit and if she decreases another 10 lbs or so, or goes down a couple more sizes, then I’ll react. But hubby will SURELY react long before I do, if she gets to that point.

My BMI ideal weight at 5’3" is 141, and granted, that is the high end of normal, but at 150 I still look pretty much normal, even tho “overweight” by BMI standards—I do think there is a lot to be said about how a person is proportioned. I was simply alarmed when I last saw her, as her clothing seemed to just hang off her, and she had already purged her closets of anything size 10 or larger in early December as a means to encourage her to NEVER gain weight again, so she wasn’t wearing larger-sized clothing just to “look” small. Then she made the “vomit = calorie loss” statement, and it scared me a bit, I admit.

I’m happy to just monitor things for now. Thanks for all your responses!