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Re: Totally Busted... Racer

Posted by CareBear04 on April 13, 2008, at 21:11:37

In reply to Re: Totally Busted... CareBear04, posted by Racer on April 12, 2008, at 14:30:25

thanks, racer, for the thoughts.

the distinctions you point out do make a lot of sense, especially fear of getting fat v. unaccountable drive for thinness. i think i know objectively that i'm not likely to get fat by any measure, but it's still somewhat distressing to gain weight (even if i want to) and comforting to lose it.

what you said about amennorhea being dropped as an element of AN is also interesting. it does seem like an arbitrary measure since people's bodies react so differently. is there any particular reason why amennorhea is included in the diagnosis as opposed to any other physiological sign (i.e., bone density, low BP, low pulse)? but at the same time, its inclusion at least injects some sense of objectivity into the criteria. if ED specialists are no longer concerned about intent, what factors do they base the diagnosis on? i guess as you've said before, people with ED often present excuses/pretext for their behavior and deny intentionality. i guess also i feel that some doctors (subconsciously or not) conflate EDs, personality disorders, psychosomatic symptoms, malingering, and other loaded issues, attributing them all to one patient to stay the hell away from. i think you're probably right as far as EDNOS. my first pdoc once said that diagnoses are only good for two things-- insurance claims and drug trials. i used to think he was full of it and was using this reasoning to avoid telling me what was wrong, but over time i've come to think that he's probably right that labeling people is unproductive when it doesn't direct the treatment.

so i guess, then, that you're right that it doesn't matter whether i meet all the criteria for one or another diagnoses. but if you were me, given that my pdoc and pcp haven't raised any concern, would you bring up the issue?





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