Am I “sick enough” for treatment?

November 13, 2022

Let's talk about the myths around being "sick enough" related to eating disorders and seeking treatment.

Before I came to Open Arms Wellness, I worked as direct care staff and a therapist at an eating disorder treatment facility. During my time there, I would hear clients express the belief that they didn’t think they were “sick enough” to be in treatment.  It was an argument that shocked me at first, but it soon became something I heard fairly often and came to recognize as sort of a hallmark of ED clients.  When clients would bring up the topic with me, I would typically ask them what they thought “sick enough” would look or feel like.  

This question would often elicit comparisons to their peers, comparing their bodies, lab work, meal plans, and outward struggles to clients they thought were sicker than themselves.  Eating disorders are oddly competitive in their nature. If your ED can convince you that you aren’t actually sick enough for treatment, it can continue on not being challenged and continue on being the one in the driver’s seat.  

The strange and scary thing is that for most eating disorders, there is no such thing as “sick enough.” 

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It’s a finish line that is constantly being pushed forward. No weight or size or measurement or behavior will ever feel like enough. Your eating disorder will always want more from you and will continue to tell you that you’re not sick enough in order to keep you in the ED. Those suffering with an eating disorder also tend to struggle with self-worth and will often believe that they are unworthy of treatment, recovery, or even feeling well, or will believe that someone else deserves it more. 

It’s also worth noting that admitting you are losing control, or maybe haven’t been in control for a while is scary.  Taking the first steps toward exploring treatment can feel scary and overwhelming.  So it makes all the sense in the world that you might try to convince yourself that you’re fine, that you’re in control, that you can deal with this on your own, that everything is okay, even when everything is actually spinning off its axis.  

So let me take a moment to bust some myths for you…..


You can be appropriate for treatment even if:

  • Your BMI is “normal” or above
  • You live in a bigger body
  • You still eat meals
  • You eat “junk food”
  • You labs are “normal” 
  • A medical doctor isn’t concerns
  • You have friends or family that isn’t concerned
  • You think other people are “sicker”
  • You are still functioning at home, work, school, etc
  • You’ve never needed a feeding tube
  • You’ve never been in the hospital due to your ED
  • You haven’t seen any health issues due to your ED

Here's the reality of being "sick enough" with an eating disorder

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Chances are if you’re having fairly consistent issues with disordered eating, you’re probably appropriate for treatment.  No one can tell the severity of your ED based on your physical appearance alone.  People with eating disorders will come in bodies of all shapes and sizes.  I’ve had young clients that “looked normal” have heart attacks and strokes and get pacemakers implanted due to the damage caused by their eating disorder. 

You don’t have to wait for “rock bottom” to start eating disorder treatment. 

You don’t have to wait until you feel “ready” (most people never feel “ready”).  You don’t have to wait until you are a certain weight or a certain size or until someone one expresses concern.  You don’t have to wait until you “look sick.”  If your thoughts and behaviors around your body and food start to take over your life, you’re “sick enough.”  If there is a voice in your head that convinces you to restrict, binge, purge, take laxatives, diuretics, over-exercise, cut out whole categories of foods (that you aren’t allergic to) or otherwise obsess about your body, food, or movement, you are sick enough and worthy enough for treatment.   

Begin eating disorder treatment in St. Louis, MO

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If you've gotten this far, that tells me you're willing to start therapy. Currently, we offer eating disorder treatment in St. Louis, MO When you're ready to start eating disorder treatment in St. Louis, MO and online eating disorder treatment in Kansas City, MO. When you're ready to begin your journey, follow these steps:

  1. Schedule an appointment with us.
  2. Get to know our team of excellent therapists. 
  3. No longer wonder if you're worth seeking treatment.