A little over 4 years ago, my primary care doctor told me that I either went to an eating disorder clinic for an evaluation, or I found myself another doctor. Unwilling to loose this caring doctor who understood my health so well, I reluctantly agreed to go. I met with a therapist, who did the eval, and then the psychiatrist and the nutritionist. I was entered, without hesitation on any of their parts, into the outpatient eating disorder program at Laureate. The psychiatrist, a very kind man, Dr. M, but I was scared to death of him. I can remember walking into his office that first day and just wanting to scream, cry ... run ... anything ... I wanted out of there. I sat down on the couch, and crossed my arms, and my legs and answered his questions. Time would go on over the next couple of years, and I became a little more relaxed, but still very intimidated by this man. I have no idea why. Then came the day, when I was finally doing everything that I was supposed to be doing with my food (ie actually EATING it on a consistant basis), and I'd gone into the hospital for surgery ... and found that I'd gained not the 8 to 10 lbs that I'd suspected I'd gained ... but I'd gained over 25 lbs. I FREAKED OUT. I was ready to drop out of therapy, I was angry at my nutritionist (who'd talked me into doing 'blind weights') mad at my therapist, mad at the psychiatrist. They'd promised me that I'd never gain back the weight I'd restricted off. Here I was, doing what I'd told them would happen ... if I eat, I gain ... pure and simple. If I put in more than 500 calories into this body, the weight comes on. They had a conference with me, the first one since I was entered into the program. Dr. M told me that he thought it was a metabolic disorder. He was SURE it was a metabolic disorder and that my eating disorder was a psychological disorder, but my weight was a metabolic disorder that needed medical treatment. He couldn't prove it to me, it wouldn't show up in the blood work. I thought he was full of it. I crawled back into my shell, and tucked myself back into my crossed arms and legs when dealing with him. Over the next year, I became a little more relaxed with him, but still wary, frustrated with the whole situation, still didn't believe any of them ... my weight was purely behavior related and if I could just eat little enough, or right enough, it would finally go to a healthy level right????? Then Dr. M changed gears, and started to see inpatients only ... and I had to switch psychiatrists and went to a nurse practitioner. Shortly after that, I started to bloom, and started to get some things I'd written published. My treatment team, after one particular dive into relapse said "this is it, sink or swim, you are either going to recover or quit, eat or go" I decided that having been in myasthenic crisis four times because of the eating disorder and restrictive eating ... a respirator so that you could loose 100 lbs in 4 months is a big price to pay ... was enough ... obese and not in and out of the hospital had to be better than being a thin brittle myasthenic didn't it? So ... I started to eat. I gained. I gained, I ate anyway ... I panicked and listened to my nutritionist who promised that even with a metabolic disorder, that when my body started to trust me, It would stop. 6 months, I hit my all time high weight (which was actually the tie for my all time high weight that I'd hit 5 other times in my life). And I stayed there. And I stayed there. And I stayed there. And I stayed there. For 12 months, I stayed there. Within one pound. I stayed there. Then I went on prednisone, and I gained 13 lbs. I cried, but I was ok. I wasn't going to relapse over 13 lbs. Then my doctor wanted to start me on Topomax for the lupus headaches ... and the 13 lbs came right back off. Some of the other weight started to SLOWLY come off too. SLOW weight loss, something I've never done before. I've lost in the last 5 months, what was normally a 1 month weight loss! I've gone down one size. ONE. And that's ok. About the time I started on the Topomax for the headaches, my monthly lab work they do to monitor the Cellcept showed that my blood sugar was slightly elevated (in the high 120's) when it did it for the 3rd month in a row, the doctor said if it did it again in December, she was going to do further investigation. It did ..she did. The diagnosis was "Insulin Resistance" As of this last monday when I met my new endocrinologist my official diagnosis ... METABOLIC DISORDER. He told me that with the severity of the eating disorder, it was probably throwing the blood sugars, insulin, everything else they look for out of whack making it impossible to find ... but when I started to eat right, it finally was able to show up. He said it probably took a good year and a half to start to show ... and he just about nailed it ... December 2002 to August 2004 ... what was I doing to myself! Geesh! So, my therapist and I a few weeks ago ran into my former psych and tell him ... and he agrees to take me back on as a patient even though he's still not seeing out patients. He was so happy to have been right about the dx he really wants to be the one to follow me with it. So today, I go to see him for the first time in 2 years. I walked into his office ... and I was smiling. I sat down, I crossed my legs, and laid my arm on the arm of the couch, then moved my leg up under me instead of crossed. Dr. M let out this sigh ... and I said "what?!" He said "YOU! You're so different! You've changed so much, you're not in this closed off tight little box! I can't wait to hear about the changes you've made and the growth you've made. I've read the things you've had published, and I know you've grown leaps and bounds, but nothing speaks as loudly, as the relaxed way you are sitting here." He was truely happy to see me happy in life. I realized something today ... I'm proud of the changes I've made. I'm so relieved that they've found the metabolic disorder. I'm so relieved that I'm not going to have to live the rest of my life as an obese woman. But I also know, that I truely had learned that my weight was not who I am ... and that God made me who he wanted me to be ... if he had wanted me to be otherwise ... he would have created me to be otherwise.