what's my psychiatrist talking about?

at my last psychiatrist appointment, he asked me how i was doing with my binging and laxative-purging problems. when i told him that the problem was still present, he said that if i still had those problems by my next appointment, he was going to have to resort to "other measures"..

i already have a counselor, and i'm on zoloft.

what other measures could he be talking about? this may be a stupid question, but i want to prepare myself for anything..

the only thing I can think of is in-patient care....

That is exactly what I was going to post...

i have the same problems with bingeing and lax abuse.

and i just got out of inpatient care

ilovechai: yes, but you're thin.. i'm not. i didn't think inpatient care would be an option for me judging by my size.

on the contrary, you don't have to be underweight to go in patient.  You can be over weight, healthy weight, etc.

You can die of bulimia at a 'normal' weight.  What is more important are your behaviors.  If you truly are at risk of really hurting yourself (and if you are actively using lax and purging, you are), you should go in patient.

I have never purged (though once or twice when I have eaten too much I wish I could!) I also have only used a laxative when I was truly in need. I don't have anyone else to ask.... So what is the reason people use laxatives to lose weight? How does it effect the weight loss process? No, I don't plan on starting now, I just don't understand. Thanks for your response!

yep, definitely inpatient care.

it doesn't affect the weight loss process.  The calories are already absorbed.  You lose water weight and people like the 'empty' feeling.

he could mean a million things.  maybe you could call him and ask him what he meant?  he may want to alter your meds and/or suggest a more rigorous course of treatment, which may include a variety of options including:

1) OUTPATIENT programs specifically designed to treat EDs 

2) intensive outpatient programs.  here, you spend all day at a program, attending groups and meeting with therapists.  oftentimes these groups instruct in mindful eating behaviors and other skills designed to help you overcome persistent patterns of unhealthy eating and weight control behaviors.  you home in the evening, usually to eat dinner with your family and to sleep in your own bed.  

3) inpatient program.  it's unlikely he'd send you straight to an inpatient program, especially if you are recording labs that are in a dangerous realm.  are you getting your labs done regularly?

4) he may want to increase how often he sees you and/or the extent to which he is monitoring your behaviors.  this may include regular labs to measure your electrolyte levels. 

 it's absolutely worth discussing this with him.  you could let him know you left his office feeling confused about what he meant when he said "other measures."  maitaining good communication with your health care provider is an essential step in recovering from any significant health concern, especially an eating disorder.  being an active consumer of your own health care will leave you feeling more empowered, rather than powerless to the decisions he may be making for you.