How JustAnswer Works:

  • Ask an Expert
    Experts are full of valuable knowledge and are ready to help with any question. Credentials confirmed by a Fortune 500 verification firm.
  • Get a Professional Answer
    Via email, text message, or notification as you wait on our site.
    Ask follow up questions if you need to.
  • 100% Satisfaction Guarantee
    Rate the answer you receive.

Ask David Akiva Your Own Question

David Akiva
David Akiva, BA, MA,
Category: Mental Health
Satisfied Customers: 167
Experience:  Counselor; Behavioral Consultant
57833540
Type Your Mental Health Question Here...
David Akiva is online now
A new question is answered every 9 seconds

Im 31 and almost wish I was bulimic, as I can not control

Customer Question

I'm 31 and almost wish I was bulimic, as I can not control my eating. I am not very overweight, but need to lose about 10 kilos, however, whenever I start to try, I eat and eat and eat. I feel like body issues plagued my teenage life, and have continued to be a major obstacle throughout my adult life - I need this to stop. What can I do? I need concrete answers.
Submitted: 3 years ago.
Category: Mental Health
Expert:  David Akiva replied 3 years ago.

Duddy :

Welcome, I am a professional counselor, Behavioral-Consultant and relationship expert.

Duddy :

Do you mind if we chat for a few minutes so I better understand your situation and needs?

Duddy :

...

Customer:

Sure.

Duddy :

Thank you very much.

Customer:

I just don't know where to go, how to fix this.

Duddy :

Please tell me more about what your experiencing and feeling.

Customer:

Found myself this evening googling how to make myself vomit - which I didn't do - and realised how sad and ridiculous it is! I'm an adult, with a little daughter;

Customer:

I'm just sick of it.

Duddy :

So we need to find you a solution here for you and your daughter.

Customer:

My sister was anorexic for years, but got over it. Now she is slim, and beautiful, and I'm the overweight siter with no self control

Customer:

Sister.

Duddy :

Don't worry about typos I make lots also in chat.

Customer:

ok

Duddy :

So how are you feeling about this?

Customer:

Frustrated at myself, that I can't get a grip, can't get over this.

Customer:

I want to go on a diet, lose 10 kilos, be gorgeous and get on with my life.

Duddy :

Do you mind clarifying what you mean by body image issues?

Customer:

I don't really like myself. I know I need to lose weight, and until I do, can't feel good about myself.

Duddy :

or body issues.

Customer:

It affects everything - I don't even want to go out and get a job, even though I have just got a great new Diploma, because I don't think people will hire me 'looking like this'.

Customer:

Yet I know I'm not overweight, I just am not happy

Customer:

It's been like this since I was 13, so 18 years now.

Duddy :

Why do you think you can't like yourself until you loose kilos?

Customer:

I just cant. I'm not acceptable to myself, to my husband, to society in general.

Duddy :

I understand the problem but what are its causes?

Duddy :

What is your marriage like?

Customer:

Anorexic sister, yoyoing mother and father, and judgemental (french) husband

Duddy :

I see that is fast concise information. Thank you.

Customer:

My marriage is ok. It has its ups and downs, but we are good together. He is a perfectionist though, and very hard on himself, and on those around him

Customer:

great self control, will power etc

Duddy :

What does he think about your body image issue?

Customer:

He says he wants me to be self confident, and happy, but the fact is that he judges me and puts subtle pressure on me. And not so subtle. And he is sick of hearing about my isses, which is why I find myself chatting with a stranger

Duddy :

I hear you.

Customer:

Tonight I ate the healthy diet soup I made myself - and the left over spagghetti carbonara for my daughter, a cornetto ice cream and a chocolate biscuit. SO quickly I didn't enjoy any of it

Duddy :

As part of brain storming here with you, I'm starting to think of 2 parts to a preliminary or tentative answer....

Duddy :

1) I'm thinking that short term cognitive behavioral therapy is indicated for your body image issue....

Customer:

Go for it. And we have no money, so unfortunately weekly sessions are out of the question, much as I would love that kind of support

Customer:

I live in Singapore, just moved here from France. Where can I get ?short term cognitive behavioral therapy?

Duddy :

2) I'm think that it is good to have a realistically healthy body, so behavioral relapse prevention around unhealthy eating, patterns is also indicated. Both are evidence-based practices that get results in just a few months....

Duddy :

First, I need to make sure that you know what these suggestions are....

Customer:

OK. Am listening

Duddy :

Let me take a moment to get you some links....

Customer:

thanks

Duddy :

This is what I mean by cognitive behavioral therapy (CBT):

Duddy :

http://www.mayoclinic.com/health/cognitive-behavioral-therapy/MY00194

Duddy :

Back in a moment..

Duddy :

This is relapse-prevention. Originally designed and researched to provide optimal behavior change intervention for drug and alcohol use, it is now state of the art in changing every conceivably life interfering behavior including bad eating habits:

Customer:

I had a look at that

Duddy :

http://www.mentalhelp.net/poc/view_doc.php?type=doc&id=9741&cn=353

Duddy :

What are your thoughts on CBT?

Customer:

Seems sensible, I guess I just have to find someone here who does that? But these things generally cost a fortune, don't they?

Duddy :

Here is a very good audio interview with the founding researcher who of relapse prevention. The interviewer is week, but the interviewee is one of the leading experts in behavior change of this century (he passed away a few months ago):

Duddy :

http://www.blogtalkradio.com/negotiate

Customer:

The relapse prevention stufff looks good.

Customer:

And like things that I can put into practise by myself.

Duddy :

CBT is evidence-based. In part that means it gets results in 7-10 sessions. You will take a major role in the processes as well. I'm not sure what CBT therapists in you area charge. In north America they charge from 80-$120 USD per hour.

Customer:

Ok. So not affordable at the moment, but maybe one day? I kind of need a magic wand, so I can just snap out of this stupid behaviour, get a grip and move on. I can't put anymore money into it, i just cant

Duddy :

They also know behavioral relapse prevention. But they target negative thoughts and feelings for positive change in addition to behavior patterns...

Customer:

Ok. So the advice you have for me - which is good, but kind of expected - is that I can't do this on my own, but need to see someone. Right?

Duddy :

I have no marketing interests or affiliations here. I just know as a therapist that counseling is incredibly important to effectively change long standing body image issues and their life-interfering affects.

Duddy :

You can definitely make eating habit changes on your own but CBT may be indicated for longer standing body issues.

Duddy :

I have another suggestion...

Customer:

No, I appreciate what you say.

Customer:

What is that?

Duddy :

You may also want to look into research or clinical trials in CBT related to body and eating issues. You could then get very high quality clinical intervention, say at a research hospital or university for free.....

Customer:

Wow, that is a great idea. Is that something I can find online?

Duddy :

You could also find a CBT therapist in training and under clinical supervision and get a greatly reduced hourly rate and also very high quality of intervention as they precisely control and supervise for clinical hours.

Duddy :

Let me do a search. Singapore right?

Customer:

Good idea. Yep, singapore

Duddy :

http://www.sgh.com.sg/clinical-departments-centers/pain-management-centre/interventional-procedures/pages/cognitive-behavioural-therapy.aspx

Duddy :

That's one source..back in a second..

Customer:

Part of me thinks - if I'm going to spend money on this stupid issue again, I should get one of those stomach staple operations, or those balloons in my stomach, because then I'll be thinner, and it won't be an issue.

Customer:

I'm going to have to go - it's getting late. Thank you for your help, and if you have any further advice, please email it to me.

Duddy :

No problem. It's hard to find therapists to know their training. I'd call the hospital and talk to senior CBT therapists about area research programs and suprvised doctoral students you can work with....

Duddy :

Have I answered your question here? Anything else I can provide you with?

Customer:

Yes, you have. It is a sensible answer, and good advice, although I admit I was crossing my fingers for an online miracle that even I know doesn't exist! Many thanks.

David Akiva, BA, MA,
Category: Mental Health
Satisfied Customers: 167
Experience: Counselor; Behavioral Consultant
David Akiva and other Mental Health Specialists are ready to help you

JustAnswer in the News:

 
 
 
Ask-a-doc Web sites: If you've got a quick question, you can try to get an answer from sites that say they have various specialists on hand to give quick answers... Justanswer.com.
JustAnswer.com...has seen a spike since October in legal questions from readers about layoffs, unemployment and severance.
Web sites like justanswer.com/legal
...leave nothing to chance.
Traffic on JustAnswer rose 14 percent...and had nearly 400,000 page views in 30 days...inquiries related to stress, high blood pressure, drinking and heart pain jumped 33 percent.
Tory Johnson, GMA Workplace Contributor, discusses work-from-home jobs, such as JustAnswer in which verified Experts answer people’s questions.
I will tell you that...the things you have to go through to be an Expert are quite rigorous.
 
 
 

What Customers are Saying:

 
 
 
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
< Last | Next >
  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
  • I thank-you so much! It really helped to have this information and confirmation. We will watch her carefully and get her in for the examination and US right away if things do not improve. God bless you as well! Claudia Albuquerque, NM
  • Outstanding response time less than 6 minutes. Answered the question professionally and with a great deal of compassion. Kevin Beaverton, OR
  • Suggested diagnosis was what I hoped and will take this info to my doctor's appointment next week.
    I feel better already! Thank you.
    Elanor Tracy, CA
  • Thank you to the Physician who answered my question today. The answer was far more informative than what I got from the Physicians I saw in person for my problem. Julie Lockesburg, AR
  • You have been more help than you know. I seriously don't know what my sisters situation would be today if you had not gone above and beyond just answering my questions. John and Stefanie Tucson, AZ
  • I have been dealing with an extremely serious health crisis for over three years, and one your physicians asked me more questions, gave me more answers and encouragement than a dozen different doctors who have been treating me!! Janet V Phoenix, AZ
 
 
 

Meet The Experts:

 
 
 
  • Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
< Last | Next >
  • http://ww2.justanswer.com/uploads/DR/Dr.Keane/2013-8-20_204325_drkeane.64x64.jpg Dr. Keane's Avatar

    Dr. Keane

    Therapist

    Satisfied Customers:

    1262
    Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
  • http://ww2.justanswer.com/uploads/RE/resolutions66/2011-1-17_05728_IMG8202smilingeditedforJustAnswer.64x64.jpg Elliott, LPCC, NCC's Avatar

    Elliott, LPCC, NCC

    Psychotherapist

    Satisfied Customers:

    5024
    35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
  • http://ww2.justanswer.com/uploads/formybunch/2010-12-06_191055_img_0975.jpg Kate McCoy, M.Ed, NBCC, LPC's Avatar

    Kate McCoy, M.Ed, NBCC, LPC

    Therapist

    Satisfied Customers:

    3733
    Over 20 years experience specializing in anxiety, depression, drug and alcohol, and relationship issues.
  • http://ww2.justanswer.com/uploads/DR/DrAkiraOlsen/2012-2-20_746_AkiraADpicmain.64x64.jpg Dr. Olsen's Avatar

    Dr. Olsen

    Psychologist

    Satisfied Customers:

    2336
    PsyD Psychologist
  • http://ww2.justanswer.com/uploads/norriem/2009-5-27_134249_nm.jpg Norman M.'s Avatar

    Norman M.

    Psychotherapist

    Satisfied Customers:

    2193
    UK trained in hypnotherapy, counselling and psychotherapy and have been in private practice. ADHP(NC), DEHP(NC), UKCP Registered and ECP.
  • http://ww2.justanswer.com/uploads/PsychologyProf/2010-07-15_171248_logos060400409.jpg Dr. Michael's Avatar

    Dr. Michael

    Psychologist

    Satisfied Customers:

    2177
    Licensed Ph.D. Clinical Health Psychology with 30 years of experience in private practive and as a clinical psychology university professor.
  • http://ww2.justanswer.com/uploads/KURTEMMERLING/2010-07-23_215531_just_ask_picture1.jpg Steven Olsen's Avatar

    Steven Olsen

    Therapist

    Satisfied Customers:

    1727
    More than twenty years of expertise in counseling, psychological diagnosis and education