"I see myself as very fat, very ugly," says 28-year-old Aimee. "At times I see myself as hopeless and reckless." Aimee suffers from both anorexia and bulimia. Her mother says she could probably also be described as a binge eater, but the food doesn't stay down.
Aimee has another word to describe herself: Evil.
"Very evil," she says, "because I hurt everybody who comes to know me."
Aimee sits at a kitchen counter shoveling food in her mouth from an array of plates before her. Her mother, Pat, stands nearby, observing.
"What kind of thoughts are going through your mind, what the eating disorder says to you?" asks Pat.
"That I'm fat," says Aimee, "and if I'm not able to get all this food out I'm going to **** kill myself." Her voice rising, she adds, "You're making me emotional while I'm eating. I don't normally eat with people. I eat by myself."
Pat asks, "What made you write to Dr. Phil?"
"I'm lonely," says Aimee. "I'm scared. If I keep on going like this I want to die. I have no people in my life."
She stands before a mirror, shirt lifted, belly exposed, and points out the places where she'd like to lose more weight. She starts with her stomach, which she fears bloats out. Drawing in a breath, she reveasls how she prefers to look at herself, with her stomach sucked in. As her ribs push out against her skin, she looks truly skeletal. "That looks a little bit better," she says.
"I push on my stomach down here all the time to try to get the bile to come out from the liver," she explains, pointing to her lower abdomen. "I used to take the barf out of the toilet and put it back in my mouth so that I would start to gag. The kind of feelings that I get when I drink water is, 'Uh oh. Now it's going in your stomach. You're feeling it. What are you going to do now? Oh, well as soon as they leave you can just go to the washroom. It's OK. There's no calories in that, Aimee.' That's where my thinking goes."
"I'm sure that Aimee could consume at least 10- to 15,000 calories," says Pat.
"I'll just keep throwing up," Aimee says. "It can reach up to 150, maybe more, a day. That's a hard one for me. I'll have breakfast around 6:00, I guess, in the morning. I binge, and throw up and keep going back to throw up. And then I'll wait an hour. And then it goes into the next binge, and I eat and I'll throw up." Sobbing, she continues, "And the binging starts again in the middle of the night. It's never enough.
Curled into a fetal position in bed, she wails, "I desperately need some help! They're not going to be able to give me any help because I'm not small enough! All my doctors and psychiatrists and stuff, they basically said that I'm untreatable, and no longer can anybody help me."
"It's been a long, hard journey for all of us, and we've never given up believing that she can overcome this, and we never will give up," says Pat.
"I don't know," she says. "I've always thought that people would care about me more if there was something wrong with me. And I thought that if I had a little bit of extra weight on, you just wouldn't think that I was sick enough to give me any kind of help."
"How many times have you purged today?" asks Dr. Phil.
"About 40," she says.
"You've purged 40 times today? And we're not to noon yet."
"It gets harder in the day," she explains.
Noting Aimee's arms wrapped around her, Dr. Phil asks, "Are you cold?"
"Very cold," she says.
"It might have something to do with body heat?" says tenuously. "I don't have a lot of fat?"
"You have no fat," says Dr. Stork. "You're afraid that we're perceiving you as fat, but you have no fat."
Dr. Masterson says, "As a gynecologist, my job is to treat women who have your same problem, and I think, as you know, you're here today because you want help, right? And you know the things that are happening to your body. You know that your bones are getting brittle, and that things are happening that you have the power to reverse, and you know you have that power, right?"
"I don't feel like I have that power," Aimee says meekly.
"Well, we're here to try and give that power back to you," says Dr. Masterson, "and figure out how to do that."