She admits to constantly checking her body for fat throughout the day. "I get really paranoid after doing body checks; I feel like I need to get on a scale," she says. "I well know that no number on a scale will ever be low enough. I'm afraid I'm going to die if I don't get help."
After watching the show with Brandon, Meg feels strongly about her own recovery. "Dr. Phil, you helped Brandon face his problem, can you help me overcome my problem with anorexia?" she asks.
"My mind is absolutely fried. I can't think about anything other than this," she answers. "I can't have normal relationships and I guess I just want to believe that there is more to what's called life than just this."
"And you recognize that this is a powerful obsession that has a grip on you, right?" Dr. Phil questions.
"Most definitely," she replies.
Dr. Phil explains that many people who are unfamiliar with anorexia would advise Meg to simply start eating more food. "But it's a whole lot different than that, isn't it?" he asks.
"It's an absolute obsession, and it's constant 24/7 thoughts in my head," Meg says.
"What do you mean when you say you are afraid to be well?" Dr. Phil probes.
"I think I'm scared because I don't know myself without the anorexia. I'm afraid of what I'll see," she says, admitting that anorexia gives her a feeling of control. "If things are stressing me out, no matter what's happening, I have so much control over what I put into my body."
"Yes," Meg replies.
"It's just the fear of the unknown that's keeping you back," Dr. Phil explains. "But there is so much of a thinking component to this. There's so much of this internal dialogue, what you say to yourself. Everyone here can look at you and see that you are underweight, that you are emaciated. And for you to look at yourself and say, 'Well, I think I look fat,' you're clearly looking at yourself through a filter that distorts what you see. Do you recognize that?"
"But the distortion is really in your internal dialogue, right? It's what you say to yourself about what you see," Dr. Phil points out. He tells Meg that if she doesn't change her thinking and her internal dialogue, her behavior will never change. He also tells her that simply starting to eat again won't remedy her mindset. "We could just strap you down and force feed you and say, 'Well, she's cured.' That's not true. Because that would be like poisoning you to you, because to you, food is the enemy. It's the enemy of what you want to be a perfect body."
"It's the first time that I can say that," Meg replies. "I have this feeling inside of me that I want it for myself."
Dr. Phil reads Meg a list of the problems associated with anorexia: "Irregular heartbeat, kidney failure, which can lead to death, liver failure, which can lead to death, ruptured esophagus, a lining of your stomach being eroded, infertility, stunted growth,
weakened immune system ... Now, even with your filter, does that sound like perfection?" he asks.
"Not at all. It sounds horribly scary," Meg replies.
Dr. Phil's list continues with the psychological effects, including depression, anxiety, guilt, fear and hypervigilance. "You've got to start challenging yourself and not just accepting this private conversation that you're having internally."
"I know. I know it's not easy to do. I don't even know how to start," Meg says.
Dr. Phil then surprises Meg with a taped video message from Brandon, who offers encouragement. "Meg, overcoming your addiction is going to be a challenge, and it's going to be a challenge for the rest of your life," Brandon says on the video. "The first couple of months are going to be the hardest, but stick through it and you get through those first months, and you've got the rest of your life to look forward to, and it's a lot better without that addiction that you had. I know you can do it."
Dr. Phil tells Meg that she needs to create new definitions in her life. "Something you can use to navigate that says logically, rationally, 'I know I am not healthy. I am not happy. What I'm doing is not working. My definition of success and perfection is anything but. My definition of control is anything but, so what I have to do is create a new definition and put it out there and look at it every single day and allow myself to get help from everyone that's offering it.'"
He tells Meg that he will provide material for her that's he's written, and encourages her to re-enter treatment at the Neuropsychiatric Association of Illinois and stay there " despite anorexics' tendency to find fault with caregivers and run away. "They know what they're doing. The more painful that becomes, it's probably a very good sign that they're talking about the things you need to be talking about. We're going to stay in touch with you and we're going to keep up with you." See Meg's follow-up.