Anxiety Over Weight Loss: Passive Self Harm

I haven’t felt anxiety about my weight since I was a teenager. Ten years ago. Suddenly, I’m facing serious anxiety over weight loss. I knew that had lost some weight, but I feel good and didn’t look *too* different. When I visited my doctor’s office to find out why my ear hurt (of course, by the time I got there, the discomfort I had felt for days was pretty much gone), the nurse did a routine weight check. I heard the number. I asked her to repeat it. I asked if she was certain. I asked her to please inform my doctor that I had lost twenty pounds since January, and that I did not remember seeing a weight this low in my entire post-pubescent life. I wasn’t surprised that I had lost weight–I did cut sugar, gluten, dairy and soy from my diet, over a month ago. The nurse was nice enough to tell me that I was still within a healthy range for my height, and because the doctor and I had recently talked about how my change in diet had really helped my migraines, he wasn’t too worried about my thyroid or heart or any dramatic underlying cause. In other words, I was the one feeling major anxiety, while my doctor was mainly concerned that I include more calories in my diet.

Of course, he did run every test he could think of. He’s that kind of doctor. None of the tests made me anxious. I did not for a moment feel afraid of a damaged thyroid or a disease of some kind.

No, I feel anxiety over weight loss, because once I see that it’s happening, I am always tempted to let it go on… and on…

I have never had an eating disorder. According to some definitions, I have engaged in “disordered eating” when I have skipped meals, because the idea of paying for or preparing one has sometimes felt like too much. My husband does most of the cooking around here, because I would just let it slide. (He’s also much better at making meal-type food, anyway–pie is my speciality. Oh, how I miss pie!) My close friend nailed this one right on the head, though, when she asked if this was “passive self-harm.” I usually love the Mayo Clinic website for defining words and phrases I use, here, but this one is flawed (“self injury/cutting” is a bit narrow) and clearly written by someone who hasn’t ever experienced the impulse to self-harm:

Self-injury, also called self-harm, is the act of deliberately harming your own body, such as cutting or burning yourself. It’s typically not meant as a suicide attempt. Rather, self-injury is an unhealthy way to cope with emotional pain, intense anger and frustration. …

While self-injury may bring a momentary sense of calm and a release of tension, it’s usually followed by guilt and shame and the return of painful emotions.

When I’m tempted to just skip one meal, to ignore that light-headed, hungry feeling for another hour or two, I am engaging in this behavior. I am refusing to listen to clear signals in my brain. Anxiety often manifests physically, but I cannot ignore its signals. Shaking hands, shortness of breath, nausea, all interrupt daily life. I can cope with the frustration of feeling out-of-control by simply continuing an activity well past meal-time, until I have skipped that meal altogether. It does bring a momentary sense of calm, release of tension. And then yes, I feel shame.

Thinking of this impulse as a self-harm impulse, rather than a first step down the terrifying road to an eating disorder, feels more accurate, because what I’m feeling doesn’t seem to have much to do with my body or body image. I don’t dislike the way I look. I don’t want anything about my body to change. I do want something to think about besides the sharp increase in anxiety that follows a discovery like that one on the scale, on Thursday. The shame comes from feeling that I have failed at this diet, even while it has helped my migraines all but disappear. I have failed to eat often enough, or to eat the right foods. Worst of all, I didn’t even notice that I am lighter now than I have been since the age of twelve. Isn’t that something I should notice? I’ve had issues with my milk supply these past few weeks. Why didn’t I think that that might have something to do with a decrease in calorie intake? Why didn’t I think?

Most of my “negative self-talk,” the mean thoughts I swirl around my mind, centers around being too stupid to see something important. I “should” have seen this coming. I should have known what to do. I should have stopped it. This is quite clearly my mind’s response to the heavy importance placed on my intelligence as a measure of my self-worth, by my father and myself. It’s a good reason to stay away from academia, and to not finish my graduate degree; it’s too easy, in that world, to depend on grades to give me a sense that I have an important place in the world.

I know all of this. I know what to do. I know what to eat (please, no advice–I’m hearing lists of foods from two professionals) to maintain my weight and easily avoid losing an unhealthy amount. All of that knowledge is playing in my head, like NPR. Calm, quiet, informative.

Anxiety acts like the static that refuses to let me listen to NPR while driving; I can’t pick up a clear signal on the real programming, so I hear and can’t stop focusing on the awful static that mutes those calmer voices.

How I feel when it's time to eat. (In case you thought I had lost my sense of humor)
How I feel when it’s time to eat. (In case you thought I had lost my sense of humor)


  1. I am glad that you know what to eat and how to eat well! If you find it helpful, please listen to “Eating More” at because, at the bare minimum, you may enjoy the 20-minute relaxation.

    Sending good thoughts to you! Your writing is so insightful, honest, and articulate. Thank you for writing for everyone! – Amy at SGV

    April 18, 2014
  2. […] There are two things happening that require me choosing self care over everything else, right now: my weight is still dropping, and a cold is threatening to become a sinus infection. Obviously, the first is the greater of […]

    April 20, 2014
  3. Anxiety is EVIL EVIL EVIL. For me, it makes me want to put all of the food in my mouth until I feel sick and even that doesn’t stop me sometimes. Goddammit!

    That said, I have a recipe for a DELICIOUS gluten free vegan chocolate cake that I can share with you anytime!

    April 23, 2014
  4. […] I was finally happy with my weight, at age 29, and then I tried to help my migraine problem by getting rid of the gluten, dairy, sugar, and soy, in my diet. I accidentally lost 15 pounds. Then, I gained 5. Then, I lost 10. I’m down 20 pounds from my […]

    November 11, 2014
  5. Anastasia said:

    Hi! I know this post was so long ago, but as someone who’s struggling with this form of passive self harm, I felt seen in this post. It helped me realize that the things I’m thinking are real and I deserve to ask for help. So thank you for sharing!

    February 13, 2019

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