Do Not Tell Me I'm Skinny, When My Eating Disorder Says Otherwise
"I'm going on a diet because I've gained way too much weight. But that isn't something you have to worry about." "You're lucky you don't have to go to the gym." "You're so lucky that you can eat whatever you want without getting fat." "You're so skinny and I don't understand how."
Those are some of those common ways I am indirectly told that people are "jealous" of the way that I look. I would be lying if I said hearing those kinds of things didn't hurt my feelings. I struggle daily with an eating disorder and my appearance. I would bet money on the fact that most of the people reading this do not know I even have such a thing.
I have what is called anorexia nervosa binge eating-purging type. There are three different disorders in that one diagnosis, and most people know what each one means individually; but what about combined? The problem is that when most people picture what anorexia looks like, they picture a girl in the hospital, weighing less than 80 pounds who is on her death bed because she never eats. Most people picture binge eating as some overweight 50 year old woman, lying on her couch eating potato chips all day, while the working class pays for her to do so. Purging isn't as commonly known, but for those who have heard of it, most picture it as a girl hurling her lunch into the toilet because she didn't want to allow her body to retain its nutrients, after all, that would mean she would gain weight.
I have spent years fighting with the voice in my head that screams much too loud for my liking. My eating disorder is what I like to call my inner demon. It convinces me that I have gained too much weight and now have to pull out my "fat pants" because I went up a whole pant size after a bingeing episode. It convinces me that the only solution to losing any of that weight is to starve myself. The voice sounds horribly familiar. Maybe even my own? I'm never able to distinguish. Whatever and whoever it is, it brainwashes me into thinking I'm not good enough, and that I certainly don't look good enough to the outside world.
Before we go any further, I'm going to set a few things straight.
First of all, all of those stereotypes are all wrong. Second of all, science is a fascinating thing, so I'm going to throw in a little education session.
Any and all eating disorders can affect anyone of any age, size, and gender. Men, women, children, and the elderly can all battle eating disorders.
Anorexia nervosa - contrary to popular belief - is actually not the most common eating disorder in America. For some reason though, it is the most glorified. It does, however, have the highest mortality rate of any other eating disorder. If you were to google it, the direct definition is: a lack or loss of appetite for food. This is where most people like to do what's called a self-diagnosis. Except following that definition, it states as a medical condition. A medical condition is a medical condition only by diagnosis done by a medical/mental health professional, not self-diagnosis (so if you believe you may be having symptoms, see a medical/mental health professional for evaluation). With anorexia, the body is denied the essential nutrients it needs in order to function properly. As a result, the body is forced to slow down all of its processes and conserve whatever energy it may have left. The “slowing down” state can have serious medical consequences such as:
Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower.
Reduction of bone density (osteoporosis), which results in dry, brittle bones.
Muscle loss and weakness.
Severe dehydration, which can result in kidney failure.
Fainting, fatigue, and overall weakness.
Dry hair and skin, hair loss is common.
Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.
Just because someone has anorexia, does not mean that they will end up in treatment, will die from it, or will look like the typical stereotype. It is rare, but not completely unheard of for children under the age of 10 to develop anorexia. It can also be present in adults of any age, sometimes being present until the day that they die of natural causes unrelated to the eating disorder – if the eating disorder does not claim them first.
The following symptoms must be present for a potential diagnosis.
Inadequate food intake leading to a weight that is clearly too low.
Intense fear of weight gain, obsession with weight and persistent behavior to prevent weight gain.
Self-esteem overly related to body image.
Inability to appreciate the severity of the situation.
Obsessive counting of calories/compulsive exercising (does not need to be present for diagnosis, but is very common in extreme/severe cases)
Binge eating is actually the most common eating disorder in America weighing in at 2.8% of all American's. Binge eating directly translates to: the consumption of large quantities of food in a short period of time; recurrent episodes of eating large quantities of food (often very quickly and to the point of discomfort); feelings of loss or control during the episode. Binge eating usually takes place as a way for an individual to use food as a way to cope with or block out feelings and emotions that they do not want to feel. Individuals can also use food as a way to numb themselves, to cope with daily life stressors, to provide comfort to themselves, or to fill a feeling of worthlessness they feel within. A person struggling with binge eating will typically have a depressive episode following the bingeing episode, which usually consists of having feelings of shame, distress, or guilt. The following symptoms must be present for a potential diagnosis:
Eating, in a discrete period of time (e.g., within any 2-hour period), an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances.
A sense of lack of control over eating during the episode (e.g., a feeling that one cannot stop eating or control what or how much one is eating)
Marked distress regarding binge eating is present
The binge eating occurs, on average, at least once a week for 3 months
The binge eating is not associated with the recurrent use of inappropriate compensatory behaviors (e.g., purging) as in bulimia nervosa and does not occur exclusively during the course of bulimia nervosa or anorexia nervosa (I will address how my diagnosed eating disorder is possible with this as a symptom of binge eating shortly)
Binge eating episodes must have three or more of the following for a potential diagnosis:
Eating much more rapidly than normal.
Eating until feeling uncomfortably full.
Eating large amounts of food when not feeling physically hungry.
Eating alone because of feeling embarrassed by how much one is eating.
Feeling disgusted with oneself, depressed, or very guilty afterward.
Purging type is most often associated with bulimia, because a form of purging is self-induced vomiting. However, purging can also consist of the sudden restriction of food, engaging in abuse of laxatives, diuretics, or enemas after a period of bingeing. An individual can have purging type without having bulimia.
How is anorexia nervosa binge eating-purging type even possible then? That was the question I kept asking when the therapist I was seeing during my four years of high school informed me that I fit the criteria. I did months’ worth of research. Unfortunately, there is not a lot of information available for such an eating disorder as it is classified under an Eating Disorder(s) Not Otherwise Specified (EDNOS) because of the fact that there are only certain symptoms from each disorder’s criteria found in other eating disorders. This means that I might only have two symptoms from one disorder’s criteria, but four from another, and only one from another. EDNOS was designed for such cases. From what I could find, I learned that it is most commonly associateed with trauma. My eating disorder started out as frequent binge eating. I remember wanting to literally eat everything in sight. I wanted anything that consisted of carbs, fats, and sugars. As a result, I gained an immense amount of weight in a very short period of time. At that time, I had always weighed between 120 pounds and 138 pounds. So when I suddenly gained enough weight to shoot me up into the 200s, I felt disgusting. I was mad at myself for gaining that much weight, and allowing it. I was mad at myself for using food as a way to cope. So instead of putting myself on a healthy diet, I just flat out stopped eating. Most days, all I would have was an apple when I woke up and a small meal for dinner. I did that only because I was on medications that required food intake before the dosage. My bingeing episodes would last for months at a time, and my purging episodes would last for months at a time, which is why the three are able to occur at different times, but still simultaneously exist in the same diagnosis. According to my previous therapist, this type of eating disorder is extremely harmful to the body. Of course, all eating disorders are. But she informed me that I was literally putting my body through shock and trauma. Just as my brain was in shock as a result of the trauma, I was doing the same exact thing to my body. Anorexia/purging can slow down your heart rate, lower your blood pressure, and lower your cholesterol; while binge eating can speed up your heart rate, raise your blood pressure, and raise your cholesterol. By alternating back and forth between the two very suddenly, the body can go into a state of shock.
Now, why do I not want to be praised for the way that I look when I go through a period of purging?
Imagine that you suffer from a series of mental illnesses, but one in particular is the only one that can, possibly, directly kill you, and yet you are receiving praise for the very symptoms that are destroying your mind and body. I am literally being praised for destroying my body. I am being praised for restricting my food intake for one period of time, and eating much more than I should for another period of time. I am being praised for harming myself.
So yes, gaining weight is something I have to worry about. No, I am not lucky I don't have to go to the gym because I'm basically destroying my mind and body while you're doing it the right way. No, I am not lucky I can eat whatever I want without getting fat, because I can definitely gain more weight at a faster rate than most. I am skinny because of an eating disorder, that's how. I do not recommend it.
The only reason the majority of people around me do not know that I have an eating disorder, is because most people who binge and then purge, do not look unhealthy or underweight. But believe me when I say that I know exactly when I've gained weight. I don't even have to step on the scale. I know when I've gained even three pounds; because I can see it. My eating disorder warps my perception of myself in order to be convinced that I am much too fat and I need to lose some weight. I don't go from 80 pounds to 200 pounds overnight, so most people don't believe me when I say that I used to weigh over 200 pounds. However, if you put pictures side by side of my different weight fluctuations over different periods of time, you would most definitely be able to see a difference.
Contrary to popular belief, eating disorders are actually not a choice. They are complex illnesses with biological, psychological, and environmental causes. They are in fact classified as a mental illness. I know that no one forced this disorder upon me. So if no one did, what did? That voice inside my head tells me that I brought it upon myself. In fact, it screams at me that I’m to blame. But no one person or thing is to blame for my eating disorder, including myself. It is a combination of neurobiology, family of origin, social and societal environments, and trauma. Depression almost always goes hand in hand. When you have depression, you lack the psychological means to deal with life stressors. As a result, your brain seeks a way to find relief in any way that it can.
Years later, and I still struggle with my eating disorder. I still fluctuate in weight frequently. But I am not responsible for the onset of my eating disorder. But I am responsible for my recovery and freedom from it. I must forgive myself for developing the eating disorder. I must forgive my brain for not being able to cope with the stress of life and the trauma I have endured. My eating disorder is an outward manifestation of inward confusion, anxiety, and distress. In order to find freedom, I must first deal with what it was that caused that confusion, anxiety, and distress. It becomes difficult to do so when I am being praised for destroying myself. It causes more confusion and anxiety within my head, thus causing me distress and to take several steps backwards.
I did not choose my eating disorder. My eating disorder chose me. But I can choose recovery from it, and I can choose to find freedom from it. Do not praise me for my illness. Do not praise me for hurting myself. Do not praise me for expressing my confusion, anxiety, and distress in an unhealthy manner. In fact, I don't want any praise at all, because in the end, the glory and praise isn't given to me. But if you must praise me for my courage or strength, or whatever it is you'd like to praise me for, praise me for my choice of recovery and the courage and strength it took to make that decision. Because at the end of the day and at the end of the road of my battle with my eating disorder, my choice of recovery is the only choice that will ever matter.
If you or someone you know is struggle with an eating disorder - or you suspect that they may be struggling with one - and needs support right now, please contact the National Eating Disorders Association at 1-800-931-2237 or text NEDA to 741741
If you or someone you know needs support right now, call the Suicide Prevention Lifeline at 1-800-273-8255, or text START to 741-741
Image credit: Unsplash
