It’s Eating Disorders Awareness Week. The theme this year is “Three Minutes Can Save a Life”. And while it is well intentioned and someone struggling may benefit from the 25 question survey, it’s missing part of the point of having a week dedicated to awareness; spreading awareness to non-sufferers.
I am of the belief that society lacks awareness of what an eating disorder really is. Some of the greatest misconceptions? That it’s an attention-seeking ploy, a diet gone wrong or an overwhelming desire to be thin and pretty. And because that’s the definition we’ve conjured up in our minds, those suffering don’t get the care that they need. The average cost of a 30 day stay in an inpatient facility for eating disorders is 30,000 dollars. Thirty thousand. For thirty days. There is something very wrong with that picture. If you need treatment and your insurance company determines that you don’t fit into their little cookie cutter criteria, then guess what? You are royally fucked. Unless your family takes out a second mortgage. And more often than not, I hear of people either being denied coverage all-together, or being cut after two weeks or so. Because you can undo years and years worth of damage in 14 days, right? I think insurance companies have slightly improved (and I owe mine a huge thank you for the coverage they’ve provided me this year), but there is still a lot of work to be done.
Eating disorders can affect anybody. ANY. BODY. You can be negative three pounds and have an eating disorder. You can also be 600 pounds and have an eating disorder. And anywhere outside of or in between. That’s the point I really want to drive home here. You can be any weight, you can be white, black, purple, blue, male, female, transgender, gay, straight; eating disorders don’t discriminate. A few things: I haven’t done extensive research and I don’t have “Dr.” before my name. I don’t want this to come across as a pity party or me saying that my experience is worse than/better than anybody else’s. All that to say this: I’ve struggled with a restrictive-type eating disorder for twelve years. If I can offer any insight into the general function of an eating disorder, at least from my experience, I’d lay it on you like this:
Eating disorders fucking suck. It’s like a constant reel of your own self-deprecating thoughts running through your head, over and over again. And they breed in shame and isolation. It is a very secretive illness.
Relation to gravity (aka the magical number on the scale) is not an indicator of how “well” or how “sick” someone is. Some of my worst relapses have taken place while I was at a healthy weight – by government standards (read: BMI charts). And body image has a part in all of this. The reeling, self-deprecating thoughts. “I should be x weight. Or y weight is too heavy. My body feels so much bigger today. Let me go check in the mirror 47 times to make sure nothing has changed.” It is not about vanity, it is about control. Control of the number on the scale. Control of the choices you make for breakfast. Control over what you deem “good” foods and “bad” foods. While we’re here, a piece of advice. Telling someone who just came from treatment that they look healthy or like they’ve filled out is not recommended. We know you mean well, but to someone in recovery, we translate that to mean we got fat. I’ll just leave that right there.
I was born with a “harm-avoidant” personality. Like a lot of others, I struggle with pretty severe anxiety and episodes of depression. So in a nutshell, I don’t deal well with ‘the feels’. I don’t do well with change. And so I use this super cool anesthetic I discovered at 15 years of age, starvation. It’s a chain reaction. Something out of my control happens – I experience distress -anxiety and/or depression – I want to not feel those things – I numb them out by restricting my caloric intake – this provides temporary relief until the next event – rinse and repeat.
Why does starving myself make me feel better or give me the illusion that I feel better? Good question. As mentioned above, control is a major function of the eating disorder, so if I cannot control what is going on around me, but can control what goes into my body, then voila, a temporary fix. Much like an alcoholic fills their void with alcohol, I fill my void by feeling my void. Over the years, I’ve noticed a direct correlation between my emotional state and my body image distress; the more I’m keyed up about something, the more I feel like I need to throw all of that energy into hyper-focusing on and/or punishing my body. It feels like the only way to manage whatever it is I’m feeling. Emotions are the excruciating pain and an eating disorder becomes the numbing agent.
Why does starving myself actually fuck up my life in the long run? Why is it all an illusion of control? Because restricting your caloric intake is like tripping the breaker in your basement. The body is a smart machine. If you aren’t fueling it, it starts to shut down the functions of your body that don’t seem as necessary, solely to conserve energy…until it shuts down the important functions…like your heart. The brain essentially becomes mush; your anxiety becomes magnified, your thinking becomes less rational, you have a shorter fuse. When I’m in the depths of it, my brain feels like a puzzle that has been thrown into the air; all of the pieces landing in a crazy mess on the floor. And I don’t know where to even begin to put it back together. So that reeling tape begins again and it’s up to maximum volume; “You’re fucking crazy, Abby. Here you are again. What is wrong with you?! You will never beat this. You’re weak. You’re worthless. What’s the point?” And how do I take care of those reeling thoughts? You guessed it, the chain reaction starts all over again.
It is a perpetual cycle. And after years and years of it, you start to become exhausted. It gets exhausting to the point that your anesthetic just isn’t cutting it anymore. You become immune to it, so you look for another escape. For a lot of people with this illness, the only seemingly viable escape is a permanent one. Another stigmatized topic; suicide. How selfish of people, right? How horrible. Don’t they know the damage they’ve caused to the ones they’ve left behind? UGH. Listen. I get it. It’s all horrible. It’s inconceivable. But when someone is deep in the trenches, it’s not a matter of being selfish- you genuinely believe you’ve become the burden and you will release others from that if you escape. Until you’ve experienced such mental anguish, you’ve fought a hopeless battle, check your judgment. For some people, the pain of living is far greater than the fear of dying. But that’s a topic for another day.
Well we just got really dark there, didn’t we? Let me follow up with something lighter. Four years ago I moved to DC. A change! I’ll let you do the math. Anyway, I relapsed and had a friend who helped me find a fantastic therapy practice in the area and I’ve been seeing both a therapist and a dietitian pretty regularly ever since; they’ve saved my life a number of times. It’s been a long, arduous road. Lot’s of steps forward, lot’s of steps back.
Recovery is never a linear process. Let me repeat that. NEVER is recovery linear. It’s not as simple as throwing a bandaid over a cut, letting it heal and watching the scar fade as the years go on. Eating disorders are much like tumors (for lack of a better comparison); you get in there and you cut out as much as you possibly can, but nobody can predict if that fucker is going to grow back or not. And if it does, you aren’t going to stand there and say, “Mmmm, yeah, no. Sorry, dude. Already cut this shit out once. Should have gone away the first time!” No, you’re going to go in there and attack that stubborn bastard as many times as is needed.
So in summary, eating disorders suck. They aren’t a hobby we just decided to pick up one day. There are genetic and environmental factors involved. They breed in shame, guilt and isolation. They serve the purpose of providing an illusion of control (at least that’s my interpretation) – It’s not about wanting to feel skinny or pretty or whatever, it’s about wanting to feel OKAY. Just because somebody goes to treatment once does not mean they are cured. In fact, there is not really a “cure”. It’s a matter of letting those reeling thoughts be in their little home (your head), but slapping the mute button on them. What I have learned is that it is possible to get into a better headspace. It’s possible to get to a place where your debilitating thoughts do not consume every aspect of your being. And what we really need is for people who have no idea to have an idea. Three minutes won’t necessarily save a life. But becoming a little more accepting and understanding that an eating disorder is a mental illness, and that mental illness is REAL…well that just might.