It’s Eating Disorders Awareness Week here in the UK and I believe in the USA it was last week.
While it’s estimated that there are around 1.25 million people with eating disorders in the UK, we don’t really know because there’s not nearly enough research. Doctors are given on average less than TWO HOURS of eating disorder training in their entire medical training. TWO HOURS! Some medical schools have no training AT ALL. It’s woefully inadequate.
Fatphobia is still endemic in eating disorder treatment all over the world, which not only is an attempt to erase the existence of fat people, it’s actively harmful and an impediment to full recovery.
Eating disorders don’t discriminate. Anyone of any gender, social class, race, sexual orientation, size, age or ability could have an eating disorder. Any eating disorder. Yep, you read that right. A fat person could have anorexia.
When I was thinking about what to write today, I considered giving you all the statistics on eating disorders – but you can find that out with a Google search. I thought about sharing warning signs about eating disorders and about how they can develop – yet all that information is available elsewhere 😉.
Instead, I thought I’d share my own story of having an eating disorder, because that you can’t find anywhere else on the internet and no one is better qualified to share that story than me. As it happens, I do somewhat fit the stereotype for eating disorders. I’m a white cis-gender female. I was young when it all started and I’m from a middle-class background. But as I said, anyone holding any of several intersecting identities can have an eating disorder and those stories, the stories we don’t typically hear, NEED TO BE HEARD!
And – I’m sharing my story anyway, because sharing our stories is an important part of breaking the stigma around eating disorders.
I’m going to bold in purple all the events from my life that are risk factors for developing an eating disorder, so you can see the picture emerge and hopefully learn what to look out for in yourself or others in your life. However, I’m not explaining in this blog why all of these are risk factors – it makes the writing too complex for this blog.
It all started when I was about 8 years old or so
I grew up in a family of dieters. Almost all the women in my life were either dieting or worried about their weight and appearance – through the generations. That’s where my body dissatisfaction began. If the beautiful and talented women in my family, whom I idolised, didn’t have bodies that were good enough – how could mine possibly be so?
I started restricting food and copying the dieting behaviours I witnessed without anyone noticing.
I remember having tea at my cousins’ one afternoon. As my aunt was making it I told her I didn’t want any sugar in mine. She praised me for this. When I changed my mind about it soon after, I felt too ashamed to say so. Whenever we had tea at their house from then on, I had mine without sugar, always feeling shame that 1) I was lying, 2) I was receiving unearned approval from my aunt and 3) I wanted something I shouldn’t want.
When I was 13, I had to have some orthodontic treatment which involved opening up my palate using a device that was fixed with cement to my teeth. It was a gruesome ordeal and I’ll spare you the worst of the details. The important bit is that I got a horrific infection in the roof of my mouth which created a gaping hole 😱. I became very ill and lost loads of weight, very quickly.
I was as sick as a dog, I could barely eat anything for weeks, but boy, did I receive compliments on my weight loss! If I wasn’t disordered enough in my eating by then, that acknowledgement and praise about my appearance certainly set me up for the next few decades.
Having lost so much weight so fast, when I got better, I couldn’t eat enough. I was hungry all the time. I was cold. I felt so ashamed that I couldn’t stop eating. I thought there was something wrong with me. I thought I was like an animal. I felt possessed! It’s only relatively recently that I’ve understood that this is a normal primal response to starvation. There was nothing wrong with me.
The next few years were spent trying to get back to that skeletal frame I embodied for a few short months when I was ill – the frame that wasn’t naturally mine, but which afforded me so much social currency. This involved very long fasts followed by long stints of uncontrollable bingeing.
Trying to help, my mother took me to doctors and dietitians to help me lose weight safely. I was put on Ponderax (aka fenfluramine – now banned) combined with injections – and I have no idea what was in those… I was 15 years old. It made me jittery, wired, dry-mouthed and I had trouble sleeping.
None of us had any idea then that there’s such a thing as body diversity – that not all bodies are meant to be thin and that dieting, especially in adolescence, is a risk factor for eating disorders.
In fact, in those days, in the 1980s in South Africa, we didn’t really know about eating disorders. We’d heard about anorexia, but that was about it. I certainly didn’t fit the bill for that. I wasn’t extremely thin. We had no idea that someone can have anorexia at any size (and even if we did know, I’d not have met the diagnostic criteria).
By the time I was 16, I was introduced to a new way of controlling my weight
I recall one time at a function when a few of us were complaining about how full we were, how we’d eaten way too much, how we’d have to go back on our diet tomorrow – someone mentioned quietly to me that she’d ‘already taken care of’ it’ by throwing up. It seemed like such a logical solution to the problem of eating too much, and certainly of eating all the ‘wrong foods.’ It made complete sense to me. I was surprised I’d never thought of it myself! So I followed suit.
As I said, we had no idea that this was an eating disorder. We didn’t even have a name for it back then. We had no idea that bulimia is potentially a life-threatening condition.
For the next 2 years, several times a week and sometimes several times a day, I would throw up. Every single day, I’d wake up wondering what, when and how much I’d eat. I’d wonder whether I’d manage to be ‘good’ today and not eat or whether I’d relent and binge. There didn’t seem to be an in between. There was no normality. I’d make a trip to the shops and stock up on all the ‘fattening foods,’ then binge on them and throw up. I don’t know how, but I managed to keep this up without my parents detecting anything. It was completely under their radar.
Eventually, when I was nearly 18 and about to take my final high school exams, I came to a breaking point. I felt hopeless. I felt a deep sense of despair. I couldn’t really articulate what was not right in my world, but I knew I wasn’t coping. I wasn’t concentrating at school. I stopped caring about my academic results and my future. I was engaging in other risky behaviours – like driving a car without a licence, drunk 😳, smoking pot openly in public spaces and going out until all hours, the night before my exams. This was not me. At least I knew that much.
At this point, I reached out to my mother and without telling her what the matter was, asked if she could make an appointment for me to see a psychologist I’d connected with at a school talk. She didn’t pry – but made the appointment.
To cut a longer story (a tiny bit) – it took forever for me to pluck up the courage to explain to the psychologist why I was there – I don’t remember – perhaps 4 or 5 sessions. In the end, we got there – but he told me that since I was underage, he’d have to inform my mother that day. At the end of that very session, without any preparation, he called my mother in and told her. I can still feel that shame; the worry that I’d deeply disappointed my parents. All I still remember was that I promised I’d stop immediately, provided my mother didn’t tell my father. I couldn’t bear that.
And that was that, for a while.
I had no further therapy!!! I still can’t believe that I didn’t receive treatment. I wonder what the trajectory for me would have been had I received it? My guess is that it probably wouldn’t have changed much, because so little was known then about eating disorders, and the idea that all bodies are good bodies and bodies of all sizes are worthy and lovable and can be healthy just wasn’t on the agenda at that time (and still isn’t for the most part). Plus, my mother, and pretty much all the women I knew, were still dieting.
I continued with the pursuit of thinness for the next 25 years or so…
Even though I stopped the bulimic behaviours, I didn’t stop wanting to or trying to be thin!
This meant that for the next two and a half decades, I dieted and binged on repeat. I went on very extreme diets that resulted in the loss of my period and my hair falling out, to extreme binges that lasted weeks at a time. Sometimes I tried more manageable diets that didn’t give me the result I wanted and still resulted in binge eating. While perhaps my life wasn’t at risk without the purging behaviours (although I did have a couple of very short term relapses when I even resorted to throwing up in public toilets😳), my fixation on thinness – which then morphed into a fixation on thinness-masquerading-as-health – caused untold havoc. Actually, I have told about that havoc – you can read about it here.
At points in my adulthood, when already married with children, I did seek help. While I wasn’t in danger, so to speak, I was deeply unhappy with the obsession I had around food. Whatever was happening in my life, the gazillion joyful moments I was privileged to experience were coloured by my relationship with food and the size of my body. I was strongly attached to getting and staying thinner and even more attached to the belief that thinness was equated with health.
My GP told me to stop worrying (because I wasn’t in the ‘obese’ BMI category 🙄) and just to eat healthily. He offered me 6 sessions with the practice counsellor which did nothing at all to help me – probably because all the advice was still deeply rooted in the idea that weight IS a problem and that we should all be trying to be a ‘healthy’ weight.
I even tried Overeaters Anonymous which just made things worse. When I was attending in the early 2000s the approach was steeped in the belief that bigger bodies are a problem to be solved, that certain foods were addictive and should be avoided and that we are powerless over food. This approach kept me obsessing about my body size and food. It was not the doorway to freedom for me.
It was only when I truly let go of the pursuit of thinness, that everything changed
I’ve written about this so many times! I can’t say this is the doorway to everyone’s freedom, but I can say it was to mine, and many people I’ve worked with.
When we can let go of the idea that thinness is a moral good and embrace the truth that body diversity is real, the potential for healing is great. When we can come to an understanding that health comes in all shapes and sizes, then we can start to work towards incorporating behaviours that make the most difference to us – mentally and physically.
Whether you have an eating disorder or a dysfunctional relationship with food, or if you care about someone in this situation, please know that help is at hand. PLEASE reach out for it. Whatever your size, gender, race, age, ability, social class etc. even if you think you’re ‘not sick enough’ please – reach out and don’t stop reaching out until you find the kind of help that feels right for you.