In line with Eating Disorders Awareness Week, Sophie Harrison confronts the misconceptions associated with Anorexia Nervosa and explains the realities of this serious mental illness. Some readers may find this article distressing.
“I TRIED being anorexic for four hours, and then I was like, I need some bagels”. I read this in a magazine interview last year, and it epitomises one of the most common misconceptions about eating disorders: that they are a choice. I have been hesitant to discuss this topic openly before. This partly stems from my determination that University could be a fresh start, but also a fear of the stigma that is attached to it. Nevertheless, as part of Eating Disorders Awareness Week, I want to use my experience, as someone in recovery from anorexia, to unveil the awful realities of this illness, but also to show how much possibility lies in recovery.
I have seen celebrities quoted speaking of their ‘anorexic phase’, or how they starved for a film role until they decided to start eating ‘normally’ again. However, this projects the myth of the ‘diet gone wrong’ which suggests eating disorders are rooted in actions. They are mental illnesses; disordered eating is the symptom of far deeper issues, often rooted in perfectionism and self-doubt. If it were simply a ‘phase’, thousands of people would not die from it, nor only 30 per cent reach a state of ‘full recovery’. This illness is far more complex than simply deciding to ‘eat bagels’. It requires so much strength, with support and understanding vital.
My own experience of an eating disorder, for example, is strongly connected to my Type One Diabetes. The two illnesses are, by nature, quite similar. Both place a large focus on numbers and food; nutrition labels and carb-counting have been part of my normality, as long as I can remember, while many foods such as pizza, sweets, and even bananas were ‘off limits’. When I went onto the insulin pump, aged 11, it was supposed to enable me to be more liberal around food choices; however, this never really happened, and I realise now how unnecessarily restrictive I was.
Diabetes also exacerbated inherent traits of perfectionism and self-doubt. I have always been fastidious in maintaining good blood sugar control, but my feelings of failure when seeing high blood-sugar readings intensified as the years went on. It was during my GCSE years that I consciously reduced my carbohydrate intake to try and stabilise them, and this was the catalyst for what became a severe eating disorder. I spent my Lower Sixth in a vicious cycle of carb restriction and purging after meals, and by the start of Upper Sixth this had developed into Anorexia.
I was in denial, pushing my self to extremes to perform well at school, undertaking an excessive number of extra-curricular activities even for someone in a healthy physical and mental state. My underlying blood-sugar was worryingly low and this, coupled with malnourishment, deeply affected my cognitive functioning. I strove to create the ‘perfect university application’, my dream being to apply to Oxbridge. The paradox of the illness is that it convinces you that you are in control, but you in reality you grow more and more powerless.
The damage I was inflicting on my body makes me horrified to this day; when I first sought help, after my AS levels, I had electrolyte imbalances and worryingly low blood pressure. Yet it was only a series of reality checks – being told I could not apply to Oxbridge, discussions of inpatient treatment (which would mean leaving school altogether) and seeing how much my family was suffering – that made me actively choose to recover in November 2012. I pushed myself to end the vicious purging cycle, and over the following months gradually increased my calorie intake to gain back to a healthy weight. I used my offer from Exeter as a concrete goal; the fear and guilt were temporary, but my future was fixed in being healthy enough to live it.
My experience has opened my eyes to the worrying shortage in treatment, both specifically related to Diabetes and eating disorders, and as a whole. While some resources are incredible, far more support and understanding is needed. I did have a treatment team, but they presented my options as very black and white; either self-motivated recovery, with minimal support, or enter an inpatient unit. The therapist I was given also had little knowledge of Diabetes, and this is where the incredible support of my Diabetes nurse was invaluable.
I am hugely indebted to my family for the past year. Eating disorders place them in a catch-22 position; when they try to force the issue, even someone committed to recovery often becomes defensive and more introverted. It deeply upsets me when people pass judgement on families. You cannot fairly do this, without being in that situation. The same is true when labelling people with eating disorders as selfish or attention seeking. Everyday, I still feel overwhelming guilt for what my family went through, but I never knowingly hurt them. It was largely due to my fear of hurting them, that I avoided seeking help sooner.
Eating disorders upend logic. My distress over eating, blood sugar highs and weight gain, irrational as they may have seemed, became so real to me in my increasingly malnourished state. I genuinely believed that an extra gram of carbohydrate would send my blood sugar rocketing. My self-worth became concentrated in the number on a blood sugar meter or scale. The fear of weight gain was not rooted in vanity. When my refreshingly honest friend told me last Summer that I looked “so much healthier, thank god… you looked horrendous!”. She’s right, I did. No person losing weight to ‘look good’, would have chosen to look like I did.
I am reluctant to use the term ‘the eating disorder voice’, as it can aggravate the ‘mental illness’ stigma. Nevertheless, nearly ever person will have experienced niggling moments of insecurity in their lives. With an Eating Disorder, imagine a near-constant stream of these negative thoughts. You become consumed by a paranoia that you are undeserving, or that people will judge you; the tragic irony is that food and weight become the outlet for these emotions, yet the resulting malnourishment only magnifies them. Moreover, when people dismiss those with mental illnesses as ‘irrational’ or ‘messed up’, it only increases these feelings of unworthiness.
Recovery is about choosing, everyday, to go against this distorted ‘reality’. In my case, this was also not necessarily the reality I lived with for ten years prior to the eating disorder. I have to try and grasp that many of the ‘diabetes rules’ I had were grounded in misinformation, both by dieticians and the media. I now have facts to help me: in the last year I have eaten former ‘off limit’ foods such as bagels, doughnuts and *queue gasps from my old dietician* I ate my first banana in memory… not only am I still here to tell the tale, but my blood sugars did not go out of control!
I cannot ever truly escape numbers; I will always have to carb count, and will inevitably experience blood sugar highs and lows. But they do not have to define me. I am not a blood sugar reading. I am not a number of insulin units. I am also not a weight, or calories and carbohydrates. I am not a grade. I am not a percentage. I amme. And, at the heart of this illness, that is where the greatest challenge lies – accepting that the simple state of being can be good enough.
It is a process that takes time and not being ashamed to ask for support. At my Leavers’ Dinner last June, I was at in a strong place with my recovery. However, the meal that was served provoked my anxiety, and my friend observed how I suddenly went from carefree and smiling, to withdrawn and worried. I think, in that moment, she got some insight into how powerful this illness is. With support from her, I ate the meal and that was another step forward.
With so much misunderstanding of this illness – particularly the belief that it is a choice – those suffering can often feel unworthy of help. If you are reading this, and struggle with an eating disorder in any form, you did not choose or deserve this. To give some blunt examples, I do not believe anyone would choose half an apple with a candle in as their 18th Birthday ‘cake’. For this birthday, I was also given “the only thing I had ever really asked for” – a puppy. I adored her, yet it would be months before I would be strong enough to walk her by myself. The first time we took her out on a lead, I only stayed outside a matter of minutes, because I was so cold.
What you can choose, and do deserve, is to fight this illness. Last summer, I took Millie on her afternoon walk nearly every day. It is the small things that help in recovery so much. Like when my sister and I went for afternoon tea last summer, and she said how incredibly strong I was. Things like this remind me that she understands how real this illness is, but also helps to give back some of the self-worth that the Eating Disorder stole.
It is not that I don’t look in the mirror now, and find fault with what I see. It is that I can now look beyond this, and see the life in my eyes and a smile that isn’t a facade. Furthermore, I realise that, even at my lowest weight, to the Eating Disorder it would never be enough. I genuinely saw myself as bigger at my lowest weight than I do now. The reality is the only weight that will be ‘low enough’ for anorexia is the one that puts you in a coffin. So why chase what can never be, when in doing so you sacrifice almost everything else?
Nourishment isn’t a magical fix, but it makes fixing possible. The eating disorder, quite literally, starves you of the chance of living. From being on the brink of a hospital admission just over a year ago, I gained back to a healthy weight, achieved my predicted A-Levels, and am now at University studying the subject I love. I am still anxious over some food, and diabetes control, but I am more scared of losing all the things I mentioned above.
I hope that if, prior to reading this, you did believe that eating disorders are either a choice, or easily ,‘cured’; I hope you realise that this isn’t the case. To me, Anorexia is as real an illness as Diabetes. I did not choose either, but what I can choose is not to have my life defined by them. I also hope that anyone questioning if recovery is worth it, or indeed possible, can trust that it is.
If you have been affected by any of the issues in this article, contact the Wellbeing Centre, or National Health services.
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