Tag Archives: eating disoreders

29 January 2014

I am not usually a sedentary person; Bauer and I probably average about 7 to 10km a day - sometimes more, sometimes less - but he benefits fairly significantly from a finely tuned guilt complex, wrapped up in the remnants of a lingering eating disorder.  The eating disorder hasn't been life-threatening for a very long time and I don't normally talk about it because, compared to what it once was, it is now a manageable cross; one born by more people than you might imagine.  Some people know.  Some people don't.  It would be easy enough for a person not to realise since it doesn't always manifest itself as anorexia - I have also been severely bulimic, as well as having periods where I have an eating disorder in the same way that someone who has been an alcoholic is 'always an alcoholic' - I might be winning the battle not to starve or stuff myself but, make no mistake, beneath that serene exterior there is most definitely a battle going on. Archie often asks me why I don't write about eating disorders since I have so much 'experience' and such incredibly strong views on the subject - and I always tell him that it's because I've rarely read anything written about them that isn't just part of the problem. Most people aren't aware that eating disorders have the highest mortality rate of any mental health condition known to humankind. If you are not careful about what you say you might just kill someone - maybe not instantly - but your misguided word or phrase will lodge in their poor diseased brain and torment them to the brink of collapse. It's not that people don't mean to be careful what they say - it's just hard to be careful what you're saying when you don't really know what you're talking about.

The first two massive, fundamental, epic misnomers are that a conversation, article or other discourse about eating disorders, especially anorexia, should centre around 'food' and 'weight'. This is the most tragic and corrosive misunderstanding of all - and probably the biggest reason that eating disorders have such a high mortality rate. Why? Because you simply can't solve something by making it worse. If you are trying to communicate with, connect to or understand a person with an eating disorder you absolutely should NOT make ANY reference to what they do or do not eat or how much they weigh. I cannot tell you how sad it makes me to know that when a person goes to the doctor in this, or any other western country, to ask for help with an eating disorder the first thing the doctor will do is put them on the scales. To do this is to completely misunderstand the mindset - all you have now done is given them a number which they will be compelled to drive down by the next time they see you because otherwise they are 'failing' to do well at having an eating disorder. Now, to add insult to injury, people will also be given a BMI and told what range they fall into - in fact, if they don't fall below the 'normal' range they will be told that they don't have an eating disorder - even if they know themselves that their relationship with food is severely compromised. A person who has a sub-normal BMI will realise that they are only in the 'underweight' category and not in the 'severely underweight' category which will flag up for them that they are 'failing' to be as good at being anorexic as other people. You have to understand that a person asking for help will have 5% of their brain on their side, while 95% of it will be resisting, wildly absorbing any information it can find to fuel the disease and resist this 'temptation' to 'give up', to 'fail', to be 'tricked' into thinking that it's OK to eat more. Anorexia is hugely competitive, the person is trying to 'improve' themselves and they've locked on to the idea that this can only be done by losing weight - NEVER give them more numbers, do NOT compare them to other people and don't ask them what they eat because they will be tormented to admit that they eat anything at all - and, if they do tell you what they've been eating, they will be compelled to eat less to ensure that the next time you ask the same question they have 'improved'. This competitiveness is also why putting a whole bunch of people with eating disorders in a treatment centre together is about the most epically stupid thing that psychiatry has ever come up with. Up until a certain point people with eating disorders should be kept as far away from each other as possible - by putting them together you are just compelling then to compete with each other. They won't want to but they won't be able to resist. If a person goes to a doctor and says they have an eating disorder why is it necessary to put them on the scales? If they think they have an eating related problem, then they have an eating related problem - you don't need to weigh them to prove it to yourself, it's not about you; you don't need to categorise them as having a better or a worse problem than someone else, what earthly difference does it make? You just need to HELP them.

The other fundamental misunderstanding that drives me mental is the commonly heralded medical definition of anorexia as being 'a loss of appetite'. Are you crazy?!!! These people are fucking starving! They are obsessed by food. They are desperate to eat. They are hungrier than you've ever been. They haven't lost their appetites, they've lost their minds - help them find their sanity, help them escape the cult like mentality which has taken over their brain. They're not refusing food because they're not hungry - they're refusing it because they're terrified that eating it makes them a worthless failure that doesn't deserve to live. Don't try and rationalise it, (they won't eat, so they must not be hungry); it's NOT rational, it's an illness, it's not playing by logical rules.

Obviously anorexia and bulimia are not the same thing - and I'll spare you my bulimia rant - suffice it to say that you shouldn't talk about 'food' or 'weight' to these people either. Weight is the barometer by which people with eating disorders are assessing their worth - but conversations about weight won't help them to solve their problems. Their issues are complex ones of inadequacy, worthlessness, imperfection, feeling judged, feeling powerless, feeling overwhelmed, feeling depressed. They are suffering from an inability to cope with the lack of control that is living - they are trying to construct a world with black and white rules so that they can survive. They are killing themselves to stay alive. If you understand that then, maybe, you can start to help them.

So why do I mention all this - or even any if it? (Especially as I will delete this post long before any child of ours ever gets anywhere near it.) I mention it because my eating disorder is one of the few things that I never intend our offspring to know about their mother - and I know that the only way I can bring this about is to be entirely normal around food from the moment that they are born.  I couldn't live with myself if I passed on these feelings of inadequacy.  I don't care what it costs me; I don't care what I end up looking like.  If we are lucky enough to have a child, especially if it's a little girl, they are going to think that their mummy loves herself; that their mummy thinks she looks good in everything that she puts on... that their mummy has never, EVER, equated weight and worth. They will get enough complete crap rammed down their throats by the media - they will need at least one half-decent female role-model and it's going to have to be me. It has been hard for me but I have been eating in healthy quantities since we started this process - and it has been made harder still by the fact that now I can't even go for a walk, (exercise and eating disorders - the very best of frenemies), but I am writing it down, saying it out loud, publishing it for the world to see so that it's out there and there's no going back.

Of course, having gotten this epic weight off of my chest, I'm almost guaranteed not to get pregnant!  Today has been the hardest day so far - the OHSS doesn't seem to be getting any worse which is not a positive sign.  Please don't post telling me not to worry though – just for today I don't think it would help.    
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