Eating Disorder Recovery: Q&A with Sarah from Psychforum
Below, Sarah shares her struggles with anorexia and how she recovered and now leads a fulfilling life.
1. How and when did your eating disorder start? What do you think contributed to it?
My anorexia started developing at seventeen and I probably didn’t recover to a normal weight for two years. I had always been aware of my body since childhood — I went through puberty and was the first girl at school to get boobs. From thirteen, I probably started weird food habits with bingeing and guilt. At seventeen, I was under increased pressure with high school exams and going to college and started getting bullied by other pupils at school.
My background was the usual — high-achieving perfectionist, been bullied, mum was very diet-conscious. I started a diet and just didn’t stop until I ate very little. The control you feel is cliché but true. Not only do you get a physical high from starving but glee from under-eating everyone around you. I thought that being thin would put me beyond the criticism of my teachers and bullies, and so I wouldn’t have to keep thinking about it. It made me feel independent. I didn’t ever feel attractive though. Your sex drive collapses to nothing and your body always looks wrong.
2. What motivated you to seek treatment?
My family recognized it before I did. My older sister convinced my parents who were rather bewildered, who sat me down with a list of the symptoms and asked if I recognized myself in it. I denied it, got angry and tearful, but agreed to go to a primary physician.
I suppose I went along with treatment because I was physically weak and unable to resist (I once cried in a restaurant when faced with a baked potato!), somewhat embarrassed (lots of weird ED behaviors) and probably didn’t think I needed it, so no great change would happen. I remember teachers and friends being concerned and that I would just shrug off. My parents hadn’t told the extended family. It was brutal when I saw my granddad for the first time and he thought I was dying.
3. Eating disorders are tremendously treatable but the key is to find the right treatment. How did you go about seeking services?
I’m English, so everything was done through our national health service and was free. My GP (primary physician) started treating me for depression. I was very underweight, but he encouraged me to start eating more (so I didn’t drop) but didn’t give me a target weight initially. This was a good approach for me. I had some time and space to get used to eating more, my obsession with food declined, and I started feeling a bit stronger and could tackle other issues. Obviously this didn’t happen at once. I was pretty sneaky and constantly trying to hide food or exercise more and for the next couple of years, my weight went up and down from underweight to normal a fair bit.
I was referred to a couple of sessions with a psychologist before I moved cities. In college, I started seeing a non-ED counselor while I got referred to services and then was enormously lucky to receive outpatient treatment at a highly specialist ED unit. I’d go once or twice a week for very structured counseling. It was based more around body image, self-esteem and used a cognitive-behavioral approach than really looking at nutrition. (ED sufferers know loads about nutrition — they just rationalize that they are somehow the exception to it!). I would see the in-patients when I visited. They were so sick-looking and frequently throwing tantrums: I suddenly saw that that’s all their lives would be, and I didn’t want it.
4. What led to your recovery?
The treatment was fantastic: intensive, focused away from weight and on depression and self-esteem. I started treatment within five months, so perhaps the behaviors weren’t too embedded. I started developing hobbies and new friends. I had space from my family to build my own life and take responsibility. I’ve always been bookish and found reading books like The Beauty Myth really helped to redirect my anger away from my body to the idea of an ideal body standard. My GP told me I was anhedonic, and taking pleasure in nothing was no way to live. I was fascinated every time I saw myself in portrayals of ED, though after a while I stopped reading too much because I wasn’t sure it made it better. ‘Misery memoirs’ can be templates for behavior too.
I was bored too. EDs are really boring. Think of all the parties and teenage fun I missed out on! I remember my doctor explaining that people only think of food when they are hungry. So for normal people that’s 10 percent, and if you are starving or disordered, it’s 90 percent. You become obsessed with food and weighing yourself and exercise and it’s just a waste of brain space.
I had to stop caring and comparing myself to others. People with EDs tend to see separate qualities not the whole package — i.e., that girl has much thinner legs — and don’t appreciate their own personality, career, friends and physical qualities. I went to a competitive university where many girls have EDs, but in the end I was only responsible for my health.
5. What were the toughest parts of your recovery and how did you get through them?
Recovery isn’t linear, and it’s not something you “win” at. It’s slow, it’ll be hard work, and you will still have guilt for a long time. You have to stay mindful about unhealthy influences: friends who “fat-talk,” celebrity magazines (which judge bodies and give out ED-type advice), diets foods (food should be about nourishment). Some trashy magazines encourage starvation level diets, exercise to purge calories not for health reasons, include weird tips like eating off small plates or restricting to something bonkers like the master cleanse. They all do that terrible “circle of shame,” picking out and judging bodies (always women). It is exactly the same as the internal monologue of someone with ED observing herself in a mirror.
I didn’t take up exercising properly again (I had exercise bulimia too) until this year and have maintained my weight and take pleasure in it. Throwing away all the children’s clothes (really) and photos was a big step. Really, I probably wouldn’t want to see a picture of myself like that now. Getting over the embarrassment of mental illness is crucial. I can be fairly open — if I met an old school friend who asked if I was ill, I could happily admit it, but I don’t tell new people unless I have a reason.
You also have to grow up and realize you do have a responsibility to your family, community etc. I once gave a talk to a bunch of schoolgirls after the school had requested a student ED survivor from my university. They kept asking questions which were really methods and wanted to know my final weight. I didn’t disclose as I didn’t want them to target that. The same kids wrote me letters afterwards admitting their own issues. It was heartbreaking. The school set up some kind of counseling service.
6. Do you still struggle with eating disordered thoughts and behaviors? If so, how do you overcome them?
Thoughts but not really behaviors. I am very critical of myself generally, not just my weight, and have to consciously stop “disasterizing.” Disasterizing is what my psychotherapist called assuming the very worst and an unrealistically bad outcome — i.e. thinking that a meal out will result in a three pound weight gain, an unexpected meeting with my boss means getting fired. I had to relearn how to consider and react to situations in a calm and realistic manner. I’m a big fan of self-help books, especially those based in CBT (cognitive-behavioral therapy) techniques and looking at compassion, mindfulness, etc.
I still have a list of ten bad ways of thinking and read it occasionally. The biggest tip I have while you’re recovering is to act the opposite: Feeling fat and avoiding social situations? Just go. Think you can’t wear the skirt? Enjoy it. Avoiding a food you don’t know the calories of? It’s a cake, not a bomb. The world won’t end.
I challenge the anhedonic tendencies by looking after myself, seeing friends, not pushing myself too hard, getting sleep and good food, and indulging in bubble baths! I volunteer with disabled kids and the homeless, which taught me compassion for others, and also for myself.
7. What are some misconceptions about eating disorders?
That people with ED are selfish. Often, they are excessively empathetic. That the mother/family is to blame, maybe or maybe not, but the individual is important too. That you can’t recover. You can. That weight rather than the eating patterns are important. I’ve seen normal-weight bulimics in MUCH worse physical conditions than anorexics.
8. Many people don’t realize the physical consequences of eating disorders, including electrolyte imbalances, irregular heartbeat, osteoporosis, severe tooth decay and digestive problems. Did you experience any health problems as a result of your eating disorder?
I stopped getting periods but that came back once my weight was up. I have no idea if my long-term fertility was affected. My sleeping patterns have never been restored. When I was ill, I was too cold, sore or manic to sleep. It takes a while to get used to this whole new body once you are well. I got big boobs again!
9. What can family members do to help a loved one with an eating disorder?
They have to realize that they can’t fix it alone. Finding a doctor who understands ED is crucial, but you might have to fight for treatment while fighting your angry, fear and ill child/sister/lover, etc.
I have a lot of guilt about what I inflicted on my family. They really did think I was dying. They did the right things: They educated themselves, they avoided confrontation and they examined their own behavior. I have a younger sister, and despite what happened with me, she’s incredibly happy and body confident.
10. Anything else you’d like readers to know about eating disorders?
It’s common, it’s an illness not some self-indulgence, and it’s not the end of the world: You can recover. People who claim they can’t recover are in denial or haven’t been treated properly.
Eight years later, I’m happy, successful, have lots of friends, hobbies and a great job. I have boyfriends and a sex life. I am comfortable with what I weigh and how I eat, even if I have days that I need to coach myself through. You are the only person who’ll be with you every day for your whole life. Be your own best friend!
Tags: anorexia
