To Avoid an Eating Disorder, Don't Start Down the Path
Personal Perspective: After struggling for 25 years, I have something to say.
Posted February 27, 2023 | Reviewed by Gary Drevitch
Please, please don’t start. I know you may not intend to acquire an eating disorder, thinking of it as something you might hold on to for a few weeks, then discard. It's not that easy.
Someone might have proffered a remark, they thought innocuous at the time.
“Did you put on a few pounds?”
“Oh, sweetie, you have your mother’s hips.”
Anorexia is an insidious psychiatric illness, one that is sneaky and crazy like a fox. It will seduce you.
“Just five more pounds, then I will stop.”
“I’ll just run six miles today.”
You will need more. And there will be no question of turning back. Like a heroin addict forever chasing a high, every ounce you lose will leave you wanting for more. The numbers on the scale will rule your day and your self-worth. If you’ve lost weight, you are good and virtuous. If you’ve gained a miniscule amount, your heart will be heavy, full of self-loathing.
You will be a slave to the mirror, to store windows, to buildings made of green glass—anywhere you are able to catch a glimpse of yourself. All you want to do is pinch, hard. You will see fat everywhere, even though it’s merely excess skin.
“No,” you cry, clutching a wisp of skin between your thumb and forefinger. “This is fat,” you insist.
You will be consumed by thoughts of food, because you will not let yourself have even one bite. Your brain and your body are starving. Malnourished. Their ability to function optimally is being compromised. Day after day.
You will develop depression, because how could you not?
In the process, you are destroying your body, because how could you not?
Your world will shrink, to you and your safe foods. To you and your body. You are delighted as your weight continues to drop. You take a naked selfie in the bathroom and compare it to the one taken hours before. You weigh yourself 10 times a day.
If you are lucky, your mother, your friend, someone will notice and force you to get the help you need. Eating and feeling sated will be terrifying. Gaining weight will be untenable. But you do it because you have no choice. Because all eyes are upon you.
Eventually, those eyes will glance elsewhere. You have a choice now. Resisting the pull of anorexia will be one of the hardest choices you will have to make. Now, six months from now, and a year from now.
Do you want to return to that world? Being a slave to the scale, to depression, and to suicidal thoughts, existing in a tunneled universe? A world of Ensures, ng tubes, and hospitals?
“Yes," you answer. Being thin is worth it. At any cost.
Your body is counting now, ticking off the minutes, the years until it self-destructs. The damage is cumulative. You are abusing laxatives, diuretics, and enemas because you need to see the weight come off faster and faster. It’s gotten harder than it used to be.
You know the ritual by now: Up at 6 am. Supervised bathroom. No chance to chug water from the faucet. Weights in a gown, no underwear where you could hide a roll of pennies in your crotch. Up on the scale, backward. You beg the nurse to tell you. Up? Down? But she's stone-faced. You are sure you gained and panic starts to set in. You pace up and down the corridor, until one of the techs tells you to cut it out.
You’ve learned to live with a number—an arbitrary number because once you see the scale pass that number, you restrict. Not Monday, not tomorrow, now. You don’t stop to think, when did you last have a bowel movement?
Two months later, you’re down 20 pounds. You don’t know how it happened. It seemed like a good idea to cut out peanut butter, then bread, because you didn’t need anything to spread the PB on. Then you started eating only plain yogurt because all the others contained sugar. Bananas had too many calories. You ate lettuce leaves and celery with a dab of spicy mustard. Your list of safe foods narrowed. Some days it was easier not to eat at all.
You’re constantly exhausted and so cold, even under layers of tights and sweatshirts. Clumps of hair fall out in the shower and lay on the bottom of the tub like dead bugs. Your complexion is pale and as you walk around, you get dizzy. It’s getting harder to go two days, even just one without eating. It’s almost impossible to go for a run without feeling as though you’re going to pass out.
You are living your life, half-in, half-out of anorexia land. Always vigilant, watching the scale, body checking. You are not all-out restricting, but you are being “careful,” you tell yourself. Your weight is at the low end of acceptable and your therapist, your nutritionist, and your primary care physician have stopped giving your grief.
You feel as though you are not a “good anorexic” any longer.
But nothing has changed in the vast landscape inside your head. There is plenty of room for self-loathing, body-hating, and constant self-criticism. The damage is done, psychologically and physically.
You have osteopenia. The precursor to osteoporosis. Your OB/GYN warns you this is a progressive condition and puts you on an oral medication to try to halt the damage already done.
“Be careful,” she warns. “Don’t fall.”
Your teeth start to crumble. The edges of your teeth become rough, irregular, and jagged as enamel erodes. The enamel falls away, exposing the brown dentin.
You start freaking out.
I never purged, you think to yourself. What is going on?
The dentist tells you that you will lose all your teeth. You are 53 years old. He explains that severe and prolonged malnutrition caused bone loss and that your teeth are made of bone. You never thought about this.
Within a month, your remaining teeth are pulled. You are referred to a restorative dentist to get fitted for dentures. Because there is extensive bone loss in your jaw as well, fitting dentures will be harder than usual, this dentist tells you.
When you look at yourself in the mirror without your dentures, you see your mother. She lost all her teeth when she was 35. You didn’t find out she was bulimic until after she died. Your aunt told you she was molested by her brother who was 13 years older than her.
Along the way, you were diagnosed with adult-onset asthma (which is more severe than having it as a child). You were constantly on and off steroids which further destroyed your bones and now, the osteopenia has morphed into osteoporosis.
A dream finally comes true and you welcome a rescue dog into your home. She is a 40-pound fireplug who chases squirrels and rabbits. You walk her five or six times a day, striking the pavement hard with each step. You develop a stress fracture in your left leg and are in a toe-to-heel boot. While favoring the right leg, that ankle develops a stress fracture. Through all this, you continue to walk her because there is no one else.
The fractures are taking forever to heal. Your weight has stabilized because you can’t abuse your body the way you used to. There are times you long to because you would like to be thinner. If you miss a meal, it triggers a migraine, an experience you wouldn’t wish on anyone. You’re in constant pain. When the physical therapist saw the MRI of your back, she uttered, “Holy sh-t.” Your digestive system is a mess.
Please don’t start. Fight like hell. If you find yourself becoming seduced by anorexia, ask for help and work your hardest to break free from her clutches.
If you or someone you love struggles with disordered eating, call or text the National Eating Disorders Association (U.S.) helpline at (800) 931–2237.