The anatomy of eating disorder recovery

In a nutshell, 

You’re going to fall down. A lot. You’ll probably hit an extreme rock bottom, maybe one that’s lower than the rock bottom you thought you reached when you were sick, and you’ll wonder what the hell at the point of all of this stupid, shitty-ass work is all about. You’re tired of falling. You equate falling with failing. Aren’t they the same thing? You’ll cry to a God if you believe in one, and if you don’t, you’ll still cry and probably wish you believed in one.

There will be low points. And they will hurt like hell. 

You’ll think you are the exception. You are the one who won’t heal, the one who cannot recover, the lost cause who is doomed to a lifetime of misery. 

People are going to tell you this part of the process. What, this falling down, slamming yourself into the ground, time and time again? This utter inability to actually take care of yourself constructively? The continuation of the very habits you want to break the most? Oh, yes! They’ll tell you with their knowing nods, condescending smiles, and confident attitudes. This is part of the journey. 

You’re going to slip. Professionals like to use that term. Slip. Maybe you’ll slip right back to where you started. Maybe you’ll slip even harder and fall into a new realm of hell. At least you’re gaining insight. This is part of the process. You’ll keep hearing those words. Be kind to yourself. You will also hear that, even though that’s the most fucking counterintuitive advice you’ve ever heard. Be kind to yourself? REALLY? Who could be kind to such a monster? Who could be kind to someone who continuously beats, torments, and wrecks me? This just seems nonsensical. In fact, you may even hate yourself now more than you ever thought you did in the past. You will not be kind to yourself for a very long time because unfettered kindness equates with immense self-love, which in turn, KILLS the eating disorder, literally diminishing it from existence. You just can’t get rid of it that fast. It just doesn’t work that way.

You will doubt recovery. You will doubt you even had an eating disorder. You will doubt the validity of positive affirmations, doubt your treatment team (if you have one), and doubt that anything is actually going to stick. You will still lie, because lying has been the basic bane of your existence. In fact, don’t be too surprised if you even get better at it. You will become talented at cheating the system and cheating yourself. You will hang on to your eating disorder for dear life, while, at the same time, doing everything you can to throw it away. You will constantly feel tormented, conflicted, and vulnerable. 

If you are fortunate, you may quickly stop the behaviors. But the negative, distorted thoughts long preceded those behaviors, so they will linger far after. You will become just as obsessed with recovery as you were with sickness, wanting to be perfect yet again. Seeing the world in black-and-white yet again. This is your habit. This is how your eating disorder trained you. If you can’t be the most perfect sick person, you have to be the most perfect recovered person. The obsession stays for a long time, and that is one of the hardest parts. Food dominates your mind. Every meal, every unplanned snack, every new item of clothing, every change in your body…this will be scrutinizes and analyzed. This will be your new compulsion.

After awhile, with some smooth sailing, you may get cocky. This happens, too. During those high points. You will get confident that you will never use that behavior again. You will never be back to the way you were. You will never choose to hurt yourself again. These statements, you will realize, are just as detrimental as the negative, all-or-nothing statements that maintained your disorder. People will try and warn you about potential triggers and the risk of relapse. You will shrug them off. Couldn’t happen to me. I GOT THIS. 

It’s only a matter time before you are triggered. You will spiral out in a tailspin. You will realize they were probably right. You will curse them…and then, you will realize you are a fucking human being who is recovering from one of the most beastly, complex, chronic mental disorders in the DSM, and therefore, YOU WILL FALTER. You didn’t move into hell overnight. You won’t be able to move out overnight either. Even though you desperately want to. But, with recovery, you get to start seeing other places to live. You get to check out the other real estate. You get to see if it’s worth moving. You are shopping; you are learning what else is out there.

And if you start liking what you see, you will start to push yourself. More than you’ve ever pushed yourself. You will start accepting, HONEST-TO-GOD accepting the fact that you can’t “WIN” recovery any more than you can “WIN” an eating disorder. You just plug at it. You may have epiphanies and you will probably feel random bursts of inspiration and motivation, but sadly there is no magic formula or voodoo secret. You will have to trial-and-error. And, in a clinical sense, trial-and-error essentially means TRY, TRY, TRY until something works. And that’s what recovery is. TRY, TRY, TRYING until something works. 

There is no timeline. There is no right or wrong. There is no prize for you at the end, except, of course, your health, vitality, sanity, and freedom. But, here’s the catch. You don’t actually receive those just at the end of your journey. Those gifts are with you from the start, from the first moment you decide you’ve extended your stay in Hell and want a new place to live. Those gifts are what keep your path, and all its ups and downs, worthwhile. Whatever sense of health, vitality, sanity, and freedom you thought you had in sickness can ONLY improve in recovery. You will notice that. You will start to see, taste, hear, and feel it. The sensations may be overwhelming. Stick with them. 

Healing hurts. Unleashing the pain hurts. The rawness of exposed wounds hurts. That is part of recovery. There is no way to avoid all the suppressed feelings, the stuffed-down anguish, the starving fears. But remember this. With an eating disorder, pain progressively increases. With recovery, pain progressively decreases. 

And on the other side, of pain, you will see, lies a pleasure you may have never known existed. 

 

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the anatomy of the eating disorder

Dear Bee,

The hardest part of recovery, and I mean the fucking tough feet-in-quick-sand-trudging-through-mud-everything-hurts-because-it-all-is-weighing-you-down type of challenging, is learning how to cope with the fact that basically, NOTHING in the world changes just because you ate X many calories, weigh Y many pounds, or did Z minutes of exercise.

That’s right. Nothing changes.

You think it will; oh yes, your eating disorder will promise you limitless gifts. It promises you “control,” in the sense that controlling your food somehow controls your destiny. It promises you escape, in the sense that, instead of actually facing life head-on, you get to face life through the eating-disordered lenses, which means you see life in terms of calorie counts and body shapes, in measures of your self-depreciation and nonexistent self-esteem. And that’s a lot more manageable than seeing life for the unpredictable, occasionally hellacious, out-of-control reality that it really is. Oh and it promises you happiness, because obviously, your body determines your happiness. Eating disorders make the universe YOU-CENTRIC, because yes, the state of existence depends entirely on what you eat and what you look like.

We buy into this shit. Oh my God, we buy into it more than anything. But not right away. It’s like a cult. Eating disorders start out so damn slowly, taking years to culminate, sneaking up on us so subtly we don’t even realize we’ve shifted from being a “little weird” about our diets to having a full-blown mental illness that’s affecting our everyday functioning. That’s why they WORK. That’s how cults work. Nobody would have an eating disorder if he or she just started AT ROCK BOTTOM. Can you imagine? Nobody starts by analyzing every single meal or throwing up every single morsel or jumping on the scale every other hour. Nope. The journey starts out progressively; the eating disorder has enough time to build our trust, to wrap its claws around our suspecting necks, and literally take control the second we think, we can stop this at any time. 

And then, we forget how to cope without the eating disorder. And we’re terrified at the thought of doing so. It’s our crutch. We can pigeonhole it for everything. Essentially, there is nothing food cannot fix. We binge because we need to stuff the feelings and numb the pain. We restrict because we’re fat and miserable and deserve to punish ourselves. Over and over again. The cycle becomes automatic; we are trapped in a lifestyle we actually once believed was a conscious choice. We are slaves to our own cruel and unusual forms of punishment. And the suffering only gets worse. It starts out with just a few skipped meals, maybe, or the casual vomiting or the continued overeating. It’s easy. It’s just a supplement to our busy lives. Just a “healthy” choice, right? And then, it’s bloated stomachs and bloodshot eyes and being unable to breathe and sneaking and lying to ourselves to others; it’s heart palpitations and constipation; it’s dizziness and headaches and losing hair; it’s brittle nails and broken bones and rotting skin; it’s insomnia and shivering skin and unbelievable self-hatred. It’s carrying more mental weight than you could have ever physically weighed. It’s feelings of helplessness, sheer terror, and a persistent pain that eats away our every flesh and bone. 

It’s hell. Day in and day out. A hell of our own minds; a hell of our own bodies. And here’s the worst part. No human has successfully been able to escape his or her own mind or body. So, when you feel stuck in that, when you are trapped in your own mind and body and don’t want to be there whatsoever, you’re stuck in the absolute shittiest hell there possibly is. 

Eating disorders are about the most putrid, disgusting, and humiliating sicknesses there are.

Nothing glamorous exists in the lies this disease carries. The glamour only exists in the beginning stages, in the disillusions of the perfect bodies we will “somehow” achieve and the perfect lifestyles we will then subsequently lead. That glamour is a facade that turns into a three-ring circus of deceit, compulsion, and distortion. 

Then, after time, hopefully sooner than later, but everyone’s timelines are different, you realize perfection doesn’t exist. And that, whether or not you gain or lose five pounds, you will get hurt and rejected and scared. You will lose people who matter. You will make choices that invoke intense anxiety. You will question your life and you will fear for your life. You will make mistakes, some that are forgivable, others which will change you indefinitely. You will encounter difficult feelings: sadness, anger, and fear. 

This hurts. This hurts so much. This is raw and bloody and terrifying. And, sometimes, there’s nothing you can do about it. 

And your eating disorder can’t save you. And losing that savior is similar to watching a great hero fall. Because your eating disorder is supposed to be your guardian and is supposed to protect you from the scary demons in life. Right? That’s why it promised you from the start. But, it didn’t do shit for you. It wanted you to sink. It never wanted to save you. That’s right. The eating disorder had one mission. Drown you. 

And when that message really resonates, you turn your back on that evil bastard. You enter those complex throes of recovery, with half your mind reaching for the light that barely shines, while your body is simultaneously being pulled back into the dark abyss that was your home for so long. And you’re just supposed to fucking deal with life. Sit with emotions. You’re supposed to develop coping skills. You’re supposed to live a full life without being obsessed with food and numbers and exercise and weight. Those are the criteria for recovery, right? Because if you don’t, you’ll never heal. You just can’t. You can’t half-ass it either. Can’t do half of recovery. Can’t give up half the behaviors. Can’t do it half the time. It just doesn’t work that way, although we will all try. We all think we can cheat the system. We all think we are somehow different. This time, after all, we know better. And then, naturally, the eating disorder will gnaw back at you, hold out its lovely hand, entice you with its convincing speech, lure you right back into the tempting swirl, promising that this time, it will be safe, and you will have control, and you will be able to handle it. 

And you will jump in, head-first, excited at the prospect that, yes, this time, it will be different.

And we all know exactly where that goes.

You are not a special snowflake. You cannot flirt with danger and expect love and kindness in return. You cannot tempt the devil and expect to taste heaven. Your eating disorder is not your friend, and the sooner you realize just how much it is actively trying to destroy every element of your life, the easier it will be to let that asshole go. 

What more could I want?

Dear Bee,

The end of a long, much overdue weekend has arrived. It has been a jam-packed past four days, full of the people I love and the things I love doing. Friday consisted of lounging around with the boyfriend…and I can’t really remember exactly what we did. Oh, wake up sex. And errands. And a long nap. And there were pancakes. And a really long walk. Saturday were the two birthday parties! On Thursday, I had written that I felt somewhat apprehensive about the food situation (one party can be triggering enough, but having two of them back to back seemed overwhelming). Needless to say, it went exceptionally well, meaning I didn’t just sit around and focus on what I was or wasn’t eating. Yesterday, I went hiking with one of my best friends for a few hours, had lunch with her, and then went over to the boyfriend’s, where we lounged for a bit, walked around an outdoor mall, and then hung out some with my family. Today, I went hiking with my dad, coffee and dinner with my mom, and watched a movie with my brother. 

It’s amazing how much I can eat without WORRYING incessantly anymore. It’s okay for me to eat out. It’s okay to eat at different times. It’s okay to be a little hungry or a little full…I can handle them both. Things have just gotten easier. For the first time, I don’t feel like I’m swinging between restriction and bingeing. I don’t feel like I’m riding onto the orthorexia train, rejecting every packaged food or ingredient I cannot pronounce. I’m just eating. Pancakes here and guacamole and chips there. Shaved ice and breakfast cereal. Coffee cake and Thai noodles. Sure, sometimes I feel a little stressed, which cues the internal, which is healthier or how much am I supposed to eat or maybe if I eat this, I’ll skip lunch or I’ve already eaten all this, so I may as well keep going, but that soundtrack is more faint as time passes.

This eating disorder will be behind me, and I know that. There’s just more to life. I chose recovery. I choose recovery. I don’t want an identity bound by sickness nor do I want to engage in behaviors bound by compulsion and maladaptive habituation. I did not choose this illness. None of us do. But I’ve moved on from that. I no longer beat myself up for something that I may have been genetically, biologically, or behaviorally predisposed to developing. It wasn’t my fault. I was sick. It wasn’t my fault. I didn’t know how to stop.

I’ve grown. This eating disorder has forced me to live beyond my comfort zone, to challenge the distortions that composed my here-and-now reality, to accept life and all the ups and downs that come with it. It has been a journey, a worthwhile one. I am finally at peace with myself and finally in the mental state I always wanted to be. There is no perfection. LIfe doesn’t change dramatically. But everything feels different. Renewed. Fresh. Beautiful. Life feels exciting. And I am very much enjoying the ride. 

And, really, what more could I ever want? 

What it felt like to be recovered today.

Dear Bee,

Today, as I committed to last night, I acted “as if.” As if you didn’t exist. As if I didn’t have an eating disorder. As if food was just food, eating was just eating, and my body was just a body.

As if I were recovered. 

I normally avoid listing specific foods and portions on here, but for today’s purposes, I believe my “results.” may be beneficial to my lovely and beautiful readers 🙂 I know that when I read recovery stories, one of my first questions is, well, what DO they eat?

So, for an entirely meticulous, detailed explanation of my day, here goes: 

I woke up around 7 and promptly went back to sleep for about another hour. I felt kind of hungry, but not starving. Maybe a 5. Waited a little bit to eat some breakfast. Asked myself what I wanted. Waited a few minutes to let myself reach an answer. Made some toast (the bread was this low-calorie, somewhat tasteless cardboard-y brand, but it was all I had on hand) and some eggs. Two REAL eggs and ONE egg white (usually, it’s the opposite or just ALL egg whites).  Melted some REAL (i.e not low-fat, low-calorie, low-whatever) cheese on the bread. Spread some artichoke tapenade from Trader Joe’s (to any of my international readers, it’s an American grocery store) and cracked pepper also onto the bread. Egg sandwich. It was delicious and I savored every bite. Made some coffee with cream and sugar (still use artificial sweeteners, because I actually prefer that taste over raw sugar) and drank that. The only “disordered” thought that ran through my mind during breakfast concerned cholesterol, because I did glance at the cholesterol section in the nutrition facts listed on the egg carton (it’s 55% apparently for one). Being a vegetarian who only consumes dairy on occasion, I’ve NEVER had a cholesterol problem whatsoever. So, this was strange. Oh well. At least, I wasn’t counting calories/fat grams/protein/sodium, like I usually do.

Afterwards, I took a Pilates Level 1-2 class. I was the youngest one there and was surrounded by very SLIM yoga-type bodies. I felt somewhat triggered, but once entering my workout mojo, I stopped caring or comparing. The workout felt great. I loved stretching my body and revitalizing my strength after a somewhat inactive weekend 🙂 

Lunch with some friends from school at this Asian-fusion-type restaurant around 1:30-2pm. Worked up my appetite by then. I know the menu because I’ve been there a few times, but I assured myself I would eat whatever appealed to me in the moment. I did not want to plan it out.  I ordered a vegetarian entree plate consisting of orange tofu, white (NOT BROWN) rice, salad, and corn. I actually put soy sauce on my food…another “unsafe” ingredient.

I also ordered a medium-sized hot honey milk green tea…because they make awesome drinks. Liquid calories are typically “unsafe” for me. I cannot recall the last time I willingly drank a regular soda, unless it was being used as either a chaser or mixer with alcohol. When I see people drink those canned iced teas or Vitamin Waters, I practically shudder. 

During lunch, I ate about 1/3 of my portion. Their servings run large. To be honest, I barely focused on the food, and for anyone with an eating disorder, this lack of an obsession is a miracle. I was consumed in conversation with my friends! I packed up the rest of my food and took it to class with me.

Yep. Summer session has begun. I have a (five-hour) class once a week for seven weeks (supposedly the most intense course of this program) and another seminar class taken over three consecutive weekends. As much as I love summer, I also love learning, and I am excited to expand my knowledge even more. I literally cannot get enough of this field 🙂

Around 5:45pm, I felt hungry again. I normally don’t eat dinner this early (I like my rigid mealtimes), but my body was evidently signaling that it wanted food. I listened. I ate slowly. I was in class, after all, and busy paying attention to the lecture. I did notice that part of my rice tasted bland, and I actually put some more soy sauce on it, which is something I would never allow myself to do (THE SODIUM WILL DESTROY ME, AFTER ALL). At one point, I put my food away and did not return to it for another half hour. Eating this “dinner” took a good 45 minutes!

At around seven, my professor offered these chocolate malt balls. They looked good, and I had two. I didn’t feel any regret. Nope. Moreover, I wasn’t in my head counting the calories, craving to binge, or beating myself on my “lack of willpower.” I had simply enjoyed some chocolate. Revolutionary, right? I love chocolate, but with the progression of my eating disorder, I began attaching serious emotion to it, believing it held this powerful hold over me. I felt guilty for liking it, as if I “shouldn’t.” As I was a terrible person. Of course, with that mindset, chocolate morphed into this intense fear food (among so many other sugary foods), which subsequently meant that when I “cracked” and caved in, I usually binged or compulsively ate it. Therefore, I rarely allowed myself to enjoy these foods the way such indulgences were MEANT to be enjoyed. Instead, I deprived and punished myself, and once I did allow for a slight indulgence, I had to “make up” for all the times I had abstained. 

 Yeah, I like chocolate, and I am no longer ashamed to say what I fucking like to eat. 

So, there’s the blueprint of my food.  I didn’t die. Didn’t gain fifty pounds in one day. I didn’t feel any urge to binge, restrict, or engage in any disordered behavior whatsoever. 

In fact, it went so well that I think it’s time for ROUND TWO tomorrow.

 

Which eating disorder is worse: a ruthlessly biased analysis.

Dear Bee,

Chalk it up to my own bias, but I believe you exist in every single individual with an eating disorder. Anorexia, bulimia, binge eating disorder, eating disorder not otherwise specified, orthorexia, what have you…the diagnosis doesn’t matter. The distortion feels the same. The progression gets worse…the restrictions become more severe, the binges become more out of control, the purging becomes more routine, the exercise becomes more fanatic.

There is an unspoken competition among women with eating disorders. What are the common underlying characteristics? Perfection and control. An underlying competitive nature almost goes hand-in-hand with those symptoms.

Anorexia is delicate. It is disciplined and rigid, controlled and pure. Anorexia convinces its victims that they are never ever skinny enough, and even when their BMI or weight indicates otherwise, the distortion in their mind tells them they can’t stop, won’t stop, don’t know how to stop. The urge to control has taken over; it is no longer about the starvation of the food, but rather the spiraling starvation of the mind, spirit, and energy.

Bulimia is wild. It is unpredictable and impulsive, spontaneous and explosive. Bulimia wants indulgence but at a very high price and punishment. Bulimia also convinces its victims that they are never ever good enough, and despite the stomach pains, deteriorating enamel, fatigue, nausea, and headaches, the distortion in their minds tell them they must compensate, must suffer, must learn how to get willpower.

Binge eating disorder is scary. It is dramatic and erratic, terrifying and humiliating. Binge eating disorder wants pleasure without abandon. Binge eating disorder is a frantic and demanding force that stuffs its victims silly while telling them that they are uncontrollable in their urges, disgusting in their actions, and grotesque in their bodies.

Eating Disorder Not Otherwise Specified (EDNOS) is a perfectly imperfect combination of disordered behavior, a unique recipe of compulsion and preoccupation. Despite the health ramifications and psychological pathology, the downplayed hype on this disorder tells its victims that they are not important enough for treatment, worthy enough to deserve recovery, or serious enough to have an actual problem.

There are others (none of these are officially recognized as DSM diagnoses yet; as of now, the three listed disorders are anorexia nervosa, bulimia nervosa, and eating disorder not otherwise specified): orthorexia (fixation with healthy or clean eating) , pregorexia (anorexic symptoms during pregnancy), drunkorexia (restriction as means to binge on alcohol), diabulimia (adjusting insulin intakes to restrict food).

Which is better? Which is worse? The answer is: they are all equally dangerous and life-threatening. When I was seriously restricting and unofficially met the criteria for anorexia, I remember wondering if I would ever to be able to shamelessly indulge again. When I was seriously bingeing and met the criteria for binge eating disorder (which again, is not yet a classified disorder, although it should be included in the upcoming DSM-V release), I remember wondering if I would ever be able to rigidly restrict again.

The point is, I never felt like I had one of them right. I never felt fortunate to have one set of particular disordered behaviors over another. 

The competitive nature of the eating disordered world is a sad reality.

Who will believe I really have a problem? 

Okay, so I’m not eating much…but I don’t restrict as much as (insert name here).

I may have lost weight, but my BMI says I’m still in the normal range.

I may have gained weight, but my BMI says I’m still in the normal range. 

I may be purging, but I don’t do it everyday.

I may exercise, but I still don’t have a six-pack.

I may be bingeing, but I’m not eating food out of the trash can.

I may be restricting, but at least I eat one meal a day.

The eating disordered voice in all of us can comprise an infinite list of excuses to compare us to others…to make us believe we are not “special” enough to even deserve treatment or assistance. How sickening is that!?!

To anyone who may be reading this, to anyone who may doubt whether or not their “somewhat weird” attitude around food or exercise is valid or not, to anyone who wonders if anyone will take their symptoms seriously, to anyone who even feels the slightest bit of distress over eating certain kinds of foods, to anyone who thinks they can’t possibly have “real” anorexia/bulimia/etc. because they don’t look like so-so or do X, Y, and Z actions…just remember that the only competition you are engaged in right now is the one with your own mind. Your only opponent is your eating disorder. 

As eating disorders progress, the perfectionist and control tendencies only worsen. The comparing and self-loathing only worsen. The competition only becomes more fierce and lethal and convincing in the idea that we must not be as serious as the other people who are struggling. The eating disorder will always try to convince us that we are unique, different, and therefore, can’t possibly be understood or helped.

Fight it. Challenge it. TALK ABOUT IT. 

Don’t let the fear of competition keep you out of recovery.