Today is the start of National Eating Disorders Awareness Week in the USA . I’m going to use this opportunity to clear up a few myths about eating disorders, namely anorexia. This is not because the others aren’t important, but because I don’t have experience of them. I’ll also provide links to some informative fact-based pieces, and some articles I’ve written in the past about suffering and recovering from anorexia nervosa. I have always shared my experiences in the hope that they lead to better quality information and understanding. I hope that they provide a window that allows sufferers to realise they aren’t alone, and provides some sort of insight to victims’ friends and families. That said, I urge anyone — or anyone who knows someone suffering — to get professional help from a doctor or therapist soonest. Anorexia has the highest mortality rate of any psychiatric disease — either as a result of physical medical complications, or suicide. It steals precious time, and precious lives.
Myth 1# Anorexia means people aren’t hungry.
Truth 1# No. Anorexics are starving hungry. Their bodies scream for nourishment. The hunger is crippling. It causes black outs, the brain to stop working properly and other organ function to decline. When a body is starving & has no immediate energy sources from fat stores or incoming food, it starts to eat its own muscle for fuel. This is a good summary of the effects of starvation, from the Scottish Eating Disorders Interest Group.
Myth 2# Anorexics don’t want to eat.
Truth 2# Anorexics often desperately want to eat, but they won’t admit it. I remember wandering round European cities staring at ice-cream and pain au chocolat, but not letting myself eat them. In the end, the body gets so decrepit that it can’t stomach rich food anyway. Anorexics will refuse the foods they love most, which is why it can be so desperately upsetting and confusing for friends and family when they present a sufferer with his/her favourite meal, only for it to be pushed away (or, let’s be honest, even thrown on the floor). This is a manifestation of the self-punishment part of the disease: a sufferer’s self-worth is so low that they don’t believe they are deserving of even basic nourishment. Denying him/herself food is part of this expiation.
Myth 3# Anorexia is a “diet gone too far.”
Truth 3# Anorexics will often start by going on a diet, or claiming to do so, while using much more extreme techniques, such as vomiting, exercising to the point of collapse, and drugs or laxative abuse. The “diet” becomes a socially-acceptable excuse and cover, even as his/her weight drops to unhealthy levels by any measure. But a “normal” person would probably recognise how dire he/she feels, and start eating more again. An anorexic will feel driven to carry on the “diet”, even as it veers away from anything regarded as healthy by qualified nutritionists. The anorexic will see the negative consequences of their behaviour — the social withdrawal, the lethargy, the depression — and carry on regardless, often driven by a desire to damage oneself. Anorexia and other eating disorders are complicated mental health disorders that involve chemical changes to the brain, deep-rooted environmental & social factors and likely genetics, too. They are definitely more than diets gone too far.
Myth 4# Eating more and gaining weight will “cure” anorexia
Truth 4#. Oh, if only! If and when a sufferer can be persuaded (or forced — hospitals will feed a patient via a tube up his/her nose, if it becomes necessary) to eat, their bodies will regain physical strength. But the mental issues that pushed them to starvation in the first place remain. This is why it is vital that treatment is specialised and doctors understand that refeeding alone won’t solve the condition. Way before it was cool or widely-acceptable to talk about one’s mental health, I went through years of therapy. Had I not had it, I probably wouldn’t be alive today. There are also major physical sequelae that won’t necessarily improve straight away through refeeding, such as loss of bone density (osteopenia or osteoporosis) which can cause fractures & breaks.
Myth 5# Anorexics are selfish because they don’t eat when there are people starving in the world.
Truth 5# Anorexics will likely be all too aware of this and it makes them feel even more terrible about themselves and their illness. They don’t need other people to reiterate the fact.
Myth 6# Anorexia is caused by fashion magazines and thin models.
Truth 6# This is a tough one. It’s insulting to suggest that someone would put themselves and their loved ones through so much pain and suffering just because they want to look like a fashion model. On the other hand, I’ve stopped reading fashion magazines, and I can’t deny that it was a good move for my mental health. I began consciously looking at other women, elsewhere, whom I admired and whose qualities I wanted — intelligence, bravery, wit. I realised that not many of them were models.
I hope that clears up some of the myths. I haven’t written anything new on my own experiences for a while, because life has moved on and I’ve had other things to write about. But I’m sharing here again a few pieces I have published previously. As I say, I always hope that through these writings, sufferers realise that they aren’t alone, and that I can improve understanding of anorexia for sufferers’ friends and family, the medical profession (unfortunately, some of them really do need to be told) and the general public.
I wrote this piece for The Times of London back in 2013. I wrote about anorexia’s effect on relationships & how I realised I couldn’t live a “two-speed life”.
I wrote this for The Telegraph in 2015, after my second round of inpatient treatment, on link between anorexia and depression: “I lie awake at night & mourn my anorexia, if only because it was a cover for the sadness that has encroached as the food preoccupation has faded.”
I wrote this for New Statesman in 2018 on accepting time lost to anorexia, and not being bitter about it, and moving on.
And finally, I wrote this for the BBC on the osteoporosis that I have been left with as a result of so many years of not eating the fat, protein and carbohydrates that my body needed.
Of course I wish that I hadn’t spent years battling with anorexia. I missed out on a lot. But like lots of things in life, that’s something that I’ve just had to accept. Going through anorexia has made me who I am, in that (I hope) I’m compassionate and empathetic. I realise people always have their private stuff and battles going on. I’m able to not let seeing great suffering get to me; I’m quite good at compartmentalising. I realise there are levels of suffering, and I’ve been through my own, and while it is *no way near* that of many people, I accept that it happens, in a world that, sadly, isn’t very nice, much of the time.
Below are some links to further information on eating disorders.
Beat — the UK eating disorders association
Mind — the UK’s leading mental health charity
NEDA — the USA’s national eating disorders association
Cotswold House at Oxford Health NHS Foundation Trust
Embrace Lebanon — mental health support and a suicide hotline in Lebanon (I include this because I am based in the country and am aware of people who have suffered here without much support).
Eating Disorders Program at the American University of Beirut Medical Center — ditto.