Ever since May said that she was going to do her Food Matters series, I have been thinking about what to write. I have so much to say, you see. Food has been such a huge focus of my life. It has shaped me in so many ways, mentally and emotionally, and it is really hard for me to know where to start and where to stop. I can say now that I have had an eating disorder. For a long time I couldn’t admit this. Partly this was due to the shame of what I saw as something vain and self-inflicted, partly it was due to the fear of making myself noticed in a physical sense and having my body judged and put under scrutiny, and partly it was because I felt that I was a fraud and that I didn’t qualify for such a diagnosis.
My thought that an eating disorder was something vain and self-inflicted didn’t come from nowhere. Still today many will share this view and as mental health issues go, it is often the one which is seen as being self-indulgent and attention seeking. People often assume that eating disorders come from the desire to lose weight and be slim and gorgeous. While for some an issue may stem from dieting which has got out of control, for many it doesn’t happen like this. Often it is a case of looking beneath the surface to try to work out what the cause or trigger might be. Ideally this would be done in a therapeutic way; in reality many hide their issues, help can be hard to find, and need means that the focus of resources ends prioritising those cases which are about preserving life.
Finding good support for eating disorders is hard, especially for young people, and while an ED can affect any gender and any age, the majority of diagnosed cases occurs within the 12-20 age group. The shortage of resources means that, as with many mental health issues, early intervention can be difficult to come by. While there is a lot of self-help material around these days which uses cognitive behaviour type techniques, finding such material for eating disorders is a bit of a challenge. There is a lot out there about what they are and why they might happen, but when it comes to what you can do, things go quiet. Contact your GP for a referral to an eating disorders clinic is the usual advice, but resources are stretched.
I suppose at the end of the day it is about educating yourself about nutrition and the way the body works, finding ways to challenge your disordered thinking, and trying to adopt healthy and regular eating habits. Often sufferers tend to have a need to control and they will become very rule based. This will apply to what they can and can’t eat, and often to what they can and can’t do physically. Foods may become grouped and only certain groups will be ‘safe’. Although the eating can look disordered to others, to the person themselves, it is exactly the opposite. Controlling their eating gives them a sense of order over their lives which keeps the chaotic elements at bay. Once this takes hold, it is not an easy thing to shake.
Fear of Being Judged
My fear that if I admitted I had an eating disorder it would cause others to look at me and scrutinise my body, held me back from being open about what I had been through. While there are different types of eating disorder, the one which seems to spring to people’s minds most readily is anorexia. Because anorexia is a condition where there is less energy taken in than the body needs, or more expended than the body requires, most sufferers become extremely thin. When you worry constantly that you are fat and disgusting, the last thing you want is for people to look at your body and agree, so you tend to hide and avoid drawing any attention about your physical appearance.
While anorexia makes up about 10% of diagnosed eating disorders and those suffering from bulimia is about 40%, binge eating disorder and other specified feeding or eating disorders (OSFED) make up the other 50%. Although I had started off by starving myself to the point that i was ill, the way my situation was managed meant that I had to put on weight. This loss of control led to my issues morphing from starving to bingeing and purging. Although I had restricted my eating very successfully for several years, eventually my resolve broke down in the face of compromise, and and I turned to laxatives and other things to manage. Essentially I moved from being anorexic to being bulimic.
While there was guilt with them both, the feeling of power I had while starving was much preferable to the hideous feelings I endured during my bingeing episodes. I would be ashamed to recount even today what a binge episode would involve. When you have this sort of relationship with your body, one of hate and self-loathing and disgust, to draw attention to it is not something you are likely to do. For someone to look at me and confirm my innermost fears and thoughts would be beyond what I felt I could take, so I avoided it wherever possible. This meant covering things up and not really seeking help.
Not wanting to be seen leads to hiding, not just what you are eating or not, but lots of other things. It can make people deceitful and dishonest which then plays again into the negative feelings for many. It is a vicious cycle like so many mental health issues. It perpetuates itself and takes hold, as the focus, the root and ultimately the meaning of everything. It is pretty destructive to relationships and I don’t think it is an easy thing to be around. It is irrational and frustrating, and often the person struggling with it will be so wrapped up in what is going on, that they may not realise the stress and hurt that they are causing others.
Fear of being a fraud
I didn’t actually get a medical diagnosis, well not until much later and that came in a roundabout way. This made me feel as if I was fraudulent somehow, as if I didn’t really qualify. I never had a ‘good’ reason to have an issue and when I did eventually ask for help, my cries for help were badly handled and I felt that my concerns were not valid. I know now that I was unlucky. Things have changed for the better and health professionals these days would not behave in the way that they did back then, but for me it meant that I remained confused and secretive and tried simply to function within my dysfunction.
While trauma, family problems or difficult childhood experiences can lie at the root of an eating disorder, some of the causes may seem less extreme. Strict parents, an inconsistent home-life, or people having high expectations of you can lead to using food as a way of gaining more control over your life. Personality traits such as perfectionism, being very self-critical and a lack of self-confidence or self esteem would all be common, and others such as being very competitive and prone to obsessive behaviours can make you more vulnerable to developing eating problems.
Understanding the causes is important as it will help you to work out the things that you need to change and work on, but sometimes it isn’t as straightforward as it sounds. Not everyone is able to identify the reasons why, or perhaps, like me, feel that they don’t deserve or qualify for help and so it can be an ongoing thing which becomes part of life and goes undetected for a long time. However, research suggests that between 1.25 and 3.4 million people in the UK are affected by an eating disorder so it is something that is a very real problem. In addition to this, anorexia has the highest mortality rates of any mental illness so it is important that if there is an issue, you are able to seek help.
What to look out for
While everyone is different in terms of how it affects them, having an issue with food can alter your behaviour and the way that you feel, as well as having a physical impact. Although indicators will vary depending on the type of issue and the causes for it, there are some things to look out for which may give an indication as to what is going on.
- Bingeing (eating lots or things that are bad for you)
- Purging (making yourself sick or taking laxatives)
- Starving yourself or reducing food intake
- Avoiding foods or food groups
- Cooking food for others but not eating it yourself
- Eating in secret / hiding food
- Exercising excessively
- Obsessing over food and calories
- Using drugs to reduce appetite/speed up digestion
- Rules about food (‘good’ and ‘bad’ foods) and exercise (how much and when)
- Checking weight all the time.
- Feeling ashamed and guilty
- Hating your body / thinking you are fat
- Feeling low, anxious or upset
- Feeling lonely, especially if no one knows about your eating problems
- Mood changes
- Feeling out of control
- Wanting to disappear
- Having to be perfect
- Never feeling good enough / worthless
- Angry and defensive when challenged about eating
- Irregular or no periods
- Issues with teeth
- Sore throat
- Scarred hands (from forced vomiting)
- Bowel problems
- Fluctuating weight / weight gain / weight loss
- Poor skin condition
- Inability to regulate body temperature
- Tiredness / lethargy
- Hair loss
While it is important to seek medical help or advice if you think that you, or anyone you know, is suffering from an eating disorder, there are some good online resources which can help you to learn a little more about what might be going on. In the UK, BEAT is a really good one. They have detailed information, helplines and downloadable resources, as well as offering support groups and even peer coaching in some areas.
If you would like to read more personal pieces about how my issues with eating have affected me then you might want to have a look at the links below:
Skeleton in my closet: eating issues undressed is about my journey and the way that I am still affected by my difficult relationship with food and with my own body.
Healing is an autobiographical account of my experience, but told from a third person perspective as the distance made it easier to write.
Body Image explains the way that some of the body image issues still affect me.
Body Image, Beauty and Balance also looks at where my body image issues have come from and how we have been able to address them as a couple.