The healthy eating myth of eating disorders

Today on the radio I listened about a new drug developed in Australia that mimicks the responses of diet and exercise in the brain. This drug has the capacity to cut approximately 1/3 of the caloric intake for a day. Needless to say I had two major reactions....the first was, "Oh my gosh, this is so dangerous, yes some people should probably eat less calories but relying on drugs is not a healthy lifestyle..." (followed by thoughts about how, no we're not going to be living until we're 150 years of age thanks to this drug so on and so forth). The second reaction was, "Gee I wonder if I could get my hands on that!" Where is that second comment coming from, well an eating disordered perspective I believe. I don't think I have a severe eating disorder at this point in time. I think it is what it is and I don't really see it changing for a whole series of reasons. It doesn't overly impact my day to day living, it doesn't torture my mind as much as it once did (although I still have bad days) and my general pattern of engagement with food remains constant in general.

However, what I'd like to talk about is this preconception that people with eating disorders only ever eat healthy. It doesn't work like that! I tend to eat fairly healthy because my body simply is intolerant or allergic to a bazillion different foods (plus the gastroperesis creates issues if I eat too much at one time)...but I still love ice cream (although my body doesn't), same with hot chips, pasta, bread etc...all these things that *I* enjoy but my body doesn't. And the eating disorder side of things DOES place restrictions on these things at times but not always. I tend to eat a healthy very wide variety of food from a wide range of cultures. However, guess what the food was that helped me increase my weight during both major relapse/breakdown periods? ICE CREAM! Yep, not so much a healthy food. I'm not able to binge very easily, but I'd compulsively sit down to a huge tub of ice cream, semi-melted (I liked it like that) and off I'd go.

I know other people who work on calories alone and not so much the nutrition and they will do similar things, eating chocolate, chips, ice cream, sweet foods much more readily and easily then making a formal nutritionally balanced meal or snack. Is that necessarily bad? I don't think so, but I do think it blows the myth out of the water that those people with eating disorders only eat healthy, they might (especially if they have a form of orthorexia) but not necessarily.

Another case in point is inpatient eating disorder programs (and some outpatient programs). Often the meals are provided on a range of foods and then snacks include a range of foods in moderation ranging from things like fruit to things like cakes and biscuits. They are desperately trying to teach "normality" in eating to the patients. Now that isn't going to work well for all patients because not every person is alike but the concept is a good one nevertheless.

As I get so sick from food, I really have learnt to have all things in moderation. I think that is what people with eating disorders should strive for as best as possible, but just next time someone you know with an eating disorder decides to order a piece of cake, or has three sushi rolls instead of two, don't comment on it other than maybe how nice (or not nice) it tastes but don't be surprised or shocked. People with eating disorders still have taste buds, they might be a bit flattened but they're still there, they will still want all sorts of food but drawing attention to that, its just not helpful at all. It's typically hard enough to eat the stuff, let alone while catching up with a friend or worker etc.

So just remember, there is no "set" description of what someone with an eating disorder is going to eat or not eat, each person will have their own set of eating disordered rules that they're desperately trying to follow. Those rules are best left to professionals to work through and sort out, but as people, be it in a professional role or even more so as friends and families, we need to nto be shocked and be open to alternatives and differences in the food choices made by people with an eating disorder :).

Thanks for listening!

PS. If you're struggling with an eating disorder and unable to get help, you can contact the Kids Helpline, Lifeline, Eating Disorders Victoria or the Butterfly foundation for assistance in Australia (These details should be on the referral information page). If you require help from outside of Australia, please do not hesitate to email me and I will provide you with the right numbers to call.

Anorexia Nervosa...

So there are many things I could write about but I want to write about MY experience of having an eating disorder, specifically Anorexia Nervosa (AN).

There is a lot of misinformation about AN out there. Some people thing its caused by the media, some people think its purely genetic, some people think that its a choice...it's none of these things but all these things add to the likelihood of having an eating disorder. There is enough evidence to demonstrate that AN is a result of a genetic predisposition to the illness. That doesn't mean that someone with a genetic predisposition will absolutely end up with AN, just that they're more likely to given the right environmental factors. I don't think I've met anyone that has ended up with an eating disorder as a result of the media, but once they have an eating disorder or are starting down that road, the media definitely fuels an eating disorder. I'm all for the media needing to identify when images are digitally altered and having a motto of "health at every size" (thus providing models of all different shapes and sizes) but in my experience as someone who has struggled with an eating disorder and as a clinician that has treated eating disorders, people with eating disorders will find the images that egg them on irrespective of what the media presents.

Then there's the aspect of choice... eating disorders are NOT a choice...but people who diet are 9 times more likely to end up with an eating disorder! We DO decide to diet. That does not mean that people who diet and end up with an eating disorder are to blame, but perhaps it does mean that we need to look into the culture that encourages dieting, especially with this idea of there being an "obesity epidemic" (I will write more about that another day!). Similarly, people with an eating disorder DO have the ability to make a choice to get well. Although that too is tricky as eating disorders, especially AN, tends to trick the sufferer into believing that nothing is wrong with them. For me, in my second major relapse, I realised I needed help after losing the plot at being given a tiny salad to eat and storming upstairs on a 40 degree (celsius) day! That is not normal and I realised I needed help. But even from that point in time, it has been one battle after another.

I tracked back my eating disorder to when I was six years old. For me it was more about food then about looks and here is another myth! AN is NOT just about looks or weight or food! It's about self esteem, perfectionism, dissociation, and trying to escape from a deep pain that is so intense. At age six, I would through food down the side of my bed after being told by my father that I ate too much and cost too much to feed... food made me sick anyway (I am intolerant and allergic to a lot of food) so why would I eat? This progressed and by age eight I was responding to comments about my weight and how thin I was. Life just continued like this, I didn't really know anything was wrong with me, it was normal and natural.

It wasn't until I moved out of home at age 18 and I had to pay for food that my first extreme experience of AN occured. Food is expensive, especially in Australia and I think that people underestimate how much this impacts an eating disorder. The amount of food required for recovery is extensive and yet again that is going to impact on people's ability to buy enough food for recovery, which is a struggle in itself when you already feel like you deserve nothing. I couldn't justify buying food, so I didn't. Somehow I justified the copious amount of laxatives and diet pills that I started in on...I couldn't eat anything without needing to purge. Here is another myth...people assume that purging related to self-induced vomitting. I can't do that! My body just won't let me...but purging may relate to extensive exercise, diet pills and taking laxatives... there are many ways of purging and for me, I simply desperately needed food OUT of my body as soon as possible. Yes, I weighed myself a lot, and yes I wanted to lose weight (mostly to become invisible), but more then anything, I felt disgusting with food in my body, I felt like a disgusting person.

After trips to emergency and drips and various forms of intervention, I moved in with another family and they nursed me back to health. Here is another myth! People assume that ALL people with eating disorders need formal treatment. Actually, quite a number of people with eating disorders are able to recover at home, typically with the help and encouragement of family and friends. Yes treatment is worthwhile and I would encourage everybody to seek treatment if they have an eating disorder as the outcomes are typically much better then those who go it alone...and the risk of death from an eating disorder is high. Eating disorders don't just end a life during the disorder, they shorten the life span of people who have suffered and recovered from an eating disorder! It's not just as straight forward as recovery, it has long term impacts on the body.

I pretty much reached a stage of recovery but after some time, I entered my second major episode of the eating disorder. This time it was different. See the first major extreme experience, the eating disorder haunted my mind and my life. The abuse hurled at my from the eating disorder was constant, I could do nothing right. I was a horrible terrible person. The second time round, it was more seductive and quiet...it was (for me) far more dangerous...because it wasn't haunting my every move so I didn't have the same incentive to recover and I've noticed this to be a problem for people that have had an eating disorder for a very long time...you sort of learn to tune out to the extreme violence that AN subjects you too... and so the struggle to even need recovery is that much more difficult.

For me, having the AN is about far more then weight and food...The abuse that I've experienced in my past just tells me that I'm not worthy of health and wellbeing. I have a heart condition and am in kidney failure plus problems with my bones and joints and chronic pain...and yet the drink that is beside my laptop (which was bought in by my mum) is extremely hard to drink...I don't deserve it, I feel like I deserve extreme pain and suffering, that I NEED to be invisible...to be quiet, unseeen, unheard....that I'm already damaged goods so I don't deserve recovery...

I believe recovery is possible...but it is so easy for an eating disorder to sneak in if you're not being vigilant! It can create relapse after relapse and for those who are hospitalised they often learn new tricks to help them lose weight. Also, it is extremely common for those suffering from AN to end up binging and purging... the body absolutely NEEDS fuel, which is food and eventually it will give out and people end up binging and purging. In my experience, this is more hidden because people feel far more ashamed that they've "lost control"...they haven't, they've just entered a new stage of the eating disorder...they're struggling and they need help.

It's important that people see a doctor because the likelihood of death is increased with electrolyte imbalances that occur during refeeding syndrome and from binge purging...but doctors are tricky because not all doctors know how to treat eating disorders and they say stupid things that feed the eating disorder, they say things that make us as sufferers think that we're okay and don't need help, its just more lies of the eating disorder. But it does show the need to find a general practitioner that can work with eating disorders and guide any treatment needed.

This is just a bit of my story, I'm sure I'll share more as I go along, I guess I just wanted you to hear some of the myths and some of my experience. I do suggest you get help, but if you're not quite ready or scared, please email me or contact your local eating disorder helpline (again, if you don't know this, contact me and I will find the appropriate service for you).

Health and recovery is possible, decide to start today!