How Do I Talk to a Friend or Family Member With An Eating Disorder? (Or You Suspect They Do)

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This is 2017’s National Eating Disorders Awareness Week, and I’m excited to be writing a few posts based on requests.

My first post is how to talk to a friend or family member with an eating disorder or who might have one… from my perspective as someone in recovery. While I was struggling through the years, I heard from friends and family that they felt powerless. It was like watching a sinking ship and not knowing if they could do anything to stop its demise.

While it is impossible to cure another person, friends and family members are NOT powerless. I think about the camp counselor who talked about her own eating disorder openly without shame while I was symptomatic but not yet diagnosed; the friend who reached out to the school administration when she was concerned about me; my mom who spent countless hours trying to understand why I wouldn’t eat. I might have resented them at the time, but now I know that they planted seeds that would bear to fruition later. I didn’t enter recovery in their timing, but it did happen.

I will forever have memories of friends, family members, professors, and co-workers expressing their concern to me over the years. If you think that your words don’t make a difference or impact to someone deep within an eating disorder, you’re wrong.

I will give a cautionary note, however. For every good friend who expressed concern and gave me unconditional love during my journey, there was another who met me with insensitivity and stigma.

Talking to someone with an eating disorder can be a tricky endeavor. On the one hand, you want to express love and concern, but you don’t want to do so in a way that is off putting or hurtful.

In this blog post I will be outlining some “do’s and don’t’s” derived from years of experience of what has and hasn’t helped me.

  1. Do ask about it…

… but try not to probe or make assumptions.

Bringing up your concerns with someone you believe to be struggling can be anxiety provoking. It is a whole lot easier to pretend everything is okay. However, if you have a sinking feeling that something is wrong, and you are close enough to the person to broach the subject, by all means consider it.

Before you do so, consider these two things:

a) Don’t push it– If you bring it up and are met with defensiveness, it might not be the right time to talk. People with eating disorders can be highly secretive. In my deepest stages of denial and shame, I avoided all conversations about how I was doing. I remember how one time prior to admission to residential treatment, a teacher asked if I had an eating disorder. Taken aback, I mumbled something about having a rare digestive disorder. I wasn’t ready to admit how out of control or scared I was. Eight years later, I still remember that conversation as formative. She did not push the issue but expressed concern, and that meant a lot. Even though I wasn’t in a place to talk about it at the time, I respected her for bringing up the subject.

b) Check your assumptions– In society, we tend to associate eating disorders with “thinness” (whatever that means), but that’s just not accurate. Most people with eating disorders are not underweight. Anorexia is the most rare eating disorder, and bulimia and binge eating disorder are more common. People with eating disorders often fluctuate between periods of restriction, bingeing, and purging. I know some of my most symptomatic, out of control times were when I looked healthy. Don’t automatically assume that someone’s thinness is anorexia. It might as easily be a thyroid issue, an autoimmune disease, drug abuse, or simply body type. Similarly, don’t assume that someone doesn’t have an eating disorder because they appear to be healthy.

I have a “spidey sense” in my judgments about whether someone has an eating disorder, but I can be wrong. I am also careful about bringing up the subject of a possible eating disorder. Far before I bring that topic up, I make sure to talk about my own experience, normalize the reality of eating disorders, and check the facts.

. . .

2. Do seek consultation…

… but avoid gossip.

I can’t tell you how horrible it feels to know that people have been talking about you in the whispers you slightly overhear as you pass by and in hushed conversations you know have happened. I think by all means people learn more about eating disorders if they suspect a problem in a family member or friend. Education is important. Talking to a dietitian, therapist, or an organization like the National Eating Disorders Association can be a great move. HOWEVER, when that trickles into gossip and shaming, it stops being helpful.

Sometimes a family or friend group might need to get together to discuss how best to broach the subject with a loved one, but as soon as it turns into judgment and teasing, it can become toxic.

A note about consultation: It is strangely easy to read an article from BuzzFeed or some other reputable source (joke, but in full disclosure, I love BuzzFeed) and think you’re Dr. Phil or something. “Is it about control?” I’ve had people ask me in condescending tones. As if that comment is unique and your therapist hasn’t talked about control 900 times. Eating disorders *can* have an element of control, but it is ALWAYS much more complex. Eating disorders are associated with a cluster of things that may or may not be related: psychological factors, personality types, presence of past trauma, significant stressors, biological predisposition, family history, etc. A cursory look at a non-scientific article or watching a horrible Lifetime movie about anorexia cannot make anyone an expert.

. . .

3. Do express concern about eating habits…

… but don’t do so during meal time. 

Eating with someone you’re almost sure has an eating disorder is difficult and uncomfortable.

It is SO tempting to reach across the table and critique a meal choice, or say something like, “Is that all you’re having?”, or, “Why aren’t you eating more?” In my experience, those conversations are never helpful. The person with an eating disorder, who is likely anxious from the experience eating out, is on guard and gets defensive fast.

I get it– meal time seems like the most logical time to express concern. After all, it is commonly thought that meal time is in fact the problem. When I was deep into my eating disorder, going out to eat was SO MUCH more than an hour at a restaurant. It was the fasting before and after; it was the fear of eating in front of people; it was planning a binge later in the night so I didn’t have to eat in front of people; it was looking up the menu online beforehand; it was counting calories hours before I stepped foot in the restaurant.

It is better to bring up the specific behaviors later in the day when meal time is over. Stick to the specifics about behavior and don’t make it personal. An example: “I noticed when you were at dinner tonight, you ordered a low calorie entree, and you kept putting parts of the meal in the napkin on your lap.” –> I know, easier said than done!! I’ve been the recipient of a lot of insensitive mealtime comments, but I’ve also given some insensitive mealtime comments to friends I knew were struggling. I get it: Frustration can mount in the moment at mealtime, but try to hold off until later. You’ll end up having a much better conversation.

. . .

4. Do focus on food…

… but look at the greater picture, which has a whole lot more to do than just food.

Someone I knew in graduate school said something to the extent of, “I don’t know why families don’t lock the family member with an eating disorder up and force the person to eat.”

While that is absurd, I have heard so many comments that are similarly invalidating and off base:

“Just eat.”

“It’s not that hard.”

“Don’t make this such a big deal.”

That approach doesn’t work.

Eating disorders are both about food and not about food. Of course, eating disorders are highly related to weight and food habits (that’s why they’re called eating disorders) but in some respects have little to do with food.

Restriction was my teenage coping mechanism to deal with a lot of internal chaos– undiagnosed generalized anxiety, crippling OCD, existential anxiety, depression, and feelings of hopelessness, and worthlessness.

In my years of being symptomatic, I was way more likely to talk about those things than my eating habits. I hated when people would make it seem like gaining weight or eating would solve all of my problems. My eating disorder served multiple functions in my life, and until I dealt with those, I didn’t get truly better.

On the other hand, eating disorders are necessarily about eating.

If someone is underweight or malnourished, it is impossible to look adequately at the big picture. Medical, nutritional recovery is a precursor to psychological recovery.

Sometimes in more psychoanalytic approaches to recovery, it is conceptualized that when a person deals fully with the psychological parts of the eating disorder, the symptoms will dissipate. That also doesn’t work.

If you are bringing the subject up with someone, consider the rather paradoxical statement that eating disorders are about eating, but they don’t give us the full picture of what’s going on.

. . .

5. Do take action if necessary

… but think it through first.

Eating disorders are dangerous.

Period.

It is well-known that anorexia has one of the highest mortality rates of all mental health issues, but it is definitely possible to die of bulimia or binge eating disorder too.

The first thing I tell people who haven’t gotten into treatment is: SEE A DOCTOR.

Eating disorders can be associated with some serious medical complications that can kill including (not an exhaustive list): potassium/ electrolyte imbalance, low heart rate, low blood pressure, and general heart abnormalities (that’s why people with eating disorders must have regular EKG’s).

I will reiterate here that someone of average weight, overweight, or obese can die of an eating disorder as well. All of the above medical problems can happen to a person at 70 pounds or 370 pounds.

That is why if you truly suspect a loved one or friend has an eating disorder, don’t stay silent.

In all three of my three major anorexia tail spins, the initial descent into the illness and two subsequent relapses, I needed intensive medical intervention to get back to normal. Two of those times, it was not of my own choosing. Friends, family, and even my school had to intervene on my precarious downward spirals, and thank God they did. Otherwise I might not be here right now.

With that said, if you are seriously concerned about someone who is NOT getting treatment for an eating disorder, there might be cases in which you should advocate for medical consultation or even hospitalization.

For someone with a SEVERE and UNTREATED eating disorder, it could be that lovingly suggesting a trip to the doctor or ER for a medical evaluation is what is needed in the moment. Or, perhaps looking up residential treatment options and calling the person’s insurance company for help.

** Now: Before you attempt this kind of conversation with someone, heed caution! Most people who are diagnosed with an eating disorder have a treatment team or are getting support of some kind. If that is the case, step back and offer support in other ways. Suggesting hospitalization or a doctor consultation additionally has a high likelihood of pissing off the person’s eating disorder, so be prepared that you will likely be met with resistance.

There are some cases when this kind of conversation happens more organically: For example, if a friend passes out or complains of heart palpitations.

. . .

I think the reason many people don’t express concern to a friend or family member about what they’re seeing is out of fear. I get it– it’s scary. People don’t inherently know how to bring it up or what to say.

You are brave and caring to consider having a conversation that might save a life. Sometimes simple comments can go a long way, things like:

“I love you, and I’m concerned about you.”

“It seems like you’ve been struggling lately, and I want to help.”

“If you ever want to talk more about what’s  been going on for you, I’m here for you.”

For more information or to take a free screening, check out NEDA’s website.

In keeping with the National Eating Disorders Awareness Week slogan for this year, I’ll finish with this: “It’s time to talk about it.”

On Gaining Weight

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Weight gain.

Even the words can be uncomfortable.

In a society that shuns women gaining weight for almost any reason, talking about gaining weight is understandably awkward. However, for people in eating disorder recovery, weight gain (recovery reframe, courtesy of my dietitian: weight “restoration”) is often a natural, healthy part of the process… and yet, rarely do people talk about it.

So let’s talk about it. Let’s talk about weight gain restoration.

I have had to gain weight at many points in my life… the consequence of relapsing in and out of anorexia for years. The most excruciating times have been in residential treatment, when I was expected to gain 2-3 pounds per week.

In the purpose of being real, my experience of weight gain has been less than wonderful. In treatment, I spent a lot of time in oversized sweaters, laying stomach-down on couches, and trying not to gag over my thrice daily supplements. The whole process was physically uncomfortable, not to mention that psychologically, it felt like a death. I was starting to look “normal,” and I didn’t know how I felt about that.

From what I can tell, my experience of restoring weight is not unique. Someone with anorexia gaining weight is the equivalent of someone afraid of heights who has to use the Empire State building elevators every day for work, or someone with a spider phobia working in a spider-infested cubicle.

It sucks.

My main point is this: Weight gain restoration is horribly sucky but it is an absolutely crucial reality of anorexia recovery. For the rest of the post, I’m going to unpack that.

Why it is sucky:

  1. It is physically difficult for someone with anorexia to gain weight. *Disclaimer: I am not a scientist or dietitian, but I’ve seen dietitians for years, so here’s what I’ve gathered from that. If you want information from a real science writer I’ll link to Carrie Arnold’s blog here.* When someone has been engaging in eating disorder behavior, the person’s metabolism is low and body goes into “starvation mode,” as it tries to conserve nutrients and body weight.  Weight gain is difficult because the body temporarily goes into a hyper-metabolic state, meaning: It can take a LOT of calories for a person who has anorexia to gain weight for a period of time. This hypermetabolism doesn’t last forever (it goes away after 3-6 months), but while it is in effect, the weight gain process is all the more difficult.
  2. Misinformation people give that scares the shit out of you even though what they’re saying is factually unfounded. I can’t even begin to tell you how many inaccurate, triggering things I’ve heard over the years like, “Wow, I could just eat a hamburger and gain 5 pounds.” Or, “I gained a pound yesterday.” Or, “That dessert went straight to my hips.” Or worse, “I just look at a slice of cake and gain weight!” The reality is that gaining weight isn’t so straightforward. Around 3500 calories equals a pound. So unless someone is eating an additional 3500 calories per day, gaining a pound from one day is highly unlikely (and note: that’s 3500 calories on TOP of what a person normally eats). Not even to mention, bodies can fluctuate about 5 pounds per day anyway, depending on the time of the month (for women) and fluid intake. If the scale is “up,” it is much more likely the effect of water, rather than a nighttime snack of cookies.
  3. The appearance comments are awful. It is hard for people not to notice if you’ve gained a fair amount of weight. I have heard my share of annoying, triggering comments over the years. Recently, someone came up to me and said, “You’ve put meat on your bones.” Um… ok? How is a person even supposed to respond to that? “Thank you…?” “I like ice cream…?” I mean… what? Even the, “You look healthy,” comment can send me into a tizzy. It’s better not to say anything. I know if I’ve gained weight. I don’t need to hear about how you feel about it. I wish I could say I can brush off the appearance comments with ease like the feminist, anti-fat-shaming woman I am, but I can’t. They affect me. As I said earlier, gaining weight already feels like a death.

Why it is crucial:

  1. I would argue that physical recovery is the most important first step to recovery from anorexia. Without that, a) the person’s life is at stake, b) the person’s bodily organs, such as the brain, heart, and other vital organs are not getting replenished, and c) the eating disorder is still serving some purpose and therapy is ineffective. I have spent years trying to half-ass recovery, or doing pretend recovery, while I really wasn’t willing to do the work, including braving the uncomfortable feelings of weight gain. Anorexia recovery often requires weight gain. If someone is underweight and that person’s dietitian says weight gain is necessary, it’s not just something optional. For me, the real work of excavating my life didn’t even begin until I was weight restored.

I get it. For people with anorexia, gaining weight sucks. There are a million things I would rather do than gain a bunch of weight. Weight gain is sandwiched (pun partially intended) somewhere between running, which I hate, and waking up early, which I also hate.

But withholding the necessary weight for proper bodily functioning is a form of self-abuse.

Again, gaining weight in recovery from an eating disorder is not optional. It’s not fun, but it’s also not optional. Partial recovery is not real recovery.

So my recovery warriors:

You are more than a number on the scale. You are more than bodily discomfort or a slice of cake. I know that getting to your goal weight is far from easy, and neither is the road to anorexia recovery.

I am saying this as much to you as I am to myself, because I have been going through my own weight gain — dammit, I mean restoration– process, and I’m not letting myself off the hook either.

Nothing wrong with a Body by Boost!

Drops of Jupiter

It happens every year, as the seasonal sunshine wafts into my consciousness, and I remember….

Did you make it to the Milky Way to see the lights all faded, and that heaven is overrated?

I am almost 13 years old, and my after school regimen is set in stone. I walk home every day from my nearby middle school, make myself Easy Mac, and watch TRL (Total Request Live) on MTV with Carson Daly. I get my cheese fix, eyes glued to the music videos blasting on the screen. I remember my favorite song from that time period being “Drops of Jupiter” by Train. I listen to it over and over, and tears would roll down my face.

I do not understand why I cry, or why the emptiness inside throbs around my heart strings. My days are slow and boring, and my weekends are lonely. While other students plan end-of-school pool parties and spring sleepovers, I think about why some things are so beautiful and why others are so sad, and why there is a void in my soul, and I cry.

Tell me, did you fall for a shooting star–
One without a permanent scar?

My liposuction-obsessed nutrition teacher has a new assignment for our 7th grade class: record your food intake for a full day, and we will receive print out how our eating matches with how we should be eating. I am terrified for this day, just as I was terrified for a public weighing in gym class just a year earlier.

This is my chance, I tell myself. I want to show that I don’t have to eat Easy Mac every day, that I can forgo all snacks for sucking hard candy. Just for this day. I still remember that day, and the discipline it took to do what would later become second-nature: restriction.

The print out of my nutritional intake comes back, and it is affirmed that I had not eaten enough for the day. My reaction to this finding: relief. A deep sigh of relief that for one day I could control my pre-puberty hunger pangs. I am proud of myself, and I feel productive, much more productive than I have felt getting A’s in school. For the first time, maybe ever, I feel worthy.

The restriction doesn’t stick, because my body is growing rapidly, and I let myself honor my healthy appetite, but I will always remember this day.

And tell me, did Venus blow your mind?
Was it everything you wanted to find? 

I decide in the spring to go on a “diet.” Or more practically, I want to eat less at parties. I start trying to manipulate my food intake, and it blows up in my face. I restrict only to consume large amounts of sweets at parties anyway because I am so hungry from restricting. I grow increasingly frustrated at myself. I don’t want to be that person who gorges herself at get-togethers with friends. I start using the word fat in my deprecating self-talk. I want to be in control. I don’t want to get “fat” and get made fun of for my weight like other girls in my grade. I devote all my time and energy into making my “diet” work. I become obsessed with controlling my food intake. It doesn’t happen right away, but I am meandering, puttering around a black hole, and eventually, I fall into it.

The diet doesn’t stick.

Anorexia does.

And did you miss me while you were looking for yourself out there?

I fall hard and fast. Within only a month, a clusterfuck of genes and environment have culminated in the worst way– my genetic predisposition, personality characteristics, life stressors, and environmental/ social/ spiritual issues brew the perfect storm for anorexia’s sneaky suction cup into my life.

I know nothing about anorexia, but I am addicted to whatever it is that is happening to me. My life feels more manageable and safe. My inner loneliness is traded for obsessing about cookbooks and trying to force other people to eat. Emotional pain is replaced with constant fatigue, to the point that I wonder if I have contracted mono.

I no longer worry about parties or friends or being a failure. I am too tired, so I don’t give a shit about anything. All that matters is the scale, my weight, and my food intake.

I no longer cry. I no longer feel.

I like it.

It will change my life. It will ruin my life. It will almost kill me. But right now, in my 13-year-old starvation “high,” I like this.


Can you imagine no love, pride, deep-fried chicken?
Your best friend always sticking up for you even when I know you’re wrong
Can you imagine no first dance, freeze dried romance, five-hour phone conversation?
The best soy latte that you ever had and me

Fourteen years have passed since that season of my life, but those years have been filled with suffering and scars to show for the wear and tear. My body is weaker and has accumulated some permanent damage.

The worst thing I hear people say to me is that they wish they had my “self-control” in regards to eating. They have no idea what they are saying. Yes, my eating disorder resulted in weight loss. But at the expense of what?

I didn’t have late nights spent with friends in high school. The day of my high school graduation ceremony, in fact, I was too hazy to remember anything except for my internal debate about eating a snack. The month before I graduated from college, I was medically withdrawn and sent to treatment. Hours and hours and days and days and years and over a decade were lost of my life.

I didn’t have meaningful teenage memories. No 5 hour phone conversations with crushes. No staying out late. No eating out. Nothing fun was able to penetrate my stone wall of isolation and anorexia. For that I mourn.

And now you’re lonely looking for yourself out there.

Even now, chills run up and down my spine hearing the song “Drops of Jupiter.” I am haunted by the memory of a 13-year-old girl, barely a teenager, whose aching, throbbing soul wanted purpose and meaning and also macaroni and cheese. I am haunted about why what started as a cursory diet became a self-sustaining monster.

Looking back, I see the warning signs of anorexia in neon colors. It feels as though I am near train tracks, watching a train approaching as fast as lightning. I shout out to my sad 13-year-old-self standing in the tracks, “Get out, you have to dodge this train, whatever you do, move off those tracks.”

My aching, throbbing soul longs for answers and meaning for the long, lonely journey that has robbed me of vitality and life in the last 14 years. And yet, such answers elude me, so I must find meaning in the questions. As a perfectionist and control freak, this is unacceptable. I hate the questions, and yet I must live in them.

I can’t remember what it is like to eat without thinking about what I am eating. It is hard not to mentally tally calories when I spent over a decade memorizing the calories of every single food product ever invented.

I hope that someday my default response to stress will be to pull out a good book or do some deep breathing rather than the instantaneous craving to starve. I hope that someday I can eat a cookie without my mind analyzing the fact that I’ve eaten a cookie.

I want to know who I am. I want to get to know the existentially empty, angsty, anxious, insecure 13-year-old that is inside of me.

I don’t want to be a lonely wanderer.

Despite all the wounds and scars from a journey I never wanted to have, I can’t change what has been. Anorexia has been my past, and its after effects still impact me today. And yet, out of the tattered ruins of brokenness, I have to believe that out of ashes something beautiful will arise.

The 44-Pound Woman Story

FYI I will NOT be posting any thinspo images in this article, this is Rachael in a healthier place (my assumption)

It’s all over the media. It is trending on Facebook, Twitter, Instagram, and Go Fund Me: Rachael Farrokh, only 37 years old, made a social media plea to help her get treatment for anorexia, and her video went viral.

The media followed soon after, printing article after article with names like, 44 Pound Woman Dying of Anorexia Seeks Desperate Help. The world responded to this viral video and the subsequent news coverage, and Rachael’s Go Fund Me page raised over $120,000.

I am glad that  as a result of this, she is going to get help at Denver ACUTE, an eating disorder treatment center in Denver that helps with medical stabilization. I believe that Rachael Farrokh deserves and does desperately need treatment.

As an honest caveat to what will follow, I do not know extensive details on this story, so I cannot say I know much about this woman’s case. I have not watched her Youtube video plea, nor will I. I will not look at the ultra-thin pictures that pop up on my Facebook.

However, I will say this: the media coverage on this story has highly disturbed me.

In my opinion, the media coverage of Rachael Farrokh’s struggle for treatment does a disservice to all of us in:

1. Inaccurately portraying the reality of most eating disorders

2. Perpetuating the glamorization of anorexia and the exploitation of extremely sick individuals

3. Failing to address the systemic issues at play

****

1. I want to take a step back.

Around 20 million women and 10 million men will struggle with an eating disorder in their lives. Currently, there are four major types of eating disorders (per the DSM-V): anorexia, bulimia, binge eating disorder, and otherwise specified feeding or eating disorder (OSFED).

One of the changes to anorexia in the new DSM is the removal of the criteria that people with the disorder must be 15% under their ideal body weight, because that is sometimes not the case. In fact, people with restrictive eating patterns or anorexia can appear of “normal” weights to others. 

Further, the most common eating disorder is NOT anorexia, it is binge eating disorder. Around 1-5% of people have this disorder, and it is associated with recurrent episodes of binge eating. Most people with this disorder, as well as bulimia, are of normal weight.

The point I’m making is this: people with life-threatening, treatment-meriting eating disorders do NOT necessarily have to be underweight to warrant immediate treatment.

You do not have to be 44 pounds to have an eating disorder… or 54, or 104, or 154, or 204.

Eating disorders are life-threatening and should be treated seriously at their earliest signs and symptoms. Purging can be life-threatening at ANY weight. Binge eating disorder and restrictive eating can be life threatening-too. People with eating disorders are usually required to get medical supervision because electrolyte levels, potassium, hormones, etc. must be monitored, thus reaffirming the point that regardless of the diagnosis eating disorders are serious.

This woman is not the norm of people with an eating disorder. Some or most of the time, eating disorders are not visible to the outside eye. At my “sickest” (binging, overexercising, restricting, whatever) people have been completely unable to tell that I was close to breaking down.

I worry about this media coverage. I know the way my brain used to think. I wanted to lose x pounds or get to x weight to feel like I was “worthy” of treatment. For people with eating disorders, this viral story can be triggering and harmful.

2. In a Communication class, I learned this point: “The media is the message.” I want to look at the message that comes through the articles.

In the news articles I saw, I viewed many pictures of Rachael looking severely emaciated and vulnerable, and media articles used words like “desperate” and “shockingly thin.” I’m glad that donations poured in, but why did this story become so popular in the first place?

The media has a strange, glamor-tinted fascination with anorexia. The more severe the story, the more people are interested. In a country full of “obesity epidemic” lingo and sayings like, “You can never be too rich or too thin,” culture is fascinated with people who maybe “went too far” by developing severe anorexia. They receive our sympathy points, and we read the articles. Oh yes, we read those articles about Rachael Farrokh. We saw the pictures, the many pictures.

The pictures that accompanied many of these articles (and the Youtube clip) are nothing short of what Kelsey Osgood coined, eating disorder porn. These images aren’t healthy to anyone. They are triggering to ED sufferers, exploitative of a woman who is clearly dying or is at extreme medical risk, and they falsely portrays what an eating disorder is like in most cases.

Rachael Farrokh is sick. Her body and mind are deprived of nourishment they need to survive. And in the midst of that the media is fascinated with how she looks, and these constant pictures seem exploitative, as if she is being show off in some theater of the grotesque and public pity.

Anorexia and other eating disorders are not sexy or glamorous, as media messages might indicate.

They are severe psychosocial disorders, and those suffering from them need treatment, rather than being exploited by their pictures being blown up on the internet.

3. Even as I write this, I think that deep down, this whole story is a farce to the real story. The real story is this: Stories like this should not be happening in the first place.

Why can’t all people with eating disorders receive affordable eating disorder treatment?

Why does there need to be a Go Fund Me page not only for Rachael but for anyone with an eating disorder?

Well, that’s an easy answer: because the American health care system is not conducive to helping people get eating disorder treatment. 

ED sufferers have a high mortality and relapse rate, and insurance companies (in my experience historically) do not like to cover full, comprehensive treatment for treating the disorder.

A few years ago, I was at a point in my life in which I was looking at doing IOP (intensive outpatient) treatment. My insurance company denied my claim for services, even though I was out of control and in desperate need for help. I flat-out asked this question: “If I weighed 5 pounds less, would you authorize me to go to treatment?” Whoever I was talking to at the ever wonderful Blue Cross didn’t directly answer that question but did say this, “You might have a better case.”

You might have a better case.

As if I have to plead the right to receive eating disorder services, that my insurance company is all but telling me: Lose 5 pounds and you can get the help that you need.

How fucked up is that.

As I’ve said in this blog post several times, eating disorders are severe, and weight is often not a good indicator of how much someone needs or “deserves” treatment.

Everyone deserves treatment. NO ONE deserves to go through the living hell of an eating disorder. While we heard about Rachael’s extreme story in the news, there are countless people who are unable to afford treatment and are dying as a result.

The American health care system needs to understand ALL eating disorders for what they are and be able to offer treatment for those who need it.

***

In sum, the media has done a disservice to others with eating disorders. The articles full of glamour-tinted images of someone dying of anorexia do not accurately describe the experience of most people with eating disorders. In addition, no articles I’ve read mention the systemic injustices having to do with lack of insurance coverage for eating disorder treatment.

I have nothing against Rachael Farrokh. I hope she recovers fully and goes on to live a full, meaningful life. But the media, society, and we as individuals need to think critically about this story and how we understand anorexia and eating disorders in general.

Bikini Season, Body Shaming, and Other Stupidities

Bikini season is coming!

We know what that means… Lots of bikini/ fitness/ diet Pinterest boards leaving people feeling horrible about themselves. Article titles like, “How to get ‘bikini ready”. Or, articles about kale smoothies and how good they taste and while you’re at it,you should exercise like 18,000 calories a day. Pictures of “best/ worst” celeb bikini bodies. It’s already begun with “shocking” pictures of Tara Reid in a bikini and talk show hosts telling Kelly Clarkson she “could stay off the deep dish pizza” after she… gained weight (WHAT!!!!) after having a baby (um, you’re supposed to lose that weight in 2 weeks, maybe less, everyone knows that *heavy sarcasm*).

I don’t know what is more sad: 1) That a bunch of tabloid dipshits judge and mock people’s bodies, how much they eat, and their weight struggles/ triumphs/ how they’re “letting themselves go,” or 2) That somehow these magazines are selling! People are reading articles by said dipshits.

I just have to ask: What is this world?

What kind of weird society do we live in that deems terms like “fat,” “dessert,” “seconds,” and “full” shameful? What is so disgusting about women’s bodies? Side note: my focus for this post will be about body shaming women because I am one and have more to say on the topic, but men are also victims of body shaming.

All of the mean twitter posts… the cyber bullying… the incessant fat shaming… WHY? The stigmatizing body shaming comments casually zinged about, they hurt. We may not acknowledge that body shaming comments hurt inside, but they do.

Body shaming hurts.

There is endless interpersonal and internalized shame about what we look like– that number on the scale what we eat what we don’t.

Culture tells us appearance defines our worth.

People are ashamed of their own bodies, and then collectively, we shame the body of others. With all this body shaming going around, it is no wonder that the diet industry is so prominent. And here’s where things get more disturbing. In 2014, the U.S. diet industry raked in $60.5 billion. More disturbing yet: that astronomical number is a DECLINE from the year before.

This video is a good visual of how much $1 billion really is. So take that video’s visual and try to wrap your mind around $60.5 billion. This is, by any standard, a lot of money. How many social ills that much money could solve in the world? Water sanitation, poverty, racial, sexual, policy to promote gender equality, and so much more! Maybe we could even put a dent in the United States’ massive debt.

Let’s just sit here for a moment and realize how fucked up this all us.

People are spending more money than the GDP of many countries on diets that become popular and unpopular as fast as hashtags or the latest in social media… Atkins is old school (the N’Sync of diets), but kale is in (the Taylor Swift of food). People are going Paleo, organic, and gluten free. Egg white omelettes are the new black. Diet pills remain comparable to the quirky and questionable relative at many family gatherings. Constantly changing options for people who are essentially wasting their money considering that DIETS DON’T WORK!!

Body insecurity is a given in today’s culture. Between 40 and 60% of young girls ages 6-12 are already expressing concern about their weight or are worried about being fat. The body-shame cycle starts so young. The same girls memorizing Let It Go and wearing Elsa costumes around the house might be considering going on their first diet. Maybe they already have.

In our culture, we are not at peace with our bodies, and how can we be with all this propaganda and equating body size and looks to worthiness? We think, maybe that next fad diet will make us enough. Maybe, then, we can feel okay and good about ourselves. Maybe, then, we’ll be worthy.

I follow an Instagram page called “Bye Felipe” which was created to call “out dudes who turn hostile when rejected or ignored.” The site usually focuses on people who are interacting on dating web sites. You can see for yourself the number of fat-shaming comments doled out to girls on this page. It is horrifying to open up my Instagram and seeing how guys degrade women by playing on body insecurities and playing the “fat” card.

These comments hurt, and they are dangerous.

So here is my message, and I wish I could put this in size 200 font:

LET’S PUT DOWN THE SWORDS.

Let’s stop shaming ourselves and others about the way they look.

Let’s treat our bodies with acceptance and compassion.

Let’s humanize each other’s bodies. Let’s humanize our own bodies.

Do we have body flaws and faults? Do some people need to gain or lose weight? A resounding yes. But can that be okay? Are we still worthy? An equal and resounding yes. It is possible to take care of our body struggles with a posture of love and self-care.

When people talk about how so-and-so is too thin/ skinny/ fat; what’s with her butt/ boobs/ nose/ ears/ mouth/ teeth/ hair, they don’t know who they’re affecting. Little girls (AND little boys) see the disgusting way people are body-shamed, and we’re breeding new generations of body-shamers.

An app exists in which you can “fit the fat girl crown”, and there was an app (thankfully it was TAKEN DOWN) that was designed to “rescue the anorexic girl.” All this when some reports suggest that incidences of eating disorders may be on the rise.

Disgusting, disgusting, disgusting.

You don’t know what the person across the street or next to you or in the cubicle over from you is dealing with, body-wise or life-wise. Be kind, for everyone you meet is fighting a hard battle. Often you know nothing about it, and it is better to be KIND and COMPASSIONATE, rather than shaming and potentially triggering. This spring marks the 14th year of my eating disorder, and frankly, I think people have to mind their own fucking business. I realize this does not sound kind, but one negative comment can set off a slip or relapse or a passive-aggressive text to my therapist about how much I hate her guts. NO ONE wants to hear a passive aggressive, “Do you really need that slice of cake?”, or, “Wow you look huge in that picture!” And especially not someone who has struggled with an eating disorder.

PUT DOWN THE SWORD.

So in conjunction with this blog post’s title, I’m going to tell you a secret about bikini season. Here is how to have a bikini body:

People are at war with their own bodies and the bodies of others. It is a war that no one will win, but there will be many casualties.

So, in sum: be kind, compassionate, and please:

Eating Disorders Kill, But Relationships Heal

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Fall 2009

Charlotte: Five years ago, the story was much different. Numbness and deprivation had drained my body of life, and vacancy replaced life in my eyes. Every night, I would pray that my heart would keep beating another night. I was spiraling into darkness, snowballing so fast that I wondered when and where I would crash. I eventually did crash, and landed on a ranch in Arizona, of all places. I had no hope but also nothing to lose by giving hope a try at residential treatment.

Janine: For over twenty years, anorexia had been the albatross around my neck. I had attended a long list of hospitals and treatment programs that seemed like one failure after another. As a last chance to evade death, I exchanged the towering evergreens of the Canadian west coast for the Arizona desert. My thoughts were jumbled in a fog of starvation and self-hatred. Anorexia had promised me everything, yet it had left me barely existing.

***

It sounds like the beginning of a bad, if not odd, joke. So this Canadian and Michigander walk into a ranch in Arizona… We, the writers, Janine and Charlotte, would never have met outside the confounds of one specific time and place: residential treatment for our eating disorders in 2009-2010. While our backgrounds were very different, in nationality, interests, and phases of life, we did share the same desperation for something better than living in the torture of anorexia. So we, along with others in our program, embarked on a journey that involved nourishing ourselves spiritually, emotionally, and physically. We cried with one another but also laughed and read books for pleasure. We ate pie on Thanksgiving and talked about identity and God. It wasn’t easy, or remotely close to easy even, but we healed together. We could see the tangible changes in ourselves. We could feel that we were no longer lifeless bodies anymore. Leaving treatment, we had hope again.

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Christmas at treatment 2009

Five Years Later:

Janine and Charlotte remain best friends. In many ways, our lives are so different now, now that we are less marred by our eating disorder scars. We are no longer treatment friends: we are just friends. We enjoy having adventures together. We have gone ziplining in Whistler, British Columbia (much to Charlotte’s terror/ chagrin) and to Disneyland (twice). While 1000+ miles separate us right now, we are intentional in maintaining our relationship through the wonderful development of Skype. Our eating disorders left us hopeless and incapacitated, but slowly, sometimes at a snail-pace, we have found freedom. In our respective ways, we want to help others out of their struggles within our spheres of influence. We would never have chosen to meet how we did or have anyone suffer in the ways we have, but we would never have changed the fact that out of the living hell of an eating disorder, an amazing friendship blossomed.

janine and i recovery

Charlotte: Treatment was a beginning of a new life chapter for me; not one filled with rainbows, unicorns, popsicles, and the end of all struggling forevermore, but one filled with real emotions, thawing, pain, and joy. In treatment, I felt unconditionally accepted and loved during one of the worst points of my life. I never believed that anyone could love all of me, even the ugliest parts. The abundant love and grace I received helped me emerge out of deep shame so I could deal with the factors that had led to my eating disorder in the first place. In the last five years, I moved across the country and then back to the Midwest and somehow earned two master’s degrees in the meantime. Although I still struggle with eating disorder behaviors at times, I believe there will be a day when that won’t be the case. I am so blessed by loving friends (such as Janine!) and a therapist who deserves an honor. I couldn’t be on this journey without them. Relationships don’t inherently heal eating disorders, but support is an integral part of recovery. While I wouldn’t wish my wild, roller coaster journey onto anyone, it is my story, and I am thankful for the beautifully chaotic mess. It is my story to own and love.

Janine: I catch myself once in a while realizing how different my life is now. A moment during work when I can’t believe I’m back doing what I love. I’m able to bring energy and enthusiasm to my job working with children that I couldn’t possibly have done when my eating disorder ruled my mind. I don’t think twice about eating cupcakes with my little nieces or laughing with friends over dinner. I am no longer numb and terrified all the time. I’m able to feel the amazing and wonderful parts of life and no longer attempt to dissolve into oblivion when the guaranteed challenges arise. Recovery has not made life perfect for me, but I am able to make plans for my life that I never thought possible. Nothing about recovery has been easy but I know it has been made easier by my unexpected and unlikely friendships.

Confessions of a Girl in Recovery

Many teenagers and young adults measure time with hugs, laughs, and kisses; with tears, heartbreak, and belting out Taylor Swift songs; with midnight donut runs and staying up all night talking.

I measured my life in calories, compulsive exercise, and setting my alarm to 3 AM, because that was a “safe” time in my mind to binge. I spent my moments daydreaming of endless buffets– plate after plate of spaghetti, followed by cookie dough ice cream caves. I would “go to the bathroom” at least 5 times during class for an excuse to walk.

I fantasized about food similar to how teenagers fantasize about a first crush or first kiss. Anorexia was my comfort… my everything. In the little world I made for myself, I felt safe. At least I knew this.

Most of my memories for a good 10 years centered around food. I remember only one thing about my high school graduation: the internal debate about whether I was going to eat lunch that day.

Every birthday party, including my own, I would be “too full” for birthday cake. Sometimes I would swear to anyone who probed, “I just hate sweets.” Lies.

Sometimes people would respond with jealousy, “I wish I could be like that,” or, “I wish I could look like you.” No, no you don’t. 

It is hard to describe what the living hell of an eating disorder is like to someone who has not personally heard the eating disorder siren call. I can’t count the amount of times others have said to me, “Can’t you just eat?” In my mind, that comment was akin to, Can martians become elected officials? Can Michigan be warm during the winter? Can I please teleport? Can there be peace in the Middle East? Anorexia had a neurobiological, psychological, emotional, and spiritual stronghold over my life. It was this gravitational vortex pull mixed with a sensation similar to being held down by the Boogey man.

Being asked to give up my eating disorder felt like asking to give up me.

At some point, I had to realize, No, this is not sustainable. I cannot maintain even a facade of normalcy. Despite the denial, I admitted that what I was doing was killing me. If I was compliant to the incessant demands of anorexia, I would either die or have everything be taken from me. I decided to give the having-a-life thing a shot.

Eating disorder recovery felt like being asked to move to a distant land, a strange, odd place where people would eat cake voluntarily. It was absolutely mind-blowing. Why would someone eat dessert? Willingly no less??? I ate celery voluntarily. I compulsively exercised voluntarily. Voluntary dessert was belching the alphabet at tea with the Queen of England, or  showing up to a job interview with mustard all over my face. It made no sense. I had to trust people who told me, This is normal. This will get easier. This is okay. You are okay.

Stabilizing my weight and food intake did not address the root issues, but it needed to come first.

After time in treatment, I finally admitted that fat free cheese was disgusting. I mean, really disgusting. It should barely count as cheese. Or not count at all. How could I have “preferred it” for years? I could say similar things about sugar free Jello (one word: gross), Molly McButter (I mean, what IS that really? is it edible? should it be?), and Splenda (confession: still trying to fully wean off that one).

Consequently, I found that cake is actually delicious. In fact, now it is one of my favorite foods. Dessert is really underrated when you have an eating disorder. I had this false dilemma in my mind: I could eat a slice or pie OR I could die. It seemed that dire of a situation. But it doesn’t have to be. At treatment for the first time, I started eating cake as often as I could. After years of severe nutritional deprivation, it just tasted so good!

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Me with cake… because it is delicious.

Recovering in terms of weight restoration and achieving medical and nutritional stability were important… but the hardest work came later.

In addition to the important eating component of ED recovery, I also had to learn how to live. Surprisingly, that has been a motherfucker of an obstacle that is ongoing.

So these things are works in progress:

I learned that there is more to life than the prison of anorexia. I learned not only to enjoy food but to enjoy people; to fall in love and fall hard; to open up to others; to experience happiness but also sadness; to feel and to feel it all, the spectrum of human experience, both the good and the bad.

Subsisting indefinitely in an eating disorder netherworld hardened me. The thawing work of recovery and subsequent therapy has hurt like hell, there’s no other way to describe it.

But I am learning how to live.

I didn’t do that for a really long time.

In the process of obsessive exercise videos and “being too tired” to go out for ice cream with friends, I missed so many moments… so much time. I missed the taste of gelato in Italy, and wine and cheese in France. I missed taking deep breaths and soaking up the sunlight. I missed years; in fact, over a decade of my life. I hurt others and myself.

The years…

the memories…

the bodily damage…

the relationships…

the lost opportunities…

I will never get any of that back.

I am still in the process of figuring out the labyrinth that is the sum of my life experiences and feelings. I have to tear off the (emotional) bandaids that I kept on for safety and address the pain that such a process produces. Not to mention the fact that the body does not do well with over a decade of abuse. I take steps forward and steps back. I like to think the overall trajectory is forward, though.

Sometimes I’m growing, and sometimes I’m not. Sometimes I feel motivated, sometimes not. Sometimes I feel like I am exploding with feelings, and I want to gauge my eyes out. Sometimes I laugh until it hurts, and sometimes I am limping in agony. Sometimes my pace of recovery is that of a turtle.

I am learning to believe that is all okay. Sometimes.