Five Things You Need To know About Re-feeding During Eating Disorder Recovery

Whenever you enter treatment for any kind of eating disorder, you will often be given about a million worksheets, pamphlets and photocopied passages from text books, about the mysterious topic of “re-feeding”.
Indeed, over the years I myself have been handed many of these scientific attempts to explain the various processes the body goes through during re-introduction of food after periods of starvation, and having been through those various processes multiple times, I thought I knew it all. I thought that when it came to re-feeding a patient with anorexia, I was an expert, an oracle of knowledge when combining my scientific genius (aka facts I memorised in text books) and personal experience. So arrogant and confident was I in my “know it all” attitude, that had I been asked to take part in the UK gameshow Mastermind, I would have chosen “the re-feeding process in treatment from an eating disorder” as my specialist subject and would have had a cabinet built for the trophy in my living room before I had even answered the first question. Luckily, nobody has ever asked me to be a contestant on Mastermind because if that had happened, I would have looked like a fool and would have had a very sad and lonely, empty of trophies, trophy cabinet.

Today then, rather than sit and mope with regard to my lack of trophies (and whopping great useless cabinet in my living room), I thought I would use my current situation as “person attempting re-feeding” to share with you the five things everyone needs to know about the re-feeding process when in recovery from an eating disorder.
This is not just the explanations that you get from the science books, this is the Born Without Marbles, real life, honest guide to get you through all the surprises that can happen during the re-feeding experience, even if you have been through it before and think you already know it all…

1. Taking it slow is important: I think there is often this misconception that the more food you can get into a person who has been starving for a long time the better, when really, that can be quite dangerous. When your body isn’t used to being given food, it sort of turns off and goes into a stand-by mode, so booting it up again is a process that needs to happen gradually. It is like if you had an out of work clown, to get them back into juggling you need to start again with 3 soft balls rather than going straight in with 10 flaming knives and a live alligator riding a chainsaw. When coming into hospital for example, people are often started off on half portions to build up from gradually over the space of a few days, to avoid the body going into too much shock and sending your electrolytes and cardiac functions all berserk. Now, this is not an excuse to let your eating disorder sneak in with “well, if it is dangerous to eat much even though you are in recovery, you should probably just eat a little bit of lettuce” because NO. All I am saying is that when you are getting back into the habit of giving your body food, you need to be gentle and start off slowly, preferably under medical supervision/working with a dietician to keep you both physically safe and to make certain you are gradually building up to the amount of food you need rather than sticking to the initial “half portions” of the first stage.

2. Any weight changes on the scales are not going to make any sense: In life, I think we treat scales a lot like calculators, machines that give us logical results and answers to various calculations of input and output made over the week. Unfortunately this is not the case, especially during the re-feeding process of recovery from an eating disorder, and instead of giant body calculators, I would encourage you to treat scales like a very drunk friend following a night out at the pub. This is not to say I advise taking your set of scales to the local takeaway for some cheesy chips and a lamb kebab (scales prefer pizza with a side of garlic bread), rather it is to say you should take everything they say not as fact, more as a vague approximation of reality/what is going on. I am not going into specific numbers here, but when I was admitted to hospital almost three weeks ago (my how time flies when you are in a mental institution!), I ate less than I had been eating at home, due to anxiety and because everything served to me was different and none of it was what I considered one of my safe foods. After a week of eating less than half I had been previously, I stepped on the scales expecting to lose weight. To my horror, I gained. A lot.
“Oh my goodness” I cried out dramatically fainting on the clinic floor. “What is this? My body is broken! Everyone says that when you eat more food you gain and when you eat less you lose weight but I am defying medical science. Someone send me to a laboratory for experimentation!”
When the doctors increased my meal plan, I was even more terrified than I had been before, figuring that if I was already gaining when I wasn’t eating, were I to eat more, my weight would spiral up and out of control. Therefore I continued to restrict in an attempt to lose the weight I had gained…and I gained again.
Soon enough, I had no choice but to start complying a bit and eating a little more, so on the next weigh day, I braced myself for another increase in kilos. You can imagine my surprise then, when I actually lost all the weight I had gained over the previous week despite having eaten double the calories. Logically, that made no sense to me, but, bodies and weights do not make sense during the re-feeding process. As food is reintroduced, chemical reactions explode like fireworks throughout the body, electrolytes get confused, the fluid levels go all over the place so when you get on the scales, any shifts you see are likely to be “false” weights due to all the internal changes going on. Thus, going back to the drunk friend comparison, when they show you a number aka tell you a story summarising the night before, though they will be able to give you a vague idea of what is going on/what your body weighs, they will not provide a logical accurate explanation of your situation/true body weight that you can gain any real knowledge or conclusions from.

3. Your body is going to do some very weird things: When people talk about the re-feeding process they will often whip out phrases like “nourish to flourish”, as if the second you start eating again, sunlight will start shining from your eyes and you will find yourself skipping gaily in a field of daisies. Admittedly, one does need to nourish in order to “flourish” and become physically well, but again this is a gradual process, and at the beginning it is likely your body will do less flourishing and more random weird things that you never expected or understand.
You will probably get tummy aches and indigestion, feel full one minute and ravenous with hunger the next, your bowels may go to sleep or into overdrive, you may fall asleep all the time or even be unable to sleep at all, night sweats and drastic changes in temperature may occur, blood sugar levels will be unpredictably random (recently mine were highest after a day of very little food and then too low after the biggest meal of my admission so far – another reason why medical supervision in re-feeding is vital), and you may experience abdominal bloating as well as this weird thing called Edema. Edema is basically when your body goes through dynamic fluid shifts and parts of your body (mainly your feet and legs) may puff up.
This Edema thing has been especially bad for me this time and my legs and feet swelled up as if someone had thought I was a bouncy castle and plugged me into one of those air machines (during this time I learnt that life is hard when you are a bouncy castle as children are constantly jumping all over you. On the positive side, if you are business savvy you can charge them a few quid a time and make a tidy profit to buy yourself something nice/ice packs to soothe all the bruises made by violently jumping feet all over you).
I think the Edema one had me especially scared because naturally your mind will convince you that rather than water retention your legs are swelling with actual weight and fat, and as someone who is currently managing Edema I can hand on heart promise that is not true. Like I said, I swelled up like a bouncy castle, but after keeping my feet elevated for the past fortnight my legs and feet have started to deflate a little. It feels as if it is a disaster and going to last forever, but it DOESN’T. Me warning you of all these things is not to put you off the re-feeding process, far from it, as it is far more dangerous to remain undernourished with no chance of flourishing in the near future. Instead what I am trying to do here is let you know what might happen so that if it does, you are prepared and know that this kind of thing is totally normal and it is not an excuse for your eating disorder to convince you that it is your body and yours alone being weird and “rejecting food”.

4. Your mind is also going to do some very weird things: You would think that with your body off galavanting and causing mayhem, your mind might perhaps wait to kick up a fuss until after all the physical stuff is over, but no, your mind is going to go a galavanting as well and will also be doing some very weird things. The re-feeding process is very much like the descriptions of puberty I was given in a lesson by my primary school teacher (good Lord was that a terrifying conversation), in that your emotions are going to go all over the place. Like I said, when you are not eating, your mind and body go into standby mode and occasionally emotions shut down. When you start eating again however, the emotions turn back on at weird and unpredictably inappropriate moments. One minute you will be numb and feeling nothing at all, the next you could be laughing hysterically at your shoe, then you will be filled with rage for no particular reason before being overwhelmed with sadness and crying yourself to sleep…It is a lot more fun than it sounds…actually it is not, but again this is not to put you off the process, rather so that you know what to expect!

5. It is different every time: This is probably the most important lesson I am currently learning as I go through the re-feeding process and I imagine it will also be the most important one for people who, like me, have been through it several times before and may be reading this thinking “this is not new information, I know what to expect” much as I may have two weeks ago. I thought that because I knew how my body had reacted to re-feeding before, I would be able to predict how it would be this time round, but that was not the case. Every time you go through re-feeding it will be a different experience and your body will react differently. The longer you have been ill or the more trauma your body has been through, the weirder the experience may be. Like I said, I have really struggled with Edema this time round, and the reason I mentally struggled with it so much is because it has never happened to me before.
I knew all about it and had seen it happen to other people, but when my legs swelled up I was convinced that it was real weight rather than water retention, because my body hadn’t reacted like that on any previous occasion and therefore I thought that kind of problem could never affect me. Had I had Edema before I think I would have coped better with it, as well as the weird things I have noticed this time round on the scales, but it was the fact that “my body doesn’t do this usually” that had me frightened that something was going on and I was actually gaining and swelling with actual weight. Just because your body hasn’t done something before it doesn’t mean it won’t give it a whirl this time and if there is one thing I would want you to take away from this post it is that for all the preparations you make, this is still going to feel very random and very unpredictable…

…What a great final point to end on! Basically I have just told you a list of things to expect during re-feeding and then told you to go into it with no expectations because you cannot predict what will happen…hmm…Great advice…Good one Katie…

To be perfectly honest with you all, I have no idea what is currently going on with my body, what it will do tomorrow and quite frankly I don’t understand a damn word or second of this re-feeding malarky right now.
All I know is that it is scary, it doesn’t feel necessary to me, and I am still doubting the words of every doctor I come into contact with/struggling to accept or trust any of this.
Regardless of any of the mental rationale behind this admission or eating however, this is an honest account of what is and what can happen physically during the re-feeding process as I am trying to get through it, so if you have ever wanted to know what to expect or are going through similar things and are scared, you know that it is not just “your” body being weird and that there is someone else out there with swollen legs covered in the bruises of toddlers who have mistaken you for a bouncy castle.

Take care everyone x

Refeeding

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How Physical Health Problems Can Trigger Mental Health Problems

Last week I talked about a recent incident where my mental health, more specifically my eating disorder’s obsession with drinking a lot of water, had a detrimental affect on my physical health and in a hilarious twist of fate and example of bizarre symmetry (and by hilarious I mean literally the most unamusing thing to happen ever), this week I am talking about how the opposite can also be true, and how physical health conditions can end up triggering or making a pre existing mental health problem worse.

So when we last left off, I had explained how I had been admitted to hospital for water intoxication and was being treated for this problem via a strict fluid restriction plan to get all of my electrolytes back to acceptable levels (it is at times like this when I wish I had one of those “previously on” video clips that they show before episodes of various TV dramas…I should really look into that…ooh and a theme tune! I do love a good theme tune!)
Now, after a few days, the fluid restriction, whilst being incredibly annoying for me, seemed to be working, and my sodium levels kept improving until they were back to normal. Really, that should be the end of the story, the problem was solved so I should have been packing my bags and making my merry way home, but alas the story did not end there and developed into what I like to think of as an epic novel of utter ridiculousness.

You see whilst my sodium levels were improving, I wasn’t feeling any better which didn’t make much sense. I had been admitted for a problem that was being successfully treated yet bizarrely, as the days went on, I became more unwell with a pain in my stomach. The doctors couldn’t really make sense of this and before long I was in so much pain that I couldn’t stand or lift my head off the pillow and was in need of all the morphine I could get. A few tests were run but no answers were revealed so a surgeon was sent to have a look at me.

After thumping me in the abdomen with an iron mallet a few times (she said she was only going to “press gently” but trust me from the pain I am pretty sure that woman had a mallet and a vendetta against my stomach region), it was concluded that I might have a swollen appendix. I was told that normally the surgeons would book me in for an operation to whip it out just incase, however due to my already poor physical health from my eating disorder, they wanted to avoid taking me to theatre (alas the operating one and not the version where you get to watch The Sound of Music on stage whilst eating a little pot of ice cream with a spoon that is basically just a mini plank of wood with no resemblance to a spoon whatsoever), because they weren’t sure I would survive an anaesthetic.

Thus it was decided that they would only operate if they were absolutely certain that such a thing was necessary and therefore some more tests were scheduled to try and clear up what was going on. The problem with this was that by leaving time for tests, we were also leaving time for things to go downhill which they did fairly rapidly. Again the surgeon visited and again an operation was suggested but also feared so I was sent to yet another test in the form of a CT scan where I was basically shoved in and out of a tube a few times whilst doctors took photos of my insides (I really hope that my organs put on their best clothes and posed nicely for the occasion…it isn’t every day someone wants to photograph your intestines).

After the CT scan was complete it was around 1am and I was finally allowed to have some more morphine and attempt a snooze, whilst my sister, who had been sitting beside my bed for the past few days, went home. That was until 4am when another surgeon woke me up, to tell me that the scan had shown that things were rather serious and I was scheduled for emergency surgery immediately, my sister being called back in by the nurses having only just left. The next little bit of time is somewhat of a blur but from what I remember I was pumped with anaesthetic and taken to theatre (again, the operating one. I didn’t get so much as a lick of ice cream and I saw no children dancing in curtains. Livid.)
I was so knocked out that it was about 24 hours before I woke up from the procedure, dazed and confused with a tube coming out of my stomach and leading to a bag of some unidentified liquid.

It was then that I was informed that my appendix, in being left for so long, had ended up exploding. (The surgeon told me that I shouldn’t say that it “exploded” because in technical terms you should say that it “ruptured” but damn it I went through a hell of a lot of pain and nonsense because of what happened so if I want to say that my appendix literally exploded like a firework on the 5th of November then I will jolly well do so!)
Consequently my body had been filled with poison, hence the tube and bag scenario coming out of my stomach after the appendix had been removed, to drain the poison out (the poison being the funny liquid in that bag.)

Since then the job has basically been to free my body of poison, recover from the surgery and try to build my body back up after its internal beating, a job that isn’t going too well at the moment because this whole physical health problem extravaganza has triggered the life out of my mental health problems, more specifically my eating disorder.

Admittedly I haven’t been doing particularly well for a while now, but I have been clinging on to some sense of stability by rigidly carrying out the same routine meal plan via some form of repetitive autopilot action. Unfortunately, this event has utterly destroyed my autopilot “just do what you did yesterday” routine.

I think when you have an eating disorder, eating your meals is kind of like a recovering alcoholic avoiding the pub.
If you force yourself to eat the same meal plan every day, you get into a sort of rhythm, a rather bumpy and unpleasant rhythm that you can’t lead a good conga to, but a rhythm all the same. Missing one meal however is like an alcoholic downing one mouthful of vodka after a few months sober and then suddenly finding it impossible to stop.

Knowing that missing one meal will always make the next one harder is the reason that I fight so hard to complete my meal plan even on the bad days because I know that not doing so will make it harder for me in the long run, but in this whole “my organs are exploding” situation, missing a meal wasn’t something I had any control over.
For the first day of the hospital admission, eating was mentally impossible because I was in a different place with different foods. This problem was somewhat solved when family and friends hauled bags upon bags of my safe foods to my bedside, but by that point I was physically in too much pain to lift my head let alone grab a spoon to chomp down on some cornflakes. During all of these pain days I was also constantly being wheeled in and out of various tests that doctors were telling me I wasn’t allowed to eat before, and incase I was going to need emergency surgery after some of these tests, my stomach also had to be kept empty on the off chance that people would be whipping the scalpels out (apparently it is significantly harder to operate when one has just demolished a peanut butter sandwich…or any kind of sandwich…not that there is any other sandwich worth mentioning).

Post surgery I was finally allowed and encouraged to eat to regain my strength and I genuinely tried, but again there were hurdles. Firstly the combination of anaesthetic/poison/million medications made me extremely nauseas, and I was being sick multiple times a day. My taste buds had also suddenly gone haywire and for some reason I could not tolerate sweet foods which for someone who always picks sweet over savoury and who lives off sweet things like porridge and cereal, this was somewhat of a problem. Even the flavour in toothpaste made me throw up (all over my toothbrush I might add…suffice it to say my breath was not minty fresh), and shock of all shocks, I started to be repulsed by peanut butter. Me. Repulsed by peanut butter aka the food that was previously the holiest substance on earth? Who am I? I think I am going through some kind of identity crisis. You might as well start calling me Malcolm.

Therefore I was trying to find new foods that I could both mentally and physically tolerate, family and friends bringing in new groceries every day (including my parents who had had to cut their holiday short and catch an emergency flight back to the UK with fears that they might not get “back in time”…safe to say their relaxing trip to Malaysia was somewhat of a disaster this year..).

Excitingly, a new safe food that I could physically and mentally tolerate was discovered in the form of mashed potato, but by this point it had been so long since I had eaten properly even that was a struggle. I felt sick at every meal time and I could never be sure why. On one hand it could have been the “genuinely physically ill with poison and anaesthetic” sick that I shouldn’t have forced myself to fight as nothing I ate would be kept down anyway, or it could have been the simply sick with anxiety and fear of food sick that I really should have been challenging to prevent it getting any worse. Sometimes food would arrive and I would feel so ill that I wouldn’t risk a mouthful only for the food to be taken away, the sickness to go and me to realise that all that nausea had been anxiety as apposed to anything related to physical complications.

After multiple meetings with my eating disorder services who visited me a lot on the medical ward, it was decided that I would be discharged home incase eating became easier there due to familiar surroundings. Armed with a ridiculous amount of mashed potato, I really tried but a few days in found that I was struggling to swallow. Again I assumed this must be that whole “throat closing up with anxiety” thing, so I persevered, but then after finding some weird white nonsense all over my tongue and throat and a trip to the doctor, it was discovered that life had thrown yet another curve ball and in my weakened post surgery state, had given me tonsillitis and oral thrush, conditions that make swallowing rather difficult and would therefore interfere with anyone’s ability to eat…Oral thrush? I didn’t even know that was a thing? WHAT THE HELL IS GOING ON WITH MY BODY.

Now I am three weeks post surgery (happy no appendix anniversary to me!) and in positive news, the nausea from anaesthetic and poison is practically gone. Having started another lot of antibiotics and some weird throat drops I have also regained the ability to swallow but after so many physical preventions to eating, I am now mentally more terrified than ever at the prospect. I have been to my eating disorder unit and the scales say that I have lost weight yet somehow I feel bigger.
Doctors are telling me that I have to get back to my old meal plan immediately so that we can add new things in to regain all that I have lost but it feels impossible. I cannot comprehend how the hell I was managing to eat before, despite the fact I was doing it only a few weeks ago, because now such an ability has become alien and frightening. I am tied up in a bundle of fear over food, throwing up, weight gain, trying to eat whilst being laid up in bed unable to carry out my usual exercise routines and consequently recovery from surgery isn’t going very well because I don’t have the energy to recover. Both the physical affects and mental health problems are feeding off each other like my body is an all you can eat buffet, and ironically the one person not getting fed in this situation is me. I have been on the edge of collapse for months now, clinging to the edge of stability with all the strength I can muster, but this has thrown me. I have fallen off the cliff. I am spiralling.

…And on that jolly note, that is pretty much my explanation of how a physical illness can go on to affect/cause/trigger a relapse in a pre existing mental illness. As with a lot of my blog posts, it hasn’t been a particular barrel of laughs as far as topics go, but it is the honest truth, and as always, that is what I am determined to put out there in terms of raising awareness of mental health problems.
Now after all this typing, I think I am very much in need of a nap and then maybe I will give some more mashed potato another go. Eating food is the last thing I want to do right now and my stomach is already full from terror, but I promise, I really am trying.

Take care everyone x

AppendixExplode

The Dangers Of Drinking Too Much Water When You Have An Eating Disorder

So in last week’s blog, I talked about a recent lesson I had learnt about the importance of familiar surroundings when you struggle with OCD, and funnily enough I have learnt something else in the past week too.
I am learning a lot of things lately. It is like being back in pre-school only Daniel Jones hasn’t stolen my green crayon (if you are reading this Daniel then yes I know it was you and I still want it back), and the topics of these recent lessons have been far more focused on mental health and less on how messy one can get whilst finger painting/what noise a cow makes (hint: it is moo).

In life, we are constantly being told to drink more water. If you have ever sat in a doctors’ waiting room you will have no doubt seen several posters about how drinking a lot of water is very important, how kidneys love the stuff, how dangerous it is to get dehydrated, and from all of these posters and health warnings you may assume that the more water you drink the healthier you are, which…well… isn’t exactly true, especially if you are someone who is struggling with an eating disorder.

Drinking too much fluid is by no means something common to all people with eating disorders however, and in my years of experience getting to know fellow sufferers, there seem to be three camps of people and how their disorders manage fluids.
In one camp we have the people with eating disorders who struggle to drink enough water and end up extremely dehydrated, then there is a second camp of people who could drink a whole swimming pool if they had a big enough straw, and then finally in the third camp there are the people with eating disorders who do not have a problem with maintaining safe fluid levels and would therefore like to leave the camp I have just put them in and go back home to a habitat that is slightly less tent like.

As it happens, I am in the second aforementioned camp (ours has a lovely log fire and on Saturdays we roast marshmallows), and I struggle with drinking too much water even if I am not at all thirsty.
It is odd because I have always known that drinking too much liquid isn’t good for you, but when it comes down to it, me gulping down glass after glass of water is like some uncontrollable compulsion, a kind of outer body experience.
Many a time I have been pouring myself another litre and in my head have been thinking “NO. STOP! THIS IS DANGEROUS NOW” but my body won’t listen and carries on filling up my glass anyway. It doesn’t matter how ill I feel, drinking the water feels like an urgent and necessary task as if I need to dowse a fireball that is burning somewhere in my stomach, no matter how much water it takes.

Even in the camp of people with eating disorders who struggle with drinking too much water, it is likely that everyone will do so for a variety of reasons and it is rare for two sufferers with the same disordered behaviours to have the same reasons for carrying them out.
When it comes to me though, my compulsion to drink a lot of fluid is partly because of posters I used to see at my local gym telling me that if I didn’t drink enough my body would hold onto water (leading me to fear that the number on the scales would go higher), but mainly it is because no matter how many doctors or dieticians talk to me about the science of the intestine, I am convinced that if I do not drink ridiculous amounts, any food I eat will get stuck in me forever.

Technically I know all about stomach acids and the body’s ability to break down solid foods via various muscle contractions and other clever things that go on behind one’s belly button, but in my head, eating anything solid conjures up an image of that solid thing getting stuck in a tube. Say for example I eat an apple, it doesn’t matter how much I chew it, when it is in my stomach I still picture it as a big red cartoon like shiny apple with the stalk attached, a lump that will stay there unless I am able to create enough waves to erode and wash it away.

For this reason, to try and keep my drinking under some form of control, I have been on a fluid chart for years where I write down everything I drink to try and keep an eye on things so that it doesn’t get out of hand. If I don’t write my fluids down my brain tends to trick me and convince me that I haven’t had a mouthful of water in days (even if I am surrounded by empty bottles of Evian and have been peeing every five seconds), so it is safer for me to keep a record of it so that when the compulsion to drink a lot comes, I can remind myself that I have already drunk more than enough and need to distract myself elsewhere. Last week however, this fluid chart thing went a little bit off plan with the disappearance of my parents on holiday.

I have had several people message me asking what on earth happened after the mass break down described last week, whether my parents ended up cancelling the holiday or whether we gave it a go despite plan A being a rather sizeable fail.

Well, after people had realised that I couldn’t stay at my parents’ friends’ house for the duration of the holiday, the immediate conclusion was that the holiday would be cancelled, but eventually we managed to come up with an alternative plan wherein mum and dad would go off to Malaysia as planned and I would stay at home with my sister and my most legendary friend of all time alternating sleeping over to try and help me stay safe.

It was going rather well for the first few days (or at least better than the disaster that had been plan A), but as time went on I started to get more and more anxious about my parents being away and consequently the urge to drink increased in order to wash all of that anxiety and stress away. I know it sounds pathetic but without my mum there to verify how much I was drinking and suddenly in total control of my fluid intake myself, things started to get out of hand. People who stayed over would be able to support me in the day time but when up late at night I couldn’t help but manically gulp glass after glass of water over the sink. All the people who write those “yay kidneys like water, stay hydrated” posters would probably be thinking that is great but as with most things in life, moderation is key and you can have too much of a “good thing”.
Drinking too much water can cause problems for anyone who has been hitting it hard on the old H20 because your kidneys cannot process it and consequently the water stays in you where it can dilute the salt/sodium level in your blood and cause a condition called hyponatremia, which doesn’t sound particularly exciting but in general language this is known as water intoxication, and I am pretty sure that phrases containing the word “toxic” are never good phrases to hear describe someones physical health.

In healthy adults eating and maintaining a healthy diet, a few extra glasses of water will not cause this kind of thing, but the risks when it comes to people with eating disorders is often greater purely because they may not have been consuming enough salt/sodium in the first place, and essentially there is a risk of drowning your cells on the inside. This then leads to things like heart problems, fainting, water on the brain, seizures, psychotic episodes, death, and basically a lot of things that mean you “aren’t very well” which is exactly what happened to me a few days after my parents flew off to Malaysia and is exactly why my poor sleepy friend had to call an ambulance at 2am on a Saturday morning having been woken by me banging around, generally delirious and spouting nonsense (and a little bit of water. I was like a living water feature. Delightful).

The reason I stayed in hospital for so long however is a slightly more complicated story which I will have to get around to next week, just so that we are all up to date and clear as to why I was so rude as miss a blog post two Mondays ago (Oh the shame. And I was raised in a house with such good manners!), but as an initial explanation, the problem was that I was hospitalised for drinking too much water, and it is now after some severe tellings off from several health professionals that I feel the need to write this post about it so that people realise just how dangerous drinking too much water can be when you have an eating disorder, in case it is something other people struggle with themselves and seriously need to seek support for. If you are one of those people who struggles with drinking too much water I know you are probably doing what I used to do upon hearing these kind of things, the whole “surely it can’t be that bad” and “it would never happen to me” but trust me when I say that water intoxication is extremely dangerous and potentially fatal so if you struggle with it, even if your head tells you “you will be fine”, it is vital you get regular blood tests to check your sodium balance.

Luckily after a few days of being on a water restriction in hospital (good lord was I thirsty), my sodium levels returned to a more acceptable level…it is just that other things started to go wrong after that but again, patience dear friends! All in good time!

Now what I don’t want is for someone who already struggles with drinking enough to read this blog and suddenly panic and start restricting their fluids more than they already were because that is NOT what I am saying you should do and that is dangerous for a different bunch of reasons all on their own. I am just saying it is dangerous to go ridiculously overboard when it comes to fluid consumption even if your eating disorder tries to force you in that direction, and that instead of not drinking anything, just do it all in moderation. Water isn’t dangerous, everyone loves a good paddle or dip in the swimming pool, you just have to keep it at a safe level and be careful not to drown.

Take care everyone x

Kidney

P.s I am sorry if this blog is a little bit all over the place. Physically I am still not in the best place right now and my ability to write is somewhat affected but please bear with me! I am sure recovery will hurry up soon!

The Frustratingly Illogical Existence Of Life With An Eating Disorder

A few days ago, I met up with a friend who I have not seen for 15 years. It was a friend I have known since the tender age of zero after we stumbled across each other at an antenatal class our parents had been attending in the hopes of learning what the hell to do with the new humans they were about to produce and were expected to raise without any prior knowledge of how to do such a thing.
We may have only been newborns but our connection was instant, we bonded over Thomas the Tank Engine and have been friends ever since (although like I said, we haven’t seen each other for fifteen years because when you get to senior school and puberty a lot of nonsense gets thrown at you and there isn’t any time left to discuss the wonderful intricacies of your favourite blue tank engine…senior school is cruel.)

Recently however, after reconnecting over the 21st century miracle that is “social media”, we decided to meet up, and thus it was that I found myself sitting opposite my oldest friend in a coffee shop several days ago.
I think when you meet up with anyone, either new to you or as old a friend as your life itself, there is always a tendency to compare yourself to that other person in some way. Frustratingly, even though I know that appearance and weight are the least important of all things, my eating disorder automatically compares my body to those around me and without fail will always manage to convince me that I am an inferior disgrace who should go home and hang their head in shame. Like I said, I know weight doesn’t mean anything and I quite frankly don’t care what other people weigh. The number of pounds shown up on someone’s bathroom scales does not matter to me in the slightest, nor does it affect my opinion of them, yet for some reason when it comes to me specifically and my body, weight is of the highest significance and summarises my self worth as a person.

When I saw my friend standing there then, I felt really embarrassed and had it not been for the desperation to see her after such a long time, I probably would have run out of the coffee shop and would still be hiding in a bin somewhere.
Eloise Unicorn McGlitterface (I may have added the “Unicorn McGlitterface” myself just for fun…she really likes unicorns…and glitter…), looked fabulous, and I wished I could look like her.
Immediately my eating disorder was triggered and the thoughts telling me to lose weight struck up their familiar bellowing.
I didn’t want to be thinking about these things at all, as I left I wanted to be thinking about how lovely it had been to see my friend, but as I got in the car to go home, my head was screaming at me to lose weight, and here is where I get confused.

I know for a fact, that my friend Eloise Unicorn McGlitterface, on paper, is a healthy weight, and even though I don’t believe the “facts” my psychologists tell me about me being “underweight”, I understand them, sort of like someone understanding the theory behind someone’s religion without believing in that religion themselves. Logically then, according to doctors and science, most people would conclude that in order for me to look as fabulous as my friend, I would need to gain weight. On paper and if talking to anyone else, I would easily be able to agree with this argument yet somehow, when it comes to me, even though I cannot explain the science behind it myself, I am convinced that the only way for me to look like someone who weighs more than me…is that I need to lose weight. WHAT KIND OF LOGIC IS THAT.
When I tried to explain this to my mum I couldn’t. Naturally she thought that I sounded irrational and like a lunatic (she would have a point), yet despite my inability to explain the science behind my thoughts, I remain utterly convinced of their truth without really understanding them…
I even thought that if I tried to write this blog post and tried to explain my theory I would realise how ridiculous I sound, how my thoughts make no sense and therefore cannot be true, yet still here I sit, unable to explain how my body defies science and needs to lose weight to look like someone who weighs more than me, yet utterly convinced that this is the case.

There are a lot of things I believe that make no sense to other people when it comes to my eating disorder, but at least I can see the logic behind them. I know it doesn’t make rational sense that I cannot eat unless my hair is tied up in a very specific way at a very specific angle, but I understand where that belief/behaviour comes from and the rationale behind it according to previous experiences. I know it doesn’t make sense that I cannot eat with forks, knives or plates and am only able to use spoons and bowls, but again I understand the reason I feel this way. There is no science behind it, but it makes sense to me and I could explain it to people.

This however, I do not understand, yet like I said, this doesn’t make it any less compelling. I guess going back to the religious comparison, it is like being a devoutly religious person who can hear all the arguments against their beliefs but believes nonetheless and is convinced in their heart by pure faith. I don’t want to insinuate that my eating disorder is at all some kind of religious movement, it is a murdering mental illness that destroys lives, but I think this example goes to show that when you have an eating disorder your belief in your thoughts are held and driven mainly by a faith that you cannot explain the logic behind. In my experience at university studying theology and when talking to religious friends, if you ask them to explain “why” they hold their beliefs, any explanation will be secondary to the feeling they hold inside them. They can say “why” but when it comes down to it the thing that convinces them is a faith, an indescribable feeling that they have which means that they “know” what they believe to be true even though they can hear people arguing about why they might be wrong.

I don’t wholeheartedly believe my eating disordered thoughts because I am stupid and don’t understand science, somehow I believe them in spite of that understanding. This whole “to look like my healthy friend I need to lose more weight” thing is exactly like my obsession with green tea. I hate the stuff and over the years hundreds of people have told me that it makes no difference to your weight, I have read the studies and I know they are true and more scientific/rational than any thoughts I get from my eating disorder…yet somehow I am still convinced that if I don’t drink a certain number of millilitres of green tea I will gain several stone overnight. Consequently I drink that green nasty fluid that I am horrified is held in the same category as all other teas. WHERE IS THE LOGIC HERE EATING DISORDER? HMM?

I think what this really proves is the fact that eating disorders make no sense and that even if their thoughts don’t have a reason behind them, they are nevertheless believable. People with eating disorders aren’t stupid people who don’t understand how bodies work, they understand all of those things, often better than most, yet still the disordered thoughts are so strong and so compelling that they are convinced to follow them without being able to say why. Eating disorders have the power to make science sound ridiculous and nonsense sound like fact. I guess this example also proves the fact that eating disorders are flipping stupid and will always manage to convince you and tell you that you need to lose weight no matter what the facts of any situation.
Usually when I write blogs about eating disorders I do it to try and explain the reasoning behind
them to people who don’t understand, but clearly, sometimes life with an eating disorder is about not understanding a damn thing about your thoughts yourself and just basking in a frustrating confusion.

Take care everyone x

NonsenseBin

“I Wish I Had The Self Control To Be Anorexic”

Several times in my life I have heard the phrase “I wish I had the self control to be anorexic” and, considering I am now writing this blog post about this phrase, you can safely assume that I have a lot to say about it.
You may be thinking “Katie, you already wrote a post about people wanting anorexia and how silly that is, why are you repeating yourself?” (a post you can find at the link here: A Message To All The People Out There Who Are “Pro-Ana”), but please hold that thought as I actually think that the problem with this phrase is not about people wanting eating disorders.
Indeed, unlike people who are “pro-Ana”, in my experience, people who say this are not actually craving the bulging rib cage and hip bone images promoted on “pro-Ana” websites. The mistake these people make is not that of idolising a mental illness, rather it is of completely misunderstanding what an eating disorder actually is and what it is like to suffer from one.

I think when it comes to illnesses such as anorexia, there is a misconception that when people with the illness don’t eat, it is because of their will power or an extreme superhuman ability for self-control. They assume that sufferers feel hungry and want to eat but powerfully override the primal urge to seek food because they are strong, yet in my experience, it is the total opposite, and it is in the times that I am unable to follow this primal urge that I feel the weakest that I have ever felt in my entire life (even weaker than the time I was beaten in an arm wrestle by an rather arrogant and ambitious sloth I met drinking tequila in a bar a few years ago…that was a BAD evening.)

Whenever I miss a meal or don’t eat a free sample handed to me in a supermarket, it isn’t because I implement my ability to make decisions/affect my actions as the word “control” implies. Instead, it is because I am not in control at all, a point I think is easier to explain if we take a trip down memory lane and travel back in time to any birthday I have had over the course of the last decade.

Most years, when it gets near to my birthday, if I am out shopping in a supermarket with my mum, when we walk past the birthday cake section, she will look at the birthday cakes and sigh. Following this signal, we may have a wander over to look at all the intricately decorated creations topped with thick white icing and pictures of various Disney characters (I don’t look at the plain old boring cakes for “adults” that simply say “Happy Birthday”. Seriously who wants one of those when you can have an sponge shaped like a minion or a giant chocolate caterpillar with a cheeky grin?!), and then after five minutes of eye wandering my mum will turn to me and ask the question “can I get you a birthday cake this year?”.
Now, if I had any degree of “self-control” when it comes to food and my ability to nourish myself, I can honestly say I would turn to my mother in these moments and say something along the lines of:

“Can you buy me a birthday cake? Why of course! There is no question regarding such a matter! It is my birthday in two weeks and I simply cannot celebrate the occasion without a cake! Quick! Let’s go around all the supermarkets and bakeries in the area to try and find the biggest penguin shaped chocolate cake available. I want nothing more than to share such a delight with all of my nearest and dearest friends! Ooh can I please reserve the chocolate beak for me because it is my birthday? I do love a chocolate beak! Hurry mother, let us away to the automobile and get started on this quest immediately!”.
I would probably then insist we head to the candle area to pick the most garish, brightly coloured candles on offer to adorn my perfect penguin centrepiece, poised and ready for the moment when I am ready to blow out the flames and make a wish that Helena Bonham Carter hurries up and marries me already.

That is the response of a Katie who is in control. Unfortunately though, we haven’t seen “In Control Katie” around much lately. That Katie popped out for bread about ten years ago leaving an out of control mess in place, and since then we haven’t heard anything (better be picking up some damn good bread is all I can say…I’m talking a good quality ciabatta or we are going to have issues).
Therefore, with “In Control Katie” otherwise engaged on a mission to find a tasty source of carbohydrates, it is the “out of control” one that turns to Mum year on year with a dejected look and says: “I wish. Maybe next time”, at which point we agree to try again next year before repeating the annual routine in roughly 365 days time.
I know it would mean the world to my mum to buy me a giant penguin birthday cake to share with her/the family, and I desperately want to accept her offer each time mainly because I want to see her reaction. I want to see her face light up with the brightness of a birthday cake candle, filled with hope that for once she can do something that normal mothers do rather than having to come up with some kind of eating disorder friendly replacement for her neurotic offspring (e.g. the act of sticking a candle in a pink lady…the kind of apple I mean…not an unsuspecting blushing female who doesn’t know what’s coming).
When I do not accept the offer of a proper birthday cake then, it is not because I don’t want to, it is because my mind throws up barriers that make me feel that I physically can’t.
It is like a “normal” person standing in front of a bonfire and wanting to put their hand in it to retrieve a particularly nice log. They can look into those flames and want to put their hand in to get the log (this person really likes logs), but no matter what, they can’t. Of course they are physically capable of moving their arm into the vicinity of the fire, but the fear of pain stops them (no matter how much they like logs).
Saying “I wish I had the self-control to be anorexic” then, is basically like saying “I wish I had the self-control not to put my hand on a bonfire”. Of course eating and setting yourself aflame aren’t the same thing, one is vital for life whilst the other is downright ridiculous and not something I advise anyone to try at home or anywhere else for that matter, but the similarity exists in the sense that both the person who doesn’t put their hand in the fire and the person with the eating disorder do not carry out their actions because of self-control, rather it is because they are both scared and fear the pain that could result from their actions.

Whenever you hear yourself or anyone wishing they had the “self-control” and “will power” to eat like someone with an eating disorder then, please know that when it comes to eating disorders, self-control has absolutely nothing to do with any of it. When someone is unable to keep themselves healthy by eating enough, it is because they are not in control, and because the reins of decision are actually being held hostage by an evil dictator in their head who is trying to kill them.
If I had self-control and willpower over my life I could write a list of about a million things I would use it for. The ability to fill my mother’s eyes with disappointment, to refuse sharing a dessert with a friend or turn down the offer of a birthday cake would not be on there.

Take care everyone x

ControllingPea

How Summer Can Affect People With Eating Disorders

When you live with an eating disorder, there are a lot of things that can affect it. For example my eating disorder rules are often impacted by things like my location, what time it is, who I am with, what is going on for the rest of that day, and, as I have learnt very recently, what season it is.

I have always known that things like the season can affect my eating disorder, but never have I realised this more than this summer, especially the past few weeks of June. If you do not live in England you may not be aware of what has been going on, so to clue you in, you should know that for the majority of June, England has been doing its very best impersonation of a Sauna. IT WAS 34 DEGREES.
For those of you who are used to living in hot countries this may not sound particularly hot, but for people who have always lived in England, 34 degrees feels like you are wearing three hundred woollen jumpers and have been thrust into a furnace with a hot potato shoved down your trousers, a feeling that is not helped by our inability to go for more than 24 hours without a good cup of hot tea (seriously we can’t do it. This isn’t a joke. Tea withdrawal disease is a very serious problem in the UK and 90% of hospital admissions are poor folk who cannot find their favourite teapot).

Now when the weather is hot, people like to take off their clothes or at least wear as few clothes as possible. Gone are the winter coats and snow boots and out come the shorts and crop tops, items that I find rather terrifying due to my eating disorder and body confidence issues. Throughout the year I live in large baggy jumpers so as to cover my body up and out of sight, so that people cannot see all of the disgustingness I see when I look in the mirror, which is a slightly problematic practice when the weather is hot. In summer when you have an eating disorder or body dysmorphic issues, you basically have two choices, stick to your normal wardrobe and roast to death or wear sensible clothes that allow a little bit of breeze here and there but that simultaneously leave you incredibly uncomfortable/stuck in the high street rigid with anxiety because you are wearing a pair of shorts.

I don’t know about anyone else, but I also find summer and warm weather extremely triggering to my eating disorder because I am so used to being cold and being cold is a symptom of being “unwell”. Indeed being cold is a feeling so synonymous and such a documented symptom for people with eating disorders that thermometers were shoved in our ears multiple times a day in hospital to see if we were at risk of hypothermia (an unpleasant experience though I suppose better than that of having a thermometer shoved anywhere else…).
Every time I say or am told by someone that I feel cold, doctors will say things like “it is because you are underweight” or “it is because you don’t eat enough”, so when I am not cold, I panic.
Due to the association with being cold to not eating enough, if I feel warm or heaven forfend “hot” at any time, my head will immediately convince me that it is because I must have accidentally eaten ten buckets of lard and have gained one thousand kilograms. If I feel warm, my eating disorder states that I also must be fat.
It is completely nonsensical but I cannot help it. As much as I try to apply logic to the situation, my brain will always convince me that being warm has absolutely nothing to do with the giant ball of fire burning in the sky (aka the sun…calm down this is not the apocalypse), and has everything to do with what I have eaten and how much I weigh. For me then, eating becomes a lot harder in the summer time because it is easier for my eating disorder to convince me that I don’t really need the food seeing as I am already abundantly covered in enough flesh to keep me toasty warm.

Another problem I have faced this year more than ever, is that of the longer daylight hours we have in summer. I know a lot of people find that sunlight is beneficial to their mood and can actually help them with mental health problems like depression, but for me it is the opposite. I hate sunshine (which is why I live in the UK).
In the sunshine everything feels too bright, too loud, too intense, and I feel calmer in the quiet winter months when people are tucked up inside rather than running around out doors with no clothes on.
I have also always struggled to eat when the sun is up, a problem that has somehow got worse this year. You see, I am currently sectioned under a CTO, a part of the mental health act that means I am allowed to live at home as long as I adhere to certain conditions like staying above a certain weight and going to appointments. I want to say that my main motivation to eat is to be healthy but as true as that is, I am ashamed to say that if I am completely honest, the main push that gets me eating is the fear of going back into hospital and having to eat more food and gain more weight. In the day time however, that fear is not as strong. When the sun is up my brain thinks “hey it is fine, you will stay above your CTO weight, if you don’t need to eat now, you can do it later”.
When the sun is down, there is no later though, and I realise that if I want to maintain my weight and with it my freedom, I am going to need to get some munchies out. The problem is that I know my weight will be acceptable as long as I eat and does not depend on when that eating happens, so naturally as with most things you fear/dread in life, I avoid it as long as possible.
In the winter, this was not such a problem because it was dark by 4pm, but in the summer with all this daylight savings malarky, it isn’t dark until around 10pm and as the months have gone on I have found my eating getting later and later in the day until the point I am at as I write this, a point where I am basically carrying out a year long, eating disorder motivated version of Ramadan. This would make sense if I was a particularly devout follower of the Muslim faith, but my adherence to such rules is not driven by a special spiritual meaning or importance, it is is because I have an eating disorder in my ear who is a total idiot.

In summer as well as taking their clothes off, people tend to change their way of life in the sense of what food they eat and the roast dinners and steamed syrup puddings of the winter time are replaced by cold salads and ice cream.
Again however, this is another seasonal transition that my eating disorder leaves me struggling with, because I eat exactly the same foods in the exact same proportions every day and one of these foods is porridge, aka that boiling hot bowl of oats that most people don’t whip a pan out for until there is a significant chill in the air.
When it is 34 degrees outside, nobody in their right mind would start getting oats out of the cupboard to perform their daily Goldilocks’ impression, but I am not in my right mind, so that is exactly what I do (the slight difference in my impersonation being that I am a brunette version of Goldilocks…Oh yeah and I don’t break into people’s houses to get my oats, especially if those people are bears).

In June then, during the hottest week England has seen in my lifetime, I was stuck in the predicament of being boiling hot and thus convinced that I didn’t need to eat because I was clearly obese. Then by 10pm when the CTO fear would hit me, I would force myself to eat despite being so warm, only I would trigger myself even more and make it even harder by making the food I was consuming a steaming bowl of porridge.
“Eat cold porridge” I hear you cry, “try overnight oats which is the exact same thing but you don’t cook it”, yet even that couldn’t solve my problem as OCD has rules about how porridge is prepared and naturally has me convinced that unless my porridge has been cooked for exactly 4 minutes and 40 seconds with stirring at the appropriate intervals, I will kill everyone on the planet. What logic!

As you can see then, summer/the season and weather in general is one of the many things that people may not think about affecting people with an eating disorder, another thing that complicates the simplified idea that people with eating disorders “just don’t eat”.
They are complex creatures, mysterious as the dark side of the moon (10 points to anyone who got that reference), and the control they hold over a person’s life creates anxieties and difficulties most people might not think about. I am of course happy for everyone out there who loves summer and if you are one of those people living in England, I really hope you are having a lovely time in the June sunshine and are feeling as sunny as…well…the sun…
In the meantime I guess I will just have to suck it up and count down until the winter months when jumpers, porridge and 24 hour darkness are socially acceptable again. My God I am a jolly soul!

Take care everyone x

SummerBear

Why Are Eating Disorders Competitive?

Many people are aware by now of the dangers of eating disorders, the emotional inner turmoil, the isolation, and the potentially fatal consequences. However, one of the biggest dangers that isn’t quite as discussed is the fact that eating disorders can be incredibly competitive. It sounds odd and it is quite hard to explain how an illness can be competitive, but basically if anorexia was ever personified, it would be the person who becomes dangerous when playing board games and is prone to breaking valuable ornaments in the home over an unlucky roll of the dice in a game of Monopoly.

I think most people, often and unknowingly, see other homo sapiens as threats for many different reasons in every day life. At work you may feel in competition with someone to get a promotion, in a supermarket you might choose the best looking bunch of bananas so that yours will be better than those of whatever potassium craving customer comes after you, or in a car park you might discreetly race another vehicle to get the last available space. Maybe your competitive streak involves competing with your gaming arch-nemesis to be captain of the tiddlywinks championship team, whatever it is, at some point in every day, whether we realise it or not, most of us enter into little competitions with our fellow humans and in turn those people become threats.

It is rare however, for people to compete with another person’s illness, and I have often wondered why eating disorders are so different in that respect. Possible reasons I have come up with are things like the tendency for people with eating disorders to naturally be high achieving perfectionistic people, or that eating disorders are an illness that usually involve a lot of numbers and in turn, ways the illness can be “measured”. Obviously, in reality the severity of someone’s eating disorder is impossible to measure no matter how many scales you weigh them on or how many calories you see them eat, but no matter how incorrect the idea, people who do not really understand eating disorders to be a mental illness rather than a physical one, tend to measure the severity of an eating disorder by the physical effects they can potentially lead to. If people see a thin person they will wrongly assume that person to be more “anorexic” than their equally troubled neighbour who just so happens to be a healthy weight. With other illnesses though, this ability to gauge how ill someone is just by looking at them, however inaccurate the final judgement may be, is far more difficult in comparison. For example two people can have a liver disease but when they are walking side by side in a park, you cannot guess as easily who you perceive to be the sickest unless you take a few blood tests and maybe open them up with a scalpel (which would probably lead to them asking why you were wandering around a park asking people for blood tests and performing major operations).

When an illness is seen as focused around numbers then, comparison and thus competition tends to breed. Over the past decade I have met people whose eating disorders have led them (for I highly doubt someone’s individual personality would compete about such things), to compete with regards to numbers as to how much someone weighs, what their BMI is, how many calories they consume, even obscure things like who takes the longest to eat a meal, who has been into hospital the most times or who has the lowest white blood cell count. It is a disgusting, sick and twisted side to the illness since you are basically competing to see who can kill themselves the best, but I cannot deny it happens.
For this reason I actually think the more distanced a sufferer attempting recovery is from the intense eating disorder community, the better. If you are living in the middle of nowhere with a family of healthy people, you simply have your eating disorder to wrestle with (and lord knows one is still far too many). In hospital settings like inpatient eating disorder units, therapy groups, or even social media recovery accounts online, you are surrounded with other sufferers and thus other eating disorders to battle with. Don’t get me wrong, it is lovely to have people you can relate to, but the ability to relate to other people who are unwell and spending large amounts of time with them can lead to a loss of perspective.

Gathering a group of people with eating disorders together, either physically or online, is sort of like gathering a group of wild gorillas in the middle of the rainforest (I would avoid both of these gathering activities if I were you as neither are particularly safe…if you are an avid collector or gatherer may I suggest gathering stamps or Pokemon cards instead).
There are probably a hundred reasons as to why gorillas sometimes stand on their haunches and beat their chests, but from my dedicated research and observation (I watched Tarzan), when a gorilla beats its chest in front of another gorilla, it can be interpreted as “look how big and mighty I am! Have you ever seen such a fine specimen of gorilla? Look at my hairy arms! They are fabulous! I am the best gorilla in all of the world and far superior to you! I am the best! Leave my forest or I will strike your hairy behind! Back off I say! Flee! Flee!”.
All the gorillas in the rainforest will naturally want to be best gorilla around to ensure their survival, establish their right to the most attractive mate or the biggest banana. They aren’t doing it for laughs (maybe the odd titter), but they are naturally born with that competitive instinct so that they can stay alive.
Similarly, when a group of people with eating disorders gather, their internal eating disorder gorillas perk up and start beating their chests to let everyone know that they are the best and strongest eating disorder around. Ironically though, unlike the real gorillas, the “winner” in terms of measuring who is the most physically ill from their eating disorder, the thinnest or the one who has gone the longest without eating, is the least likely to stay alive the longest.

If you are reading this as a healthy minded person you are probably thinking that competing as to who can lose the most weight is ridiculous and sick, and when it comes to that judgment, you would be right.
However I think people often forget how much competition there is with regard to weight loss even in “healthy” circles. On TV shows like The Biggest Loser, people compete to see who can lose the most weight with a cash prize for the winner, and though perhaps less extreme than competing with white blood cell counts, surely this is similar? What about in local weight loss clubs when people compete with their next-door neighbour to see who can lose more weight than anyone in their area in order to be awarded with the sash declaring them “Slimmer of the Year”. When you think about it, in our society, competing around food and weight is not as alien an idea as people with eating disorders can make it seem.

There is however one reason people often suggest as the answer to the “why are eating disorders competitive” question, that I strongly disagree with, and that is the idea that people compete purely because they want to be the “thinnest” and that the competitive drive is all about vanity and outer appearance. If anything, I think the drive is the total opposite to vanity, and more to do with insecurity and low self esteem regarding the internal self.
When you live with an eating disorder you basically live with a voice in your head telling you that everything you do is wrong and no matter how hard you try to please it, it will never be satisfied or see your “efforts” as enough. No matter what you eat, your eating disorder will tell you it was too much. Even if the portion was initially decided by your eating disorder, it will tell you that you could have left a bit or maybe it will tell you that you ate it wrong; too quickly, too slowly or with the wrong sized mouthfuls. Whatever you do, the voice will tell you you are not living up to the standards you should be, you are not good enough.
My drive to lose weight is not to see a nice patch of rib cage, it is to achieve something that my eating disorder tells me is “better” than my former self. Of course there is nothing “better” that can come from starving yourself and if I were talking to any other sufferer I would tell them that the “best” they can be is the healthy version of themselves who is able to nourish their bodies and enjoy a healthy relationship with food. Yet still when it comes to me, the eating disorder somehow manages to manipulate my thoughts in that direction that I am a “better” me, less repulsive, less annoying, less deserving of a punch in the face, if I stick by my eating disorder’s rules. I am constantly held up between my past self, current self and encouraged to compete against them to reach this “superior” future me. When you add another sufferer into the mix then, it is yet another person for my eating disorder to compare me to. No longer is it telling me to lose weight or starve because I am not good enough compared to the potential me I could become if I were to behave myself, now I am also not good enough compared to the person or group of people surrounding me. I don’t follow the rules to the standards my eating disorder would like in an ideal world, and when I am around other people it tells me that I am even more inferior because they are following these stupid rules better than me. I don’t feel competitive because I am vain and want people to admire my collarbones, I feel competitive because I despise myself, because behaving well and following all my rules gives me a sense of self worth, a sense that I am doing something right, so if I am not following the rules “the best”, then I am not good enough.

So why are eating disorders competitive? Well, there are many reasons from internal anorexia gorillas to self hatred, perfectionist personality traits or the ability to compare and misunderstand the importance that physical numbers have to play in a mental illness. Obviously this competitive undercurrent is wrong, needs to be tackled and is disgustingly disordered, but we are dealing with eating “disorders” so I suppose it makes sense. What I want more people to know though, is that of all the reasons, as sick and twisted and horrible as they are, they are not reasons that derive from vanity or any sense of bodily pride compared to the person in the next bed to you. If anything it is about desperation to be good enough in the eyes of a devil that is constantly telling you you are worthless, both in yourself, and in comparison to everybody else.

Take care everyone x

HairiestGorilla

Eating Disorders Away From The Table

If I were to hand you a pencil and ask you to draw a person who, in the moment depicted, was struggling wth their eating disorder, you would probably draw an image of a person sitting at a meal table with a plate of food in front of them (Unless you are anything like my mother who instead, when given a pencil and asked to create a picture, will throw that pencil back in your face and run for the hills screaming “I can’t draw – leave me alone!”)
On one hand, drawing someone at a table would be right as it is likely that if someone has an eating disorder, meal times are going to be difficult for them. However I think there is an idea that when you have an eating disorder your struggles come into action at the dinner table and depart once the meal is over, a nice idea, though one that is unfortunately far from the truth.

For me at least, my eating disordered thoughts are there from the second I wake up and my first thoughts of the day will be about food and how much/what I am planning on eating during that day. It is silly really, because everyday I eat the exact same foods in the exact same amounts, so there is no decision to be made and any dithering is futile. There is no point in wondering whether or not I want Coco Pops or toast, I can ponder and postulate pancakes and Pop Tarts all I like but no matter what, the first thing I will eat that day remains the same as every other, in the same amounts and even on the very same plate. It is also pointless to think about this from the second I wake up as currently I am struggling with this rule that I cannot eat when the sun is up so, being summer, the first meal is usually hours away and shouldn’t be an immediate concern.
Nevertheless, every morning the thoughts and worries about what I am going to eat are immediately there, thinking about infinite options, things that might be healthier, lower calories/lower fat, before inevitably settling with the usual. It is like this for every meal no matter how far away that meal is, be it hours, days, even years.
There are several reasons why I have the same foods every day. For one thing I know what my weight does/how my body reacts to this meal plan, but mainly I stick to the same thing because it removes the need to debate the decision for hours each day.
Everything is planned down to the smallest most specific detail, I don’t just eat an apple a day, I eat a Pink Lady apple specifically to avoid the chance of spending three hours debating between a Golden Delicious or a Granny Smith, yet even if I know the debate is heading nowhere, it still arrives before every meal. I will spend the hours leading up to it debating the options and calculating various calorie amounts without ever getting an acceptable result.

Then, even when the inevitable decision has been made, the eating disorder is still there for the food preparation extravaganza, controlling every movement and weighing out ingredients to the exact gram, no matter how long it takes. I often weigh things multiple times on different scales to check that one set isn’t lying to me (I once saw a set of kitchen scales on Jeremy Kyle who failed the lie detector test. Turned out he WAS the child’s father and I have never trusted a pair of scales since). As always, the weight will be the same on every set of scales, but still I will spend time worrying that the food I was weighing was “different to usual” and that I randomly managed to pick up an incredibly dense courgette with twice the calories of a normal one.
Food prepared, there is then the obvious struggle people know about, the bit we all picture when we imagine someone with an eating disorder, the eating that takes place at the dining table. However even when I leave that table, the battle is still going on, and rather than sitting at the table politely waiting for the next meal, anorexia follows me rabbiting on about what went on at the table and the meal that, for everyone else, was over hours ago.
Did I eat too quickly? Did I eat too much? Do I feel fuller than usual, aka a sign that the scales were lying earlier and I was dealing with a magically calorie dense genetically engineered superhuman courgette? Have I gained weight that I can see? All of these questions swirl around in my brain amidst the thick soup of guilt and I replay the meal in my head over and over again incase I missed some key piece of evidence of something that I should be worrying about. I said in the part about worrying about meals before they occur that the meal can be hours or weeks away, and similarly the worrying afterwards can carry on for years after I put my knife and fork down on a plate.

Eight or nine years ago, during one of my admissions to hospital, I had a meal involving mashed potato. I had been eating the hospital mash for months and months before so I knew exactly what to expect, yet there was one particular day that the mash tasted different. They say variety is the spice of life, but as I ate that mash the difference frightened me and as someone with an eating disorder I wished that variety would keep its peppery little paws off my food thank you very much.
At first I wasn’t sure what the difference in the meal was but then it hit me that the mash tasted sweeter than usual. Immediately I became convinced that someone had mashed a doughnut into it and hoped I wouldn’t notice. Other than the slightly sweeter taste I had no evidence to support this theory, hospitals were not struggling with an epidemic of caterers with an uncontrollable urge to shove an iced ring into every dish, but that sweet taste was enough to have me convinced. It has been 9 years and yet I still think and worry about the doughnut that I am convinced was in my mashed potato nearly a decade ago.

Every waking hour between meals is consumed with food fears and often every sleeping hour is too. Not only does anorexia not live at the dinner table, it doesn’t live in the land of conscious thought either, and is well known to infiltrate and get its claws into the snoozetastic unconscious place known as “The land of nod”.
I have nightmares most nights, all of them with varying storylines, characters and background music, yet a lot of them have similar themes, one of these themes being food. I will dream that I have been held up at gun point and forced to eat an entire chocolate cake, before waking up and fearing that I did it for real and that I therefore have to go for X amount of time without food to make up for my behaviour. On many occasions I have woken up so convinced that I have eaten something that was actually part of a dream, that I have had to search the kitchen for evidence to prove to myself it wasn’t real. One specifically memorable dream involved me cooking and eating a gigantic spaghetti bolognese and the fear upon waking made me feel so sick that I had to go downstairs and check cupboards to see that all the pans were clean, the pasta wasn’t open and the bin was bolognese free, so I couldn’t have cooked and made it for real (apparently my brain believes I might unconsciously cook and eat a meal but draws the line at the idea that I would have washed up afterwards.)
I also dream about exercise and whilst some people have unconscious thoughts that lead them to sleepwalk, mine sometimes drive me to do sleep sit ups on autopilot so that I will wake up halfway through a set, stomach muscles aching, out of breath, wondering what the hell is going on.

For me then, having an eating disorder isn’t just about struggling at meals, it is about being constantly controlled and dictated to 24 hours a day 7 days a week, a voice that follows me no matter where I go or how unconscious I am, interfering with thoughts and my ability to function even when food is nowhere nearby. It is a nice idea to assume that eating disorders do just live at the table and that meal times are the only difficult times for sufferers, but to tell you the truth, when you have an eating disorder, that devil will stick to you like an unrelenting shadow.

Take care everyone x

EatingDisorderTable

The Problem With Before And After Photos In Eating Disorder Recovery

A few months ago, towards the end of February, it was Eating Disorders awareness week, so naturally I did as I always do on this occasion and buried my head in the sand for the duration of the week (I also allowed children to use the remaining sand to build sand castles atop my hiding place because I am such a lovely person). This may sound like odd behaviour for someone who is constantly talking about mental health problems like eating disorders in order to raise awareness and for someone who has a strong disliking of sand, but then again odd behaviour is what I am known for. Literally.

The reason that I avoided the internet during that week, and indeed avoid it every year, is that it is a week in which social media is filled with “before and after” pictures, aka photos of someone taken during the depths of their illness, compared to a later photo taken post/during recovery. Don’t get me wrong, these photos certainly have their place and I would be lying if I were to say that I have never been inspired by any of them. Often these pictures will come with an empowering and motivating story of someone’s journey in recovery and triumph over anorexia, and that is brilliant. That is something that should be celebrated, and those stories  are shared throughout the Eating Disorder community to encourage others to fight their illnesses and to give hope to those who doubt recovery is truly possible. I love these stories but it is not the stories of recovery that I have a problem with, rather I have a problem with the “before and after” photos that are often involved in telling the triumphant tale.

Firstly, these images will usually show the person in the depths of their illness as an incredibly underweight individual, with ribs popping out so far all over the place that you could easily use them as a xylophone. Regardless of the inspirational intention with which they were posted, there is always the risk of these pictures going on to be triggers for other sufferers or, dare I say it, “thinspiration” for all those misguided souls who think that anorexia is something to aspire to. They can also make sufferers who are perhaps not as underweight (or who are unable to see themselves as that underweight) consequently see these images and feel that they cannot seek help because they aren’t “thin enough” or “bad enough”, when encouraging people to seek treatment is supposed to be the whole point of a week dedicated to educating and raising awareness of eating disorders. Similarly, in their representation of someone with an eating disorder and someone without, they encourage the myth that eating disorders are about being thin and that eating disorders can be seen, (a myth I have tried to tackle here: Why it is physically impossible to “look anorexic”.)
For people who do not know much about eating disorders and who do not have the time or interest in reading full accounts of recovery journeys, these snapshots may be the only experience they get of someone with an eating disorder, so the risk is that the stigma and lesson of “ill is underweight”, “well is a healthy weight” will be perpetuated without taking into account the far more complex and important internal and mental struggle that is having an eating disorder.

Similarly, as an image to summarise recovery, I feel it is problematic in that the main difference that is visible between the two pictures is weight, which implies that the main difference one goes through is the difference of the number on the scales. It suggests that in recovery, the biggest thing you “gain” is weight, when really weight is probably the smallest of all the things I have seen people gain in recovery. I may not be able to speak as a recovered person myself, but of all the friends I have watched beat their eating disorders into a soggy pulp on the ground that is no longer able to control their lives, the change in their weight has been the least significant change of all. Okay there is a change in weight and perhaps clothes size, but when I see my recovered friends, I do not see the change in their BMI, what strikes me most is the change in their lifestyle and their overall presentation as a person. To me they have not gained weight as much as they have gained themselves. When you are in the depths of your eating disorder, as much as you fool yourself, you cannot maintain a normal life. Your ability to have a job, have normal relationships with people, be happy or even function are seriously compromised, and these things are all aspects of life that can be improved on with recovery. I have seen friends go on to study medicine at university, have romantic relationships, give birth to children, climb mountains (I am talking proper big mountains like Kilimanjaro), and travel the world. They have regained their ability to properly smile, to laugh without having to fake it, and to me seeing all those photos of them skydiving in Australia or getting married and having babies have been far more significant and noticeable changes than what size jeans they wear. It is these aspects of recovery that are the really important reasons that people need to fight and it is these changes in lifestyle that are the really inspiring stories. Yes weight gain is a part of the journey, but what is more important is the places that weight can take you, for example to medical school or up a flipping huge mountain.

On a similar note, my other issue is that I feel before and after photos simplify the process of recovery. In one picture you probably have someone who is underweight and either looking miserable or faking a smile out of dead eyes, and in the other you have someone who has gained weight and perhaps, is beaming at you with genuine joy. This then makes recovery very straight forward, “Being underweight make you unhappy and thus gaining weight will make you happy”. It automatically assumes that the happiness comes as the weight increases, without highlighting the far more complicated journey in getting that weight to be there.

It is hard to explain exactly what I mean, but it is like looking at a picture of someone standing in a field looking miserable, and then another photo of them smiling in the same field but with the addition of an ice cream. At face value then, you can look at these pictures and think “well a person was sad because they didn’t have an ice cream but then they got an ice cream and they were happy” , simple. What the picture will not tell you however, is how that ice cream got there. Little would you know that the person had not simply walked up to the nearest ice cream van, asked for a 99p Mr Whippy and walked away smiling, just as the person in recovery had not simply gained some weight, and in turn, a smile (side note did you know that they don’t even do 99p Mr Whippys anymore? They are now at least £1.50! How do those ice cream men still have the nerve to play jolly tunes as they patrol the streets for customers now that they are basically performing daylight robbery rather than offering a merry treat. You can play Greensleeves all you want but that doesn’t change the fact you are making me re-mortgage the house to buy myself an ice cream. SHAME ON YOU ICE CREAM MEN. SHAME ON YOU.)

Anyway, what the picture doesn’t show is that to acquire their ice cream they were forced to go on a perilous test of their endurance, that pushed them to the limits of mental and physical strength. To get that ice cream in the picture, that person had in fact had to walk across continents and cross oceans to America, the largest producer of almonds in 2014 I will have you know, and then had to hand pick hundreds of almonds ready to blend into a creamy milk worthy of a tasty frozen dessert (this person was lactose intolerant so almond milk was the milk required for the job.)
Then, exhausted from months of trekking, nut picking and milk making, that person had to swim across even more oceans into the freezing cold pole of the Arctic where they stirred their almond milk with a wooden spoon atop a large glacier that acted as a natural freezer for their ice cream churning process. Even when the ice cream was made it didn’t get any easier as they had to then wrestle with a penguin who had cheekily tried to steal the ice cream (I don’t blame him to be honest. I would steal ice cream if all I had ever eaten was raw fish), and then they had to get the ice cream all the way back to that field in their country of origin, back through the hot climate of almond fields in America, without the creation melting. Clearly that is a far more character building excursion to get to that point of “person with ice cream in a field” than the picture initially suggests, and I didn’t even tell you the 5 month side trip it took to make the cone in which the ice cream was to rest (it would take too long to tell you fully but as a brief summary it involved a very angry rhino and a lot of waffles).
The person worked hard to get to the point where they were standing in that field with that ice cream, and all that hard work is eradicated, as it is in recovery journeys, when all you see is a simple before and after shot.

Obviously I am not saying we should stop people from sharing their recovery stories and indeed, if you have recovered from an eating disorder, then I am OVERWHELMINGLY proud and impressed by your determination and strength. If you were here with me now rather than wherever you are reading this, I would give you so many rounds of applause that my hands would fall off and I would be left clapping stumpy wrists to show appreciation of your achievement. What I am saying is that maybe, more often we should be celebrating and telling these stories without the underweight photos that go with them. A story is still a great story without pictures. Hell, look at Harry Potter, that story changed and continues to change generations of people, it has grown theme parks and movie franchises, careers and other astonishing things, all from a pile of words cobbled together with no images at all (For the purpose of this post can we please just pretend that the illustrated versions that are currently in production don’t exist.) Still, even when pictures are added to the Harry Potter books, it will still be the words that are doing all the talking.

So that is why I have a problem with before and after photos when it comes to eating disorder recovery, not because I don’t like inspirational stories or don’t want people to celebrate their achievements, but because those pictures don’t really do anything but diminish and reduce the value and greatness of what has been achieved. As a snapshot ok, a picture may say a thousand words, but a recovery journey is made up of millions of them.

Take care everyone x

BeforeAndAfter

The Importance Of Seeing Food As Fuel When You Are In Recovery From An Eating Disorder

When I first thought about writing this post, as you can see from the title, I was intending to talk about why people with eating disorders need to see food as something to fuel them and keep them alive, yet now I have changed my mind (not that I am indecisive or anything…or am I…I’ll have to get back to you on that…). Ok this post is still going to be about the importance of seeing food as fuel, but actually I feel I should address why EVERYONE needs to start doing this, as it seems that in our society, whether you are mentally ill or not, food is primarily thought of in terms of what it will do to your weight.

For example, a few years ago during an inpatient admission, I was on bed rest which meant that, as you have probably guessed, I “rested” in a garage (only joking, it was in a bed. Just keeping you on your toes). Anyway, I was lying there and I was confused as to why I had to eat my meal plan when I wasn’t “doing anything” to burn it off. In my eyes, if I ate even a pea whilst lying down all day, I would gain weight because I wouldn’t have exercised enough to burn it off. I talked to one of the therapists about this and I remember her telling me that even if I wasn’t “doing anything”, I still needed to eat and still needed to have energy just for my body to work. Ok I may not be running around anywhere, but my body still needed the food so that all the bits inside could do their jobs and she drew out this chart as to how much food is actually needed just to sustain life without all the wandering in-between. I, by jumping from “eat X” to “gain weight from X”, had skipped a massive step and had imagined that whatever I ate would make me gain weight. Nevertheless, every time I was given a meal plan increase, my first thought was “that is going to make me gain weight”, without thinking of all the reasons and uses for food that come before the body even gets around to considering weight gain. Hearing that from someone with an eating disorder probably isn’t surprising, but at the same time the idea of food as a dictator of weight and nothing more is something that I see throughout society.

These days what you eat seems to be less about giving you energy to actually help keep your liver livering so that you can live your life and more about making choices based on what size jeans you want to fit into.
It is like those articles online or segments on daytime television, where they tell you what exercises you would have to do to burn off a certain food. I am pretty sure that a few years ago they were even considering adding that information to the wealth of nutritional guidelines scrawled across any packet of Hobnobs just so that people would know that if they ate one of the biscuits, they could easily burn it off with fourteen and a half press ups and a quick run through of the Macarena.
It just makes me wonder what on earth we think food is for if all we are doing is thinking about how it needs to be “burnt off”, skipping the state where we allow the body to actually use it, like I did all those years ago. Why do we need to be so obsessed with burning our food off? Know what happens if you “burn off” and “use up” every calorie by running on a treadmill? You win a prize? No. YOU DIE.

Think about the times when there is a cake in an office or people order desserts at a meal. Usually if someone turns down a piece, you can bet a good chunk of cheddar that their refusal will be something along the lines of “Oh no I can’t join in with that because it will go straight to my love handles”. It is rarely, if ever, someone will turn down food because they “don’t want it”, and is unfortunately usually down to this idea that whatever they eat will affect their weight which of course it won’t and that immediate connection is incredibly disordered.
The truth is, the primary purpose of food and indeed the necessity of food is to keep you alive and any other consequence is only a secondary consideration, yet it is the secondary consideration that people focus on all too much. Like I said when I began this post I intended to encourage people in recovery from their eating disorders to see meal plans as things that are there to keep them alive rather than seeing them as things that are going to cause them to gain weight. Ok weight gain may result if enough calories are consumed to allow that (weight gain that if you are on a re-feeding diet I highly expect is necessary), but that is not the first thing to happen. Indeed people with eating disorders, myself included, seem to focus so much on the effect of food on weight that they forget that it has any other purpose.
Years ago during another admission, I remember following my meal plan for months and eventually I did manage to gain enough weight to get me back in the healthy range and my first thought was “oh well I clearly don’t need to eat anymore because I don’t need to gain any more weight”. When the doctor told me to keep my meal plan the same I was confused as I had imagined he would say that I could stop eating now I had gained to the point where my body was healthy, what use did I have for food? What use did you have for food past Katie? Hmm let me think…TO KEEP YOU ALIVE BECAUSE THAT IS PRIMARILY WHAT FOOD IS FOR.

Food did not originate with the sole purpose of changing our bodies like those “eat me” cakes in Alice in Wonderland or that mushroom where if she eats from one side she gets tall and from the other side she gets small (I actually have a theory that all mushrooms have that power but because we tend to eat mushrooms whole aka we eat both sides, the magic of each side cancels the other out, thus we remain the same size…maybe don’t shout about that in public though…in my experience whenever I talk about magic mushrooms someone tends to call the police and I end up with a lot of explaining to do.)
No, unlike Alice’s wonderful mushrooms (or, if I am right, normal mushrooms), food is primarily there to keep the heart beating and that is it, yet like past Katie this seems to be something we have all forgotten.

Take the hellish old saying of “a moment on the lips, forever on the hips”. This makes it sound like the second you take a bite of a tasty salted french fry (after it has been dipped in ketchup of course), that french fry immediately sets off through your digestive system until it reaches the hip, at which point it will decide to set up camp and stay there as an extra piece of flesh. No. In reality, the first thing that french fry will do is go down your digestive system and start looking for things to do. Looks like the heart could use a little energy? Awesome, then the fry will head over there and give a few beats to keep the old ticker going. Kidney need a bit of help (or kidneys if you are one of those lucky devils who still has two), fine, that fry will head off to those kidneys and do a bit of filtering or whatever kidneys do. Without food those things don’t just keep happening! What do people think is keeping us alive if food is only there to dictate the width of our thighs? Do we think livers and kidneys run on fairy dust and pixie magic? HAS THE WORLD GONE MAD?

I just think that we all need to back up out of this disordered attitude of “things you would have to do to burn off a carrot stick” thing and be reminded that food is actually fuel that keeps you alive. If you are in recovery from an eating disorder, don’t get me wrong, I understand, and with every bite my head is focusing not on what that piece of food is going to do for my kidneys but what it is going to do to the number on the scales, but when those thoughts crop up remember that the whole weight gain aspect is a secondary thing and not the primary purpose of food as is made out in society. You do not need to be underweight to earn the right to eat cake on your birthday and you don’t suddenly stop requiring food the moment you are weight restored. No matter who you are or what your weight, you NEED fuel to survive like a car needs petrol. It doesn’t matter what colour the car is or what size the wheels, no matter what the physical composition of that car, it needs petrol to move just as you need food to breathe. YOU ARE THAT CAR. It doesn’t matter if you have small tyres, a huge engine, dodgy limp wing mirrors or a sizeable windscreen wiper, you need fuel to go, end of discussion.

Whether people have eating disorders or not though, collectively if I could do anything in this post it would be to urge people to see food less in the disordered “a moment on the lips forever on the hips” sense and in a way more akin to “a moment on the lips and then down to the aortic pump for a good few beats to keep me alive so that I can actually get on with my day and have a life”. Admittedly it isn’t as catchy, but trust me, it is far more scientifically accurate.

FoodIsFuel