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

The Difficulty Of Trusting Psychologists When You Have Mental Health Problems

Trigger warning: This post mentions the eating disorder behaviour of distorting your weight from professionals, so if that would trigger you then flee! Flee I say!

When I was younger, I was always taught not to trust someone who promises to give me sweets if I climb into the back of their van (unless of course those sweets involve any kind of combination of chocolate and peanut butter in which case who cares about potential kidnap, get in the damn van and don’t let those beauties drive away).
Unfortunately, somewhere in my brain as I have got older, “don’t trust strangers with sweets in a van” has morphed into “don’t trust psychologists” (regardless of whether or not they drive a van containing a portable candy heaven). Turns out however that when psychologists say they are going to do something and give you ultimatums, you should believe them.

Since coming out of hospital post “appendix explosion gate”, every week in my eating disorder appointments my psychologist has been telling me that I need to increase my intake in order to regain the weight I lost. To be fair, I have been trying, but a problem I have is that unless someone gives me specific deadlines for things I am scared to do, I will procrastinate until my arms fall off and tentacles grow in their place (not eight tentacles like an octopus though…that seems a little excessive…four is enough for me thanks.)

Every time my psychologist would tell me to increase I would hear her, try, but ultimately think “it is fine, she will just say the same next week and I will do it then”. Two Tuesdays ago though, my psychologist gave me a proper ultimatum with proper dates and deadlines by which I had to carry out her instructions. I was given one week to gain a certain amount of weight with the alternative being that I would be recalled back into hospital under the Mental Health Act. Seeing as how my brain works, you would think that this fairly clear statement would be easier to adhere to than the alternative casual “you need to eat more”, but still my head found ways to procrastinate, not because I wasn’t listening, but because I didn’t believe her. This was a mistake.

As much as I know I am mentally not very well at the moment in some aspects, physically I am finding it hard to see that there is a problem at all. Hearing threats and statements about my health that are designed to scare me, therefore make little sense. It is like telling someone over and over again that they are going to die of alcohol poisoning and that their liver is failing because of alcohol when they know that this can’t be the case because they haven’t touched a drop of liquor in their lives.

Back home I tried to increase but I was so scared of gaining weight that it didn’t go well, partly because I didn’t believe the “consequence” I was told about were I to fail to do so. Still, I didn’t want my psychologist to be disappointed or angry with me for failing her, so on the morning of weigh in I drank the weight I had needed to gain in water so that the scales would show the increase required and keep everyone happy. I hate “water-loading” before weigh in (aka the behaviour some people with eating disorders do whereby they drink a lot of water prior to weigh in to manipulate their weight on the scales and prevent therapists from knowing their true weight). It always freaks me out because even though I can know that I have just drunk water, whenever I see the number go up on the scales, my head will convince me that it is real weight and not just excess fluid swishing about in my bladder.

Thus I stepped on the scales prepared to be triggered, but somehow, it didn’t work, and I saw that I had not reached the goal set for me at all. Initially I didn’t really panic because I thought as always that my psychologist had been lying and that I could get out of it. I thought I could easily insist that I would just “meet the target” next week, but she hadn’t been lying and to my utter shock and horror, I couldn’t get out of it. What happened next? Well, considering I am writing this at a hospital desk in an inpatient eating disorder unit, I think you can guess. That’s right, that is the update this week, Born Without Marbles is back in the loony bin, and to be blunt, it sucks.

People keep saying things like “at least you know the place” and “you have done it before” but that doesn’t serve as much comfort because even though I know that, this time it feels different, so unnecessary and therefore scary. If you believe there is a physical problem it is easier to understand the need to take the medicine needed to cure it (in my case that medicine being “Food/general nosh”), but this all feels like one terrible mistake. I don’t need to be here and thus I do not need the medicine.

I am almost waiting for ward round on Tuesday where everyone discusses how things are going and for them all to turn around, apologise for the inconvenience and send me on my way.

The scales may say that I am under my CTO weight (a full explanation of the Mental Health Act and CTO’s can be found here: Demystifying The Mental Health Act…With Penguins, but basically a CTO is a legal document under which you are sectioned but allowed to live in the community as long as you adhere to certain conditions aka in my case, stay above a certain weight), but I don’t think I have actually lost any weight. I can read the scales and everything so I know that the number is lower but I am 100% sure that this is purely because I had my appendix removed and thus the weight of a whole organ has gone. If you chop someone’s arm off their weight is obviously going to go down but it doesn’t mean they have lost “weight” all over, it just means that there is some rude reckless person running around cutting people’s arms off.

I am so scared in here and I don’t know what to do. I am trying my very best to work with people and “listen to the professionals” but it is harder than I thought. Trusting them feels the same as trusting all those terrifying people with vans and sweets when I was a child (especially that particularly frightening lollipop obsessed child catcher in Chitty Chitty Bang Bang…seriously if you ever need to teach kids that “don’t get into vans with sweets lesson” just show them that film and you will be sorted…of course they will also learn that cars can fly and that dressing up as a Jack in the box will get you through security at a royal palace, but I think the worth of the sweets lesson trumps the potential misinformation spread by the latter).

So yeah…Mental health awareness lesson of the week: trusting professionals with medical degrees and things who should technically know more than you is hard when you have mental health problems. Very hard.

Other than that, I don’t really know what to say today. I just want to go home. I feel I should write an extra good, extra long blog today considering I am in hospital and certainly have free time to write but the words won’t come. Maybe I should offer them some sweets as encouragement.
I am also struggling to keep this update upbeat rather than explode all over you, so I think I will sign off for now and hope that I am a little bit more coherent in the next post. Sorry.

Take care everyone x

ChildCatcher

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!

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

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

Why Gyms Need To Be More Aware Of People With Eating Disorders

Recently, I have noticed that gyms have been popping up all over the place, and it is getting to the point where I would not be surprised if I went down to the bottom of my garden one day to find that a new branch had set one up in my shed between the empty plant pots and the lawn mower. Obviously I understand the benefits of the gym, getting a bit of exercise is important to keep healthy, and it is nice to have a place that allows you to look sweaty and tired whilst exercising without the potential judgement one would receive were you to start doing press ups in the cereal aisle at your local supermarket. The problem is that while gyms advocate health and fitness, there is often far too much emphasis on the idea that both are achieved by losing weight, which of course, it isn’t. For some people maybe, but the generalisation that weight loss will improve your health is a dangerous one, especially for people with eating disorders, and in my opinion it needs to be addressed by gyms immediately.

When I first joined my local gym I was 16 years old and in my preliminary session with a member of staff I stated that my goal was to lose weight. This member of staff then took my height, weight, and calculated my BMI to discover a number that I will not post specifically, but let’s just say it was towards the lower end of healthy. Despite this information, the personal trainer happily agreed to set me up with a meal plan and exercise regime to achieve my weight loss goals, without any debate or suggestion that my intention to “shed the pounds” was unnecessary and actually detrimental in terms of fitness.
A few months after that preliminary session, I was admitted to hospital on an eating disorders program where I stayed for ten months, gaining back all the weight I had lost on the treadmill.

The day I was healthy and had been discharged, I went back to the gym, not with the intention of losing this time, merely “toning” my new healthy body, but soon enough it became an obsession again and I was there all the time exercising until I was about to pass out. One morning I went to the gym at 6am, the moment they opened. By 9am I had been admitted to hospital again due to my eating disorder and exercise addiction, which combined had made me rather underweight and not “fit” in any sense of the word (unless your sense of the word fit is that it means “to be a weak, dizzy mess on the brink of collapse”, in which case I was REALLY fit). A mere three days before that day, I had been approached by a personal trainer who offered to work with me and help me to lose weight.
Annoyingly, this being a blog post constructed of words rather than expressions displayed on my spectacular visage, you can’t physically see me right now, but as you read that last sentence, please just picture me throwing my hands up in despair and shaking my head at the ridiculousness of that situation.

Now, I understand that personal responsibility for one’s self and one’s actions is important. After all, gyms cannot be asked to dictate the lives of their members, weigh them upon entry, demand they get off the treadmill if they didn’t finish their bran flakes that morning, and cook them a hearty balanced stew for dinner each night (although I would not be adverse to any of these ideas), but when an eating disorder really takes over someone’s mind, that person can have no control, be unable to take responsibility for their own safety, and need people to step in. In part, this is because they may not realise that they are even ill, denial and distorted perceptions being a massive issue in people with eating disorders. The other and in my opinion bigger issue that can result in a lack of control over one’s behaviour however, is the feeling of a lack of permission to look after oneself.

Every time I went to the gym I was terrified and certainly didn’t want to be there at all. I had been told multiple times by doctors, my eating disorder service, nurses in A&E, that I could have a heart attack at any moment, but not going simply wasn’t an option. My head told me I wasn’t allowed to make that decision.
If I pleaded with the eating disorder that I was scared and couldn’t go to the gym, it would scream so relentlessly that I felt I had no choice but to give in, and I would end up on that treadmill whether I wanted to be or not.
Furthermore, the fact that I was continually let into the gym despite being so underweight almost supported the voice of the eating disorder. I had doctors telling me I was physically unwell and looked awful, but when I went to the gym and started rowing on one of those damn machines that is nothing like a real boat experience whatsoever (6 years at that gym and I didn’t see a single duckling), nobody batted an eyelid, so I assumed the doctors were lying and that I must look fine. If I was clearly “so underweight”, then why on earth would a gym let me in and offer me a personal trainer to lose more flab than I had already? Surely this meant they thought I was overweight too? Not saying anything to people who are clearly unwell is one thing, but asking if they want help in making themselves even more unwell in the interest of “fitness” just to make money is a whole new kettle of fish, a very dangerous hot kettle with sharks in it who are able to withstand shockingly high temperatures.
What’s worse is that my experience is by no means unusual or a sign that I clearly had a bad gym, as it is something that happens to loads of people in loads of gyms all across the country.

Now again, I am not asking gyms to approach skinny people in the gym, catch them with a giant net and fling them violently out of the window. Such a code of practice would be futile due to the important fact I have stated in previous posts, that not everyone who is skinny has an eating disorder and not everyone with an eating disorder is skinny. Indeed, someone could be severely unwell, on the brink of death or a heart attack and look a healthy weight or overweight. What I am asking for, is personal trainers and other staff to be made more aware of people with eating disorders, and how to support or help them when they are in a destructive relationship with the gym. They need to be able to spot various symptoms or unusual behaviours, be trained to have a grasp of eating disorders and exercise addictions, or be aware of someone’s motivations in losing weight if there are signs of any underhand eating disorder suspiciousness going on.
At the very least, if they measure someone and know someone is already a healthy weight or underweight, they shouldn’t give them a weight loss meal plan or ask if they want to pay you to help them shed the non existent rolls of fat they are complaining about just to make some cash in the name of “fitness”. When someone has an eating disorder, such suggestions are more like offers to assist in suicide for the price of £20 an hour. BARGAIN.

I know that it is a massive pain to say gyms have to spend extra money on funding training, especially when it may be that such training may be irrelevant for the majority of the time when it comes to healthy members.
Nevertheless, I would still say that it is less of a pain to be aware of sufferers and deal with them whilst having slightly lower profits, than to have to deal with a law suit and a hell of a lot of guilt when someone who clearly shouldn’t be exercising dies on one of the treadmills. I may not be a personal trainer, but that certainly doesn’t sound like fitness to me.

Treadmill

Why it is physically impossible to “look anorexic”.

A few weeks ago, the woman whose womb I once inhabited for 9 months (otherwise known as my mother), was chatting to a fellow human, and during the conversation my mother mentioned the fact that her offspring, aka me, has anorexia. The first response to be uttered (after the obligatory “Oh dear that is sad”), was the question “what size is she?”.

Has a more irrelevant question ever been asked? The answer is no. It is a question equivalent to asking someone with a broken leg “what colour is your cast?”, as if that will tell you about whatever funny business the bones are doing inside. Honestly I do not know what size I was before I heard of this incident, but right now I can assure you I am well and truly FURIOUS sized (like fun size chocolate bars only less fun, more rage.)
Unfortunately, this ridiculousness is a common response or question when someone hears that another person has an eating disorder, so I want to clarify one vital piece of information that everyone needs to know:

The weight or size of a person will never tell you how ill or how well someone is with an eating disorder.

Eating disorders (though obviously having implications in the “real world” in terms of behaviour around food/affect on physical composition of the body), are mental illnesses, the severity of which will never be judged by a number on the scales or a size on a pair of jeans. People with eating disorders can be underweight, a healthy weight or they can be overweight, but no matter what size, you will not be able to tell from their appearance what is going on inside their heads. Not only can you not tell the mental strain from appearance, you cannot tell the physical strain and the effect the illness is having on the body either. People with eating disorders die with bones popping out all over the place at a BMI of 2, but they also die whilst looking healthy or overweight because the physical complications caused by these illnesses are so much deeper and more complex than “weight loss”. Heart attacks caused by the body eating heart muscle for energy, electrolyte imbalances caused by purging and insufficient nutrition, and multiple organ failure caused by the general strain of eating disorders on the body are but three of the many ways people lose their lives in the fight and all of these things are invisible on surface level.

It isn’t even as if this misconception that eating disorders can be seen benefits anyone, as it is a dangerous belief for all involved. Sufferers may feel they aren’t really ill because they don’t look like the stereotypical skeletal pictures of people with eating disorders in the media, parents may not take their child’s issues to food seriously because they “look alright”, and medical professionals might deny input or treatment because the weight of the patient isn’t “too low” so they “can’t be that bad”. It is also an idea that even damages people who are trying to recover from an eating disorder, as sometimes help is withdrawn once weight is no longer “low” which is exactly the time that people need to be supported most.

Many people have even been refused treatment at all until the number on the scales is seen as corresponding to being “anorexic”, and until May 2013, there was actually a BMI criteria that had to be met in order to officially be diagnosed. Thankfully, the new DSM (basically a massive book that gives the lists of symptoms one needs to be diagnosed with any mental disorder) has revised this issue and anorexia can now be diagnosed in people of any weight, but despite this, the misconception still remains. It isn’t exactly unusual to hear the word “anorexic” used as an adjective to describe someone’s frail appearance, a casual turn of phase that further perpetuates the issue. Unless you have insanely magical x-ray vision and can see the thoughts and fears someone is harbouring about food (and if you do have such vision please go to a doctor as you are a medical marvel and could potentially help a lot of people with unseen medical conditions…or find buried treasure…but more importantly help people), you will never see a person “looking anorexic”.

The myth that eating disorders can be seen or measured is a dangerous, stigma inducing and potentially fatal story that needs to stop being told. If you really like myths, maybe give Theseus and the minotaur a go (it’s actually rather good, there is a maze with string, monsters and everything), but whatever you do please don’t believe the one I have attempted to debunk in this post.

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