Eat

Stigma: Anorexia Vs Bulimia and Binge Eating Disorder

/ bornwithoutmarbles / 12 Comments

Every mental health problem has a troubling mist of stigma surrounding it, but recently I have noticed that not all stigmas are created equally, and often the level of judgement varies depending on what condition that judgment is focused on. 

It isn’t even as simple to organise as “personality disorders get this level of stigma and mood disorders get this level”, because the amount of stigma can vary even between conditions of the same category, especially, I have noticed, when it comes to eating disorders, more specifically, anorexia, bulimia and binge eating disorders. 

I am sure there are exceptions out there but as a broad overall in my experience, I have found that the stigma surrounding bulimia and binge eating disorder (henceforth referenced by its acronym BED), is a lot worse than that existing around anorexia, and considering they are both so similar in being considered under the umbrella category of eating disorders, it makes me wonder why that is. 

I hate to say it but the level of judgement isn’t even exclusive to people who don’t know anything about mental health, and I have found it is incredibly prominent in the world of eating disorder sufferers themselves. 

For example, over the years in various groups and hospitals, I’ve met a lot of people with anorexia and I have found that many of those people actually had the fear of becoming bulimic or having BED as one of their reasons to fear recovery from their anorexia. I even remember one particular incident in treatment where a new patient asked another patient if their eating disorder was bulimia and the insinuation that that could be the case was taken as extremely offensive. Obviously it isn’t exactly polite to go wandering around introducing yourself by asking people intrusive questions about their mental health, but that wasn’t the part of the question that was taken as offensive, it was the bulimia part, and I know for a fact that had the question been “do you have anorexia?” the reaction would have been more “yes I do but blimey that is a bit outright as a question, we haven’t even had a cup of tea together yet” rather than “how very dare you accuse me of such a thing”.

I suppose in life it is common to fear the unknown, so it is more likely you will fear something that you haven’t experienced as opposed to something you live with everyday. 

For example I used to be terrified of blood tests but now I have them every few weeks and am not scared of them at all. Indeed I am quite the professional and can now have blood taken whilst remaining perfectly relaxed and without so much as a shudder (as long as that blood is being taken by a professional using one of those syringe things…I don’t mean I am cool with having people stop me in the street and attack me with a chainsaw…I imagine that would result in quite a lot of shuddering so please do not do that to test my statement because I will certainly shudder and you will certainly get arrested).  

Still, as much as that would make sense for people who don’t already have eating disorders, it seems a bit odd for someone who is familiar with the life of living with an eating disorder that is trying to kill you, being so scared of basically an eating disorder trying to kill you with a different name. It’s a bit like the experience of having a tabby cat, living with a tabby cat, yet still fearing ginger cats when really it is the exact same thing only with a slightly more tangerine-esque glow. 

I actually don’t think the fear of the unknown is really a part of the increased stigma around bulimia or BED versus anorexia at all though, rather I think it has to do with the fact that so many traits and behaviours that are associated with anorexia are praised in society.

Despite the fact that not all people with anorexia are underweight and, contrary to popular belief, people with anorexia DO eat, as a general consensus, people associate being anorexic with losing weight, being thin and never letting a morsel pass your lips, three things that are seen as good by most people. 

Think about it, when it comes to all of those diet clubs out there like Slimming World and Weight Watchers, you get things like certificates and “I lost half a stone” keyring prizes for losing weight and I am pretty sure they only hand out certificates in life for things that you are supposed to be proud of. When I was learning to swim as a child at least, they certainly didn’t hand out prizes for the person who was drowning in the bottom of the pool (which is understandable as that is not exactly the aim of a swimming lesson but still a bit sad as it is the person who was drowning at the bottom of the pool who could use a bit of cheering up with a certificate, as opposed to the person who managed to swim a perfect ten lengths of front crawl…what do they need cheering up for? Isn’t it enough not to have water up your nose? Kids today are so ungrateful!). 

Similarly, as I have mentioned before, in society we have this weird obsession with associating refusing a piece of cake at a birthday party as “being good”, while those of us with icing on our chins are doing something “naughty”, so the idea that anorexic people don’t eat unhealthy foods is similarly admired, rather than feared as a sign that someone is potentially starving themselves to death. 

Anorexia is often seen as a sign of strong self control, whereas bulimia and BED on the other hand is associated with things like a lack of control and even more infuriatingly, greed/gluttony. These two things are so opposite to being admired that they are two of the seven deadly sins for goodness sake, and it drives me up the wall, back down round Tottenham and up the wall all over again because neither bulimia nor BED are anything to do with greed or gluttony. I am seriously considering getting that as a bumper sticker so that at least whilst I am doing all this being driven mad I am educating people along the way, although I would really rather not drive at all because I do not have a license and petrol is incredibly expensive. 

If a person with bulimia or BED goes around a supermarket and buys a lot of unhealthy food to binge on or eats excessive amounts to the point that they are compelled to purge (or not), it is not out of personal want or greed, it is because they have an eating disorder in their head that drives and compels them to do so. It is not the person with the disorder in control thinking “ah this will be a lovely way to spend an evening, I thoroughly enjoy a few hours weeping into a toilet with a throat as raw as sandpaper”, it is the disorder that is at the steering wheel, and when people are attempting recovery it is more about learning to steal that control back from the disorder rather than trying to control their personal desires. 

Similarly, anorexia is nothing about self control and I would even argue shows an extreme lack of control. You can praise people for not dunking a hob nob in their morning cuppa all you like, but how in the hell is it a sign of good self control to be incapable of eating and starving yourself to death? Who would give a certificate out for that? (I realise this may sound hypocritical considering I was arguing that we should give prizes to people drowning in a swimming pool five minutes ago but let’s just set that example aside for the time being…). Much like the person with bulimia, when I struggle to eat I do not feel in control of the situation and I do not look forward to an evening crying over a bowl of cereal, excitedly clapping my hands at the prospect of a few hours staring at a Weetabix. 

Bulimia, BED and anorexia then are, despite the varying stigma, very much the same and very similar in that they are about wrestling with a deadly eating disorder. That’s it. It doesn’t matter that two of the disorders are known for expressing themselves via binging and possibly purging, whereas the other has its name up there as a sign of a lot of lettuce and weight loss. Aside from the treatment required, the expression of the disorder has nothing to do with it just as the colour of a ginger cat means nothing next to the tabby, THEY ARE BOTH JUST CATS AND BULIMIA/BED/ANOREXIA ARE ALL EATING DISORDERS. Both bulimia and BED are as much about greed as anorexia is about self control, aka they have nothing to do with it, and I really think we need to spread that message to stop the level of shame surrounding such disorders. 

Admitting you have an eating disorder is hard and embarrassing, but it is even harder and even more embarrassing when you have extra stigma piled on top just because of the name of your condition. If bulimia and BED are portrayed as about greed and shame, people are far less likely to admit to having a problem and seek help which is incredibly dangerous as both disorders are serious, they are deadly and can be fatal with complications caused by things like electrolyte imbalances, heart attacks and other consequences of recurrent purging, so seeking support for these conditions is as important as seeking help for any restrictive disorders. We need to stop the judgement and discrepancies between different names for eating disorders and need to see them back under the same deadly umbrella, they are ALL serious, ALL dangerous, and ALL are worthy of the help and support needed to get better. 

Take care everyone x 

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What Do People With Anorexia Eat?

/ bornwithoutmarbles / 7 Comments

Over a year ago I wrote a post about how people with eating disorders were misrepresented in the media via their use of skeletal pictures when interviewing or discussing someone with the disorders, yet lately I have noticed there is another stereotypical image being promoted that drives me equally round the bend, that being the idea that people with anorexia do not eat anything at all, and it is this myth I really want to tackle in this post as it is simply not true and is unhelpful to everyone.

You see when you come across articles in the paper interviewing someone with an eating disorder, they always make it sound as if the person has gone years without ever letting a morsel of food pass their lips. 

I am often reading pieces stating that someone lived on half a cornflake for three years or something ridiculous, a statement that is physically impossible and that must be taken with a pinch of salt as everyone knows journalists will often exaggerate or make things sound worse by picking and choosing details from an interview to make a good story. If an article makes it sounds like someone interviewed supposedly hasn’t eaten more than half a cornflake for three years, it is most definitely false and cannot be taken as a fact in general or by which other sufferers can be measured. 

Admittedly, people with anorexia frequently do not eat enough, it is after all one of the symptoms, the classic restricting of calories to lose or prevent weight gain. Indeed people with anorexia often eat very little, nowhere near as much as they need to keep themselves alive, but that still doesn’t mean they don’t eat anything at all and spend years living on air. In addition to those in relapse  who still eat at least something (regardless as to whether it be enough or not), when people are in recovery and on a weight gain meal plan they may actually eat more than some “normal” people. I know I have certainly followed meal plans that exceed the “government guidelines” irrelevant calorie limit, which have been prescribed to me both in and out of hospital. People in relapse and recovery are still considered as having “anorexia” if their mental state dictates that diagnosis, no matter how much they eat, and they should all be counted and taken seriously as a voice for people with eating disorders without being discriminated against for (brace yourselves)…having breakfast. What about the people who have severe anorexia but eat to keep their families off their back or to maintain a job? The ones who eat purely to stay out of hospital or the ones who are trying their best to eat to get better yet are still in as much mental pain as anyone else and hating every second? The ones who want to scream and shout every time they eat but force themselves on anyway because they don’t want their kids to see them worrying about food in fear that they may also pick up on the anxiety? That image, of people with anorexia eating, is never represented in the media, as equally valid or not it isn’t a dramatic image that would sell a story in a magazine. After all, headlines of “anorexic eats an appropriate number of calories, not because they are better but because they don’t want to scare the children” are never going to sell or create as much drama as “anorexic eats nothing and only licks a blade of grass once a month for 10 years”.

I am pretty sure that every member of my family is aware that I have anorexia and in a way I find this helpful. With them knowing, it means I don’t have to lie all the time, if I disappear for a few months to go into hospital it isn’t a big secret and I don’t have to pretend I have been off travelling, climbing Kilimanjaro or building schools for orphaned penguins in the Arctic, but in a way it actually makes things harder because I feel there is an expectation of the way I should behave at family gatherings. I am currently unable to eat outside of my house or with family anyway, but even if I were able to I would find attempting it incredibly intimidating as I imagine if I were to eat anything, people would be confused. If a person without an eating disorder goes out for a meal and eats, nobody raises an eyebrow, but if someone who is known to have an eating disorder goes out for a meal, when they eat people start to question whether there is anything actually wrong with that person in the first place. If you hear someone has to go into hospital for a new leg and then you see them prior to admission dancing the tango pretty happily using their old one, you might wonder why on earth the new leg is needed as clearly there is no problem. The issue is of course that though someone may appear to be eating happily on the surface, they could still be going through mental torture inside and may be just trying not to make a fuss and embarrass themselves or draw attention.

The dangers of this misconception that “anorexics don’t eat” are very similar to the ones created by the idea that people with anorexia are underweight. Again, family members or professionals may not be concerned about someone they suspected may have an eating disorder because the person often sits down for a family meal. Sufferers also might find themselves in situations where they don’t eat, not because of their disorder in particular, but because they feel they can’t incase people suspect that they are faking the whole thing. Much like images of skeletal bodies, people hearing the myth that people with anorexia don’t eat can cause people to think that they are not “that bad”, “not ill enough to warrant help” or even worse it can trigger them to restrict their intake further because they think there is some “anorexic standard” they have to live up to. You cannot compare the severity of a person’s illness with that of someone else’s just by looking at what they look like or how much they eat without having any idea of what is going on inside their heads. 

Overall I guess the message of this post is that when it comes to the portrayal of people with eating disorders in the media, take all the pictures and interviews as pieces of journalism to sell a paper with the nuggets of truth inside partially skewed or not representative of eating disorder patients as a whole. Making judgements based on accounts that are for the purpose of selling papers rather than truly giving a voice to people with no ulterior motive is never going to provide an unbiased piece that one can make conclusions from. Basically what I want to say is do not trust the media at all, instead you should trust strangers on the internet like me…actually don’t trust strangers on the internet…that isn’t the message I want to promote at all…. just don’t think that people with anorexia don’t eat. 

Take care everyone x

Sandwich

Why Boundaries Are Important When Living With Mental Health Problems

/ bornwithoutmarbles / 11 Comments

A few weeks ago when I was talking about the fact that I am getting discharged from an inpatient setting on the 20th of February/tomorrow if you are reading this on the day of upload, (handy link to that blog post here: The Pressure To “Get Better” When You Are Struggling With Mental Health Problems), I mentioned that there were going to be a lot of rules and boundaries in place regarding my mental illness that I would have to follow back home.
Seeing as these boundaries were set by my parents you might think I live in a particularly strict household with rules and regulations more often seen in a school rather than a home setting, but actually, I am starting to think that when you are living with mental health problems, it is vital for everyone to set some boundaries.

Thing is, when you have a mental illness bobbing along with you through life, you can guarantee that it is going to do all it can to interfere with any plans you had prepared. Thought you were going out for a night with friends? Surprise! Depression has crossed that out of the calendar and scheduled you in for a good old evening of crying into a pillow and thinking about what a terrible person you are. Decided to spend several hours working on that novel and actually being productive with your life? Nope! Instead OCD would like you to waste those hours antibacterialising various objects in the house that were already clean to begin with. No matter what illness you have, it is obviously going to impact your daily routine, and if left with total freedom, it is likely that it will impact your daily routine more and more as time goes on until you find yourself looking back and wondering how on earth things managed to get so out of control. Now when you are in an inpatient setting this aspect of mental health problems is managed somewhat by the rigid structure of your day to day life on the ward, but on the outside it is a hell of a lot easier to get carried away with your own rigid routines.

The reason for this is that I have started to realise that mental illnesses are much like dinosaurs, and living with them is analogous to being that professor that Richard Attenborough plays in Jurassic Park and it is that analogy (to be fair it has been a while since we settled in for a good old traditional Born without Marbles analogy) that I want to talk about today.

Maybe some of you out there haven’t actually seen Jurassic Park (and if you haven’t you really should, it is fabulous), but basically in Jurassic Park there is this guy called Professor Hammond (that’s the person with mental health problems in this analogy), and he owns this safari park of dinosaurs he created out of some blood that has been hiding inside of a mosquito for several thousand years (in the analogy the park is your brain and the dinosaurs are your mental illnesses, except obviously in the mental health version you did not create your dinosaurs/illnesses, rather they appeared one day and as a result you found yourself as keeper of this prehistoric zoo of insanity).

Having the dinosaurs there is obviously dangerous, so Professor Hammond does all he can to keep that danger to a minimum. In order to keep the visitors safe, he has a whole team of keepers helping him to keep an eye on his dinosaurs (aka psychologists and other mental health professionals), and there are physical boundaries/electrified fences set up all over the island around the dinosaurs to keep them in check. They are still dangerous dinosaurs, but when confined by their boundaries, their level of threat is somewhat controlled.

However in the film, before long, this idiotic man with absolutely no common sense turns off all the electric fences and cages that were housing the dinosaurs, and utter chaos ensues.
Without the fences, the dinosaurs do not remain in their neat little pens, they run amok and cause a hell of a lot of destruction and noise when doing so. That image (aka that of dinosaurs running madly all over the place eating people and crashing into everything), pretty much illustrates the importance of boundaries when living with mental health problems and why I have so many regulations in coming home.

For example, whilst I have been in hospital at my local eating disorder unit, there have been very definite rules set out to govern my behaviour. These rules are numerous and I cannot list them all for fear of boring you all to floods of uncontrollable tears, but as an example they have been things like the fact that if I do not eat my meal, there will be a replacement issued which if not completed will lead to consequences in ward round, or the rule that meal times take place at set points throughout the day with no option to delay that peanut butter sandwich for another five minutes. Meal times are meal times, you eat your meals in meal times, end of discussion.

Similarly there are rules to govern my OCD such as time limits for showers because without this kind of rule, my OCD tends to grab hold of all control over how long I take to shower and run with it a lot faster than I can chase after it (I was never one for athletics in school.)
When I have a time limit however, I have something to aim for, and though my OCD will still be present in my behaviours for the duration of the shower, it is my attempt at controlling it as best I can. If in hospital I weren’t to shower within the allocated time, I would be removed from the shower, so I sort of had to reason with my little OCD dinosaur to get through it. My dinosaur wanted to spend the next three years washing yet the rules meant this was impossible, so we had to work together and compromise. I would shower and do all the rituals I was told to, but only for a certain length of time. Having a time limit obviously didn’t always work and there are times where I still couldn’t stick to it, but like I said, it gave something to aim for and consequently I will still have that shower time limit now that I am heading back home again. Again it is unlikely that I will always be able to keep myself in check, but I know that without any rules in the shower things would be a lot worse than they often are and if I didn’t have a boundary set in place, then I doubt I would ever be able to get out of the shower at all.
I can of course tell my OCD that I have finished washing but OCD will always come back with “just another five minutes”, a request that, when given into, will be repeated every five minutes leaving me stuck in a ritual with no way out. With my rule, I at least have an argument against that. In the shower the OCD still dictates behaviours, but when it is time to leave the shower, I at least have the statement of “time is up and we must leave now to avoid consequences” to come back at any “five more minute” suggestions that should arise.

If you are living with mental health problems then, it is important to have your own rules in place to try and keep track of the interference it causes. You can’t control whether or not you have a disorder, but there are some things you do have control of that can help lessen the impact. Say you have an eating disorder and, as I will be attempting when I get home, you are trying to give yourself enough nutrition.
If you say to your eating disorder “I am going to eat better today”, then it is unlikely that you will achieve much, as “better” is a negotiable, subjective term that you will find yourself debating. Instead, hard and fast rules like “I am going to eat three meals and three snacks today” are more likely to merit results. They won’t necessarily mean you achieve what you want, yet again, like the shower time limit, it gives you something to aim for rather than a wishy washy “I will eat something” or “I will shower quicker” which without specifics don’t really mean anything and give too much control to your illness. I know that especially with eating disorders, giving into little things are a sure fire way of letting them spiral completely.
Whenever I have a bowl of cereal for example, I weigh out exactly the same number of grams each day without question. This is disordered of course, and one day I would like to pour cereal with all the gay abandon of a cereal pouring professional, but I know that if I don’t have a weight from my dietician to stick to, aka a boundary, then my portions will just get smaller and smaller. My eating disorder won’t ask for anything dramatic at first, just little requests like “just one flake less today” or “one gram less”, which doesn’t sound much but if you keep listening to that you will end up a few weeks down the line staring at a solitary rice crispy in the bottom of a bowl wondering where all the others went (and possibly hearing a very quiet pitiful sobbing from the rice crispy as they are very social creatures who, when portioned out individually, often get rather lonely. Rice has feelings too kids.)

You don’t have to make loads of rules and they can be small rules to start off, but no matter what the size it is vital that the rules are there. If you have depression, that sucks and you cannot control the effect depression will have on your mood. What you can control however, is things like taking any medication you have been prescribed or attending any appointments to try and keep it in check. If you have an eating disorder and a meal plan you have been told to stick to, make that meal plan your rule, your boundary that cannot be negotiated. Ok the eating disorder will still be there screaming and it may interfere with your behaviours, but having that meal plan there is a non negotiable that is not up for debate. With OCD rituals put time limits on how long they can take so that a quick five minute tidy doesn’t descend into a five hour mass organisation mission or at least put a limit in place as to how many times you are allowed to do something simply to give you something to aim for.
Like I said, this is not going to cure you of any mental health problems nor is it going to stop them interfering/being dangerous beasts much like the dinosaurs in Jurassic Park. In or out of a cage, a T-rex is a T-rex (unless it is a bunny in disguise), and you cannot control the existence of that T-rex or its nature/behaviour as a stomping, roaring, chomping scaly thing. What you can do however, is put boundaries in place to try and limit the destruction that dinosaur can cause, to do the best you can to take control of something that otherwise will take lack of rules as a chance to run amok to see what it can get away with, and that is why, as I go home tomorrow, I go with a set of rules and boundaries in place.

Coincidentally, that is also why mental health problems are like dinosaurs and why it is vital to have boundaries when living with them in your head/prehistoric safari park. Rules may be broken, but having certain rules in place at home does often help me to manage typically unmanageable situations a little better. If you have been in hospital, take hospital rules back home when you are discharged so that the illness doesn’t have the total freedom to reinvade, and if you haven’t been in hospital then maybe come up with some rules with friends and family who are willing to support you in your battle for sanity. Remember, a dinosaur is always going to be a wild destructive interference, but with boundaries, that destruction can at least be controlled as much as possible…I hope…

Take care everyone x

BoundariesDinosaur

The Difficulty Of Eating In Public When You Have An Eating Disorder

/ bornwithoutmarbles / 8 Comments

To the average person the idea of going out to eat is a pleasant one, and when someone suggests going out for a coffee and a piece of cake in a local cafe or out to dinner at a fancy Italian restaurant, the usual reaction would be “Why yes what a lovely idea”, or “of course! I think I shall order the lasagne”.
To someone with an eating disorder however, it is likely that the idea of eating food out will be a terrifying one, reserved to the realms of nightmares rather than sweet dreams, and if you are anything like me when it comes to life with my eating disorder, it is likely you would rather dance a tango with a giant hairy spider than go out to “grab a bite to eat”. It is for this very reason that when I was in ward round this week and I was told that I had to go out to a local coffee shop for a snack with a member of staff, I started to wish there was a chance to whip out my dancing shoes and go to a ballroom with an enormous arachnid instead.

It is silly really because like I said, as a rule people generally enjoy going out for food (even if, like my mum, that is simply because you don’t have to wash up at the end of the meal), but for me there are so many things to be scared of and I don’t think people realise just how many things there are to worry about when it comes to going out for something to eat when you have an eating disorder rampaging in your frontal lobes.

First off there is the difficult task of looking at a menu and choosing what you are going to eat. Alright you may have to make some food choices in the home or out at the supermarket, so choosing food shouldn’t be a sudden and new experience, but at least with that kind of thing you can plan far in advance and prepare what you are having yourself so you know exactly what the meal comprises of. When you are eating out however, the ability to plan everything and control each stage of the process is whipped out from under you quicker than a slippery yoga mat on a vaseline coated floor. Ok, nowadays most restaurants and cafes tend to have menus online so in a sense you can prepare for what you are going to attempt and do not have to make a choice on the spot, but even if you make a choice from an online menu you can never guarantee that what you decide on will be available in the branch of the restaurant that you visit in particular. What if you have your heart set on the roasted aubergine spaghetti and then get to the table only to be confronted by a waiter breaking the news to you that they are all out of pasta and severely lacking in terms of aubergine supplies? What if you get your head all psyched up to tackle a chocolate muffin with multicoloured sugar strands and then find that the muffin man got caught in a traffic jam on the way to deliver his cocoa rich rainbow sprinkled delights? HOW CAN ONE RELAX AND MAKE A DECISION WHEN THE WHEREABOUTS OF THE MUFFIN MAN AND AUBERGINES ARE ALL UNKNOWN?

Then again, what if the aubergine harvest has been plentiful and the chef can prepare your chosen dish? How are they going to prepare it? How much pasta will they use? Will there be oil? Will there be butter? How will it be arranged? Will the sauce be served on top of or mixed into the spaghetti? Exactly what kind of concoction should you expect? Also what if you can’t even get that far and can’t make a decision as to what to have in the first place, either because there are too many options or not enough safe ones? When it comes to people going to restaurants a little bird told me (a very little bird. about half the size of Tweety Pie to be exact) that people chose what they “fancy,” but again when you have an eating disorder and find most of your decisions controlled by calories and grams of fat, what exactly does it mean to “fancy” something?

Even when food is chosen and aubergines can be found in abundance, the worries don’t end because then you have what I would say is the hardest thing about going out for food and the thing that I worried about most after this news about a snack out had been broken to me: eating in public. Indeed the choosing from a menu worry wasn’t even what made me anxious about the excursion as when I went out for snack with my nurse I actually took the food with me to the coffee shop from the hospital (not that that is technically allowed in terms of coffee shop table taking up without making a purchase regulations, but when you are terrified and have an eating disorder you don’t give a damn about the rules!), so it wasn’t the menu issue but the eating in public part that was troubling me.

Truth is, when I eat I prefer to do it in private because even though I am well aware that other people have too many things on their minds and in their lives to have space to think about what is on my plate, I am always paranoid that everyone around is looking and judging me for every mouthful that I consume. Why do I care what random strangers have to say about my choice of snack of an afternoon? I have no idea. Why do I think that a business woman on her lunch break or a student cramming for an exam over an espresso and a laptop, care about whether or not I eat a hobnob? Who knows, but regardless of the reason, I do care and I care a lot. For other people I do not see the act of eating as something to be ashamed of at all but when it comes to me there is something so guilt and shame filled about it that the idea of eating in public is sort of how I imagine the idea of showering in public would feel to most people, aka self conscious and like you want to throw a sponge and curl up in a ball so nobody can see you.

No matter what you do or what you eat, it feels like everyone is staring at and judging you, even if you can see for a fact that others around you may even be eating more than what you have on your plate and are not actually looking anywhere near your direction. When I was out for snack there were plenty of people busy reading papers over plates far fuller than mine, yet still I thought that they were somehow looking at me with some kind of laser vision and thinking that I was greedy for attempting what I had before me. It was so bad that just to get through the snack I had to close my eyes and play that childhood game where you imagine that because you can’t see other people ,they can’t see you either (side note: it is surprisingly hard to eat a snack when you can’t actually see it…).
Somehow I got through it using my head down, eyes closed, just keep munching method but still it was a horrendous experience and one that I am not planning to repeat in the near future or ever if I can help it.

Overall then, though it would seem that the idea of eating out in public, either for a snack or a meal, is some kind of treat to be looked forward to, when you have an eating disorder, it really isn’t that simple a task nor is it a particularly enjoyable one either. Like I said, I know I for one am not going to be attempting such a thing again voluntarily simply because even without the ordering stress and malarky it is the actual act of eating in public and being judged (however irrational that thought may be), that causes all of the anxiety. A snack out in a coffee shop may be a piece of cake physically, but in practice I can assure you that it certainly isn’t! PLEASE DON’T EVER MAKE ME DO IT AGAIN!

Take care everyone x

EatingPublic

5 Ways To Deal With Weight Gain When You Are In Recovery From An Eating Disorder

/ bornwithoutmarbles / 14 Comments

If I had a penguin for every time I have heard someone say or have said myself “I want to recover from anorexia but I don’t want to gain weight”, I would have more penguins than exist on this planet and would therefore have to get the existing penguins to rapidly reproduce in order to make up numbers (which is why all the penguins of the world are probably grateful to hear that I don’t have to have a penguin for every time I have heard that sentence or else they would have a lot of egg hatching to do).
Admittedly, there are many sides to the Rubix cube confusing madness that is recovery from anorexia, both mental and physical, and there are a lot of fears revolving around all of them, but I think when it comes to recovery, probably one of the top three things most people worry about is the weight gain side of it all. Personally at least, I know that the fear of weight gain is certainly a big thing for me and is particularly relevant right now as in my current admission to hospital it is the forced and rapid weight gain that has ended up distressing me most of all to the point that I haven’t even been able to focus on any of the more long term mental health sides of the illness as I am too focused on the scales.
I know that to other people, my weight does not define me as a person and that the number that flashes up when I step on a little machine should not dictate the way I live my life but when you have an eating disorder, those thoughts are often automatic and knowing they are irrational doesn’t take them away.

Unfortunately, despite the fact that the weight gain side is incredibly hard, if you really want to recover from your eating disorder, the fear of weight gain is an unavoidable thing that will need to be tackled and that, if neglected, will never truly allow you to get back to a healthy mind and body again.
So how do you manage it? If you want to recover from your eating disorder (or even if you don’t and are in forced treatment at the moment…ahem), how are you supposed to deal with one of the most frightening challenges to face someone struggling with anorexia: weight gain. Well, if that question has been on your mind at all then welcome to a blog post containing some possible answers, because today I am here (wearing a bow tie no less because I am fancy and have dressed smartly for you on this occasion), with 5 thoughts to help you deal with weight gain when you are in recovery from anorexia. So without further ado, lets get into it *straightens bow tie and gets down to serious business*…

1. Weight redistributes – When you start the re-feeding process after depriving yourself of adequate nutrition for a long period of time, your body will have no idea what the hell is going on or what the hell to do (something I explain a little more in this post here: Five Things You Need To know About Re-feeding During Eating Disorder Recovery). Because of this confusion and deprivation, when your body first starts gaining weight, it will want to prioritise on life saving things first (handy that) and for this reason a lot of people find that weight gain in the early days primarily goes to the tummy area so that the body can focus on repairing things like a dodgy liver or an out of whack kidney. This has happened to me multiple times (including right now) and understandably it can be quite distressing as your body can start feeling out of proportion, but what I want to emphasise with this point is that even though weight may initially go to life saving organ places, it WILL redistribute and spread out eventually as long as you hang in there and give it time. Restricting your intake to lose the weight again will only make this process more dramatic, so the key is to stick with it and always remember that redistribution will happen!

2. You are gaining weight you shouldn’t have lost in the first place – Whenever you see or hear an advert for a weight loss diet club, the people will emphasise how good it is to have lost the weight they did with whatever weird low carb eat upside down with a pineapple up your nose (difficult task, would not recommend) diet they have been following and therefore the idea of gaining any weight back is automatically “bad”. Culturally this has then created this false idea that the act of gaining weight is a bad thing in itself however this is not always the case, especially when it comes to recovery. Thing is, when you are regaining weight you have lost through an eating disorder, you are actually not gaining weight but are regaining parts of your body that you should not have lost in the first place, so whenever you see that number go up on the scale remember, it is not weight gain in the negative way that the diet clubs claim it to be, it is just re-finding a little puzzle piece of the wonderful you that may have been lost to this terrible illness.

3. The alternative is worse – I will hold my hands up and admit it: weight gain is scary. Then again, if you think about it, isn’t the alternative, aka death (for anorexia is the mental illness with the highest mortality rate of all), even scarier? “I am not that bad” I hear you cry, “I am not going to die of anorexia”, but hey, that’s what they all say and in a lot of cases, it turns out not to be true. Anyway, even if you are one of the fortunate souls whose body somehow manages to survive the abusive nature of an eating disorder and live, what kind of a “life” is it to spend your days tortured and tormented by a beast in your head? Weighing things up then (no pun intended…actually screw it…with me the pun is ALWAYS intended), although weight gain is scary, when you are going through the process it is important to think of the alternative, and remember that that alternative is a hell of a lot worse.

4. Weight gain is not as visible as you think – If you are like me, when you stand on the scales and see that the number has gone up, you can immediately see where that extra weight has gone to. This however, in the nicest possible way, is utter nonsense because in actual fact changes in body weight are no where near as visible as we might think. I remember one week when I gained one pound and instantly I saw my physical appearance change into something unrecognisable to the person I had been before that pound. Know what everyone else saw? Nothing. I would be lying to say that no weight gain is ever visible (as someone who has just spent 5 months in hospital I can guarantee I do look very different now), but my point here is that weight that you gain every week at weigh ins is not as visible as you might think and if you think you can see that pound or two of extra weight then it is simply proof that your eating disorder is distorting your vision. Don’t listen to its lies I say!

5. Getting bigger doesn’t mean you are big – If I ran a banana farm and after the harvest found that I had 1000 bananas, that would be a lot of bananas (and I would clearly be one hell of a good banana farmer). In that circumstance then, 1000 banana would be the definition of a lot of bananas. If the next year I then had 100 bananas would I think that I had hardly any bananas (trust me I do have a point here and am not just trying to send subliminal messages to you all about my secret dream to become a banana farmer). If however I had 0 bananas one year and then the next had 100, 100 bananas would be my definition of “loads of bananas” and that is what it is like with weight: aka all relative. Just because you are gaining weight and getting “bigger” it does not mean that you are big. You might think “I am huge” because the number on the scales has gone up but what I am saying is that just because the number has got higher it doesn’t mean that number is big. 100 bananas only looks like a lot of bananas if you previously had no bananas, just as a certain number of kilos only seems “huge” because it is bigger than the nothing you had previously and every “high” number you fear only seems high because you are looking at a lower one first. Getting bigger does not mean getting big therefore and if it was the other way round (aka the 1000 banana situation first) then your “high” number would be someone else’s low in a different situation. Whenever you see you have gained weight and feel like your weight is high, remember the bananas and the fact that a high number only seems big because it is bigger than the previous number and it is not that the number is big in itself.

SO there you have it! 5 thoughts to help you manage the fear and stress that is the weight gain side to recovery from an eating disorder! As always I am not saying that this blog post is going to solve the problem, nor will it probably make gaining weight any easier, but these thoughts are at least important and sometimes helpful/comforting things to bear in mind when the voices are getting a bit too loud for comfort and you have no arguments to fight against them. These thoughts are therefore your arguments against all of those bad thoughts, your weapons for the recovery battle, so take them brave soldier and use them wisely to outwit that cunning eating disorder who is trying to fool you into making weight gain seem like a bad thing.
In the meantime, if you are someone struggling with the anxiety ridden process that is gaining weight, please know that I really do feel for you as someone who has gone through the process multiple times myself (and is still going through it today), and I hope that this blog post has perhaps helped a little bit. Remember, recovery and weight gain is hard but losing your life to a cruel demon in your mind is far worse.

Take care everyone x

WeightGainFear

Should The Government Be Teaching Children To Count Calories?

/ bornwithoutmarbles / 11 Comments

When it comes to the government, they are always coming up with handy suggestions as to how people should live their lives. You know the stuff, “eat at least five portions of fruit and vegetables a day”, “don’t drink more than 14 units of alcohol a week” and “drive on the left hand side of the road” (actually that one might be a rule rather than a suggestion…I wouldn’t know. I failed my driving test and every time I asked my instructor for more driving tips after that, he ran away screaming which really did not help with answering any of my questions…)
Always ready to tell the population what to do then, for 2018, the government in the UK have come up with a new suggestion, complete with its very own catchy advert, where play-dough people morph around the screen and a happy jingle plays advising parents to teach their children to restrict themselves to “100 calorie snacks, two a day max”. Now I am not one to turn down advice from our dear Theresa May who is doing such a wonderful job of running the United Kingdom without any trouble whatsoever (pause for laughter), and even I can admit that it is a catchy slogan with a tune that isn’t bad either, but in my opinion this “handy lifestyle suggestion” is a terrible thing that should cease being taught to children immediately.

Obviously for someone (aka me) who is in hospital trying to recover from anorexia and is following a meal plan where snacks exceed 100 calories and are more frequent than twice a day, this kind of thing is unhelpful and triggering. On one hand I have dieticians and psychiatrists coming out of my ears (I really don’t know how they got in there in the first place), telling me that I need to eat this far higher meal plan than the one Theresa May suggests and on the other hand I have play dough people telling me to restrict my intake, which as I have said is obviously confusing and not particularly useful, but it is not just to people with eating disorders that I think this advert is detrimental, rather it is bad for the entire population (far worse for your health in fact than, dare I say, more than two snacks a day comprised of over 100 calories each).

The problem I think with any lifestyle suggestion or diet tip from any source, is that people hear it and immediately take it as gospel. In the real world however, nutrition isn’t governed by blanket black and white, one size fits all rules like that, and there is no such thing as a “diet expert”, only people who have done a lot of research about food and have opinions about it, a point highlighted to me during my brief stint working in a bookshop.
Unsurprisingly, this job involved various tasks including book shelving, and one day I was in the self help department (insert joke about how I need to spend a lot more of my time in such a section here), which was helpfully next to all the diet books. Therefore whilst shelving, I couldn’t help but get a good look at all the titles and diets being advocated.
Now generally, when it comes to reading about a topic, one would assume the more books you read, the more educated you become. For instance say you read 30 books about penguins, it is then likely that you will be more intelligent on that topic than someone who has only read one and that you would do better on any quiz regarding penguins. Alas, when it comes to nutrition, things are not like that, for as I shelved those diet books (working very hard I might add just incase my former boss is reading this…), I realised something ridiculous. Turned out if I were to read all of the diet books, take all of the information, all the “no carb”, “no protein”, “no fat” nonsense and I were to mush it together to make one overall diet plan (which you would think would be the best and most informed having been the culmination of so many books’ worth of information), I wouldn’t be able to eat anything. All the health advice added up together in the world and the conclusion from it? No food is safe, which I think is fairly unhealthy considering such a thing would lead to death, and, were we all to follow that advice, the extinction of all human life on earth. Marvellous. Therefore when it comes to rules like this “twice daily 100 calorie snacks” thing dolled out by nutritionists, taking them as gospel is never a good idea as they are merely opinions rather than facts.

“But for some people limiting snacks to twice daily amounts of 100 calories might be a good, healthier idea than their current lifestyle choices” I hear you cry and I am not going to disagree with you on that, but another thing I want to point out when it comes to guidelines is that they are not universal and are actually only helpful or beneficial to SOME people, which is why it is not helpful to have them rolled out as rules for the general population. As I have already said, this advert is obviously not applicable to people who are in recovery from eating disorders, but neither is it applicable to a large number of the population who all vary in height, weight, activity levels and nutritional needs. What about athletes for example. Is this rule supposed to apply to them too because I am pretty sure that that Mo Farah and Usain Bolt wouldn’t get very far nor would they get any more gold medals were they to restrict themselves to two 100 calorie snacks a day…
Okay I get it, there does need to be some kind of suggestion out there as to how to live a healthy lifestyle and it is important to teach children about food and nutrition but whatever happened to “general education” and suggestions like “eat your vegetables”, “everything in moderation” and try to have a “balanced diet” as opposed to these rigid rules and guidelines ridden with fixed numbers. Where pray did these numbers come from because last time I checked people don’t eat numbers, they eat food (and for good reason too. I once tried to eat a number nine and it was terrible. Tasted purely of pepper.)

It is just somewhat ironic that the whole focus of this campaign is to encourage health but encouraging children to see food in terms of calories and numbers really is a disordered habit struggled with by many people with eating disorders. If healthy snacking is the priority then advising healthy snack foods and providing possible examples would be a far better way to go about it because this focus on calories isn’t healthy at all. When numbers are brought up things start to get obsessive and this is where I think the problem lies. By specifying 100 calorie snacks they are labelling a strict limit to adhere to, but how ridiculously close are people supposed to stick to it? Is a 101 calorie snack ok? What if it is a really healthy snack that is slightly over? Should an “unhealthier” food be chosen instead simply because it fits the amount? Should we weigh already healthy fruit to check that they are “safe” in this new government scheme? Should children be taught how to count calories from the moment they exit the womb? Is that a normal healthy attitude to food? Seriously, think about it, does all of this sound healthy and worth advocating or more akin to rigid disordered behaviour seen in people with eating disorders aka a mental health condition needing treatment?

Overall then, if I had any say or control in any of this government malarky, I would say the whole “100 calorie snacks” with “two a day max” idea needs to be binned and for calculating numbers to be kept in children’s maths lessons in schools rather than in their lunch boxes or at the dining table at home. If you want to educate and give healthy food guidelines from the government then fine, go ahead, but when this advice is given it should be just that, GUIDELINES like the old “eat more fruit and veg” rather than strict, prescribed, rigid calorie counted rules that must be followed exactly and are carved in stone and sung over the breakfast table like some terrible national anthem.

If you have or even if you don’t have an eating disorder but are finding these adverts unhelpful, as hard as it is, my advice would be to do your very best to ignore them. Remember, just because it is prescribed by the government it doesn’t mean it is automatically healthy and it doesn’t mean that its obsession with numbers is not disordered. Nobody is the authority on rules regarding food and diet, it is all opinion, and strict rules, hell even general guidelines, are not applicable to everyone.

Take care everyone x

GovernmentFood

The Difficulty When Mental And Physical Progress Move At Different Speeds In Eating Disorder Recovery

/ bornwithoutmarbles / 30 Comments

In a few days time, I will have been in hospital for 16 weeks aka a grand total of 4 months, and because of this, I am often being asked questions like “How are you getting on?” or “are you feeling better?” which are both very complicated and difficult questions to answer when you are in treatment for an eating disorder. You see, on one set of paper work, things are going rather swimmingly and I am indeed doing much better, yet on the other set of paper work in my opinion, I am actually feeling and am “doing” worse than I ever have done in my life.

Oddly enough, this discrepancy between paper works is not because I have two very different doctors with opposing ideas writing sets of notes about my progress, but because when it comes to recovery from an eating disorder, there are two very distinct and different sides to it, the mental and the physical, and unfortunately these two sides do not work as sleeping otters do (aka hand in hand – yes, fun otter fact for you, otters hold hands when they sleep to make sure that they don’t drift away from each other. Apparently they also make waterslides and play with pebbles. Conclusion: Otters are cool).

Indeed the two sides to eating disorder recovery are so separate that I think that asking someone in treatment for an eating disorder how they are, is a question that needs to be asked twice, once for each side of recovery, because otherwise getting one coherent answer is impossible.

To be fair, towards the beginning of my admission, the physical and mental sides of how I was doing were fairly in sync. Mentally things were a bit all over the place and physically things were too. This then continued as I struggled to work with the program at the eating disorder hospital, until the introduction of my NG tube and since that most unwelcome introduction, everything has changed, in my eyes, for the worse.

Before, when I was mentally struggling and didn’t feel able to manage food, I was able to avoid it which obviously didn’t help my body very much but it prevented my anxiety levels from getting worse. Now though, since the NG tube, I have a constant and unavoidable source of nutrition and it doesn’t matter how I feel, food cannot be avoided. If I don’t eat, the food still goes in, and consequently my mind is in utter turmoil. My body on the other hand is as they say “loving life” and ironically, it is killing me.

Seeing as food is unavoidable now, I have been following my meal plan in one way or another for weeks and the affect this has had on my body is dramatic. I am gaining weight faster than I have ever gained weight before (perhaps because I have never had such an unavoidable source of nutrition stuck up my nostril before), so health wise, I am “improving”. I am no longer at a weight where I require a wheel chair, I am now able to stand in the shower for long periods of time, even on one leg (I am a fantastic flamingo impersonator these days), and when I get out of bed in the morning, the world doesn’t swim before my eyes and go black. Objectively these all sound like good things and for the medical professionals and my friends and family, these are good things but to me, these are terrible things.

I really don’t know how to explain this idea to people who may not have eating disorders as I know that to most people it sounds absolutely ludicrous. Physical health, the ability to stand in the shower and walk down the corridor are abilities to be appreciated not feared, but when you have an eating disorder, these abilities mean entirely different things.
To me, not being able to stand up without things all going fuzzy was a sign that I was “behaving” myself, a sign that I was doing a good job at punishing myself so the guilt I felt at being alive was lessened. Now though, I am unable to “behave myself” by not eating because even if I don’t eat the food will go in without my permission, so with things not going fuzzy, it is like a sign that I am doing something “bad” (even if it isn’t always me who is doing the eating), and I guess I am feeling all the guilt and shame as anyone else would were they to do something they thought was bad, like stealing or punching someone in the face.

Now I take up too much space in the world and with the weight going on as it is I take up more and more space each day, which is something I have always struggled with. When you hate something you want to make it as small as possible (or you want it to disappear altogether), you want it to take up as little of the world’s space as possible so as there is more room for the good things. In gaining weight I feel like a weed taking up too much space in the flower bed and stealing all the sunlight from the marigolds.

It is incredibly hard to watch this body you hate, morph in front of your eyes into this thing that is getting bigger everyday, getting “better” everyday whilst inside you are all the more depressed and tormented.
I don’t have any idea if I am making sense here because to be honest I am on so many medications right now that my brain is not functioning but if I had to resort to the good old Born Without Marbles way of explaining things, aka an analogy, it feels like my body and brain are one of those cars people drive off in after a wedding with tin cans on the back and “just married” scrawled across the rear windscreen.

My body is the car and as it gains weight it is zooming off full speed. Meanwhile my brain is the collection of tin cans tied to the back, being dragged along and through all of this road that it is not ready for, each can bouncing and denting, bruising and breaking a little more with every mile that passes. My body gains weight, my brain cracks a little more, I feel more broken, depressed and bruised and the faster my body goes the further it is from my brain which is actually all the way back at the starting line. I guess this analogy isn’t perfect because you could say “but your brain is moving in the right direction like your body if it is tied to the car” but that is where the analogy fails because that is not happening at all, like I said, as the car moves the brain just gets battered and even staff have admitted that in the past few weeks things have mentally become worse and worse as time has passed and weight has gone on.
Christmas day is a perfect example of this. When I woke up on Christmas day I was weighed (NOT something I asked Santa for and if I ever wake up to a set of scales in my stocking on Christmas morning again I swear to God I am marching to Santa’s grotto to give that beardy man a piece of my mind…and his scales back), and I had gained a lot of weight. On paper then and to the doctors, my body had got “better” but mentally the shock of it all had such a strain on my mind that I totally lost it. Within minutes I was having to take medication to calm down from the anxiety and agony and when my family came to see me for our two hour visit, the visit wasn’t better for the weight gain, it was worse. It should have been better logically, my body was healthier than the last time they had seen it but in becoming that way I became so upset, distressed and anxious that I had what we shall simply call “ a little incident” and I had to ask my family to leave early.

It is that which I think illustrates my point best as to how impossible it is to answer the question as to “how are things going” when you are in recovery for an eating disorder. Am I better? In a way, yes and I am getting “better everyday”, but in the other more important mental side am I better? Am I progressing? Not at all. I hate myself more than ever, I am more unhappy than ever and I feel more trapped than ever in a body that I no longer relate to. The distance between my body and mind is so great now that I have asked staff if there is any chance we can slow down on the weight gain so that my mind has got a chance to catch up but they are refusing and it all feels like I am being dragged and pushed too far out of my comfort zone. I am in hospital being treated for an eating disorder and the physical problem is being taken care of by a tube, but the mental aspect is being torn apart and I really don’t know how much longer I can handle it.

It is so frustrating trying to explain all of this and I guess in the end the main thing I want to do at the end of this blog post is apologise because I feel like I haven’t made any sense and that I have wasted your time with my incoherent waffle. Like I said though, I am on all sorts of crazy meds at the moment (to calm me down because I am in so much distress due to this whole struggling mentally with the physical progress my body is making right now when I am not ready for it), so please blame those meds and not my inabilities as a writer. I don’t understand half the things that are going on at the moment so explaining them coherently is somewhat difficult. I really am sorry. I am just so battered. I hope this makes some sense at least or that I have got the point across in some way that physical recovery and mental recovery for an eating disorder do not go hand in hand and can sometimes be literally travelling in opposite directions. “How are you doing?” is such a simple question but good lord when you have mental health problems is it a difficult one to answer.

Take care everyone x

RecoveryCar

Is It Ok To Give Food Related Christmas Presents To People With Eating Disorders?

/ bornwithoutmarbles / 7 Comments

As soon as winter rolls around, there are certain questions that suddenly pop up every time you interact with another human. These questions vary but include things like:
“Are you doing anything nice for Christmas?”
“What do you want for Christmas?”
“Do you really need to buy more penguin themed decorations this year?” (Yes. Yes I do)…
And of course the ever sigh inducing “Have you started your Christmas shopping yet?”

Due to the birth of commercialisation and consumerism (two things that, although very much involved in Christmas, were not actually born in Bethlehem and laid in a manger), Christmas shopping is a big stress over the festive season both for money reasons and of course wondering what the hell to buy for everyone. Mental health wise however, there are further complications because sometimes there is a question not just to what you should buy a friend or relative, but whether there is anything that you should definitely not be buying…

As you may know, I have a lot of friends with eating disorders and several of these friends have come to me in the past exasperated and fed up, poised with a story to tell me about a distant relative who sent them food as a birthday or Christmas present. I know a lot of people with eating disorders might get frustrated, find the gift insensitive, rude, or even cruel, like taunting an alcoholic with a bottle of gin, and the majority of people I know have stated that “people should not give food related presents to people with eating disorders”.

I think that one of the difficulties in this issue, is trying to decide whose responsibility it is for someone to manage the whole gift giving/receiving situation. Is it the responsibility of the person who is choosing the gift to give (maybe an unfair burden considering not everyone will know every personal detail of whoever they are buying for this December and surely if it is “the thought that counts” any present is incredibly kind and generous), or is it the responsibility of the person receiving the gift, to manage what it is appropriately for them?
If you give a Dolly Parton hater (for-shame! Come on now, you have to at least like Jolene? 9-5? IT IS A SONG ABOUT THE MONOTONY OF WORK LIFE! DOLLY GETS US!), a copy of Dolly Parton’s Greatest hits, whose responsibility is it to deal with the CD? The gift giver for not knowing about a person’s hatred of the world’s greatest country singer and for not being too careful, or is it the responsibility of the gift receiver to simply donate the generous present to a charity shop where it can be enjoyed by someone else who is able to appreciate a bit of “I will always love you” blasting from the speakers? However, what if a gift is medically inappropriate? Whose responsibility is it to manage then?

For example what about Horris who is deathly allergic to peanuts? Maybe Horris didn’t write a Christmas list this year (always a risky move), and maybe his third cousin twice removed’s husband’s goldfish wants to send Horris a gift (for he is a very generous goldfish), but is unaware of Horris’ unfortunate peanut condition.
If this lovely Christmas loving goldfish sends Horris three tonnes of peanut butter, a t-shirt made from knitted peanuts and a trip to the “World of Peanut” theme park with the “Ultimate Peanut Experience Peanut roller coaster” (you ride around the track within the shell of a giant genetically modified peanut and then at the end enter a flume tube filled with peanut butter that will leave you utterly soaked upon plunging into it). If Horris uses this ticket to the theme park, surely it is partly his fault for not taking proper care of his health requirements (aka the requirement to not plunge into a pool of peanut butter at 100mph in the shell of a giant peanut). Then again, what if Horris is so allergic that the mere sight of the ticket and the tonne of peanut butter sends him off in an allergic reaction without him having any warning of the deadly gift? Who do we blame? Goldfish or Horris? Surely this is a very different kettle of ethics than the previous Dolly Parton debate? So what about people with eating disorders?

On one hand, as a person with an Eating disorder myself, I can see the point of those who say that giving food as a present to someone with an eating disorder is inappropriate or something they don’t like happening. It can indeed be frustrating to be given food presents that you fear every year and are possibly unable to enjoy due to your illness. I have heard people with anorexia say that it makes them feel more isolated from the rest of the Christmas festivities because being given, say a Christmas present that is a box of merry smiling gingerbread men with chocolate buttons, a freshly cut yule log or a batch of homemade mince pies is like being shown something “normal” about Christmas that others can enjoy and that they may want to take part in like other people, but due to their illness, feel they can’t. Some could say that getting food presents makes them feel misunderstood or like their problems/disorders have not been taken seriously, belittled and assumed to be “a mild difficulty with food” that can easily be solved if you put a nice bow on a box of chocolate penguins, rather than a fully fledged eating disorder ruining their lives no matter how many bows you stick on top of that box of rich 70% cocoa waddlers.
As well as food presents for disordered eaters being problematic in the sense the present receiver may be too scared to enjoy them, there is also the risk that food presents could trigger someone in other ways, for example someone who feels the compulsion to binge and maybe purge afterwards. Some sufferers keep certain foods that they are likely to binge on out of the house to make them feel more in control, so when that food is suddenly handed to them wrapped in glittery ribbon tied paper, they struggle to deal with it in the way they might like to when fighting their disorder.

That said, though what I am about to say is something most Eating Disorder sufferers would disagree with, I don’t think that people should put a full-on ban on food presents for people with eating disorders and I think that getting a food present once in a while is more likely to help rather than hinder your recovery.
What if one Christmas as the countdown to the 25th was underway, you went into some form of new treatment that you started to find more beneficial than any you had tried before. What if an image of what life could be like without your eating disorder started to give you hope in a positive future and what if, like a Christmas miracle, your eating disorder backed off a bit and you felt strong and determined enough to kick some ass. What if in this Christmas miracle you became so inspired to fight your demons that you made a promise to join in on all the scary Christmas food things this year, finally buy that advent calendar, make that gingerbread house with the candy cane decorations, try one of Aunt Enid’s famous mince pies and join in on all the party canapé platters at the work Christmas buffet (I hear the brie and cranberry filo tarts and chocolate penguin profiteroles are a delight). What if all of these goals arise, all this determination to fight and join in with everyone else…and then nobody gives you the opportunity to do any of it because they are all too scared to offer you that filo tart or wrap up that tub of Celebrations. To me, that would be incredibly triggering, if I were to be there ready to fight, ready to eat and join in and everyone just left me out anyway because they assumed I wouldn’t do it. This year, considering i am in hospital and not particularly well right now, that assumption might be right but in my head, never being given food presents at Christmas or any other time of year like Easter or a birthday, is simply a way of other people confirming the idea you already have in your head that you don’t deserve or need food and therefore shouldn’t eat it. People treat you like an eating disorder and you will find it hard to see another identity for yourself. Furthermore, when would the food ban stop and would it ever? How would that be decided and wouldn’t that be more triggering in itself to have food presents suddenly reintroduced? If you have an eating disorder at one point, are families to avoid food gifts even if you are recovered “just incase” which again isolates you from certain celebrations. Yes food can be triggering as a gift but wouldn’t it be more triggering to be very unwell for years and then one year to be maybe doing a little better mentally and physically, so much so that people notice, give you food and then you freak out thinking that they are insinuating that you “aren’t ill anymore” or that they think you have put on weight so are clearly fine with eating again.
Personally to avoid all of these issues, when it comes to food presents, I would rather be treated as normal, like everyone else, receiving the odd box of Quality Street and being offered the iced mince pies. Even if I can’t accept the mince pies or have to give the Quality Street to my mum, I would rather they were there to make other people treat me “normally” until I am in a place to play that role of “normal person who eats food presents at Christmas and gets two candy canes stuck in their gums by getting a bit too enthusiastic when impersonating a walrus”.

Overall though, I guess that with this topic, it is impossible to make any conclusion because whether or not you give food to someone with an eating disorder is going to be a tricky thing to gauge and will vary from person to person. As I said, even I and my group of friends who share the diagnosis feel very differently about the topic so to be on the safe side, if you are wondering whether or not to give someone with an eating disorder a food related gift, you might want to check with the individual or maybe a relative of that individual first to see how they might react to it. There are many types of eating disorder and even people with the same one will experience them differently at different times, such as when they are going through periods of relapse or recovery, so as much as I would like to have given you a black and white simple answer (and we all know how much I love things that are black and white ahem penguins ahem), I am afraid I will have to conclude in a rather hazy grey as the answer will vary from person to person.
All I would say is, if you are the gift giver, try not to get too anxious or caught up in overthinking it because ultimately you have a 50/50 shot of getting it right and if you get it wrong, it isn’t your fault, nor does it make you a bad person. Similarly, if you are the receiver I am sorry if food present wise, things don’t go your way this year, but equally remember that other people may not be thinking as deeply into the meaning or significance of a box of chocolates as you might be and maybe it is just their way of trying to show they think you are pretty awesome. A Christmas present is a Christmas present, it isn’t a holy significant statement laden with meaning as to how someone views you or your body, it is a sign of appreciation, a sign someone cares, and at the end of the day, it is always the thought that counts.

Take care everyone x

Pudding blog

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

/ bornwithoutmarbles / 11 Comments

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

How It Feels To Be Recalled To Hospital Under A Community Treatment Order

/ bornwithoutmarbles / 16 Comments

If someone had asked me what it feels like to be recalled on a Community Treatment Order (part of the Mental Health Act), before it had ever happened to me, I am not sure what I would have said. Possible guess answers that I might have offered would have probably included things like “scary”, “shocking” or “dramatic”. Probably one of the last answers I would have given, would have been “it feels like having your car stolen by a band of incredibly apologetic thieves who are very sorry for your loss”. However, as it turns out, that is exactly what it feels like…

As you will all know from the fabulous explanation of the Mental Health Act that I posted last year and linked to again last week (hint…it is right here: Demystifying The Mental Health Act…With Penguins), when you have a CTO, you have a list of conditions hovering over your head which must be adhered to if you want to avoid being legally recalled to hospital. Rather than conditions hovering like ominous wasps at a picnic who like a look at your jam sandwiches though, I like to think of them as “things that hold you accountable” or “reasons to do things”.
Every time I was scared to challenge my eating disorder and follow my meal plan I had an argument I could use, that being, “you have to do this because otherwise you will lose weight and go back to hospital”. It was a system that worked but admittedly I felt really trapped by it.
Every day I would wake up and force myself to eat a number of calories that made me feel depressed, knowing that it would keep me at my CTO weight which felt equally depressing.

All I wanted to do was give up, give in and lose weight but I felt I couldn’t because that would only involve being recalled to hospital which was simply not an option. My CTO weight was the border to a war zone and I was not taking a single step into no man’s land.
Then however, the recent hospital surgery medical drama, naturally led me to lose weight and I crossed that barrier without even intending to. Before, that CTO number had held a power over me, every digit had felt significant, like a law from the gods that I would probably find carved into one of those massive rocks at Stonehenge if I visited and looked close enough (a lot of people have theories as to why those mysterious stones are there including “for religious reasons” and “rituals”…My theory is that they were simply put there by some cheeky prankster who wanted to leave a pile of stones lying around so that future generations would ask “why the hell are those stones there?”)

When I went under the weight however, the power of that number and the spell was broken. I had thought that one step over the border would have resulted in guns and tanks sending bullets and bombs flying all over the place…but nothing happened. Of course it would have had the weight loss been “my” fault, but I had an excuse, my appendix did it not me, so it was almost allowed. Obviously the CTO weight still mattered and I had to get back to it, but with this medical “it isn’t my fault” get out of jail free card, I knew that I could take advantage and lose more weight without getting into trouble.

Thus it was that, as you know, I ventured further into no man’s land, and it was a sudden surprise when after all this “oooh this feels quite safe and allowed” turned into the previously expected “guns and tanks and swords and back to hospital for you”. Unsurprisingly, it was pretty distressing and traumatic, so a lot of people have been very sympathetic which has been lovely. I really appreciated comments from people online who were not directly involved in the situation because they felt genuine, but it is when we get to the words of the people closest to me that we get to this whole “I feel like I have had my car stolen”.

To use another analogy, I suppose you could view my body as a car that the garage have been keeping very strict rules on. I may have owned the car but there were restrictions as to what I could do with it, what colour I could paint it and how far I could drive. Then, when the CTO barrier was broken, I suddenly regained control over that car, so I grabbed that wheel, painted it purple and zoomed off into the distance (I suppose if we are combining this with the other analogy I zoomed it off into former no man’s land…just like people did with BMWs in World War Two…I may need to retake GCSE history).
With the car all to myself I set my speed limit, I pumped the tyres to a level that I wanted and I filled every seat with penguins because that is what I wanted to do. I could chose…until I was ambushed by bandits who seized the car and stole it, meaning that it didn’t belong to me anymore. Suddenly they would decide how much petrol went in, how plump the tyres were and how many miles it could run and my opinion was irrelevant (the bandits in this analogy being all the doctors and psychiatrists who recalled me to hospital).
Naturally, having just had my car stolen, I was not best pleased. Thing is, when you ACTUALLY have your car stolen you never tend to see the thieves who are the new owners enjoying a trip around the block in what used to be your very own automobile, and they are unlikely to be very apologetic.

Being in hospital though, I am not only seeing the “thieves” every day, I am living with them, and watching them abuse my car. The doctors and therapists decide what I eat now, when I sit down, where I can go and it is all very hard so I try to talk and work through it with them. I say how scared I am to eat, how scared I am to gain weight, how scared I am of everything and like many people online said last week, they say things like “I am so sorry you are in this position”, “this must be very hard and scary for you” but unlike when people online say it, it makes me angry, and all I can think is “WELL YOU CAN’T BE THAT DAMN SORRY BECAUSE YOU ARE THE ONE DOING ALL THIS. YOU STOLE MY CAR, I AM UPSET ABOUT IT AND CRYING AND NOW YOU ARE SAYING HOW SORRY YOU ARE ABOUT THE SITUATION BUT YOU ARE THE THIEVING, HYPOCRITICAL VAGABOND! VAGABOND I SAY!”

I don’t believe that they can really be sorry because they have what they want, they have the car and are legally allowed to do whatever the hell they want with it. I feel the same way about professionals as I do about close family members like my mum, which I know is terrible and I know I shouldn’t feel that way, yet still as much as I love our visits and I would not be able to get through this place without her, what I get out of them is entertainment, love, company, kindness and knickers (she brings in my clean washing…thanks mum). What I do not want from my mother, is sympathy because in my eyes she is kind of like a thief. Admittedly she did not do the legal act of stealing the car, but she gets something out of it, she now has a say over the car and the thieves will take her views into account. If my mum insists on yellow wheels and the thieves like that idea, those wheels will be the colour of sunshine within 24 hours. She could not have stopped the legal act from taking place but she has more say in it than I think she has used, I am sure if the next of kin kicked up enough of a fuss someone would have to listen, but no fuss has been kicked. On top of that, by me eating and being forced to stay in this hell hole gaining weight, she has benefitted from the thieving.
Again it sounds AWFUL to describe it like that, to compare my mum to someone who is in cahoots with criminals and joyrides around with lemon wheels, when I know she would argue that all she has actually done is not try to stop the people attempting to save the life of her offspring by their actions. She isn’t joyriding (my mum is not a joyful driver…especially if there is a cyclist nearby), she is finally offloading this nightmare she has been living with to professionals who can look after it instead and she can finally sleep rather than stay up into the early hours arguing about sweetcorn. She is benefitting because she gets a break, because as I gain weight she will feel safer and therefore I assume happier yet again, any “I know this is hard and horrible and I am sorry” inspires that same “WELL MAKE THEM GIVE ME THE DAMN CAR BACK AND WHY DID YOU PAINT THE WHEELS YELLOW” rage.

That is why if you were to ask me “how does it feel to have been recalled on your CTO and sectioned back in hospital” I would tell you that it feels like some very apologetic thieves (some of whom are related me), have stolen my car.
Now I am just watching them all make the changes they want, implementing the modifications they have decided, desperate to run out and stop them but with my hands tied. I am just an observer watching people do things to my car, watching things happen to this body that I have had to disconnect from and pretend isn’t mine anymore for my own sanity. I guess a more accurate explanation/analogy then would be to say it is like having your car stolen and then having the thieves force you to be a mechanic carrying out every wish of theirs or risk being whacked on the head by a spanner, but that isn’t how it feels. It feels like things are being done to me, any movements I make are via the puppet strings that they hold, I have no say. When it comes to living with an eating disorder you don’t have much say or control either, but this feels different, this feels more stripped, more naked. This is not my body, it is just a body that I am trapped in, and I am witnessing it be torn to pieces every day. Every meal. Every bite.

CTORecall