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

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

How Physical Health Problems Can Trigger Mental Health Problems

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Take care everyone x

AppendixExplode

The Problem With Before And After Photos In Eating Disorder Recovery

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

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

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

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

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

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

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

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

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

Take care everyone x

BeforeAndAfter

How To Deal With People On Diets When You Are In Recovery From An Eating Disorder

When it comes to treating an eating disorder, there are about a million ways out there that people go about it. It is like the overall goal of recovery is the Triwizard cup from the Triwizard tournament played out during Harry Potter and the Goblet of Fire, and all people with eating disorders are standing inside this perilous maze running down various paths to try and find their way to victory in recovery (and hopefully not a surprise encounter with Voldemort as happened to Harry. By God that was unfortunate). Some people take the path of medication, others attend groups, try various different kinds of therapies, visit hypnotists, but of all eating disorder recovery journeys you can guarantee they will all, at some point, share something in common: a meal plan. Sometimes people construct these meal plans themselves, others are prescribed them by therapists or dieticians, and some have their meal plans dictated by doctors and nurses in a hospital setting.
Obviously eating the meal plan is hard enough in terms of having an eating disorder and the thoughts that go alongside that, but one thing that can make following your meal plan a hell of a lot harder than just carrying out the basic set of instructions, is the almighty trigger of people on diets.

Picture the scene. You are sitting there at home, ready to eat your healthy balanced lunch prescribed by your dietician. All your basic food groups are present (protein was a little late to the table as he got held up by a tractor on the motorway but everyone is there now). You are anxious but determined to soldier through the meal in your journey to recovery. Then a member of your family comes to join you. You smile and wave, grateful for the company, anticipating a nice bit of conversation to distract you from the eating disorder screaming at you not to pick up the fork, but then the family member sits down. Glancing at their plate, your face falls. All they have is lettuce. THE NERVE OF IT.
If you are anything like me it is around this point that you will start to feel very angry and indignant, and your already difficult task of eating lunch becomes a hell of a lot harder. Suddenly your recovery meal plan lunch looks like it has doubled in size like some unwelcome food multiplication miracle in the style of Jesus and all those loaves and fishes. The already intimidating quantity feels even more excessive and unnecessary than it felt before and the thoughts are churning. “If I eat this when they are just sitting there with a salad I will be greedy”, “clearly I don’t need this much for lunch if that is all they are having for the equivalent meal”, “why should I eat this food when they are allowed to eat lettuce” etc etc. Then things escalate, and before you know it you have hit your lunch time companion over the head with the left over half lettuce in the kitchen, torn up their copy of Slimming World magazine and crumbled any diet pills they were taking to dust, dust which you then sculpt into a giant sand castle prison to lock them in until they agree to eat normally again (not that I have ever thought this through in detail prior to writing this post you understand). Basically, it sucks, but for all you people out there who struggle with this trigger, never fear, for I have words of potential wisdom that I hope will help, as there is a key thing to remember in all of this.

The most important thing to remind yourself when you are at that table, eating your recovery meal plan around potentially salad chomping dieters, is that you are in a completely different situation to that person, so different and far apart in fact that you are actually not even on the same table.
If you are in recovery for an eating disorder and have been prescribed a meal plan to follow, that meal plan is your medicine, and the nonsense in your head trying to tell you not to eat it because someone else is eating less than you, is a voice that makes as much sense as someone with an ear infection refusing to take antibiotics because nobody else in their household is.
Who knows? Maybe that person on a diet has been prescribed their low calorie meal plan by a doctor because their previous diet was giving them health problems, or maybe they are just doing one of those silly fad diets for a few days after an advert they saw in a magazine. Either way, that does not mean that automatically you should not follow the meal plan that is prescribed/necessary for your body, and following it does not make you greedy simply because you are eating “more” than someone else.

When you are at the table trying to eat your meal plan and you are with someone who you know is having less than you, the most helpful thing to focus on for me is imagining the distance in your situations (aka a person with an eating disorder and a body damaged by the effects of starvation and malnutrition vs a person without an eating disorder who is not malnourished), as a genuine distance in physical location.

For example, imagine an explorer standing in the Arctic as representing a person with an eating disorder (for the purpose of this example we will call him Eggbert because I would imagine that people called Eggbert are rather adventurous/like the cold). Eggbert is surrounded by a blizzard, a glacier is rapidly approaching from the North and a polar bear to his left is giving him very funny looks (even the polar bear looks a little on the chilly side despite being designed as fluffy enough for these conditions).
Now picture a holiday maker on a beach in Barbados as representative of people without eating disorders. Doreen, for that is the name of our sand loving pal (actually that’s a lie…her real name is Doris but she had to change her name because she is on the run from the law…SHHHH!), is on a beach in Barbados with temperatures so hot that the local chicken eggs are laid hard boiled.
Now imagine the food aspect of things as a giant pile of coats and blankets.
Eating disorders aside, I think we can all agree that in these circumstances, Eggbert who is shivering with the polar bear in the Arctic, is definitely in need of all the coats and blankets and hot water bottles available to him. Indeed it is vital for Eggbert’s survival for him to take those things on board and snuggle up regardless of what Doreen is wearing on her beach in Barbados. By keeping all of the blankets to himself and not sharing some with Doreen somehow, Eggbert is not greedy, he just is at a place in life where he has different needs to Doreen to keep him alive. It is a situation in which Eggbert is using necessary resources to keep himself safe, and he still needs all those blankets and hot water bottles even if Doreen is lying elsewhere on a beach towel fully nude (AVERT YOUR EYES CHILDREN).

That may sound a bit of a drastic difference in situation to illustrate the point, but it is vital to acknowledge the difference in situation between you and the person you are eating lunch with if they are eating less than you. You are not on a weight loss diet because you do not need to lose weight, their diet magazines do not apply to you, and if you tried to attend their weekly weight loss sessions for more weight loss tips you would be turned away. As hard as it is, you really do just have to cut that person’s weight loss mission, diet and exercise out of your life and not allow the voice to trigger you to use someone else’s behaviour as a reason to avoid doing what you need to do. As with needing jackets in the Arctic, you need the food, even if the person sitting next to you is as naked as the day they were born and munching on lettuce. What a lovely image to end a post on. I really hope you enjoy it.

Take care everyone x

newyeardiets

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

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

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

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

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

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

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

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

Treadmill