xesce november 2004

Anatomy of an Eating Disorder, by Xesce - Page 1

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Yes, this is an ambitious undertaking, and since I'm not sure I will actually be able to hang in there long enough to tie it all together, I'll just start out for now with what I can and will maybe make attempts to connect dots and make it more academic later. Please bear in mind that I've got an enormous amount of info to try to sort through and organize and that this is just a beginning, and this page may change dramatically over time:

Early reactions to seeking help

1. A psychiatrist I talked to at age 15 (1981) seemed angered by my comments. At this time, I didn't understand I had an eating disorder, and I don't think he picked that up, either. I was anxious and depressed, and just felt that I was a person who had no consistent self-discipline when it came to my body, food, etc. I felt embarrassed when I admitted that part of my depression stemmed from my feeling that I was "fat and ugly". He was "overweight", and at the time his reactions resulted in me feeling I was a horrible, insensitive person to have the feelings I did and express them in his presence.

2. At age 17, I clicked with a school guidance counsellor, and it was because of him that I was able to attend school for the year after almost dropping out. [early on, I missed something like 50 days, but with his encouragement I was able to hang in there, catch up and complete my credits. It was the last year I ever attended high school.] I talked with him on a regular basis throughout the year, and I really liked him. However, when I trusted him enough to hand over my food and weight diaries, he didn't understand. I felt I had disappointed him with my shallowness. I had tried to explain verbally about my out-of-controlness with food, but he had underestimated the seriousness of it, and just joked that all I needed was a bit of exercise. I didn't have the self-esteem to say that I actually did exercise, sometimes excessively, and that my fitness level and some of my abilities were probably on par with those of school athletes even though I didn't look athletic. I was so ashamed of my appearance and what I thought it represented to others that I didn't think I'd be believed.

3. At age 21, I had called a distress centre and explained that I hadn't left the house much in the last 5 years, although at age 17 I did attend school. I said I'd talked to my family, saying I didn't know what was wrong with me. No one talked to me or tried to get me help. The person was quite concerned and said that I needed to do something as soon as possible, or my patterns would likely be set for life. I focused my efforts as well as I could. I had no support system at all. No one talked to me or took an interest in the state of my life. I had no contact with anyone outside my family, and they didn't seem to understand my situation. I started trying to 'hypnotize' myself, in a way, with positive thinking. I made lists of all the things in life I wanted to try and do, in detail. I started exercising and dieting. I spent a lot of time in my room with the door closed, just hugging my knees and telling myself over and over, if you want to have a life, you've got to be strong, you've got to concentrate, you've got to understand your triggers and fears, and you've got to be psychologically prepared beforehand. I lost 30 lbs, and started looking for a job.

4.After six months of living on my own, I came crawling back home because I couldn't make it. And this is when I learned how to vomit, and began to do it on a regular basis. A few months later, I was vomiting as much as 14 times a day, while my father and stepmother were at work. Eventually, I was so scared that I confided in my stepmother. I was crying uncontrollably. Her reaction seemed to be anger. She said absolutely nothing, but the look on her face was judgmental and stern. Sometime later, the only reference made to this came through my father. I guess she told him about our conversation, because in front of company he made a joke, asking if I was "still puking after meals."

5. At age 23, when my father had me committed to a psych ward, I was open about the fact that I was bulimic. A nutritionist was assigned to me, to explain about proper nutrition, but no one addressed the psychological issues. I did actually understand that binge/purge behaviour had certain physiological and psychological effects, as do restricting and fasting, that would contribute to my problems. I actually had some awareness of what good nutrition was. I just had absolutely no control over what I ate. You can tell me I'm going to feel better if I eat this and this and this, and don't starve or vomit, but it's another thing to actually get me to be 'healthy' long enough for it to have an effect, because other things need to be addressed in conjunction. The answer to everything there seemed to be medication. And since I perceived only a very marginal lucidity in only a small portion of the other inmates there, I became quite scared.

A condition of release from that hospital was that I attend "Weight Preoccupation Therapy", on a regular basis, which I did for a while. The people there were nice, but at that point, my problems and issues were extremely complex, and eventually a recurrent problem (being unable to leave the house) made it impossible for me to continue with the therapy. There was no one to check up on me in my welfare flat, and I didn't have the internal resources to do more.

[In order to return to the hospital, I would have had to agree to their ideas of therapy - which meant heavy medication, without addressing psychological issues. My doctor imo had some kind of complicated power issues and I had the feeling that he wanted to squash me. That he felt he could get away with it because of the position I was in in life. (He said to me that he thought I was "stupid" for refusing to take the medication he prescribed, even though when I asked him to explain what it was and why it was being prescribed, etc, he wouldn't tell me and seemed to think I didn't have the right to ask.) I suppose some might call me paranoid. Maybe I perceived things inaccurately. I don't know. There were nurses that you could talk to about your problems, but it wasn't with a focus of analyzing or working them out. The nurses weren't trained for that, and one thing that bothered me was that most of the nurses there seemed so burnt out by their jobs that they demonstrated a high level of contempt and distaste for their patients.]

6. Also at age 23, an old friend of my mother's took an interest in me, and actually provided me with all kinds of info about bulimia to read, which I don't think she read herself, because she told me to "just try to have a little self-control." She told me about how sometimes she had an urge to eat a whole packet of cookies, but knew she had to have more discipline than that. She was a very kind- hearted person. I think this is just an example of how even good intentions can backfire or make a person feel more isolated. I think that even 15 years later, most people still don't know all that much about eating disorders. Unfortunately, I wasn't very strong or assertive, and wasn't able to help anyone understand.

Onset of Symptoms/Possible Contributing Factors

1.Christmas. As a child, the happiest time of the year for me, spent at my grandparents' house on Christmas Eve. Encouraged to eat excessively, and it was even associated somehow with strength, health, endurance, being like adults, and it was rewarded with positive attention. I plowed through lots of food I didn't actually like all that much to get to the cookies, candies and chocolates that I did like. I didn't notice until later on that I had a pattern of having the 'flu' on Christmas morning. On a few Christmas mornings, I vomited, but then felt ok and went on to dinner at my father's sister's place.

2. I often felt stress about going places with my parents and fought against it. I didn't want to go to church, my brothers' hockey games, visiting certain relatives and friends of my parents. On the few occasions I was left alone in the house, it seemed the first thing I thought of to do was sneak food, like cookies and sweet cereal.

3. I think my mother, having experienced problems with her own weight when younger was determined not to have fat children - she wanted to provide discipline, guidance, help. She controlled our portions, but made sure we did have a certain amount of treats, in moderation. But by eighth grade, I remember many mornings waking up feeling extremely nauseated, and I guess now I'd recognize that as relating to not really eating enough.

4. I went on my first diet when I was quite young. My mother had given me a little booklet with caloric values of foods, ideal weights (which at the time were considerably lower than they are now), etc. I'm not sure how old I was but at the oldest I would have been 10, youngest 7.

5. When I moved in with my father at the end of Grade 8, when I was 13, I weighed about 100 lbs and was somewhere from 5' 2 1/2" - 5'3". When I got home from school, I was unsupervised for several hours. Usually I had been too nervous to eat my lunch at school, and if I had eaten my lunch at school, it would only have been a sandwich and an apple, over a period of 10 hours since I had a bowl of cereal and a glass of orange juice for breakfast. It's probably no wonder I binged after school. I ate large quantities of cheese and crackers and cookies. At times I was alarmed by how much I ate, and I kept expecting for my father or his girlfriend to say something about it, but they never did. They kept replenishing the food supply. Food was a recognized need, whereas other things I needed, like period supplies, new clothes, etc, were often neglected. This was partly because I was too shy to speak up about things. My mother had always taken care of things like this in the past without me having to ask. In addition, I was always very self-conscious about anyone having to spend money on me.

The afterschool binge was followed by dinner that my father's girlfriend prepared. Her meals were usually high in fat, to please my father's palate. I wanted her to like me, so I tried to eat as much as I could as a sort of compliment. I think food became a kind of nurture substitute for me. My own mother was very angry with me for choosing to live with my father, and hurt, and at a time that is very critical in the development of a girl's self-esteem (age 13), she told me over and over what an ugly person I was, that I was throwing away my life, etc. Plus, she lived a few hundred miles away. My father's girlfriend did not want children, and did not really want to become very involved in the life of my father's children. She wanted him, not us. She was a nice person, but was not really emotionally involved, and didn't provide nurturing or female guidance. What I did pick up from her was some of her exercise routines from the YWCA. She was average height and weight and always battling her weight. Obesity ran in her family, and it was like she tried very hard to escape that fate.

6. Starting when I moved in with my father was something else. He would start getting drunk friday night when he got home from work. He drank one drink after another, and then would start spilling all sorts of secrets. I felt special to be involved with hearing this. His girlfriend went to bed early. I took to eating bowl after bowl of ice cream while he drank drink after drink and talked.

7. Right away, right after moving in with my father, I noticed that I couldn't control my eating, and my weight fluctuated from about 100 to 120 that year. But when I spent the summer with my mother, my weight was relatively stable for 2 months, my eating was stable, and I remember very clearly that I only felt depressed one day that summer and that day turned out to be the day before my period started. That was the last summer I ever enjoyed.

8. I was 14, my weight was steady at 113-114 lbs all summer, and I was fit. I actually thought I looked pretty good, but my mother commented that I wasn't exactly fat now, but that I shouldn't gain any more weight. A boy I had met the previous summer when I weighed 100 or less took one look at me, said I'd really gotten fat, and he took off, had no more interest in me and I never saw him again.

9. At age 15, I lost 15 lbs before the annual trip to the doctor. My mother took us every year, I was living with my father. So, when she saw me I weighed 110 lbs, and she was not unhappy with that. When I came to visit her for summer vacation, I was 125 lbs. When I told her, a look of fury (!) came over her face. It may have been an uncontrollable reaction, and in part it may have been puzzling to her. I don't think she could tell I'd gained that much by looking at me. I think one of my brothers commented that he couldn't tell. But I was fit, and one thing I've noticed about my body is that with my frame certain weight ranges for me aren't noticeable depending on the clothes I wear. Moving on... I went on an immediate crash diet, eating about 600-700 calories per day, and exercising a few hours a day. According to the scale, I lost about 12 lbs in a week. I was irritable, and one day I felt incredibly weak and nauseous. My mother suggested that maybe it was because I was eating too little, and I snapped at her, saying I could handle it, or knew what I was doing, or something along those lines.

But when I went on my annual camping trip out on the islands with a friend, I sort of snapped. On the way back from the camping trip, the motor for the boat we had wouldn't start. It had just died. And so we were stuck out in the middle of the bay, with only one paddle. I sort of freaked. I started to eat all the food we'd brought with us, on the spot. I remember I ate an entire box of Frosted Flakes, dry. And then, because I was the fitter/stronger/more decisive one, I paddled us back to where we lived. It was not a canoe, it was a steel boat, and we had various supplies and were a fair distance out and it was no small feat. I suppose it could be argued that I was depleted and needed the food for energy to complete the task before me. Anyway... when I got back to my mother's place, I'm not sure exactly when, I told her that I thought I needed to see a psychiatrist. She wanted me to talk to her. I tried to explain that I felt I needed an outside opinion, but it hurt her feelings. My summer visit was cut short, and my father set up an appointment for me. It didn't go well, and I felt at a loss. After a couple of appointments, I knew it wasn't going anywhere. And so I was depressed and spent a couple of weeks in bed. No one seemed concerned. My father dragged me very physically out of bed each day in my nightgown down to the barn to help feed the horses. And then came the really bad year, the year that probably decided the rest of my life.

10. Skipping school: it was not easy to attend school when my clothes were tight (tight jeans especially are very uncomfortable to sit in for long periods - and if there is no money to buy new clothes you are screwed if you can't control your weight gain.) Also, at a certain point my anxiety level was so high that it was almost impossible not to perspire constantly. I would be soaked with sweat for most of the day, and I'd also shake. Later in the day, I'd start to feel very chilled. I'd also very frequently experience excruciating stomach pains. It was impossible to concentrate at school in this condition. On one occasion, when experiencing these pains, they were so severe that I felt I was dying and actually asked to be taken to the hospital. I think most people who have panic attacks and feel like they're dying feel that way because they can't breathe... but for me it was the stomach pain. Perhaps it was a kind of panic-related thing. Add to this self-consciousness about the smell associated with sweating for long periods. Even though I showered every morning before school, it wasn't enough.

10. All of this led to feelings of frustration, helplessness and depression. I couldn't force myself to just buck up, and I wasn't coping with my problems. I'd think it would be obvious something was wrong. I'd asked for psychiatric help, my weight fluctuated a lot, I had stomach pains and anxiety, I was obviously depressed, but all of it was ignored and when I finally started skipping school and attracting negative attention (eg, getting in trouble for drinking), I was seen as a bad, problem child rather than a child with overwhelming problems that were unresolved. To me, it seems like the adults were either lacking in perception or insight, or just didn't notice me all that much. At the time, I felt that I was dropping out, that I just couldn't handle things.


I've often wondered if part of the problem with perceiving 'fatness' where others see emaciation refers not to the overall picture, but to one aspect of appearance, or a combination of a few features. Say a person has larger legs than is currently in fashion, or a rounder face, or some part of their body isn't as perfect as what their esthetic ideal is. Maybe they keep dieting until they deal with this particular aspect? Maybe their perceptions aren't totally wrong, but because of their perfectionism they are missing the overall picture?

I sometimes think that some of us realize that with the raw material we've been given to work with, we can't 'win' according to society's ideals, and so we try to create an internal structure to compensate. It's actually about making the most of things, I think. You realize you can't fit society's ideal, but you decide to be the best you can be, and I think that in some cases it's like an artistic esthetic that is formed.

How do you deal with all the conflicting messages that you receive from the outside world? The medical profession may say that a certain weight range is healthy, but a child may blurt out that you have "legs like tree trunks", the men you're with may secretly wish you were more conventionally ideal, people might judge you as not really fit if you have cellulite - even if you work out a lot, and the world in general may dismiss you as unimportant according to your personal appearance. And I guess you can work on other things, you can give to relationships, you can learn about the world around you and you can participate however you can, you can develop whatever interests or abilities you have. Even if you do those things, you will still face the conflicting messages, and you will have to face that there are probably women who can do what you do, and are beautiful/thin/fit at the same time.


Just one brief comment for now: It's evident that a lot of my problems snowballed because I wasn't assertive enough to keep trying to communicate. I'd become easily deflated, I'd collapse, and it would take a long time for me to be able to work up the courage again. Also, for too long I didn't know how to articulate what was wrong with me, and because I had something of a 'stoic' attitude because of my background, the seriousness of my discomfort was something I couldn't even really admit openly. My fears of being insensitive to others, my fears of appearing weak, whiny, lacking in self-discipline - all things I had been brought up to find unacceptable or unappealing in myself, got in the way of me articulating what would have been necessary.

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