Category Archives: eating disorders

How To Cope At Christmas: A Rough Guide For Those With Eating Disorders

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We are just two days away from Christmas, and people are stocking up on food, wine, and last minute presents. This time of year is always filled with trepidation for those of you with eating disorders. It’s a holiday focused around alcohol, food, and family, and at least two of the former bring on that familiar rising panic for lots of people suffering or recovering from eating disorders, whereas for the rest of us, it’s generally just the one (family; I’m talking about family).

If you are someone with an eating disorder, and you are approaching Christmas Day with dread, you are not alone, and you can get through it. It is probably going to be a tough day, but there are steps you can take to make the most of it. Here are my suggestions on how to get through the day:

Focus on Family

Food is a big part of Christmas for most people, but you don’t have to let that be your main focus. Prioritise your family and/or friends and/or partner and enjoy their company. Catch up on the gossip, take part in the board games, and sing along to the carols with grandma. Spend time doing what is enjoyable for you. If your family can make this easier for you, let them know how. Maybe it means trying to keep the topic of conversation away from food. Maybe it means keeping food in the dining room and having the lounge as a food-free zone. Maybe it means going out for a walk with your siblings to get a bit of fresh air and space. Whatever you do, try to keep the focus on the company of those you love, and enjoying the time spent with them.

Set Boundaries with Loved Ones

This is a day that everyone should be able to enjoy to their very best, so do take the time to talk to the people that you will be spending your time with and set your boundaries for the day. This could mean asking them to refrain from talking about New Year’s diets, making food-moralising remarks, or reminding them not to comment on any of your eating habits. Do not be afraid to voice your needs. It is important to make clear what you need from them in order for you to enjoy the day.

Challenge Yourself…But Not Too Much

A huge part of the anxiety of the day is that there will be a lot of delicious food around that you will want to eat but also will not want to eat, and that’s the fight between you and your eating disorder. For a lot of people, this battle is going to go on all day, and that can make the day extremely stressful and anxiety-provoking (see Focus on Family for ways to minimise this). This is also a great time to challenge yourself, but a time to not push it too far: you don’t want to make the day even more stressful by pushing yourself to the limit. One way to go about using this day as a manageable challenge is to make rough plan of what you might eat that day. This will give you a guideline that might help you feel a little more contained, but could involve trying something new or facing a fear food. Try not to restrict yourself as much a you can, but it’s okay if you need to feel safe for a day that is so difficult already.

Take Care of Yourself 

You may be around people this Christmas that will not respect your boundaries or may be insensitive or ignorant to your recovery. They may talk about the triggering topics which I mentioned in the “Set Boundaries With Loved Ones” section above, such as complaining that they have put on weight/are going to put on weight, lamenting that they have eaten “too much”, are being “naughty” or “bad” because they are “indulging”, or moaning that they need to go on a diet because of that. Please ignore them. They are battling their own insecurities and are looking for reassurance that what they are doing is okay and that other people feel the same and that they are not alone. This is really, really sad, and something that no one should have to feel. Enjoying the Christmas food is part of the festivity, and no one should have to feel guilty for it. Know that other people’s worries are not a reflection on you, and you should keep in mind that it is not something positive that they are experiencing, but guilt, anxiety, and insecurity. So instead of letting their negativity impact on you, empathise with them, as guilt, anxiety, and insecurity are emotions that you are likely experiencing also (albeit on a much grander scale to those who do not have eating disorders). Keep moving forwards towards your goals. Keep moving forward on your journey towards health and happiness. Keep in mind your motivations, and remember that the way you respond to others affects you primarily.

Leave the room for a bit if you need to. Take yourself off for a relaxing bath or a nap or to read a book. Go for a stroll. Have a quiet word with that relative who keeps calling the chocolate yule log “bad”. Just take care of yourself and do what you need to do, for you, to have the best day that you can. Do not be afraid to speak up. You need this. You deserve this.

If you are someone who has an un-supportive, highly triggering family, do know that it is okay to decide not to see them at all. If you want to spend Christmas with yourself, your partner, your partner’s family, your friends, or your pets, do it. Do what is best for you. Do what you need to do to continue moving forwards. Do what you need and you deserve to continue working towards health and happiness. Make positive choices, and don’t feel guilty about them. This is what you need. This is what you deserve.

Move On

Christmas is unfortunately never going to be an easy time for those with eating disorders, and it often means that those people go into it with anxiety, and leave it with guilt. It is okay to experience those feelings: you are not alone and those feelings are not your fault. However, you have to keep remembering that these negative emotions are caused by your eating disorder and the control that it has over your life. Keep fighting the war against it, and don’t respond to those negative feelings. You are going to be okay and you can get through this. Christmas will be over in a blink of an eye, and then it is time to put it behind you and move on from that day. Don’t carry the stress from it with you. Let the day go. Remember that it is absolutely, 110%, super okay to eat more than usual, go outside your meal plan, eat “normally”, or respond to extreme hunger (this applies for always, of course). It is okay to put on weight. It is okay to enjoy yourself. The guilt of going against those eating disorder rules can be overwhelming, but it is important to remember that this is part of recovery. Going against your eating disorder and doing what you deserve is part of fighting the battle inside your head. Eating whatever you want, whenever you want, is the goal, and so if you were able to do that for a day, or two, or more, or even if you were able to eat a little more than normal, you are making small steps towards achieving that outcome. That is a wonderful thing.

If the anxiety is becoming overwhelming, check out my article on anxiety management here.

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Extreme Hunger in Eating Disorder Recovery: Why You Are Not Binging and Other Fears Explained

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Recently I have been inundated with questions about extreme hunger. This is not unexpected, as extreme hunger is one of the most terrifying aspects of recovery, and one that the eating disorder will latch onto; screaming all of your/its fears into your brain and how they have/are about to come true. Extreme hunger is probably the most common topic that comes up in messages to me asking for information and advice, alongside digestive issues. Recently though, the questions have become even more unrelenting: I could answer five questions in a row about extreme hunger and then within hours receive five more, even though their question was answered in the previous messages. Either the senders of these messages did not take the time to read them (or my FAQ), or, as is understandable, they see themselves as the exception to the recovery process (the “I am a magical unicorn” thinking process).

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Our anxieties and our eating disorders tell us that what we are experiencing isn’t the normal symptoms of recovery; that we are different; that our experiences with an eating disorder do not warrant the symptoms of recovery; that we were not sick enough for this; that somehow we need less food; that somehow our weight gain is not normal; that unlike everyone else the numbers on the scale will increase forever more and we will gain into infinity. And I get this entirely, because I was the same, but there is only so many times that I can repeat the same things over and over again, especially when they are in messages that come directly after one another. And so I decided to create this article to address the fears and doubts that are the most common: the ones that come up in those messages time and time again. The first part of this issue is to talk about the main fears of those with extreme hunger. The second part is a collection of experiences from those who have gone through extreme hunger and come out the other side.

Without further ado:

You can experience extreme hunger regardless of what weight you are or how much weight you lost.
If you restricted your intake, your body experienced an energy deficit. This energy deficit causes damage. This can result in extreme hunger.

Extreme hunger varies in severity and length of time.
It often lasts longer, or is more extreme, in those who have restricted for long periods of time, or those who have restricted very severely. Combining the two is therefore likely to double the chances of this. However, everyone is different, and the severity of extreme hunger is down to how much the damage the body has to repair. If you have extreme hunger, you have it for a reason.

Extreme hunger can come at any time.
Extreme hunger can come and go, be constant, start on Day 1 of recovery (or even during your ED, hence “binging” episodes), come during the middle of the recovery, or the end, or not at all, and it can last for varying periods of time.

It is totally normal to crave what you may call “unhealthy” or “junk” food.
High carb, high fat, and high sugar foods are foods that you are likely to have restricted during your eating disorder, which is why your body craves them now. It is deficient in those things and also in energy, and these foods tend to be high in energy and are easier to process by the body. Basically, this food is easy energy for a starved body. Your cravings for these types of foods will calm down in time as your body gets healthier and your mind recognises that you will not deprive it of these foods again. As a side note, just remember, that there is no “healthy” and “unhealthy” foods; “good” or “bad”, there are just foods that have different nutritional and energy values. Food is food, and also food is not a moral issue.

Extreme hunger is normal, natural, and expected.
If you starve your body, it is going to need more calories than a healthy, energy-balanced body, in order to get back to its balanced state. You can read more information about extreme hunger, why it happens, and how to cope with it here. I also have a video on the topic here. You are not alone in this experience.

Extreme hunger will not lead you to gain forever.
If you starve and lose weight, you will gain that weight back when you start eating more (and possibly more if your body is still growing and developing as your natural weight is not static until around 25ish when you have grown fully  into your adult body). However, extreme hunger is more about internal repairs. So yes, some energy will go towards gaining weight, but lots of energy also goes into healing the damage done to your insides, which means it is used up doing this and is not part of weight gain. When your body is not so severely damaged, your appetite will taper down.

Extreme hunger will stop.
Extreme hunger is there for a very good reason: because your body is severely damaged and needs energy in order to repair this damage. When the body is healthier and not in need of so much energy, it will stop giving you signals for so much energy. Trust the body. It wants to heal you. It wants you to be happy and healthy. Your eating disorder wants to kill you. Put your faith in the right one, even though handing over control feels so scary. Remember that the illusion of control is scarier, and that with your ED you were never in control at all. You were controlled by something that wanted you as miserable and as sick as possible. It’s ultimate goal is your death. Take back control by working with your body, not against it. By giving over control to your body, you will be more in control than you ever have been, because you are reclaiming your health and happiness.

Your eating disorder will try and tell you that you are using extreme hunger as an excuse to eat, but that you were “not sick enough”, “didn’t restrict enough”, “didn’t lose enough weight” to warrant experiencing extreme hunger in recovery.
This is manipulation and bullying by your eating disorder. It can feel that it is losing, and it will try anything to have total control over you again. P.s. you never need an excuse to eat whatever you want, and if you can eat amounts that are “extreme hunger amounts”, then there’s a very good reason for it, and that reason is that the body needs it.

What you think is extreme hunger might not be extreme hunger.
2,500-3,500 calories is a very normal appetite. 3,500-4,000ish is more of a grey area. It is a larger appetite than most people with a healthy, energy-balanced body (although can be reached by energy-balanced people, usually by eating lots at a restaurant, or a buffet, or a night out drinking lots of alcohol and mixers), but it is not exactly extreme. 4,000-4,500+ is when it would start to be more in the extreme hunger range. All of these ranges can be experienced by a person in recovery from a restrictive eating disorder.

You are not binging and you do not have BED.
It feels very very much like binging, but it is not BED, and here we can look at the criteria for Binge Eating Disorder:

DSM-5 Diagnostic Criteria
  • Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following:
    • eating, in a discrete period of time (for example, within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances
    • a sense of lack of control over eating during the episode (for example, a feeling that one cannot stop eating or control what or how much one is eating)
  • The binge-eating episodes are associated with three (or more) of the following:
    • eating much more rapidly than normal
    • eating until feeling uncomfortably full
    • eating large amounts of food when not feeling physically hungry
    • eating alone because of feeling embarrassed by how much one is eating
    • feeling disgusted with oneself, depressed, or very guilty afterwards
  • Marked distress regarding binge eating is present.
  • The binge eating occurs, on average, at least once a week for three months.
  • The binge eating is not associated with the recurrent use of inappropriate compensatory behavior (for example, purging) and does not occur exclusively during the course Anorexia Nervosa, Bulimia Nervosa, or Avoidant/Restrictive Food Intake Disorder.

You will probably read these and think but this is what I am experiencing! Let’s go through it point by point:

  • Yes, you will eat food that is larger than most people would eat in that time because you have a starved body that needs loads more energy than most people.
    You will absolutely feel a lack of control because your eating disorder (which gives you the illusion of being in control) is not driving this: your body is, and therefore your ED will feel out of control.
  • Yes, you will probably eat rapidly because your body wants to get energy is as fast as it can because it is desperate for it.
  • Yes, you will feel uncomfortably full because a) your stomach is shrunken and b) this is an amount of food that your stomach is not used to at all.
  • You may not feel physically hungry because extreme hunger can be experienced in many different ways. Extreme hunger can be the feeling of hunger and tummy rumblings etc, but for the most part, from talking to people and experiencing it myself, it comes in the form of feeling empty and/or intense urges to eat/mental hunger.
  • Feeling embarrassed, disgusted, depressed, and guilt, along with marked distress, whilst and/or after eating a large amount of food, is quite obviously going to be experienced by someone with a restrictive eating disorder.
  • Again, it can be experienced every day, or on and off on some days and some not, or once a week, or not for a week and then constantly for weeks, etc etc.
  • Now if we take a look at the last in that category, I want to draw your attention to “does not occur exclusively during the course Anorexia Nervosa, Bulimia Nervosa, or Avoidant/Restrictive Food Intake Disorder“. You are in recovery from one of these eating disorders (or OSFED/EDNOS). This means that you still have that eating disorder, because even though you are moving forwards from it, it is still active for you, until it is inactive and you are in remission. Meaning that you do not have BED. You have anorexia, bulimia, OSFED, or ARFID, and your body is trying to recover from the physical effects that this has had on you.

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Personal Experiences With Extreme Hunger : Those Who Have Come Out The Other Side

Extreme hunger was definitely the most daunting part of the recovery process for me. Mine began about 1 week into recovery and lasted non stop for approximately 3 months and then fairly regularly for the next 9 months with only the odd day here and there after that. It was emotionally traumatic and I was, like many people who go through it, certain that I had developed a binge eating food addiction. I had not… it was exactly what my body was screaming out for and all I had to do was listen to it and respond appropriately without compensating through exercise or attempts to restrict afterwards. I would eat thousands of calories in single sittings, often after a meal is when it would hit me. For example I’d have a normal lunch and would then suddenly feel like a bottomless pit, like my insides were desperate for more. I’d eat several family packs of biscuits, boxes of cereal, whole boxes of magnum ice-creams, share bags of salted nuts, loaves of bread, you name it. It was terrifying but I battled through the fear and the hatred my ED would scream at me and allowed my body to do the healing it so desperately needed to do. Over time the episodes of EH would become fewer and further between and now I simply couldn’t eat as much food as that in a single sitting- now I look back on it and know with confidence and experience that it was essential for my recovery and pivotal in my battle of overcoming my eating disorder. – Emily, 22

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I developed an eating disorder when I began restricting calories in order to lose weight. It got out of hand and I then developed bulimia. I wish I had known that my binging (extreme hunger) was a normal reaction to the restriction. Eventually I realised the only way to end the bulimia cycle was to just go all in and let my extreme hunger run its course. It was really really REALLY hard, and scary, with many slip ups, and I recommend building a good support system around yourself. I didn’t count my calories at the time, but I’m sure they went to at least 4000-5000 most days. I think on average I would have hit 4000 calories a day. But there were definite days where it could have easily been 8000 calories. What I remember most is eating entire loafs of bread with butter in one sitting. Definitely entire large icecream tubs were in there. Just complete freedom. It was the best decision I have ever made. It meant I could enrol into university and study. It took the better part of a year for the extreme hunger to completely subside, and then another year for me to be completely rid of disordered thoughts around food. I know I’m so lucky to have gotten through it. I’ve tapered down to a weight that has stayed stable for months without any effort. I now have the brain space to focus on things I actually love doing. I wouldn’t have gotten here if I didn’t let extreme hunger run its course. – Ira, 24

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Before I experienced extreme hunger, I had tricked myself into thinking I wasn’t sick anymore, because while I was eating the minimum amount of calories recommended for me for my body weight (which turns out is less than half what I should have been eating to live a normal life) and experiencing extreme orthorexia, I was still, in my mind, eating. I thought that I was well enough to go back to work as a chef. In the six months that followed the years and years of starving myself overwhelmed me and extreme hunger kicked in. I had no idea what it was and was terrified I had developed BED. I would eat cake until I felt sick, throw it away in tears, and then feel the need to eat it so badly that I’d get it out of the bin again. I would eat entire loaves of bread and cheese and all of the food I’d told myself I wasn’t allowed to eat, and panic until I had anxiety attacks. I was terrified and felt so wildly out of control that I started making myself sick again. After months of this, although it was incredibly difficult, I stopped being sick, I stopped counting calories, and I tried really hard to eat what my body was telling me to eat. I threw away my scales. I didn’t look in a mirror for months. I just told myself that it was going to be okay, and that I had to let my body do this so that I could live my life without spending every waking moment thinking about fat and weight and diet plans. I just wanted to be able to live like normal people lived. Obviously I put on weight, because my body was starved and was desperate to hold on to the calories I was putting in to it, but after a few months of extreme hunger, my body began to calm down. My appetite lessened, and my weight evened out. I learned how to eat normal food again, how to eat without calorie counting, and how to eat meals like normal people at normal times. Extreme hunger terrified me because I didn’t know what it was, but I needed to go through it not only to let my body recover from all of the awful things I’d put it through, but also to learn how to eat again.  Anonymous, 24

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My experience with extreme hunger was a scary one. Going from eating so little to so much in such little time was a shock both mentally and physically… and was actually kind of terrifying at times. My extreme hunger began very soon after embarking on a ‘3000 calories a day’ meal plan. After a few days of this plan, it was as if my body completely took over my mind and wouldn’t rest unless it was well fed. For the first few days of extreme hunger, there was actually very little fear or hesitation involved when it came to eating. I felt FREE. I ate pretty much everything I’d been restricting by the bucket load. If an award could be won for the most chocolate consumption in one sitting I’d definitely win them all (are these awards a thing? I hope so). I’d say that my consumption started at around 5000-6000 at the beginning for around 2 weeks and then crept up to around 10,000 calories a day which I’d say lasted for around 4-5 weeks. Can I just add that it sounds WAY more terrifying than it actually is. Yes – it is scary, but it is also the most freeing thing you could ever experience. After eating around 10,000 calories a day for 4-5 weeks, my hunger began to taper a little; week by week my intake lessened slightly until I was eating 3000-4000 calories naturally and comfortably a day.
Body wise, I gained weight quickly. I had the whole puffy face, slightly pregnant belly thing going on. At the time, I honestly didn’t concentrate much on how I was looking. The feeling of freedom was completely overwhelming and overshadowed the physical effects of what I was going through. That being said, extreme hunger didn’t come without its discomfort. My body was obviously not accustomed to digesting this volume of food, which meant that I experienced fairly severe stomach cramps. I ensured that I stuck to easily digestible food at this time and after a couple of weeks, they passed.
My extreme hunger diminished completely at around 7 months into recovery and I am now 3 years in! Extreme hunger helped me break down so many barriers in recovery and it has enabled me to build a far healthier relationship with food. – Emmy, 22

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I was meeting with a nutritionist about once a week at the beginning of my recovery. She would give me a meal plan, calorie goal, etc. It was extremely difficult at first because I had to not only eat, but keep in, the calories I was consuming. Once I was on this meal plan for a few weeks the extreme hunger started to kick in. The biggest issue I had with extreme hunger is that in the beginning you don’t trust your body or think that it’s accurately telling you the things that you want. But one day I just said “fuck it” and tried a different approach. Whatever I was craving I ate, no matter the amount I wanted. The extreme hunger lasted for six months, and was one of the more difficult parts of the recovery process but it is so, so worth it, and is exactly why I can be typing this right now while enjoying ramen with my roommates and knowing that yes, this can be overcome. – Natalia, 21

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Last year, I used MinnieMaud to recover from anorexia. Extreme hunger hit me like a truck, and I was a ravenous beast for a solid 4 months. I went from about 90 lbs to 150 lbs, and once I hit that weight, my appetite normalized, which was pretty awesome and relieving. It was a rough and scary road, but having confidence in the principles of MM, and especially the Minnesota starvation study, and TRUSTING my body, helped immensely. – Anonymous, 30

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During the early parts of recovery my hunger was huge. I was CONSTANTLY hungry/craving large amounts of food. I would eat blocks of cheese, chips, sandwich after sandwich and still feel hungry even though my stomach felt so full and bloated. It was scary to think the hunger would never end and I’d just keep on eating and eating. BUT, I trusted the process and resigned myself to allowing myself grace during this period knowing many other people had experienced the exact same thing with good results in the end. I knew the key was to not limit myself when it came to food and cravings. It took awhile but slowly I started noticing myself eating and craving smaller portions and feeling satisfied with those portions. The body just needs all those calories and nutrients after being in the negatives for so long. Give yourself time to make up some of the deficits without freaking out too much! You can do it! – Shannon, 34

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My extreme hunger started before I even chose to recover. My body eventually decided that after seven years of restriction that varied from minor to severe during that time span, and one year of severe, unrelenting starvation, it was going to have to do something about it. My body would put me in what I can only call “trances”, where I would go to the kitchen and eat loads of porridge oats, then “wake up”, and chaos would ensue, both in my mind and my reactions to what I had eaten. A month or so of this ensued: with my body taking over, and then my eating disorder reacting to it and making me compensate. Then I chose recovery, and tentatively gave myself permission to respond to the hunger and cravings that I was experiencing. During extreme hunger I would eat whole cheesecakes; pints of Ben and Jerry’s; bowls of cereal; whole big Thornton’s chocolate boxes…I was terrified that I had developed BED; that I was using recovery as an excuse to binge; that I would never stop eating so much…but it did. It stopped when I was healthier. My appetite tapered down. It stopped demanding so many high carb and high fat foods. My days of experiencing extreme hunger lessened and grew farther apart. During the second year of my recovery, my appetite was generally normal, with a couple of days of eat around 4,000 calories (in the grey area between normal appetite and extreme hunger, but then again some days I probably didn’t eat enough for my body and therefore ate more on other days). Now my weight is stable, my appetite has normalised, and I haven’t experienced extreme hunger for years. It was terrifying to go through, but it is not endless. It does stop. And it is so important to trust that your body is that hungry for a reason. – Myself (Sarah Young), 25

I hope that this article answers most of the questions related to extreme hunger and gives some reassurance that this is normal and does end.

 

Hidden Behind A Healthy Weight: The Eating Disorders You Can’t See

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Eating disorders are complex illnesses. They are a mental illness that often result in the deterioration of physical health, and there is not one recovery method that has a high success rate as of yet. They have a complicated entanglement of genetic and environmental causation that is entirely individual to each person. There are many different types of eating disorders (anorexia, bulimia, EDNOS/OSFED, ARFID, BED, purging disorder, rumination disorder, pica), and people of all ages, genders, weights, ethnicity, sexual orientation (etc, etc) can develop one. And yet we are bombarded only with images of eating disorders in the form of extreme anorexia: the emaciated, skeletal bodies of those walking the fine line between life and death. The media blasts out the headlines that often scream something like “I WAS 4ST AND ONLY ATE A LETTUCE LEAF A DAY”. They plaster photos of bones protruding across the articles and present to us an “after” photo of the recovered victim: nearly always a slim, beautiful, white young woman.

And there we have it: the damaging stereotype of what an eating disorder looks like and who develops one. This stereotype harms everyone who deviates from the narrative of pretty young white girl who starves herself to within an inch of her life. I’ve never seen an article about anyone black with an eating disorder. Ever. I’m sure that there are one or two articles out there, but the media all but erases the existence of black men and women with eating disorders. It erases the existence of older adults with eating disorders. It erases the existence of men with eating disorders. In fact, the media erases nearly all eating disorders in themselves – the minority of people with eating disorders experience anorexia nervosa, and an even smaller amount have the chronic anorexia that the magazines depict. “Before the latest change in diagnostic criteria, it was estimated that of those with eating disorders, 10% were anorexic, 40% were bulimic and the rest fall into the EDNOS category” (from here). Most of the 90% of people with eating disorders that are not diagnosed as anorexic will be fit into the “healthy”, “overweight”, or “obese” BMI categories. That’s not to mention all the undiagnosed people who are not seeking help and are invisible because of their weight, who are not getting the help and support that they need and deserve.

There are also different types of “invisible people” with eating disorders at a “healthy” weight. Those who have lost lots of weight but come from a higher weight are one set of people. These people are often congratulated for their weight loss, even though it has been lost in exactly the same way  that someone going from a “healthy” BMI to an “underweight” one has – someone who would be diagnosed with anorexia rather than praised for their efforts. We offer treatment to those that lose weight and fall into the weight criteria for an anorexia diagnosis, and pat those on the back that lose the same amount of weight but come from a weight perceived as socially unacceptable (or a weight perceived as “acceptable” but not “desirable”). And what many people do not know, or forget, is that we all have our own natural healthy weights (that can be pretty much any weight, shape, or size), and if people are well below those weights, they are underweight for their own individual body. So if someone is naturally a BMI of 27 and they starve themselves to a BMI of 20, they are severely underweight for themselves, but their eating disorder are often dismissed as “healthy weight loss efforts”. Their illness can be not only hidden, but recognised as something positive, and therefore encouraged and reinforced. Included in this category are those who will never dip below a “healthy” BMI and could remain invisible for any amount of time, and those who will continue to lose weight. At this point society will go “woah, lose weight but not too much weight!” This is when their weight loss will be recognised as an issue, but as it was never noticed before, by now the person will likely be entrenched with their eating disorder.

Another group are people who have eating disorders but find that their weight doesn’t change much, or there are those that gain weight during their eating disorder. Weight is only a secondary symptom of some eating disorders, and it is important to understand that not everyone experiences a change in weight when suffering from an eating disorder. They are primarily mental illnesses.

Another group of “invisible people” at a “healthy” weight are those who are recovering from a low or lower weight and have gained weight to a weight that society deems “fine”. Peoples see them in the street and don’t suspect a thing. Friends stop worrying and family heave a sigh of relief. Those close to the person show less concern and more frustration: they think that the journey is over. You look fine therefore you must be fine. It’s important to remember that this is a mental illness, and that the physical symptoms are secondary. It is also important to remember that the person may still be at an unhealthy weight for their own personal body, and though they may be an acceptable size in terms of society’s standards, they may be underweight still regardless of BMI. Just because you can’t see their pain doesn’t mean that they are not experiencing it. The mental anguish that led them to rock bottom is still there and still needs to be addressed.

People who look fine but have expressed that they are not need to be taken seriously. They need to be supported, and they need to be encouraged to move towards being healthy and happy: whatever that looks like for them. It might not look like your idea of healthy and happy, but you have to put aside your biases, your judgements, and your prejudices in order to help that person achieve the best life that they can for them.

If you are someone who is living at what society says is a “healthy” weight, but you have engaged in disordered habits to get there, or you are regaining weight and are still unwell but people think you “look fine”, then sit those people down that are important to you and tell them. Set your boundaries, let them know what you need, and ask them to support you to get better. Be open and honest. Don’t downplay your struggles. Be assertive when telling them what is helpful and what is unhelpful.  Print off information on eating disorders to support what you are saying and to give them something to read later to help them to understand how pervasive and powerful an eating disorder is mentally. Write a letter if that is easier. Whatever you do, talk. Your voice needs to be heard.

Celebrating the Day that I Chose to Live

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TRIGGER WARNING.

This article contains before and after photographs of someone who has previously suffered with an active eating disorder, and also names eating disordered behaviours that they previously engaged in. This article could be triggering for vulnerable people, those with eating disorders, and those recovering from eating disorders.

Today holds an extortionate amount of significance for me: four years ago today I made the decision to make the first steps towards recovery from my mentally and physically destructive and severe mental illness: atypical anorexia. It didn’t feel like much would come from the vague, half-hearted decision, but it was a monumental moment that put me on the road to recovery. That moment has gotten me to where I am now: a healthy, happy woman who has been in remission from an eating disorder for over one and a half years, after an intense two and a half year battle in which I emerged victorious.

I’m well aware that I wrote a post last year which will probably be very similar to this one, but the topic isn’t an insignificant one: this day four years ago saved my life in many ways, and celebrating it is, in reality, celebrating the day I decided not to die slowly, and to fight tooth and nail for my health, my happiness, and ultimately, my life.

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Four years ago today I was entirely, unequivocally, weary of being sick and miserable. I was weary of being in a living hell. I was weary with the despair and the darkness and the anger and the devastation. I was weary of watching my hair fall out in clumps in the shower; of watching it become thin and dry and brittle; of being dizzy; of living in a grey world where my senses were dulled as if my brain was smothered in cotton wool. I was fed up of the insomnia; of the nightmares; of the calories circling around my head all day and all night, leaving little space in my mind for much else. I was tired of counting down the minutes until I was “allowed” to eat; of the starving and compulsive exercising, and eventually, the purging; of the intense fear I felt at going anywhere near food; of the absolute and utter desolation of my mind and body that meant that I lived in a starving shell that could not function, and a mind controlled by  a single focus: lose weight lose weight lose weight. A focus that meant I could not think about anything else; could not deal with anything else. A focus that meant that I did not have to confront the emotions and experiences that had caused my eating disorder in the first place. A severe mental illness caused by a combination of genetics and my environment was my way of handling the world and myself, but finally, after 8 years, I had decided that this could not go on. At first, I viewed death as the only escape from the torment my eating disorder wreaked upon me, but moments of clarity started to push their way to the forefront of my mind, until the possibility of recovery developed from rejected thoughts to cautious actions. And over time my strength grew, and grew, and grew.

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I know: you’ve heard it all before. You’ve read my posts or the posts of others, you’ve watched a loved one battle an eating disorder, or you’ve experienced it first hand. But today I also want to talk about where my recovery took me and how it might differ from that of others.

I have come across a lot of people who live under the title of “recovered”. It may be a title they have given themselves or a title a professional has given them. It doesn’t matter. What I see are a lot of very slim people who use the word “recovered”. Some of those people will be naturally slim – people whose natural, healthy weights are down the lower end of that “healthy” BMI category. And that’s great! All weights, shapes, and sizes are fab, as long as the person is at their natural, healthy weight and is healthy and happy. However, I tentatively would suggest that there are those that maintain a certain weight by closely monitoring and restricting their intake and controlling their exercise. And if that is where you end up at in recovery because you are unable at that point in time to go any further or feel that that is all you can manage, then I applaud your progress and your strength and bravery in getting to that point – you are amazing and strong and wonderful. Some people will manage their eating disorders and live with it in a state halfway between being free of their eating disorder, and being utterly consumed by it. That is absolutely okay, and if you want to call that full recovery, who am I to decide that it is not by your own personal definition? But I also want to stress that that is not where you have to be if you want to choose differently. You can push further. Whether that is now, or in the future, there is the option to press on forwards to a life where you live pretty much entirely free of your eating disorders influence. I know, because I decided to take the path to that place.

I decided to reject the idea of an “ideal” body. This took me a very long time. It took years of research into health at every size and weight set point theory. It took getting involved with feminism and the body positivity movement. It took learning about the impact of diet culture and how the diet and weight loss industry intentionally make us hate ourselves for profit. It took deciding to be as healthy and happy as I could possibly be in both body and mind. It took deciding to let go of the importance that I had placed on being a certain weight.

I turned out to be one of those people who naturally have a higher body weight than others. It can mean dealing with increased stigma around weight and size, and comes with knowing that I am at a weight where some people will look at me and decide that I am unhealthy/lazy/greedy, whilst knowing nothing about my lifestyle, or indeed myself as a person. Some people will look at me and see me as a weight/shape/size. I am also aware of my own weight privileges in that there are people at far higher weights than me that suffer a hell of a lot more stigma and discrimination. I am aware that although I am far from society’s “ideal” body weight, shape, or size, I still wear “acceptable” clothes sizes (as in, the clothes stores that I shop in cater for my size, even if it is a size some feel shameful about). It is also a size that I maintain effortlessly eating a balanced diet (and by that I mean I eat what I want, when I want, which leads me to eat a wide variety of foods from all food groups), and with physical activity that I do for enjoyment rather than to alter my weight, shape, or size, or any other disordered reasons. It is the size that I can live my life as a healthy and happy person. If I wanted to be smaller, I would have to focus on calorie restriction and possibly an excessive amount of exercise, and we all know where that would lead. Don’t misunderstand me: I’m not going to lie and say that if I had to option to do all this at a smaller size, then I would choose not to. Because of the importance society places on our bodies, being at a smaller size would mean not having to think about or deal with the discrimination of being at a higher weight, and I would rather choose not to deal with that. But my body and its weight/shape/size is not at fault for those stigmas, and nor am I. I accept my body. It is everyone else accepting my body as happy and healthy and beautiful that is the problem, because not everyone does. But that’s okay, because I choose my health and happiness over the approval of others. I choose me.

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To get to where I am now, I chose to reject the ideas and ideals that are so entrenched in our culture and our society. I chose my actual health over the idea that you have to be a certain weight, shape, or size to be healthy. I chose my happiness over the absolute lie that you have to be a certain weight, shape, or size to be happy. Those lies are fed to us all day, every day, everywhere we look, but I just don’t buy it any more. I’ve seen enough evidence of all kinds to call bullshit. And I have decided to live my life in a way that means working with my body and letting it be whatever weight, shape, or size it needs to be to enable me to be healthy and happy. I will not change that for anyone. I choose me.

Orthorexia Nervosa: The Invisible Eating Disorder

veggies.jpg

Orthorexia Nervosa. Have you heard the term before? Many haven’t. “Orthorexia” is a word that is not yet an official eating disorder diagnosis, but is used to describe a particular set of eating disorder behaviours that are distinguishable from other eating disorders, although can be experienced in conjunction with other eating disorders (usually anorexia nervosa). It is also an eating disorder that is easily overlooked in a society obsessed with “healthy eating” and exercise.

Those suffering from orthorexia have an unhealthy obsession with healthy eating and healthy lifestyle, so much so that it becomes extremely rigid and restrictive in regards to food, and can also include compulsive and excessive exercise. Orthorexics can be obsessed with feeling “clean” or being “pure”, and generally fixate more on this than on body weight as a motivation for behaviours. Orthorexics can also feel morally superior for the choices that they make in regards to their lifestyle, and the way they view themselves becomes entangled with the way they live their lives and what they put into their bodies or do with them. Orthorexics can find that their diet becomes so restrictive in both calories and food variety that it can become extremely physically unhealthy as well as mentally. This can also be the case in regards to excessive exercise. Like other eating disorders, it will end up becoming a top priority for the sufferer, and they can end up isolated.

In a culture that celebrates weight loss, calorie and food group restriction, and exercise, it is easy to go unnoticed if you have an eating disorder at a “normal” weight, but even easier if you have orthorexia. In a society that focuses so much on health, those with orthorexia will more likely than not be congratulated for their “healthy” life choices, determination, perseverance, and motivation. Others may aspire to be like them because they appear to work so hard at being healthy, whilst in reality they are driven by a relentless and miserable force that has nothing to do with being healthy and more to do with being mentally ill. That mental illness will be driving that person into the ground both mentally and physically with its extreme rules and restrictions, and that may go unnoticed in amongst the admiration of others.

Eating disorders are terrifyingly common, let alone the phenomenal amount of people living with disordered eating (issues with food, weight, etc, that are not a mental illness but are a problem). Our preoccupation with a “healthy” lifestyle and our celebration of “healthy choices” is misplaced. Living a healthy lifestyle is great, but we are missing the bigger picture: so many people are utterly miserable trying to achieve goals that are usually more about being thin than being healthy, or are driven by guilt and shame about not being “healthy” enough. In trying so hard to be physically healthy, we are sacrificing mental health, which is just as important – if not more so. With our food/weight/exercise/health obsession, and the equation of “health” with morality, no wonder so many eating disorders go undetected. It is a culture for eating disorders to thrive in, and that horrifying truth is something that we need to recognise and address.

So could you recognise orthorexia? Do you think you may have it yourself? The Timberline Knolls website talks about orthorexia and how to recognise it particularly articulately, so I have put it below. If you want to read more information on it, just click the link above.

Orthorexia is the term for a condition that includes symptoms of obsessive behavior in pursuit of a healthy diet. Orthorexia sufferers often display signs and symptoms of anxiety disorders that frequently co-occur with anorexia nervosa or other eating disorders.

A person with orthorexia will be obsessed with defining and maintaining the perfect diet, rather than an ideal weight. She will fixate on eating foods that give her a feeling of being pure and healthy. An orthorexic may avoid numerous foods, including those made with:

  • Artificial colors, flavors or preservatives
  • Pesticides or genetic modification
  • Fat, sugar or salt
  • Animal or dairy products
  • Other ingredients considered to be unhealthy

Common behavior changes that may be signs of orthorexia may include:

  • Obsessive concern over the relationship between food choices and health concerns such as asthma, digestive problems, low mood, anxiety or allergies
  • Increasing avoidance of foods because of food allergies, without medical advice
  • Noticeable increase in consumption of supplements, herbal remedies or probiotics
  • Drastic reduction in opinions of acceptable food choices, such that the sufferer may eventually consume fewer than 10 foods
  • Irrational concern over food preparation techniques, especially washing of food or sterilization of utensils

Similar to a woman suffering with bulimia or anorexia, a woman with orthorexia may find that her food obsessions begin to hinder everyday activities. Her strict rules and beliefs about food may lead her to become socially isolated, and result in anxiety or panic attacks in extreme cases. Worsening emotional symptoms can indicate the disease may be progressing into a serious eating disorder:

  • Feelings of guilt when deviating from strict diet guidelines
  • Increase in amount of time spent thinking about food
  • Regular advance planning of meals for the next day
  • Feelings of satisfaction, esteem, or spiritual fulfilment from eating “healthy”
  • Thinking critical thoughts about others who do not adhere to rigorous diets
  • Fear that eating away from home will make it impossible to comply with diet
  • Distancing from friends or family members who do not share similar views about food
  • Avoiding eating food bought or prepared by others
  • Worsening depression, mood swings or anxiety

You can also read my article ‘Food Is Not A Moral Issue’ here.

 

What People With Eating Disorders Would Like You To Know

Communication

This week is National Eating Disorders Awareness Week. I asked people suffering from eating disorders “what would you like people to know about eating disorders – whether in general or yours personally?” and was met with people eager to share their thoughts and feelings. So I bring to you this post constructed of 32 people’s top things that they would like the public to know about eating disorders and recovery from them. This post illustrates both the different and shared experiences of those with eating disorders and the way they would like to be perceived and supported. Please remember that people with eating disorders are not exempt from your life. They are your husbands and wives, brothers and sisters, sons and daughters, friends and colleagues..you will know someone with an eating disorder, and they may need your help and support. Without further ado, let’s take a look at what they have to say.

“It’s not something we can control. And it doesn’t matter how much weight we lose, it’s never enough.”

neda recovery

“OSFED (formerly EDNOS) is the most common eating disorder. It also has a higher mortality rate than bulimia and at the least the same mortality rate as anorexia – some studies suggest that it is even higher. It would be nice if people stopped thinking that OSFED/EDNOS is not as dangerous or as “real” as anorexia or bulimia.”

neda recovery

“Eating disorders are not about food and dieting, but about control and a distraction away from deeper insecurities and not feeling good enough alongside everyone else. They can’t be turned on and off at will, but then CAN be fought and recovered from. An eating disorder is not a choice, but fighting for recovery is.”

neda recovery

“Eating disorder recovery isn’t just a physical change, but mostly a mental change. Yes, physical changes do happen, but you won’t recover unless you change mentally too.”

neda recovery

“It’s not something someone can just stop. It’s like a constant voice in your head always whispering to you. It’s not some silly phase you just grow out of. It’s not something beautiful. It’s hard, unhealthy, and it tears you apart both inside and outside. It’s always inviting and easy to slip back into and it takes so much effort to not do just that.”

neda recovery

“Eating disorders are not visible from the outside.  Also I think it can’t be stressed enough how triggering any kind of comment about eating behaviours/body can be.”

neda recovery

“I think more information about orthorexia is needed as obsessions with healthy eating and fitness hardly ever are recognised as real problems. I also think orthorexia might be much more common than people might think.”

neda recovery

“Relapse doesn’t mean someone was faking their recovery or that they don’t want recovery. It’s really irritating when someone suggests that I didn’t want it until I hit rock bottom.”

neda recovery

“Now that I’m open about my eating disorder, it doesn’t mean that I am faking or seeking attention now. I just want people to know more about the facts of eating disorders. Also understand it is important for me to tell people to help me get better and not keep any more secrets.”

neda recovery

“Weight restoration and recovery are not synonymous. The way I feel and the amount of pain/difficulty I’m going through is often inversely proportional to how healthy my body looks. I usually need most support at the very times i look healthiest. Don’t assume anything from how someone looks. Don’t confuse physical health with mental health. When my weight is higher, I need way more support than when it’s dangerously low.”

neda recovery

“Please don’t get mad, impatient, frustrated, or annoyed with me when I am struggling with something. I know it may make no sense to you. ‘Food is good, how could you be afraid of it?’ ‘How could you care about something as dumb as this or that?’ Guess what… I don’t even understand the thoughts and compulsions myself sometimes. Just be there for me, try to be understanding, and encourage me to nourish myself. I’m getting better, step by step.”

neda recovery

“My eating disorder is not just a diet, and I don’t engage in these behaviors because I have more self control than you. It’s an illness that is controlling me and eating me alive, and fighting it requires more strength than you could ever imagine.”

neda recovery

“They’re not fun, and the romanticisation of them online is what caused mine.”

neda recovery

“Just because someone is at a “normal weight” now doesn’t mean that they aren’t still scared to eat or gain weight.”

neda recovery

“How many times you do/do not relapse doesn’t determine the severity of your illness or that you are “better”.”

neda recovery

“I’d like people to know that I don’t do this to hurt them, I don’t purposely try to upset the people who care about me, I’m trying to do the complete opposite. All I want is to make people happy and sadly my brain tells me that this is how I can achieve that.”

neda recovery

“Getting angry at me only further fuels my ED, please stay calm and collected.”

neda recovery

“That recovery is never ending. Eating disorders can become a coping mechanism, and so, if you have no other way to cope or if the stress is so severe then the eating disorder gains strength.”

neda recovery

“It’s really not about food. Way too many people see eating disorders as superficial and hold a mentality that deadly diseases are just diets gone too far. I want more people to recognise the seriousness of eating disorders, including the “invisible” eating disorders such as BED and EDNOS.”

neda recovery

“I want to talk abut it and be asked about it. I’m not ashamed but I have found that my friends and family act as if it doesn’t exist/never happened and it makes me feel awkward. I wish they’d just stop making it the elephant in the room! Anorexia is not a swear word!”

neda recovery

“Saying “you’re not fat” or “you don’t need to lose weight” doesn’t help at all, and when you open up to someone they don’t understand what you think of yourself. I think what would help instead of telling them to “eat more” would be to help them love themselves again and enjoy food and exercise.”

neda recovery

“BED is as serious as any restrictive eating disorder. Men develop eating disorders. Recovery means using healthy coping mechanisms to fight disordered thoughts, not getting rid of the thoughts.”

neda recovery

“Ich bin an allen Informationen interessiert da ich mich endlich befreien möchte und in recovery gehen will aber jede Menge angst habe. Mut und Zuspruch wäre das wichtigste und das man es schaffen kann.”
(Google translation: “I am interested in all the information because I finally want to free myself and will go into recovery but plenty ‘m scared . Courage and encouragement would be the most important and it can be done.”)

neda recovery

“It’s not easy. It’s complicated and tormenting and doesn’t receive enough awareness.”

neda recovery

“Just because you are gaining weight and you are looking healthy does not mean that you are okay. You are still recovering. And it’s still hard. And even after recovery and remission, it’s not like all of the recovery problems disappear, they are still there, you just can cope with them better.”

neda recovery

“Commenting on my body in any way is not helpful, even if you mean it with the best intentions, it can be triggering. Find other ways to measure our success in recovery, like how much more we smile.”

neda recovery

“Don’t comment on how other people’s bodies are thin or heavy. Don’t make body size and appearance so important. Focus on happiness and health instead. Don’t blame the person with an eating disorder for being ill. Try not to be angry with the person with an eating disorder; it will make them hide from you even more. My parents, for the first years were so angry at me. They treated me as if the eating disorder was something that I was choosing. They kept asking me to quit acting out and were angry at me for not. They interpreted my behaviour as a personal betrayal. It hurt me a lot. I missed them and being close to them.”

neda recovery

“Understanding that public situations involving food (or even not food, just a lot of people) can be totally terrifying because of how the person with the eating disorder may feel (rightly or not) that their body is being judged. Be understanding that we may want to go out and have fun, and we may plan (depending on where we are in recovery) to be able to “act normally” and eat, but when the moment actually arrives, it’s too terrifying.”

neda recovery

“It’s not about anyone else. And no one in my life can cure me. No matter how I love my friends and family and boyfriend, I can’t just eat and gain weight to make them happy. But I truly do hate how this illness tortures them as well, and I wish it was that simple to take away their pain.”

neda recovery

“My eating disorder is just as serious now as it’s ever been. The only difference is that I weigh more than I used to. Gaining weight never made the problem go away, it just made it invisible.”

neda recovery

“I am not looking for attention. It’s easy to say the wrong thing. How I look is not a reflection of how I feel. This is a disease, not a choice. Nobody made me this way. I want to talk about it. My life has been hugely impacted by this. What I go through may not seem like much to you but to me it has been my world.”

neda recovery

“Everyone has their own natural and unique body shape and size and gaining weight should not be seen as bad.”

 

Do you have anything to add?

Men with Eating Disorders: Suffering in Silence

men and eating disorders

Eating disorders amongst men: we are not talking about it enough. We are not doing enough to end the stigma against eating disorders in general, let alone for the male population that suffer with them. We need to raise awareness. We need to be having conversations about it. We need to be educating the general public about it. We need men on TV, in magazines, on the internet, on every social media platform, to speak out about their struggles and help others do the same so that they can get the help and the support that they need. The thing is, many men don’t feel comfortable talking about it with their closest friends and family members, let alone the public. In fact, they aren’t just uncomfortable: they are terrified, and this is because of the incredibly detrimental stigma wrapped around eating disorders that is magnified tenfold when it comes to the male population. And when people don’t get help, there’s an increased risk of them dying from complications due to their eating disorders.

Out of those with eating disorders, it is reported around 10% of sufferers are male, although these statistics are unreliable due to the fact that so many men do not come forward for treatment and so are not recorded as part of the statistics. A recent study on a large university campus found that the female-to-male ratio of positive screens for eating disorder symptoms was 3-to-1 (you can read more statistics with references in my article Men Get Eating Disorders Too).

For this article, I talked to two men with eating disorders, a friend of mine, Leo*, who is a man in his mid-twenties from the UK, and Joshua*, an Italian-American, who got in touch with me via this website to talk about his experiences with his eating disorder and the stigma surrounding men with eating disorders.

Leo talked to me about how his eating disorder affects him in day-to-day life, and about the one and only time he sought help from a professional.

“I wake up every morning and the first thing I do is check the mirror and look at myself and think I’m fat. I will do it again after a shower and again once I’m dressed. I will do this throughout the day while at work if I go to the toilet as well. I try not to eat to much because in the back of my head is someone saying you’re fat, you’re fat, don’t do it. People at work have joked about me being fat, and I cannot get rid of them saying it over and over again in my head. I want to be perfect, I want to feel normal, and it probably started with the bullying at school and has always sat with me. I went to the doctors and explained that I didn’t feel normal and I hated eating food and I wanted to make myself sick and all I got was the doctor telling me that I need to eat to be healthy and we need food to survive, and that was pretty much it.”

Leo experienced disordered eating for three years, before developing a full blown eating disorder which he has now suffered with for seven years. He struggles with restriction, self-induced vomiting, and compulsive exercise. As you read, when he opened up about it to a doctor, he was met with dismissal. After describing his fear of weight gain, and sustained body hatred, his doctor chose not to explore this further and just told him to eat. I asked him about whether he would consider going back again to see if his experience could be different if he saw another doctor.

“I don’t go back to the doctors because it is embarrassing. I’m a guy and I have to not show weakness. I tried to cry for help and no one cared and so I shut all my emotion off towards it.”

Unfortunately, this is all too common an experience for men, and because of these negative experiences, men don’t seek help in the first place, or don’t go back again after being met with invalidation. Doctors are reportedly less likely to make a diagnosis of eating disorders in males than females (again, you can read my article “Men Get Eating Disorders Too” for references and more information). Not only is there limited training in eating disorders for medical professionals, but the stereotype of eating disorders being an illness exclusively suffered by white, young, females still lingers, and professionals are not exempt from absorbing the myths and stigma that surround eating disorders. Coupled with the damaging pressures from society telling men what they apparently should be like, people seem to have a really hard time accepting that men can suffer from such a debilitating illness as an eating disorder. These societal pressures, which include not showing emotion (or not too much, whatever that means), not crying, not needing help or support, are aspects of being a woman, and they are also supposedly aspects of being weak (because, just in case you are unaware of this entirely ludicrous concept, in our patriarchal society, being like a woman – and therefore being a woman – means that you are weak). On top of that, eating disorders are seen by some as obsessional vanity, whereas they run much deeper than that, and can stem from a variety of things (bullying, abuse of any kind, sense of worthlessness, deep insecurity, trauma, to name a tiny proportion of triggers). They are also a biological illness with genetic links. Your genetics play a part in determining whether you are someone who will develop an eating disorder or not. Those who understand eating disorders already know that developing one is not a choice, but this provides further and solid evidence for those who may not be able to fully comprehend the fact that there is no choice when it comes to mental illness. Still, so many people are still ignorant about mental health. Leo says,

“People look at it as a female disorder. I have mentioned it in conversation with friends and family, and I always get the same opinion – that it’s a woman’s disorder because they are weak or have issues because of how society sees them.”

Leo feels like he can’t talk to anyone about his eating disorder, because they won’t understand. He is terrified of the reaction that he could get.

“I can’t talk to people because they won’t understand. They won’t understand waking up every day feeling the way I do about myself and how I want to fit in and for people not to say I’m fat or chubby. I can’t talk to them or even want to talk to them because my step-dad, my brother-in-law, and I are always in competition in everything we do and I wouldn’t let them know I am weak. I don’t know how they would react. They will see it as a weakness and will think less of me. Even my mum wouldn’t understand.”

I ask if he thinks his mum would view him as weak. “I’m not sure, but I don’t want to risk it.” The concept of men (and women) with eating disorders being weak is so persuasive that Leo sees his own eating disorders as a weakness in him, but says that he doesn’t make the same judgement about anyone else.

Another issue we have to look at is the “ideal” male body that our society has created. Women face a huge amount of pressure to look a certain way thanks to our society, our diet culture, and the media continuously shaming women, telling us to lose weight, giving us diet tips, banging on about “health” 24/7, and showing us a disproportionate amount of slim, beautiful women who have been photoshopped to the nth degree, but whilst we do receive the majority of this pressure, we forget that there’s so much pressure going around that there’s plenty left over for the guys too. Men are being exposed to an increasing amount of images and messages pertaining to what a man “should” look like, and this is extremely harmful. Leo has been affected by this.

“Having 0% body fat and all the muscle in the world is the only way to fit in society for men. Women are seen as having to be skinny but men have to be both skinny and muscular.”

Whilst this is not a reality, and in general only men who are fat or very thin experience stigma around weight, the message has become so strong from the media that for some men, this is how they feel – that they and their bodies will not be accepted unless they look a certain way. The expectations that this is driving some men to have for themselves are unrealistic and unhealthy, and is having a dangerous impact on the mental and physical health of men.

Eating disorders can also be harder to spot in some men because it is more likely for women to have dramatic weight loss, whereas in men their eating disorders can expressed through “bulking up” and hitting the gym, which is not seen as particularly suspect in a society so keen on advocating exercise and showing male body “ideals” as lean and muscular. It is important to note that if an individual is taking performance-enhancing supplements in their attempt to become more muscular and then engages in weight lifting, they are at increased risk of suffering a heart attack or stroke (this paragraph has been taken from my article “Men Get Eating Disorders Too”).

Joshua also talked to me about his experience with an eating disorder.

“My situation largely stems from my cultural love affair with food and how the outside world placed such an unnecessary stigma on what are “good” or “bad” modes of eating. I am an Italian-American, and as such, our lifestyle revolves heavily on cooking and family gatherings that centre on delicious dishes. It is a tradition and rite of passage to learn how to cook for many of us. This is an overwhelmingly positive facet of our heritage, but the media’s obsession with “thin” and “perfection” have demonized any sort of fascination with food beyond what they deem “healthy or fit.” Admittedly, I was heavy as a child and into my teen years – but with changes in my daily lifestyle and just growing, I evened out to what was my normal weight (which was apparently still slightly “larger” than the projected ideal). I still enjoyed any type of food that I wanted and never did I have to restrict. Naturally, as I got older, I became interested in finding a meaningful relationship with a girl. This was when the pressure of having to achieve that outrageous image of “true masculinity” began to weigh heavily on my mind, and my interactions with women in my age group reinforced these damaging gender stereotypes.”

Joshua was also influenced by the media.

“The problem is that “having abs” and looking like an actor/model is so much more than losing weight – it is about obsession to the point of illness.”

Joshua was shamed for his appearance when he became very ill during his eating disorder.

“Ironically, I never did achieve the appearance I aspired to even when I was dangerously skinny. I merely became an emaciated mess, which ended up working against me as I was told it “feminized” my looks and made many girls lose interest.”

Although no one should ever reach any weight, shape, or size by unhealthy means, this shows again the idea of an “ideal” body shape and size for men that has pervaded our society. Whilst no one is naturally emaciated, many men are naturally slim and can feel ashamed of being so. In fact, within a couple of weeks of being with one of my partners, he asked me, “Is my body okay? Am I too skinny?” because he was naturally slim. I had never even considered that this might be an insecurity of his, but it is more common than we think. Insecurity is rife amongst both men and women, and whilst this is damaging in itself, this can also contribute towards the development of eating disorders, which are severe and life-threatening. Anorexia has the highest mortality rate of any mental illness, and other restrictive eating disorders follow close behind.

“I find it so difficult to explain to anyone I meet (especially potential dates/prospects) that I am trying to heal from this battle. It is such a strange position to be put in – knowing that double standard of men not expecting to be concerned with weight or appearance (to be outwardly cavalier/macho) but still having to hide their true feelings when exercising themselves into oblivion for muscles/being defined. Gender roles and expectations for men are just as serious [as they are for women] – yet they fly under the radar as something that doesn’t happen and are laughed at by those from older generations.”

These myths, stereotypes, and stigmas need to become a thing of the past. We need to be talking about eating disorders more in general, but we also need to start prioritising the inclusion of men in every conversation that we have about it. We need people to stand up and talk about their experiences, but this should never have to be their responsibility in the first place. We need to educate ourselves and each other about the realities of eating disorders and how they affect men as well as women. We need to dispel the untruths and we need to be more proactive in challenging hyper-masculinity in our society. We need to help our men, and we need to help them to ask for support. If we don’t, we are going to lose them. If you are someone who looks down on men with eating disorders; if you are someone who sees them as weak, put that aside now, and take the time to research eating disorders. Keeping your mind shut to their suffering is costing them their health, their happiness, and sometimes even their lives. These are your sons, your brothers, your husbands, your friends. Each minute we continue to treat our men with eating disorders as weak; each minute we continue to dismiss them, we put their lives in danger.

*Names have been changed for confidentiality