Mags GarganDuring an information evening hosted by Bodywhys, a national voluntary organisation, and the Eating Disorder Service in St Patrick’s Hospital, Dublin, one of the service users shared the daily torture of an eating disorder
I have been dealing with an eating disorder for a number of years. I have read loads of books on the subject. I’m here today to tell you what I have never found in books – the day-to-day torture of an eating disorder. I hope by telling you about my experience I will provide you with some insight into the illness, and to drive home the point that an eating disorder is preventable, but if left untreated can leave the person with a horrendous life.
I will start with the question that everyone’s asks – why did I develop an eating disorder? I had a normal life. Like everyone else I had good times and bad times. Like lots of people I had difficulty in communicating and expressing my emotions, but from an early age I turned to food, weigh and exercise as a way of coping with unpleasant situations.
There were symptoms of something wrong. I did attend my GP on a number of occasions with physical ailments and was told things like I need to improve my nutritional intake; I’m exercising too much, but there was no major intervention in the early years and the result was the unusual exercise and dieting behaviours in time became habits and the habits turned into obsessions, and a new value and beliefs system was developed. That is the eating disorder.
Let me describe myself when the eating disorder has control of me. I am a perfectionist, goal orientated, with tunnel vision. I have one self-absorbing aim in life – to obtain the ideal body as I see it and nothing else matters. I am manipulative, secretive, disceitful – I tell lies, I have to in order to conceal my behaviour and achieve my goals.
Confused
I’m confused. I can’t distinguish between what is normal and abnormal. My thoughts and behaviours are irrational and obsessive. I may obsess over food, exercise and weight or all three. In my day-to-day living I am childlike, needy and attention seeking. I am hurting and deep down I want help. When you try to help me, be aware that I am sensitive, paranoid and highly impressionable. So your words and responses have a real impact.
I have poor self-esteem – any feeling of self-worth I have is linked directly to weigh. Losing weight gives me the kick, that feeling of success, but I can never really achieve true success as there is always someone better.
I have body image distortion. I’m fat 24/7. What I see and what you see are worlds apart. What I see changes frequently. My life is based on discipline, routine and rituals. These are vital to me – without them I lose focus and control. I believe that if I lose my control there will be an automatic gain in my weight. As a result I live in a constant state of stress, anxiety and agitation. I am unable to relax. I am consumed by the eating disorder.
I am deceiving myself all the time. In spite of the intense physical pain of the hunger my energy is focussed on supressing it. I’ll never eat when I’m starving. I work at eliminating my cravings.
In a normal understanding of food and exercise, food intake is balanced with exercise output, but for me the output always exceeds.
What people say – ‘you’re looking great’, ‘that looks great on you’ – would normally be good things to say to someone but to me they translate to ‘you’re fatter’. Whereas, ‘you’re getting thin’, ‘your eyes are sunken’, ‘you look gaunt’, ‘your jeans are falling off’, aren’t normally considered compliments but to me that translate to ‘that’s ok, I haven’t out on weight’.
Anorexic
My day-to-day life is consumed with eating disorder thoughts and fears. I am afraid of getting fatter. Anything I eat brings that fear that I want a little bit more of what I ate – want that second helping. As an anorexic gains control the fear of fat becomes a terror of want. I now believe that by eating anything additional will have a dramatic effect on my weight and in my head I can actually see it happening.
As a bulimic I fear that I will never gain control of the starve/binge cycle, and achieve the supreme control and status of the anorexic. I become isolated, depressed and have suicidal thoughts. I believe if only I was thin I would be happy and everything would be different.
When my eating disorder had control over me I viewed myself as being worthless – I became self-loathing and the only thing I was motivated to do was to continue my eating disorder and conceal my behaviour. For me motivation to seek help has always come from external factors. So the starting point of a relationship with a GP is a delicate one. Fundamentally I don’t want to be there. I don’t want to admit to anything.
So what can you do? You can talk to me. Ask me about my behaviours so you can establish whether I am at risk. Use probing questions rather than direct questions, that way I don’t pick up on any new eating disorder tricks. You can educate me non my choices and hopefully encourage me on the right path and seek expert treatment.
Motivated
How you communicate with me is key to whether or not you can keep me motivated in the right direction. Highlight the effects of an eating disorder – don’t hold back. Don’t be afraid to scare me. Be truthful and honest, even if you think it will hurt. It is the only way I can trust you.
Don’t allow weight to be the main issue, instead the focus should be on a healthy lifestyle and a balanced meal plan which will result in a healthy weight. Encourage me – you can have a positive impact by giving me hope. Be sympathetic but frank and unambiguous. Acknowledge by concerns but don’t be manipulated by them.
Encourage me to socialise. Start with easy things, emails, texts, telephone calls – don’t put me under pressure to go for lunch with friends. Get me to focus on the present and the short-term.
Don’t accept the behaviour. Don’t give me special treatment such as special food. Don’t try and overfeed me. Take the responsibility of food away from me. Most of all talk to me. There is something wrong but don’t allow me to make the food the issue.
An eating disorder is a debilitating, life-threatening illness, which is preventable with proper early intervention.
* Recovery from eating disorders begins with a will to change, an acknowledgement that the eating disorder is a problem and working to build up a strong sense of self and a new, healthy way of coping that does not need the eating disorder to feel safe. Recovery requires working on underlying issues, building self-esteem, and learning to manage and express feelings, as well as addressing the physical and nutritional aspects of the disorder. Further information can be found on www.bodywhys.ie or contact the Bodywhys Helpline: lo call 1890 200 444.
What are eating disorders?
The term ‘eating disorder’ refers to a complex, potentially life-threatening condition, characterised by severe disturbances in eating behaviours.
Eating disorders can be seen as a way of coping with emotional distress, or as a symptom of underlying issues.
- Eating disorders are not primarily about food
- People can and do recover
- Eating disorders can affect anyone
Eating disorders in Ireland
- The Department of Health estimates that up to 200,000 people in Ireland may be affected by eating disorders. An estimated 400 new cases emerge each year, representing 80 deaths annually.
- According to a 2007 study of Irish children and adolescents, 1.2% of Irish girls may be at risk of developing anorexia nervosa, with 2% at risk of developing bulimia nervosa.
- Based on the KIDSCREEN study of children in 13 countries, Irish children aged 12-18 ranked 12th out of the 13 countries in terms of self-perception score.
- HRB data shows that in the case of child and adolescent psychiatric admissions in Ireland in 2008, eating disorders represented the second highest level of diagnosis at 18%.