Fortunately, most people don’t understand the battle that goes on whenever someone with an eating disorder sits down to eat. It’s agonizing, isolating, and terrifying. And, the person is grossly misunderstood. When it gets to the point of a ‘disorder’, it’s not about the person being in control of the overall behavior. There is no ability to cope with the actual process of eating, and it becomes completely overwhelming. Many people with eating disorders have all-or-nothing thinking. Food = fat. Period. And fat = failure, and the loss of the right to take up space on the planet. It’s not about the food. It’s about self worth. In some bizarre way, consuming food symbolizes proof of absolute worthlessness. Telling someone to ‘just eat’ is the same as telling them that they don’t matter. It’s messed up, but I guess that’s why it’s called a disorder.
To be in front of a plate of food, no matter the leanness of the meal, triggers panic, and honest-to-goodness terror. The exchanges going on in the thought processes demand absolute rigidity to the ‘plan’ (of not eating/getting fat). The more someone has starved, the more entrenched their thoughts are to the disorder. And, some research has shown that endorphins are released during starvation, so when someone who is starving eats, they feel bad. Physically. The endorphins stop enrobing how they feel, protecting them from the reality of what is going on. It’s a vicious cycle that can only be fixed with nutritional rehabilitation at first, and then a lot of work to figure out the reasons for such self-loathing. And that involves dealing with the pain and actual ‘fight’ to resume some sort of eating, however small the steps may be.
Most people simply pick up a fork and eat. There is no thought about raising the fork, deciding what to put on it, putting food on it, raising the fork to their mouths, taking the food from the fork with their lips and teeth, chewing, and swallowing. Each step in that process is like some alien-enforced cruelty to someone with an eating disorder. Every step is another chance for the thoughts to interfere and remind the person that they are not in charge of what they do, and if they proceed with eating it proves they’re not good enough to even avoid eating ‘right’. It sounds bonkers to someone who hasn’t ‘been there’. But to the eating-disordered person who is faced with the task of eating a meal, it’s all very real. And most know that nobody around them really ‘gets it’.
I remember feeling actual guilt and shame for consuming more than %25 of any particular item, and if I ate a whole ‘anything’, I was thrown into panic. Even if that ‘whole’ something was a single saltine cracker. “Why did I eat a whole cracker?” “What is wrong with me that I actually ate that much?” At one point, I ate 3 CURDS of cottage cheese- and they had to be ‘medium sized’ curds. Seriously, that’s what went through my head. Eating in front of someone was unbearable. That continued for years, often resulting in comments by one administrator at a nursing home I worked at…”you never eat”, or “it’s nice to see you eat”. By that time, I could cope with those supportive comments to some degree; before then it would have been a race to drop more weight as quickly as possible, no matter the method. One night after a long shift at work, I felt odd, and pulled over. A co-worker was behind me, and pulled in alongside of my car. She asked why I was surprised that I felt bad when I hadn’t eaten, and I was mad. I’d eaten TWO hard boiled eggs in one day. How is that not eating?
As a nurse, I finally decided that I had to disassociate myself from food, and act as if I was giving a meal to one of my patients. It had to be a mechanical process, and started out very slowly. I had no resources in the town I lived in, so after returning from 5 weeks of inpatient treatment, I was on my own. I added one item to one meal until I could handle that without too much distress. Then I’d add something to another meal, and on and on until I was consuming the meal plan set out for me at the treatment facility that was otherwise nuts. Food was unpleasant, but necessary. It simply ‘was’. If I didn’t meet the bare minimum (I don’t remember how I figured that out), I ‘grounded’ myself from walking the neighborhood for weird lengths of time. My boss at the time said it was like trying to catch a greased cat to get me to slow down on my ‘laps’ around the block.
I bought as many professional eating disorder treatment books as I could find, and read them from cover to cover. I did all I could to apply the principles to myself, and put food in the proper context. It was fuel- nothing more, nothing less. It wasn’t a measure of my worth as a human. It was inert and powerless. And, bottom line- at some point I’d have to eat. It wasn’t going to get any easier, and I was just going to get sicker, and lose more of the things that were important to me: my job, my health, and my friends. Being around someone with an eating disorder is more work than a relationship is worth in the context of friendship. People just leave, which reinforces the feelings of self-loathing. It’s just one big mess. And, I was in the driver’s seat, as much as it didn’t feel like it. By acting ‘as if’ I was dealing with one of my patients, I finally was able to make the small steps that eventually ended up with a fairly normal, but superficial, relationship with food, no purging, and a focus on avoiding being sent somewhere like the place in California, that has since been shut down.
As my nutritional status improved, my thinking about food improved. SO much of the obsession is driven by starvation. The Keys Study on the effects of starvation (related to the refeeding of millions of people from WWII) showed that decades ago. I was amazed at how little effort it took to muffle those disordered thoughts as I got better. Finally, those thoughts just weren’t there ‘enough’ to keep me actively doing any eating disorder behaviors. I might have the occasional ‘nudge’ in my thoughts when I was in front of someone’s celebratory cake, but I was able to ‘out-talk’ it in my head if I actually wanted to have a piece.
It took about three years to be able to go out with friends and not feel guilty for eating, or the eating disorder telling me to quit being a pig. I had some ups and downs, and in rereading a bunch of journals from that time, realize how goofy my thinking was for much longer than I had remembered. Every meal was a conscious effort at being healthy in relationship to food. One forkful at a time, I got better, and the fights were fewer and fewer. It’s still terrifying to think about how brutal the compulsion to starve had been. And I know it could come back… I’ve relapsed many times.