I was first diagnosed with an eating disorder 15 years ago, but have struggled with “problematic” eating most of my life. Across this time it has varied from “disordered eating” to anorexia nervosa — both restrictive and binge-purge sub-types (the latter features elements of bulimia nervosa) — to OSFED (the “not otherwise specified” type where it doesn’t fit any distinct DSM diagnostic criteria). When it peaked in severity aged 16-18 and I was hospitalized for eight months, it was fairly clear that anorexia consumed my whole life and it almost took it. Through subsequent therapy I learned about what was going on underneath what seemed to be all about food, weight and body image — a lot of it about control, self-worth and difficulty regulating emotions (as it is for many people). And the behaviors that were part of my diagnoses have now massively reduced in frequency, as I have replaced them with healthier coping mechanisms as part of my recovery process.
However, what isn’t clear to others is just how much an eating disorder affects your whole life. How it goes so far beyond what people see on the surface. How it changes aspects of your personality, impacts your relationships and affects your choices even in situations unrelated to meals. Some people compare eating disorders to addictions and I can completely see why. For me, recovery is constant work and despite my significant improvements I don’t consider myself “recovered” by any means.
My body may be in a much better place now and no one would externally look at me and guess I have an eating disorder, but I do. Unfortunately, eating disorders are often simplified to a matter of BMI and being underweight, which means many people fall through the gaps in the system with concerning, life-affecting issues that don’t get addressed because they aren’t obvious or considered serious enough. People can have eating disorders at any weight or size, and they often start with disordered thoughts and beliefs around eating, food and weight. Binge eating disorder is the most prevalent of them, and orthorexia is increasingly common but is often missed under the guise of “healthy eating” (it does not have its own separate diagnostic criteria currently). Many people don’t even realize they are going down the road of an eating disorder because a lot of disordered behaviors and related beliefs are normalized in society as a part of diet culture.
It is exhausting inside the head of someone with an eating disorder, regardless of what type, what weight or size they are, whether they are diagnosed or if they are acting on their thoughts/feelings or not. It can truly affect your whole life:
It often makes you paranoid: whether it’s fears of food being able to magically enter your mouth just by you looking at or touching it, or paranoia that people can see you’ve gained a tiny amount of weight (or just binged, purged or eaten). Or a constant suspiciousness of others’ motives and behavior around food.
It makes you seemingly lose your ability to be logical: whether that’s repeatedly doing the same thing to no avail, yet believing the next time you do it will somehow be successful. You may begin fearing foods of certain colors. Or believing that someone has done something to your food, even though you literally just watched them make it from start to finish.
It makes you think you’re the exception to every rule: whether it’s thinking you’re the only one who needs to exercise a certain amount (it’s OK for everyone else to do less) or you will gain large amounts of weight from eating one calorie more, or you are guaranteed to explode from slight fullness/if you eat a full meal. Thinking that everyone else needs a certain amount of food to function though you need less, or you are the only human in the history of mankind who can survive without food or drink.
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It makes you seemingly blind to the obvious: whether it’s being unable to see that you have lost or gained significant amounts of weight (body dysmorphia can become a prominent issue), being unable to see your repeated injuries are related to the amount you are exercising, or being unable to accept that purging food doesn’t actually rid you of your difficult feelings.
It affects your ability to do everyday tasks: from having difficulty making meals due to anxiety or risk of bingeing, to not going to the supermarket due to anxiety/fear of buying food. From struggling to bathe or shower due to body image issues, to feeling overwhelmed by the sight of food that putting away a food shop makes you feel panicked that you’ve got to eat it all now, to having difficulty putting out rubbish bags at risk of bingeing from the bin.
It affects your romantic relationships: from making you secretive and act in ways that make you feel ashamed, to consistent lying and deception about disordered behaviors. From disrupting things like date nights, celebrations etc. because of the food component, to angry outbursts about changes to plans. From making your body image or self-worth so poor that you can’t be intimate in any way, to refusing to believe your significant other could possibly love you or think you’re attractive (and therefore pushing them away).
It affects your social life: from missing social or festive occasions due to the anxiety that the food/eating component brings, to not being present during conversations due to mentally obsessing about food, to worrying about being triggered or upset by diet talk, or even withdrawing entirely due to anxiety or associated ill health or hospitalization.
It can impact you financially: whether it’s purchasing large quantities of food for binges, or lots of exercise equipment or gym memberships to feed an exercise obsession, or having to purchase specific foods to accommodate food rules, or ending up throwing away a lot of foods. Or having to miss or give up work (or even be fired) due to the impact of exercise obsession, other behaviors or ill health.
It can contradict all your other beliefs and values: whether it is interfering with religious beliefs or practice e.g. not being able to take communion because of concern about calories, or meaning you lie or steal. Or whether it’s spending a lot of time on public bathroom floors while purging despite anxiety about contamination, or throwing away lots of food despite your hate of food waste. This in turn can be incredibly distressing.
It can make you do things you often know are objectively ridiculous: whether it’s looking up the nutritional information for non-foods (e.g. a fly), refusing to touch a food that you’re not going to eat (in case the calories count), refusing to eat a meal because one component wasn’t “just right,” choosing what to eat entirely dependent on nutritional information rather than what you actually like or don’t like, purposefully eating foods you don’t like or intentionally cooking food incorrectly to ruin it so you “don’t like food.”
It can affect your whole personality: you might normally be seen as a smart, logical person but be convinced by complete illogical nonsense when it comes to food or weight. You might normally be a really social person who loves meeting friends, but withdraw and avoid social events due to anxiety about food. You might generally be a very friendly, gentle person but if plans change around food become snappy, rude and argumentative. You might generally be very honest and trusting but become secretive and suspicious. You might normally be an upbeat person and become low, withdrawn and negative due to the depression that often accompanies eating disorders.
In the grips of my eating disorder I behaved in ways I never thought I would and occasionally I still say or do things that horrify me later in a calmer moment; and that is where looking at the disorder as a separate being is important. However, for true progress and some form of healing I had to take responsibility as well. Responsibility for the choices I make now, and for the impact it does have on others around me. It is a difficult balance to strike, but awareness is key for me.
This involves identifying when things are getting worse, knowing and managing my triggers and recognizing what is irrational or illogical. I frequently check myself mentally, evaluating whether my motives and behaviors are healthy or not. I sometimes have to check facts with someone close to me, as my own reasoning can get warped. Recognizing the way my eating disorder impacts the rest of my life has helped me to be more patient with myself and seek support when I need it, which in turn, enables me to maintain the more stable point I have reached in my recovery.