Look at these pictures: Which girl is going through an eating disorder?
It’s all of them.
I was watching a Youtube video earlier about a woman with bulimia talking about how Anorexia is the ‘acceptable’ eating disorder – more easily palatable to the media as tragic tales of starving young women. There’s not the association with unpleasant bodily functions, the stigma of sufferers being ‘greedy’ or having no self control, she observed. Although anorexia is deadly and 1000% deserves the spotlight of awareness, understanding of other eating disorders such as bulimia, binge eating disorder and OSFED – Other Specified Feeding or Eating Disorder (previously known as EDNOS, Eating Disorder Not Otherwise Specified) are lagging behind in the public eye.
Anorexia nervosa may be easier to spot due to the dramatic low weight of sufferers but other eating disorders can also be seriously destructive and life-threatening. Bulimics more famously risk teeth erosion and could lose teeth from continued acid erosion and dry mouth but also face the scary risks of heart failure, electrolyte imbalance or ketoacidosis, all of which can be fatal. Many Binge Eating Disorder complications are more well known as they are associated with the obese population however not everyone with BED is obese, nor do all obese people have BED. Furthermore the shame, anxiety and depression that comes with BED is rarely discussed in the media – there can be the ignorant perception that BED isn’t real and they are just ‘fat, lazy’ people that will be fine if they buckle up and find the willpower to diet and lose weight. Many sufferers of not only BED but all eating disorders have had traumatic,abusive or emotionally damaging experiences from which they have turned to food to cope with the emotional impact original stressor. Shaming BED sufferers does not lead to recovery – they need compassion and understanding to support them to deal with uncovering these sensitive past issues without binging as a coping mechanism.
Many people are totally unfamiliar with OSFED or the old term EDNOS. OSFED is basically eating disorders that don’t fit the criteria of BED, anorexia nervosa or bulimia. For example an obsession with chewing food and spitting it out, a person with all the typical anorexia symptoms but with a BMI above 17.5 or someone who binges / purges but less frequently than the diagnostic criteria for BED/ Bulimia. Historically people with OSFED/ EDNOS have not been taken as seriously, often denied inpatient treatment or any treatment at all but the disorder may be more deadly than anorexia! This 2009 study showed ‘Crude mortality rates were 4.0% for anorexia nervosa, 3.9% for bulimia nervosa, and 5.2% for eating disorder not otherwise specified’. Heart failure, low blood pressure and thinning bones are all possibly complications of OSFED that includes calorie restriction even if one is not of an ‘anorexic weight’ for example. A person who was previously overweight who lost weight very rapidly through starvation / overexercising could be just as malnourished and at risk of death as an anorexic inpatient and yet their BMI is often misused as an indicator of the severity of their ED. Furthermore an increased risk of morality for ED sufferers of all weights is suicide.
For most of my life on and off I would fit into the EDNOS/ OSFED category and then into anorexia nervosa but I was never diagnosed or received any treatment for either. Looking back, many of my friends have had undiagnosed eating disorders that fit OSFED criteria at some point too. This recent Metro article cites that half of ED patients rate their GP and poor or very poor and 3/10 are not referred to mental health services immediately.
Thing is, I didn’t always see my habits as an eating disorder. The media promotes diets like the way I was eating and abusive overexercising is glamorised by many toxic ‘fitspo’ instagrams online. The way I saw it was I was just eating the way I had to to avoid gaining weight, to be thin, ‘healthy’ . Unfortunately years of yo-yo dieting had done serious damage to my metabolism (btw that is totally reversible if that’s you, don’t worry). I could gain weight practically overnight. It was a yo-yo cycle where eating normal amounts always caused weight gain and the cycle began again. For this reason I was terrified eat out at a restaurant even once and never ate what other people cooked as I couldn’t calorie count. (Ironically I still do those things now for a different reason: because I have many food allergies. No doubt the eating disorder contributed to the intestinal damage.)
Why did I develop an eating disorder? It can be difficult to pin it to one reason. I was a fussy eater as a kid and used to steal sweets and cakes from the shop at the farm I grew up on so sometimes I was a little chubby. Most of the kids in my class were just naturally very slender so I felt abnormal even at times I look back and see I didn’t look much bigger. I didn’t see many role models with chubbier limbs and a not-perfectly-flat stomach and nearly all the children my age had different kinds of bodies to me. The boy in primary school who called me pig and whale and once asked me why I was crying, if it was because I finally found someone fatter than me probably didn’t help. Nor did the girls who asked me bounce up and down to see if my belly wiggled to ‘decide if I was fat’. Kids can be cruel but the fact that my weight was so important to them also says something about the culture they were raised in. Either way one year when I was maybe 7 I began asking for a packed lunch and throwing the food under the table across the lunchroom floor piece by piece when nobody was looking. Nobody warched me eat breakfast and for dinner I refused to eat pieces of food more than 100 calories. My mum would have to chop the ends off a potato waffle or a chicken breast or I wouldn’t touch it.
My eating disorder story was not simple and linear, didn’t fit into one box. There were binges when I couldn’t stand the hunger and times of starvation. I’ve been over and under weight. There were also times where I had a healthier relationship with food until someone or something triggered the feeling that my body was disgusting, unloveable and needed beating into submission. Coming to terms with being an endomorph body type is only something I’ve really accepted in the last year when chronic illness forced me to either let go of the ED or stay housebound. If anyone’s curious I consider myself fully recovered from the ED and I’m making progress with the illness recovery and I’m confident about the future😊 Meanwhile it’s exciting to finally see models like Iskra Lawrence represent diversity in the modelling industry.
Without going into more detail about my own ED, the result was that years of subclinical malnutrition were never picked up on. In school nobody taught us about the dangers of overexercising, and I was unable to see my 4-5 hours of daily exercise as anything other than necessary to reach a low BMI. The damage to my body has been slow, coupled with following diets that weren’t healthy for my metabolic type (if you’re unfamiliar with the term read: there’s no perfect diet for everyone, some people need more of certain macronutrients than others etc). If I had known what I know now about nutrition I would have stopped but the education wasn’t there and the media normalised what I was doing with attractive young women as mascots. There are so many women and men doing harm to their bodies to strive for the media’s presentation of a ‘perfect body’ and many of these people look healthy on the surface and are even praised for looking leaner or more muscular.
What isn’t always acknowledged is that disordered eating behaviours have a grey area. At either end of the spectrum we have people who have always trusted their bodies and enjoyed eating in a balanced way and at the other end emaciated anorexics and morbidly obese binge eating sufferers but lots of people struggling are not either of those bodyweight extremes. Sometimes the type of eating disorder a person has changes. Having an eating disorder is independent of your bodyweight. You could pass them on the street and never guess and yet their eating disorder still consumes their life and it needs to be taken seriously. Normal-weight eating disorders can be much harder to spot but educating others on their existence is an important step to empower sufferers and their loved ones to acknowledge their disorder and seek help.
If you are suffering from an eating disorder please know you aren’t alone and a full recovery is possible! Here are some people who can help:
Overeaters Anonymous: https://oa.org/
P.S. I’m thinking of writing another post about how I overcame my ED. If anyone has any specific questions or requests don’t hesitate to ask below or you can tweet me @bobbyjodearnley 💖