National Eating Disorder Awareness Week (Feb. 24-March 2, 2013)

In 1990, I saw the profoundly disturbing movie Eating by Henry Jaglom. Prior to this, I was oblivious to eating disorders. The film was about a group of women cooking for a celebration. Throughout the film, they individually act out in their respective eating disorders. Watching their secrecy, shame, self-loathing, and powerlessness triggered an overwhelming sense memory in me. What they were feeling was no different than how I felt shooting coke in a locked bathroom. It made me realize how similar eating disorders were to addiction. Seeing this film helped me to feel empathy and compassion for my women friends who continued to struggle with bulimia even after years in recovery.

Our society isn’t very compassionate toward people who have diseases that manifest in self-destruction.  “How can I feel sorry for him? No one is putting a gun to his head forcing him to take heroin.”  While society is finally becoming educated in substance abuse and depression, eating disorders make people uncomfortable. It is cruel when adjectives such as lazy, greedy, and glutinous are used to describe over-eaters and those suffering from obesity. It is just as cruel to pretend there isn’t a disease affecting the health of a friend. People in 12-Step meetings become uncomfortable, even angry, if a member shares about vomiting after meals even if they share that this behavior makes them want to get high. The  whispering and dissing of the “skinny girl” is harmful and hateful. Eating disorders do not arise out of thin air. Childhood pain, violence, trauma, abuse, and sexual abuse are often at the core.

Recovering addicts and alcoholics with eating disorders are fortunate to already have a language to describe their experience. They have recovery tools and support. They know how to walk into a fellowship for their specific eating disorder and ask for help.  Yet, even with this leg-up, the road to ED recovery is riddled with potholes. I know many women with decades clean and sober whose recovery from bulimia continues to be two steps forward one step back. Binge eating relapses keep them trapped in a cycle of shame, self-berating, hopelessness, and despair even while they are role models of recovery in their primary 12-Step group.

Sustainable recovery from eating disorders is very difficult and painful and we (society as a whole and those of us fortunate to be in recovery ourselves) should be extending kindness, support, and compassion to anyone who is suffering so that they do not have to isolate in secrecy and shame. We can help by encouraging them to be honest and courageous, and by guiding them to professionals who can give them the help they need. Our generosity and love does not have to be insular. We have enough that it can be shared beyond the confines of our particular substance abuse group.

A dear friend in recovery became anorexic this past year. At first, I tried helping by applying what works to cut through the denial and arrest the disease of addiction but this was different. I realized she needed professional help and we found a therapist willing to work within her budget. After several months, it was clear that she needed a higher level of care – inpatient. Unfortunately, unlike drug addiction, there is very little help available in America for anorexics without financial resources. Anorexia Nervosa is a disease that leads to death – if not from starvation, it can cause a heart attack, fainting behind the wheel, shattered bones, and major organs shutting down. Many anorexics commit suicide before their bodies fail. Yet even with the high suicide rate statistics, there is very little help offered to people without $30,000 to spare or comprehensive health insurance. In my friend’s case though, it’s going to take more than good insurance or extra cash in the bank. Even after being discharged from therapy and told she needs a higher level of care, the denial continues to convince my friend that this disease can be self-managed.

No one could force me to get clean and I can’t force her into inpatient treatment. I hope she becomes willing. I continue to encourage her to not give up, to pray to whatever she believes in or doesn’t believe in, to blindly ask the universe or her own heart to guide her to safety so she can live. She asked me to dedicate this week’s blog in honor of Eating Disorder Awareness Week.

You may have friends in recovery living in shame, guilt and secrecy, suffering from an eating disorder they have not made public. These friends are your opportunity to practice empathy, compassion, tolerance and patience. Help them to feel safe enough to bring their ED out of the darkness. Eating disorders are not gender specific. Men this is your opportunity to bring your ED out of the closet so other men will not feel so alone. Together, in loving kindness, we can all recover.

For anyone reading this blog who may be suffering from an eating disorder, there is plenty of information online for local helplines, resources, 12 step groups. Not everyone needs to go to a treatment facility. Most eating disorders can be arrested and a healthy recovery can occur using a combination of 12 step meetings, therapy, trauma work (such as EMDR or gestalt therapy), and Dialectic Behavioral Therapy (DBT) groups, mindfulness (such as meditation, yoga, breathing exercises). Your life is worth it.

The following is a guest blog written by my friend who has Anorexia Nervosa. I asked her to write about her inner experience living with this disease. Perhaps next year she will be able to share her recovery from this illness.

Anorexia? WTF Happened?

During the course of this vicious anorexia cycle, I have confided consistently with one person. This alone may have saved my life— so far.

I don’t exactly remember when the idea had surfaced that I had an eating disorder.  At some point in late 2011 something started happening internally that resulted in an increase of anxiety, not sleeping, not eating, horrible leg cramps, night terrors, depression, anger, and hopelessness.  By April 2012 I had been in therapy for five months and remember feeling completely disconnected from my body. My mind was constantly spinning and I had 3 years clean from drugs and alcohol. I wanted to escape the screaming in my head and the pressure I constantly felt. Using and suicide bounced in and out of my mind.

I had slowly stopped eating. Well- I wouldn’t eat a couple days, but then would eat a few days and be fine. I didn’t really obsess over it and it was just one of those habits I think I had always had- since childhood. The idea of eating never really mattered to me much and the thoughts of over eating (or watching others over eat) grossly disgusted me. My frame is naturally small and the most weight I had ever gained was through both my pregnancies which I absolutely hated. Even though I had lost all the weight I had gained through my practically back to back pregnancies, my body was left with deep stretch marks which leave me with a strange self-conscience feeling I still have to this day.

Eventually, my first therapist kicked me out after about 10 minutes of what ended up being our last session. She looked at my sick body and advised me to come back after I sought help for my eating disorder. I hadn’t really talked much to this therapist but felt extreme anxiety when I knew I had an appointment that day and felt like I had been hit by a bus when I left. I don’t remember talking to her too much about anorexia.

Over the last year, I’m not sure why I have constantly denied that I could have an eating disorder. Most of the last year and a half has consisted of not eating, weighing myself obsessively, checking my BMI to see if I’m actually underweight (thinking that as my BMI is normal than I must not have a problem), puking every 3-4 days when I do actually eat, migraines, performing google searches about eating disorders, crying, punching walls, throwing chairs, anger, hiding out…

My health has been questionable. My digestive system feels fucked up. My heart rate and cholesterol are high. I’m almost positive I am anemic. I’ve passed out, lost track of time, been in four car accidents, fallen asleep at the wheel.  I have severe leg cramps every night which leave me falling down. I lost 30 lbs on my already somewhat small frame in the course of 4-5 month period and my weight was declining weekly. People were commenting on my body and it infuriated me when they questioned if I ate or if they told me that I’m getting too thin. I read articles and books about how to get help. I went to eating disorder meetings. I wrote letters to the fucking universe expressing my anger and pain and needing help.

Yet with all of the evidence pointing toward the clear fact that I do have an eating disorder problem, I continued to fight it (I still fight it).

I want help and I don’t want help. I want to fix my own problems and my own pain. I don’t want to let one more person close to me. I don’t want to become vulnerable.

I did eventually go to another therapist who specializes in eating disorders. I made as much of an effort as possible to kick this shit and feel better. I deactivated my gym membership, I gave up my scale, I wrote food logs. The terms were up front from the beginning with her. I had to stay honest. I had to do the work. If after a certain amount of time, no progress was made with my health, than she would recommend a higher level of treatment. This was and is one of my greatest fears. Needless to say, I was discharged in January of this year from my second therapist.

I actually made it to 4 years clean in January but feel like I am living my life in active addiction. I feel like I am in a downward spiral but not sure exactly what I am willing to do to get better. I still fantasize about all of this just disappearing on its own.  I feel like my mind is playing tricks on me. I tell myself things like this: I haven’t thrown up in a while now, I ate twice every day for 5 days in a row (only skipping two days of meals), I haven’t weighed myself since being at Publix two weeks ago, I am sleeping more than I had been sleeping, and that I haven’t lost any weight since my last therapy session. All of these things I tell myself eventually convince me that I can fix this by myself because I am obviously doing better than I was when this ‘eating disorder’ surfaced.

I absolutely hate everything about anorexia. I hate what is happening and feel trapped. I hate feeling like  there is something wrong with me and that I can’t control any of this. These are the same thoughts I have about addiction. I despise them both. I hate the internal fight of wanting to die and live all at once. And I hate feeling like I am being attacked by one or the other, if not both

Fuck addiction. Fuck anorexia.

Truth is- with all of my denial, anxiety, rage, depression, etc. –   I do hope that I continue to hold on until I get better.