When you don’t know what to look for

forkforest
Illustration by Michael Woloschinow

Day 2: National Eating Disorder Awareness Week

Tuesday: talk about warning signs associated with the disorder you struggled with. Help to raise awareness for others and encourage them to reach out for help before it gets worse.

*****

I am sitting in a friend’s living room at University. She has told me she has switched to skimmed milk and given up eating bread. She’s also joined a running club and is jogging every day. I start to see red flags.

Why do I do that?

Well, if she was an overweight person who had been medically advised to lose excess weight, these might be good choices. But she wasn’t. She was a perfectly sized individual. That might have been all right if she was being made happy by her choices, but she wasn’t. She was tense, and tired, and only thinking about the food she wasn’t eating, the running she wasn’t doing. And that was the main problem for me, the problem I recognised all to well in my own life: the fact that she couldn’t stop.

Those were signs of an eating disorder. My stomach dropped when I recognised them.

Most people would suggest that she was just making incredibly healthy life choices. But I was there to read the signs that I could recognise from my own life; the signs of an inner monologue inside her, growing stronger, that was only concerned with what she ate and when she ate it. An unseen, aggressive, deadly obsession.

Maybe it was good that I was her friend at that point, that I could tell her it wasn’t really about the food. I could explain to her how it was for me and how I suspected it was now for her, too:  it was about the fact that there was a voice in her brain telling her exactly what she could and could not consume, and that if she kept listening to the voice and doing what it said, soon she would not even be able to recognise that it was there. It wasn’t like she was starving, or calling herself fat, or refusing to eat meals.

But that’s part of the problem. There are so many signs that are easy to miss.

On the national eating disorders website, it has a list of warning signs for anorexia nervosa. Many of them are signs that everybody associates with anorexia, the signs we have seen played out on weekday soaps and in health class text books. Signs such as dramatic weight loss, commenting on feeling or looking fat, and anxiety about gaining weight. The top billers. Consequently, when a friend loses a lot of weight we might consider saying something. Or when a brother or sister constantly makes comments that they are ‘fat and ugly’ we might begin to worry that something was going on inside their minds.

But when a friend says lightly ‘Oh I’m not hungry thanks,’ when we go for coffee at lunch every day, we might not say anything. Denial of hunger – seems quite innocuous, doesn’t it? Maybe they just don’t want to eat anything, maybe they’re just skipping lunch to lose a few pounds! That might be true, but consider this:

Someone who has a healthy relationship with food goes on a diet. When they talk about their diet with others they will talk about the good things and the bad things, the foods they miss and the foods they look forward to. They will eagerly sit down at meal times to enjoy the food they have. An anorexic will not do that. An anorexic will say they are not hungry. Rather than engage food and enjoy it, the anorexic wishes it was gone, that he didn’t need it. Saying they are not hungry is rejecting the desire that they instinctively have, it’s being ashamed of it, the natural need for food.

Another example: ‘Development of food rituals.’

‘Well wait,’ you might say, ‘we all have these, don’t we?’

‘I only eat chips with ketchup, that’s a ritual.’

Yes, it is, you’re right. But what happens to you when you can’t eat chips with ketchup?

If you have a healthy relationship with food you might just order something different. No chips with ketchup, that’s fine, I’ll have a side salad.  You might have a sulk. Well, I won’t have any chips at all! OR a side salad!  You might just shrug your shoulders, close your eyes and eat them anyway.

If you are an anorexic, you don’t eat anything.

You maybe don’t eat anything for the rest of the day, the rest of the week. You can’t eat. That carefully orchestrated food moment where you allow yourself nourishment in a very specific way is completely tarnished, and you cannot have it now. These are food rituals that cannot be broken and when they are, there is nothing adequate to replace them. I once read an article by a mother of a anorexic who recalls driving around multiple shopping centres at night to get one specific brand of yoghurt for her daughter, knowing full well that if the yogurt wasn’t brought home, her daughter wouldn’t eat a thing.  It may seem quirky that a person is specific about how they eat their food, in what order they eat the components on their plate, but perhaps it’s worth asking why they are doing that. Is it a force of habit from childhood? Something that makes them smile? Or is it something much more dangerous? Perhaps they have to eat the carrots first because they increase metabolism and will break down the food faster, making it less likely for them to gain weight. Perhaps they have to eat the lettuce first because it has very few calories and if they eat it all, it will make it look like they have eaten most of their salad.

Red flags. Easy to miss, but just as potent warning signs. (Full list here)

Perhaps when reading this you have recognised some behaviours in someone you know. Perhaps now, you are worried for them and want to make sure they are okay. You can do that, but just know that most people with eating disorders like mine carry it close to their chest like a shameful, ugly secret. It can be painful for us to share, and very easy for our hackles to be raised if we think someone might want to talk about this incredibly private thing that we are guarding from the outside world. It can take a long time for people to feel safe to open up. Maybe just come alongside them for now, invite them to hang out, let them know you are there and worthy of trust. Then maybe broach the subject tentatively, making it absolutely clear to them that whatever may or may not be happening, you are there for them. Many people just need to hear that you aren’t going to judge them, or “make” them stop, and that they can always talk to you about these things. Make sure they know the conversational door is always open to them, should they ever need to use it. Maybe they will.

Perhaps when reading this you have recognised some behaviours in yourself that are giving you cause for concern. Perhaps you’ve read the warning signs list and are starting to think, ‘maybe I really don’t have a healthy attitude towards my eating!’ That’s fine. Don’t panic. I don’t think you’re a ‘psycho’, I don’t think your ‘mentally disturbed.’ You might just have a problem that you could use some help with. In the course of my battle with anorexia I have picked up many friends with similar eating disorders. We often find each other, it seems. Some of these friends have battled for a long time, some of them will battle all of their lives, but many of them fight a short battle and recover quickly. When given the right support and help, many people who exhibit warnings signs of anorexia can overcome their mental hurdles and never experience some of the terrible effects of living with anorexia nervosa. They learn how to disengage from dangerous thinking patterns, they learn what their triggers for controlling eating are, and they live their lives healthily. Don’t be afraid of seeking a little bit of help because you are worried of what you will be “labelled.” Anorexia nervosa is a disease of the mind, and just because you have some symptoms does not mean you will develop them all, or suffer all the side effects.

That being said, like most diseases, if a warning sign is left unchecked it can fester inside you and become worse. I know that it might be frightening to engage with an area that most people consider to be black and white – people tend to think you’re either mentally ill or you’re not – but all of our minds are subject to change and threat and imbalance, just as they are capable of recovering and healing from past traumas. For some people, our relationships with food are a big part of that, and we need to be honest with ourselves about the fact that what we do physically will effect how we react mentally. Don’t ignore a warning sign because you think it’s probably nothing. Just as you might have a threatening mole on your skin checked at the doctors, so we should all be consistently in the habit of checking our mental landscape for potential areas of damage. So talk to someone. See if there is a bit of work that needs to be done. After all, mental health is a journey, not a status.

******

If you need to talk about anything that I’m posting about this week, please get in touch. I’m here for a chat, or whatever. Don’t be silent.

Have a happy Tuesday and I will be back tomorrow with some of my top tips on getting through the hard days.

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