The Obvious body – The anorexic and the Dietitian

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The dietitian looks at me, gesturing gently with her fine, thin wrists as she speaks.

“That’s something we would only recommend if you were overweight.” Her eyes are wide and sincere, “which you’re obviously not.”

She continues to talk but my mind has stopped listening. It is like a record skipping, over and over, continuously tripping over those words.

You’re obviously not. You’re obviously not. You’re obviously not. 

****

Going to a dietitian when you have an eating disorder is nerve-wracking as hell.  I imagine the sensation is similar to what a lapsed catholic must feel when they finally head to confession. After indulging in some casual satan worship along the way. I couldn’t help but feel like I was the absolute antithesis of everything they had worked for. I couldn’t help but feel like I was the embodiment of everything they considered unholy.

The thing is I wasn’t even going to the dietitian because of my eating disorder, I was going because of my stomach problems, and I had hoped to avoid the topic entirely. Slip through the back door, masquerading as someone with a totally normal relationship with food. Then the dietitian asked me to keep a food diary for the week before my appointment, and my cover was officially blown. For 24 hours I mulled it over in my mind, wondering if I could do it, testing out the idea of keeping a food diary. But the suspicions I had when I first saw the words of her email were only confirmed by hour 20. I had already started to censor my eating. Rather than simply recording what I ate, I was already pulling back and eating less than usual. I slipped easily back into the mindset of my eating disorder where I had been in the habit of writing down everything I ate, day by day trying to shorten the list and take out the carbs. Memories of endless diaries filled with stanzas of starvation flooded back. So I emailed her and outed myself. I have an eating disorder. Here we go.

The week before my appointment I tried to prepare myself for all the terrible things she might say or invasive questions she might possibly ask me. I prepped myself for how to manage the mental backlash I would experience if she told me I had to exercise more. I squirmed when I imagined what she would say about my habitual cookie eating. I fretted and sweated over what the hell I would do if she tried to weigh me! And I kept the one, awful question from that little girl with the eating disorder at the back of my mind: What if she thinks I’m fat?

In the end, it wasn’t her questions that devastated me. It wasn’t even the fact that she told me I would have to start eating gluten again for six weeks (SIX WEEKS!) before we could have a satisfactory coeliac test. It was the sheer, awful banality of my eating disorder when it was laid bare before this kind, friendly woman. This woman who didn’t judge me, weigh me or demean me. She just wanted to help me. This woman who told me in the gentlest of tones that skipping meals was the worst thing I could do for my stomach problems. This woman who mentioned off hand that she wasn’t surprised I hadn’t felt like doing much exercise since I was probably exhausted. This woman who didn’t shame me at all, and just asked kindly what status we might give my eating disorder.

“Managed.” I said. “It’s managed. We manage it.”

Then we left and went to a restaurant where I burst into tears and had to leave because I couldn’t order anything.

We might be managing it, but some days, managing it feels like a full-time job.

Her words ran around and around in my head. You’re obviously not, you’re obviously not, you’re obviously not. And I cried because it wasn’t obvious. Not to me. It had never been obvious to me.

****

This is one of those times when my mental health plays ball front and center with my physical health. Usually, I have to do some convincing for people to really believe that mental illnesses are physical illnesses, but when you start getting super skinny because of something that’s happening in your brain, then people tend to start linking up the dots all by themselves. I’m not super skinny. The dietitian says I’m obviously not overweight, but I know skinny and this ain’t it. But even when my body isn’t “looking” anorexic, it seems like my eating disorder still plays a very physical game.

Anxiety affects your nervous system, and the dietitian reminded me that it this anxiety induced effect that impacts the nerves around your gut, causing spasms and pains. This has been the reasoning doctors have given me in the past for my stomach problems, leading me to the helpful logic that if I could just stop all this anxiety nonsense then my stomach problems would clear right up!

As to how one does that, well, I am yet to meet a doctor who has a clear answer to that.

Whilst I know that my anxiety does make my stomach problems worse, I also know that it’s not the only reason for it, and thank god, the dietitian knew it too. That was an astonishing joy to me, to hear the dietitian recognise my symptoms and link them up to a stomach disorder, not just to my anxiety disorder. But whilst she was clear about that, something else also became abundantly clear to me. My anorexic mind is still capable of making my body sick.

The anorexic mind makes me fear food and I skip meals. The dietitian told me that skipping meals essentially messes with the natural balance of my intestine, which only makes stomach problems worse. The anorexic mind makes me stick to strict routines of food that aren’t always healthy. The dietitian told me that restricting my diet and cutting out fruit and vegetables is not only making my experience of eating less enjoyable, but it is also making me more unhealthy and not allowing me to get the nutrients I need. The anorexic mind makes me worry about how what I eat looks to other people. The dietitian pointed out to me that everyone’s response to food is different, and I have to eat what’s right for me and my stomach.

The dietitian says I have IBS. Thank God for a solid, medical diagnosis! But I still wonder how much of it has been caused by my anorexia.

****

So I’m crying as we leave the restaurant, blinking madly to stop my eyeliner running and trying not to make eye contact with strangers. We take refuge in a coffee shop and my husband heads off to order the decaf soy latte which is the only thing I can possibly put in my mouth right now. I wait for him, staring out of the window at the pouring rain, unable to stop the dietitian’s words coming back to me over and over.

You’re obviously not.  

These are words I have craved throughout my life; this outright acknowledgment that I am not overweight.

But as I sit, I realise that these words haven’t given me the sense of happiness I had thought they would. All I felt was crushing relief, followed by brutal weariness. The relief was automatic – thank god, I’m not fat! – but the weariness was deeper, like an ache in my bones. I wanted to lie down in that coffee shop and fall asleep, my body shattered by the sheer heaviness of the years of fear and exhaustion. Because whilst I might be obviously not overweight, I was obviously unwell, in mind and body. That’s why I had gone to the dietitian and why I had started to cry; because I had got to the end of my rope with my doctors and what they were suggesting and reached the limits of my own tentative research. Because the list of things I could eat had shortened and I didn’t know why. Because I had more sick-days than good days, and my mind was heavy and buckling under the burden of always thinking about food. The terrible realisation was that being not fat wasn’t enough anymore. The exhaustion came from seeing the barren lie of anorexia laid bare. Being not fat isn’t enough. Because being not fat isn’t the same as being healthy.

And yet…

The creeping nature of this disorder is that it lurks, ghoul-like, in the recesses of my brain, extending it’s fingers to grasp tightly at any mention of weight. It will never let go. The dietitian told me I wasn’t fat, and the dark little monster that is my eating disorder clings to those words like a trophy. In my bad days and low moments, it tries to tell me that maybe those words are enough to sustain me. Maybe I don’t need to be happy or healthy, or to eat without fear. Maybe I can live off the off-cuts of conversations, carefully voiced concerns about my weight from friends and family that I can cut up and refashion into compliments, and reasons to stay thin. Maybe.

But I can’t.

Because here I am, on a special diet from the dietitian and trying to stick to it. Here I am, with stomach problems that won’t go away and I have to wonder if part of it has been brought on by years of eating nothing but porridge oats and taking unnecessary medications. I have to wonder if the reason I am here at the dietitian is because I spent so many years feeding the ghoul rather than feeding myself properly.

So I’m not choosing the obvious anymore. Whatever I look like on the outside, I only want one thing moving forward. Being told I’m not fat isn’t enough me anymore. I want to be healthy.

****

b-eat (beating eating disorders) website: https://www.b-eat.co.uk/

online support: https://www.b-eat.co.uk/support-services/online-support-groups

helplines: https://www.b-eat.co.uk/support-services/helpline

 

 

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