Disclaimer: This is a series of posts about my experiences with anorexia and bulimia. Many of the things I discuss could be extremely triggering if you are dealing with an eating disorder, so please read at your own risk. I am not a doctor or a therapist. I am simply telling you my story.
Just in case you’re tuning in for the first time, check out part 1 and part 2 of my story first. Otherwise you’ll have absolutely no idea what I’m talking about. Last we left off, I had finished telling you the story of the past 11+ years I’ve spent suffering from anorexia and bulimia. Today’s post will talk about what recovery looks like for me today, the health issues I’ve suffered from as a result of my eating disorder, and some of the tools I use to try and encourage my recovery.
The Health Issues
When you’re an eating disorder patient, doctors, therapists, family, and friends spend a lot of time trying to educate you on the health issues that can result from anorexia and bulimia in an attempt to scare you straight. At the risk of sounding like an asshole, I’m going to tell you that I always thought this tactic was kind of funny because of the type of person I am. From where I am sitting, no one, no matter how stupid, can possibly think that starving themselves or purging all their food is healthy. That being said, it’s possible that people don’t realize how dangerous it really is, so that’s fine. I, on the other hand, knew exactly how dangerous it was because I am a compulsive researcher. I love to learn. I am fascinated by details, facts, etc, so I knew exactly what I was doing to my body and how damaging it was. And I absolutely did not care. Eating disorders aren’t a choice, so it’s not like I was picking to live a lifestyle I thought was healthy and then found out it wasn’t.
Let me drop some knowledge on you for a second. Anorexia Nervosa, the medical name for anorexia, involves self-starvation. By depriving the body of nutrients required for bodily functions, the body is forced to “slow down” to conserve energy. When it slows down, this is what happens:
- Abnormally slow heart rate and low blood pressure, which mean that the heart muscle is changing. The risk for heart failure rises as heart rate and blood pressure levels sink lower and lower.
- Reduction of bone density (osteoporosis), which results in dry, brittle bones.
- Muscle loss and weakness.
- Severe dehydration, which can result in kidney failure.
- Fainting, fatigue, and overall weakness.
- Dry hair and skin, hair loss is common.
- Growth of a downy layer of hair called lanugo all over the body, including the face, in an effort to keep the body warm.
Bulimia Nervosa, the medical name for bulimia, is characterized by binge-purge cycles, which can disrupt the entire body. The type of effects one suffers can depend on the method of purging used. Consequences include:
- Electrolyte imbalances that can lead to irregular heartbeats and possibly heart failure and death. Electrolyte imbalance is caused by dehydration and loss of potassium and sodium from the body as a result of purging behaviors.
- Inflammation and possible rupture of the esophagus from frequent vomiting.
- Tooth decay and staining from stomach acids released during frequent vomiting.
- Chronic irregular bowel movements and constipation as a result of laxative abuse.
- Gastric rupture is an uncommon but possible side effect of binge eating.
Both of these conditions can lead to heart attack and death.
OK, sorry for all that technical stuff. Probably the most common question I get when people find out I am bulimic is about my teeth. For the record, my teeth are just fine. My dentist is actually consistently impressed by them, and he has never asked me if I am bulimic because he can’t tell. Danielle = 1, Bulimia= 0. But that’s pretty much where my victories end.
As those of you who have been readers of my blog for awhile now know, I have a heart condition called Paraxysmal Atrial Tachycardia. I started having heart problems about 6 years ago, when I noticed irregular heart beats, a racing pulse, and the feeling that my heart was pounding out of my chest. At the time, my doctor told me to cut caffeine out of my diet, and I did – I haven’t had caffeine since (yes, that means no coffee. Ever.) The condition has worsened over the years, and back in March, I got the full gamut of tests run on me and got my official diagnosis. Telling my cardiologist my whole medical history, anorexia, bulimia, and all, he told me in no uncertain terms that the electrolyte imbalances I’ve been causing myself for the past decade have disrupted the electrical impulses in my heart, causing my condition. My heart muscle has changed as a result, and I will likely always deal with this condition. So, my teeth made it out just fine, but my heart? Yeah, not so much. And that’s kind of a big one.
I’ve been asked by some people if my stomach problems and chronic reflux can be attributed to my bulimia, and the answer to that is a difficult one to answer. GERD (gastroesophageal reflux disease) runs in my family, so it’s no surprise that I suffer from it. That being said, bulimia can weaken the lower esophageal sphincter (the thing that keeps your food inside your stomach) over time, so its highly possible that I have made my condition worse than it might have been otherwise as a result. It’s not hard to imagine that with the constant abuse of food coming back up, the sphincter just gave up trying. I don’t really blame it. In a way, my GERD has actually been a blessing. I am so sick from my reflux most of the time that I am throwing up unintentionally – I don’t have the compulsion to throw up intentionally as often because I’m always sick. It’s kind of strange, but it seems to be the case.
So basically, I’ve completely screwed up my heart and my stomach, and I have no one to blame by myself. And let’s not forget the femoral neck stress fracture I gave myself back in 2010. I wanted to believe I was going to be one of the lucky ones who never suffered from any of the serious health consequences of eating disorders, but that was stupid. It’s pretty much a given that if you torture your body for as long as I have, you’re going to have serious effects. For a long time, I believed that I could blame other factors for my health issues, but the reality is, the majority of them have either been directly caused or clearly exacerbated by my eating disorder, and that’s a bitter pill to swallow – pun obviously intended.
As I mentioned in my most recent post in this series, my recovery process is a battle every single day. Each time I eat a meal, I have an intense mental debate over whether or not I should throw it up. I always know that the answer is that I should not, but that’s not always the resulting behavior. Sitting at a table with other people, particularly people who know that I am bulimic, causes me a great deal of stress. “Alright, we just ate. I can’t go to the bathroom right now, they’ll know. No, I really shouldn’t throw up. But I have to. But I can’t. It’s bad. But I’m going to get fat. Who cares if they know? But I can’t…” and it just goes on and on. I’ve missed out on so many conversations thanks to this little argument. That being said, I’ve learned a lot over the course of many years of therapy, and I’ve come to be pretty good at identifying my triggers and figuring out what things I need to do to ensure a healthy day. What you won’t hear me saying are things like “think kind thoughts” or “be nice to yourself.” Are those things important? Sure, but I’m a person who needs actual tasks in order to succeed. Nothing nebulous. So, here are some things that have helped me personally. They might not work for everyone, but I’m only the most hilarious blogger of all time, not a therapist. I can’t do everything.
1. Throw away the scale.
When I first started going to therapy and trying to get my handle on my eating disorder, I was told I had to get rid of my scale. Although it was extremely traumatic at first, it was one of the best decisions I ever made. Seeing the number on the scale was a huge trigger, no matter what it was. A “high” number meant I was failing and had to try harder. A low number meant I was on the right track and had to keep going. For someone with an eating disorder, there is no “goal weight.” There is no number at which you are satisfied with your appearance. The “goal weight” just keeps getting lower and lower as you reach each one. I found that I often was the most disgusted with myself at my lowest weights, because this is when the eating disorder has the strongest grasp on my brain. Although I bought a scale about 6 months ago, I keep it behind a closed door now – out of sight, out of mind – and I rarely weigh myself. AJ uses it more than I do. When I go to the doctor, I turn around on the scale and ask the nurse not to tell me my weight, because scales vary dramatically and I don’t want to hear a “bad” number that will set me off. They usually laugh at me, but it’s something I’ve found that is super important.
2. Recognize your weaknesses.
One of the most important things in recovery is to be honest with yourself, and I’ve learned this the hard way. I’ve lied to myself a thousand times throughout this issue, and one of the things I have lied the most to myself about is that I can watch what I eat. I can’t. Any time I have tried to lose weight by going on a diet, however honorable my intentions are, I always end up becoming obsessed and going overboard. This happened just recently back in August when I felt that I had gained a bunch of weight and needed to lose it. This happened just months ago, and I’ve known this about myself for years. I joined Weight Watchers and started tracking my food on MyFitnessPal, and I lost 13 pounds in about a month. I do not have the ability to count calories, points, or anything else. As soon as I try to tell myself that I am going to eat in moderation, or that I “can’t” eat certain things, I immediately want to beat my calorie goal. MyFitnessPal tells me I should eat 1,200 calories a day plus whatever I burn off running? Forget that, I’m going to eat 900 total. I get so competitive and so focused that I just can’t stop myself. I’ve learned over the course of my recovery that it’s really just not possible for me to “diet” and lose a few pounds. I need to just maintain a healthy weight through exercise and just eat whatever I want, because as soon as I start to restrict, I freak out. I can’t promise I will never go down that path again, but admitting you have a problem is the first step to recovery, right?
3. Identify body triggers.
Pretty much everyone has some part of their body that they are the most unhappy with. Eating disorder patients hate pretty much everything about themselves, and I’m no exception, but my thighs have always been the thing that makes me the most insecure. I feel physically ill every time I see my thighs in the mirror, with no exceptions. It’s stupid, but it’s true. As a result, as soon as I get out of the shower, I almost always immediately put on long shorts, sweatpants, etc to cover my thighs while I am blowdrying my hair. If I am forced to stare at them in the mirror for too long, I freak out. There’s something about seeing them bare that I just cannot handle. Maybe this isn’t the best tactic for ultimate body acceptance, but right now, it’s about survival for me, so I’m not going to pretend like I stand there and tell myself how fit and toned my thighs are and how proud I should be that they carry me through marathons, because I don’t. Maybe one day. Right now, I cover those suckers up and forget they exist.
4. Avoid the Golden Corral.
I love food. I’m not going to lie. As a runner, I am almost always hungry, which doesn’t exactly help my cause. As much as running has helped my recovery in many ways, it has made it more challenging at times as well, because I feel so hungry most of the time. As someone who has a history of restricting calories and throwing up when I feel like I’ve eaten too much, feeling hungry all the time can be very dangerous, because the amount I need to eat to feel satisfied is a lot of food, which in turn can make me feel depressed, anxious, and like I need to purge. Therefore, it’s important for me not to put myself in situations where I have the ability to eat everything in the world, such as buffets. Trust me, I love a good buffet, but I just can’t do them anymore. I always eat too much and I always end up throwing up everything I eat. I do not have the self control I need in that environment, so I can’t go.
5. Find distractions.
I know that every time I eat, I’m going to have anxiety. It’s a given for me at this point in my recovery. That means that I have to come up with creative solutions to settle my nerves in the event that I eat a bigger meal than I should have or less healthy food than I should have. At work these days, I’m pretty busy, so I’m usually distracted enough to be ok. The problem is more at home after work or on the weekends, when I’m less distracted. A few things that work well to distract me are going for a walk, run, or bike ride, watching a favorite show (ok, it’s pretty much always SVU) with AJ, or doing a little online shopping. I don’t usually end up buying anything, but making myself believe that I might distracts me just enough to let some of the fullness pass. Of course, the thing I do to resolve the anxiety depends on the source of the anxiety. If I want to throw up because I ate too much, the solution is different than if I want to throw up because I had a bad day at work. Multiple solutions for resolving stress are key because it doesn’t make sense to stop myself from purging my food through vomiting if my alternative is purging through excessive exercise.
6. Identify food triggers.
Inevitably, some foods affect how we feel differently than others. Small amounts of some foods make us feel very full, while large quantities of other foods don’t. Eating a ton of vegetables isn’t likely to make you feel really bad about yourself. For me, the food that makes me feel worst about myself is typically dessert, but especially ice cream. It doesn’t seem to matter if it’s ice cream or frozen yogurt, either – I think it has to do with the consistency and the way it sits in my stomach. Whatever the case, it is incredibly challenging for me to eat ice cream without throwing it back up. I absolutely love desserts and sweets, so that one is tough for me too. That’s not to say it’s impossible, but it really just depends on how much I have eaten before I eat dessert and what it is. I have been working really hard on waiting awhile after I eat dinner to decide if I feel well enough to eat dessert, but again, it’s a battle. The important thing is identifying problems and figuring out solutions before you’re faced with the situation.
7. Find foods that make you happy.
Food doesn’t have to be the enemy. Just as there are foods that make you feel bad when you eat them, there are also foods out there that make you feel good, even if you aren’t in a place to believe that yet. Identifying these “safe” foods is just as important as identifying your trigger foods, because they are foods you can trust. For example, I drink hot chocolate every morning, made with skim milk, because it settles my stomach, never makes me feel like I ate too much, and is delicious. I don’t feel bad after having it, so I rarely throw it up. I look forward to drinking it. I also eat a lot of rice, because unlike bread, it doesn’t make me feel too full when I eat it. I pick baked potato chips instead of fried. It’s not even necessarily about making healthy choices – a brownie is going to upset me mentally much less than ice cream. That doesn’t mean I don’t like ice cream, it just means that I’m going to try to pick the “safe” foods as often as I can. Sometimes it happens, sometimes it doesn’t, but knowledge is power.
8. Cut the crap out of your life.
Ok, flame me if you want for quoting Nicole Richie, but I remember reading this quote in a magazine article about 7.5 years ago and thinking it made so much sense. She said: “A lot of times you have to separate yourself from the people who are still in [a negative place]. Hopefully when they come out of it, you can start a friendship with them. You have to cut out the people who are not good for your life.” As you’ve seen from this series of posts (or maybe have experienced yourself), many people joke about eating disorders, make insensitive comments, etc. without ever intending to cause harm to the people they are speaking to. I’m not saying that people shouldn’t be held accountable for their words, but it’s challenging to be sensitive about something you don’t understand and are unaware of. Luckily, we have options. If you find yourself unable to be around someone who constantly obsesses about food or weight, says things that make you feel bad about yourself and your body (intentionally or unintentionally), whatever, cut that person out of your life. At the very least, stop talking to them about the topics that upset you. Change the subject. Ask them a question. Whatever. In an ideal world, you would explain to them why their behavior bothers you, but you might not be in a place yet where you feel strong enough to do that. And in reality, they still might not stop their behavior and you’re faced with a difficult choice. That’s ok. You have to do what is best for you and your recovery. This is something I continue to struggle with, but I’ve found to be extremely important.
On that note, it’s not enough just to cut out people that make you feel badly about yourself. Are you obsessively reading “healthy living” blogs and being told that brownies are bad, while secretly harboring an undying love for brownies (like me)? Participating on weight loss message boards and being told your daily menu isn’t up to par? If something you are reading or doing is negatively affecting your self esteem, stop. No one can do this but you. This doesn’t mean that the actual content of what you are reading is necessarily bad or unhealthy. For some people, working out a million times a day and existing on salads and fruit might be totally healthy and not obsessive behavior at all, but I’m not one of those people. Reading about stuff like that makes me feel bad, so I don’t read it.
It’s for this reason that I actually don’t read many running blogs. Running blogs, particularly running blogs written by more talented athletes than me, make me feel bad about myself. I don’t eat the right things. I’m not as fast. I don’t do as many hill workouts as I should. I detest speed workouts. Well…so what? They aren’t inspirational to me, even if they should be, and it’s not the writer’s fault. They aren’t doing anything wrong, my brain is. If I’m reading something that makes me feel bad about myself, it’s my responsibility to stop.
Obviously, I hope my blog has never made you feel bad about yourself, but if it has, DON’T READ IT. I won’t be offended. Your mental health is far more important than my number of subscribers.
And that’s pretty much life for me these days. It’s tricking myself. It’s being honest. It’s making the hard choices and trusting that the small victories will add up to a big win over time. My ideal recovery will be a world in which I never have negative thoughts about my body, I embrace my self worth, and I make healthy food choices most of the time but don’t feel guilty about treats enjoyed in moderation, but that’s not my reality yet. For now, it’s about the baby steps that I’m taking that will lead me there.
Tell me: How do you cope stress and problems in your life? If you’re recovering or recovered from an eating disorder, what helped you?