For almost two years now, I have been caring for a teenager with anorexia, disordered eating, and the undiagnosable orthorexia. If I had a dollar for every time someone had told me that “she looks healthy” or “at least she’s eating” I would be exceedingly wealthy. I probably wouldn’t be sipping cocktails in the Hamptons though, because I’d have to be here, caring for my healthy looking daughter who eats ….. and has an eating disorder.
Eating disorders aren’t about food, and eating isn’t the magic cure. Eating disorders are a mental illness, not eating is a manifestation of the illness, eating is not a sign that health has returned. To say that another way, being underweight, or malnourished, is a symptom, it is not the illness itself.
Something else that eating disorders are not, is vain, selfish, or self absorbed. They aren’t always associated, nor do they begin with the desire to lose weight. Many things can trigger them, and as they spiral out of control – often unnoticed by loved ones – the mind gets sicker and sicker, the weight drops off, and eventually they may start to fixate on weight loss, but often they fixate on “health” and because they are so UNhealthy, their perceptions of health are completely skewed and unrealistic.
I am by no means an expert on eating disorders, my only claim to fame is that I am an expert on my own daughter. But I was still shocked when we started seeing the nurses and doctors at the eating disorder clinic, to discover that my daughter – who LOOKED healthy – was actually in a lot of trouble physically. When you look at someone who is days from a heart attack, you can’t always tell. When that person is a teenager, you most certainly wouldn’t guess that it was on the cards. Not that my daughter was in that much strife, but other teens are.
You might think that it would be easy to identify someone with an eating disorder, but the reality is that they often look pretty normal. Visible bones are definitely a sign that there could be a problem, but it’s one of the last signs. Long before they get to that point they can be pretty sick without any visible signs of illness. It’s their behaviour around food that’s the give away.
Unless you know someone very well you might have absolutely no idea that they have a problem. To make things even more complicated, even if you know them well, you might be deceived. The nature of the eating disorder is deceptive, and deception, to be successful, is so casual that unless you can start to see a pattern, unless you’re focusing on how the people around you eat, you really might not notice.
Yes, my daughter eats. But you try giving her a sandwich.
A normal person who is presented with a sandwich will say “thanks”. A person with a pattern of disordered eating will have a thousand and one excuses to explain away not eating it. “I’m not hungry”, “I just ate”, “I don’t feel very well this afternoon”, “I can’t eat gluten / dairy / fat / <insert other food group here>” and so on and so forth. They might even look like they’re eating, but really they’re just taking it apart and reassembling it in such a way that it appears like they’ve eaten. And here’s where it gets even trickier, a person without an eating disorder might say any one of those things about a sandwich, they might eat half and leave the other half, they might pick certain ingredients out, or cut off the crusts, so if it starts to become a pattern do you really think you’ll notice the casual deception?
The other day I took my daughter to a cafe and bought her a piece of chocolate cake. At first she refused to eat it. Eventually she picked at it a little bit. It was too sweet, too big, too unhealthy, she didn’t like it, it was unnecessary, and more. Sure she ate some of it, but her eating was filled with misery rather than enjoyment of a rather nice, rather small piece of cake, and she rearranged it on the plate to make it look like she’d eaten more. What might have been a lovely mother daughter afternoon, was actually swamped in anxiety and tension.
People might suggest that she doesn’t need cake, and in terms of nutrition that is absolutely true, but as I explained before, an eating disorder isn’t cured with nutrition. At this stage, with her physical health as it is, the only way forward is to confront the thinking patterns. It’s one thing to have a healthy body, but as long as her mind isn’t aligning with that she’s in real danger …. whilst eating and looking healthy.
For two years now there has been almost no shift in her mental health. I’ve lost count of how many “healthy diets” she’s been on, none with the overt intention of losing weight. To list a few there’s been gluten free, dairy free, gluten AND dairy free, low fat high carb, vegan, vegetarian, fruitarian, and currently high fat low carb, but there have been others as well. Throughout all of them, the foods that are not included on the “good food” list are the foods that are pushed around her plate so they appear to have been eaten, they’re found stashed in her rubbish bin a week after they were on her plate, I once found peanuts in a sock that I had washed, our dogs started getting fat. I can’t buy enough of the “good foods” because they are all gone before anyone else gets a look in, and the bad foods (that were good a fortnight earlier) rot in the fridge.
If you have no experience with eating disorders please don’t try to comfort me with “at least she’s eating”. It may shock you to discover that eating disorders are the top killer of people with mental illness. Believe me when I say, there’s a whole lot more to it than “just making them eat”, and when they do eat it’s precious little comfort. You might see my daughter having lunch, but you have no idea how much anxiety goes into eating it. You have no idea how keenly I watch to see if she hides food, or feeds it to the pets. The truth is that you have no idea how much of a struggle our family goes through with our healthy looking daughter that eats.
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