Most people see nutrition as something that is important to maintaining health, however for some people it goes beyond that – nutrition becomes something that they must control completely. Gradually they begin to obsess over it until they reach a point where eating something non-nutritious can literally send them into a panic. There is a fine line between eating well, and an eating disorder, and I learnt that the hard way.
I went to school with a girl who was unbelievably fit and healthy – she was a competent long distance runner, spoke four languages fluently, and was dux of our high-school. After we graduated, she went to university and began studying fitness with the ultimate goal of becoming a PE teacher.
Whilst studying she discovered martial arts as a hobby. She decided to enter a tournament, and discovered that she faced a dilemma. She could either be the smallest person in one weight category, or the biggest in the one below …. but to enter that field she would need to lose three kilos.
She never stopped losing weight, and when she died she was 25 years old, and she weighed 25kg. It’s hard to comprehend how someone so HEALTHY could ever succumb to anorexia, but what most people don’t understand is that anorexia isn’t always about being thin, often it’s about being HEALTHY.
Anorexia is not a physical illness – although it has obvious physical manifestations – it is actually a very dangerous mental illness. A little known fact is that it kills more young people – the majority girls and women – than any other mental illness. Which brings me to the hardest part of this story. My daughter is a sufferer.
It was new years eve 2013 when she came to me and said that she thought she might be suffering from some of the symptoms of anorexia. At first I thought “oh here we go again, it’s Dr Google,” but when I thought about it there were some rather alarming things happening. Things that I had chalked up to her desire to learn about nutrition, and to stay healthy.
My own daughter – a child who had been raised knowing how false the images of beauty we see in the media are – had become so focused on HEALTH that it had begun to control her life. Although it began as a way to get healthy, she was restricting her diet and portions so strictly (and cunningly hiding it) that she was suffering from many of the signs of starvation.
The most frightening part was when I discovered that by the time you are suffering physical signs, your brain chemistry has been altered. Although you may not appear to have lost a great deal of weight, the damage has already set in and the eating disorder has taken control, and from what I have seen in the months since then, there is no more ruthless master than an eating disorder.
We were extremely lucky to get into the hospital within a fortnight of referral from the GP. My daughter was weighed, a blood and urine sample were taken, they checked her blood pressure, her heart rate when resting and standing, and other vitals as well. Then came the hard part. They quizzed her about how much she ate.
Despite the fact that she over-exaggerated her portion sizes, the nurse informed her that she was NOT eating enough for a growing fifteen year old, and then told us how her vital signs were showing the signs of starvation. We were given phosphate tablets that she had to take after every main meal (because her levels were so low they were worried about her heart) and sent home with instructions to eat breakfast, morning tea, lunch, afternoon tea, dinner, and then supper until further notice, and she was strictly forbidden to engage in any physical activity until her body was back within a healthy range.
To say I was shocked would be an understatement. I knew she had lost some weight, but of course the gradual nature of weight loss meant I had underestimated just how much. I also had no idea that, whilst she still had the appearance of a normal, healthy teenager, her body could be in such danger.
That night I took control of her portions. She was FURIOUS with me, and before I could give her supper she stormed off to bed. Breakfast the next morning was horrible, I was sworn at and called names, and by the time
I presented her with morning tea (two small slices of raisin toast) she holed up in her room and threatened to slit her wrists rather than eat.
We went to emergency where we struck astonishing ineptitude from a psychiatric nurse who told her that she “looked perfectly healthy” and she seemed to “know her body well enough”. He noted that there was “extreme dysfunction” in our relationship because we were TALKING (we never even raised our voices), but we had differing views about what the nurse at the eating disorder clinic had said. He also said that her vital signs could simply have been showing stress because she was so upset, and told her that she should talk to the eating disorder doctor about it. I asked him how many “healthy” teenagers he had dealt with after raisin toast inspired suicide threats.
The paediatric doctor then came to see her and she actually retrieved the notes from the eating disorder clinic, and agreed with me, but it was too late by then and the damage was done. We were eventually discharged that evening after my daughter agreed that she would eat what she was told to eat until she could see the eating disorder specialist on Monday (two days away). Of course she had no intention of actually DOING that, but the food the hospital offered her literally sent her over the edge in panic. She preferred my offer of sourdough raisin toast to their offer of yoplait.
She was convinced that the doctor would tell her that her mother was crazy and that she could go back to her previous eating plan ….. but it didn’t happen quite like that. Over the next few months we fought about food, we visited the hospital weekly, we fought about food more, we visited the hospital and ….. you guessed it! We fought about food some more, but bit by bit she edged closer to physical health.
With the strict mother controlled diet regime, her mood improved within days. Having never been the mother of a teenager, I thought her extreme mood swings were normal, but I was shocked to see that when I fed her, she was her usual polite, easy going self (in between meals that is). Within a fortnight she herself commented that she was more comfortable physically. But the signs of health that the hospital was particularly interested in were another four months away.
Part of living in Australia is having access to free healthcare, and in this instance it has been such a blessing. The hospital follows the most current evidence based practices, using a technique known as the Maudsley Method. It’s the most successful treatment for eating disorders ever. It operates on the theory that if you first fix the nutritional depletion, and get the body back to full health, the mind follows. Whilst other methods begin therapy straight away, Maudsley waits until the body and brain are properly fuelled by nutrition first.
Typically it takes eighteen months to go from regained physical health, to a place where the patient is mentally and emotionally stable, however it’s important to note that as with drug addiction, eating disorder sufferers frequently relapse.
I have now been battling with her over food for nearly eleven months and to say that the whole process has been exhausting would be an understatement. Some of the arguments we’ve had have been quite volatile and they all end in tears. But she just keeps on seeking “health” whilst her eating disorder controls her perception of health completely.
We are now entering the therapy stage of treatment, and we expect this to be challenging, but positive. I do feel as though I can see the light at the end of the tunnel, and I feel incredibly relieved that we caught it early enough, before her mind was even more depleted. I know that my high-school friend’s family faced a far more daunting prospect because her mind was so dangerously affected before the diagnosis, and also because the treatment they used back then was so ineffective.
One of the most dangerous and common misperceptions about eating disorders is that they begin out of vanity. Often they begin on a quest for health, and attaining proper nutrition. An emotionally healthy person will not punish their body to the degree someone with an eating disorder – or the tendency for one – will in their quest to find health, and once they are healthy they find balance. A person with an eating disorder loses control. Ironically they control their food and exercise routines so excessively that they completely lose control of everything. The more they control their “health,” the more they are controlled by their unhealthy views; and the more those views take hold, the less nutrition there is to fuel the brain. Slowly, logic seeps away, and before you know it, there is a shell of a person who thinks they will die if they break their food rules or miss an exercise session.
Everyone should know the signs of eating disorders because they are increasingly prevalent, and frighteningly, although we assume that the weight loss will be a giveaway, by the time the weight loss become apparent, they are already in the danger zone. I feel confident that my daughter will survive, but I know that the main reason her prognosis is so positive, is that she told me (an exceptionally rare occurrence) and that I recognised the signs and didn’t brush it aside because she had the physical appearance of health, and could talk nutrition until the cows came home. I hope that in some way, some day I will be able to say thank you to my friend, because her spiralling out of control health habits may just be what save my daughter’s life.
If you liked this article you might also like She Still Has An Eating Disorder.