Things to Know About Bulimia

Bulimia nervosa, also known simply as bulimia, is an eating disorder characterized by binge eating (eating large quantities of food in a short period of time, often feeling out of control) followed by compensatory behaviors, such as self-induced vomiting or fasting, to prevent weight gain.

Things to Know About Bulimia

According to the National Eating Disorders Association (NEDA), 30 million women and men will struggle with an eating disorder at some point in their lives.

Bulimia is characterized by binge eating, often with high caloric foods followed by purging. If not stopped, it can cause major health concerns. Bulimia does not discriminate against race, sex, weight, body type or socioeconomic status.

Many people struggle with this life-threatening illness. So, why is this disorder so misunderstood?

Through my personal experience, I’d like to provide some insight.

1. Development of bulimia

Bulimia, along with other eating disorders, has been stereotyped as only related to weight.

It’s important to understand that this is not always true. Yes, social idealization of being thin can be a culprit, but environmental factors often contribute to the development of eating disorders. This was true for me.

In my experience, trauma played a role. Sexual abuse, constant emotional and physical torture from high school bullies, along with a loss as a young adult left me emotionally scarred. Over time, depression set in. This was the beginning of the foundational cracks in my mental health.

On the verge of an eating disorder, you are often unaware of what is happening to you. So when one emotional evening had me eating too much, I got painfully bloated. I purged for the first time. The release felt good. There were no thoughts about weight. Only loss and pain. Because of my emotional state, somehow the release I felt made me feel better, emotionally. On days I felt down, I ate junk and the cycle repeated. Before I knew it, what had been manifesting over time, suddenly had a strong, overpowering grip on me.

It’s important to know that something that causes a negative impact on your psyche has the potential to manifest into something destructive.

2. A day in the life of a bulimic

Dopamine is released during overeating, which creates a sensation of pleasure and euphoria. This process allows us to continue the behavior so that we feel good again. It’s an addiction.

I lost a little weight and was complimented on the way I looked. I welcomed it. I lacked self-esteem, so the more compliments I received, the better I felt.

For something that had nothing to do with weight, it soon became all about it.

I told myself that I was going to stop once I’d reached my goal. I never did. Still, I thought I was in control.

A day in the life of a bulimic consists of being consumed with thoughts of food. Every minute of every day. Food cravings, ingredients, calories. How food would impact the scales. A tug of war between “I’m going to be good today!” and the consequences of failing.

Guilt immediately after eating and more so knowing you’d purge. This immediately turns to disgust once the inevitable has happened.

Apprehension and panic take hold. Will everything come up? When you feel lightheaded or pass out, this quickly switches to, “maybe I should have left a little inside to keep me going.”

On the outside, I would put on a façade. Behind closed doors, I was depressed and felt as though I didn’t want to go on.

3. Changes in behavior

I became obsessive and compulsive. The daily battle was intensifying. The me I once knew morphed and I became irritable and had aggressive outbursts. I was deceitful and found myself doing things I could never have imagined. Lying, treating people disrespectfully, stealing.

4. The truth about bulimia

Many don’t understand why they become bulimic. I believe it’s one of the contributory factors of relapse. They are treating the symptom and not the cause.

Many bulimics look healthy.
It can disrupt personal and family dynamics.
You can be bulimic even if you eat healthy meals between purges.
This is not a choice. It’s a serious illness.
There’s an increased risk for suicide and medical complications
Misconception: Those battling bulimia can stop at any time.

Those tormented by bulimia make frequent trips to the bathroom after meals and often abuse laxatives. They drink excessive amounts of water when consuming food.

You may see scars over the knuckles.

5. Setbacks and triggers

Setbacks are to be expected. I can attest to this.

The sequence of binging and purging can be triggered in response to stress and anxiety. The feeling of guilt and being a failure for slipping up, adds to this.

6. Side effects of bulimia

Cardiovascular complications
Syncope, from dehydration and lack of nutrition
Memory loss and lack of concentration
Digestive issues
Esophageal damage
Hair loss and dry skin and nails
Dental problems
Menstrual irregularities
And more…

7. Road to recovery

A strong support system is crucial. Positive reinforcement for all the small steps that are made towards recovery are encouraged.

Supporters: these words of encouragement are for you.

The more I learned, the more I realized why I hadn’t been successful in my recovery. The key to it all was nourishing your mind, body and soul.

It isn’t enough to eat healthy and hope that nothing triggers a purge. Staying strong emotionally and physically through exercise is important, but isn’t enough. Dealing with past trauma is a crucial part of healing, but on its own, it isn’t enough. Taking time to yourself to reflect and relax, giving back and being grateful for what you have, all have healing properties, but that too isn’t enough.

You need mind, body and spiritual fulfillment.

Win your battle with bulimia!

To those that are fighting their own battle: Here is a letter from me to you.

Take the first step on your journey to a more fulfilled life…

Signs You May Have an Eating Disorder

In today’s society, fad diets, exercise trends and juice cleanses cloud our idea of what “health” truly is. It can blur the lines between wanting to be healthier, struggling with disordered eating or struggling with an eating disorder. But an important difference between disordered eating and an eating disorder is the severity in which the “abnormal” and intrusive behaviors around food and body occur.

Personally, I knew my behavior was a real problem just by the intensity and frequency of thoughts I had about food and body that I knew were not typical. They were obsessive, intrusive and always cruel. Being in recovery now, I am able to see even more how unhealthy my thoughts when I was sick were.

If you don’t see yourself in this list, and your relationship with food still makes you unhappy, don’t hesitate to still use the resources listed above. Your feelings are valid, and you don’t have to wait to get “bad enough” for help.

Here’s what people shared with me:

1. “I felt worthless when stepping on the scale, regardless of what the number was. If I gained I was useless, if I lost, I clearly was also useless as I could have lost more.”
2. “I realized there was not a second in my life that my mind wasn’t consumed with thoughts/worries about food. Every decision I made was influenced by what food might be involved. I realized this consumed every inch of my being, and choked me like a heavy dusty blanket.”
3. “The moment I realized I couldn’t stop like I thought I could.”
4. “My desire to be ‘healthy’ was turning into my desire to not eat.”
5. “I started to hoard sweets, chocolate and other ‘junk foods’ in my room. The initial idea was that when I lost enough weight, I would treat myself to them. But when it actually got to that time, I was too scared.”
6. “I first learned about binge eating disorder (BED) in eighth grade. We got new health books and this eating disorder wasn’t in our previous one. I remember sitting in class and our teacher was having us read the chapters as each kid would read a paragraph, then the next kid would read, etc. when we got to BED, I remember trying so hard not to cry in a room full of my peers because, ‘OMG. This is what I do.’ It was a lightbulb that went off. It scared me so badly and gave me a little peace at the same time.”
7. “I stopped going out to eat and avoided eating with other people as much as possible. I couldn’t stand to eat in front of other people for fear of judgment.”
8. “I don’t think there was just one thing, but different occurrences together. Some include crying because I didn’t want to work out, but also crying because I didn’t want to get fat, avoiding situations where there was a lot of ‘bad’ foods, being cold on hot days.”
9. “I first wondered when I started getting scared of my weight going over a certain number. I remember writing in my diary, ‘Does a person know if she’s anorexic? I hope I’m not.’ I was 12-years-old at the time. I realized that I actually did have an eating disorder many months later when I was lying to my mom and my friends about what I was eating.”
10. “There was no ‘one sign.’ It was a combination of many little things that, taken separately, seemed perfectly harmless to me and even to others. It wasn’t until I had the realization that these little things were connected that I started to understand they were not harmless and I had a very real problem. I had to start to see the big picture before I was able to recognize that I needed help.”
11. “It was all I thought about. My entire day revolves around the topic of food. I would bring every thought I had back to it or find a way to focus on it even more. I realized that it was dangerous when I couldn’t function around others because I was so absorbed in it. I had to leave school, couldn’t work or go to social events.”
12. “When the numbers on the scale were used as the way to validate myself and my worth.”
13. “After I went from feeling happy and motivated to ‘eating healthy,’ to suddenly feeling guilty no matter what I ate. I started feeling ashamed, embarrassed and guilty for eating — even in the midst of my irrational anorexic thoughts I could see that that was a sign things were getting too far.”
14. “When I realized I was really unable to stop myself was a big moment.”
15. “I realized I had an issue when I was up crying at 3 a.m. because I was thirsty and the fear of gaining even water weight terrified me. Or when I would watch documentaries about the anorexia and bulimia to ‘punish myself’ for not being skinny enough. I am still ashamed of my diagnosis because of the way my body looks. You just have to surround yourself with positive people and remind yourself that you’re worth more than a number on a scale.”
16. “Avoiding parties or gatherings where food might be involved.”
17. “The biggest sign was that I spent more time obsessing over numbers and staring in mirrors than I did living or eating. My whole life revolved around that scale, those sizes, each calorie.”
18. “When I couldn’t get through a grocery store without a panic attack.”
19. “I realized my binge-eating disorder was real when I had $20 in my bank account and spent all but $3 on food for me to binge on by myself that night instead of putting gas in my car since my gas light was on.”
20. “When me and my family went out to dinner and the food wasn’t ‘right.’ It made me so anxious I broke down crying
21. “The very idea of eating made me feel ashamed of myself. And seeing people eat less than I was was upsetting.”
22. “When I couldn’t enjoy mealtime with my husband and children without great anxiety about what I was eating.”
23. “Thinking of food all the time.”

When I Stop Fighting the Bulimia Label

Nowadays, I seem to often forget about my bulimia nervosa diagnosis, at least until I see it in writing. That is when it feels like my world is caving in. Initially, I deny it. I’m not bulimic, no, no, no. I have “eating disorder – not otherwise specificed” (ED NOS). I had seen that diagnosis hundreds of times. For years, that was what I carried with me. ED NOS, which of course brought its own challenges. However, being diagnosed as bulimic feels so real. I used to brush off my NOS diagnosis. I used to tell myself, it’s not “full blown” anorexia or bulimia, I’m fine. When I first tried to state why I thought I wasn’t bulimic, all I could come up with was “But, I don’t overeat,” but I looked back onto my life with the monster I call “Ed” and realized just how many of my behaviors pointed to bulimia.

It still shakes me when I remember I have bulimia, and there are days I wonder when I won’t carry it behind me. Nonetheless, there are also days when I will stand in the diet pill aisle in a store, stare and lose track of time inside my own mind. There are still days where I have to resist sticking my finger down my throat. I still cannot have a gym membership because I know how severe the risk is that I will abuse it. For all intents and purposes, I am still bulimic; I am just in a place where I am not necessarily engaging in the physical behavior. I am lucky in that sense. However, my safety has nothing to do with luck. Despite being a year free of most behaviors, I still maintain a strict treatment plan. I have therapy weekly, meet with my nutritionist biweekly, see my psychiatrist monthly and am medication compliant.

The times I forget about my diagnosis are hard. I see my restrictive dieting as a part of daily life; I see my impulses as normal, ordinary even. When I am reminded, it destroys me, and eventually empowers me. I still try to deny it, but on a deeper level, I understand. When I stop fighting the label of bulimia, I give myself more power to fight my behaviors and impulses.

I follow an eating disorder recovery page and saw a picture that really spoke to me. It was an image of a dog with a “Recovery Is” sign that reads, “She has the energy to play with me.” I also have a dog who I love with my whole heart. Seeing this reminded me that when I am not trying to deny my diagnosis of bulimia and when I am actually fighting the disorder, I do have more energy to play with my dog. I have more energy to see my friends. When I take the energy out of fighting the label and direct it to fighting the disorder, I am stronger, I am healthier and most of all, I am happier.

Wish Others Understood About My Bulimia

When some think of bulimia, they think of a someone kneeling by the toilet, vomiting their dinner.

“How horrible that must be,” I’ve heard some say. “To have to put your body through that after every meal?”

What they don’t understand is that’s the easy part for me. The ghost of bulimia doesn’t just come out for a short visit after meals. It doesn’t go back into hiding once its job is done. The ghost of bulimia is a constant, negative force that controls my every sense, my every emotion and my every thought of every second of every day.

For me, bulimia is not a single event.

For me, it’s peeling off that gold star sticker when I was so sure of it that morning. It’s stepping on the scale before I even get to enjoy my cup of coffee. It’s skipping classes just so I can get a workout in. It’s eating the same thing. Every. Single. Day. It’s judging others and constantly wondering if they judge me. It’s crying as I eat something on the way to the bathroom. It’s the failure I feel when my gag reflex won’t work. It’s the dizzy spells, the hunger pains, the headaches.

It’s avoiding friends and family gatherings. It’s not hearing anything because the voice of reason and the voice of bulimia keep arguing in my head. It’s missing birthday parties because a piece of cake is more terrifying than the clown. It’s never becoming close with new friends who want to grab a drink at a pub. It’s crying in my car while I wait in the drive-thru at eight in the morning. It’s telling the cashier about that “big party” I’m having so she doesn’t judge me on the amount of food I’m buying. It’s never having spontaneous dates with a partner because these things need to be planned ahead of time. It’s never going to a restaurant that doesn’t have their menu online.

It’s no one taking me seriously because I’m actually at a relatively “healthy” weight. It’s searching therapists and resources online after one of my bigger binges at two in the morning. It’s seeing that therapist and having her hand me a food pyramid guide with a smile on her face. And another “how to meditate” sheet. It’s canceling plans last minute because every outfit I have makes me “look fat.” It’s being jealous of others who actually lost weight with their eating disorder. It’s the fear of going to a dentist to really know the damage I’ve done. It’s panic attacks, sore throats and ulcers. It’s nightmares about binging and waking up in tears. It’s hours spent laying in bed looking up triggering hashtags on Instagram. It’s the back pain from “posing skinny” and “sucking it in” all day. It’s the thoughts, the thoughts, the thoughts.

It’s bulimia and it is everything.

Lessons from a Health Educator Who Lives With Bulimia

I have run booths about eating disorders, organized #MirrorlessMonday events and hosted body positivity yoga sessions. Nonetheless, today will have been two days since I last ate.

As fresh as the hypocrisy is, I have to remind myself: teaching about eating disorders and battling an eating disorder are two very different things. I have the education, and now I get the experience. Reading blogs, studying articles, even having a degree in psychology, all seem like futile attempts at understanding what I now get a front-row seat to. However, as futile as they may currently seem, I have to reluctantly admit that some of this education stuck. I swear by the counseling process, I know to take my medication every day and I did recognize the warning signs when my eating habits started hurting my day to day life. So, on that somewhat optimistic outlook, I will join in the “futile” efforts of blog writers everywhere to share what I learned from my eating disorder. These are the lessons I wish I had known about eating disorders when I was teaching about them, with the hope it may somehow help the next overzealous health educator.

My background is relevant to this blog façade of a personal journal. I hold a Bachelors of Science in psychology, have volunteered in health education for five years and coordinated a peer health education program. I was diagnosed with generalized anxiety disorder in 2014 that began to present itself as bulimia in 2020. I also have a dog. Each of these is equally important to who I am today — hopefully, I’ll get to choose what is important tomorrow.

1. Definitions don’t define everything

Yes, I am looking at past-me and my activity board that sorted symptoms into their corresponding diagnosis. Little cards with “binging-compensating behaviors” were sorted into the bulimia category, “long-lasting sadness” into depression, and so on. At the end of the day, diagnoses are important for communicating symptoms between health professionals (and perhaps your insurance company). They can help a client understand what they’re experiencing. They can create a community between people with similar experiences. But, diagnoses are not perfect. You may be struggling but not meet the exact criteria or severity for a diagnosis. Your specific health professional may decide on multiple or singular diagnoses depending on their training. You may, like me, debate your psychologist on length of whether your fasting qualifies you for “bulimia” as opposed to “binge eating disorder.” This particular argument ended with wise words of advice: “call it what you want, the symptoms don’t change.”

I’m not saying not to talk directly about anorexia, bulimia or binge eating disorder as official diagnoses (see the previously mentioned benefits of using official labels). Just don’t end the education with the symptom definitions. Talk about the experiences and what the struggle feels like, offering the diversity that these stories deserve. At the end of the day, call an eating disorder what you want, but it doesn’t change what it is: a mental illness that hurts you. It isn’t a rulebook to follow or a symptom threshold to be reached before you’re acknowledged. Don’t teach it like it is.

Health Education Tip #1:

Don’t rely solely on diagnostic criteria for teaching what an eating disorder is. Instead, emphasize stories of struggle and success. Remind your audience that any struggle is legitimate and valid and should be discussed.

2. Recovery is ongoing and dynamic

Before receiving my diagnosis of bulimia, I was triumphant in having “recovered” from generalized anxiety — apparently, I was wrong. I quickly made great strides in battling bulimia and drastically improved my eating habits…before ultimately and frustratingly falling backwards after a few months. What I once called “recovery” was a binary success or failure — this is not the case. I do not say this statement lightly, as I am still learning its true importance myself. Recovery is an ongoing battle that takes strength and resilience. It requires acknowledging setbacks without letting them overcome you, and periods of working to maintain wellness.

Even treatment can be a dynamic process. I have the privilege of not only having access to therapy, but finding the right fit in a therapist on my first try. I know others who have struggled with therapists or explored different types of therapy, from group to one-on-one or mindfulness to CBT. My therapy was once enough to hold my anxiety at bay; it stopped being successful a few years back, and I reluctantly went on antidepressants. While struggling with the ongoing battle of recovery, the dynamic nature of the very treatment tools you are using can be unexpected and exhausting. As health educators, we can prepare people for this reality with the knowledge of diverse tools and resources.

Health Education Tip #2:

Teach about the ongoing nature of recovery and that taking steps back is not failure. Promote diverse resources and tools so your audience is the best equipped they can be.

3. Shame is real

I binge eat. I cannot control it. I hate myself for it. I do not talk about it.

No matter how many campaigns I coordinate to fight stigma: I binge eat, I cannot control it, I hate myself for it, I do not talk about it.

This thought process seems immensely counter-intuitive. Somehow, I should connect the uncontrollable nature of my mental illness to self-compassion and forgiveness. (I don’t.) Somehow, I should connect my experience on stages behind microphones to allowing myself to openly talk about my experiences. (I don’t.) The incoherence of these arguments hurts the logical side of my brain. It is this duality that health educators must remind themselves of: a duality between emotion and logic. I refer openly to both my logical side (the health educator) and my emotional side (a sad blanket burrito of self-hate). Some days one side is louder than the other.

I did not realize the extent that shame can affect you until I tried to explain to friends and family my latest diagnosis. I used the term “eating disorder” instead of “bulimia” in the hopes we could leave the specifics out of the conversation. Me and my tray of mini-cupcakes would prefer to go unnoticed. It is this lesson that health educators must constantly remind themselves — shame is real, stigma is real and the battle must go on.

Health Education Tip #3:

Try to reduce stigma every chance that you can. No matter how many useful programs and resources you offer, stigma will stand in the way of someone asking for the help they need. Include reducing stigma as one of your communication goals in every campaign.

4. Love yourself again, and again and again

Not every lesson you teach as a health educator will stick. Not every post of “love yourself” on Instagram will change someone’s day. However, do not stop doing this. As a once idealistic health educator, I convinced myself that what I said would or would not have an impact. It’s far more complicated than that. Messages take time and repetition to have an impact. Your mind codes information each time it sees it. Seeing something multiple times and in different formats helps you learn and internalize the idea.

I struggle every day with thoughts of self-hate and body image issues. I repeat positive coping mechanisms and compassionate messages to myself. Many don’t stick, but some do. Just as I struggled one day, the same coping mechanism may work the next. I find these flip often throughout the recovery process, with the coping mechanism and compassionate thought sticking more and more each day.

Remind others to continue repeating these thoughts, to ride the waves of self-hate with just as relentless countering. One day you will listen, and you want to make sure that you are saying something productive when you do.

Health Education Tip #4:

Don’t just say it once. Repeat successful campaigns and address the same topic multiple ways with different campaigns. You never know which time may work.

Good health education works.

My last message to health educators is the importance of the work that I called futile at the beginning. I read the blogs, I studied the articles, I listened attentively to lectures about eating disorders. These did not stop me from getting an eating disorder, but they were never supposed to. My education was supposed to teach me to recognize the signs of mental illness, familiarize me with the resources to reach out to and remind me the importance of caring for one’s mind and body. I always thought my education was there to just help others — as much as I hope that it also helped someone else, I know that it helped me.

Good health education includes talking about the difficult topics, letting experience drive education, reducing the stigma surrounding them and repeating the message.

Keep teaching and keep learning.

Myths About Bulimia – Bulimia Recovery

Up to two percent of Americans have bulimia, the seemingly “invisible” eating disorder that often lurks in its anorectic sister shadow. Bulimia recovery, like any mental health illness recovery, is hard to quantify. It’s even harder to conceptualize. We still need to do a better job of understanding it.

1. It’s Not About the Vomiting

Imagine the quintessential person living with bulimia. Where does your bias lie? Do you picture an underweight female gorging herself with sweets, only to secretly purge in the toilet immediately afterward? A dancer or gymnast, perhaps? Wealthy?

We all have biases, and they aren’t inherently right or wrong, good or bad: but it’s essential to keep them in check. That’s because bulimia isn’t always about the vomiting, just like eating disorders aren’t just about eating. In fact, bulimia can be in the form of many different types of compensatory behaviors including:

excessive exercise
laxative abuse
diuretics
periods of fasting/restriction
Professionals can easily miss the mark when it comes to diagnosing or even engaging a client in bulimia recovery. If they’re only looking for the cliches, they risk overlooking many telling clues. They may miss the health-obsessed male talking about relationship issues. They may miss the mother who gets so stressed with her children that she “forgets to eat.” It’s easy to make assumptions, but eating disorders are cunning, manipulative and insidious. They flourish in being hidden.

2. It’s Always About Body Image

I can dispel this one quickly. It’s not. In fact, in all the work I’ve done with eating disorder and bulimia recovery, body image just represents a piece of the proverbial shame puzzle.

While it’s true that most people struggle with their bodies, it’s rarely, if ever, the sole reason. What do I hear more often? It’s about control or release or enacting a feeling of numbness.

It’s often about rebelling against the body or society — having one last vice or one tantalizing hurrah that still feels taboo. Self-esteem is typically at play, but self-esteem is so much more than skin-deep.

The bulimic ritual is as sacred as it is sick, as comforting as it is disturbing. Even though body image may play a pivotal role in the development of an eating disorder (going on a diet), most strugglers will candidly state: it’s not even about how my body looks anymore.

3. There’s Always Some Form of Restriction

I hear this one often when talking about bulimia recovery, and the intentions are good. However, we need to acknowledge that some people do consume square meals and snacks: and they still struggle with compulsive or binge eating.

Even if the person holds onto entrenched forbidden food rules or regulations, that doesn’t mean they are currently restricting or “depriving” themselves. It doesn’t mean that everyone struggling with bulimia restricts and then binges.

There is an in-between, and we must acknowledge that (or we’re presumptuous). With that said, it’s premature to simply assume that decoding bulimia recovery means decoding ulterior motives of restriction.

Yes, it’s true that many people who are struggling with bulimia attempt to control their food and then “lose control” with bingeing. But this is not always the case. Some people engage in “normal-eating,” followed with intense periods of compulsive or binge eating. Nobody should discount that.

4. Trauma Happened

Most mental health professionals want to search for the trauma underlying the eating disorder. The intention is typically sound. In fact, research shows high correlative rates between childhood trauma and eating disorders.

However, it’s certainly not always the case. When we assume trauma is part of the story, we invalidate those individuals who do not present with traumatic pasts. Inadvertently, we may even shame them: as if to say they needed to have trauma to warrant their disorder.

Although eating disorders may have the connotation of being an adolescent or young adult problem, the onset can happen at any age. There is no one consensus as to what defines the precipitating event. Yes, it may occur in childhood.

For others, it may result from unnerving societal pressure and getting carried away on a diet. For others, it may correspond to another mental illness, such as depression, anxiety or a substance use disorder.

Final Thoughts on Bulimia Recovery

Like with all mental illnesses, bulimia recovery is unique and individualized. The more we learn about eating disorders, the more critical it is for all of us to take a compassionate and non-judgmental stance.

Things I Need You to Understand About My Bulimia Recovery

(From You) When I was 15, I began flirting with bulimia. Slowly, we danced and became acquainted with one another until eventually, she looked me in the eye and had a full grip on my every move — holding me captive for over a decade of my life.

Being 28 now, the demons inside still taunt me while I’m fighting to rid the voices of such a horrible disorder I am brainwashed to love. Only those who have experienced bulimia nervosa can understand the blend of both comfort and disdain “she” brings.

And for those bystanders who look at us doe-eyed with concern for our well-being, wanting us to get better, this is an explanation for you on why recovery is so difficult when we are truly trying so hard. There are a few things you need to understand.

1. I’m not doing this to be thin.

I know you think I’m pretty and I don’t need to “lose weight.” I also know for a fact that some people who suffer from bulimia are typically “average” or “overweight” if they fall into a strong binge-purge cycle of eating. Believe me, I know all of this. You don’t need to remind me.

2. This eating disorder has been the most constant thing in my life.

For as long as I can remember, this eating disorder has been in my life — through relationships with significant others, parents splitting up, big accomplishments and failures, moving in and out of houses, making and breaking up of friendships, heartaches, abusive relationships, all of it. Bulimia has been there as a safety blanket and comforter.

In a way, it has become an invisible best friend to see me through it all. It never left my side, whether I wanted her to leave or not.

3. The existence of the disorder is really not our fault.

While it may have stemmed from earlier experiences in our lives, the persistence of an eating disorder is out of our hands now. It has manifested into this compulsive lifestyle through our own habits and familiarity with the ongoing cycle an eating disorder brings.

4. I know I have friends and family who care about me.

You don’t need to hold my hand and tell me you’re here for me. I already know that — I do.
I’m not using bulimia to rebel against my family or my friends, at least not anymore. I love all of you too. I want you as safe and healthy as you want me to be.

I’m also aware of the health issues and possible major effects “she” brings so I am trying. I really am.

5. I am trying, even when I relapse.

Even at my worst, I’m still aware of my progress, or the lack thereof. I’m still trying every day. Each sundown that passes where I’ve messed up, I look hopeful to the next day where it will be better and I can put this old unhealthy “companion” behind me.

Thank you for loving me during the good and the bad times. Here’s to a better tomorrow.

Lies I Told When I Was Struggling With Bulimia

Lying about my eating disorder was a regular practice for me for over a decade. I even lied about the diets I was participating in to sound like a better person, as if my adequacy as a person depended on how well I counted calories. As my disordered eating progressed into full-blown bulimia as a teenager, I became a professional at hiding my behaviors. I was convinced I needed to be thin, and if anybody found out I was “cheating” on my diet, I would be shunned by the culture I had become so engrossed in. My eating disorder entrenched me in lies, and anxiety stemmed from the fear of being “found out.”

When I finally broke the silence and came forward about my eating disorder, I felt an immense amount of relief. I no longer had to hide. I was able to receive help from those around me. Though I didn’t receive the care I desperately believe I needed, I was able to begin therapy and work through many of my difficulties.

Being honest with where I am at in recovery is essential to my growth. If I am having a hard day, it is imperative that I reach out for support. If I slip up and use a behavior, I must be accountable for my actions and tell a professional in my life. I reach out to friends and tell them how I am doing. I resist the urge to respond with “I’m fine” when asked how I am, as it is usually a lie. The smallest forgery can affect my ability to stay on a positive road towards a recovered life.

If I am trying to hide something, it is usually due to shame. I am afraid I am bad for participating in an eating disorder behavior, or that I am not giving my 50 percent to a relationship I care deeply about. It is sometimes because I am afraid of the consequences my truth will bring. Regardless of the reasons behind lying, it causes an erosion of my ability to care for myself and a tenfold increase in my anxiety.

As I show up more authentically in my life and tell the truth on a regular basis, I am able to look people in the eye. I am unafraid of existing or being “found out.” I have fewer fears and my anxiety is lessened. It allows me to grow both as an individual in recovery from an eating disorder and as a human being in general.

Lying is exhausting. Keeping track of the lies I told each person was making me sick with unnecessary worry. With this newfound willingness to tell the truth, I am able to show up for my life in a way I’ve never been able to before. I have incredible friendships that I would not give the world for. I may not be able to mend the relationships I’ve lost, but I can accept responsibility for my actions and move forward. I am tired of being intertwined in fiction and unable to remember the true from the false. I want an easier life for myself, and I believe that is possible if I tell the truth on a regular basis.

Showing up as an honest human being can feel nearly impossible sometimes. Today my lies are less apparent to those around me — I lie by omission. I simply don’t tell people what is going on in my life. I have lost close friends by not telling them my truth. It has been heartbreaking to have the realization that I was not a good friend because I was not sharing equally in the relationship. I am not a quiet person, but I rarely tell people about my hardships. By practicing vulnerability on a regular basis, I am learning that opening up to those around me creates strong relationships. It is by building a foundation of honesty that I am able to create true connection with those around me.

Ways to Cope on Thanksgiving When You’re in Bulimia Recovery

Being in recovery from bulimia is difficult during the holiday season, especially on Thanksgiving. Thanksgiving is known to be a holiday where the general population binges, so it only feels right that I participate. I need to remember I am not like other people when it comes to food and that my recovery must come first.

As friends and family members pile up their plates this year, I’ll be mindful about how much food I consume. I know if I binge, I will be more likely to want to purge. Since overeating is part of life, I can be lenient on my portion sizes. I just need to be aware that if I do eat too much or too quickly, urges may arise.

Not only is it hard to be around others who are eating abnormally large amounts of food, it’s also hard to have that much food accessible to me. As a current part of my recovery, I don’t keep excess amounts of binge foods in my house because I’m not able to control my urges late at night, or if I am feeling emotional.

When others are reaching for their fourth piece of pie, I may want to feel like I belong too — but this is dangerous for me.

If the urge to rid myself of my food does come up, I have coping skills I can use.

1. Be Creative.

Having something to distract myself is important.

Creating art is enjoyable to me. It’s an excellent coping skill if I feel like I need to use my hands. It also keeps me mentally engaged. In addition, it doubles as an opportunity to make holiday gifts for those I love. Whether it’s crocheting, drawing or other crafts, it’s an excellent way to cope.

2. Watch Football.

I really don’t understand why grown men dress up in tight pants and tackle each other on live television. But if I allow myself to get into the competition of the game, I am able to distract myself from the large amount of food I’ve consumed. It fills the window of time between when I overeat/binge and when I could purge.

3. Play Games.

Playing games is a classic family tradition in my household. Every year, we would play competitive card games that really got our hearts racing. It’s fun, engaging and creates a bonding experience.

4. Help Cook and Clean Up.

If I’m helping prepare the food or cleaning up, I am busy and being of service. This allows me to get outside my head and I can even use tasks like washing dishes as a mindfulness practice.

As a person in recovery from bulimia, Thanksgiving can be really hard. I hope the reminder of these coping skills can help you get through your holiday with more ease.

A Day in the Life of a Student With Bulimia

(From You) There was something both funny and frightening about sitting in the unit’s day room, listening to one of the social workers talk about the pain that accompanied attachment. I imagined myself as a patient, bored all day and night, using my attendance at group therapy as a means of escaping the floor sooner. I imagined what the four men in the room thought of me and my friend, two young female nursing students, observing them like exotic creatures to further our studies. For us nurses in training, these individuals were simply case studies. Nameless patients we would discuss later in post-conference, where insensitive remarks about mental health would inevitably be made. Sometimes the instructor would take the lead with a joke: What do you call an unmedicated bipolar? An addict.

Every day of my psychiatric clinical rotation left me tying the experience to the past and future. “Mindfulness,” apparently the act of “being present” according to whoever the hell wrote the handout the social worker was reading off of, was way beyond me. My thoughts wandered to the image of myself occupying the space of a patient, observed and evaluated, considered only in the context of my illness. A schizophrenic. A bipolar. (There was plenty of cultural and religious sensitivity content written into our curriculum, but little education on sensitivity towards those with mental illnesses.) Before long, I would be “a bulimic” to counselors and nurses in a residential facility. That’s what I thought, anyway, given how my peers and some of the staff at the hospital spoke.

Yeah, that was the funny part. Situated in the day room during a group therapy session, knowing I would be in a similar position as the patients we were asked to observe. That was hilarious to me. Upsetting, yet comical. I’d have a file, like the ones we looked at earlier — a fat red binder with my admission information. Patient reports that she binges and purges. Exercises obsessively. Admits to SI. Denies HI. Physical complaints include muscle cramps, swollen glands, thinning hair. How much of what I said to the woman who conducted my admissions interview would end up in that chart? And then my thoughts took another turn, wondering what sort of forms and tools they used within facilities primarily for eating disorders. Could I ask to look at my own chart? Probably not, I decided.

For a reason unknown to even the clinical instructors themselves, we had two teachers for our psychiatric rotation – one on Tuesday, another on Wednesday. Wednesdays sucked. Not because I disliked the instructor, but because she sat with us during lunch and often turned her attention to the fact that I didn’t bring anything to eat.

The first time we sat together for lunch, I said that I had forgotten to pack food in the morning and didn’t have money on hand. I figured that would be enough.

“Here, here. Have half my salad. I couldn’t possibly eat this all,” she lied, pushing the small plastic container towards me. I denied her offer, but could feel my own embarrassment and anxiety possessing my body — the warm cheeks, the clammy hands, my heart beating hard enough that I felt like it was hitting my sternum. Finally, one of the girls in the group offered a banana, and I took it so that the instructor would leave me be.

“Thanks, Jess. I love bananas,” I said.

“My mom always packs me a big lunch,” she said. “No problem.”

I don’t want to eat this, I don’t want to eat this, but at least it’s not drenched in dressing and oil. I peeled the fruit slowly, took a few well-paced bites, and threw the rest away.

Today, I had a strategy. I brought some money with me and walked around the hospital’s tiny cafeteria for a few minutes. I purchased coffee. If I had something in my hands, maybe the kindly old lady would leave me alone.

“You didn’t bring anything to eat again,” the instructor said. She frowned, deepening the already quite severe creases around her mouth.

“I ate a protein bar before you sat down,” I replied. Not true, but it was a stock excuse for when people commented on my lunch habits. “I was going to get something else in the cafeteria, but they didn’t have many options.”

“That’s not much of a lunch,” she said.

“I eat a big dinner at home,” I responded. Some of the girls at the table turned their attention to the conversation.

“Amber eats like a bird,” Jess said. “She never eats a lot for lunch.” She was always commenting on how small and petite I was, phrasing her compliments in a variety of ways. I wish I looked like you! But Jess — and everyone else at the table — were perfectly beautiful girls. (Women, women. I was a bad feminist.) And I envied them when I saw them eating sandwiches on bread, or the delicious looking cannolis from the cafeteria.

How did people eat like that and not feel guilty?

My friend, who was my partner during the rotation, agreed with Jess’ statement. “She eats really healthy.”

Not true either. Not when alone, or when I knew I’d have access to some privacy and a bathroom. I was a complete and utter failure when it came to valuing my own health.

It reminded me of hearing from people in my program — instructors and peers alike — that I seemed calm and in control when it came to the didactic and hands-on challenges of nursing school. Wow, thanks! I’d say, with forced enthusiasm. An honest response would’ve been too frightening: I’m slowly self-destructing and if you knew who I really was you’d be disgusted. Calm? In control? No, not when people weren’t looking. Outside of college, I was the real and terribly disappointing version of myself that occupied nearly all free time by eating massive quantities of food so I could then self-induce vomiting. There was also exercise, but I had angrily quit going to the gym when the woman responsible for my admissions interview claimed I overexercised. I don’t. I don’t even need to go. So I didn’t, but the guilt was overwhelming.

I was a fraud. I wasn’t healthy, and I wasn’t in control of anything.

Do I really need to go to residential? The question was on repeat in my mind. I’m “functional,” I thought, pulling into the ACME parking lot. No one knows. I’m going to finish this semester with great grades. Do I really need that level of help? I parked my shitty, decades old Toyota Corolla in a spot that was far away from the store itself (despite a downpour and the flats on my feet) so that I could increase my step count for the day.

As soon as I entered the store, my gray pants and blue button-up completely soaked, I became self-conscious about my current activity. Any time I shopped for food to binge on, my anxiety became transformative, granting people who did not give a shit about my presence the psychic ability of mind-reading. Oh, yeah. They totally knew what I was doing, and they were absolutely judging me. And I think I don’t need help, I thought, self-awareness colliding with the paranoia brought on by a part of me that was seriously disturbed.

Where was I in relation to the continuum of mental health? What did it mean to be functional on the outside, but to internally live in compulsions that, while providing temporary relief, made my life feel like a living, inescapable hell?

I carried these thoughts with me as I picked up a basket. I browsed the ice cream aisle first to see what was on sale, determined I would grab a gallon of Turkey Hill before I checked out, then moved onto the reduced-price baked goods. Most binges were ultimately disappointing, but a cheesecake for half its original price or chocolate frosted brownies at a steep discount always gave me some hope that the next session would be a fantastic opportunity to relieve some stress and feel genuine pleasure.

Eventually, my frugal values wore down to nothing. I told myself I would be done soon, given I was going to residential in a week’s time, and that it didn’t matter if I spent a lot of money on foods that would end up in the toilet.

When I got home, I ate everything. I took breaks to purge, and at a certain point lost count of how many. During these hours, my thoughts became fuzzy, lost in the overwhelming compulsion to eat and vomit. But it occurred to me that what I consumed didn’t matter. Not at all. What I really desired most was the relief I felt following the purge.

Nothing else in life provided the same feeling. Probably because I was also deeply depressed, and found myself incapable of doing activities I used to enjoy – read, watch Netflix, play some video games, cook (haha). But I couldn’t justify the idea that I needed help with my eating disorder, or with constantly feeling on the verge of ending my life, when I woke up every day and went through the motions.

I was doing well in my nursing program. A lot of people respected me for being intelligent and motivated.

I’m fine.

Ramadan Is Hard With Bulimia

Perhaps celebrations in general can be hard for people who struggle with an eating disorder. Eid, the only celebration that a Malay Muslim typically celebrates, is the hardest time of the year for me.

I was diagnosed with bulimia nervosa in August of 2016 by my psychiatrist. In November of 2016, I was rushed to the emergency room after I attempted suicide. I was sent to the nearest hospital, assigned to a new doctor, and haven’t seen my previous doctor ever since. The latest doctor wouldn’t diagnose me with bulimia, therefore, help wasn’t attainable for me.

Before we touch on anything regarding Eid and my eating disorder, I think I should explain why Muslims celebrate the holiday. Eid is a celebration of success from a month-long fasting. During this time, we refrain from eating and drinking during the day.

Fasting has became a common practice in Malaysian culture, to the point where I know children as young as 5 who will not eat or drink from sunrise to sunset in the scorching hot weather. I obviously could not skip the fast for health purposes, since it would be considered a taboo. The government has launched raids to police people who are not fasting and have issued fee tickets, even for those with gastric issues and diabetes.

Every Ramadan, the fasting month, has been excruciating for me because I was so afraid I’d go into starvation mode since no one else is eating. And since we only eat two meals a day, I usually skip sahur, which is a very early breakfast, and use behaviors during the next meal, ifthar.

Then, comes the Eid, where we usually have new outfits to wear and pictures are taken. This often gives me anxiety, and a few days before the celebration, I often end up crying in front of the mirror, feeling disgusted about how I look. It is a mental hurdle I have to overcome every year.

On top of that, typically there is a feast to indulge on the first day. Overeating is a must for everyone. But for someone with bulimia, it’s a mental struggle not to go into an uncontrolled binge, and purge all the food consumed.

Everyone has their uninvited opinions about other people’s body, including mine, especially from my aunties who would say; “Eh, girl, you look fatter this year!” or, ”Wow, you must’ve been eating so much!”

To break down into a self-loathing train wreck is so easy when pictures are being taken, food is in every corner of my eyes and unsolicited negative remarks are being made about my body. It was incredibly difficult seeing everyone around me so happy and having the time of their lives while I crumble on the inside.

I’ve always wanted to tell this part of my story because I want people to know that an eating disorder does not discriminate. Eating disorders effect people at any weight, people of color, and people who are dissimilar to the media stereotype. Eating disorders aren’t always about obsessing over body image, but might also be about control.

I feel like the mental health system in Malaysia has failed me. It has diminished my hope, and for that, I am forced to face this alone, and to go through this on Eid when most others are happy. Having an eating disorder has become very isolating.

I still won’t stop looking for help. I will continue to try and work on recovery. But for now, sharing my story is allowing me to feel better.

When You’re Big People Don’t Believe You

When we think of eating disorders, we think of those who are skinny down to the bone. They are struggling with an eating disorder; they are deserving of help, medical treatment and compassion.

But what about us?

I am the “Big Bulimic.”

If you looked at me, you wouldn’t know I was bulimic. I am curvy, large and chubby-faced.

My body structure has always been a major problem in my life. My body is naturally very curvy, so when I started dance at 7, I stuck out like a sore thumb. I went to a dance club for many years with skinny girls with flat chests and stomachs and slim legs. I was 7, already started puberty, had begun to get the curves associated with puberty in girls and looked drastically out of place. My dance coach would have to add extra fabric in costumes because they surprisingly weren’t designed for 7-year-olds with curves. It was embarrassing and made me feel awful.

When I got to 10 years old, I started to restrict because I was bullied for my size. By 12, I was purging.

I didn’t tell anyone. No one knew until I was 16, and my family was dismissive at that point. Back then, it was not as bad back as it is now. Maybe a couple of times a week…

Now I am 20, I am purging several times a day and I am even more overweight. My face is puffy and round from swelling; my fingernails brittle and dying. I have random heart fluctuations that make me dizzy and pain all through my body with my bones and muscles cracking obsessively. Acid lingers in the chest and wakes me up at night. I know what these are; I know what causes them. When I am alone and my partner comes home, they will see me on my eighth purge of the day.

These are all the outcomes of years of struggling with this.

In reality, I will never be treated the same. Being a large lady is an issue in health care — period. But for eating disorders, women, men and others are struggling because they are not believed. Because they are not perceived to have an eating disorder. Larger people can still die of the complications of eating disorders just as skinny people with eating disorders can. We can be hospitalized for medical emergencies, given feeding tubes and potassium through an IV.

The effects of restriction, purging and laxatives can affect anyone of any size… it’s time we saw it that way.

I wish I was skinny; I wish I had support.

You Can’t Fix Your Bulimia

I find that, a lot of the time, when I disclose my struggle with bulimia to someone, they immediately start thinking about how to fix the problem — things I could potentially do to stop engaging in behaviors. I have lost a lot of friends and relationships over the years when people become frustrated or discouraged that I am “not motivated” enough to fix it or stop. Or maybe I’m not making the progress in reducing symptoms they want to see. I know wanting to fix it or to see me better comes from a good place. I love these people for it. But please trust me when I say I have thought of all the potential solutions you are suggesting, I have tried most of them before.

It is not as simple as getting rid of my scale or just eating what I want at a restaurant without purging. My eating disorder is far more complex. It is only something that can be “fixed” by me. This is my own internal battle I have to, and will, fix on my own. Yet there are days when I feel like I still need to use symptoms to make my life manageable.

You will never fix my eating disorder or “save me” from how I feel about myself because my eating disorder has always been my safe, protective place. My eating disorder has been a constant companion. It has numbed me from the pain of emotions and the shame I have associated with my body. It has continued to save me from feeling and processing the trauma I experienced so many years ago. It has kept me safe for so long, and for that I have a lot to thank it for.

You will never fix my eating disorder for me because you cannot change the fact that my body was violated when I was so young; that someone took away my control over it. That someone made me think I was going to die there. That someone made me feel like I lost every shred of value I had. That someone made me feel worthless in a few moments.

You will never fix the fact that because of this, I feel as though I need to have total control over my body.

I feel as though I need to measure my value from numbers on a scale. Because then maybe I have value.

I feel as though I need to become as small, invisible and unnoticeable as possible. Because then maybe someone won’t target me again.

I need to not remember what happened. Because then maybe I can pretend it never happened.

I need to feel safe. Because then maybe I can make it to the next day, and the next.

It has been so long, and I still haven’t allowed myself to properly process or feel what happened in the past. When I do try, the flashbacks, nightmares, anxiety, depression and suicidal ideations take over. My eating disorder is my distraction from reality. Removing my safe space, despite how destructive it is to my body, is something I cannot figure out how to fully do yet, and not something you should do for me.

A lot of the time, I feel too connected to my body. Feeling full reminds me my body is there. The anxiety becomes unbearable. Purging, starving, over-exercising and all the other behaviors are the only way I can properly detach again and not have to feel. When anything triggers me, reminds me of that time, or someone notices or comments on my body, I need to hide it. I need to make it small. I need to disconnect and be invisible, or not care about it once again. Being too far in my body is dangerous, scary and threatening. All these behaviors allow me to feel like a shell, like I am out of my body. It allows me to disconnect from reality, and distract myself from anything triggering, as I focus purely on how I can manipulate it. This destruction of my body is much safer.

This year was the first time I started to admit the trauma of my past in counseling and I am slowly working on telling people in my life. I realized I was truly never going to get anywhere in recovery, despite claiming to be in recovery or working on it for several years, if I didn’t talk about it. But now, by talking about my past, trying to process it, and attaching any value to it has resulted in constant triggers. By saying it out loud, it became real, and now I have to deal with the fact that it actually happened.

So when you don’t hear from me for weeks at a time, even though you have tried to reach out — I’m asking you to help me. When you provide potential solutions or get me out of the house and I push back, it’s not because I’m trying to be a bad friend. When I can only make it two weeks without purging and not three, it’s not because I am “not motivated” to get better. It is never because you failed as a friend in supporting me.

It is because I am so deeply triggered that everything is threatening because it reminds me of what happened. I am exhausted of fighting the anxiety of the constant reminders. I sometimes feel so unsafe in my own body that I can’t move unless it is to use behaviors. You cannot fix the overwhelming feeling of not being safe, even though I know you would not hurt me.

Instead of trying to fix me, I need you to be patient with me even if I am not making the progress you hoped for. The process of coming to terms with what happened, moving forwards and finding value in myself is something that only I can do. And it is going to take a long time. I have come to terms with how long it could take, even though I know you wish you could fix it for me right now.

Trust me, I wish that too.

But this is why you will never fix my eating disorder.

Bulimia Wasn’t About Body Image

Growing up, I was always the kid who sat around in her underwear. In the ballet dressing room, I was always the girl who was comfortable changing in front of everyone. I was openly comfortable with my body. Because of this, a lot of people were confused when they found out I had bulimia.

People would say things like, “But you have such a good body.” And it’s true, I did. I love my body. Of course, I had some insecure moments. What teen girl doesn’t? And after thinking about these comments, I was confused, too. According to popular belief, eating disorders are for people who want to be skinny. They’re for people who ate salads and jogged until they felt like they were going to pass out. But really, everyone who struggles with an eating disorder has a different story.

I didn’t think (or maybe didn’t believe) I had an eating disorder until my therapist told me. I remember sitting in her office as a scared 14-year-old. She looked at me and said something that contained the word “bulimic.” Now, at 18, I can’t remember the exact sentence, but I can remember my reaction.

“What did you say?” I asked nervously.

“Bulimic. Would you say that you’re bulimic, Ashley?”

“I don’t know,” I answered.

“I would say so,” she said with certainty.

I remember grappling with this new found label. I didn’t get it. I ate “normally.” The only abnormal thing about my behavior was if I got stressed out, I would purge. I definitely did not think this fact deemed me worthy of the label “bulimic.” Alas, according to my metal health professional, it did.

Now my task was to come to terms with this label. My name is Ashley and I have bulimia.

In order to do this, I had to redefine what I believed about eating disorders. It was not all about body image or diet. I had to figure out what it meant to me. And for me, my eating disorder represented control and relief. Of course, everyone’s defining moment is different. My break through came when I stopped listening to other people’s definitions of my disorder and started to figure out what it meant to me.

Accepting Your Mental Illness Is a Journey, Not a Quest

Growing up an aspiring fantasy author, I studied the many paths my characters could take. An adventure is a trip without a destination. A journey is where the trip itself matters most. A quest is a trip to accomplish a specific task. I dreamed of romantic journeys, wild adventures and life-changing quests. As a character in my own personal epic, mental illness was just another quest: something to overcome and move past. I did not just reject the idea mental illness could be an ongoing journey, I completely ignored any consideration of it.

I have worn many labels in the form of my diagnoses: generalized anxiety disorder (GAD), major depression, panic disorder and most recently, bulimia nervosa. Each label is a new quest, a new challenge to overcome. A series of quests to the “perfect mental health.” That was true, at least, until I sat down to an online mental health seminar titled “The Imperfect Recovery.”

My goal in attending this seminar was recovery: to beat bulimia and move past it once and for all. This workshop was aimed at “imperfect recoveries,” and recovery was there in the title and thus essential to the plot. My quest was already laid out for me.

I closed my computer barely minutes in when the realization of the true title hit me. “The Imperfect Recovery” — they were talking about adventures, journeys… not quests. Accepting an imperfect recovery meant the story might not end as nicely as I had hoped. A potentially never-ending road of battles and I closed my computer barely minutes in.

An imperfect recovery simply did not compute with my own, deeply held need for perfection. Never properly analyzed, I still have no idea what this perfection meant. What is “perfect mental health?” The absence of mental illness? A never-ending tirade of smiles and happy days?

As a health educator, I should have known “perfect mental health” did not exist. As a health educator, I often describe mental health as being similar to physical health: There are good days and bad days, temporary injuries, chronic conditions and sporadic pains. I held conversations with others to help them come to terms with mental health being an essential part of wellness, to overcome the burden of stigma and to explore options for support before they were inevitably needed. I held the conversations, designed the posters, hosted the events and yet still held onto my own internalized stigma. I would not accept good days and bad days, for I was on a quest for “perfect mental wellness,” mental illness would never be chronic, not for me.

As I battled with my latest diagnosis, bulimia nervosa, “The Imperfect Recovery” hit on deeply held beliefs I had never fully acknowledged: my need for perfection and my consequently internalized mental health stigma. Although not all mental illness will be chronic, I had never properly considered that mine might be.

If perfection is defined as the complete lack of mental illness (which I would argue it’s not), we are setting ourselves up for inevitable failure. It was gently pointed out to me by my therapist that, like physical illness, the complete lack of illness is sometimes impossible. Perfection is an impossible quest.

But, the loss of perfection does not mean the loss of joy. Similarly, accepting a life with mental illness is not giving up. It is accepting just one battle in your life, one opportunity to fight, one story where your strength will shine. It is the first chapter of an epic saga.

I can try to find joy in progress. I can celebrate every small accomplishment and search for room for innovation in every setback. My imperfect recovery with mental illness will include trials and tribulations, good days and bad, and I can continue to grow through each and every one. I can accept this journey that stands in front of me. This is not a quest I am failing at because I have not reached the end — this is a journey where the trip matters most and a set of adventures lay ahead to explore. Perhaps I will never reach my destination, but I can find joy in the constant innovation and creativity that it takes to move forward each day. Acceptance is not done — I will have to practice it every day. But, I am on the journey and that brings me joy.

Reasons I Want Recovery From My Eating Disorder

We all have reasons why we want to do things. Some of them make sense to other people, but others may not. As for me, I have listed five reasons why I want to recover from bulimia nervosa. Here they are:

1. I want my freedom back.
   Eating disorders are extremely demanding, isolating and manipulative. There have been so many times that I have cancelled on friends because my eating disorder tells me to, especially if it has to do with food. A typical conversation with my eating disorder will go as followed:

ED: “If you go out and eat with your friends, you’re sure to gain all of the weight back you worked so hard to burn.”

Me: “That cannot be true. I don’t believe you.”

ED: “If you’re fat, no one will truly love you. They will think less of you because they see you like I do. They will see you as a fat pig.”

Without ED controlling my life, I will finally be able to do the things I used to do, such as wear a pair of shorts without feelings like my thighs are grotesque and large. I have slowly been able to wear shorts more frequently, but I still get screamed at by my ED voice. It is something that I will slowly have to get used to ignoring because ED is there to hurt me, not to help me.

2. I want to be able to smile and actually mean it.
   I miss smiling and feeling genuinely happy. Yes, I smile now, but the smile is like a puzzle with several of the pieces missing. It isn’t complete anymore, because how can a smile be complete when you have a voice in your head telling you how insignificant you are to the human population? I miss being able to throw my head back and laugh my loud, obnoxious laugh because while it was loud and obnoxious, it was full and filled with love and happiness.
3. I want to be able to love myself again.
   This is probably the biggest one. I haven’t been able to go swimming in such a long time because I am so ashamed of my body. Due to my body dysmorphia, I haven’t been able to see how truly beautiful my body is in a long time. While I am looking at what doctors consider a healthy body, I see an obese, completely unhealthy body. While down at Menninger, I had to cover my mirror up with sticky notes that had positive affirmations on them because if I looked in the mirror, I would cry. I would see what I thought was a disgusting beast looking back at me, and I would fall to the ground and sob. This is the one thing I want to change most. I want to be able to cry while looking in the mirror but from self-love, not from self-hatred. I want to be able to lose weight the healthy way, not by hurting myself. As my individual therapist from down at Menninger always told me, “Jordan, your body deserves to be loved and cherished because it is a valuable thing.” I want to truly be able to believe that. I will believe that phrase someday.
4. I deserve happiness.
   This is another big one for me. I deserve happiness. I deserve to be happy. Those words haven’t left my mouth in a long time. My dietician asked me this week, “Jordan, why do you want to recover?” This was the first thing that popped into my head. I have not always believed that I deserve happiness, but I am slowly beginning to realize that I do. I don’t deserve to feel awful all the time. I don’t deserve to take out all of my anger toward myself and the world on my body. My body is so much more precious than I will ever give it credit for.
5. I want to recover so I can make myself and my team from Menninger proud.
   Let me just start off by saying that I have a handful of specific people in mind when I say this, all of them being from Menninger Clinic. I will throw out their names just incase they ever get the chance to see this. I want to give a shoutout to my team from CPAS first. My psychiatrist, Dr. Walker, social worker, Andrea, primary MHA, Julie, and finally, my primary nurse, Jerel. They were the first people I met at Menninger who originally taught me that they were not going to give up on me. They taught me what self-love truly is, and they helped me learn that being myself is the best thing I can be. Now, moving onto my team from Compass; my psychiatrist, Dr. Ashraf, social worker, Kira, primary MHA, Edmond, primary nurse, Mona, IT, Lindsay, and I cannot forget about my nurse practitioner, Avani. I was absolutely terrified going into Compass. I only knew two or three people from the Eating Disorder Track who were on Compass. This team welcomed me with open arms. I cannot express how much each of these individuals have changed my life. They taught me that I want to go into the mental health field. I have always had a love for psychology and an even bigger love for helping people, but all of these amazingly beautiful individuals have taught me that I have an even bigger love for helping myself. I want to recover so I can make myself proud as well as all of these amazing individuals proud. I want to be able to send an email update saying that I am in remission for my eating disorder, whether that be a few months or a few years down the road. I know that no matter what, my entire Menninger team will be rooting for me. If any of my Menninger team reads this, whether you’re from CPAS or Compass, thank you. You have helped me discover that I want to help others, as well as help myself. You all have helped me find hope in my life, and for that I will be forever grateful. Know that I think of you all often and I miss being able to share my vulnerabilities with you all, no matter how hard it was. You all have hearts of gold, and you will forever be in my heart.

Recovering from an eating disorder is not easy, but it is possible. I have had to learn that while this will be the most difficult thing that I will ever have to deal with, it will be worth it in the end. To whomever reads this, if you are struggling with an eating disorder, read back through this list. I can guarantee there is at least one reason on here that you can relate to. You deserve recovery because you deserve to have a healthy, happy body as well as a happy and healthy relationship with food. No matter how down you get on yourself, never give up because I and many others believe in you!

Things I’m Gaining by Recovering From Disordered Eating

I’m trying to picture a life free from disordered eating. What would it look like? How would I feel? What would be different? The voice of doubt always wants to knock me down, but I’m working hard to vanquish that voice and bring forth positive messages to empower recovery.

In this picture, my external life would be largely unchanged; I will be married to the same man, have the same children, friends, family and colleagues, work at the same job, live in the same house and have a beautiful, brown Burmese cat. But a lot should be different as well. I know some things will improve and some will not, but my goal is for the scales to be heavily balanced in favor of ups rather than downs.

I am not in a perfect place, maybe barely even in a good place, but I am at least in a better place. Part of my recovery process is looking forward, looking for the pluses — the current and future gains. Here’s a little list of real world recovery bonuses:

1. Energy

If you’ve never lived it, you probably have no idea how exhausting an eating disorder is. Seriously — it takes up an astonishing amount of mental space. I could have done two PhD’s with all the time spent cogitating upon how to plan a binge or avoid eating. I can be extremely physically demanding — vomiting, restricting and bingeing are exhausting, blood sugar fluctuations, malnutrition and headaches are exhausting. It’s all exhausting.

2. Health

There is nothing healthy about an eating disorder. Being “less fat” might seem like a health goal, but it’s not. A health goal is good health — not changing a number on a scale. When I restrict, my health deteriorates quickly — energy levels crash, blood sugars go wild, immune system is compromised. When I binge and purge I have a sore throat, sore stomach and reflux. I have issues with hair loss and brittle nails. Not to mention my metabolism is compromised.

Good health is something I can look forward to, even if it is a little early in the process to have made much progress here yet.

3. Relationships

Poor emotional skills can go hand-in-hand with an eating disorder, which can have a huge impact on relationships. My self-esteem is pretty nonexistent, which makes it difficult to relate authentically with other people. Fear of conflict, anger and almost all emotions, brings a level of dishonesty to relationships. I focus on other people’s issues because I don’t want to deal with the impact my behaviors might have. I know people worry, even though I don’t want them to. The best way to stop that worry is to recover. I don’t want to talk about my eating disorder issues — I feel vulnerable and ashamed. I feel judged even when I’m not. I’m judging myself.

Again, healthy relationships with healthy boundaries is something I hope to gain in recovery. I’m not there yet. I am incredibly honest with my struggles, but not at a deep level. I’ve yet to find the courage to talk about this stuff out loud with many people. I am grateful for the tool of writing and blogging, which keeps my loved ones near and far in the loop.

4. Finances

It pains me to admit this, but having an eating disorder costs a fortune. Eating food that is, for the most part, flushed down the toilet. Crazy stupid diets and even more drastic procedures. Increased visits to doctors and therapists. Investing time, energy and resources into trying to recover. All of this money would be far better spent on shoes. Or a trip to Thailand.

As far as right now, I’m quite possibly at the most expensive part of my disorder, as I’m heavily financially invested in recovery right now — doing an online course, purchasing books, seeing my psychologist etc. But one day in the future, in lieu of books about bulimia, I will have an absolutely fabulous shoe collection.

5. Purpose

We all need purpose in life. All of us. I used to have purpose, as a mum and a musician. I’ve completely dropped my music, and while I’ll always be a mum, the hands on, daily aspects of mothering are long behind me. Part of the rapid deterioration of my mental health in recent years was related to losing my identity. I developed the identity of a person with an eating disorder, which is not great.

My recovery is related to finding purpose in life — purpose, hope, belief. They are intricately related. I am very happy in my current job. I have no pressing desire to change the world with my career. I recently realized how much I love writing, and I’m working hard on picturing a future that involves a lot of writing. No guidelines or rules, just keep writing. I also look forward to being a nanna — I adore babies! But I wouldn’t wish early parenthood on my children, so this is a joy for future years. I look forward to being fully recovered and setting a fabulous example to all my lovely future grandbabies.

Each morning the voice of doubt tries to suck me back into disordered eating, and each morning I try and vanquish that voice with reminders of the things I have to gain. They might seem like simple basic things, but in a world of disordered eating, these simple things would change my life.

The Bulimia-Like Eating Disorder You May Not Have Heard Of

I have lived with an eating disorder for as long as I can remember. From a young age, I have obsessed with my weight and had distressing thoughts when I looked at myself in the mirror. My condition has developed from starvation periods and lying about when or what I have eaten to family, friends and teachers, to my now-situation of a cycle of normal eating, to purging, to starvation and back again.

One thing I have noticed is that most people assume that there are two eating disorders: anorexia and bulimia. Since I started purging two years ago, I assumed I had bulimia. However, one thing I noticed medical professionals always asked me was what my binging habits were. The trouble is, I don’t binge. I purge, I starve, but I don’t binge. When I told nurses and doctors, they always gave me a look like I was lying about the whole thing. It wasn’t until I was discussing my problems with a friend that I stumbled across a disorder I had never heard of before: purging disorder.

Purging disorder is defined as an eating disorder that is diagnosed when a person purges to influence shape or weight but does not binge. Essentially, it is bulimia without the binging. Purging can come in many forms. Often, it is assumed to be self-induced vomiting, but it can also be seen in forms of laxative and diuretic misuse, excessive exercising or extreme fasting.

Purging disorder has been studied far less than bulimia nervosa. Many people who live with purging disorder are incorrectly diagnosed as having bulimia nervosa or may not be diagnosed at all. It isn’t listed as an official disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Instead, it is included as a described condition within the category of Other Specified Feeding and Eating disorder (OSFED). Even though it lacks its own official category, purging disorder can be just as serious as any of these other disorders.

When I discovered this condition, I was relieved. I often felt like I was “failing” my eating disorder either by the fact I didn’t restrict my eating enough to fit into the anorexia definition or by not binging enough to be classed as a bulimia case. This sort of thinking only made my condition worse, as well as elevated my depressive states. I have not had a chance to raise this condition with my doctor, but when I do I am hoping that I can either get some focused treatment for this or at least have them recognize this disorder. In myself, I am somewhat happier that I know what I might have now, and I’m no longer obsessing over the fact I’m not a “proper bulimic.”

My hope is that, by writing this, I can share this condition with others. If you feel like you are “failing” your eating disorder, there are others in the same boat as you; there is hope, and you are not alone. When I get in contact with my care team and explain to them my beliefs, I will update either this post or write a new entry to share what professionals say about this disorder and whether there is any treatment specifically for those of us who purge without binging.

Why ‘Diabulimia’ Needs to be Formally Recognized by the Eating Disorder Community

“Some of the most wonderful people are the ones that don’t fit into boxes.” — Tori Amos

This is one of my favorite quotes which celebrates those of us who may feel “alien” or “abnormal.” It rejects the idea of fitting into moulds or being confined and rectangular. I don’t like the idea of type-casting people and stamping their heads with statistical criteria. This can extend to the notion of a diagnosis, particularly when it comes to mental health.

Why? Because it feeds into the concept of being defined by a disorder and having it steal someones identity. Nobody is the sum of their eating disorder, their depression or personality disorder. It may feel like you have lost yourself when you are entrenched by your illness, and diagnostic labelling can exacerbate that.

This may be especially true when it comes to eating disorders that are often distinguished by weight guidelines that classify someone. It has always seemed bizarre to me that you can be bulimic one week, but a few pounds less the next and you are suddenly “anorexic with binging and purging.” Of course, as much as we might deny that weight matters when it comes to determining how sick someone is, an anorexia classification is often a “prize” in place of a bulimia diagnosis, where weight loss is often the goal.

But someone with type 1 diabetes shouldn’t be given a diagnosis or either anorexia or bulimia, even if those disorders are recognizable by behavioral features. A person with type 1 diabetes and an eating disorder needs to be treated in a different way than someone without diabetes. This is why we actually do need some official terminology.

Diabulimia (ED-DMT1), in my opinion, is not the best term for a number of reasons, but it’s something that has become familiar, largely by way of the media. ED-DMT1 is a foreign language to most people, fairly so as it’s a clunky mouthful of a word, so T1-ED is a better fit and literally states what is in the tin: type-1-eating-disordered. Regardless of what it is, we need to have something formally recognized and defined by clinical features as a matter of urgency. The lack of such is costing lives. Those with urgent care needs are being overlooked, dismissed and invalidated by doctors that can’t distinguish a problem worth dealing with. You can feel like your problem is not a serious one and it can be easy for the disordered, irrational voice to whisper that you are not sick enough or worthy of support.

A concrete diagnosis would make the medical profession sit up and listen, and could provide those with T1-ED with the means of validation. It would open the gateway to appropriate treatment facilities and become simpler to explain when raising awareness and informing those that are unfamiliar with it as an illness.

But furthermore, setting parameters around the means of identification are important. By this I mean distinguishing exactly what T1-ED consists of. It should ideally contain subtypes for anorexia and bulimia that run alongside, but not separate to type 1 diabetes. Insulin omission or “diabulimia” should be pinned down by a particular number of omission episodes, because just like one episode of self-induced vomiting does not always equal bulimia, missing one insulin dose does not always mean someone has diabulimia,. Other documented factors may involve a fear of insulin and rejection of diabetes care services.

I still don’t like labels. I feel like classifying someone as a person and not a diagnosis is important. Essentially, I feel that patients should always be considered individually rather than being lumped into a pile with others that share a broad diagnosis. No one person with an eating disorder is the same, so treatment should be tailored accordingly. This means listening and allowing doctors the time to do so.

So, what’s in a name? Nothing, yet absolutely everything.

What COVID-19 Restrictions Mean to Those in Eating Disorder Recovery

The coronavirus is triggering many people, even those whose illnesses are long gone.

As the coronavirus (COVID-19) turned from a worrying new illness into a terrifying global pandemic, I was preparing for a kitchen renovation. By the time I’d finished carefully wrapping my plates, glasses, cutlery and fancy gadgets in sheets of white paper, and storing them all in boxes, it was clear this was not the ideal time to have no means to cook the food I needed to sustain me.

Yesterday I postponed the renovation. Even if we commenced work later in the week as planned, there’s a good chance that the government would introduce more draconian restrictions than are currently in place. Total lockdown would see work grind to a halt and leave me without a kitchen indefinitely.

This prospect unsettled me, probably more than it would most people. I knew I wouldn’t starve. I had a freezer full of food I’d prepared in anticipation of the period when I’d have to rely on a microwave for hot meals. I knew there was a range of prepared foods that could still be delivered to my door. I also knew that my nervousness was different from the generalized anxiety that has resulted in panic buying and empty supermarket shelves.

The reason for my disquiet reaches back many decades. Anorexia nervosa entered my adolescence with a savagery for which my comfortable middle-class childhood had ill-prepared me. It almost cost me my life. Anorexia not only changed me physically but also created a rigid, obsessive, hostile version of myself who, for several years, was more than a little “crazy.” Starvation does that.

Despite the profound effect my illness had on my family and me, I’m proud of my hard-fought recovery and of the life I’ve built for myself since those dark days. Although it has never been easy for me to discuss my illness, I’ve tried to be open about my experience for two reasons.

First, I consider the stigma attached to mental illness to be one of the last widely sanctioned ways of marginalizing a section of society. Discrimination often occurs when peoples’ demons are at their most distressing and destructive, when they are most in need of compassion and care.

These people have no voice. I do.

The stigma attached to eating disorders is particularly shaming, as these are conditions often seen as self-indulgent vanity rather than illnesses. Many people believe eating disorders are trivial and can be easily overcome, even though anorexia nervosa has the highest mortality rate of any mental illness.

The second reason I speak out is that the media shapes most people’s beliefs about eating disorders. And especially when it comes to television, the media focuses on the extremes of the illnesses. Apparently this makes for compelling viewing.

What the wider community doesn’t see or read about is someone like me, who overcame her illness and went on to lead a happy, productive life. I tell my story because it is a story of hope.

And yet, despite how far I’ve come, the coronavirus has reminded me that I need to remain vigilant against an instinctive need for control. I’m a rigid person who likes routine. Whether this is a character trait that predisposed me to anorexia or a result of my illness is a moot point. Bottom line: I’m feeling anxious.

Examining the brains of people with anorexia nervosa has opened up exciting new research into the illness. One focus of the research has been cognitive flexibility, which the last week has shown me I’m still lacking. Set-shifting is one’s ability to move back and forth between tasks, operations or mental sets in response to a change in environment.

Studies have consistently shown that people with anorexia nervosa have trouble with set-shifting, and the majority of studies show that cognitive flexibility remains impaired even when people recover. So maybe that’s why I am currently feeling the way I do.

Whatever the reason, I’m confident I’ll navigate my way through the current crisis. There have been many times over the years when I’ve had other physical ailments and needed to be particularly vigilant about my weight. There have been just as many periods of emotional distress when I’ve had to resist the siren-call of restriction. I will live with my current discomfort and be fine.

But many others around the world are far from fine. I am currently working on a book for the families of people with eating disorders, so recently I joined some online “lived experience” forums for eating disorders. What I’m reading on these websites is heartbreaking.

Not having ever had the condition, I can’t speak to the emotions of those with bulimia, other than to say this: however maladaptive binging may be as a coping mechanism, it is how some people manage their world. People with bulimia are usually advised to limit the amount of food to which they have access. Now people are being told to stock up. The extent to which people can binge is normally restricted to the time they can be alone. Now the advice is to isolate yourself.

Deep in the bulimic mindset is a fear of running out, of not having enough, of not being strong enough to resist what is available. The dangers posed by a world in lockdown are obvious. For many anorexics, restricting food is a way of controlling a world that feels out of control.

The rapidity with which the coronavirus has redefined our day-to-day existence has left even those of us with no psychological vulnerabilities feeling powerless, so imagine factoring that sense of powerless into the struggle to overcome a restrictive diet.

Most people in the grip of anorexia need certainty around their food. In their minds, there are good foods and bad. They want to eat particular foods, and they need to prepare and eat them in a certain way. And then they need to exercise. These patterns may be unhealthy, but all too often the alternative to their ritualistic behavior around food is abstinence. Even people committed to putting on weight are now finding that many of the things they have put in place to facilitate weight gain are impossible. They will need to eat what is available, not what they want or find easy.

Anorexia is such an isolating condition. It thrives on secrecy; so almost inevitably, people with the illness cut themselves off from loved ones, to succumb to the demands of their compulsions. A vital part of recovery is reconnecting with the world, with people who can encourage us, which helps us normalize our relationship with food.

Self-isolation is narrowing people’s focus, and their destructive internal voices are growing louder. I’m sure some people who will look at the perilous state of the world, at those terrible scenes in hospitals and rising infection rates and death tolls, and see concerns about food as self-indulgent narcissism.

Maybe if I had not waged my battle so long ago, I would feel the same way. Instead, I see the impact the pandemic is having on the lives of people already desperately fighting for an existence that most take for granted, and I feel the most profound sadness.

People in recovery will die, but they will not show up in any of the coronavirus statistics. Their struggle is worthy of acknowledgement.

I Want You to Know About the Eating Disorder We Don’t Talk About Enough

When you think of eating disorders, what do you think of? Maybe if you or someone you know is struggling with an eating disorder, you’ll be reminded of that eating disorder and the hurt it can cause. But for people without an eating disorder and without much experience or knowledge on eating disorders, it’s quite likely that the only eating disorders they’ve ever really heard of are anorexia and bulimia. It’s completely understandable, because those are the eating disorders that are most commonly talked about openly; and although they are both very serious eating disorders, people with other specified feeding and eating disorders (OSFED) are still struggling. This disorder is serious and needs to be recognized.

If you’re not familiar with OSFED, here are some facts:

OSFED stands for other specified feeding or eating disorder, but was previously called EDNOS, meaning eating disorder not otherwise specified.
OSFED is the most commonly diagnosed eating disorder in adults and adolescents.
Around 30 percent of people with an eating disorder are diagnosed with OSFED.
OSFED is defined as a feeding or eating disorder that doesn’t quite meet the diagnostic criteria of another eating disorder. This could mean that someone struggling with OSFED has all the symptoms of anorexia, but doesn’t quite meet the weight criteria for anorexia; or may show symptoms of binging and purging, but not frequently enough to meet the diagnostic criteria for bulimia; or might exhibit behaviors found in both anorexia, bulimia and binge eating disorder (BED).

The lack of awareness around OSFED can have an upsetting and sometimes fatal impact on those struggling, especially in those who exhibit behaviors and symptoms of both anorexia and bulimia. Electrolyte imbalance, cardiac problems, a ruptured esophagus in those who purge food, laxative and/or diuretic addiction, re-feeding syndrome, malnutrition and poor blood flow are just a few of the health complications someone with OSFED might face.

Along with all of these, the damage OSFED can have on someones appearance is often contradictory to the way eating disorders have been glamorized for so long. Decaying teeth, brittle and damaged hair, blue fingernails from cyanosis and easy bruising are some of the ways OSFED may affect physical appearance. Someone with OSFED may also (but not always) struggle with body dysmorphic disorder (BDD), because OSFED can affect the way someone looks at themselves.

OSFED can also have an effect on mood, and just like many other eating disorders, those struggling with OSFED are at a higher risk of depression — half of all anorexia-related deaths are from suicide. That is why all eating disorders desperately deserve and need more social awareness and education.

So why is OSFED a lesser known disorder? It is just as important as any other eating disorder, from anorexia to binge eating disorder. Those struggling have real experiences and are at risk — just like anyone else with an eating disorder. That is why I think this is such an important subject to talk about; both to help those struggling be heard, and to help people recognize the signs and know just how serious OSFED can be.

“I guess due to what we barely ‘learned’ about eating disorders in school, none of us really feel ‘sick enough’ or valid, simply because we’re not diagnosable as clearcut anorexics or bulimics,” one person struggling with OSFED told me when asked about her experience. “My biggest concern is the death risk in people with the disorder, because we cycle through periods of restriction and binging and purging, so [I] could maintain a healthy weight until [I] just drop dead one day.”

Weight does not always determine how badly someone is struggling, and nobody should have to die from an eating disorder to make people realize that.

Celebrities Who Opened Up About Their Struggle With Mental Illness

1 in 5 adults in the U.S. experience mental illness in a given year, according to the National Alliance on Mental Illness.

However, many people don’t seek help or share their experience.

Here’s a list of 9 celebrities — some local — who have shared their struggle with mental illness and call for an end to stigma.

1. Leonardo DiCaprio

When Leonardo DiCaprio played Howard Hughes in “The Aviator,” the obsessive compulsive disorder (OCD) that plagued his childhood was reawakened. “I remember as a child, stepping on cracks on the way to school and having to walk back a block and step on that same crack or that gum stain,” he told ABC News. “Let’s just say it took me a while to get to set, having to step on tons of things.”

2. Ken Griffey Jr.

“The Kid” struggles with depression, like 16 million other Americans. In 1988, when he was 17, he attempted suicide. But Griffey opened up about his suicide attempt years later to help others battling depression and suicidal thoughts.

3. Brittany Snow

Brittany Snow was taken to the hospital for self-harm, depression and eating disorders at age 19. “I wasn’t the person I wanted to be and I knew something was wrong,” she said. The actress was diagnosed with anorexia, exercise bulimia, depression and body dysmorphia. “When I was 16, I read an article in a magazine about a model who was anorexic and bulimic and cut herself,” she said. “I burst into tears. I saw myself. The model talked about how she got help and has an amazing life — I carried around that article in my back pocket for a month, to feel like there was hope. That article saved my life.”

4. Brandon Marshall

Brandon Marshall has become one of the first major advocates for mental health in professional sports. The Jets wide receiver opened up about his borderline personality disorder (BPD) diagnosis and is serving in an advocacy role comparable to Magic Johnson. “It’s my purpose,” he said in a 2012 interview. “not only in sport, but in this world.

Marshall, a Pro Bowl MVP, made headlines when he wore bright green cleats in a game during Mental Health Awareness Week in October. In addition to raising awareness of a not well-known disorder, he began advocating for public awareness and better support and care for professional athletes.

“In sports, there’s a lot of people out there struggling and they don’t even know it,” he said. “That’s because they can’t identify with mental illness. These people just feel like they’re just having a bad day or that it’s just weakness. So, any resources available to them will never be used.”

Today, Marshall’s nonprofit, Project Borderline, works to spread awareness, educate and end the stigma surrounding BPD and mental illness as a whole.

5. Olivia Munn

Actress Olivia Munn struggles with anxiety and has been open about her struggle throughout her acting career. Specifically, social situations trigger severe anxiety for Munn. But her anxiety manifests itself by way of hair-plucking, or trichotillomania. Munn plucks out her eyelashes as an impulse caused by her anxiety. “I don’t bite my nails, but I rip out my eyelashes,” she told the New York Daily News. “It doesn’t hurt, but it’s really annoying. Every time I run out of the house, I have to stop and pick up a whole set of fake eyelashes.”

6. John Green

John Green — young adult novelist and creator of sensational fictional relationships — has always been vocal about his battle with depression, anxiety and obsessive compulsive disorder. His point is, especially, to end the stigma surrounding mental illness. “Like millions of others, I take medication to help treat my mental illness,” he said. “Treating chronic medical conditions must not be stigmatized.”

7. Adam Levine

Maroon 5 frontman Adam Levine sends a message to young people with ADD/ADHD and adults who haven’t “grown out” of the symptoms — you’re not bound to be a failure and you shouldn’t be ashamed. “After visiting a doctor, I learned that I still had ADHD. It was affecting my career the way it had affected me as a kid in school. I got the word out that ADHD doesn’t go away when you grow older,” he said in an Op/Ed for Additude Magazine. “If you were diagnosed with ADHD as a kid, you might still have it now. ADHD isn’t a bad thing, and you shouldn’t feel different from those without ADHD.”

8. Joey Votto

When Joey Votto left the Cincinnati Reds in 2009, fans had a lot of questions — and theories — about the unknown illness that could have led to his hiatus. When he returned, he gave the public a candid answer: He was struggling with serious depression resulting from the death of his father. Votto went on bereavement leave when his father died, but depression lingered for the next 10 months. He struggled with anxiety attacks and panic attacks during the Reds season. “I’ve been struggling so much with this in my private life, even though I’d go on the field and do well,” he said after his return in June 2009. “Going out on the field? I couldn’t do it anymore because I was so overwhelmed. The stuff I was dealing with finally seeped its way onto the game. I had to put an end to it, because I just couldn’t be out there.” Votto began seeing doctors back in Cincinnati and said he wanted to share his story to show “how difficult the grieving process is.”

9. Emma Stone

Joined by another 3 million Americans, actress Emma Stone opened up about the panic attacks she had as a child. They started at around age 8, she said. Her first panic attack happened at a friend’s house where she “thought the house was burning down.” The experience caused her to develop some social anxiety. “I was just kind of immobilized by it,” she explains. “I didn’t want to go to my friends’ houses or hang out with anybody, and nobody really understood.” Stone said therapy and acting help her cope with anxiety.

My Eating Disorder Struggles Affected My Time in a Sorority

There I was, standing in front of the mirror. My body was disappearing. Flashback to the statement I made as I sat in my therapist’s office merely four months prior. “If I just lose 10 pounds, I know I’ll be so happy,” I insisted. She wasn’t buying it, and apparently neither was I.

There was no happiness to be attained from reaching my goals. Instead, I was left only with perpetual self-disgust and misery. My eating disorder disguised itself as my “happy ending.” With each pound lost and each meal purged or skipped, I felt as though I was one small step closer to achieving the euphoric destiny I had longed for. On that race to the finish line of elation and perfection I felt something else too — something that gave me an unexpected rush of adrenaline which exacerbated my desire for thinness even further.

For once in my life, I felt in control. Up until that point, I had lived a life that was so reckless, at times traumatic and overtly out of control. Therefore, I didn’t dare challenge this newfound sense of empowerment that served as such a relief for my greatest faults and obstacles.

The first time I came face to face with my eating disorder was during my junior year of college. At the time, I served as my sorority’s recruitment chair in which I (wrongly) presumed my chapter would garner more prospective women who might be interested in joining had we showcased ourselves as stereotypical “skinny” and “pretty” Barbie dolls rather than as the real, diverse and genuine women we were.

I recall my co-recruitment chair chastising me for proposing that we should mandate that the women in our chapter wear Spanx during formal recruitment rounds. My inherently feminist sense of morale and better judgment knew requests such as these were wrong. I wanted to be the woman who helped to end the body shaming and objectified culture sorority women were subjected to, but in that moment, I simply couldn’t. Morals, innate desires and the means for tolerance were no match for my mind that had been hijacked by an eating disorder.

Luckily, with much convincing from my more grounded and accepting sisters, I never did give such orders to my chapter. I did, however, act upon those insidiously critical body shaming thoughts that engulfed my people pleasing mind. The night before the hysteria of chanting girls, freshly made up faces and overly enthusiastic conversations (more commonly known as “Rush Weekend”) was the very night it all started. On the eve of my big debut as our sorority’s “best yet” recruitment chair, I was perched above the bathroom toilet in my college sorority house. For the very first time, I had binged and purged.

You see, I had deceptively convinced myself my sorority’s success as a growing and thriving organization was dependent solely upon our outward appearance as a sisterhood. If I could act as one stereotypically “attractive” and “skinny” girl in our struggling, quirky little sisterhood, then maybe at least one more potential new member might want to join our organization because they saw me as a representation of it. Along with occasional bouts of bulimia, I started exercising excessively and strictly monitored my food intake — counting nearly every calorie I had consumed.

Much to my own surprise, this phase of my college career wasn’t what I consider the “official” start of my disorder. It wasn’t until my “super senior” year (fifth year in college) when I fell victim to clinical depression and generalized anxiety disorder (GAD) that I was even diagnosed with a full-fledged eating disorder. In my mind, that was because the bouts of disordered eating I had experienced years prior were reflective of my wanting to “improve” myself. This time around, it had nothing to do with making myself or those around me appear to be “better.” Instead, it had everything to do with the fact I completely and utterly despised myself and was holding on to this means of thinness as a way to give myself an identity and a sense of purpose.

Despite the fact I was still enrolled as a full-time college student, upheld part-time employment at a renowned local business and maintained a plethora of friends, family and sorority sisters whom adored me — in my eyes, I had nothing. I was nothing because I was a failure academically, professionally and personally. Every arena in which I had previously excelled in prior to my series of careless decisions and emotional ailments — from school, to my social life, to writing and professional development — were now meaningless to me. I was not the 4.0 collegiate, congressional intern and prospective Ivy League graduate student I once was. According to my twisted, cognitively distorted mind, I was nothing more than a “silly,” “slutty,” sorority girl whose only redeeming qualities were presented in the form of her physical appearance.

By that standard, I felt I had no other choice but to focus on the one and only thing I believed determined my worth — my looks. Subsequently, I proceeded to engage in disordered eating behaviors nearly every day. My hair began to thin and fall out, my face was pale and sunken in and my menstrual periods stopped. It became apparent those around me were concerned about my drastic change in appearance, despite the fact I was convinced they were falling for my, “I’m just running a lot” excuse.

I am by no means trained to offer medical advice or administer specific treatment plans. However, the steps I took in pursuing treatment for my eating disorder may be beneficial to take note of when starting this often daunting and fearful process of recovery.

This is what I did to kick my eating disorder’s ass:

1. Start with counseling.

Regardless of which mental illness might ail you, beginning your recovery process by seeking out a trained counselor or psychotherapist will ensure you are being monitored and that you will be held accountable for your actions. Though this may not seem like the simplest way to ease into recovery, it will prove to be an effective means of taking charge of your own life and health — so long as you choose to be honest with your therapist and actively participate in the treatment plan which he/she lays out for you. I recommend being selective when choosing your care provider. Treat your initial assessment appointment as if it were a first date. After all, your goal is to select someone who can provide you with a treatment regimen which suits your personal needs and flows with your own desires as well. The foundation of effective treatment begins with a positive and trusting relationship with your health care provider.

2. Seek out a specialist

Therapy alone, from a general mental health practitioner is likely going to improve your understanding of yourself and the feelings which lie beneath your behaviors. In any case, you may need far more than a sense of self-awareness to be able to cope with such an all-encompassing illness. Research online to see if there is a practitioner in your area who specializes in disordered eating and body image. You may also want to consider looking up eating disorder treatment centers which can offer either outpatient therapy, inpatient care or a combination with intensive outpatient treatment.

During my treatment, I was under the care of both a general clinical psychologist, a specialized psychotherapist from an eating disorder treatment center, as well as a clinical psychiatrist who prescribed me medication for my depression and anxiety.

3. Don’t be afraid of medication.

There is, without a doubt, an enormous stigma associated with considering medication as a treatment option for behavioral health. Frankly, there shouldn’t be. Medication has done wonders for not only my depressive and anxiety related symptoms, but I also credit it as serving as one of the chief components in expediting my successful eating disorder treatment process. It was essential in decreasing my compulsive thoughts which instigated my bulimic and anorexic behaviors. The pills did not make them dissipate completely — however, they did significantly decrease the frequency and urgency of those thoughts.

4. Get off social media.

Like most young women I know, I have a love-hate relationship with Instagram. Yes, it is undeniably fulfilling to receive attention from your peers and feel like you’re a celebrity on your campus or in your community. Unfortunately, I believe the pressure of this self-induced publicity can also come at a hefty cost. Filters, Photoshop, angles and lighting all play a serious role in manipulating photographs that appear to be of “real people.” Scrolling through your feed and spotting a toned and tan acquaintance on the beach spewing the caption “Life’s a beach when you’re a babe,” can incite a level of competition and envy that’s reminiscent of high
school days. I believe social media will only hinder your treatment and feed your mind with more negativity towards your own self-reflection. My advice: turn those damn notifications off, delete the app and don’t look back.

5. Remove yourself from a triggering environment.

Living in a sorority house at a university deemed worthy enough to make a spot on the list of “Colleges with the most beautiful women” is not exactly the type of environment that was conducive to my eating disorder recovery. The expectations I maintained about presenting myself as a “sexy sorority girl” became too much to bear in the midst of my healing process, so I left and went back home to mom’s house. Though I am aware not everyone has the option to simply vacate the area they are living in or the one they are working in or spending most of their daily time in, there are ways to condition yourself to reject the cultural standards of that setting itself. A specialist or therapist can work with you to determine which methods you can draw upon to deal with these incessant triggers.

6. Decide you want to get better for yourself.

Everyone who loves raunchy reality TV is familiar with the great series known as “Intervention.” I believe the lesson we can all take from this program is that treatment will only truly work for someone if they themselves are willing to undergo the process for the sake of their own well-being. No matter how many doctors, specialists or therapists you see, you will not see a difference in yourself and a change in your behavioral patterns until you decide you want this for you — and for no one else.

7. Because trust me, you do want to get better.

Now that I consider myself fully recovered from my eating disorder, I have decided to dedicate my time to helping others cope with their own struggles by sharing my experiences. I frequently attend a group therapy session at my eating disorder treatment center where I tell and retell my story to those whom are still grappling with the firm grasp their eating disorder holds in their lives. The sole most important piece of advice I reiterate to them is this: no matter how good you may think skinny feels, the feeling of recovery is insurmountable. I used to thrive off compliments from people who noted how much weight I had lost and how great I looked. They made me feel accomplished and worthy. Those feelings were fulfilling at first, but they served only as a temporary fixation for my insecurities. Yet, the feeling I receive when a person acknowledges my treatment — that’s something that stays with me permanently. It is not only extremely rewarding to know I beat the odds and survived this disorder, it is the single most empowering experience I have ever encountered in my life. I believe there is nothing better than defeating this demon that took over my life. You are more than capable of doing it — so please, don’t wait another second. Start on the path to recovery. You might come across detours and tricky terrain along the way, but I believe you will succeed when you remember what lies ahead in your destination: the rest of your life.

Myths People With Eating Disorders Want to See Busted

If the image that pops into your head when you hear the words “eating disorder” is a white teenage girl obsessed with her looks, you don’t even know half the story. Eating disorders don’t discriminate, they aren’t exclusively for girls and they definitely aren’t about “looking better.” They’re real, and deadly, mental illnesses, and those who suffer from them desperately need our support and understanding.

To further crush some stereotypes, we asked people in the National Eating Disorder Association’s (NEDA) community to tell us one myth about eating disorders they want to see busted.

Here’s what they had to say:

Myth #1: You have to be “sickly thin” to have an eating disorder.

An eating disorder is actually defined by “extreme emotions, attitudes and behaviors surrounding weight and food” — not by pounds lost. “Most people will probably be surprised or even skeptical to hear that a kid struggling with obesity can also be anorexic,” former president of NEDA, Lynn Grefe, told Today.

“Having an eating disorder is serious. Just because I look ‘normal’ does not mean I’m OK.”

Myth #2: It’s just like a really strict diet.

Having an eating disorder isn’t a version of an extreme diet. While you have control over a diet, an eating disorder can control you. There are no cheat days when you have an eating disorder.

“People think having an eating disorder just means you want to get skinny. When I tell people about my eating disorder, they’ll ask, ‘But why? You didn’t need to lose weight!’ An eating disorder is not a diet fad — it’s a mental illness!”

Myth #2: It’s just like a really strict diet.

Having an eating disorder isn’t a version of an extreme diet. While you have control over a diet, an eating disorder can control you. There are no cheat days when you have an eating disorder.

“People think having an eating disorder just means you want to get skinny. When I tell people about my eating disorder, they’ll ask, ‘But why? You didn’t need to lose weight!’ An eating disorder is not a diet fad — it’s a mental illness!”

Myth #4: Once you start eating again, you’re magically cured.

Recovery from any mental illness is a process for everyone, and there’s no hard rule about how long it takes. “Typically, recovery does not happen once, but takes place over years of mindful application of the lessons learned in treatment,” NEDA explains on their site.

“When you start eating in a ‘healthier’ way, that doesn’t mean the disorder is gone. It can be a lifelong recovery you have to choose every day and every meal.”

Myth #5: It’s just for attention.

Risk factors of eating disorders include body dissatisfaction, negative affect, thin-ideal internalization, dieting, troubled personal relationships and history of physical or sexual abuse. Not on the list? Being an attention-seeker.

“Instead, consider it the deadliest mental illness.”

Myth #6: Eating disorders only affect young, white females.

The 20 million women and 10 million men who have eating disorders come from diverse backgrounds. With the exception of anorexia, the prevalence of eating disorders is similar among Whites, Hispanics, African Americans and Asians in the United States.

“Eating disorders affect all ages, all genders, all sizes, all colors. It took me almost 40 years to find there was a name for what I did.”

Myth #7: It’s about wanting to be attractive.

Although in our culture we associate “thin” with “beauty,” an eating disorder is a mental illness that goes beyond the desire to be thin.

“It’s about how ‘attractive’ we are to people (especially to men). It disgusts me that this idea that women want to always be appealing to men is so pervasive that it even affects how people view eating disorders. It erases males with eating disorders, it erases trans-men like me and it erases lesbians with eating disorders. That view simplifies a complex problem and stereotypes us as vain.”

Myth #8: It’s all about food.

Eating disorders arrive from a combination of factors, and food is only one. Some might use food to cope with feelings and emotions, while others use it as a way to feel control over their lives.

“Eating disorders are all always all about food! For me, it’s extreme negative self-image, very low self-esteem, control, obsessive compulsive disorder and so much more. I wish people understood this.”

Myth #9: There’s only one type of “serious” eating disorder.

Although maybe the most well-known, anorexia is not the only kind of eating disorder — or the only kind of eating disorder that should be taken seriously. Other eating disorders include binge eating disorder, bulimia, and Other Specified Feeding or Eating Disorder.

“Can we finally acknowledge that binge eating disorder (BED) and bulimia are just as serious as anorexia? That the mental anguish of BED and bulimia is just as excruciating as that of anorexia, and that the medical complications from those illnesses can be equally serious?”

10. The “control” is takes to have an eating disorder is something to be praised.

Although we’re taught weight loss is something to be desired, someone isn’t “lucky” for having an eating disorder. It comes with heavy emotional and physical consequences, and we shouldn’t treat it like something to be desired.

“When people think/say things like ‘I wish I had your problem,’ it just shows they have no clue what it all entails. This illness isn’t a choice.”

Types of Eating Disorders We Don’t Talk About

When we think of eating disorders, usually the first types that come to mind are anorexia and bulimia. And while we should definitely continue to talk about these types of eating disorders, oftentimes they are the only EDs that get discussed — especially in the media. Too often we overlook the other types of eating disorders people can struggle with.

To open up this conversation, we’ve listed five eating disorders we don’t often hear about. Before beginning, we want to preface by saying this list is not an exhaustive one, and you can read more about eating disorders on the National Eating Disorders Awareness (NEDA) website.

Here are some eating disorders we need to start talking about:

1. Binge Eating Disorder

According to NEDA, binge eating disorder (BED) is an eating disorder characterized by recurrent episodes of bingeing on large quantities of food. People with BED often feel a loss of control during the binge and can experience shame and guilt afterwards. Though we don’t often talk about BED, it is the most common eating disorder in the United States.

Articles and resources for people struggling with anorexia and bulimia are plentiful, while I’ve found support for those with BED is minimal. I thought I was greedy, or had no self-control. This lack of discussion and awareness had a polarizing effect on me.

Food was my first “addiction” and has remained my last. It started when I was very young, I would sneak into the kitchen and grab whatever I could to self-soothe away the various crap my tender, young heart, body and brain endured. Cookies in the closet. Chips in the dark under the covers. Completely zoning out — or what is clinically described as “blacking out” — during meal and snack-times, going for seconds constantly, etc. I remember getting in epic trouble at a particular foster homes and was often treated like a glutton. No one ever took the time to realize there was something seriously wrong, or get proper help/care for the kid who was in a world of pain.

According to the Binge Eating Disorder Association (BEDA), treatment for BED typically involves working with trained therapists and physicians to address past trauma, family dynamics and any underlying mood disorders. Self-compassion is also key for lasting recovery.

2. Orthorexia
   Though at this point in time it is not officially recognized in the Diagnostic and Statistical Manual (DSM), orthorexia is an eating disorder based on an obsession with “healthy” eating and lifestyle. Common behaviors of this disorder include compulsive checking of ingredient lists and nutritional labels, cutting out an increasing number of food groups (ex: all sugar, all carbs, all dairy, all meat, etc.) and preoccupation with eating food items deemed “healthy” or “pure.”

It usually starts with the innocent desire to adapt a healthier lifestyle. We may read things on the internet that confuse us yet convince us. We might buy into things that don’t even make sense. We often pay the extra $2.20 for the organic products. We might spend hours reading labels at the grocery stores and scanning restaurant menus before going out. Eventually, all of that may stop. We might stop buying processed foods all together. We often refuse to go out to eat with friends or family, insisting we’ve already eaten. We can become fixated on the quality and purity of our food, and if that food doesn’t meet our standards, we might not eat or purge after the fact to rid our bodies of all uncleanliness.

This can manifest itself in all forms — from exercising, stricter eating or even fasting. This lifestyle is often rigid, lifeless and moralistic. We may become prideful of how “good” we eat compared to other people. We might receive affirmation about how healthy our diets are and how other people wish they were like us. If they only knew. And despite what many people believe, despite what I believed for a few years, this type of eating usually isn’t healthy. If anything, it’s the opposite.

At this point in time, there are no clinical treatments designed specifically for orthorexia, but many ED experts rely on treatments that help patients with anorexia and obsessive-compulsive disorder (OCD). These treatments may involve exposure to certain “fear foods” and psychotherapy.

3. Diabulimia
   Diabulimia is a term applied to someone with diabetes (typically type I) struggling with an eating disorder. Diabulimia is characterized by purposely restricting insulin in order to lose weight.

It’s not a choice. It is not a decision made with any rationality. Someone with an eating disorder and diabetes is not choosing to not take their insulin just because they can’t be bothered or want to throw their toys out the pram (in this case syringes and test strips!). They are not just being ungrateful for that crucial life source which is now so luckily available. The discovery of injectable insulin to treat diabetics is meaningful to everyone that has to rely on it to survive. But with a mental illness, with an eating disorder, survival is not a priority. It’s also not just “another label” that can be lumped in with other conditions — it has characteristics that require treatment to be specifically tailored.

In treatment for diabulimia, it is important that a patient sees a doctor who has knowledge of both diabetes and eating disorders. In addition, it’s often important for a patient to see specialized clinicians such as an endocrinologist and a mental health professional who specializes in treating patients with eating disorders.

4. Other Specified Feeding and Eating Disorders (OSFED)
   Previously known as Eating Disorder Not Otherwise Specified (EDNOS), OSFED includes people struggling with eating disorders that do not meet the strict diagnostic criteria of anorexia or bulimia. Unfortunately because of its “catch-all” status, it can be wrongly viewed as “less serious” than other eating disorders, making it so that some people struggling are denied coverage for treatment.

What it meant? It meant the demon inside my head had plenty of fuel. “You’re too fat. Too fat to have an eating disorder. Too fat for anyone to care. You should prove to them how sick you are. You just wasted nearly two hours of their time when they could have been helping somebody who actually needed help instead of you. That’s it. You’re done.”

As Blaisdale shared, being denied treatment for any eating disorder can lead to feelings of needing to appear “sicker” to be taken seriously. People with OSFED are struggling with significant, life-threatening eating disorders and we can’t afford to turn these patients away. Treatment interventions that can benefit individuals struggling with OSFED may include seeing a doctor/nutritionist, cognitive behavioral therapy (CBT) and psychiatric medication.

5. Avoidant Restrictive Food Intake Disorder (ARFID)
   Avoidant restrictive food intake disorder (ARFID) was previously known as “selective eating disorder.” It is an eating disorder similar to anorexia because it involves limiting amount and types of food eaten, but differs because it does not involve any distress about body shape or size, or fears of fatness. Oftentimes, it includes individuals we might be tempted to describe as “picky” eaters — but it’s so much more than that.

Those who have ARFID can’t just “try new foods…” Imagine going to a restaurant with a five-page menu and finding none of your safe foods. Safe foods are foods people with ARFID feel comfortable with eating because they are familiar with them.

The exact cause of ARFID is unknown. Some believe it is born out of a fear of choking or vomiting. For me, I believe it came from my birth circumstances. Before I was adopted out of Russia at a very young age, the baby food given to me wasn’t good…

[AFRID is] not simply “being a really picky eater.” I’m well aware of starving children and am not trying to be “selfish” with my eating choices, so please don’t try to guilt or shame me into eating. I’ll sit there at the dinner table for hours just staring at the food. I’m hungry, but my eating disorder has so much control over me that I simply can’t eat. Picky eaters typically outgrow their picky habits by the time they’re in their twenties. For someone with ARFID, this problem might persist beyond that age range.

Treatment for ARFID is still being researched and understood due to its relatively new categorization as an eating disorder. According to Eating Disorder Hope, some treatments that have had success include forms of exposure therapy and cognitive behavioral therapy (CBT).