Sunday, 21 March 2010

What It Takes

As with all things in the mental health realm, the DSM IV lists a number of must-haves in order to be a Real Live Anorexic.

If you have been reading here with any regularity (or any memory), you may recall that my sister, who has spent roughly half her life being defeated in her attempts to starve herself to death, was possibly the case on which the DSM criteria is actually BASED.

Okay. Maybe not.
(But she could very well be)

For anyone interested, the DSM states that Anorexia Nervosa is defined by the following four factors:
  • Refusal to maintain body weight at or above a minimally normal weight for age and height: Weight loss leading to maintenance of body weight (85%)
  • Intense fear of gaining weight or becoming fat, even though under weight.
  • Disturbance in the way one's body weight or shape are experienced, undue influence of body weight or shape on self evaluation, or denial of the seriousness of the current low body weight.
  • Amenorrhea (at least three consecutive cycles) in postmenarchal girls and women. Amenorrhea is defined as periods occurring only following hormone (e.g., estrogen) administration.
Obviously, seventeen years of bearing witness to the horrors of this illness have taught me that in actual fact, the above prerequisites to the label of 'Anorexia Nervosa' are only the very tip of the iceberg.
I could name many more factors.
But that is, perhaps, for another post.

You could be forgiven for thinking that, given the fact I have lost my sister to the horrifying effects of this illness... given that I have raged at it, pleaded with it, cried to it and knelt moaning before its merciless, monstrous darkness... I would be the least likely person in the world to be drawn into its world.
You'd think I would be incapable of drawing others under the agony that wrapped itself around our family.

You'd think.
I thought that too.
Until something, at some point, changed.

Today I am 6 stone 5.

I'm not a proper anorexic... (which is what I wanted to write about when I began this post).

I'm very, very confused because I don't 'fit' in with the notion I had of Anorexia.
I thought that Anorexia had to come easily to those with it.
I thought that I was a 'fake' because I crave chocolate and all I really want to do is eat lovely food.
I think I'm crazy because I hate working out, but i have to, but I hate it, but I have to.... and my HUGE fear is that one day, I won't have the willpower to drive myself to run for miles, climb hundreds of floors, cycle like a maniac, cross train at high intensity, row hard and fast, use the resistance machines, do my floor exercises until I can't move.

Anorexia, if it is anything like this, isn't about suddenly hating food. It's about a spiral of absolute dread that you will lose control of it, even as it controls you.


  1. You are so is not about the food at all.
    Hugs, and prayers, andrea

  2. What can I say - it is not about the food, not even the weight, but rather a descent into a parallel universe that is essentially a living nightmare.

  3. May I also add that in Cardboard: A woman left for dead I very much want the reader to understand anorexia as more of an identity issue than an eating issue - that it is a rewriting of your sense of self that is required if you are to journey back out.

  4. HI-

    I am stunned by your investment. I wish for you distraction - natural and simple where food, body image are of no interest beyond basic health. I wish, I wish, I wish......

    Loving you

  5. I think you hit the nail on the head, this is all about control. You are making choices, one of those choices is to try to label yourself. Let go of the labels, step outside yourself and observe. What do you see? Does that person need help? Is that person creating a dangerous environment for herself? What would you do if you were her friend? Now choose to take action.

  6. Andrea - Thank you.

    Fiona - Hi and thanks for stopping. It sounds as though you know a lot about the subject and yes.. a "parallel universe" is a very good way to describe it. It certainly feels as though I am living in a bubble alongside others...
    I looked up Cardboard: A Woman Left For Dead. Congratulations on your success.
    At some point, I would really liek to be able to read it,but in all honesty, the whole topic is just so horribly painful for me right now that I don't think I could bear to.
    I have only ever read two books on anorexia (at least eight years ago now) and they both left me reeling and swearing never to read about it again. If you read any posts about my sister, you might understand why.
    It is a living nightmare and it must have to do with rewriting, though I don't understand how.
    Thank you for your understanding.

    Gail - Distraction is nearly impossible given that my world seems to revolve around food, exercise and discipline.
    What you wish for is what one part of me would kill for... Unfortunately, I'm split in two and the other part becomes suicidal if the discipline slips or the weight doesn't stay as low as I want it.
    I do have a line I won't cross...
    I find it hard to believe this is happening.

    Mark - I'm not sure I am trying to label myself. I seem to have spent a long time fighting and denying and arguing the labels that others are so intent upon giving me.
    "You are anorexic" (from my Dad, sister, mum, friend) is what prompted this (rather frightening) post... It took a long time to get near to writing it.
    Doing as you say, stepping outside... label-less.... What do I see? Desperation and depression.
    Does the person need help? Yes, but I don't know what possibly could.
    Dangerous environment? Well, yes... in terms of risking a heart attack, harming too deep
    If I were her friend? I'd sit with her but feel utterly helpless in trying to reach someone so far gone.
    Thanks for making me think.

  7. I'm so sorry to hear about your sister :( Control is such an issue with all addictions. I completely understand. I struggle with using food as it's purpose, not a technique for control.

  8. it's not about the really isn't...I'm praying for you too...Stay strong..keep your corner. Sarah

  9. I certainly know it is not about the food. Thank you for sharing from your heart dear one.