Thursday 14 February 2013

Eating Disorders Awareness - One Truth About Anorexia

I'm conscious that it's National Eating Disorders Week. 
I'm also conscious that much of my writing here has borne witness to my own, very personal, struggle with Anorexia and that, whilst there are many apparent similarities between sufferers, each and every person has their own 'strain' of the illness. 
I recently watched a BBC documentary by a now recovered minor celeb who, having suffered from Anorexia in her youth, embarked upon a quest to find out 'The Truth about Anorexia'. I watched with a  degree of cynicism, (typical of me) because the results of this exploration were pretty obvious from the outset. 

(Aside) As it happened, I was more intrigued the next day, by the widespread and vicious backlash on various discussion forums, where anorexics ripped the programme, and its celebrity 'investigator', to shreds, claiming that she obviously hadn't been a 'proper' anorexic! 
That would be another topic!

One thing that I've learned from the large number of patients in the treatment centres I've been in, is that there IS no single 'cause' of anorexia. There can be no 'getting to the bottom of it' because it's as shape shifting as the virus for the common cold.  

You think you can spot an anorexic? It's the legs that give it away right? The two pins that, by some miracle, are holding them up. And the face. The way their eyes sink into the skull, dark skin sagging at the ridge of bone which runs from the top of their cheek to the deep line around the mouth.
The clothes that hang baggy off their shoulders. Tired, tiny arms, narrowed, fleshless at the tops. 
Yep. Definitely.
As I type, I sit in Cafe Nero. Couples sit sipping valentines coffee. A barrista sweeps conscientiously, moving the easel with the 'Hot Soup' ad, concentrating on each swish across the tiled floor. A young man sits at his laptop, looking over dark glasses at intervals. 
I'm drinking a one shot Americano with skimmed milk, hot. My make up is immaculate (last time I checked anyway). Subtle grey eyeshadow, a touch of mascara, a little blush. I'm about seven stone; that's forty five kilos to the metric crowd. My clothes are an eight. I've just eaten a Kit Kat. 
Nobody knows I'm anorexic. 
Nobody can see that beneath the recently acquired flesh, a cold skeleton howls, like a forgotten child. Nobody can hear the whispers, the taunting desire to have one of the brownies that the rosy-glow girl to my right is enjoying. Nobody can see the rapid calculations, the figures flicking up and down as I add, divide, add, multiply; 107 calories = my biscuit, 100ml of skimmed milk =  43Kcals x 2 plus a bite of cereal bar. It's too much. How can I compensate at dinner? 
Nobody sees the anorexic who knocks around in a body too large.
I may be sitting near another at this very moment.

I think I've digressed somewhere. 
I set out to illustrate the fact that the one truth about Anorexia I know is that everyone's illness is different.

During inpatient treatment people presented with dangerously low BMIs. But how they got to that point varied. 
Okay, we all have an issue with food. But some anorexics are calorie obsessed, whilst others are more preoccupied with the fat content in foods. 
Some are addicted to exercise (myself included) and can hardly sit down for more than ten minutes without having to get up and do press ups or squats; others can happily lie on a sofa for hours and sleep. 
Some patients have buggered up their system by taking laxatives and/or making themselves sick. Others won't take a tablet, even for a migraine.
Some quake at the sight of a potato because carbs are sworn enemies, others are too afraid to eat a carrot because it has somehow become a 'fear food'. Still more are terrified of dairy products, not touching milk or cheese for years.
I met patients who will 'water load' to throw their weight (water loading is a common but dangerous behaviour practised by eating disordered patients who consume vast quantities of water in order to fake weight gain). Then again, some people are so obsessed with knowing their actual weight that they will wear exactly the same clothes to be weighed. 
Some anorexics are so scared that their body will absorb fat that they won't use cream shower gels or moisturiser on their skin. 
I've met anorexics who drink copious amounts of alcohol, whilst others won't even sniff it.
When I was at my worst, I couldn't drink coffee for fear that it contained hidden calories. I couldn't trust the calorie content on certain labels and so I ruled out anything which I deemed to have 'too few calories to be believed'.
Some people can't watch food programmes, others read cookbooks obsessively and liked nothing better than to cook a three course meal that they could never eat.

Eating Disorders may present similarly, but no one sufferer has the illness in quite the same way, which may be why they are so difficult to treat and why they are still so widely misunderstood.