Anorexia: Disease or Lifestyle?

Monday’s Telegraph newspaper marked the beginning of Eating Disorders Awareness week with an article about ED websites: More specifically, ‘Pro Ana’ sites.  (For the uninitiated, these sites are sites set up to encourage those who want to starve themselves. They share tips and tricks about hiding food, fighting hunger, effective purging, dealing with interfering parents / loved ones and often sporting photographs of skeletal bodies to give ‘thinspiration’ to followers).I skimmed Sarah Rainey’s article , too tired of the topic to want to engage with the politics and the emotion held between the lines of the pro ana blogger, the parent of a (nother) very bright, talented ‘whole life ahead of her’ dead Anorexic and ED organisations. One thing however, leapt out at me.This:“Anorexia is a lifestyle, not a disease”.It’s something I’ve heard many times in various forms and generally from sources who, clearly, have no understanding of the pathological nature of Anorexia. Without wishing to state the obvious, I find the implications of the statement upsetting because it embodies the attitude that somehow, Anorexia is a choice one makes. For me, this is an absurd idea. However, as I have previously tried to explain (here), I think there are different types of Anorexia and it is possible that, for some people, devoting their time and energy to becoming extraordinarily thin, is a lifestyle choice, in much the same way that a total devotion to anything may lead to radical lifestyle choices. All well and good (excuse the irony), and perhaps in this instance, starvation is a choice… just another way of living. But, can a disease be a lifestyle? Unfortunately, what the article I read didn’t point out, was that if this is a choice, it can’t be Anorexia or Bulimia or EDNOS. A disease, by its very definition and nature, isn’t a choice… Nobody CHOOSES to suffer with a disease. True, it can appear that way with some mental illness’, but nobody makes a choice to become sick. People don’t choose to die from malnutrition any more than they don’t choose to develop leukaemia. And this is where it all becomes very complex… because CHOICE plays a large part in the distortions that characterise this illness so vividly. A person suffering with Anorexia, believes that they have CONTROL of their weight and their body. They believe in the choice element. They believe that they are IN CONTROL. In fact, the extreme opposite is true. It is the disease that controls them and the disease which distorts their thinking. The disease ROBS the Anorexic of choice. It STEALS their capacity for logical thought about their weight. It DILUTES the ability to rationalise their fear of weight gain and to recognise that they are no longer in control of their mind. I understand the Pro-Ana blogger’s statement in the light of those who wish to diet, but “choosing an Anorexic lifestyle” is an oxymoron. One last point, and perhaps the most important: Luckily, there IS some element of choice.It is reserved for those who are in the grip of an Eating Disorder (or addiction, I think) and it is this: The sufferer may choose to remain in the half life that it forces on them. They may CHOOSE to give up the fight for wellness. Just as somebody who is diseased with cancer may choose to stop treatment, an Anorexic or Bulimic can CHOOSE not to fight the illness. RECOVERY or NOT is the choice. A lifestyle of recovery is agony, but a lifestyle led by the choice NOT TO recover, is to submit to the power wielded by this dreadful disease.