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. 

Distortion - The Extent To Which Anorexia Lies

I sit in the shabby hotel conference room, anxious for the guy whose innocent gesture has landed him a bidding price that is far, far higher than anything he can afford. 

Nobody else is bidding and my fingers are twisting themselves into tight, three dimensional infinity symbols. 
"Any advances on..." 
A grey suited, old man, wearing a felt Trilby, half rose and then collapsed in the middle of the room.

"Time... Time..." 

Time for what? 

A melodic voice in the distance

"... that time again..."

I lurch and my breath is caught and it's sudden: The realisation that I'm here, not there. I'm awake. 

Six am, in the half light of Weigh Day, and the Support Worker stands cooing at my door. 

I know I must leave the bathroom door ajar so she can hear me as I pee.

It's a long time since this felt like an indignity. 

I stumble down the corridor into the glare of the clinic room. Somehow I manage to keep shading my eyes as I peel off my nightwear.

The scales confirm weight gain.

I fight my way through a cloud of sleep - laden mist to calculate just how much.

I do, and I am not devastated. 

Perhaps I'm getting better. 

Perhaps I'm just too tired.

I pretend I'm still asleep as I crawl back into bed.

Miraculously it works. Until 7.45 when the alarm pips me back into reality.

Even as I write the word 'reality' here, I debate whether to use inverted commas, because actually, within minutes, the distortions conjured by this illness can transform your mind from a Ferris wheel, to a drop spindle for your thoughts. 

At six o'clock in the morning, I knew exactly how much weight I'd put on in the three days since my last weigh in. Approximately one and a half hours later, during which time I had done nothing but sleep, I awoke convinced that at least three days worth of weight had suddenly piled on and, were I to stand on the scales again, they would read quite differently. 

Just to make it clear: in this moment, I was utterly convinced that my body had withheld weight until one minute AFTER I stood on the scales, at which point, it suddenly and spontaneously added the pounds / kilograms that it had been hiding. 

Yes. 
These are the lengths that Anorexia will go to in order to keep its victim ensnared.  

And this is only one of the many distortions its capable of.

The fact that the mind can do this in a period of time when there has been no food intake, perhaps you can imagine the outstanding strength of some of the convictions that an Anorexic has after eating, the sheer havoc wrecked by having food in the body.

Although everyone has a different experience, I am often overwhelmed by the physical sensation of fat layering itself onto the backs of my legs and my thighs. At any given point in the day, I will suddenly be aware of this thickening of my body. I swear, I can FEEL it. I've been told this isn't possible, and yet, it's always someone who hasn't HAD the experience that tells me. Perhaps you have to have experienced feeding your skeleton, putting flesh onto bone, to feel it. 
Or perhaps it really is another of the distortion of reality... which is a frightening thought because, how will I ever know what's real and what is, in essence, a figment of the imagination. Like a phantom limb, the fat clumps on my body. I feel it and, I SEE it. 

And yet, as I do my calculations, I briefly think of the previous nights' anxiety; the conviction that I must have put on a least a kilogram (that's two point two pounds). 
I hadn't.

Can I really feel POINT three of a kilogram? 
Really?

The ugly truth is that part of my reality is almost certainly distorted.
My truth is not THE truth.