Why telling me “just eat” doesn’t really help
My name is Kelsey and I am a master of worry. I worry about the weather. I worry about my father driving to work every morning. I worry about having enough money 50 years from now.
My name is also Kelsey, struggling anorexic. This means I also get to worry about eating a single unplanned cracker at 3:43 p.m. I worry about not being able to feel my ribs one by one. I worry about catching a glimpse of my stomach as I hop into the shower.
By no means am I alone in this fight. Anxiety is the most common comorbidity associated with anorexia and, boy, do they make one hell of a team. Anxiety can make us crave routine and a feeling of control. An eating disorder tricks us into thinking we are in control by having us restrict our food intake and having us stick to ridiculous habits and schedules. As we lose weight, we become less and less capable to think rationally or emotionally process our feelings. We become more dependent on our habits and become completely incapable of handling any departure from them.
So when people say; “Well why don’t you just eat?” it doesn’t really help us. Our problems are not mechanical—raising forks to our mouths cannot solve them.Don’t get me wrong; refeeding is a major part of recovery. However, failing to deal with underlying anxiety issues may be why so many anorexics relapse over and over again. In fact, a study done by researcher Tamara Berends and colleagues shows that up to 41 per cent of patients will relapse within 18 months. Personally, I have relapsed twice already, and each battle is more exhausting than the last.
In my experience, anxiety was a sort of preparatory course for anorexia. My anxieties taught me how to obsess, how to focus in on a single issue, and how to imagine the worst possible hypotheticals in every situation. My mind was already tailored for anorexic thoughts and behaviours. It felt normal to obsess about calories. It felt normal to focus on nothing but the feeling of my waistband digging into my stomach for hours at a time. It felt perfectly natural to convince myself that going out to dinner with my housemates would make me morbidly obese.
Generalized Anxiety Disorder also teaches you how to be a high-functioning individual despite your mental illness. We get used to completing assignments and studying for exams while a continuous thought loop of worry plays in the background. This makes it really easy for people suffering from anorexia to trick loved ones into thinking we are fine. We can still ace midterms despite thinking about food and weight every second of every day. We can have a panic attack behind closed doors and then immediately go socialize as if nothing is wrong.
So, how do we get out of the loop? After the refeed is done, how do we stop our anxieties from triggering our disordered thoughts all over again? This is a question that I, as well as hundreds of clinicians and researchers, have been asking for years.
Unfortunately, there is no magic pill or treatment for us. Everyone’s journey is different, but in my experience, there is only determination and a willingness to accept help. All those little food habits we have? Bust through them. Even if we are not currently struggling with anorexia, those habits were born out of anxiety. By keeping them up, we reinforce the idea that controlling food can control our life. It can feel next to impossible, but we have to do it.
Secondly, we can’t be afraid to ask for help because we are worried about being a burden. If we are going through a period of intense anxiety, we should ask friends to watch out for anorexic tendencies. We should seek counselling on campus, seek more formal treatment, or even just speak with our parents. The more we expand our support team, the more likely we are to feel like we can handle our anxieties without indulging in disordered eating habits.
We are human and that means we are prone to flaws and imperfection. However, we are also strong beyond measure and we can do this. We may always be worriers, but we don’t always have to struggle.
Photo courtesy of porschebrosseau.