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Debunking Superficial Misconceptions of Anorexia

posted Aug 25, 2017, 3:24 PM by Erica Johnstone

The most frustrating misconception about anorexia is that it is a superficial fixation on appearance or attractiveness. It is not. It is actually not a reflection of society’s drive for thinness. Even in the absence of the media glorification of thinness, eating disorders would exist. They occur in countries that do not idolize thinness, and they occurred hundreds of years ago. Eating disorders happen to use food as a coping mechanism - it is the ‘drug of choice,’ but it is merely one means of allaying anxiety and dealing with insecurity. My point is that emaciation is not the core feature of anorexia though it is the most salient symptom. The association with appearance links eating disorders to a superficial and self-absorbed personality. This egocentricity often associated with eating disorders is what I feared being identified with the most - the idea that my eating needs and my workout schedule in particular were self-centered pursuits. But these were not choices easily rearranged, these were commandments I was obeying. It is not selfishness, which implies self-love and self-approbation. It is quite the opposite. These rigid schedules are demanded as forms of self-punishment and self-deprivation. According to anorexia, you only deserve to exist if you have exhausted yourself and restrained yourself. You must accomplish these activities in order to exist without guilt and self-disdain flooding your mind all day. You feel you have to earn the right to enjoy, and even survive, life.


For loved ones of those with eating disorders, making the sufferer feel guilt or shame for working out too much or not eating what others eat is counterproductive. This produces feelings of guilt, inadequacy, not being good enough, which in turn make the sufferer feel that he or she must self-deprive and self-punish using the tools he or she knows, and those tools are disordered eating and exercise behaviors. Personally, when I feel inadequate or that I am not meeting someone’s expectations, my brain automatically goes to a place of thinking about what foods I can cut out and what exercise I can do more of. This happens automatically, without conscious choice. I think this serves dual functions - it is something the eating disorder deceives you into believing you are good at and capable of, but it also serves as self-punishment and self-denial, which the eating disorder has told you is necessary in order to be worthy of living. This becomes the go-to behavior in any instance of feeling inadequacy or unworthiness. The deeper question becomes why do you feel unworthy and not good enough, why don’t you deserve what everyone else does? It seems a sense of self-hate and a lack of self-compassion although you have the utmost compassion for others.  The key to recovery is undoing this false belief and learning to value yourself and believe that you are as worthy as anyone else. You deserve happiness just as everyone else does.


What cause this feeling of self-doubt, inadequacy, unworthiness? So many things. I think a common thread is wanting badly to be accepted. I have always been very concerned with pleasing and appeasing. So many choices are about making others happy and hoping to not disappoint, and I realize that is the same relationship I had with my eating disorder (ED). Anorexia preyed on my vulnerable predisposition to pleasing others. It swooped in and made me believe that if I obeyed it, I would become worthy and lovable. I wanted to appease it - I wanted to change my body so that it would be acceptable, and then I would earn the reward of happiness, although this is completely false. This exemplifies how ED misleads you. I wanted to be the perfect friend. I felt that I could not contradict or say the wrong thing. I wanted to be seen as perfect because I was afraid that if I was seen as flawed, then I would be rejected. This was not true - I was and am loved with all my flaws, but perfectionism runs deep. I felt that the rejection was the worst possible thing because I would have nothing anymore since I did not have love for myself or acceptance by myself for myself. I needed to love myself and believe in myself. I had to learn how to do this. The process has been long, but I have begun to see that I am in fact valuable, worthy, loved, and lovable. I no longer need anorexia and its elusive, paradoxical promise to make me valuable through my own self-destruction.


Making the Invisible Visible: Why I wish everyone was watching Feed instead of To the Bone

posted Aug 16, 2017, 2:28 PM by Erica Johnstone   [ updated Aug 16, 2017, 2:30 PM ]

Films depicting mental illnesses are not new, but films with a particular focus on anorexia are rare. This summer two feature films have been released: To the Bone and Feed. Netflix’s To the Bone focuses on the protagonist’s experience in an eating disorder treatment center. Both the star Lily Collins and the writer/director personally experienced eating disorders. Feed is written and produced by Troian Bellisario of Pretty Little Liars. Bellisario’s film is somewhat auto-biographical in the sense that she has struggled with anorexia herself. I appreciate both films bringing much needed attention to eating disorders and anorexia in particular, which is the most deadly psychiatric illness. There is little dialogue about eating disorders and a great deal of misinformation. Having developed and been in recovery from anorexia for many years, I feel that the most dangerous message in the media about anorexia is that it is a choice and that it stems from vanity. I was delighted that both films demonstrate that wanting to look thin is not the driver behind anorexia. In both films, the protagonists are suffering emotionally and seeking a way to cope. This is key: Eating disorders are coping mechanisms, a way to deal with painful feelings, anxiety, self-hate, and a sense of unworthiness.


To the Bone presents a young woman already in the midst of her eating disorder. My main criticism of the film is that it could have gone deeper and done more to demystify anorexia. It did not capture the actual inner experience of living with anorexia, while Feed excelled in this area. It glamorized the disorder by depicting a romantic relationship while in treatment, which felt very unrealistic. I also found the film to be more triggering than Feed, which detracted from its educational value.


Feed illustrates the onset of anorexia triggered by the tragic death of the protagonist’s twin brother Matt. It is in a sense a horror film, as Matt reappears to the protagonist Olivia and transforms into the haunting voice of anorexia. Ironically while Feed contains surreal elements, I found it to be more realistic than To the Bone. When living with an eating disorder, you experience a voice in your head that becomes a dictator, often demanding that you not eat and that you exercise obsessively and that you achieve perfection. Using the brother’s ghost as this voice provided a great illustration to those in the audience who do not know what living with anorexia is like. It demonstrates how the voice of ED controls your every move and never allows you to be at peace. The voice screams at you and demeans you, as Matt does in this film.


Particular phrases stood out to me. Matt screams at Olivia, “You are nothing without me.” This provides a realistic depiction of the ED voice, which makes you believe that you are nothing without it. It also makes you believe that you are at fault and are a failure, which Matt communicates to Olivia in the film. He makes her feel that his death was her fault. The ED voice continually tells you that you are undeserving, bad, and worthless. Matt is nearly constant in Olivia’s life as the film progresses, which parallels the ED voice in reality, as it becomes louder and louder the more that the disorder has progressed. In the film, Olivia is terrified hearing her brother’s voice, and this accurately portrays the reality of living with the ED voice. It is terrifying, and it feels that you have no choice but to obey. It also served to paint the a picture of the misery it produces. I appreciated how the film did not romanticize anorexia in any way. It showed the true horror it inflicts.


The film did not focus on body image or weight. There were no scenes of Olivia being weighed as opposed to the multiple weigh-ins featured in To the Bone. I valued this omission because it again reinforced that anorexia is not driven by a desire to look a certain way. I also feel that seeing weigh-ins can be triggering for viewers with an eating disorder history. Weight loss is not the primary goal but rather a form of self-destruction. Restricting food serves as the means to the end of self-deprivation and punishment, as we see in the film. Olivia is taunted and punished by her brother and feels she must feed him while depriving herself. Depicting the anorexia as her dead brother may seem far-fetched, but it captures the love-hate relationship someone feels toward her eating disorder. You feel that you cannot live without it. It is the way that you cope in the world. It is how you survive, and yet it is trying to kill you. In the film, as Olivia realizes she could die from this, she asks her brother if she will, and he does not answer. Again, this mimics the ED voice, which will in fact push you to the point of death.


I found the end of Feed very powerful. We see Olivia recognize that her brother, code the ED voice, is not real and does not have her interest in mind. She has made incredible progress in recognizing this; however, the demon is not gone. As she goes out to lunch, she orders a small meal, and as she stares at her food, her brother, or the ED voice, reappears, and she is terrified. This is incredibly poignant and telling because anorexia does not just go away. It is not something that is easily cured and eliminated. For most people, the thoughts linger, and recovery is an incredibly long process. It is a journey, as Bellisario explained in discussing the film and her experience with anorexia. It is a process, and one that is incredibly dangerous and challenging. Watching this film, I thought to myself, “Wow, Bellisario really gets it.” And that is true because she has lived it. We do not usually get to experience our innermost demons portrayed accurately on a big screen, but this film goes a long way to debunking the stereotypes of anorexia and portraying the true horror that it invokes.


17 Years Counting Calories is Enough

posted Aug 8, 2017, 9:03 PM by Tyler Johnstone   [ updated Aug 9, 2017, 4:17 PM by Erica Johnstone ]

8/1/2017

I just turned 30, and I have counted calories for over half of my life, as far back as I can remember. I developed anorexia at age 12, and by 13 I knew the calorie counts of nearly everything I ate, and if I didn’t, I didn’t eat it or I calculated all the components, erring on the side of overvaluing them. In the past few months, I have accomplished a major victory over my anorexia: I have not been counting calories. I never thought this would happen. After years and years of inculcating my mind with calorie counts and the idea of an acceptable daily total that could not be surpassed under any circumstance, I was resigned to the fact that this would be part of my life forever. I have been at a healthy weight for the past few years and in solid recovery for the past 6 years, but I still counted calories, agonized over parties with dessert that did not fit into my daily calculation, and exercised on a rigid schedule six days per week. I was, as everyone else would tell me, “so disciplined.” Let me tell you, this disciplined rigidity is not something to aspire to. It is not inspirational or motivating. It sucks the energy, joy, and spontaneity out of your life. It is more akin to living under an internal dictatorship. You cannot disobey. You complete all reps, limit calories, calculate for the day ahead and the next day and the day after that. You must develop a plan every time a workout is 1 minute too short. You must eliminate something to compensate for this failure. And that is what it really is about - a sense of failure and unworthiness. You must drive yourself to the ground and deprive yourself so that you can earn the happiness in your life.

I felt that I would always be partially or mostly recovered. I would be healthy enough, and I would manage well enough, ironically feeling that I was never good enough. I was inordinately happier than I had ever been, so I would settle for that. I am married to an incredibly loving, supportive husband who brings me enormous joy. I am completing my master’s in counseling and will be starting work in an eating disorder treatment center in the coming months. However, I knew that a part of me wanted more freedom from my eating disordered thoughts, and yet another part, the eating disordered one, was scared, telling me “No, don’t go farther. Look what you have already done, how big you have gotten.” It was an eternal battle I would fight forever.

During my last period of restriction, last March, my dietitian had me write down the pros and cons of restricting. I had done this before, but this time it was very impactful. Prior to it, I thought there were more pros than cons because in the moment restricting made me feel better. It made me feel like I had earned the right to live because I had successfully deprived myself. And yet there were so many cons: I was not free, I felt bad for those I was disappointing around me, I had less energy, I was hungry and exhausted from calculating and calculating day after day. I wanted to be truly free. I also knew that I was entering the field as a clinician soon, and I needed to be fully recovered to do so. I wanted to be able to have a baby and be a healthy role model. As I started experimenting with intuitive eating after many previous attempts, I finally got some satisfaction from the freedom, from defying the ED voice. Before I had always thought of how hard recovery from anorexia is because you feel partially bad about it all the time. It seems different from recovery from drugs or alcohol where you can feel accomplished for each day sober. With anorexia, a part of you feels horrible because of what you are doing. The eating disorder tells you that you are disgusting and indulgent, and it makes you think you will never be able to tolerate, much less accept, the body you are growing into.

However, I started to think I could be ok with it. I could be ok with this body because it is going to be what it is going to be. I think the biggest contributor has been a subtle shift in trusting my body. Though I have been told that my body will figure out what food it needs, it is incredibly terrifying to believe that, as someone who has feared her body, and particularly changes in it, for her whole life. I was scared that I would never stop eating and never stop growing. However, I am learning that my body tells me when it is full. It tells me what it wants to eat. It does not want to eat endlessly. It also does not want dessert all the time. It craves many different foods. It is not against me. It is me. Making peace with this is so incredibly relieving. It is a sense of freedom, a great weight off your shoulders. It is strange to be 30 years old, to be what I consider now a “real” adult chronologically, and yet I am relearning the most basic of all skills that babies learn. I am learning how to eat again. As challenging as it may be, the taste of freedom is worth it.

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