What My Eating Disorder Won’t Let Me Say: Letter from my Teenage Self

Dear family, friends, healthcare professionals, teachers, and coaches:

          Please be my hope holder. I have eaten food out of trashcans. I have stolen food. I feel horrible, disgusting, and oh so ashamed. I desperately need you to believe in me, because, honestly, sometimes I think that I’m going crazy. My world is spinning out of control, yet, amidst this inner turmoil, I somehow look okay.

          You can’t tell how I’m doing by looking. Sure, I wear a smile, and, my resume seems to indicate that I have a bright future ahead. Physically, I even “look normal,” friends say. I might not appear sick or malnourished, but I am. A body size isn’t an accurate barometer for pain and suffering. Neither is an official eating disorder diagnosis or lack thereof.

          I’m more than a diagnostic label. While 1 in 200 adults in the United States have experienced full-blown anorexia nervosa, bulimia nervosa, or binge eating disorder, at least 1 in 20 (1 in 10 teen girls) have suffered with key symptoms—and need help. Not every eating disorder fits neatly into a little diagnostic package. Lesser-known eating disorders are not less than. In fact, Other Specified Feeding or Eating Disorder, OSFED, can be just as serious, or more so, than other eating disorders. No matter what diagnostic code my insurance company denotes by my name, I deserve recovery. (Sometimes, I need you to remind me of this.)

          Recovery feels backward. Imagine trying to do everything with your non-dominant hand. If you are right-handed, write with your left hand. This is how uncomfortable, how unnatural, recovery feels. As strange as it may sound, bingeing, purging, and restricting have helped me to navigate life. Eating disorders serve all kinds of purposes, including coping with anxiety, avoiding underlying depression, and pushing down past traumas. In this way, an eating disorder isn’t about food at all. Paradoxically, to heal, food is the best medicine.

          I can’t “just eat.” This is why I need help from experts. Something as seemingly simple and biologically driven as fueling my body (babies do it) feels impossible. I can’t just eat any more than a cancer patient can magically make dangerous cells just disappear. An eating disorder, like cancer, is a life-threatening illness that requires immediate attention.

          I might refuse help. I don’t want to be a burden. I feel guilty for spending money on treatment. Not to mention, I don’t believe that I am sick enough to deserve help. (Remember how I said that I’d need you to remind me that I am indeed deserving.) If my eating disorder were just a phase that I could stop, I would have by now. I don’t like to admit it, but I am still just a kid. I am a kid with a starving brain, one that can easily lose sight of this whole recovery thing

          Full recovery is possible. Apparently, I wasn’t born with an eating disorder but rather traits that made me vulnerable. I am learning that these traits, like perfectionism and persistence, aren’t inherently bad, but that I can use them for good. Being perfectionistic means that I am motivated and driven. What if I could use these beautiful traits in the service of recovery—and life—rather than my eating disorder?

          Recovery can bring us closer together. We hear a lot about how eating disorders tear relationships apart, but we don’t hear enough about how recovery can bring people together. You didn’t cause my eating disorder, but you can do a lot to help me get better.

          It’s not your fault. Nothing you did—or didn’t do—caused my eating disorder. Fifty to 80 percent of eating disorder risk is genetic and heritable. Add this stat to a culture that celebrates eating disordered behaviors (think dieting and over-exercising), and it’s no wonder I developed the illness— and that it hid for so long, from all of us. I’ve actually received compliments for having the psychiatric illness with the highest mortality rate, praise for killing myself. It’s all very confusing.

          You don’t have to understand. What my eating disorder drives me to do and say is hard for even me to grasp. What I need from you are love and support. I need you to believe me. If I say that I hate my body, I need for you to truly listen rather than reassure me over and over again. (You have probably noticed that doesn’t work.) Consider saying something like, “I believe you. I don’t understand what that’s like, but I’m here for you.” When in doubt, ask, “How can I support you?” Please keep this dialog open, because starting the conversation myself feels scary.

          Have patience with me. I might yell at you. Even if you say something inspired and helpful, something that I asked you to say, I might get upset. I’m more irritable than ever. This isn’t about you. I’m mad at myself. I’m mad at my eating disorder, which I am learning, in therapy, to personify as “Ed.” Much of the time, I can’t tell the difference between my thoughts and Ed’s. It might help for you to try this therapeutic technique, too: separate me, the person you love, from the eating disorder—the one who yells and pushes you away.

          I need you. Ed doesn’t like me to need people. This is similar to how, at times, he tells me that I don’t need food. At other times, I binge and purge people just like I do with food. But, beneath Ed’s lies, I do need you. I thank you.

          Beneath my eating disorder, I’m still here. Sometimes, you might think that the person you used to know—the “real me”—is gone. But, I haven’t gone anywhere. I am more than my illness, and I am learning more about who I am every day. No one would choose to have an eating disorder, but I am beginning to see the gifts of recovery emerge. Finding my voice is one.

Love,
Me
P.S. Many years later, as an adult, I can finally say: full recovery is possible!

A Senior Fellow with The Meadows and advocate for its specialty eating disorders program, The Meadows Ranch, Jenni Schaefer is a bestselling author and sought-after speaker. 

Special Note from Jenni: I would like to thank my incredible community on Facebook, Twitter, and Instagram for providing key insights for this article. This post would not exist without all of your heartfelt comments. I am forever grateful for your support.

References:

K. L. Klump, J. L. Suisman, S. A. Burt, M. McGue, and W. G. Iacono, “Genetic and Environmental Influences on Disordered Eating: An Adoption Study,” Journal of Abnormal Psychology, 118 (2009): 797–805.

K.T. Eddy, N. Tabri, J.J. Thomas, H.B. Murray, A. Keshaviah, E. Hastings, K. Edkins, M. Krishna, D.B. Herzog, P. Keel, D.L. Franko, “Recovery From Anorexia Nervosa and Bulimia Nervosa at 22-Year Follow-Up,” Journal of Clinical Psychiatry, 2017 Feb; 78(2): 184-189.

J. J. Thomas, L. R. Vartanian, and K. D. Brownell, “The Relationship between Eating Disorder Not Otherwise Specified (EDNOS) and Officially Recognized Eating Disorders: Meta-analysis and Implications for DSM.” Psychological Bulletin, 135 (3) (2009): 407–33.

J. Thomas and J. Schaefer, Almost Anorexic: Is My (of My Loved One’s) Relationship with Food a Problem? (Center City, MN: Hazelden 2013, 2013).

M. Strober, R. Freeman, C. Lampert, J. Diamond, and W. Kaye, “Controlled Family Study of Anorexia Nervosa and Bulimia Nervosa: Evidence of Shared Liability and Transmission of Partial Syndromes,” American Journal of Psychiatry, 157 (2000): 393–401.

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Helping Your Teenager Avoid Fad Diets and Improve Her Relationship with Food

Every week there seems to be a new fad diet, claiming to be the latest and greatest method to “lose weight, and lose it fast!” Low carb, high fat, no fat, only plant-based foods, Vegan, Keto, Atkins, Whole 30, Paleo – the list is endless and ever-changing.

The trouble is, dieting in any shape or form can be destructive and potentially triggering, and especially for a teenager who may be susceptible to mental illness or an eating disorder. Fad diets come and go because they are simply not sustainable for the long-term, nor are they a realistic way of living.

Most individuals who attempt a fad diet may see some initial weight loss but often regain the lost weight plus additional pounds as well. This can create a vicious cycle that triggers many consequences, including damages to physical and mental health, low self-esteem, and poor body image. Research has found that 95% of diets fail, and most individuals who diet will regain their lost weight in 1-5 years [1]. Teenagers who diet can be at increased risk for other health-compromising behaviors, including substance abuse, unprotected sex, and smoking.

The Appeal of Dieting Among Teenagers

For teenagers who are becoming more autonomous and independent, dieting can have a luring appeal or something to try, simply because it is trendy and socially acceptable. On the surface level, dieting may seem like an innocent attempt to be “healthier”, but in actuality, dieting can progress into disordered eating or be a precursor for an eating disorder [2]. Dieting also gives a false impression that weight is something that can and should be manipulated, but this is a dangerous mindset, especially for a growing teen.

The concern with weight and shape is also very prevalent during the adolescent years, and teenagers are constantly exposed to an unrealistically thin beauty ideal that is portrayed in the mainstream media [3]. While there may be a variety of reasons for a teenager to be drawn into a fad diet, the desire to achieve a thinner body size and body image dissatisfaction, in general, are motivating factors behind the majority of weight loss attempts [4]. Research on adolescent dieting has found that 41% to 66% of teenage girls and 20% to 31% of teenage boys have attempted weight loss at some time in the past [3].

Teenagers are highly influenced by their friends and peers, though research has shown that adolescents’ communication with parents has a stronger impact on their health and well-being [5].

How to Help Your Teen Avoid Fad Diets

While it may seem impossible to be a voice of reason over the external noise your teenager may be exposed to, the good news is that you are more influential than you may realize. There are many different approaches you can take to help educate your teenager about the dangers of fad dieting and encourage better eating behaviors. Here are some practical ways that you can help your teen avoid fad diets and the associated consequences:

• Keep communication open: It’s important for your teen to feel that they can talk to you, to reinforce the fact that they can always communicate with you about anything. Make consistent and regular time to check in with your teen and ask open-ended questions to prompt conversation. Listen intently and give her uninterrupted time to share with you. This will help build trust and encourage her to speak with you about various things going on in her life.
• Be aware of red flags: If you are talking regularly with your teen, it’s important to be aware of anything that might seem off, in both conversation and in behavior. If you notice her skipping meals, avoiding social events, or disengaging from activities she previously enjoyed, these things should not be ignored. Gently communicate your concerns and try to get to the root of the problem. Remember – dieting is not about food, there is likely an underlying issue that is triggering her urge to lose weight or diet.
• Have regular family meals: With overloaded schedules today, family meals have become more and more scarce. Making this a priority for your family ensure that you are having time to connect on a regular basis. This also allows you the opportunity to observe any behaviors in your teen that may warrant more attention. Just like you would schedule other important activities, make family meals part of your regular calendar.
• Be the example: Teens learn and observe behaviors from their parents and the people they live with. If you teenager observes you or another parent regularly dieting or speaking negatively or your body, this will likely influence her perception of herself as well. If you frequently jump from fad diet to fad diet, feel unhappy in your body, or are actively trying to lose weight, consider how this might impact your teen. Enlist the help of professional support if needed to nurture a more peaceful relationship with food and your body.

Connecting to Help and Support

At The Meadows Ranch, we understand how important the family system is and the necessity for nurturing and supporting relationships. If your teenager is struggling with chronic dieting or an eating disorder, this can be difficult to understand and accept, which may disrupt the overall family dynamic. Know that you are not alone on this journey, and we are here to help your family heal. Recovery from an eating disorder is possible, and families are an integral part of the journey. Connect with us today to find out how we can help.

References:

[1]: Statistics on Weight Discrimination: A Waste of Talent, The Council on Size and Weight Discrimination, Accessed 12 July 2018

[2]: Pathological dieting, precursor to eating disorder, Philadelphia Eating Disorder Examiner, Accessed 12 July 2018

[3]: Dieting in adolescence. (2004). Paediatrics & Child Health, 9(7), 487–491.

[4]: Wertheim, EH, et al. Why do adolescent girls watch their weight? An interview study examining sociocultural pressures to be thin. J Psychosom Res. 1997 Apr; 42(4):345-55.

[5]: Tomé, G., de Matos, M. G., Simões, C., Camacho, I., & AlvesDiniz, J. (2012). How Can Peer Group Influence the Behavior of Adolescents: Explanatory Model. Global Journal of Health Science, 4(2), 26–35.

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Five Warning Signs You Need a Higher Level of Care for Eating Disorder Relapse

Recovering from an eating disorder is a process that involves diligence, perseverance, and the support of people and professionals who know how to best help you. The eating disorder recovery journey is highly individual and will look different from one person to the next. A common experience among women recovering from an eating disorder is a relapse episode, or temporary regression to past eating disorder behaviors.

While eating disorder relapses do not mean that a person has somehow “failed” at recovery, the experience of a relapse could reflect that more help and support is needed along the recovery journey.  Research on eating disorder relapse is limited, but studies have found that risk of relapse may be higher among women with more severe eating disorders [1]. Studies have also found that the rates for relapse are higher in the first 18 months post-treatment [1].

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