Updated: May 3
First and foremost, no one expects anyone to know everything and we all have to start somewhere. But there is huge strength and courage in recognizing a need to further educate ourselves on mental health issues that we just simply don't understand. I'm going to try my best to explain what it's like living with an eating disorder, recovered or not, and how others can better understand it from an outsider's perspective.
When people often think of eating disorder's the first thing that pops into their heads is Anorexia, and then the secondary thought of 'Oh wait, no, there's Bulimia too.' But, alas, there are far more than just these two eating disorder's and Anorexia Nervosa is actually the least common eating disorder of them all. Other EDs include Binge Eating Disorder, Diabulimia (restricting insulin levels as a means of weight control for Type 1 Diabetics), Orthorexia, Rumination Disorder, PICA, OSFED and I'm sure there are more. And it's not just about food.
Eating disorders cannot and should never be categorized on a binary scale. Every person who suffers experiences it differently and although the DSM tries it's absolute hardest, the mental health experience of an eating disorder has very little to do with BMIs and weight. They are widely considered, and I personally agree, to be compulsive and unhealthy coping mechanisms. Controlling intake, losing weight, eating compulsively and endorsing diets, sugary foods or weight gain/loss, is a method of numbing underlying mental struggles. For many, feeling overwhelmed and out of control in regards to life and mental health calls for a compulsive way of coping and overriding those feelings. For me, I found it very difficult to hide as a child and often felt humiliated by things I'd say, my behaviors and my weight. These feelings led me to want to lose weight so that I wouldn't stand out as much and this in turn became a compulsive coping mechanism for my low self-esteem.
In my opinion, the relationship between those with eating disorders and those who go on Facebook after a hard day at work is much the same. Let's distract ourselves with an external substance or behaviour that makes us feel better about ourselves, improve our self worth and ultimately, try and hold ourselves together. The difference is, however, that Anorexia, whilst regarded as an illness relating to addiction, has the highest mortality rate of any psychiatric disorder. What makes this more shocking is that the mortality rate doesn't just come from medical complications as a result of the illness, but also from high rates of suicide among those who suffer. Admissions for certain eating disorder treatments are rising by approximately 7% each year. What boils my blood is the fact that in order to access treatment for Anorexia Nervosa under the NHS, one must meet the criteria of having an underweight BMI to be diagnosed. Not only are BMIs incredibly inaccurate at measuring the body mass ratios of people, but the criteria does not take into account other existing medical conditions that may prevent this criteria from being met. For example, I was unable to access treatment due to my under-active thyroid keeping my weight just above that of an underweight BMI. My GP told me that it was near enough impossible for my metabolism to ever allow me to be underweight and therefore, I could not get a referral for my ED.
However, I refuse to discuss this topic more because eating disorders should never be categorized by someone's body mass. You wouldn't refuse a blind person access to support if they were only 30% blind, so why should someone have to wait and strive to waste their bodies away in order to get help? The reason this is so important is that without treatment the mortality rate of eating disorders is up to 20%, but with treatment that falls to 2-3%! Please see Hope Virgo's campaign Dump The Scales and support it if you can - for yourself as well as those with ED's! https://www.change.org/p/eating-disorders-are-not-just-about-weight-dumpthescales
Eating disorders are coping mechanisms. These people are in pain and unable to healthily cope. No one can fully understand eating disorder's unless they experience them themselves and even then, they will only have complete understanding of one account. If you know someone who has or is in recovery from an eating disorder, just ask them what that's like. It takes courage to accept that you just 'don't get it' and that's fine. But I urge you to try an educate yourself and get as close as you possibly can to understanding the mental conflict it causes without being unwell yourself. I also urge those with eating disorder's and mental health struggles to let people start somewhere. We weren't born with omniscient knowledge so allow people to be ignorant and then to learn. Take it upon yourselves to educate those around you if you are able to do so. Mental health conversations are one of the most underrated past times so indulge yourself in some healthy activism and education!
For more information please vist BEAT https://www.beateatingdisorders.org.uk/