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Inside the Mind of an Anorexic

Exposing Anorexia from the Inside Out

"I am no bird; and no net ensnares me: I am a free human being with an independent will" —Jane Eyre by Charlotte Brontë

'Okay, so if one Weetabix is 75 calories, along with 20 extra calories from the 50ml of almond milk, that means I am allowed a skinny, sugar-free cappuccino when I get into uni, which is probably under 100 calories so if I add 200 onto my morning total, just to be safe, that will be 300 calories overall...'.

This was the relentless inner monologue that dominated my first two years at university. At this point, despite the constant calorie counting, and the fact that I was bordering on skeletal, I did not realize that I was ill.

I have been affected by an eating disorder for nearly three years and only recently accepted it. It is still odd to see it written down. This is my attempt to expose anorexia from the inside out; to allow outsiders a first-hand look at a condition sustained by secrecy and for me to come to a deeper understanding of my own disorder.

Eating disorders come in various shapes and sizes. Each one is complex and unique, arising from an infinite number of triggers, meaning that it is impossible to group them into definitive categories. However, many sufferers demonstrate similar behavioural patterns in regard to their eating habits, allowing for the easy (if inaccurate) categorisation of certain disorders. The two that are most commonly diagnosed are bulimia and anorexia. Bulimia, originating from the Greek boulimia, meaning 'ravenous hunger,' is the consumption of vast amounts of food followed by periods of fasting or self-induced vomiting in order to 'purge' the body, and therefore remain thin.

Anorexia, ['An': without, 'orexis':appetite] is the deliberate restriction of food in order to keep body weight low, resulting in starvation and ultimately, at worst, death.

My disorder most closely resembles anorexia.

Growing up, weight gain was never an issue for me, if anything I was too small, the runt of the family. This does not mean that I did not regularly conquer second helpings of dessert, or multiple bowls of sugary cereal as an after-school snack—I liked my food and considered my ability to put away large quantities of it quite a talent. Always having been a cross-country runner, I was skinny and sporty, so I never gave my weight much thought. Not once did I suspect that I would fall victim to an eating disorder.

There are several factors that stand out to me as potential catalysts for the disorder, many of which I believe are linked to the upheaval of moving away from my family home for the first time. Prior to university, my knowledge of the nutritional value of food was not exactly extensive. I knew the basics about what is considered healthy and what is not, but not being particularly scientifically minded I didn't care about the breakdown of certain proteins or carbohydrates and their effects once they have entered the body. I was aware of the fact that I ate a healthy diet, and I don't remember calories or the occasional bowl of ice cream ever seeming remotely a bad thing to me. Once hitting puberty I filled out a little, but was still considered petite. My teenage years were unaffected, I remained a stable eight stone whenever I weighed myself, which was not often.

In 2013 I started university. This meant being around others 24/7, and thus learning the living habits of a new group of people. I was exposed to a whole new world of calories, carb controlling and comparison.

My first few months at uni were happy and carefree. After the initial nerves and awkward introductions, I enjoyed newly discovered independence. This included the freedom to go out clubbing (i.e. drinking), and the tendency to cook whatever required the least effort (regardless of nutrition). The 'fresher's fifteen' has become something of a rite of passage for new university students, relating to the fifteen pounds supposedly gained by freshers in their first few months away from home. Whilst I didn't gain quite that much, I did discover that I was not, as I had always presumptuously assumed, immune to weight gain. I learned the hard way that too much alcohol and not enough vegetables means tighter jeans and spottier skin. I had always been defined as the small one, so who was I if not the thinnest, lost amongst all these people?

As to be expected, the ups and downs of university also saw me experience my first real heart-break. Although the feminist within me is loath to admit that a boy could be a contributing factor to a potentially life-threatening mental illness, it is no coincidence that the disorder reared its head in correlation with a distrustful relationship, which evidently brought out some deep-rooted confidence issues. I would hate to pin the blame for this disorder onto someone, especially as the person in question was sensitive and supportive in his own way. However, it is too glaring to overlook the control issues that arose from lack of trust. Being fairly naïve in the world of relationships, I was devastated when it turned out he had been seeing other people as well as me. Of course, he apologised and groveled suitably, and I forgave him and we went on to stay together for nearly two years (before a repeat performance), but it was to the detriment of my self-confidence. I found myself feeling inferior to other girls, making endless comparisons. If I was smaller than them, I was better, different. I could not control what he was out doing with them, but I could control the way I looked, by regulating what was on my plate. Although I did not realise it at the time, I believe that this is what I was sub-consciously doing.

Eating disorders are ultimately based upon control: the sufferer rigidly controls what they eat, often through lack of ability to regulate other aspects of their life. I have always been fairly neurotic. My mother tells me how I used to worry obsessively over minor things as a child. I remember laying the dining table, making sure the mats were exactly in line, the knives and forks precisely straight. Individuals with anorexia often display similar obsessive behavioural patterns from birth, such as perfectionism, anxiety, and neuroticism. 

Recent dieting crazes such as 'clean eating', whereby participants consume only non-refined, minimally processed foods, or the 'Raw Food Diet' (eating only raw foods in order to avoid anything that might have been artificially tampered with) reflect and fuel the obsessive nature of eating disorders. The increasing popularity of these diets is dangerous, often prompting an unhealthy preoccupation with food. The dieter can become petrified of consuming anything that they consider to be 'unclean,' which results in the list of foods they allow themselves to eat becoming increasingly small. The rise in recent years of social media applications such as Instagram and Facebook has contributed to the wide-spread knowledge of dieting trends. People post pictures of their food, their bodies and their exercise regimes with labels such as 'thinspiration' or 'eat clean' in order to smugly show off their healthy diet, or their 'perfect' body. This (sub-consciously) has the potential to make the viewer feel inferior about his or her own meal choices.

It is easy to scroll through Instagram and pick up any number of unverified nutritional 'tips'—which can be incredibly damaging for a sufferer. I remember eliminating yogurt and milk from my diet, after someone's nonchalant comment that dairy may cause acne. This demonstrates the vulnerability of those who suffer with disorders, and how quickly a simple diet can turn into an obsession.

Each of these factors, and probably many more, prompted the beginning of what I called a 'lifestyle change.' I wanted to be 'healthier' [i.e. thinner] and so decided to fully commit myself to fruit and veg. The latest trend was eating 1,200 calories per day to achieve sustainable weight loss. I decided to see if it worked.

It's hard to remember when my 'lifestyle change' morphed into a full blown eating disorder. My warped logic was that by embarking upon the diet I had slowed down my metabolism and so if I strayed from it, my body would cling onto the fat and I'd gain lots of weight quickly.

I recall the slowly decreasing list of foods that I would allow myself to eat. Breakfast was one Weetabix with skimmed milk. Lunch was two Ryveta topped with tomato and spinach and (if I was feeling decadent) a smear of pesto. Dinner was eventually reduced to blended up vegetables with stock— what I disguised as 'soup' but what was in reality just liquid broccoli (mmm). Carbohydrates became a scary enemy. A fat free yogurt became an exciting indulgence. I began to feel incredibly anxious about eating food that was out of my control. Everything started turning topsy turvy. I began to resent things that I had previously enjoyed—I saw my mother's home-made apple crumble (a much-loved treat) as her ploy to make me fat. Going out to restaurants became particularly stressful.

For the regular person, dining out at a restaurant usually signifies a celebration of some sort: an occasion on which to indulge and enjoy. For the ED sufferer, however, eating establishments represent a complete lack of control, a source of stress to be avoided, unless absolutely necessary. The prospect of a meal out includes a number of pre-emptive tasks...

The inevitable arrives. It's Dad's birthday, and so the family is marking the occasion with dinner at Pizza Express—a choice I subtly suggested, as I know the calorie content is displayed next to each option on the menu [first task complete].

The day leading up to the meal consists of further restriction than usual, in order to compensate for the calories I will have to consume at dinner. I instead find myself filling up on Diet Coke and squash in between a (hardly fast breaking) breakfast of a singular Weetabix and a lunch consisting of two Ryvita.

The day wears on, complete with multiple online checks of the nutritional information of the menu— despite the calorie content being displayed in the restaurant, I still want to make absolutely sure of my options, in order to avoid unnecessary dithering when everyone else has ordered, whilst trying to do the math in my head [second task complete].

We arrive at the restaurant and sit down to order. Food is reduced to numbers. A quick scan down the side of the menu determines which meals are 'safe' [under 500 calories] and rules out ¾ of the options, before I even see what they are. I don't bother approaching the pizzas because I know they'll all be too high in calories. I order a salad from the 'lower calorie' section that will leave me satisfyingly hungry.

Dining out was bearable if I felt 'ready' or 'deserving' of the indulgence. If I had restricted enough in the weeks leading up to the event (eaten nothing but 'clean' foods consisting largely of just vegetables and eggs) then it became a lot easier to work towards it, without feeling too panicked. Sometimes I was even excited by the prospect, telling myself I would have a dessert, properly indulge, but the reality was always too difficult. When it came to actually choosing, all I could think of were the consequences of all that sugar and cream in the cheesecake, or all of the carbs and fat in the cheesy pasta. Instead of bread I saw tomorrow's puffy face, instead of ice cream I saw next week's spots, instead of birthday cake I saw the fat arms of the future. Until recently, when eating out I only felt comfortable enough to order salad or soup (provided it was non-creamy). They both left me with a residual hungry feeling after being consumed, so I knew that I could not have over eaten.

The reality is that I restricted myself during the day in order to compensate for the imagined prospect of an evening's indulgence that never actually came to be, because I always ordered the option lowest in calories. Therefore I came away believing that I had indulged because I had dined out, but had actually possibly had a lower calorie intake than a normal day.

Skip forward two years after the trip to Pizza Express to a recent 21st birthday meal for a friend.

Although I was (and am) in a much healthier mindset after having made a lot of progress towards recovery, I was still very aware of the fact that this meal was something out of my ordinary routine, an event that would probably be topped off with birthday cake and alcohol. As the occasion was soon after the Easter holidays, I felt that I had gained a little weight after a few weeks of home cooked meals and spontaneous Easter eggs. I was okay with this, even pleased to finally have surpassed 45 kilograms on the scales (at which I usually plateaued). However, I knew that the restaurant would be a challenge; this time I was on my own, no family watching over me. As much as my friends know and care about my struggles, they are much less in a position to tell me what to eat than my mum. This time, I decided, would be for myself and not to please scrutinising eyes: I would get what I wanted and I would enjoy every last bite, for me.

Easily said.

We sat down in the restaurant and ordered drinks first. I admittedly slipped up here: the words 'slimline tonic' were out of my mouth before I realised, accompanied by the same feeling of slight embarrassment present when I order a 'skinny, sugar-free, please-don't-judge-me-for-being-fussy' cappuccino. I avoided eye contact with my friends.

Next came the real challenge: ordering the main and attempting to discern what I actually wanted in under three hours—being anorexic as well as incredibly indecisive is time consuming.

My eyes automatically fall on the section entitled 'salads.'

'Mmm, I love butternut squash', I say, justifying my choice of salad, by pretending that it is the squash appealing to me rather than the lack of carbohydrates.

This time, however, I really look at the salad: 'roasted squash, red peppers, bulgar wheat, quinoa, edamame beans...'.

I realise I don't even know what bulgar wheat is, and I'm pretty sure quinoa is some kind of chewy, brown grain.

I turn tentatively to the main menu and survey the options. First on the list: 'Steak burger, toasted bun, Russian dressing & chips'. The carbohydrate heavy chips along with the bun make me feel immediately uneasy—perhaps another day.

I move on: 'Baked salmon en croûte' sounds safe enough to challenge myself with. That is until I realise it is wrapped in pastry. On one hand, I know I would enjoy the pastry, as much as I know that I love chips and would love to be able to eat a burger. However, on the other (unfortunately stronger) hand are the negative connotations that are attached to certain food groups in my mind, and which force me to skip those two options. It's as if there is a constant tug-o-war going on inside my head between that which I want to have and that which my anorexic mind deems as 'safe' to eat.

I next arrive at 'chickpea, carrot and turnip biryani, lemongrass and coconut sauce, griddled flat-bread'— that sounds nice! The flat-bread will come separately, so I can leave that if I feel it is too much; the curry alone will still present a challenge and an achievement if I can bring myself to order it.

The pressure mounts as the waitress moves around the table. My eyes dart up and down the menu; I am changing my mind a thousand times per minute. Once I have ordered there is no going back. I could still get the salad.

My friend clocks my dithering from across the table, and gives me a reassuring look. She knows the struggle that restaurants represent for me. Her simple understanding brings me back to reality: I am being ridiculous, it is one meal. I want the delicious curry.

I'm sure the salad would be tasty, but I realise that I am not choosing it for the right reasons.

'I'll have the biryani, please,' I say to the waitress, after one final pause. My friend beams at me from across the table, showing her pride. I beam right back.

One of the things that most baffles me is that I genuinely did not crave the foods that I perceived to be unhealthy. I could no longer think of a pizza solely in terms of taste: all it was to me was a number (and a whole lot of fat). The lower the number, the more desirable the food became. If the nutritional content of the meal met my criteria, I could fully enjoy what was on my plate, without feeling as though it would make any difference to my weight. The numbers meant that in my mind I was fully in control of my size, despite the fact that I was obviously spiralling in the opposite direction.

This is where it becomes clear that eating disorders are not simply 'strict diets'. There have been numerous studies to show that anorexia can actually change neurological pathways, shaping and altering the mind of the sufferer. Whilst someone trying to avoid 'junk food' as part of a healthy lifestyle might crave the pizza (and allow themselves to enjoy it in the knowledge that one pizza will not make any long term difference), an E.D sufferer will actively crave the lower calorie options: the pizza becomes repulsive.

It came to be that my weight loss was, ironically, the elephant in the room.

The illness isolated me from my family. I became uptight and closed off when the subject of my weight came up. I had attempted to reassure my parents, time and time again that I did not have a problem, that I was simply exercising more and forgetting to make up for it with extra calories. I made empty promises that I would eat more and really try to put on weight. However, each time I returned to university and returned to restricting. It had a rippling effect throughout the household, causing unnecessary arguments. One particular instance sticks out in my mind, now jokingly referred to in our household as 'Mashed Potato Gate'. . .

It was the Christmas holidays, and I had returned home from uni. At this point my weight loss was somewhat of a taboo subject, no one had openly acknowledged the problem.

One evening, I was standing against the kitchen radiator, idly chatting to my mum as she cooked dinner. At least, outwardly it was idle, but that was just my guise; in reality I was keeping an eye on what she was cooking. I clocked each added ingredient, with slowly building panic at the amount of calories all that milk (in reality just a dash) would add to the mashed potato. The irrepressible, judgemental 'E.D' voice always pipes up when watching other people cook, usually sounding something like:

"Is it really necessary to pour all that oil into the stir fry pan?" ~ "Do those scrambled eggs really need all that milk?" ~ "Does that salmon absolutely have to be smothered in oily, fatty pesto?" ~ "Surely that will be far too much rice for just four of us?"

On this particular occasion I felt my chest tighten, as I saw the dollop of butter being added into the potatoes. It was a struggle just eating plain potatoes when at home; now I was hyper aware that all that carbohydrate would be supplemented with (what appeared to me) colossal amounts of unnecessary fat. I could not repress my horror.

"Mum, does it really need all that butter?" I burst out, with poorly concealed panic in my voice.

My mother looked up, startled at my tone.

"What's wrong with butter?" she replied, slightly hurt by my snippy comment, but also fully aware of what my problem with butter was.

'I just don't really think it's necessary Mum, it's so unhealthy. I don't like it, it makes the potato all greasy.’

My mother looked at me. We both knew what the real, unspoken, issue was.

"Kate, you say you don't have a problem," she began, losing patience, "but if you can't cope with a bit of butter...this has to stop!"

"You're the one always trying to lose weight, you're never going to if you keep eating like that!" I shoot back, storming out of the kitchen.

This was not me speaking, it was the eating disorder. I am not proud of how horrible I was to my mum, of what a brat I turned into. This episode is just one example of many similar fights and demonstrates how the obsession with food turns the sufferer against everyone around them.

I am grateful now that we can look back and laugh at how ridiculously I behaved—a 21 year old throwing a tantrum over some mashed potato.

As the word 'anorexia,' quite literally meaning 'without appetite,' would suggest, many people mistakenly believe the disorder to be defined by a simple disinterest in food. In fact the exact opposite is true: eating disorders are an obsession with food, and an addiction to ravenous hunger.

Food takes on a deeper psychological significance to the sufferer: it is at once a source of joy, sadness, fear, despair, satisfaction and ultimately control. The food that the sufferer believes they are so rigidly controlling paradoxically ends up controlling them.

The meticulous planning and careful preparation of a 'safe' meal to be consumed at exactly the right time in the perfect environment [so that it can be enjoyed to its full extent] comes to be a source of comfort for the sufferer. This again derives from the need to be in complete control of the meal, knowing its exact components and therefore feeling deserving of it.

However, this preoccupation with meal preparation becomes exhausting. In the library, in bed at night, even when holding a conversation, in the back of the sufferer's mind will be the constant planning of the next meal: the worrying about what they can have, what they want, changing their mind a thousand times. The obsession becomes, ironically, all-consuming.

I felt utterly hopeless and trapped: constantly faint, unable to concentrate, always tired, but never managing a full night's sleep. My extra small running lycras were baggy. It hurt to sit on plastic seating because my spine stuck out so much. My hands were constantly painfully cold.

I felt bad when I ate and bad when I did not. Yet I was incapable of telling anyone because vocalising it would make the disorder real. If I told people, they would force me to eat, force me to get fat: the matter would be out of my control. They would know that all my little excuses—"I already ate" ~ "I don't feel well" - were just alibis to sustain my disorder.

It did not occur to me that they already knew.

I could no longer go on without help. I rang my sister. At first I found it hard to say anything at all. When I did try to talk my throat constricted, my eyes teared up. Admitting to the disorder was an irreversible step to take.

Eventually, I managed to articulate myself.

'I think I have a problem with food,' I said, my stomach tightening.

Once I had started talking, it became easier to carry on. I poured out all of my feelings of helplessness, isolation and terror. Vocalising my problems made me realise that I could tell people, they could help me: I was not alone.

"Oh Kate," she replied, the mixture of sadness and relief evident in her voice, "I know."

Telling my sister, under strict instructions that she relay nothing our mother, was the first step towards recovery and the best decision I could have made. She encouraged me every day with texts and phone calls, and was there to support me when I finally decided to tell the rest of the family. I believe that if I did not have such a caring support system the disorder could have gone a very different, more sinister way.

Is full recovery from an eating disorder possible? That is a question I do not have the answer to.

Many believe that once a person has suffered anorexia, they will never regain a healthy relationship with food; I know that I will never be able go back to being blissfully unaware of the calorie content of a banana. My perceptions of food have definitely been altered irreversibly.

I am also aware that I am still in recovery—I have good days and bad days. I often over think food choices, especially if calorie content is displayed; I still struggle if I am at a restaurant or being cooked for. However, I am aware now that the fear that grips me at the thought of eating cheesy mashed potato is not me—it is irrational, destructive, and unhealthy. If I am having a particularly stressful day sometimes I do find myself relying on calorie counting, returning to that familiar feeling of yawning emptiness in my stomach. The difference now is that I will eat something and my day will get a whole lot better: blood sugar levels make a colossal difference to mood.

What I believed to be healthy was almost irreversibly harming my body. If I have negative thoughts I try to talk about them, in order to expose them. This allows me to view the eating disorder from an outside perspective, which makes the crippling fear I used to feel of eating two Weetabix with a banana (double carbs!) look vaguely ridiculous.

It is difficult to break rules so strictly and rigidly adhered to for such a long time—such as not ordering 'skinny' milk in my coffee, or not meticulously weighing out a half portion of rice for dinner. But with each rule broken, the next becomes a little easier.

Running has become enjoyable again, and I have greatly improved, as a result of fueling up properly. Despite over-exercise being a common feature of eating disorders, athletics was the one thing that remained separate for me. It is my safety net—a no fail remedy to life's ills. If ever I am having a bad day, or feel as if I am going to relapse, I just remind myself: 'eating well = running well.'

I know now that my worth as a person does not correlate to my shape. I certainly would not judge a person's character on their weight, so why do I think people would judge me?

A disorder that has shaped three years of my life, controlling my decisions and relationships, is never going to disappear. I have changed and learnt a lot during this period. Hopefully I will be able to use my experience to help others who are in a similar situation.

Many people will write off a sufferer as completely recovered, as soon as they are physically healthy again. This is wrong: anorexia is far more a mental disease than a physical one. Someone might appear to be completely healthy, but still be engaging in damaging thoughts, which can be incredibly draining. If I could offer one piece of advice to anyone who is suffering in any way from obsessive eating patterns it would be to talk about it. Unmask the disorder for what it is: destructive, deceptive and unhealthy.

Recovery is a long and slow process—I know I am not through it yet.

I am, however, a lot stronger, healthier, and overall happier than I was at this time last year, simply as a result of recognizing this disorder and learning to free myself from it.

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