Tag Archives: anorexia

How do you choose what to eat?!

TW – Trigger Warning – this post contains discussion about food and anorexic thought processes and may be triggering to people to some people. Please exercise causing if you choose to continue reading.

Many of you will know, I recently fractured my jaw and this has led to a severely restricted diet as I had metal work holding my teeth tightly shut to pull my fragmented mandible into correct alignment. At best during the last 9 weeks I’ve been able to get a teaspoon into my mouth and manage smooth soup, at worst, it’s been smoothies and milkshakes through a straw. Unfortunately, this has led to weight loss and the restriction has triggered some familiar thoughts linked to previous experience of anorexia.

2 days ago, I was given fantastic news, I can now open my mouth fully and I’m able to chew food again! I’ll be having the metal work removed within a few weeks so the end of the ordeal is finally in sight!

The hospital has a Costa and I’d been dreaming of enjoying cake from there for weeks! But…standing in front of the array of cakes I simply could not decide, I realised, I had no idea how to choose! The part of my mind that was looking after my fractured jaw needed to choose something soft and easy to chew (rational wise-mind), the part of my mind controlled by anorexic urges was frantically trying to calculate the calories (automatically) but there was a part of me that simply wanted to choose something I liked!

I’d thought about trying to plan for this moment but I’d not wanted my hopes to be dashed. The recovery of my jaw had not been a smooth road so I thought it was best to protect myself and be prepared for not getting the all clear news.

So, how do I choose?!

I love carrot cake but this one had walnuts in it and I’d been advised to avoid nuts at first. I love chocolate cake but I’d been drinking a lot of chocolate milkshake so I wasn’t too enthusiastic about eating a chocolate cake right now. Some of the cakes looked a little hard for the first thing I was eating (pastry/tiffin/crunchie etc). As I gradually ruled out more and more cakes, the choices were reducing which was helpful…or was I making excuses to avoid calories? As I stood there with the waitress waiting for my order, the pressure was on, anxiety raising in my chest, every fibre in my body wanted to turn and run…

I wanted cake, but at the same time, I didn’t want cake if it was going to be this hard! I wanted to enjoy this experience but it was becoming too stressful!

As I’ve noticed a lapse in symptoms of anorexia, fortunately I’m able to catch myself and make a conscious decision not to go down that route – I really do not want to experience that dark hole ever again! But it’s reminded me of some of the difficulties I thought it would be interesting to write about them so people might understand what it’s like to try and recover from an eating disorder.

I, like most, had a dietitian support me to make changes as I tried to put on weight and break free from anorexia. I was advised to make changes such as increasing portion size and varying the foods I ate. So, for example, I was advised to add a sandwich to the fruit I was eating at lunchtime. Simple enough, right?! But, how do I choose which bread to buy If you’ve not eaten bread for years? Have you seen how many types of bread there are in a supermarket?! Up to this point I‘d chosen food based on calorie content, an anorexic mind then persuades its host that it’s its personal choice to want that specific brand. At my worst, I would visit multiple supermarkets for specific brands of specific foods, it didn’t feel like a choice, it was a compulsion.

Confused in the supermarket

So, trying to recover, standing in the bread aisle:

  • Do I go for the most eye-catching brightly coloured packaging? Sounds weird, but it’s a way of choosing!
  • Do I go for the “moral high ground” and choose organic?
  • Do I want large slices or small slices? Smaller, right? Oh no, hang on, that’s probably a disordered thought… But, why would I go for large slices?!
  • Do I like seeded or granary? Is wholemeal different from wholewheat? How will my gut respond to fibre?
  • Do you want a half loaf, just in case you don’t manage this challenge you don’t want to waste too much? Or should I assume success?
  • How about cost? Is more expensive bread nicer? Should I calculate cost per slice or per portion? I don’t want to get a taste for expensive bread, do I?

As soon as you start comparing breads, it’s all too easy to compare calorie content and bam, easy, decision made. Who’s going to bother going through the palaver of the above when it’s so much easier, simpler and far less anxiety provoking to just pick one up based on calorie content?!

And that was just bread for a sandwich, don’t get me started on the margarine/butter debate or sandwich fillings!!

It’s important to remember people trying to recover from other eating disorders may choose food based on, for example, how comfortable they are to binge/purge or how the food makes them feel when they eat it (emotional eating or eating to avoid boredom). Any eating disorder restricts your ability to choose food based on a) whether you like it and b) whether it has a helpful nutritional content for what you need.

It’s so hard to remember, when in this state, food has no moral value, no food is good or bad, food is fuel with nutritional value and should be consumed without guilt or shame. Recovery is hard when surrounded by modern diet culture that normalises, even endorses, unhealthy restrictive eating habits.

When you’ve been absorbed by an eating disorder, you lose touch of your likes and your dislikes – not only can you not remember them but you don’t think you ever had any, beyond preferring foods with a lower calorie content. “Seriously, I love cucumber and water for lunch, it’s just what I prefer!” Yeah, right!

Fortunately, my current situation has only been for a few weeks so I can remember the foods I like, I will be able to fall back into my healthy habits easily. When you’ve been surrounded by an eating disorder for a long time, many years for most, sometimes decades, the disordered habits can be so ingrained that it’s hard enough to even imagine things could be different and it can feel impossible to go through the process of change.

I’m here to say, change is possible, stepping out is hard but once you’re broken away from food rules and rituals, freedom tastes fantastic!

You are never “good” or “bad” when it comes to food. Food has no moral value. It’s just food.
You never know what’s around the corner

We never know what’s around the corner

TW – Trigger Warning – this blog contains honest content about weight loss and symptoms of eating disorders. Please consider taking care of yourself and clicking away if this may be triggering for you.

For 2 weeks at the beginning of September I lived with an undiagnosed fractured jaw. Not just a little chip, my mandible is completely broken, all the way through! I went to hospital but they were certain it wasn’t broken (that’s a story for another blog). During the 2 weeks before diagnosis I was trying to manage a soft tissue injury which involves gentle exercises and trying to chew despite the terrible agony! I was even playing my saxophone!

Anyway, long story short, fracture diagnosed, surgery untaken, restricted diet underway and I’m losing weight like it’s going out of fashion!

I’m trying really hard to be honest with people about how things are going. Things haven’t been straight forward with the recovery, I’ve needed extra appointments and additional management.

This is a mental health blog where I talk honestly about mental illness and recovery. Being on the right side of recovery it’s (relatively) easy to talk about the bad stuff because I can see that things turn out alright in the end. But at the moment, while things are physically really hard, my mental health is under strain.

I always think twice about writing a blog like this because I don’t want anyone to worry about me (as there genuinely is no need).

My mood has taken a hit, for a number of reason: missed diagnosis, pain, fatigue, not being able to do the things I usually do. I think all these things would take its toll on anyone’s mood.

I also have a history of anorexia and despite full recovery, something I struggle to talk about is my residual poor body image. I was told, as I was supported to weight restore, that my mind would catch up with my body; they tell you, you must weight restore first, then you will gradually start to feel ok about a “normal/average” body size. But I never have, I’ve never felt ok in a “health” body. It’s always felt too big, too fat, like I’m taking up too much space. So as my weight has dropped on a liquid diet, I’m feeling a bit better about my body – I know this can be a slippery slope but it’s a familiar space and when you’re feeling low, you grasp for anything comforting. Old thought habits fall into place easily.

I’ve had people say “you’re looking good”; this really doesn’t help. Those of us who’ve been down the ED black hole know these comments fuel the fire.

The most scary thoughts/feelings are when I’m walking around a supermarket or in a cafe and I see lots of foods I want but can’t have. People often think anorexia is about hating food, forgetting about it and not being bothered by it – far from this, anorexia is an obsession with food, thinking about it all the time, the body wants it but the mind has to find ways to avoid due to shear fear and anxiety. When I had anorexia whenever I walked around a supermarket I would see lots of foods I wanted but I couldn’t have – right now this is all too familiar.

Ways I’m looking after myself:

  • Learning to rest and enjoy it – a familiar pattern would be to exercise away my limited calorie intake but I know this would be unhelpful. My body needs to heal, I need to help it as much as possible. It’s easy to feel guilty about resting but why should I feel guilty about looking after myself?
  • Getting fresh air everyday – it’s easy when feeling down to shut yourself away, especially with so little energy but fresh air is good for the soul!
  • Continuing with routine – although I can’t do a lot of things I usually do I’m still going to work and church. If I’m looking for familiarity, I can’t go wrong with being around familiar people.
  • Keeping meal times – not being able to eat (only drink) it would be easy to fall out of meal time routine but I’ve remained with the pattern of breakfast, lunch and dinner, trying to vary the drinks I have!
  • Being honest with people – how easy is it to say “alright” or “fine” when someone asks how you are?! I cut down what I say depending on how much time someone has but right now things aren’t ok so I say it how it is. I never want people to lie to me when I ask them how they are, so I treat people how I want to be treated.
  • Being conscious of calories and nutrients – Feeling low and lacking appetite, it would be easy not to bother with food but I know it’s important. It’s hard work getting in enough calories when they’ve got to be accompanied by so much water but there’s good information online for post surgery dietary intake. Plus I have a good dietitian friend who’s helped me out!

I wanted to write this blog, partly to raise awareness about the chronic nature of mental illness. Even when recovered, it can lurk in the background, we remain susceptible to relapse. I also wanted to let anyone who’s struggling with relapse know they’re not alone, it doesn’t have to be an inevitable black hole. Right now, I’m working hard to stay well, by looking after myself I know things can get better.

Young person looking at their phone

Can a film about eating disorders be made “responsibly”?

Recently, while in conversation about the good, the bad and the ugly of mental health portrayal in film, I said, “although it divided the eating disorder (ED) community, I thought , To The Bone was a good movie”. The person I was speaking to responded saying that they didn’t think it had been made responsibly because it showed eating disordered behaviours. “Fair enough”, I thought, everyone’s entitled to their opinion. Read my thoughts on To The Bone here.

To The Bone character Ellen looking concerned at weighing scales

I’ve been reflecting on this and I’m wondering why ED’s are treated differently to other mental illnesses when it comes to portraying behaviours in the media.

There seems to be a fear that ED behaviours can be caught and that if the media gives hits and tips, a “how to…” develop an ED, maybe there’ll be an epidemic. No one thinks that a portrayal of a psychotic episode with someone experiencing a delusion they can fly will lead to an epidemic of teens jumping out of windows, pretending they have bipolar disorder!

I’ll spell it out, if you show someone doing sit-ups, running, counting calories or carrying out food rituals, you’re not going to give anyone ideas about how to get anorexia. If someone is predisposed to anorexia, they will be able to come up with these weight loss schemes all by themselves!

Board of sliced food

I’m not naive though, I know young people can be influenced by what they see. We are seeing a concerning rise in self harming and we need to consider whether talking openly about these things is making such behaviours seem more acceptable. We’re in a precarious position in trying to raise awareness of all mental illnesses. While we want to normalise discussion of mental illness, it’s important that mental ill health does not become normal!

Of course, there needs to be careful consideration when depicting any illness; there needs to be sensitivity given we’re making other people’s pain into, let’s face it, entertainment.

It is important to recognise these imagines may be triggering for people who are already suffering but there comes a point where it’s your responsibility to decide if you can manage this. The media company can put a warning at the beginning of the content, they can do no more. If someone is in the mood to trigger themselves, there’s plenty of content available.

Of course, care has to be taken when showing particular behaviours to show the reality and not to glamourise it. Anorexia isn’t about getting thin, then getting care and attention. Doing sit ups with a boney spine, you will get painful bruises. I even started to get pressure sores on my buttocks. Also, there’s the everso attractive lanugo – excess hair to keep your body warm. Nothing about eating disorders is pleasant. To The Bone showed the ugly side to eating disorders, the guilt, the shame, the grief, the physical and emotional turmoil, it was not pretty.

Young lady liking sadly at a small slice of bread and glass of water

If someone has a genetic susceptibility and environmental factors lead to them being on the cusp of an eating disorder, they will not need hits and tips. I, for example, had no media input to my eating disorder, I naturally knew how to lose weight, I cut food out of my diet and I moved more. Food rituals develop as a way to reconcile external pressures with internal turmoil – if I absolutely had to eat in front of someone, if I cut my food into factors of 3, it was more manageable (for example).

If I’d watched a film depicting eating disorders accurately when I was struggling as a teen, I think I would have felt less alone and might have felt able to seek help sooner.

We’re relying in mainstream media to bring the unmentionable and the unexplainable into the open. If they don’t show behaviours, if they gloss over them with clever edits and subtle hints, they’re not giving an accurate portrayal and this would be unhelpful and they’d be criticised. It’s never going to be easy and it’s going to divide opinion but at least we’re talking about it!