"You're Just Not Sick Enough"
Imagine the scenario. You're a 32-year-old woman and you're sat in a busy GP waiting room, wondering whether you actually have the guts to go through with this. You've ummed and ahhhed about making the appointment for the last month, and every single day since booking it you've thought about cancelling. You step into his office and he sits patiently and waits for you to speak. You fidget nervously as you try to figure out how to verbalise everything that's jumbled up inside your head – how can you make it so that he will understand and not look at you like you're an absolute idiot, or worse, a fraud?
“I'm here because I think I have a problem with food…”
The moment the words spill out you want to die and you wish you could suck them back in – they sound ridiculous and you just want to get up and run, to be anywhere but here.
The truth of the matter is I know I have a problem with food. I've had one for most of my adult life, or for as far back as I can remember. This isn't a new thing, but I have become a world-class liar and secret keeper, so it isn't something I talk about to anyone. And above all that, I'm embarrassed about it, and saying it aloud is like standing naked in a room full of strangers. After all, I'm a grown woman, I'd say I'm fairly well educated, I run my own successful businesses, I have a family, and for the most part I just look normal. And yet I know this can be anything but.
We go on to talk more about what I mean by “problem”; we discuss weight, numbers, emotions… I've been here before and I'm well aware of what is going to happen next. On being weighed I am told my BMI is within the healthy range for my height, and despite the fact that in the last two months I have lost a lot of weight, quite frankly I just am not considered to be in any imminent danger.
So let's define danger
Is it dangerous when I restrict my calorie intake while embarking on a fairly rigorous exercise regime? Is it dangerous when I make myself vomit to the point where I am seeing stars? Is it dangerous when I take laxatives without a second thought for the warning on the box: “Do not exceed one dose within a 24-hour period?” I'd say so, wouldn't you? But on paper I am just not quite sick enough to warrant any help. I get that his hands are tied by the system – I'm not stupid and I know I don't necessarily look sick. But as I go on to speak with him about my total and utter disregard for the dangers I put myself in, I break down and cry. And I cry mainly because I have a young child who depends on me, yet I am basically playing Russian roulette with my health every single day. The best way I can describe it is like having an out-of-body experience – I can see myself and see what I'm doing, I know it's stupid and dangerous and I want to reach out and stop myself, but the truth is in that moment I don't care about anything, other than not getting fat. And I can't stop – I just cannot stop!!
So on top of everything else I also feel like the most selfish person on the planet. How could any mother in their right mind do this? And there lies the answer: I'm not in my right mind. I'm driven by something so much bigger than me, by the validation from others – “Wow, you've lost so much weight, you look fantastic.” I appreciate they have no idea that I've basically done nothing but starve and exercise to get to this point, but either way I relish in the fact that my negative behaviour yields such positive reinforcements. And I'm blinded by that, I'm needy, I'm small, I'm frightened. It's so much for one person to experience and it's all-consuming. It's like I'm not even me anymore – I don't know who I am and certainly no one else does.
But back to the appointment. It takes a lot of strength to admit that you are struggling, to reach out to someone and tell them that you have an issue, that you need help. Identifying the problem is the first step. So to then be basically told “you need to be thinner before we can offer you anything” is not only demoralising, it's also downright dangerous. You already feel like a failure and now you can't even do this right – the voice in your head laughs at just how pathetic you really are.
I guess the main problem with eating disorders and our understanding of them is that the media only really shows us one side. But you don't have to look emaciated to be suffering. Eating disorders are mental health problems – it isn't all just about the physical side and in fact you could be an overweight anorexic. In the 19 years that I have experienced disordered eating, I was sick at both my highest and lowest weights, and everywhere in between.
So where do we go from here?
Where do I go, as a person who has recognised themselves to be in the very quick downward spiral of a relapse and wanted to get help before I was too far down that rabbit hole? Do I just figure it out alone? Do I pay for private treatment, do I persist with my doctor and fight for what I should be entitled to or do I just carry on as I have been doing until I reach the point where I am “sick enough” to be treated or hospitalised? I will be very honest because otherwise what is the point of writing this: the blatant rejection makes me shy away from the idea of recovery. I suddenly don't feel ready anymore, because how can I be ready to recover if I'm just not sick enough?