Eating disorders (EDs) were introduced to me through a magazine article I read in high school. The article was about models suffering from anorexia and bulimia, and its obvious goal was to instruct on the dangers of these illnesses. But for some reason, it had the exact opposite effect on me. Maybe it had something to do with the other pages of the magazine, which were graced with images of beautiful, thin, stylish girls. Or maybe EDs are just part of my DNA and I was destined to end up with one anyway. Significant research has shown a strong link between anxiety and EDs, and I’ve got boatloads of anxiety. Boatloads.
What I can say for sure is that the article remained in my thoughts long after the magazine went out with the trash. It intrigued me to know that there was a shortcut in the weight loss game: vomiting after eating sounded like a pretty good way to cheat the system. So one day when I was feeling particularly fat—and I should note that I was never truly overweight, but certainly heavier than most models—I ate several pieces of cake, then vomited them. Nobody knew. It was so easy. I was hooked.
Fast forward to college, where my binging and purging spun out of control. There was so much food available, especially in the cafeteria, where you could eat as much as you wanted, three times a day. I think the only thing that kept me out of the hospital during college was living in dorms and apartments, and sharing bedrooms and bathrooms with other students. I vomited quite frequently, but logistics made it complicated, because part of being bulimic means keeping your illness a secret.
It wasn’t long, though, before I began to recognize the serious downsides of the disease. My face broke out like crazy, and my social life was strongly impacted, due to my appearance, odd eating habits, and tendency to sneak off to be alone. Also, my studies suffered because I had a hard time concentrating on schoolwork. And yet, I chose not to seek help. At one point, a close friend confronted me, saying she thought I might have a problem, but I presented her with a very eloquent argument to the contrary. And I guess it was convincing, because she never mentioned it again. Of course, I was also extra careful not to arouse her suspicions again.
In many ways, my bulimic years were like a dangerous game of intrigue, although I didn’t realize I was the only one playing. Life was going on around me. My peers were having fun, while I obsessed over food, calories, input, and output. In other words, I was mentally ill. Psychotic. Self destructive. But I wasn’t ready to accept those words. I still saw the whole thing as a phase I was going through; something I’d eventually stop on my own, when I was ready.
After college, I worked in several different jobs—some wonderful, some not so much—but none paid very well. Therefore, I continued to live in various roommate situations involving small living spaces and few bathrooms. If I’d been able to afford my own apartment, I might not be alive today. Because almost every time I was completely alone, I’d binge and purge. And eating disorders have the highest mortality rate of any mental illness.
The damage to my body and social life got worse and worse. I slept poorly and felt weak, despite the fact that I was actually gaining weight. (One myth about bulimics is that they’re skinny, when, in fact, the human body soon begins to retain some of the food the person tries to purge.) My heart rate kept getting lower. My face was covered with acne, my lips were chapped, my mouth was dry, my stomach was permanently bloated.
And I won’t even attempt to describe the damage I did to my teeth. Instead, I’ll tell you that almost none of them are real any more. That’s right. Because shortly after I recovered from bulimia, my teeth started breaking off and falling out. My mouth is now filled with a complex assortment of dental implants, crowns, bridges, and dentures, all of which have caused me to spend hundreds and hundreds of hours in the dental chair, and you don’t even want to know how much money. Glamorous? No.
Bulimia also made me reclusive. I’d usually manage to show up at work in the morning, but I’d avoid most social events, making every imaginable excuse because I was self-conscious about my appearance, and also needed time to binge and purge. I dated a bit and had a couple of boyfriends, but no relationship ever felt right, thanks to my screwed up head. I have no idea why my true friends stuck by me, but they did. They are truly special people.
The silver lining of the disease (if you can call it that) was that every once in a while, I’d get so weak, dizzy, or ill that I’d temporarily force myself to stop puking. Because despite my frequent misery, I didn’t want to die, and sometimes, I’d feel so sick that I’d fear falling asleep and never waking up. So I’d summon all my strength, “get clean,” and stay that way for a week or two. During those respites, my skin would clear up a bit, I’d sleep better, and I’d start feeling almost normal. Of course, because I was unhealthy, I’d eventually start binging and purging again, but it was during one of those “clean periods” that I met the man I’d eventually marry.
I wish I could tell you that my ED ended right then and there, but it didn’t. It went on for several more years. My boyfriend traveled a lot for work, so even after we’d moved in together, I was able to hide my sickness from him. It wasn’t until we started talking about marriage that I broke down and told him everything.
And that was when things began to change. Once the words were out of my mouth, the next step became perfectly clear. “We need to get you help,” said my boyfriend. Truer words were never spoken.
The very next day, I called my health insurance provider and got an appointment with a therapist. The therapist listened to my story—and honestly, I couldn’t believe how easy it was to talk to her, once I got started—and she assured me that if I wanted to get better, I could make a full recovery. Even though I’d been vomiting for over fifteen years, she had no doubts. She said talk therapy alone might do the trick, or perhaps I’d need medication too. But the important thing was that she was on my side. And so was my boyfriend. I wasn’t alone any more; I had a team. The relief was palpable. After all those years of wondering in isolation if I’d ever be able to eat and live normally, suddenly I knew the answer.
I stopped vomiting cold turkey. When my official therapy sessions ended—and I still check in with my amazing therapist from time to time—I got married. Shortly thereafter, my husband and I welcomed our first, healthy child into the world. And two years after that, we had a second. I was eating well, exercising, making new friends, and living an active, healthy life. But I’d be lying if I said I never worried about the bulimia coming back.
Then a strange coincidence occurred. We’d moved to a new town, and I’d decided to find a new general practitioner. Since high school, I’d had several different doctors, and had lied to them all about my ED. Now, it felt like time to make a new, honest start.
So I started scanning the names of doctors in our health insurance directory, and found one whose credentials and general location seemed perfect. His receptionist also told me he was accepting new patients. But when she started giving me directions to the office, my stomach sank. “We’re at McLean Hospital,” she said. “In the medical clinic.”
McLean? The famous psychiatric hospital in Belmont? The place where Sylvia Plath was treated? And Susannah Kaysen, who wrote Girl, Interrupted based on her experiences there? No. No, way. I wasn’t going to McLean. Because deep inside, I was still afraid of being labeled mentally ill. Even the medical clinic at a hospital like McLean scared the crap out of me.
One thing led to another, however, and eventually, I agreed to an introductory visit with the doctor. And once I met him, I began to realize that McLean was exactly the right place for my medical care. Because the doctor clearly understood psychiatric disorders far better than your average GP. In fact, I learned that one of his specialties was treating patients with eating disorders. It was pretty amazing. For once, I had a medical doctor with whom I could honestly discuss my health concerns.
So now let’s talk about you. First and foremost, if you suspect that you or someone you care about has an ED, please seek help as soon as possible. If you don’t know of a good therapist, your insurance company may be able to help you locate one. Another option is asking your medical doctor, or someone at the health care clinic you visit. And if none of these options seems right for you, try visiting the website for NEDA (National Eating Disorders Association). This well-respected organization provides all sorts of resources to assist people with EDs, including lists of therapists who can help and links to support groups.
And once you find a good therapist, you may want to look around for a medical doctor who specializes in treating patients with psychiatric issues. Because EDs have both physical and mental components, and it makes sense to keep an eye on both.
Above all, don’t be ashamed. I promise: getting help is much easier than you think, and you’ll be amazed at how much better life gets when you’re freed of your ED. I only wish I’d spoken up fifteen years before I did.