We need to talk about Kevin Mia

I have never read the book nor watched the movie but the title was too appealing and appropriate to exclude from this post. Just like Kevin, Mia is one hell of a dangerous …………… (I’ll leave you to fill in the blanks). Mia is not my cousin thrice removed nor a person I once knew. Mia is in fact a shortening of the word Bulimia.

I care not for labels so l’ll cut straight to the chase. I decided to write this post for 2 reasons:

1) Having read books and blogs from those who have recovered or are in recovery, one thing I have noticed is a disclaimer whenever they talk about ‘purging’. The disclaimer goes a little something like this: ‘I used to binge and purge but never vomited. I’ve never done that. I used to go out and run for x amount of hours.’ This disclaimer stinks of snobbery, eating disorder snobbery. We’re all in the shit boat together and that shit boat is called the eating disorder shit boat. No need for disclaimers. Let’s row together.
2) In my time in treatment (daycare, inpatient and therapy) I noticed a reluctance on the part of patients to speak about bingeing and especially vomiting and worse still, I noticed a reluctance on the part of ‘professionals to speak openly about this and to encourage patients to speak about it.’ This reluctance sends out the message ‘if you binge, vomit, you should be ashamed’ or ‘what you do is the shame which dare not speak its name.’ I remember one professional whose face became a contorted mess whenever the word vomit was mentioned, another who seemed to stutter everytime she uttered the word ‘purge’ and a third who whenever in conversation would whisper the word ‘purging’ as though she were talking about a virulent strain of STD which she’d contracted.

Why do we need to talk about MIA?

  1. It is way more prevalent than you might think. Statistics*, which only ever mention those diagnosed show that 1.25 milliion people in the UK struggle with an eating disorder. 40% of those ‘strugglers’** are considered ‘bulimic’, 10% are considered ‘anorexic’ and the rest are said to fall into a category called ‘EDNOS(eating disorder not otherwise specified). It’s worth noting that within the ‘anorexic’ category, there are 2 subtypes (restrictive and binge/purge). In the US, up to 30 million people are said to struggle with eating disorders. If this many are struggling ‘openly’, how many more are struggling in silence?
  2. Eating disorders are said to have the highest mortality rate of any mental illness. Although this fact is often only attributed to anorexia, it is my belief that purging is equally dangerous. Suicide due to depression and heart failure are features of ‘bulimia’ and ‘anorexia’.
  3. Bingeing and purging affects people of all races, genders, professions and social statuses. You only need to go onto eating disorder forums to read messages from nurses, doctors, teachers, students and others who struggle(d). John Prescott and Princess Diana were very candid about their struggles with vomiting. Jockeys have spoken about it, gymnasts have struggled with it, Karen Carpenter struggled with it. The list is endless.
  4. I have known women of colour who have struggled with vomiting and have told me about it but have not sought help for it or spoken to anyone else about it. It is a massive lie that only ‘white people’ struggle with eating disorders. It’s simply in my opinion the case that women and men of colour who struggle with it are less likely to seek help for it. I’ll leave you to figure out why.
  5. We need to end the shame around bingeing and vomiting in order to encourage people to seek help and confront the dangers of these addictions/behaviours. I call it an addiction because it does become one. More psychological and behavioural than physiological in my opinion.
  6. We need to speak about it in order to prevent others from falling into the trap of bingeing and purging. It is a trap because it can relieve tension and stress and also lead to tension and stress.
  7. It can do untold damage to people’s teeth and people are often not aware about how to protect themselves from the ill effects of vomiting in particular. It can lead to cardiac arrest, stays in hospital, osteopenia or osteoporosis (due to low weight) etc.

Who needs to talk about Mia?

  1. Medical professionals: GPs need to talk to their patients openly. I was lucky enough to have a GP who heard me and did not make me feel judged or  ashamed. Dentists need to talk to their patients without judgement. Dentists can see all the hallmarks of vomiting when a patient says ‘aaaaaaarrgghh’ but oftentimes they wait for the patient to say something. Shame is the glue which keeps people’s mouths shut. When people say nothing, they also limit the amount of knowledge they can give or receive about how to stop the erosion enamel, the decay and the eventual loss of teeth. Eating disorder professionals need to speak about it openly because the less they say, the less inclined many patients feel to discuss their struggles with bingeing and vomiting.
  2. Strugglers: if we don’t speak, how can we expect others to? I’ve been in treatment with people struggling in the same way I do and it’s taken me months to find out. Knowing is not about swapping helpful ‘how to’ tips,  it’s about supporting one another and shining a light into this dark crevice.
  3. Those who have recovered need to speak more about how they recovered and how pernicious these behaviours are. Mia is a frenemy (a thing which starts out as a friend but then becomes an enemy). Telling others ‘I did it and now I’m recovered’, helps others believe they too can overcome it.
  4. Friends and family members need to allow those struggling with it, the space to discuss these behaviours without the fear of judgement.
  5. Educators whether teachers or eating disorder educators need to warn others in schools, colleges and universities of the dangers of bingeing and purging.

What needs to be said about Mia?

  1. If you struggle with or struggled with bingeing and/or purging, you are not disgusting, a weirdo or a freak. You are simply a human being in need of support to address a crippling issue in your life. There is nothing new under the sun. You are not the first to struggle with this but you can be the first in your circle of life to demystify it. YOU CAN RECOVER FROM IT. Many have before you and many will continue to do so after YOU HAVE RECOVERED.
  2. Bingeing and purging can occur irrespective of diagnosis. I have known someone diagnosed with anorexia who binged on fruit, another who threw up what little she ate and a third who shattered the illusion that bingeing and purging leads to weight gain by remaining at a worryingly low weight in the time I knew her.
  3. Bingeing and purging does not discriminiate. It cares not about race, gender, sexuality, religion, social standing, level of education, profession or anything else which separates us as humans. I have met one man who struggled with this and known of another man of colour who struggled with it. I have known Christians and Muslims held captive by its grip.
  4. Knowledge is power. Brushing your teeth after vomiting will only erode the enamel. Drinking lots of fizzy drinks will have the same effect. Dentists need to help those who are in the grip of the disorder to manage their dental hygiene better.
  5. Bingeing and purging IS NOT just about feelings as I have been told on many occasions. It has both physiological and psychological roots. Physiological because dieting, starvation and restriction lead to the body craving a huge amount of food in a short space of time. This part tends to come first. Psychological because eventually, those struggling get sucked into the illusion of calm which sometimes comes with either bingeing or purging and so begin to think that any stressors in life or any negative feelings can be dealt with by bingeing and/or vomiting. The latter is a lie straight from the pit of ……
  6. Bingeing and purging can be conquered by eating regularly and substantially. (See Ali Kerr’s Bulimia Help Method).
  7. You don’t have to have therapy to conquer these addictions/behaviours.
  8. Bingeing and vomiting does not cure or keep the tides of depression at bay. It exacerbates depression. It keeps depression in your life.
  9. The reality about inpatient treatment being oftentimes ill-equipped to help those struggling with bingeing and purging needs to be discussed and addressed. Oftentimes, treatment providers focus on getting an individual to eat substantially and this ‘substantial’ eating is exactly what induces vomiting with some who struggle with it. Little and often may be the answer for some but try telling this to IP treatment centres.
  10. Practical support not professional support is the most aluable tool to overcoming this in my experience. Others may disagree and that’s just fine. Whatever way you find your freedom is okay with me. Some even get there alone.

When do we need to talk about Mia?

NOW!!!!!!!!!!!! What are we waiting for? A more convenient moment, a private room to use? Speak now. Don’t forever hold your piece within the walls of your mouth.

Where does this conversation need to take place?

From the mountaintop, in cyber spaces, in literature, in schools, in homes, in treatment centres. Wherever people are. In our modern age where information and misinformation is everywhere, it is unlikely that speaking about it will become a ‘how to guide’ for those who think these behaviours are the way forward.

So let’s learn where knowledge is missing and unlearn where knowledge is misleading or erroneous.

Yes, some people eat, then throw up. You may be one of those people and you may not be one of those people. Who gives a shit?

A beautiful woman once said to me “Everything which has a beginning must have an ending.” She was right. What matters is not how you started or where you are now. What matters is where you end up and how you find your way there.

I’m finding my way there. And for this I must thank those both home and away who have supported me and listened to me without judgement. And most of all, I must thank the most special person in my life who may not witness my recovery but always had confidence that I would recover.

*Stats were taken from the BEAT website, the UK eating disorder charity.

** I choose to use the word struggler rather than sufferer because the latter strikes me as too passive. The former makes me feel like there is hope of one day overcoming it.

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How to keep one’s mind focused on RECOVERY in a world of courgetti and cauliflower rice.

I write this not because I have reached recovery paradise – Eden. I write in order to reach Eden. I am however under no illusion that recovery does not take away any of life’s difficulties. It simply means that I choose not to carry the extra baggage of an eating disorder with me. Watching Nigerians hauling excess baggage at airports reminds me that if I can do without it, it’s better to ditch it. The baggage I have to ditch as I now embrace the joys and horrors of recovery is that of the restrictive/dieting mentality.

It is hard to go one day without hearing about a new diet, clean food fad, cleanse, fast or whatever else. Some may say they’re watching their weight. Nigerians may say they’re watching their height. Whichever it may be, diet talk is hard to escape. It’s not just the average Joe Public engaging in this but also doctors and those in the medical world.

This post was in itself prompted by an article I read about Dr Andrew Renaut who believes that skipping breakfast is the key to losing weight and is also on a mission to ‘educate’ people about the dangers of obesity.

Since I am not a specialist, I will not pretend to contradict him. However, I would like to posit a different theory. BALANCE rather than AVOIDANCE and FADDINESS is the likely key to good health (note I do not talk about weight loss). I do not believe in focusing on losing weight. I simply believe in finding balance and not dictating what one’s body should look like. Breakfast does not kill but dieting sure might. Obesity probably is dangerous in the long run but so is malnutrition and/or being underweight. Malnutrition can exist at any size.

As someone recovering from an eating disorder, I have to find ways to keep my mind focused on recovery even as my body grows to uncomfortable levels. For me, this is like walking down a road littered with chewing gum on the ground and having to hop, skip and jump so that I don’t end up with a mountain of chewing gum under my shoe at the end of each day. It reminds me of the time I lived in France and spent my time dodging dog mess on the ground whenever I went out. It gets annoying to say the least.

The more I read, the less I believe in dieting. We think as human beings that we have a monopoly on intelligence but that is not the case in my opinion. Our bodies are more intelligent than we think. We cannot outwit our bodies by pretending that cauliflower is real rice or that courgetti is really spaghetti. Our bodies will fight back through cravings which can often lead to binges and/or purging (through vomiting or overexercise) and then back to restriction again, therefore undoing all our ‘dieting’ efforts. I choose not to fall into this trap.

What can I do to avoid the chewing gum and the dog mess?

  1. Educate myself. Read lots of literature about the dangers of dieting, recovery from eating disorders and other literature which boosts my self esteem without reference to my size or shape. This has been a godsend.
  2. Remind myself that everyone’s story is different and so are our journeys in life.
  3. Ask myself whether I want to return to the depths of the eating disorder (the answer will always be no). I am by no means ‘recovered’ but ‘recovering’, with all it’s physical and mental side effects, is much better than being trapped in an eating disorder.
  4. Avoid comparing myself to others. Physically or in terms of nutrition. I always used to find it weird to be ‘complemented’ on my unhealthy and manipulated weight. In fact, I used to smirk. Not because I was proud of my shape or size but because I always used to think ‘if only you knew’. If only they knew the hellish existence I lived to maintain that size, they would pity rather than complement me.
  5. Remember that I am MORE THAN and so are YOU. Yep, you heard me. More than our size or weight. More than our bodies. More than our race, gender or other descriptor. More than our names and more than our diagnosis. More than the labels others tag us with and even more than the labels we tag ourselves. More than the food we eat and more than the way we look. Our bodies, in my humble opinion,  are not the key to our happiness. They are simply vehicles which help us live, thrive and navigate life’s obstacles. These vessel will wither, fade away and eventually go onto the scrap heap. I chose therefore to respect, take care of and nourish this vessel. But, I will not worship it. My body is not my god. Nor will I idolise food, diets, fads nor anything else man-made which claims to be the key, the secret, the elusive elixir of life. Don’t get me wrong. Health is wealth but how to enjoy good health is likely not through a lifetime of dieting/restricting or the inverse, bingeing.
  6. In keeping with the thought that I AM MORE THAN WHAT I EAT, I choose to use my time and mind in meaningful ways which benefit myself and others, such as helping those who struggle with literacy and warning people about the dangers of dieting and how diets can lead to eating disorders for those with a predisposition to such disorders. I also choose to spend my time and mind focusing on what I can do rather than how I look. This does not mean I will ‘let myself go’ and stop taking pride in my appearance. It simply means this will rank lower in my list of life priorities. I want to spend good time in the company of others rather than obsessing over food and therefore isolating myself.
  7. Finally, I choose to remember that in the end, WE ALL DIE. It really is that simple. We cannot name the day or time. Some things are beyond our control. I have seen people die prematurely from all sorts of illness who were not overweight. What I remember about these individuals is not their weight or ‘height’. What I remember about them is their compassion towards me, their attempts to understand me, the way they made me laugh, the way they allowed me to cry and be vulnerable in their company. In conclusion, what I remember is the way THEY LOVED ME – for who I am on the inside, not what I am on the outside.

LOVE NEVER FAILS. Diets do.

 

The key(s) to eating disorder recovery*

In the past decade, I have found recovery out of reach, an impossibility. I have often wondered why others recovered but not me. I have been given opinions by those without eating disorders and professionals.

How to recover according to the church of others

People without eating disorders have told me that:

  1. You need to be determined.
  2. You need to want it enough.
  3. You’ll recover when you hit rock bottom.
  4. You just need to get out there and live and eventually things will get better.
  5. If you get yourself a boyfriend you’ll probably forget all about the eating disorder. 

Professionals have also given their opinion about the key(s) to my recovery.

  1. Engaging in a course of DBT, CBT or some other BT.
  2. Getting to the root cause of why I continue to engage in disordered behaviours around my eating.
  3. Therapy
  4. Medication
  5. Dealing with the depression which I experience with sometimes alarming frequency.
  6. An inpatient admission

The reality of medical support/treatment in the UK

Admission to an inpatient unit in the UK is done for the purposes of medical stabilisation (not recovery) or if you are having serious suicidal tendencies. Given that many who struggle with eating disorders have suicidal tendencies, it is clear that this in itself will not qualify you for treatment. A seriously low BMI and/or medical instability in your blood work are usually required. What generally qualifies an individual for IP treatment in the UK is a severely low BMI which means many anorexics and bulimics** will not qualify.

Access to DBT, CBT and therapy is often subject to a long waiting list so medication it seems may be the only option left to those with eating disorders. But I don’t believe this is the key to recovery even though it may support an individual to get into the mind-frame required for recovery or may impact their actions to some extent. Fluoxetine has been said to reduce the frequency of purging for some who struggle with this.

If like me, you have an aversion to medication, does that mean that you are therefore up shit creek without a paddle? NO.

The key(s) to eating disorder recovery

What professionals and others have suggested to me in the past can only be defined as either triggers or aids to recovery. They can start off the chain of events leading to my recovery or they can support my recovery but they are not the KEY to my recovery.

The triggers to my current foray into recovery have been the knowledge that my life cannot improve unless and until I am in recovery, a change of location, a letting go of the desire to hang onto a particular body type as well as a period of G’ing (gearing) myself up for more. I had a period of about 3 months of telling myself that I would get better even though the reality looked different. Yet, none of these triggers were key to my current state of being ‘in recovery’.

I believe there is 1 key (the main singer in the band/the main act) to being in recovery and being recovered and other tools  (back up singers or supporting acts) which can aid both processes .

THE KEY TO EATING DISORDER RECOVERY IS – FOOD/EATING. I’m sorry to say this but also happy to say this. Sorry because there is no magic wand but happy because that means I don’t have to rely on others or wait for someone else to act before I recover.

Think about it. You can have all the therapists in the world, all the treatment options and food plans in the world, things could hit rock bottom, you could have the best partner in the world but if you don’t eat, you will not recover. It’s brutal but simple.

When I say eating, I mean eating consistently and substantially. It’s taken me 20 plus years of an eating disorder to realise this. No professional I have ever worked with has impressed this point upon me. I’ve been told that ‘it’s not about food, it’s about feelings’, ‘food is not the issue’, ‘you need to get to the root cause of why you keep engaging in behaviours’. But no one has ever said ‘you need to eat consistently and substantially’.

The supporting act or back up singers in recovery for me are:

  1. Myself: making the decision to recover no matter the cost. The cost for me is losing the body which I’ve kept for almost a decade and which I thought allowed me to function, kept the depression at bay and allowed me to feel mildly comfortable in my own skin. I gain so much more than I lose by recovering.
  2. Having the practical support of one or some who know(s) and love(s) me to get me through the uncomfortable, sometimes painful and sometimes distressing process of refeeding.
  3. Encouragers: those who cheer me onto and beyond every new milestone.
  4. Books and blogs from those who HAVE RECOVERED: Bulimia Help by Ali Kerr, Rehabilitate, Rewire, Recover: Anorexia recovery for the determined adult by Tabitha Farrar and BRAINWASHED: Diet-induced eating disorders. How you got sucked in and how to recover by Elisa Oras.***
  5. My current belief that I am the key to my recovery, not a professional and not an eating disorder unit. Professionals and ED units cannot bring about recovery if an individual does not make the decision to actively recover and commit to their own recovery. If the case were otherwise then relapse would not occur. I believe that an over-reliance on professionals can cripple those with EDs. It can stop us from acting and sometimes from recovering. It can however support those who believe that therapists, treatment programmes and/or ED units are crucial to their recovery because ‘as a man thinketh, so is he’. If I believe I can recover without professionals, I will. If I believe I can only recover with the help of professionals, then likely that is what will happen. For me personally, the first option is much more attractive. It means YOU DON’T NEED TO WAIT TO RECOVER.

I CHOOSE TO RECOVER. I KNOW I CANNOT RECOVER WITHOUT EATING CONSISTENTLY AND SUBSTANTIALLY.     

* this entry is based solely on my opinion and experience. What works for the goose may not always work for the gander.

**i hate labels and am using these terms simply for ease. We are NOT the labels others accord us. We are the labels we accord ourselves.  “As a man thinketh…”

***I do not endorse these authors or fully agree with their views. I do however find a lot of sense in many of their assertions and some of their views are aiding my recovery. I take what makes sense and leave the rest.