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?
- 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?
- 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’.
- 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.
- 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.
- 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.
- 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.
- 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?
- 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.
- 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.
- 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.
- Friends and family members need to allow those struggling with it, the space to discuss these behaviours without the fear of judgement.
- 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?
- 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.
- 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.
- 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.
- 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.
- 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 ……
- Bingeing and purging can be conquered by eating regularly and substantially. (See Ali Kerr’s Bulimia Help Method).
- You don’t have to have therapy to conquer these addictions/behaviours.
- Bingeing and vomiting does not cure or keep the tides of depression at bay. It exacerbates depression. It keeps depression in your life.
- 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.
- 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.