Starvation for thought: Drawing the line between being sick and being thin
Illustration: Eric Ensey/Iowa State Daily
Eating Disorders
February 20, 2011
Imagine that the mere sight of food repulses you, and every bite has a number etched into it.
That number grows larger with the more bites you take, and the more bites you take, the more sickening it becomes. You want to be perfect. You want to be thin. And each bite is taking you further from your goal.
I recently became obsessed with eating disorders after my best friend, who lives two states away, called me in tears saying she had a problem. Her sister had posted some pictures on Facebook from the family’s trip to Paris. In those pictures, my friend, who stands at an average height of 5 feet 6 inches, weighed just under 110 pounds. According to medical insurance charts, this is 10 pounds lower than what is healthy for her.
Erin Pederson, staff psychologist for Student Counseling Services, said statistics on what constitutes healthy body weight are based on medical insurance charts instead of actual scientific studies.
But instead of seeing it as unhealthy, my friend took those images and compared them to the average weight she is now and saw herself as fat.
My reactions were varied. At first, while we were talking on the phone, I was wrapped up in what I had to do that day.
At the end of the call, she had agreed to make an appointment with a counselor. Before we hung up, she told me she was sending me something via Facebook I “needed” to see. What awaited me when I logged in wasn’t a long message: it was a link to a tumblr account.
For those unfamiliar with tumblr, it is a mixed media blogging site for individuals to post pictures, short blogs and/or videos. She had given me her account information so I could log in and see everything. What I read brought tears to my eyes. The first thing I noticed was the number of followers she had and their usernames: “Thinnest-of-the-thin,” “puzzlepieceribs,” “eat-air” and countless others. It was a cyber-support group for girls with eating disorders. I felt like I had been thrown into a nightmare. My friend had listed her daily caloric intake from late November 2010 until the end of the fall semester. Not one day exceeded 500 calories. I was stunned and frightened at how meticulously she counted.
How could an entire community of girls like this exist without getting some attention? I had heard of girls who were “pro-Ana” before, but this group seemed different. “Pro-Ana” is a term that exists so people experiencing this illness can support each other.
I Googled “Ana,” the originator, a face – or body – that I could blame. I found no one. “Ana” is simply a pseudonym for anorexia nervosa. People announcing their pro-Ana statuses have garnered attention recently, but somehow in my mind eating disorders were diagnosed to those who had purged or starved their bodies so much that it required emergency medical intervention.
That night at the dining center, I stared at the feasting going on around me. The whole time I was thinking about my friend who wouldn’t dare to touch even a third of the food on my plate for fear of gaining weight.
I’m a kinesiology major. In my future career, it will be my job to analyze what is best for a person’s body. To have someone so close to me become the victim of an eating disorder was excruciating. I needed to know more about what she was going through. Over the next few days, I asked her various questions about what drove her to call me, how the tumblr community had affected her condition and what her current mindset was concerning eating disorders. What follows is an edited account of our exchange, which she gave me express permission to use.
***
Bridget: How and when did your eating disorder start?
Friend: I’m not anorexic … never for any significant amount of time at least. I was [first] triggered by watching an episode of Skins. One of the first ones had an anorexic character … I don’t know when that was, but soon enough came Thanksgiving, which forced me to get back on a more normal diet. I relapsed [back to an eating disorder] going back to school, but then came winter break. I’ve never kept it on for terribly long, except perhaps in the summer. I don’t know how long that was. Everything got aligned just perfectly to make me lose tons of weight. Then it stopped being about being healthy. It started being about “Holy s*** I’m gaining weight back.”
Bridget: What exactly went through your head when you saw the pictures of your younger self on Facebook?
Friend: It’s not really something that’s easy to put into words. It was a realization of how much better I was doing then (weight-wise) than I am now. It made me remember … the mindset you have when it’s like that. I don’t know if you ever lose that. There was also a sense of failure, of being worthless.
Bridget: You broke down when you were telling me about it. Why was that exactly?
Friend: Probably because I had a breakdown about it in the morning … about being too fat. It even sounds ridiculous. When I called you I realized I was in a bad position, but without too much urge to stop it. Earlier I had had a breakdown after seeing the pictures and then going to take a shower – there’s a scale in the bathroom. I can’t remember much except the basic feeling of “I’m so fat.” I knew … I know… what is happening to me isn’t good. But that’s a hard thing to tell people. It’s a hard thing to tell someone who you think has a beautiful body, it’s a hard thing to admit there’s something wrong with you, it’s hard to talk about a secret.
Bridget: How did you find tumblr as a source for support?
Friend: It’s actually kind of ironic how I found the tumblr community. [On] my first account I followed a lot of things that were feminist-perspective blogs and queer-friendly blogs. One of them sent out a link to another tumblr blog that was “encouraging anorexia.” And it was a drastic change in the information I was getting. My first account was filled with body-positive rhetoric and images. My next was filled with people who were actively blogging about their eating disorders, giving tips and advice, posting their height, CW (current weight), UGW (ultimate goal weight), BMI (body mass index), things like that. They have exercise plans, ways to hide food, ways to make yourself be not hungry, ways to distract yourself. It’s a wonderful and dangerous resource.
The people on tumblr and I have a bit of a dysfunctional relationship. It bothers me, when I realize a lot of those girls are younger than I am. But at the same time it’s a symbiotic relationship. If I see them doing stuff, then I feel as though I can, too. People will post about recovery and then we all feel sorry for them. The horror of having to be force-fed food, to be out of our world. It’s somewhere where all calories are counted, even single digits. It takes a certain kind of person to get an eating disorder as well. You have to be able to be some kind of perfectionist and be able to use your mind to control your body.
Bridget: Do you see those things as accomplishments now, or only when you’re in an eating disorder state of mind?
Friend: Oh yes. They’re all accomplishments in some way. When you’re in a community, you can have a competitive feel as well. So yeah, it’s an accomplishment and something to brag about. But you also have support while being there. I think it takes certain kinds of people to look at it from this perspective. You feel bad for those ones who were caught and have to go to a clinic. This type of eating disorder, whatever you’d like to call it, had happened to me before. Only now I had people to share it with. At the same time, I know I don’t speak for everyone. I don’t have an eating disorder that can be shoved in a box. “You starve yourself: Anorexia.” I don’t want to belittle the labels, but there are more than two types of eating disorders. There’s an entire world out there that I hope you don’t get to know.
Bridget: Tell me more about having an eating disorder.
Friend: It’s not something that’s seen as a problem [by me]. Even if you had been with me all of the time and noticed something, I wouldn’t think anything was wrong, nor would I care. Starvation is just a label for a process. Dietary guidelines are seen as BS when I’m in that state. You just feel accomplished. So tired, though. The way I see it is like having a split personality. I see myself having 300 calories in a day and feel as though I failed. At the same time, I can, rarely, see this from a more “normal” perspective, one that says 300 calories a day is starving.
I can describe what it’s like when you aren’t eating enough. It is never, ever warm enough. Your hands are freezing, but heat feels amazing. You’re a bit dizzy and shaky, but you feel thin and [think] it’s wonderful. [But] it’s not completely about being thin. There’s a very strong aspect of control as well. A better human being, better able to control your body, better able to look good, better able to do what society says you should. But this is taken to an extreme.
Bridget: What can you say about your body image right now?
Friend: My body image has never been good. It’s not good now; it hasn’t been good in a long, long time. The only time I thought it was alright was over the past two summers, both times when I had some type of EDNOS [eating disorder not otherwise specified]. You don’t always realize it. I can look in a mirror some days and objectively call myself average [which isn’t good enough]. Other days I look and I’m just fat. I don’t weigh myself, because there’s nothing good that can come of it. I can’t tell measurements, even though that’s what I really worry about. I don’t [care] about weight. Nobody else knows it. What I see is how it’ll look when I’m at that weight. If I look good, I feel good. That’s the way I’ve always seen it. I need an objective measure and that happens to be society’s measure. I’m deficient in social skills, so I’ve got to make up for it somehow. It’s a balance. “If you don’t have social skills, look good and it works.” That was the view I acquired during high school. The people in high school who were popular were skinny. It must work that way. I want to have people like me. If I’m skinny this happens.
Bridget: Will you go back to the tumblr community?
Friend: Tumblr, yes, I’m already back on. It’s motivation.
Bridget: Do you consider going to treatment or counseling?
Friend: Counseling, maybe someday. I know I’ve got a problem, but it’s a rush. It makes me feel good, as though I can control anything. When I called you I was thinking that maybe I ought to get help. Now I’ve regressed for a few days and don’t know if I want to or not. I’m pretty comfortable where I am, and I don’t know if I particularly feel like changing anything anymore. Another thing to note: Just from my experience online, I think a lot of people with an eating disorder also have depression or other things going on in their lives. Sometimes we’re loners, sometimes we’re suicidal, sometimes we’re trans[gender], sometimes we’re scared.
***
There were so many things that jumped out at me during our conversations, things I had either not recognized or just never noticed before: her insatiable desire for perfection, her mindset that being skinny makes her desirable, the way she relies so heavily on a group of people who share the same skewed views of the world. These were ideals I could never see her having before now. But there they were.
It was at this time I considered a professional’s opinion. How many more college students suffered from eating disorders? How many of them were “under the radar” like my friend? Pederson, coordinator of Student Counseling Services’ Eating Disorder Services, answered my questions.
“I think a conservative estimate would be that we have contact with at least 40 individuals with eating disorders per semester,” Pederson said in an e-mail.
Her “most conservative estimate” was that Student Counseling Services has contact with “over 500 people per semester who struggle with their body image.” Of these, “at least 200 individuals have some degree of disordered eating/exercise yet may not quite fall into the category of an ‘eating disorder.'”
Though this isn’t a considerable percentage of Iowa State’s student population, consider that this is the number of people who have gone so far as to actively seek treatment for these issues. It is possible that an even higher number of students may have diagnosable eating disorders but simply don’t want treatment (much like my friend).
After exchanging a few e-mails, Pederson and I agreed to meet in person to discuss the content of the e-mails with my friend. Upon reading them, Pederson expressed her concern for my friend’s condition.
“It sounds like your friend is in a very bad place,” Pederson said. “This is definitely something beyond subclinical.”
Pederson said the Diagnostic and Statistical Manual of Mental Disorders (the book clinicians base their diagnoses off of) “has undergone five minor to major revisions” since its original publication in 1952. The newest of these is set to be published in 2013.
“It is too early to know what the precise changes will be, but it looks like the eating disorder diagnosis options will be able to be more accurate to clinicians’ assessments of the severity and type of the eating disorder,” Pederson said.
Pederson went on to say she thinks the current criteria that constitutes an eating disorder is too strict and is looking forward to the upcoming revisions.
At this time, none of the Department of Psychology’s professors or researchers are studying eating disorders, even though eating disorders have the highest mortality rate of any mental health disorder in the United States to date.
I don’t know where the line is between being sick and being thin. It is almost impossible for me to think of beauty in terms of calories or inches or pounds, yet I have seen young women who can think of nothing else. People count their calories and work out until their hip bones protrude like handlebars and the rest of us are none the wiser.
This week is time for a change. This week, I encourage everyone who has read this and been affected by it to attend and participate in the events Student Counseling Services is hosting for National Eating Disorder Awareness Week.
You may be ignorant, like I was, about what constitutes an eating disorder. Or you may be someone who has lost a friend to an eating disorder. You may even be someone currently seeking treatment for an eating disorder. Whatever the case, I hope to see you there.
