There is more to the story

A woman sits by the water with her head on her knees.

Anorexia. What do you think of when you hear this word? Probably you are thinking of emaciated models. Or you are thinking of these famous pictures and drawings of a woman looking into a mirror, seeing a much curvier silhouette than she really is. You probably think that anorexia is the simple renouncement to food. But do you actually know what anorexia is? What it means to the patients? I have discovered that most people, even doctors have no clue about this topic and there are many misconceptions around it. How can she claim this you might ask yourselves now? The answer: I was anorexic myself.

So now after almost four years I want to share with you my story and thereby want to attempt to reduce these (mostly unconsciously) distorted views on the topic. I want to share with you my personal experience – I cannot make any claims about how this condition influences and is precepted by other patients.

When I returned from the summer holidays in 2014 I had lost 12 kg in 6 weeks. The weight loss was evident to all (except me at that time) and I could feel everyone staring at me. Then came the questions “Why did you do this?” “Why do you want to lose weight?” etc. etc. All questions that questioned the “why”. The same questions I got from my parents, my siblings and my doctors.

I would trace back my anorexia to my accident the very same year: in my last sports lesson one of my classmates and me bumped together while playing football. I just heard a huge snap, fell to the ground, couldn’t move my left knee anymore and started screaming. The only one that was able to calm and touch me was my best friend Thomas – he carried me to the nurse and I got an ice-pack. The next two weeks I pretended that I had nothing as it was a very stressful time at school. At the end my sports-doctor forced me to go to a surgeon. And then came the devastating diagnosis: a ripped ligament – meaning that I would have to stop sports for at least a year and then would have to stop with all of my team-sports. That was the first blowback. Then I had surgery and went to a rehabilitation centre where I was screamed at by the trainers as I could not hold up with the improvement charts – I was simply not able to bend my knee more than 90 degrees. That was the second blowback. Then we got a letter from our insurance company that wanted my family to pay back the costs for the surgery as I was apparently simulating my pains and conditions. My surgeon (which has by now become my boss for my student job) started a fight against the company. That was the third blowback. And in all between this my IGCSE exams and a week alone at home as my dad worked and my mother went on holiday with my brothers (they are not to blame as I forced them to go without me!). I had questions and concerns going around in my head: Will I every be able to walk properly again? Will I be able to do sports like a normal person? Will I be able to study and work? Will I always depend on the help of other? I started eating less.

What I want to show you with this long story is that anorexia is not something that simply appears out of nowhere. It is rather a very complex development comprising several stimuli. And you do not simply get anorexia from one day to another … you slowly slide into it.

The second question that most people ask me is: “Why don’t/ didn’t you get back to eating normally?”. You have to understand that anorexia is an addiction. And an addiction is by definition a repeated involvement with a substance or activity, despite the substantial harm it causes, because that involvement is perceived as pleasurable or valuable. I did not consciously tell myself to eat less or to eat nothing at all. All of this happened unconsciously, and I was actually not aware of the fact that I was eating too little when my parents finally addressed the topic. I was totally undiscerning and denied my funny eating habits. Now looking back surely, I am aware of the fact that it is not normal to cry after eating grapes (sugar!), replacing bread with lettuce, permanently comparing foods to each other in calorie and nutrient content, counting calories, being scared to go to parties and events as food is always an integral part of them. But to reinforce I did not willingly do all of this – I had no control about what I was thinking and doing – it is a simply indescribable condition. You feel helpless and in control at the same time. You have to understand that anorexia is not a diet but rather a mental illness.

The first step to get out of anorexia is to break this vicious circle of intransigence. This does not happen in one talk … just like the slipping into anorexia it is a process. I had uncountable talks with my family, friends and teachers that all stood behind me supported me in any way possible. They argued with me, gave me safe-space, showed me pictures of my change, forced me to eat, tried to distract me etc. At that time, I hated them I admit. I did not want them to intervene in my life and I simply didn’t want to see that I was anorexic and losing more and more weight. And I was nasty to them; I lied to them, I was aggressive, I was bad-tempered, I had emotional breakdowns, I had mood swings (could switch from being totally happy to depressed or angry in seconds), I was inaccessible and unreachable as I reclined into my own little world. At this point, I want to thank all of them for being there for me all of the time in whatever function and for having the resilience to withstand my intolerable behaviour.

Then, finally, I was able to flip a switch in my head … almost one and a half years later. I am not sure what triggered it exactly, but I wish to believe that it was the sentence that my little 12-year (so he was about 4 back then) younger brother told me: “Why do you want to kill yourself? I don’t want to lose you.”. As you might imagine that was an emotional hit. Slowly I started to see and accept that I was anorexic and started to make efforts to get back to normal eating. But I want to highlight the word slowly! It took me another year to fully get back to eating normally and there were surely several relapses. 

So am I healed? In a way I am … in another I am not. It is true that I am eating normally again (but still a bit too healthy for some), I am no longer counting calories, I am back to a normal weight and fat-level. People seeing me would never imagine that I was once anorexic. But anorexia is still an integral part of my life. I still sometimes feel uneasy with my body - I do not think that I am too fat but I just don’t feel comfortable in my body sometimes. I also often feel guilt and ashamed towards that part of my life. 

In addition to that, your closest peers will not forget all of the stress and pain so quickly and they are scared that you will fall back into it. They will continue to watch you continuously while eating, will treat you like a vulnerable egg and their warning bells will sound as soon as you have a meal or snack. And they will link every action or decision of yours to your anorexia. For example, just last week I have talked to a very good friend of mine about my medicine studies and the paper that I am writing on the topic of Health Literacy. At some point in the discussion, he just looked at me with very concerned and loving eyes and told me the following: “I like the topic and it is interesting, but somehow I have a feeling that all of this links to your anorexia back then.” And I am surely grateful that they are still thinking and supporting me. But I also want to finally close that stage of my life and want to be seen as a regular and determined young woman, also by my closest family and friends, a young woman that they can trust. I do not always want to be associated with this condition.