Different Phases of My Eating Disorder

Trigger warning! If you recognize yourself in any of these phases, please seek help

Sep 19, 2021

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During the first lecture of my master’s elective ‘‘Transdiagnostic Approach to Eating Disorders’’, the lecturer touched upon a very important topic: the diagnoses for eating disorders are not static. This means individuals can go back and forth between different types of eating disorders. It is very common for people with eating disorders to later develop other types of eating disorders.

According to research, individuals with anorexia nervosa usually alternate between struggling with the binge-purge subtype and the restricting subtype. The binge-purge subtype of anorexia nervosa is likely to turn into _ bulimia nervosa._ The opposite crossover, the latter shifting to the former , is also common. The least prevalent transition is the one between anorexia nervosa and binge eating disorder (this does not mean it never happens, it is just uncommon ). Lastly, people with binge eating disorder quite frequently develop bulimia nervosa. And from personal experience, I can vouch for that.

Here is a figure to make the fluctuating nature of eating disorders more clear. Smaller and empty arrows indicate lower prevalence.

Phase 1: ‘‘ Hmm… Maybe I can try eating healthier and working out a bit ’’

I like to call this phase “ the inception” of my eating disorder . I strongly believe that emotion dysregulation lies at the root of (many) eating disorders. There is usually an initial trigger event that we have a hard time dealing with. Nobody wakes up one day to change their long-time eating habits and activity level. At least not out of nowhere. For me, this was my break-up with an ex-boyfriend; who was into fitness, eating healthy, and working out. Contrary to expectation, he was never shaming me over what I ate or how I looked. It was his thing and I was never interested in his healthy ways… Until we broke up.

I suddenly (!) thought to myself ‘‘ Hmm… Maybe I can try eating healthier and working out a bit ’’. I implemented the simplest and the most basic information I knew about getting fit ‘‘eat less, move more’’ and never gave it a second thought. As simple as that. Only now I can see that this was some kind of emotion regulation strategy.

It is initially very harmless and comforting to think that you can change something about yourself to feel better. What can go wrong anyway? You will be taking care of yourself and your body (!) so that you can be the best version of yourself. It seems like healthy coping after a breakup, at least according to society. You know, the whole concept of ‘‘ revenge body ’’ and all that. It has been the subject of many different movies over the years: you go through a devastating break-up and all of a sudden you decide to lose weight, become someone else and show them what they have lost (on the price of losing your sanity and mental health).

Such a toxic way of seeing break-ups

But if you look at it from a distance, it is crystal clear that instead of letting yourself process the event, you are diverting your energy to something physical to avoid unpleasant emotions.

Phase 2: ‘‘ Fitness is my passion ’’

Then came the mild obsession with nutrition and working out.

All I could think was when and how I could work out and what I should be eating. I started looking up information. Every day, I spent hours reading those classic articles ‘‘How to get in shape in x days’’, ‘‘The best workout plans for transforming your body’’ and etc. It is safe to say that it was my leisure time activity. These articles slowly planted the seeds of my disordered thoughts and beliefs.

I downloaded the most toxic calorie counting app ever created on earth (you know exactly which one I am talking about). To log my calories, I formed the habit of checking the nutrition facts label of every single food to touch my plate. The clearest thought I can remember about that time is ‘‘ Oh my god, how am I going to limit my caloric intake when everything is packed with calories?! ’’. It was like the glass-shattering moment from that episode of How I Met Your Mother where they became aware of something obvious that they were before clueless about. All that information about calories later helped form my long list of fear foods. After the shattering of the glass, I could never go back to seeing food as I used to.

At this point, I was completely oblivious to my slowly developing eating disorder but too much aware of the calories I was consuming. It was all I could think and talk about. I was one of those people: when we went out to eat, I would complain about how much we have eaten. I would engage in diet talk and worse, ask people ‘‘ Do you know how many calories that cupcake has? ’’. I probably bored and annoyed a lot of people around me by talking non-stop about how much I worked out and how much better I felt, which definitely was not how I was feeling inside. It was more of a façade I was putting on to convince myself and everyone around me that I was confident and happy with who I was. (This is why you should do your best to ignore someone when they engage in diet talk or judge you for what you eat, it is 100% a projection of their own eating disorder and self-loathing).

Phase 3: ‘‘ Maybe I’m not trying hard enough ’’

Fast forward a month or two, things were not as I wanted them to be. My body was not looking as good as I wanted it to look. It was not changing as fast I wanted it to change. My interest in fitness was sadly some kind of desperate way to control my life and how I was feeling about myself.

I was very active and much aware of what was going in my body. Every day, I opened my eyes to the same thought ‘‘ What can I eat today that will not ruin my workout? ’’. I planned my days and my meals ahead. I was spending all of my mental and physical energy on counting calories and working out. But I was still not feeling as happy or - as worthy I wanted to feel.

If I was doing all that, why didn’t I look that good? I thought to myself, ‘‘ Maybe I’m not trying hard enough… ’’. This only made my obsession worse. I pushed myself to go to the gym every single day, claiming that I was addicted to it. (We release endorphins after an intense workout, which lead to feelings of well-being and pleasure while reducing pain. Exactly what you need when you feel worthless and sad every day.)

I came up with my own rules: No eating after 6 p.m. Drink water when you feel hungry, as you might confuse thirst with hunger. No carbs unless you absolutely have to. Have everything low-fat. Always choose the healthiest option on the menu. No snacking between meals, eat lean protein every 4 hours. Work out every day for at least 45 minutes. Lift and do cardio, otherwise, you will not see any results. And so on…

Phase 4: ‘‘ I don’t understand what is wrong with me, I feel hungry all the time ’’

Of course, my body started reacting to all these restrictions. The more I pushed myself to work out and restrict, the hungrier I became. I could not stop eating or thinking about food. Every morning I started a new diet, which was thrown out of the window every afternoon. I remember leaving the gym, drenched in sweat after working out for two hours , to grab an extra-large menu from McDonald’s. I came home after school to finish a whole jar of peanut butter. I started eating food in weird combinations, which came to be with my long binge episodes. Something salty first, have a meal! On to dessert now! This is now too sweet, now we need something salty to balance it out. All in huge portions and under twenty minutes. I had developed a binge eating disorder.

Stuck in the diet-binge cycle, I gained a lot of weight. Not to say that weight gain is bad, but it was unhealthy for my frame. You could see that it was sudden as I was constantly bloated, I had a puffy face from all the binges and stretch marks all over my body, from the sudden weight gain. Ironically, all the things I was doing to feel better about myself resulted in me hating myself even more. This is why eating disorders are very sinister: They promise you self-love and a better body - so to say - then leave you with _ the exact_ opposite to keep you coming back for more.

Phase 5: ‘‘ This is who I am now but I can’t go on like this ’’

After three years full of endless binges, diets, and tears, one day I told myself ‘‘ I can’t go on like this ’’. I was supposedly getting help for my binge eating. I was seeing a therapist weekly, talking about how terribly depressed I was for 50 minutes non-stop. But nothing changed, if not my eating disorder got worse. I felt stuck. If I was seeing a therapist, why weren’t things getting better?

Unknown to me, I was working with the wrong therapist. When you and your therapist are not a good match and you still continue therapy, you might end up worsening your situation. I was already very self-critical and low in self-esteem, not seeing any improvements after three years made me question my whole life and existence. ‘‘ There must be something fundamentally wrong with me, I binge eat constantly and even the best therapist could not help me. Maybe this is who I am ’’. This was my reasoning. So I decided to take the matter into my own hands. If recovery is not possible, then I need to find a way to fix everything , I thought. One day after eating to the point I felt sick, my brain came up with some unpleasant ideas to get rid of the calories. And it was only downhill from there. I developed bulimia nervosa.

That went on for another two years. There are no words to explain how hopeless I felt. Every day I told myself that I could not go on and that I would never be able to recover.

But in the end, I _ did_ go on. I _ did_ recover.

It would be unfair to generalize these phases to every single person struggling with an eating disorder. Every person has their own unique experience of eating disorders. I am only sharing what I went through.

But if you are reading this with tears in your eyes because you relate just a little too much, I am here to tell you, you are not alone. You are not a lost cause. I understand how you feel. And I know you understand how I felt too. I am sorry that you are going through this. This is your sign to fight another day. You are strong. Please seek the help you _ need_ and _ deserve_ . Recovery is always possible, no matter at which phase you are. I am the living proof of it.