The fact that one in five people with Anorexia Nervosa who aren’t in treatment will die is tragic but, perhaps even more tragically, unsurprising. It’s unsurprising when we consider how much Anorexia impacts people in every aspect of their life.
As an illness which is characterised by ‘an intense fear of weight gain’, people with Anorexia are typically underweight. Even in cases where people are not underweight, in an effort to prevent their greatest fear- gaining weight- from arising, they will engage in self-harm behaviours such as restricting their food intake, over exercising, bingeing and purging etc, all behaviours which put an undeniable strain on the human body, something which can lead to death… For, the heart is a muscle and, like any other muscle that is overworked and denied rest and recovery, it can’t keep going forever. Under such constant strain it will eventually rupture. However, the more likely result of death from Anorexia is not from the physical side effects of the illness, but from the mental side effects.
Anorexia: The Mental Illness Where The Mental Symptoms Get Ignored…
When Anorexia so often presents itself physically, in people who are emaciated, who look physically really unwell, the mental side can get overlooked-
appointments focusing on the declining number on the scales,
the worrying blood test results,
bone scan readings-
all the while, someone’s mental health is being completely ignored, despite their physical ill health being only a fraction of what is going on inside their mind.
Despite being a mental illness, the mental struggle gets overlooked in favour of dealing with the physical struggle.
And so, based on this, it’s unsurprising then that so many people resort to suicide as a ‘way out’ (one in five deaths from Anorexia are attributed to suicide, with eating disorders increasing the odds of suicide in teenagers and young adults by up to 32 times)…
When I was 16 and at my lowest (not just physically but mentally, too), I was going to CAMHS every day for them to weigh me and tell me that my bone marrow was failing, that my heart was shutting down, all the things that were wrong with me physically, all the while the absolute hell that was the struggle going on in my mind was completely ignored.
I was told that I couldn’t receive therapy until my BMI had increased for, ‘I wouldn’t have the capacity to take anything in, so therefore it wouldn’t work.’ But, when Anorexia is a mental illness, ‘an intense fear of gaining weight’, the expectation that people will gain weight before they are given any support mentally is completely nonsensical. I’m not saying that I didn’t need to gain weight, I did but, in the same way that someone with cancer wouldn’t be given talking therapy before life saving chemotherapy, because that just makes no sense, I shouldn’t have been denied talking therapy until I gained weight, when it was talking therapy that I needed so that I could see my need to gain weight for myself. I think this is why so many people struggle with Anorexia for so long, sometimes for their whole lifetime because, the physical issue is dealt with- we’re shown how to gain weight, how to be healthy on the surface, externally, but, we’re never really shown how to gain our life back, how to be healthy internally, how to be well mentally…
We’re so focused on the the externally presenting symptoms of malnutrition- the low weight, the blood test results, the weak bones, the low heart rate, whatever it may be, to the extent that we fail to realise that what we are seeing on the outside, doesn’t even touch the surface of what is happening on the inside– within our minds. We fail to realise that, with every emaciated body there is a completely messed up head that just wants to feel better…
You can tell us that we need to eat more, get us back up to a healthy BMI but, ultimately, what’s in our mind is still going to be there, albeit hidden for you, but a constant source of pain and struggle for us. A struggle that only intensifies as the years go by when, because we look better on the outside– we eat, we’re a healthy weight- people automatically assume that this translates to us being better. The reality though is that, in dealing with the physical symptoms while completely ignoring the mental symptoms, we are essentially applying a wet paper towel to the chest of someone having a heart attack. Covering it up, pretending that it’s not happening because we can’t see it happening but, all the while, inside, we feel like we’re dying.
It’s why so many people, having ‘recovered’ from Anorexia (i.e., having gained weight so that they’re no longer diagnostically eligible for having Anorexia Nervosa), still struggle so much with their mental health (between 50% to 75% of those that struggle with an eating disorder will also experience symptoms of depression. Why? Because, the issue is still there. It was never properly dealt with. The feelings of unworthiness, of being ‘too much’, of general self-loathing, they’re still there.
This is my reality, anyway. It’s taken me a while to realise that it’s Anorexia, not the remnants of a ‘teenage illness’, but the illness itself, having never gone away. All the thoughts are still there, but I just don’t act on them now and, because I don’t act on them (i.e., because I don’t starve myself or run 10 miles a day), I don’t ‘look’ like I have an eating disorder. But, where Anorexia is ‘an intense fear of weight gain’, I am Anorexic.
Where Anorexia is a desperate clinging on to a sense of control, I am Anorexic.
This (^) being a fact that is awakened in every area of my life…
In my relationship with myself- never feeling enough.
In my relationships with others- constantly feeling too much.
I struggle with feeling like I am deserving of anything/like I am worth anything. All the issues with self-esteem are still there, at the forefront of my mind every single day having never left. It’s relentless. And, you can tell me that I am enough, that I’m not too much, that I am deserving, that I am worthy but, I won’t believe you, for so ingrained has this become in my mind, more than eight years worth of it. When a habit takes just 28 days to form, well, when you times that by 96, that’s a lot of unbreaking to be done.
And so, physically, sure, you might look at me and say that I am ‘better’ now, that I am ‘recovered’ but, mentally, I am still that lost 14 year old girl who just wants to feel good enough.