It is a simple blueberry muffin: fresh, warm from the oven, crowned with a perfectly browned top and covered in sugary crumbles. It looks and smells delicious. Any normal person would enjoy this delectable bakery item as a breakfast treat or midnight snack. Not me. Muffins in general, and this muffin in particular, terrify me. In fact, I am afraid of anything that contains significant amounts of fat or sugar. I sit defiantly in my chair; arms crossed, mouth tight, looking straight ahead, and make sure my gaze avoids that buttery monstrosity. I refuse to let even one crumb of the blueberry goodness slither down my throat. There are rules that I follow, and breaking a rule was not an option today. The blueberry muffin was off limits.
“I really can’t do this,” I say to Tina, the ditzy psychologist-in-training. She gives her impeccable blond head a shake and sighs, “Yes. Yes, you can. One bite at a time.”
I stare down at the muffin, my anxiety heightens, and my head starts spinning with questions. Was it my imagination or had the muffin grown bigger? How much butter had the bakers used? Were those real blueberries? How many calories from fat were in this muffin? I feel frantic and desperate as the tears begin to well in my eyes.
“Please. I can’t,” I begin to cry. Tina starts to pat my back, as if that is supposed to suddenly make me feel better. It is a rather ridiculous sight: underweight girl swallowed by sweatpants and a hoodie while the ignorant intern attempts to reassure her that the bakery item is harmless.
I know there is no choice. Eventually, I am going to eat the damn muffin. The alternative, which involves a nurse shoving a feeding tube up my nose and down my throat while a machine pumps godknowswhat into my system, is a fate so painful I would not wish it on anyone. Defeated, I sniffle, blow my nose into a napkin, tear off a chunk of muffin and put it in my mouth. The moment that blueberry goodness touches my tongue, another voice enters the conversation.
“Fatass. You can’t control what you eat, can you? You think these people are trying to help you? They’re just going to make you fat. You were doing fine before. Since you’ve been ‘in recovery,’ you have just gained weight. You haven’t gotten healthier. If you keep eating like this and losing control of food, you will lose control of your entire life. If you eat this muffin, you will––”
The relentless voice goes on and on: insulting, harassing, degrading, and persuading. It can convince me that an apple will make me gain 10 pounds, or that if I don’t exercise every day that I will surely turn into a blob of useless gut. It also makes sure I know that I am a terrible student if I do not get an “A” in every class. I must be the perfect daughter, who always answers to her parents’ beck and call. The voice demands perfection in all aspects of my life.
I continue to tear off and eat pieces of muffin, and the voice continues its tirade: “You are disgusting: a failure, a fat, ugly piece of—”
I finish the muffin, walk out of the cafeteria, and down the hall, where I curl up into a tiny ball and proceed to cry and curse the muffin and Tina for making me eat it. It’s easy for Tina to cheer me on as I battle my way through the hellish snack because she has never lived with an eating disorder. She has never spent months in a hospital, gone through the physically painful process of “refeeding,” and been forced to give up the one comfortable, familiar, and controlled aspect of her life. To me, my eating disorder was my life, my identity, and I was in the process of losing it.
While my rendition of the muffin fiasco is actually a lighter rendition of the reality of the experience, I do not want to minimize the devastating quality of eating disorders. People with eating disorders are not shallow, close-minded, and wrapped up in physical appearance in the way one without the disease might think. What is really hiding underneath the obsession with food, weight, and size is much deeper and more complex than simple vanity. Beneath the façade is dissatisfaction and discomfort with existing in this world, and the despair that, no matter what, one’s efforts will never be good enough. When I realized that I had no control over circumstances outside myself, I turned my focus inward. By molding my outer appearance to fit an imaginary ideal, I could ignore the fact that I felt inadequate in all other aspects of my life. I convinced myself that as long as I remained a certain size, I was happy and in complete control.
I also want to clear up a few other misconceptions surrounding eating disorders. During my time in treatment, I came into contact with all kinds of people from all over the country. What I learned is that eating disorders are not just the disease of young, white, upper-class women. Out of the estimated 8,000,000 people in the United States suffering from eating disorders, 10 percent of the cases are men. Sadly, this number is probably skewed; many men who do suffer from anorexia (refusal to eat), bulimia (throwing up, purging, or fasting after eating), binge eating, or EDNOS (eating disorder not otherwise specified) are too embarrassed to ask for help because “men can’t have eating disorders.”
Doctors also often overlook older women because of the misconception that eating disorders affect only the younger population. From my own experience, I can say that many of the patients in my particular treatment center were over the age of 40 and have families. On the other end of the spectrum, some children are showing symptoms of an eating disorder as early as five years old. Eating disorders affect all populations: men, women, and children, no matter their age, race, or financial background.
I asked three fellow patients, none of whom fit the typical stereotype of a white, middle-class, young female, to share their stories. The first person I talked to was a 19-year-old man named Will* who has suffered from bulimia for nine years. We sat on the concrete stairs that led to the building’s entrance, enjoying the afternoon sun, and relishing in one of our brief 15-minute breaks between groups and meals.
“So,” I asked, “what is it like being a guy with an eating disorder?” Will sighed, picked a few blades of grass, and began to tear them into tiny pieces.
“There was always a lot of pressure to conform to what society accepts as ‘the attractive male,’” he explained. “You know, the tall, muscular, athletic guy. Because I didn’t fit this profile, I often felt inferior. The other piece is emotion. If men show their emotions or any kind of affection, it is either perceived as ‘gay,’ or that they are manipulating others in order to get something that they want. A lot of times, I get put into the ‘little buddy’ role and am not seen as an equal. People don’t take me seriously and I become somewhat like the ‘gay guy friend.’”
“Is it just because you’re smaller?,” I asked him.
“Yeah, plus once you recognize that you have [an eating] problem, the shame grows tenfold. There’s so much more shame in a man asking for help with an eating disorder than [there is for] a woman,” he said. “People are always taken aback when I tell them that I have an eating disorder. Thanks to society, women are ‘expected’ to watch what they eat. It comes as a surprise to many people when they hear that a man [also] wants to restrict his food intake in order to lose weight.”
I can’t argue with Will on this one. It is much more socially acceptable for a woman to have an eating disorder than it is for a man to have one. In past years, Will has been forced to repeat treatment at the same centers over and over because only a few facilities in the United States actually allow men into their programs. It’s a stigma that even the so-called experts on eating disorders have not completely come to terms with yet.
The next day, I spoke with Lisa*, a 46-year-old woman with an animated personality and strong convictions. I found her curled up in one of the private rooms trying to catch some shut-eye before dinner. I asked Lisa to describe how her eating disorder developed and how it correlated with her coming out as a lesbian to her friends and family.
“I started bulimia when I was 28 years old. This was the same time I ended a 10-year relationship with my best friend,” she said. “I came out to everyone, including my mother. It was really empowering…I think being closeted was really damaging and my eating disorder was related to that. My mom pushed me towards men, having me date a 25-year-old when I was 16. My mom wanted me to be her little feminine ‘girly-girl.’ I was always on a diet. She was always telling me to lose weight.”
Lisa paused for a moment, looked at me, and continued, “I remember this one time, when I was in third or fourth grade, I was sitting in my mom’s kitchen and I started to eat a bunch of cookies. After I was finished, I decided that I would simply just cut the fat off of my stomach with a kitchen knife. I put the knife up to my skin, but realized that, of course, that wouldn’t work.”
I tried to imagine little, third-grade Lisa holding a knife up to her stomach, but it was too sad and horrifying to picture. I was in third grade when my own issues with food began, but at least I had a mother who never pushed me to be a certain size at such a young age.
“What has it been like for you since being in treatment?” I asked her.
“I’ve been feeling so much loss, especially being around young people. I feel like I’ve wasted my life, always thinking about being fat, trying not to get fat, engaging in behaviors [to prevent getting fat]. I feel old and I’m worried. What if I’ve done permanent damage that I am going to have for the rest of my life as a reminder?” she said.
I thanked Lisa and left her to the rest of her nap.
That night, I telephoned Rachel*, a woman who has lived with anorexia for over 45 years. I listened to the phone ring numerous times before she picked up.
“Hello?” Her voice was quiet, sweet and grandmotherly.
“Hi, Rachel! How are you?” I tried to begin the conversation on a light note, I was afraid that if I dove into a potentially upsetting conversation too quickly, Rachel would be reluctant to open up about her experience. We talked about what each of us was doing in our daily lives. Rachel had been focusing on doctors’ appointments, painting, and her children and grandchildren. Just when the conversation began to falter, I mustered up the courage to ask Rachel about her journey.
To my surprise, she willingly began to tell me about her tumultuous life with anorexia, an abusive husband, and a devastating event that caused her last relapse.
“When I was a kid, my parents didn’t teach me anything about life. I was raised in a hardcore fundamentalist family, where if you weren’t ‘perfect,’ then something was wrong with you,” she explained. “I remember that I started hating myself when I looked my reflection at age seven or eight and thinking, ‘Look at that fat, ugly girl.’
“I was in high school when I first had signs of it. I never really understood what happened, but it got worse. Back in those days, nobody knew anything about eating disorders. They would simply put you in a hospital, feed you, and turn you loose. The doctors just made me gain weight and we all know that gaining weight is only a small part of treatment.”
It is an anorexia patient’s worst nightmare to be strapped to a hospital bed while being pumped full of fluids and nutrients. We know now that being forced to gain weight and then being released into the world without any coping instructions, any support, or any motivation to recover is dangerous.
“After college, I met my husband, who had just come back from Vietnam,” Rachel continued. “I had no idea that he was an alcoholic, a drug addict, and extremely abusive. I stayed in the marriage for 12 years, but the only coping mechanism I had was anorexia. Even though I was very sick, I was still able to take care of my sons. That’s all that mattered to me. I didn’t matter to myself. Things turned around when I got divorced. I had custody of my kids, went back to school, and became qualified to teach Special Ed kids.”
When I asked about her most recent relapse, what she told me next caught me completely off guard. Six years before, Rachel was raped at gunpoint while out on a familiar trail during a Saturday afternoon walk.
“I coped by engaging in my eating disorder and I never dealt with the rape,” she said. “I had to get away from the state in which I was living, so I moved. But I kept starving myself. I didn’t want my sons to have to deal with their mother getting raped.”
I sat frozen at the computer, unable to type. There was a knot in the pit of my stomach. For a moment, I was certain that all of the nutritious food that I forced down my throat earlier in the day was going to reappear in a most unpleasant state on the bedroom floor. After a few hard swallows, I regained my composure and nervously blurted out my next question.
“And you finally got help?”
“My daughter-in-law found this treatment center and I was immediately admitted into acute care. This is the only time in my life that I have had treatment. I never thought that there was something mentally wrong with me, but I talked to a doctor a few weeks ago, and she told me that anorexia is ‘the medical complication of an emotional problem.’ I didn’t realize how depressed I was until I finally got help. I think that if I had had this treatment when I was young, I wouldn’t have allowed anorexia to destroy my life.”
Rachel did not break down, cry, or even complain. Her strength after all of that trauma, abuse, and misery, and the very fact that she accepted treatment at age 65 astounded me.
“I know that if I hadn’t gotten help this August, if I hadn’t gone into treatment, I would have died,” she said. “I think it’s a miracle that I am alive today. I’m 65 freakin’ years old, but you know what? You’re never too old to get better. You’re never too old to get help.”
I sat on my bed for a while thinking about Rachel’s story, and Lisa’s, and Will’s. They are three completely different people, from different States and backgrounds, and they espouse different values. Yet, I recognized their related feelings of inadequacy and inability to be my own person. All of us were lacking something, so we controlled our diets to fill that void. Now that we are all separating from the disease and working toward recovery, that void becomes even more apparent. We have no choice but to discover who we really are without the disorder. After all this time, each of us has been given the chance to finally find out what we are each truly passionate about, what we value, and what makes our lives meaningful.