Updated: Nov 13, 2020
As a child, Kelsey carved a hole in the box spring of her bed. That's where she hid the wrappers, willing the evidence of her appetite to disappear. She never asked for seconds at the dinner table, and she accepted her mother's "lite" cream cheese and fat-free milk without complaint.
“I can’t think of a woman in my family without some sort of disordered eating.” Kelsey racks her memory. "All of us were tall, athletic. We were thin, although who knows if we were naturally thin."
Natural or not, the merits of thinness were not be overlooked. Take this journal entry from Kelsey's own childhood diary.
Kelsey's reasons for wanting to be thin were only partially aesthetic. Both her family and peer group were made up of runners. Kelsey wanted to wear shorts, spandex, a sports bra. She wanted to be "on the same level" as her competition. She didn't want to be the "fat girl" on the team. Was her desire to lose weight superficial - or was it more than that? Was it the desire to belong?
Kelsey would complete cross country practice on nothing but a granola bar. She knew it wasn't rational, but she also had learned that rationality wouldn't get her very far when it came to fitting in. If she puked or fainted at practice, it was simply evidence that she was trying her best.
Trying her best meant a lot. In fact, it was everything. Stellar performance in school and sports gave her a sense of identity, a way to matter. Kelsey waffled between wanting to matter and wanting to disappear.
Eating disorders embody this same internal debate: to disappear, or to claim significance? To be the best, or to not be at all? Kelsey hatched a plan on lined paper, one suited to accomplish both: Eat slower. Record calorie count. Drink large glass of cold H2O in morning.
Kelsey coaxed her fellow members of the cross country team to take good care of themselves. Rest, recover, rehabilitate. Even as she fell apart, she played the team mom with ease. A parent who is present for everyone but themselves is, in fact, not much of a parent at all. And neither was Kelsey; she disappeared.
By the time she graduated high school, Kelsey was sick and tired of being sick and tired. She promptly quit running and gained a bit of much-needed weight. Unfortunately, a few months into her recovery period, her dad signed the family up for a half-marathon at Disney Land. While her competitive family whizzed passed Micky Mouse - it was a race, after all, and no time for pictures - Kelsey confronted her own limitations head-on, for once not willing to fight. What is wrong with me? She thought, switching from running to walking. Where was her drive, her self-discipline?
At the start of college, Kelsey felt isolated. Making friends was hard work. To add to that, she was for the first time in complete control of food. Unsurprisingly, she was interested in finally trying out full-fat cream cheese. It was scary to confront the need to explore, to indulge. She began to binge, and compensated for this with purging and restriction - behaviors that only maintained the cycle.
Joining a sorority in her sophomore year meant that Kelsey gained camaraderie in more ways than one. Finally, she had friends; unfortunately, they too were disordered. "In the house bathrooms, the drains were always clogged," Kelsey drily notes. "Were we vomiting because we were drunk, stressed, or bulimic?" The answer was conveniently ambiguous.
The first three years of college were marked, in Kelsey's words, by "barely getting by." She survived a sexual assault that she never quite accepted, let alone processed. She consistently self-harmed. The counseling and dietetic advice she received was insufficient. As Kelsey shares, I imagine the girl she must have been at the time. Her cheerful tone, her easy jokes, the way she graciously answers my every question - it's clear that Kelsey knows how to be likable, problem-free. In college, I would imagine she made a full-time job out of "I'm great! How are you?"
I'm just imagining, of course. I didn't know her then.
In her senior year of college, Kelsey began receiving the appropriate level of care. She alternated between partial hospitalization and intensive outpatient treatment at Opal: Food + Body Wisdom, an eating disorder treatment center just down the street from her school. Opal was and is rooted in intuitive eating and the scientific principles of health at every size (HAES). Kelsey unlearned old behaviors and, more gradually, old beliefs.
I ask Kelsey if we can pause for a moment. What does it mean for eating disorder treatment to be rooted in these principles? In practice, what's different?
For one, the weight gain associated with recovery is perceived as necessary, part of healing. This is true for those with anorexia and those in smaller bodies, but it's equally true for those across the spectrum of disordered eating, and those whose bodies are larger.
In this same mindset, food and movement are not punishing, but play. "If my groceries for the week included three kinds of cheese, the staff wouldn't question it," says Kelsey. 'They'd say, 'Cool! Whatcha makin'?'"
Mainstream eating disorder treatment professionals often entreat their clients to "trust the process." Don't worry; we won't let you gain too much weight! Sometimes they invite their clients to engage in body-tracing exercises, where they compare their real versus perceived size. The takeaway is always this: "See, you're not nearly big as you thought!"
Seem innocuous enough - until you realize the deeply problematic implications. In both cases, the treatment professional not only validates but endorses the fear of being bigger. ("If you were big, if you did gain weight - well, that would be a problem.") This fear of food, of weight, is antithetical to recovery.
As a counselor herself, Kelsey admires the integrity of the practitioners she saw in treatment. They refused to sell a version of recovery that appealed to clients' internalized fatphobia. They modeled a serious distrust of the cultural forces at work, particularly those that encourage body-blaming and body-shaming. Kelsey's providers showed her that no accurate appraisal of her eating disorder was complete without an uncompromising assessment of the sociopolitical landscape in which it developed. In comparison with simple "body positivity," this is hard work - requiring both the client and the counselor to broaden their gaze, to pivot outward.
Since her stay at Opal four years ago, Kelsey has very occasionally relapsed on eating disordered behaviors. More frequently she experiences the thoughts, but she sees them with fresh eyes. When she goes up a size in clothes, she gets to interrogate her latent fears of "sizing up." When her brain would have her believe that her body is the problem, Kelsey probes further for the real culprit. “I still struggle with my mental health," she says, "but I don’t take it out on my body."
Like it did for Sequoia, recovery from disordered eating has allowed Kelsey to "level up." She is now a counselor and advocate for those experiencing size discrimination. She has gone from focusing on disordered eating in therapy to focusing on childhood trauma. She has the energy and emotional availability to do more than put out fires and clear away the ashes. She is now on fertile soil and empowered to spread her roots.
To search for weight-neutral care providers in your area, search the database linked here.