Updated: Nov 13, 2020
Typically, when I think about eating disorders, I focus on the similarities. Rigid rules, preoccupation with food, secret behaviors, body dysmorphia, shame. Regardless of whether someone struggles with anorexia, bulimia, binge eating, or the whole host of unspecified eating disorders, these common threads persist.
But what about the differences? I’m not sure how much the differences matter. In alcoholism, they don’t; in alcoholism, it doesn’t matter if you drank in the morning or only at night. It doesn’t matter if you drank alone or only with friends. In disordered eating, does it matter if you restricted food groups versus counted calories? Does it matter if you compensated by throwing up your food, versus trying to exercise it away? What meaning, if any, can we make of the differences?
Leigh’s story is different from mine. Decide for yourself.
When Leigh was around fourteen, she began to transform from a gangly kid to one approaching puberty. Her first memory of body consciousness occurred at home. Leigh sat next to her dad while she ate a cupcake. “That was cute when you were little,” he told her. “But it’s not anymore.”
While her older sister introduced her to makeup and home workout videos, her mother introduced her to body dissatisfaction. Although she never suggested that Leigh diet, she modeled dieting as a viable way of being, forever. She has been on Weight Watchers for as long as Leigh can remember. At 27, Leigh is finally learning to tune it out.
Leigh lost a few pounds the summer before her freshman year. On the one hand, the transition to college was stressful; on the other, it afforded her the freedom to use and abuse food in ways she never had at home. Leigh’s one and only coping mechanism was available just in time, right when she felt she needed it. Binging and purging lead to weight gain, and she quickly became miserable.
Disordered or not, Leigh has always had a low tolerance for bullshit. It’s one of my favorite things about her. She soon began seeing both the school therapist and a local nutritionist who specialized in disordered eating. The nutritionist invited Leigh to eat salt, sugar, fat, even alcohol - all in normal quantities, each time keeping it down. Over the course of the following year, Leigh’s weight fell to its natural set point.
If that sounds too simple to you, you’re not alone. It does to me, too. I was shocked that, as a disordered eater, Leigh could simply allow her weight to return to its natural set point. In my disease, “successful” weight loss triggers the compulsion to continue losing. Wasn’t it the same for Leigh?
In a word, No. Although Leigh struggled with body image, weight was more peripheral to her disorder than mine. “I didn’t have an eating disorder because I thought I was fat,” she said. “I had an eating disorder because it was the only way I knew to cope.” True, in order to get better, Leigh had to remember how to eat normally. But just as important, she needed to learn how to manage life on life’s terms.
Two years later, a rocky transition to a summer internship had Leigh grasping for control. Again, she began to binge in private, though she less often threw it up. “The purging part wasn’t very satisfying,” she said matter-of-factly, “and it didn’t actually work to prevent weight gain, anyway.”
I laughed again at the simplicity. My eating disorder was less attuned to what “worked.” Like Leigh herself, Leigh’s eating disorder was a little better at negotiating. It knew that to gain any credibility with Leigh, it would need to make a strong case. Purging was out, but the self-perpetuating cycle of binging and restricting was still in.
This relapse lasted for two and a half years. It saw her through two stressful moves and two equally stressful jobs. Leigh and I made a habit of checking in on each other’s eating disorders during this time. While hers was in full swing, mine had temporarily taken a backseat to alcoholism. “I don’t really think about food anymore,” I boasted - in complete denial of the fact that booze had taken its place.
Three years ago, a temporary period of joblessness allowed Leigh the time and space to address her bulimia once again. She thought back to her freshman year nutritionist, who Leigh now recognizes as a proponent of intuitive eating. Don’t count calories, she told Leigh. Eat food, even the sugary and salty kinds. Throw away your scale. Accept your body as it is. Eat normally; weight loss or gain is merely a side effect.
“Yes, I was heavier than I wanted to be,” Leigh reflects. “But I was also tired of hating my body.”
Leigh hasn’t binged or purged since November 2016, and she has returned to her set point weight. She still eats mindlessly sometimes, overeats others. This week, bored at work, she ate three bowls of animal crackers - a food she doesn’t even like. But here’s the thing: We all do that. (Maybe not with animal crackers.) These behaviors aren’t a relapse, but rather a flexible way of being. Yes, as humans, we sometimes use food in funny ways. As long as we don’t pathologize ourselves, it can stay that way: Funny.
Leigh says that her eating disorder never totally goes away. Just this month, she ended a romantic relationship in which her partner was nearly her same size. She is working to accept the fact that, at least for now, she wants to feel like the small one.
This reminded me to ask: “Do you think our romantic partners contribute to our eating disorders?”
She nods fervently. When someone important tells her she looks great, it matters. When he asks about her history, that matters too. In contrast, she once mentioned her eating disorder to her ex, and he acted as if he hadn't heard her. “I sent an invitation,” she says, “and he didn’t pick it up.”
Leigh avoids spending time with people deep in their disease. Perhaps they maintain a clinically significant eating disorder, or maybe they just have untreated "food issues." Either way, these people make poor company.
Twice this year, I visited Leigh. Both times, she noticed that I’d lost weight. She asks me now if she should’ve said something; I tell her no. I ask her if I was hard to be around; she tells me yes. Her disease had slyly commented: Anna's smaller. Maybe you should be smaller too.
This was humbling. Despite my extensive research into the relationship between disordered eating and relationships, I’d somehow forgotten that my own disordered eating could threaten the recovery of people I love. No, I wouldn’t expect that information to bring my eating disorder to its knees; these disorders are selfish by nature, bent on self-preservation. I will say, however, that an unexpected benefit of eating normally is that I can stop making daily contributions to diet culture.
I know that Leigh said it never fully goes away. But as I listen to her speak, I wonder if she herself isn’t evidence to the contrary. Yes, she still wonders about weight loss, and yes, she can occasionally find herself making useless comparisons with other women. But I wonder how many women in 2019 can say otherwise. When I look at Leigh, I’m reminded of the girl I saw in class back in college, then a stranger. I remember watching her give a presentation and thinking, Wow. She's just a whole lot better at this than the rest of us.
I thought the same thing as Leigh laughs dryly about the animal crackers. “Yep, I ate them because I was bored,” she says. “Nope, it wasn’t a problem. It was normal.” Got a problem with normal? I could practically hear her boredom with her own eating disorder, which was now sulking in the corner.
Indeed, eating disorders have a huge problem with normal. But, as Leigh’s story shows, we don’t have to listen.