Let’s talk about relapse…
Statistically speaking, one third of people with eating disorders relapse after they “recover.” This is for a variety of reasons, but my main guess is that, due to insurance reasons, once the weight gets put on, she gets discharged, as insurance covers the only the minimum amount of time possible at inpatient. You see, inpatient treatment for eating disorders is astronomically expensive. My stay at R cost my parents upwards of six figures. $160,000 to be exact. And to be frank, putting the weight on is like putting a bandaid on a stab wound: it’s just fixing the symptom of the deeper, mental and emotional issues that are the cause of the disorder. The weight is simply a manifestation of the bigger issue at hand. Therefore, the girl leaves inpatient absolutely terrified of the weight she’s gained, because she hasn’t truly got the tools to combat the voices in her head.
Like I mentioned earlier, I relapsed before I even set foot out of inpatient hospital. I couldn’t wait to go to college so that I could get back into my eating disorder.
Somehow, I had managed to get into college while all this was happening. I got home from R, and basically had two weeks until I had to be at orientation. So during those two weeks I was home after inpatient, I “followed” my discharge meal plan in order to keep up the “act” that I was “recovered.” In actuality, I was just counting down the days until I could get to college and get back in my eating disorder.
You may think it was irresponsible for my parents to allow me to go to school so far away after just recovering from an eating disorder. But the deal was that I would have a team of doctors and therapists in place at school that I would be responsible for meeting with every week. The thought was that going to college would help me “normalize” and have goals to work for again that weren’t my eating disorder. (More on that later.) But as it would turn out, I would only visit my therapist once, and I never went to the dietician.
My relapse was severe. You could argue that since I had no one to be accountable to, I took it to the extreme. I did live with a roommate, but she was too busy having phone sex with her long distance boyfriend (with me in the room, I might add) to notice.
I did give succeeding at school the “good old college try.” I rushed a sorority, got straight A’s, tried to make friends, even went to parties. But in the end, I just got sucked into the eating disorder again. I wasn’t a promiscuous girl, and so since there were no friends or boys around, my eating disorder quickly became my best friend.
I had a meal plan at the cafeteria, and I went three times a day, but I was barely eating anything. In the morning, I would have one hard-boiled egg white. Lunch was another egg white from the salad bar with the skin of half of a green apple, and dinner – if I went at all – was lettuce from the salad bar with balsamic vinegar.
That seems pretty alarming, and it was. But that’s the thing about the disease – there needs to always be “progress” – progress in the numbers of the scale going down and progress of slowly diminishing the amount of food you eat.
There were three or four times I remember I went to the cafeteria and binge ate – pizza, waffles, fried green tomatoes and okra, corn bread, fried chicken, you name it. But then the following day – sometimes two – I wouldn’t eat a single thing. Not even water. I felt so dirty and so disgusted with myself afterwards that I took that punishment to the extreme. However, looking back, I think the nutrition gained from those three or four episodes are what kept me alive.
My daily routine: I would wake up at 7 am for a 9 am class every day. I’d leave for the cafeteria at 7:20, but wouldn’t get there until 7:50 because I’d take a 30 minute walk before and after my egg white. Same with lunch and dinner. I walked all over campus. All over the city. I also visited the gym every night to walk on the treadmill and do sit ups on the exercise ball. I’d watch the Food Network while on the treadmill. For anorexics, the Food Network is like watching porn. Literally. There is some masochistic pleasure in watching people cook and consume food – it’s euphorically torturous. Watching the Food Network was something I had to do in secret at home, because it made my mom physically sick to see me watch the Food Network in her presence.
I remember the girls in my dorm all getting together on Thursday nights to watch Grey’s Anatomy and eat Ben and Jerry’s. I would always find an excuse not to go. I would just leave to go to the gym or library. Isolation and eating disorders go hand in hand.
I don’t remember how low my weight got that first semester, but it was scary enough that my parents wouldn’t let me go back after Christmas.
During that time, my hair fell out. It literally fell out and I had to chop it all off. Now, you have to understand, my hair was my trademark. I don’t mean to boast, but I have this gorgeous head of thick, curly, hair. Big ringlets. It’s what I’m known for. Well, due to the lack of nutrition, it all fell out. I was left with peach fuzz about 2 inches thick. So I had to cut all of it off at the ears. I was unrecognizable. Seriously hideous.
That’s a glamorous side effect of eating disorders they don’t tell you about.
But I never told anyone at home that I was struggling with my eating disorder and relapsing. I was ashamed and frankly, I was too wrapped up, like I was during my senior year, to give anything or anyone a thought.
Plus, I didn’t want anyone to know that I had failed. I knew how angry and upset my family would be after everything they’d been through. I already was carrying around so much guilt from the lying and deception from before. This was just another layer of self-loathing on top of it. “Of course I’d let them down – because I’m an utter, worthless piece of shit. What else would they expect? Once a failure, always a failure.” Those were the tapes that would play over and over in my head.
I had so much self-hatred and shame, and that was reflected in the deterioration of my body and the withdrawal from my family and friends.
That’s the reason why relapse is often more secretive than the first onset itself. It’s because now, post-rehab, there’s so much more shame associated with it. Additionally, your daughter has seen first hand how “proud” and “happy” you were when she “beat” the disease. She saw that her actions really do have a deep impact on your wellbeing. How could she submit you to the same torture as before?
And furthermore, by admitting that she’s struggling, she’s showing weakness. I know for me, there was so much fear of showing my father that I had failed again. It was one thing to get anorexia in the first place. But, hey, she had gone to inpatient and was cured. See that? It was just a fluke. Nothing wrong here. Time to get on with things. She’s cured. But the truth is, I wasn’t and I’m still totally not. How could I tell my dad that I wasn’t cured and that I wasn’t strong enough.
And even more so than that, how could I tell my mom that I again was back in that dark place? With her, it was more of a moral disappointment. She thought that if only I prayed more or was closer to Jesus, then I wouldn’t be having these thoughts. That Jesus would fill the emptiness inside that the Eating Disorder was filling. And you know what, she was actually right, and I just didn’t want to hear it at the time. Listen when I say this: when you are in the throes of anorexia, not even that can pull you out of it. That’s what was so hurtful. I believed that my mom thought I was this atheist heathen, absorbed in vanity and secrecy. Yes, that was partially true, (not the atheist part), but that was my Eating Disorder. I know it sounds like such a cop out, but did you know that I was in prayer every day, went to church more than once a week, (granted I was petrified of the calories in the communion wafer and would often not eat for the rest of the day as a result), and had a deep love and trust in God. But all that was clouded by my anorexia and I couldn’t get through the fog. I didn’t want to share that with my mom because I felt this immense judgment that, “Well my daughter’s going to hell,” or, “I can’t believe I raised such a moral disappointment.” This seems extreme, but after you “beat” anorexia, and you relapse and are back in it, there’s so much anger and hurt around that history, that admitting you’re still sick has so much guilt, and shame, and disappointment attached to it that you conceal it like crazy.
And she’s “better than that.” That language is so dangerous when it comes to anorexia. By saying or implying that she’s better than that – that she’s better than having a relapse, or better than having an eating disorder, not only does it nonverbally place an expectation on her, as she’s fighting just to make it through a day, but it also implies that she has a choice in the matter: That she’s just choosing not to eat. And although, yes, it may seem that she is just deciding, or making the choice to lose weight and not eat, the truth of the matter is that she’s not – it’s more complicated than that. Believe me, she’s trapped in this disease and can’t get out. And if she had the choice, she’d be in a different place.
Lastly, the harm in the thinking that she’s “better than that,” is that it places her value and worth in the disease: connected to it; dependent on it. Remember those mental tapes and lies I talked about before? Well, this is a biggie: nearly every girl with anorexia has some sort of issue with self-worth and value. It was true for me and it was true for probably 99% of the girls at inpatient with me. They felt worthless. You may not mean to send this message, but by saying or acting like she’s “better than that,” better than having an eating disorder or better than relapsing, sends the message that she is good when she doesn’t have an eating disorder, and she is bad when she’s in the eating disorder. Sounds nit picky, but her entire life is a series of nit pickiness and obsession. Little things can feed the disorder, and this is definitely a big one that contributes to a lot of shame and self-loathing.