The Truth about Relapse

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.

24 responses to “The Truth about Relapse”

  1. Thank you so much for sharing your struggles. It’s helping me know what to do for my little sister, and we’re getting desperate….I wish you didn’t have to go through this ever, in the past or with the struggles that remain today. Along with my sister, I am praying for you, that God will always give you strength.

    • Thank you so much. I really appreciate that. I’m so sorry to hear that your sister is struggling with ED. I will definitely keep her, and you and your family in my prayers. She will get through this. God will give her strength. Thanks for stopping by!

  2. I don’t want to tie you up by commenting on every single entry, and I was restraining myself on this entry until the last paragraph. “They felt worthless,” pulled me right in, again, but for more than one reason. After I manage to pull myself away from your words today, I really need to get started on my next blog entry. Lo and behold, my next entry is to be titled “Your Life Matters.” As I mentioned, I struggle with depression, and I know many others who do. I find it is easy for people around us to feel like “you should be able to just get over / through this” but it’s not that easy – not easy at all. Anyway, I thought it was interesting you discuss the significance in perpetuating, even unintentionally, a sense of worthlessness in those desperate to find even an ounce of self worth on which to grasp.

  3. I’m sorry to impose. I decided to do a search under the term “relapse” on your blog to see more about this topic, as you have written. I am finding more than I bargained for. I was out-of-place asking so many questions. You HAD written to topic quite well, if I had just known where to return. I do not have photographic memory. Excuse my impertinence, but I believe your wires are crossed. I believe the blessing was ED, and the problem WAS the expectations, demands, particularly, as I read in the concluding paragraph –“better than that”– intonations. I believe your choice to be anorexic, no matter Death being a constant (I am a mathematician), still sometimes what we choose kills us. But it’s a choice. The absolute wariness of potential death, whether physical, social, ecumenical, or academic can be all-consuming as to pose an idol-form of deity itself. I refer to book of Revelation 12:11 where the saints overcame Lucifer through testimony, blood of Jesus and loving not their lives even unto death.

    To give in to expectations of “well-meaners”, as parents, neighbors, siblings, simply on grounds that “they have our best interest” is itself suicide. WE alone have our best interest (Maybe God, too, if you believe in that.). I believe you were right not to turn immediate to Jesus at the behest of mother, because a sincere heart does not come from another giving their “best interest.” and following that other person’s idea. The seed of faith is germinated in the WORD alone, not in the pressures to go a certain way. Choice should always be on the table. I don’t want you to run from ED. I don’t want you to run from expectations of being, how do you say, “better than that.” I just think, and this is just me, (whether with God or however) faith is always the answer. What do I mean by that–try anything.

    You seem to be a very good calorie counter. You seem to know substance, as apple peeeeeel. You have a very keen mind to detail. THAT is your strength. ED has allowed you to increase strength of mind-to-detail. Painfully, yes, but still. Your strength developed, leads you to conquer in many a field. The same strength that kept you fortified to ED is the same strength to get you out permanent. I have often found that what generates a problem is itself a solution, just as often close to poison ivy is the soft-leaf plant (I forget the name, something like milkweed but not) to heal it. Meeting people’s expectations is NOT nor will ever be a cure. Your mind for detail is your cure. The same mind that counts calories, the same mind that selects the Particular apple peel, the same mind that measures steps and treadmills so effectively, and minutes and (half-hours). The mind for excellence. The mind for truth within you. I fear (and this is MY fear) is that giving so much over to Jesus (I don’t want to dis religion) and continuing to give credit to him, you hinder your strength, which is that vice-grip mind you have. Don’t make yourself dumb over people’s expectations, even if that expectation is to FOLLOW Jesus. Be all you can be. Isn’t that the ESSENCE of Jesus–“For God so LOVED the world (John 3:16) … [as to] life eternal.” Isn’t LOVE teaching the HOW to overcome? You are then thankful, not that he is THERE, but rather that THROUGH him you are STRONG–you overcame! As seven times repeated the phrase “He that overcometh…he that overcometh… …. in Revelation 2-3).

    I’m not trying to mess you up. I’m not trying to mess with your head. I just think that finding positive objectives will bring food into your mouth and anorexia bye-bye gone-gone for good. I think you are in the “furnace of affliction” spoken of by Isaiah when he says, “I have chosen you IN the furnace of affliction.” Did not Jesus also say, “Take no thought what ye shall eat or wherewithal ye shall be clothed…” (Matthew 6:25). You are simply taking this commandment to possibly where it needed to go for you, for the lesson of your strength.

    I don’t think I can tell you what you needed to know. All I wanted to do is provide another perspective that maybe you haven’t heard before. I am told I think in a different paradigm than the rest of society.

    I probably spoke too much. I’m sorry if I spoke out of turn.

  4. My god, this completely sums up my relapse into Ed and alcohol seven months out of treatment, I mean *completely* it’s like you took the words written on my heart and posted them. It’s good to know I’m not totally alone x

    • Hi Robbie, thank you so much for sharing this. I’m sorry that you can relate so personally. but you’re right, we’re not alone. praying for you, friend, in your recovery. you got this! hugs xox

  5. Yes, I am on a reading role 🙂 I love your writing, and I’m considering writing some more personal posts somewhat in a style of what you’ve shown. You’re an inspiration. (And I’m a picky reader, so your work speaking to me is a big deal)

    A lot of people forget the internal battle when it deals with someone they know. Whatever the person is dealing with.

    I myself went through a period of depression, and it hit hard in the spring of 2012. God got me through the hard days, but the thing is I never really revealed the intimate thoughts/feelings of the depression to Him. I just skimmed the surface when I talked to Him about it. I, too, was in college when this happened. I was failing my courses, struggling with the thoughts of feeling like I was letting everyone down. It really hurt.

    I was never suicidal, but I also didn’t want to exist. I told my best friend I’d rather be in the courts outside of God’s temple.

    Four months go by, and I knew I had to give it to God. So I sat down on my bedroom floor, and I opened the Bible up. Do you want to know what the Bible opened up to ? A scripture that said, “I’d rather spend a day in Your courts.” And my eyes watered knowing God was speaking directly to me. Telling me, He understood. He knew my heart. And when I read that I felt loved and I heard. I knew I was ashamed of myself. Afraid of failure. Afraid of admitting the truth.

    And through it all, God knew.

    And He still loved me, and wanted me to know. <3

    Praise God that He will use our most intimate and ugly feelings/thoughts to show us the truth of His light, and His love. For He is the Potter, and we are the clay.

    <3 T.R. Noble

    • Wow, TR, that is such a powerful testimony. I’m so sorry that you’ve had to walk that journey, but I’m so glad you’ve found that healing and embraced His love. That is so so true – God knows our hearts and wants to take away those fears and trepidations from us and give us peace. Yes, praise God. And I hope you do decide to publish those innermost thoughts! It think it would be a blessing to so many people, and I, for one, would love reading your words. You have a powerful testimony! hugs friend xox

  6. Good morning!

    This post speaks with such honesty and power to all of us who struggle with those demons that become their own little idols in our heads. The myths we tell ourselves to help us cope with the self-loathing, the feeling that failure to meet others’ expectations lurks around the corner to consume us, the feeling of shame that when born immediately begins to twist itself into a seductive beast that invites us back inside our heads over and over and over again.

    I thank you for this, you have no idea how powerfully you are informing my journey as I set out on a road I have always seen through the trees but never had the courage to walk. Now I take those simple first steps and the birds waking to my morning in life sing to me that we are not alone, no matter how less travelled the road remains.


      • So many thoughts race through my mind this morning I would like to share, but time is short due to work commitments. I did send a note via email a few days ago, not sure if you saw it. Hope you are doing excellent today. Holding on to the light and the hope. May we not be alone, indeed.

  7. This post…wow. I relate so much. Because although I was never extremely underweight, I starved myself and kept going until I thought I was small enough. And even when I quit, I started making myself throw up or purge in any way I could. Relapse is hard, and I’m not gonna lie and say I don’t still struggle some days because I do. But I’m better than I was. I’m glad you are so open and vulnerable in your writing. Thank you.

    • Thank you for sharing your story. You’re right – recovery is an every day decision and relapse is definitely real. I’ll definitely keep you in my prayers. You’ve got this, friend. Hugs and love xox

      • It’s kind of weird because my eating disorder at first was more about just losing weight but as it went on, it was more about wanting to disappear because I didn’t want anyone to get close to me. Thank you so much, I appreciate it. I’m gonna keep reading your blog posts and catch up on your story eventually. You truly are very gifted!

    • I’m glad this resonated with you. Recovery is a long and winding road for sure, but always forward 🙂

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