An Open Letter to Anyone Hiding an Eating Disorder
The true costs of suffering in secret—from someone who's been there.
Once upon a time, you lied because you didn't want anyone to stop you. The meals you skipped, the things you did in the bathroom, the scraps of paper where you tracked pounds and calories and grams of sugar-you hid them so that no one would get in your way. Because no one would ever understand you, understand how you needed to control your body, whatever the cost.
But you want your life back. The life where you could listen to a conversation at a party without thinking about the food table, the life where you didn't steal granola bars from the box under your roommate's bed or resent your best friend for having a meltdown that kept you from your evening workout.
I get it. Oh my goodness do I get it. I spent four years of my life consumed by eating disorders. After the first year or so, I became desperate to recover. I threw up blood; I lay in bed convinced I would die that night of a heart attack. I violated my personal code of ethics, again and again. My life shrank until it was barely recognizable, a shriveled remnant of a life. Bingeing and purging stole the time and energy I should have spent studying, pursuing my interests, investing in relationships, exploring the world, growing as a human being.
Still, I didn't seek help. I didn't tell my family. I saw only two options: fight my disorder on my own, or die trying.
Fortunately, I recovered. I moved away from home, shared a bathroom with a roommate, and-after many failed attempts-finally broke the habit of bingeing and purging. And I felt proud that I had overcome my eating disorder on my own, without inconveniencing my parents, without incurring the costs of therapy or treatment, without outing myself as someone with "issues."
Now, more than a decade later, I regret not seeking help and opening up to people sooner. If you're coping with an eating disorder in secret, I have so much compassion for you. I see how you're trying to protect the people in your life, how you're trying so damn hard to do everything right. But there are serious reasons to open up. Here they are:
1. Even if you recover on your own, the underlying issues will most likely come back and bite you in the ass.
Ever heard the term "dry drunk"? Dry drunks are alcoholics who quit drinking but don't make substantive changes to their behaviors, their beliefs, or their self-image. And after my recovery, I was a "dry bulimic." Sure, I no longer binged and purged, but I didn't address the anxiety, the self-hate, or the black hole of shame and isolation that led me to become eating disordered in the first place. As a result, I embarked on new bad habits, attracted painful relationships, and generally made myself miserable.
This is a common pattern among people who attempt to work through eating disorders on their own. "The main behaviors may go dormant," says Julie Duffy Dillon, a registered dietitian and certified eating disorder specialist in Greensboro, North Carolina. "But the underlying issues remain and fester."
The upside of this situation is that treatment for an eating disorder can resolve so much more than just your relationship with food. "If you get help in discovering and dealing with the underlying issues, you have an opportunity to clear a pattern of being in the world that is not serving you, and you have an opportunity then to have a more fulfilling life," says Anita Johnston, Ph.D., clinical director of the 'Ai Pono Eating Disorder Programs in Hawaii.
2. Your relationships are suffering in ways you don't see.
Sure, you know that your loved ones are baffled by your mood swings and irritability. You can see how hurt they are when you cancel plans at the last moment or withdraw into food-obsessed thoughts when they're trying to have a conversation with you. You might think that keeping your eating disorder secret is a way to compensate for these shortcomings.
I won't give you anything else to worry about, you might think. But secrecy can damage your relationships in ways you don't even realize.
Remember those parents I tried so hard to spare? Nine years after I recovered from my eating disorder, my dad died of cancer. It was a slow, painfully protracted death, the sort of death that gives you plenty of time to consider what you'd like to say to each other. And I considered telling him about my bulimia. I imagined finally explaining why I'd stopped practicing the violin as a teenager, even though he tried so hard to encourage me, even though he drove me to lessons week after week and took careful notes of everything my teacher said. Every day he'd come from work and ask whether I practiced, and I'd lie, or roll my eyes, or seethe with resentment.
In the end, I didn't tell him. I didn't explain. I wish I had. In fact, I wish I'd told him 15 years earlier. I could have stopped a wedge of misunderstanding from creeping between us, a wedge that narrowed with time but never went away.
According to Johnston, the destructive patterns that underlie eating disorders can't help but manifest themselves in our relationships. "Someone who restricts their food," she says, "typically restricts other things in their life: their emotions, new experiences, relationships, intimacy." Unless confronted, these dynamics can stifle your ability to connect deeply with other people.
You might think you're protecting your loved ones by hiding your eating disorder, but you're not-not really. Instead, you're robbing them of the opportunity to understand you, to glimpse the messiness and pain and authenticity of your experience and love you regardless.
3. Don't settle for "recovered enough."
Eating disorders steer us so far from healthy eating and exercise habits that we might not even know what "normal" is anymore. For years after I stopped bingeing and purging, I still skipped meals, dabbled with crazy fad diets, exercised until my vision went black, and feared foods I'd labeled unsafe. I thought I was fine.
I wasn't. After years of so-called recovery, I nearly had a panic attack during a date because the rice on my sushi was white instead of brown. The man across the table was trying to tell me how he felt about our relationship. I could barely hear him.
"In my experience, people who get treatment definitely get a more thorough recovery," says Christy Harrison, a registered dietitian nutritionist in Brooklyn, New York. Those of us who go it alone, Harrison finds, more often cling to disordered behaviors. A partial recovery like this leaves us vulnerable to relapse. Among the eating-disordered adults Dillon treats, "most say they experienced an eating disorder when young yet 'worked through it on their own,' only to now be knee deep in serious relapse."
Of course, relapse is always possible, but professional help reduces the chances (see next).
4. Recovery is more likely if you get help.
I'm lucky, I see that now. Insanely lucky. According to a review in the Archives of General Psychiatry, eating disorders have the highest mortality rate of any mental illness. These behaviors may start as coping mechanisms, or attempts to regain control over the slippery randomness of life, but they're insidious little bastards that want to rewire your brain and isolate you from the things-and people-you love.
Studies have shown that treatment, especially early treatment, improves chances of recovery. For example, researchers at Louisiana State University found that people who undergo treatment within five years of developing bulimia nervosa are four times more likely to recover as people who wait 15 years or longer. Even if you're years into your eating disorder, take heart. Recovery may not be easy, but Dillon finds that, with proper nutritional therapy and counseling, even people who have suffered for many years or who have experienced relapse can "recover one hundred percent."
5. You're not alone.
Eating disorders are often rooted in shame-shame about our bodies, our worthiness, our self-control-but they compound shame rather than resolve it. When we struggle with food or exercise, we can feel profoundly broken, incapable of managing even our most basic needs.
All too often, this shame is what keeps us suffering in secret.
The truth is that you're not alone. According to the National Eating Disorders Association, 20 million women and 10 million men in the United States struggle with an eating disorder at some point in their lives. Even more people suffer from disordered eating. Despite the prevalence of these issues, the stigma surrounding eating disorders all too often stifles conversation about them.
The antidote to this stigma is openness, not secrecy. "If eating disorders and disordered behaviors were easier to discuss among friends and family," Harrison says, "it is likely we would have fewer cases in the first place." She also believes that if our society viewed eating disorders more openly, people would seek treatment sooner and receive greater support.
Speaking out "can be scary" Harrison acknowledges, "but your bravery will get you the help you need, and it could even help to empower others."
6. You have options.
Come on, you might be thinking. I can't afford treatment. I don't have the time. I'm not thin enough to need it. This isn't realistic. Where would I even start?
There are many levels of treatment. Yes, some people need an in-patient or residential program, but others can benefit from outpatient care. Start by meeting with a therapist, dietitian, or doctor who has expertise in eating disorders. These professionals can walk you through your options and help you chart a course for your recovery journey.
Worried that no one will believe you have a problem? This is a common fear among people with eating disorders, particularly those who aren't underweight. The truth is that eating disorders exist in people of all sizes. If anyone tries to tell you otherwise, walk out the door and find a weight-inclusive professional.
Check out the directories of treatment providers and facilities compiled by the International Federation of Eating Disorder Dietitians, National Eating Disorder Association, and Recovery Warriors. For a listing of weight-inclusive providers, look to the Association for Size Diversity and Health.
If the first therapist or dietitian you meet isn't a fit, don't lose faith. Keep looking until you find professionals you like and trust, people who can guide you from secrecy and restriction into a fuller, richer life. I promise it's possible.