A 12 year old client came in this week and cried the entire hour she was in my office. She was despondent over the lack of happiness in her life. She struggles to get through a day in school, then spends her free time in her room fantasizing about the life she wants, creating imaginary friends who aren’t image conscious, who won’t criticize her for having gained weight, who don’t care if she has a “thigh gap” or not, who eat a normal lunch at school, and who will want to do the fun things she wants to do instead of obsessing about thinness, makeup, perfect hair, and clothes. She hears comments by the boys about how “hot” certain girls are. They only pay attention to the girls who are ultra-skinny, have long hair, and wear the nicest clothes. She feels unloved. She has given up going to school clubs and activities. She still cheers but has been demoted to the back of the team, because she weighs too much to be a “flyer” like she used to be. Every day she is reminded of how painful it has been to gain weight, so she turns to the only “friend” she now thinks she has…food. The pain she feels in her life, she exacerbates by bingeing. She soothes the pain momentarily while she is in her food obsessed moments, but as soon as the binge is over, she is starkly reminded physically and emotionally of the pain she feels. She is in 8th grade!
Sadly, this client’s experiences are similar to many middle school and high school girls that I see. They live each day in the world of comparisons, diet talk, sexuality, and bullying over anything and everything. They often turn to restrictive eating, bingeing, purging, compulsive exercise, and self-harm to “feel better”.
I decided, in this post, to share my story. Several people have asked me lately why I am so passionate about treating people with eating disorders. You see, like my 12 year old client, I was bullied in middle school for being “ugly”. I struggled in middle school to be sane. I fantasized about a life I didn’t have just to give myself hope. Home wasn’t a place of reprieve either. I encountered stressors there as well. I never thought at age 12, that things would get better. But, they did. I struggled throughout high school and college with an eating disorder, but I finally got help. There weren’t good resources back then, but it helped just finding someone to listen. I am very fortunate to have recovered and can pay it forward by having a career where I can help people who struggle. (For those of you who have read my book, you have seen my story before.)
What I want everyone to do after reading this post is to pay attention to the girls and boys who may need support. You can’t take the place of a treatment professional, but you can provide someone in need with a little kindness and a positive connection.
We can’t tell these girls that it will get better in time, when they are in college, or as adults. Those words are not reassuring. They need help NOW! Anyone who is involved with the school systems needs to develop more diverse clubs and activities, support groups, safe places and people for those who aren’t the “popular” kids. And, for those who are “popular” or “happy” on the outside, they are often suffering too. I know we are all deeply saddened and frustrated by the amount of bullying in schools. It is heartbreaking to talk with a 10, 12, 14, 16 year old who feels worthless because she (or he) has been made to feel that way by her peers. I think we also need to keep a close eye on those kids who may need a little something extra. It is so simple to give a few more minutes of time, ask a few more questions, lend a hand, and show a little more interest to those kids who may not have the voice to be able to ask for help.
If YOU are one of those girls or boys who struggles, don’t be afraid to ask for help. People will care. You just have to find trustworthy people. I know, at times, it may not seem like things will get better. They will, with just one or two caring people to support you.
What we achieve inwardly will change outer reality. Plutarch
Find a place inside where there’s joy, and the joy will burn out the pain. Joseph Campbell
Believe you can and you’re halfway there. Theodore Roosevelt
We can’t help everyone, but everyone can help someone. Ronald Reagan
The best way out is always through. Robert Frost
The most authentic thing about us is our capacity to create, to overcome, to endure, to transform, to love and to be greater than our suffering. Ben Okri
Only those who have learned the power of sincere and selfless contribution experience life’s deepest joy: true fulfillment. Tony Robbins
And, when all else fails, remember Dr Seuss’ five lessons of life (above)!
I am a nutrition therapist for individuals with eating disorders and disordered eating, a wife and mother of two amazing children, and stepmother to a wonderful young woman. I am a daughter, a sister, and a friend. I am also recovered from an eating disorder. I struggle at times, but I triumphed over my disorder. I am a warrior when it comes to defeating my illness. While it gets easier and easier, I am always cautious, because my disorder has far-reaching roots.
Seeking My Place in the World
I learned very early in my childhood that I was the “good girl.” Good girls do what they are told and never ever complain, never voice discontent, take only what they are given, and ask for nothing. If good girls ever have a problem, they isolate, cry on their own time, wipe the tears from their faces, and emerge smiling. If they express negativity of any sort, they are told they are unappreciative and they can go live somewhere else, or they get beaten or ignored. These are the principles by which I lived.
My father was a deeply compassionate man. He was reserved and a good provider. He worked tirelessly as an air traffic controller to provide us with a home in a middle class neighborhood, two cars, food, clothing, two vacations a year, and an occasional dinner out at a local restaurant. He worked all different shifts, ranging from the day shift to overnights. Our lives revolved around these shifts and how well we needed to behave based upon “dad’s sleep schedule.” He was an alcoholic, and he had significant medical problems ranging from high blood pressure, diabetes, and gout, to inoperable cancer. Mom blamed his drinking on his stressful job. My brother and I simply did not know what to expect from him day to day. I was the good girl though, so I never got into trouble. I never got hit by him. I followed the rules to the letter. I feared the ramifications. My brother, on the other hand, was the recipient of verbal abuse and physical altercations. I would often try to come between them to keep the peace, but it made things worse. I learned it would blow over if we did what was expected of us. I had to be mute, and my brother had to be submissive.
My mother was raised by a single mother, “The Dragon Lady,” and therefore had no role model for how to take care of two children. I admire her tremendously for how she survived her upbringing without having been parented or loved and eventually fled her abusive mother. I have no doubt that she loved my brother and me. But love was not enough. Simply stated, she did not have the resources to parent us. At times, she would be incapacitated and bed ridden from stress. She struggled during our childhood with severe blood sugar irregularities, which led to emotional volatility, sometimes causing her to become violent and punish us with an assortment of kitchen utensils. During happy times, she was adoring and affectionate. During stressful ones, she was unpredictable and frightening.
My brother is three years older than me. As adults, we joke that we raised ourselves. We did not do a very good job. As teenagers, we partied together, we did considerably reckless things behind our parents’ backs, and we supported each other during the tough times at home. When our parents would fight, scream, and throw household objects across rooms, we would sit together in my brother’s room, blast heavy metal music to drown out the noise, and cope with the chaos.
As a child, I loved being out of the house. I was preoccupied with playing and exploring, as most young children are, and did not think about my looks at all. In seventh grade, at the age of twelve, all that changed. A boy in sixth grade called me an “ugly dog.” I was devastated. I went home and asked my mother if I was really that ugly. Her response, in a kindly mothering way was, “Well, you have other attributes which you should emphasize. You are good at sports and you are very smart.”
That was not exactly the reassurance for which I was looking. I thought, If my own mother can’t even lie and tell me I’m pretty, I really must be ugly.
In high school, I decided to go out for cheerleading and track team. I needed to be good at something that would help me change the way I saw myself. And it could not be based upon my looks, or I knew I would fail. When I tried out for the track team, I felt such urgency, almost as if the course of my entire life depended on being accepted. During freshman year, I set the record for the high jump and the discus. I felt like I had found my niche. As my confidence in track grew, my self-consciousness dwindled. I was validated for the first time! I was good at something!
Then, sophomore year, I could no longer get over the high jump bar. No matter what I did, it was all over. I asked my track coach why I could not do it. His response: “You’ve got a fat ass.” I felt like I had been sucker-punched. Here was a person who I admired, trusted, and actually thought was one of my staunchest supporters, and he not only betrayed me; he humiliated me in front of the whole team. In reality, I was not even overweight, but his comment sent me reeling. I felt defeated and trapped, with no other options for success. I could not bring myself to muster up the courage to try harder to improve my track skills. I gave up trying – and trusting. Now not only was I ugly; I was fat, too, and alone.
At that moment, I decided I would never again be criticized about my looks or size. If I got thin enough, no one would call me fat, and if I spent enough time putting on the right makeup and the right clothes and styling my hair just the right way, maybe I would not be so ugly. All I wanted was to be happy and sure of myself. Happiness, as far as I knew, meant being a “good girl,” pretty, and thin.
I was on a mission. Breakfast became a miniscule bowl of oatmeal, lunch was crackers and pickles, and dinner was steamed vegetables. On weekends, I would have an enormous elaborate salad for the day that would take me hours prepare and hours to eat. I would allow myself to eat no more, only less. The rules were the rules. If I ate a morsel more than what my rules had demanded, I would do jumping jacks until I felt I had worked it off. I would spend hours baking beautiful cakes, cookies, and breads for my family and watch them enjoy the treats. I would smell the wonderful fragrance coming off the food but would not put a crumb of it into my mouth or I would have to face days of insane self-criticism and hundreds more jumping jacks.
My weight went down, my clothes grew looser, and I thought I was on my way to being happy. I obsessed day in and day out about food and my weight. I gave up track. I could not bear the humiliation. I kept cheering, not because it was fun anymore, but simply because it was a great way to burn extra calories. I did not care that I was depressed or that I lost my period. Being dizzy and hungry was a small price to pay for eternal bliss. Was I closer to happiness? Not a chance.
During junior year, I began drinking. I would starve myself during the day and then drink after school with friends. I would get completely obliterated, sober up enough to come home, do my homework, eat the smallest amount of dinner I could get away with, and escape to the isolation of my room. On weekend nights, I would guzzle a bottle of sangria on my way to the bars, knock back massive amounts of mixed drinks until the bars closed, black out, and get dumped on my doorstep by anyone willing to drive my drunken self home. I would inevitably end up vomiting on myself and be forced to clean up the dried caked-on mess the following day.
Off to Rutgers University I went. I was so excited to leave my past behind and start over. I would re-invent myself! I would be the perfect student, perfect friend, perfect daughter, perfect college athlete, perfectly thin, happy, all-American girl. Right from the start, to keep myself in line, I decided to join a sport that required me to “make weight.” As coxswain on the crew team, if I gained a pound, I’d have to starve myself, run, and take laxatives to get the weight back down. Being the only girl on the boys’ team was a dream come true though. For the first time in my life, I got the positive attention I craved. I was, dare I say, popular. The reward for years of obsessing was finally paying off…or so I thought. The stakes were never higher. I could not ever let this go.
I took diet pills to curb my growing hunger and give me a reprieve from stomach pains so I could study. Three a day, then ten, then twenty, then a bottle every few days seemed like it would do the trick. Then, I would chew a sleeve or a box of chocolate laxatives with diet iced tea to make sure any food I had allowed myself to consume would come out. I would spend hours obsessing about which clothes to wear to make the best first impression. Multiple clothes changes seemed like normal female behavior. I did everything everyone wanted me to do so I could stake my claim as the best friend anyone could have. I never wanted to let anyone down. That would surely be the death of me. I would not allow myself to fail at anything. But this self-imposed pressure was more than I could bear.
I spent every waking moment in pursuit of the next level of starvation I could accomplish. I was driven to keep the weight off, above all other goals. I panicked at a fraction of a pound of weight gain, fearing I would lose precious control and become the shameful loser I feared lurked within me. I suffered constant splitting headaches from lack of food and unsuccessfully tried to mask them with bottles of aspirin.
One day while studying, a friend told me her little secret. She ate whatever she wanted and then got rid of it by vomiting. I thought I had found the answer! I began bingeing and purging, sometimes six or more times a day. I would ride buses from campus to campus within the university to go to different dining halls and fast food restaurants. I would find a secluded table in the dining hall, carry my tray piled up with all sorts of food, and binge until my stomach would be in excruciating pain. Then I would purge in the bathroom, hop on the bus and go to another campus and do the same thing.
By the time the bingeing and purging became addictive, I had already gained a substantial amount of weight, and it was climbing. Now I was unable to stop. My weight kept going up, and I thought I was going mad. I was beginning to unravel.
I was so focused on perfecting the outside that I lost complete touch with (or perhaps was never in touch with) who I really was and the things in life that were really important. I gave up time with friends so I could binge and no one would be suspicious of my habit. My bingeing was my best friend. I thought it made me happy. It distracted me from all the realities of life, because it took up all my waking hours. I spent countless hours planning and scheming to find the right time and place to binge and to hide my secret. I did not care about my grades. I skipped classes due to food hangovers, sore throats from purging, and pounding headaches from constantly straining my head over the toilet. The next binge and purge were the only “accomplishments” I focused on. I did not make the connection that my eating was going out of control because my life was out of control.
I avoided those feelings about myself that I feared: the feelings of worthlessness, loneliness, lack of direction, emotional immaturity, extreme anxiety, and vulnerability. I was running from who I might be since I was certain that I was not beautiful and did not know how to strive to be anything other than beautiful, thin, or smart. My grades were slipping away, reinforcing for me my loss or lack of intelligence. My boyfriend and friends stopped tolerating me. I stole their food, constantly apologizing and promising to buy them more food, only to steal it again when the impulses to binge were more powerful than any promise I had made. I would binge day and night, causing my mood to deteriorate, and I canceled any plans for social events. They began to avoid me, only validating my assumption that I was unlovable. Once again, I was alone – with just my food, that imposter for my friend.
Whenever I thought I might need help, I could not bring myself to ask for it. You see, as the “good child,” I had no voice for anything unless it was positive. I was not allowed to complain, to feel sad, to feel hurt, or to ask for anything. I was mute. To make matters more confusing, I did not even know I had an eating disorder. Eating disorders were not talked about or well-understood then. There were no support groups. I was alone with my shameful secret. The prison walls were getting higher and stronger, and I did not know how to break out.
Then my dad died. I hit rock bottom. I had nowhere to turn, no one to run to. I was backed into a corner, face-to-face with myself.
My Turning Point
The turning point came for me, ironically, while at college. Looking back, I think it was losing everyone and everything in my life that made me finally face myself. I never felt so alone, but in a way, it was necessary, because part of my problem was that I could not see myself through my own eyes; I could only see myself from others’ perspectives, and what I thought they saw was never good enough.
One day in my junior year at Rutgers, I was so despondent that I took myself to the college counseling center. There, I met a therapist who was so kind and compassionate. He told me that I was worth saving, that I was not the horrible ogre I thought I was. I almost felt guilty going to our sessions because surely he could not be saying these things about me; he just had not seen the real me yet. It took me weeks just to feel like I even had the right to be there.
I must have wanted to believe him, because I persevered. I embarked on my “healing/feeling” journey, and I began to realize that what I was going through had very little, if anything, to do with my eating and my weight. I had merely been using food behaviors for years as a means to shut down, control, and distract myself from my feelings, my past negative experiences, my mother, father, brother, friends, and anyone with whom I could conceivably have a real relationship. I had been trying to be a human robot, getting by doing normal human things, with no feelings, no hopes, no dreams, and no true sense of self.
We began talking about how I felt when I ate, when I did not eat, when I purged, and when I binged. It took me a long time to even figure out how I felt during these times; it was hard enough to just admit to him that I did these things. Gradually, we began talking about some of the experiences I mentioned earlier: the chaos in my household, my father’s drinking, my mother’s temper, the comments from my track coach, my inability to stand up for myself, and how, as time went on and I continued to separate myself from others, I lost the ability to voice anything important to me for fear of being ridiculed or hurting someone else’s feelings. I especially could not express how I felt, because half the time I did not feel I had a right to these feelings and, during the other half, I could not feel anything but absolute numbness.
Finding My Voice
I knew from experience that I could not just change my feelings, so I began to practice trying to understand what I felt. I was so used to numbing my feelings out with food in one way or another that I felt I needed to start all over. I practiced feeling sad, angry, frustrated, and overwhelmed. I talked with my trusted therapist about my “immature” feelings and practiced expressing them with him.
I started slowly, but I began speaking up. My therapist made this possible for me, because he provided a safe place for me to practice. I was so scared to feel or speak, but I knew it was the only way to stop the critical voice in my head that kept telling me that I was not good enough to have feelings or a voice, that I just needed to strive harder to be thinner, that I was not trying hard enough, that I was weak. He promised me that he would never humiliate me or disappear if I spoke up to him. During our sessions, he would bring up these very uncomfortable issues and encourage me to work through them with him. I would continue to ruminate about the issues, thinking about them for the whole week. Whenever I was alone, I would think about how much it upset me, and I would feel so tempted to binge or starve. It was the first time I was able to see the connection between my feelings and my eating. It was the first time I was able to feel anything real.
I feel sad when I look back and recognize how difficult it was for me to speak about myself. I had to practically hide my face while I said difficult things, but I persevered. I was genuinely proud of myself. I think it was the first time that I actually spoke up for myself and expressed what I was feeling. We never really talked about food after the first few weeks. We were talking about feelings. Over time when I left his office, I would feel a sense of calm I had never felt before. Of course, the old feelings would come back, but the more we talked and the more I practiced speaking up and expressing myself in very small ways, I noticed that my need to starve, hide food, binge, and purge began to diminish.
Working with my therapist helped me to feel connected in a healthy way to at least one person. That made me begin to feel better about myself and to believe that I was worthy of others’ companionship. I slowly began to get in touch again with some of my college friends, although this was very frightening to me. I took those feelings and practiced expressing them. I stood up for myself a little more, and it started feeling really good. I began to realize that I was important and my feelings mattered, even if they did not please others.
These were monumental steps for me, but I found that speaking up did not bring the earth crashing down around me. I also needed to find the language in which I could speak up. I always saw speaking up as confrontational, and that scared me. The feelings of nervousness were too unbearable and would usually trigger the need distract or numb out through starving or bingeing. I learned, however, how to set boundaries and speak up without being combative, so these situations did not terrify me anymore. I could simply say, “I’d rather do something else,” or “I’m not comfortable with that,” or “Thanks for asking, but I feel like staying home.”
Self-reflection and looking at the past were excruciating in the beginning but exhilarating at the same time. It was excruciating because feelings about the past and my current means of self-expression (eating disordered behaviors) that had been so masterfully buried were almost all negative, ugly, and painful. It was exhilarating because through self-reflection, I was able to understand that the past is past and did not have to pave the road for the future. I felt during those years that I was truly standing at the end of a road with two distinctly different paths ahead. On one path, I was destined to continue to forge through life emotionally flat-lined until some catastrophe (usually self-inflicted) jolted me back to life. On the other path of utter unfamiliarity, there stood a slim chance of happiness or joy, or at least perhaps less misery. I chose carefully. Even as I slowly trudged down that new path, there were deep grooves in the gravel from my heels being firmly planted in resistance.
About the Food
In my relationship with my body and food, I was resistant to let go of those behaviors because, although I was learning how to feel feelings and take care of myself, self-destructive food behaviors are addictive. I learned how to eat enough to satisfy my body and my mind, but the process was long, hard, and fraught with errors. I had to eat very mindfully and slowly so that I would keep the power I needed to fight urges to “keep on going” and binge and purge, followed by restriction, laxatives, and exercise. It was a time of serious mind games – my healthy mind against my disordered mind. I still made mistakes in my eating. I overate. I binged, but more mindfully. However, I did not call them mistakes anymore. They were choices. I never wanted to go back to my eating disorder. I was tempted, at times, to feel numb. I had strong desires to avoid that which was uncomfortable or painful, but it would have been a slippery slope to tread on if I even dabbled in those behaviors again. My mantra was, and still is, “My worst day well is still better than my best day sick.”
After I spent some significant time in therapy, I began to see my true self more clearly. I realized that there was much more to me than my outward appearance. In fact, I discovered passions and inner strengths I never knew I had. I began to enjoy the subjects I was studying at school. I had a clearer path toward what I wanted to do for a career. I no longer envisioned myself as an anxious, powerless, voiceless child. I felt strong and capable, yet somewhat vulnerable. I was able to set boundaries with others and use my voice to express myself. I learned how to take care of myself both physically and psychologically. I began the journey toward self-acceptance.
Redefining My Relationships
During my early recovery, I rekindled and formed a number of healthy relationships. I also began dating the man who would later become my husband. Despite my added weight, despite my outer imperfections, he loved something else about me. Of course, I constantly questioned his affection. I feared he would turn on me like everyone else had or that I would ruin everything like I had done in past relationships. I needed so much reassurance. I thought he would certainly get tired of me. It was just a matter of time. He told me I was the girl of his dreams. He told me he loved that I always had a smile on my face when he saw me, which made him feel good about himself. He pointed out my hidden, but real, strengths over and over. He began to make me question, albeit for fleeting moments, the horrible images of myself I had held onto so tightly. Was I really the “ugly dog” with the “fat ass?” Or were those perceptions inflicted upon me as a vulnerable, insecure girl. Why had I felt so deeply that I was worthless?
This man, Dean, helped me see the value of myself as a loving, caring, flawed, and worthy person. With his encouragement, I was able to talk to my mother about the issues I had dealt with in the past. I told her how I struggled to be heard as a child and how her actions and those of my father affected me. I even told her most of what I had been through with my eating disorder. With Dean’s love and support, the continual support of my mother, who currently still regrets her “motherly” comments, and the support of my college therapist who helped me see behind the walls I had built up and to find my voice, I began to slowly climb back to sanity and break out of the prison, brick by brick. It took years of gradual work, but, over time, I began rebuilding my relationships with the people in my life who were important to me. This took my constant vigilance in separating the perceptions that I had so ingrained in myself as a child from a more mature perspective, one that included me as a strong, worthy, feeling individual.
Looking Back and Making Connections
Seeing all of this in black and white, it is obvious to me now that the biggest contributing factor to my eating disorder was my inability to express my feelings and believe that they mattered. I had gained approval and attention as a child for being a good girl, and good girls never complained. I learned to be very self-reliant, never dependent on anyone for fear they would let me down. I felt that being dependent on others made me weak. I had grown so used to stuffing my feelings that when other people had strong opinions or made hurtful comments to me, I was convinced that what they believed must be correct and that I did not have the right to refute them. Since these were people I trusted, I began to believe that I did not have a right or a need to feel. Obviously this disconnect had to come out somehow. It emerged through my eating disordered behaviors.
If I could control myself to the point of almost starvation, then I could control these wayward feelings that kept popping up. When that stopped working, I would load myself with food to satisfy my needs and stuff down the feelings that were trying to scream to me. This started the vicious cycle of binging to numb out because of a need I “should not’ have or because of a feeling I “should not” feel, and purging to flush the need or feeling into the toilet. I felt I somehow needed to get rid of all of it. All of this really had very little to do with food.
My Role as a Nutrition Therapist
I never would have guessed that I would have been able to use my own difficult experiences to help others, but it was these experiences that led me to my current profession, my mission. I began studying nutrition at college, knowing someday I would want to work with people who had food, weight, and nutrition concerns. I decided to learn as much about nutrition and eating disorders as I could. I graduated from college with a degree in nutrition, earned my Registered Dietitian’s degree, and completed my Master’s degree in nutrition. I was a research assistant at St Luke’s Roosevelt Women’s Hospital in New York City performing bulimia research, primarily to gain as much insight into the illness as possible.
For the past twenty five years I have been treating individuals with eating disorders in private practice after working briefly in an in-patient eating disorders unit in a hospital in North Jersey. I consider myself a “nutrition therapist” instead of a traditional “dietitian,” because I combine nutritional guidance with insight and supportive, therapeutic listening. In my office, I provide a safe, non-judgmental environment for individuals who hope to get the help they desperately seek to share their thoughts, feelings, and fears about food, their weight, and their food-related behaviors. I teach people how to see the relationship between their feelings and their eating behaviors. I also help put structure and sanity back into their eating with the hope of helping them regain a healthy perspective on what normal eating is.
I speak to young boys and girls in schools to help them appreciate themselves and their differences in size and shape. I try to help them see that their unique qualities are far more important than their weight or clothing size. I try to help take away the shame that larger kids feel about their size or shape. I show them magazine pictures of the unrealistic ideals – emaciated women and “ripped” men – they are told they should look like and help them see these images for what they truly are: impossible and dangerous. I teach parent groups to recognize the warning signs of eating disorders, to de-emphasize weight and outward appearance, and instead support their children if they are beginning to go down the path of unhealthy dieting by being healthy role models with their own food and weight-related behaviors.
In my own home, we do not discuss weight and size in a negative way. We fuel our bodies well, we eat foods we enjoy, and we eat fun foods just for fun. We emphasize and appreciate diversity. We acknowledge our strengths and support our weaknesses, both physically and in other areas of our lives. We do not allow the word “diet” to be used. In our house, “Diet” is a four-letter word that is just as negative and derogatory as four-letter curse words. I never want my children to feel judged, humiliated, or unheard. I encourage my children to express themselves, no matter how difficult.
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