What is an eating disorder?

Amy’s Story

Life with an eating disorder, if you can call it life, is similar to a puppet show. You are the dancing, smiling puppet, and your disorder is the puppeteer. It calls the shots and pulls the strings. It tells you when you’re going to eat and how much. It even writes the script, putting its own values where yours used to be. All of a sudden, you don’t care about your health, your friends or your dreams. All you care about is being thin, and you don’t even really know how it happened, when, or why. So there you go, smiling as your bony body bounces around onstage. Some clap at your slenderness, while most stare in horror at what you’ve become. They don’t know that you go backstage and cry because you’re tired, hungry and scared.

It’s funny because I consider myself a very educated, intelligent, beautiful and successful woman – but a few years ago I was trapped with an eating disorder.  Amy Pezzente

It started out so simple; in high school with the desire to be thin, and ended up as a powerful, inner, self-loathing endless mental battle. I slowly began to lose not only my weight, but my reality, my mind, my friends as well as anything and everything that I cared and loved. Anorexia had 100% control of me and my life. I was no longer Amy. I was an eating disorder, a lying, destructive, conniving eating disorder. It was an out of body experience, a loss of control so intense that I can’t even imagine behaving that way now. The eating disorder was there for me, protecting me from this uncontrollable world. It was my coping mechanism for handling my emotional distress of feeling unloved and unworthy. Then, when idle time crept up and my control was slipping, I became a ravenous animal and ate everything in sight, only to purge it all out immediately after. I would weigh my self-worth in pounds.

For a while I was in denial. Everyone was just jealous of my self-control to be thin. One time while in high school during the middle of my Biology 12 class, the principal came, took me aside, and told me my mom was outside ready to take me to the Children’s Hospital Eating Disorder Program. Because I was under 18, she could do this. I was horrified and wasn’t going to let it happen. So I lied to the doctors. She was in tears and looked tired and defeated, but I felt triumphant. My attitude was, “we can talk about change, but I’m not ready to make changes.” After all, my original motivation for going into treatment was to appease my parents. Thankfully my lying worked and I didn’t have to go through with it.

Every night I would review my daily calories. But I had to eat to show my family that I was eating in front of them. It was the only way to get them off my back, to leave me alone. So I used exercise to expend those extra calories. I got a membership at the local gym and would be ther first one there every morning, shower, and off to UBC. Nobody in my house knew. I would compare myself to everyone at the gym, wondering how in awe they were of my magnificent thin creation.

After a few months of me withering away, the manager of the gym came up to me and requested a doctor’s note before I could come in again. I was mortified and angry. So I went to a walk in clinic (so the doctor wouldn’t know my history with an eating disorder), got the doctors note (who prescribed typical exercise), and handed it to the manager.

Then one morning the manager at the gym told me she had terminated my membership for health reasons. She said I wouldn’t have to pay any of the extra termination fees or pay off my contract – she said it was a ‘special’ kind of termination and that I was no longer allowed in. I remember this day like it was yesterday – I cried for hours upon hours. But that wasn’t going to stop me.

So the following day I went out and bought the first treadmill I saw at Canadian Tire and I would run in the basement continuously in the middle of the night so my family wouldn’t know. I refused to let a morsel of food pass through my lips without a punishing and exhausting workout. My body was an enemy that needed to be controlled and punished. My parent’s eventually found out, but at about 23-24 years old, they knew they could not do anything. My mom would often come down to the basement and just watch me run with tears in her eyes. But that didn’t stop me. Nothing did.

University was hell. Somehow I managed to get into grad school for the department of Physical Therapy. My black and white thinking would not allow me to accept anything lower than an A. I would think, “if I don’t get an A, I might as well have an F,“ or, “if I’m not size zero, then I’m obese.” I had no friends and only kept to myself. I would spend all my spare time studying in the library, trying to use up every ounce of concentration I had towards my studies. I remember chewing a stick of Trident gum and reading the calories. I became anxious – one part of me thought, “well, you already ruined your entire day, you might as well ruin it more by gorging on ice cream and chocolate bars.” Sometimes I would do this, and purge it out.

Then one morning the Dean of the Physical Therapy program called me into his office and told me I could no longer complete my Masters at that time. He was expelling me. I remember he said, “Ms. Candido, the faculty are very concerned with you. This is a health profession, and if you can’t help yourself, how can you help other people.” You can imagine how I felt. At this moment, my world fell apart. All my marbles were placed into being the best Physiotherapist Vancouver had seen, but now what. Was I going to work at a Starbucks for the rest of my life? I cried for days. I was exhausted. This, was my rock bottom. After all these years of internal arguing, mental clutter and resistance, I was able to admit that I had a problem. I was tired. I was falling apart. This was when, I surrendered.

Recovery…

One thing I had to remember was that this eating disorder required so much of my will power and discipline to get into, I KNEW I had that same power and strength to get out.

With the support from my mom I found therapy, structure, and hospitalization at the St. Paul Hospital Eating Disorder program. I more or less lived there for 2 years. During that time I went through intense cognitive, behavioural, and group therapy. I was diagnosed with osteoporosis because I hadn’t had a period for over 5 years, I would get pedal edema and often couldn’t even put on my runners, my once gorgeous hair stopped growing and looked like straw. My skin had this green/yellow leathery tint to it and I was full of lanugo hairs. My eyes seemed giant because of my gaunt face. I had no feelings – just a constant numb, stale mood.

The plan was to have me make small, manageable changes in my behavior. Sounds simple, right? Well, these changes were neither small or manageable. They asked me to do things that horrified me, like eating regularly whether I was hungry or not. They explained that because I’d been ignoring my body’s hunger signals for so long, the signals weren’t working properly anymore. To me, however, eating more often sounded like a quick recipe for weight gain. No matter what they said and how much sense it made, I told myself I could never do any of it. Being thin and perfect was more important. Asking me to just change my eating-disordered thinking would be about as successful as asking someone with a tumour to change their cancer cells back into healthy ones. Whenever I went to eat something, the eating disorder always had something to say, dictating what I was allowed to eat.

My dietitian said that I was fainting because I was weak and needed to eat something. But my eating disorder said that I was just being lazy and that everyone was trying to make me fat.

My doctor told me that I was getting dizzy during exercise because I wasn’t eating enough to sustain physical activity. My eating disorder told me that I was just being a wimp and that my doctor didn’t know anything about fitness. I firmly convinced myself that if I listened to them, I’d lose all control, and become a lazy, pathetic, sloth.

My therapist would guide me and challenge some of my thoughts. For instance, I refused to open any Christmas or Birthday gifts because I felt I didn’t deserve them and felt guilty, unworthy. So she would ask me, “well, doesn’t your family open gifts on Christmas/Birthdays? Would you tell them that they don’t deserve them either?” And, of course, I would never do that. My therapist sometimes had me play newil’s advocate and talk about why I felt that I deserved to die for gaining five pounds. Then she’d point out that, according to my own logic, everyone who gained five pounds deserved to die. “No,” I would say, “it’s only me that deserves to die.” But when she asked me to explain, I couldn’t, because I knew it didn’t make any sense. It took years of working with the treatment team at St. Paul’s to unravel all the years of lies I’d been telling myself.

At first, recovery felt like making a path through untamed woods. I had to keep going over and over the same original path to forge a trail and shift my thinking. It has taken years, but slowly I’ve been able to reconnect with myself and push the eating disorder aside. One thing I had to remember throughout this journey was that this eating disorder required so much of my will power and discipline to get into, I knew I had that same power and strength to get myself out. And I can confidently say, for the past 3 years, that I did just that, and recovered.

During recovery, there are days where your determination and willpower are put to the test. Especially during hard or difficult times in your life (such as exam time, moving, changing schools, parents divorce, etc.), and you may be tempted to return to the old, familiar, unhealthy ways of coping with those situations. And for me, as you already know, it was with an eating disorder. I always tell people it’s okay to relapse. It doesn’t mean they lacked effort or motivation, in fact, it’s often an inevitable part of recovery. It’s what we learn from the relapse that matters.

I honestly think the key to building resilience is continual learning and self-awareness. So the more I learned what my triggers were, what I was good at and where my vulnerabilities lied– the easier it was for me to adapt. Likewise, the more I knew what strengthened me and the support and resources I possessed, the easier it was to adapt. I think you need a combination of people who support you, challenge you, and who respond with encouragement, understanding, and empathy when you’re struggling. For me, the scary part was knowing that it was my responsibility to learn what worked and what didn’t. I had to practice these techniques and take accountability.

My support network put positive and high expectations on me. This challenged me beyond what I thought I could do. My therapist recognized my strengths, mirrored them, and helped me to see where I was strong, which kept me in a hopeful frame of mind. New doors always open and it takes strength to walk through them, and awareness to even notice one has opened.

Another important point in recovery is you have to keep pushing yourself to the edge – if you’re just on cruise control, you won’t get anywhere. You need to take an active role in the process of recovery. However, you must also consider strategies to avoid a negative outcome during the process. With eating disorders it’s important to understand your personal level and anticipate challenges. Like with my grandma, I know every time I see her she will comment on my weight (I guess it’s the European in her). Don’t wait for it to happen – try to anticipate it. At one point putting me in a food court alone with idle time is like putting an alcoholic in a bar. So it was important for me to plan ahead and keep busy at all times because idle time was always a disaster waiting to happen.

General tips:

    • Set small, manageable goals in order to reach your long-term recovery goals. The very common all or nothing mindset doesn’t usually work well in eating disorder recovery. This journey is completed one step at a time.
    • Arm yourself with truth and positive thoughts in order to combat the lies and negative thoughts that feed the eating disorder.
    • Be gentle with yourself. Learn from your slips and celebrate your victories.
    • The hardest step is the first step. That’s the step where you chose recovery. It is a life decision. Understand that after that one step you will have many more to travel. Keep your steps tiny; go one day at a time. Be patient with yourself and believe in yourself. There is life after an eating disorder. You need to believe that recovery is possible and that you absolutely deserve it!
  • Eating disorders are not something to get over -they are something to be embraced with love. When we love the parts inside us that hurt -the healing process can begin.
  • It is possible to recover. Don’t give up! You can learn to enjoy your life again. Keep on believing in yourself and continue to be strong.

Specifically, some of the things that kept me going:

  • Telling someone I trust about my recovery process made me feel accountable to keep going.
  • My mom would write little notes for me, like my pillow or jacket pocket and they would say something like, “you are worth it,” or “I’m so proud of you,” or, “you’re beautiful.”
  • I would have someone in mind that I admired – for me it was my sister. I would describe them and ask myself, “what is it about that person that I want to emulate? Their qualities? Attributes?”
  • I diversified myself and chose activities I was good at and what I enjoyed to help boost my confidence and self-esteem.
  • I make small goals, wrote them down. 1 day at a time. Made planned changes
  • I tried responding positively to my mistakes
  • I was aware of what my triggers were and knowing how to handle them
  • I would often reflect upon the future. Do I want to be this way in 5 years?
  • I would keep a journal of my frustrations – write them down so I could look at them objectively.
  • I tried to be present as much as possible (focusing on the future made me anxious, and focusing on the past made me depressed).
  • I would write down 5 things I was grateful for at the end of each day.
  • I would be selfish and not afraid to call on those who support me
  • Created visual reminders all around my room and house
  • And listening to self-help and motivating audio books. The headphones would take the place of the negative thoughts that would often come my way.

What helped me with anxiety:

  • Leave the room and that environment.
  • Be busy. Do something, anything. By doing something you keep your mind off your anxiety. When I woke up in the morning, I started doing something right away, and kept busy all day. Cleaning the house, washing the dishes or working in the garden, and journaling helped to keep the anxiety at bay. I always helped my mom with dishes, vacuuming, folding laundry – because it was always available to do and I could do it anytime.
  • Listen to audio books. I wasn’t always a reader. Audio books don’t have my thoughts to enhance and allow the anxiety to manifest within me. I know of other people who preferred soothing music. Silence wasn’t always the best for me, as the “bad thoughts” would easily enter.
  • Plan ahead—idle time was always “danger” for me. I started volunteering at the SPCA – not for the reason that I have a yearning passion to save dogs, but because I literally had to do SOMETHING with my day. It also allowed me to leave the anxiety‐driven environment.
  • Talking about my anxieties ‐‐ to someone I trusted, like my mom. Talking about my anxieties and feelings often alleviated them and put them in the right proportions. You have to be honest though. There were times where I would break down and cry after eating – and talking this through with my mom gave me an objective insight to just how out of touch with reality I was.
  • Mantras. If the anxiety was over what I had just eaten and the heaviness it had in my stomach, I would repeat, “This feeling will pass” and it eventually did. These type of mantras helped me get through this.
  • Finding a supportive friend who is willing to take the day off with you. (after taking a day off exercise)
  • Having someone there with me who was supportive and confirmed over and over and over that I was doing the right thing. Talking with someone supportive who was realistic and would say things such as, “I just ate that, am I fat now because of it?”

Apprehensive about meeting up with an old friend:

  • This was difficult for me because I was worried what they would think of me and my new healthy weight.
  • When they say, “You look good” – they really mean that I look good!
  • They are not shocked at how ‘fat’ I’ve become, rather, they are relieved and proud of how much I’ve accomplished and battled to regain the weight.
  • If they DO think, “Whoa, Amy has been having too many donuts,” then who cares about them. They are ignorant, immature, and not worth my time and presence

 

~Amy Pezzente

Types Of Disorders: How do I know if I have an eating disorder?

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