When you bring up the topic of eating disorders, people tend to think of two things:
- Food issues.
- Body image issues.
It is true that body image plays a huge role in the development of eating disorders, especially in our appearance-centric society. The constant access to social media and photo-shopped images encourage self-objectification and criticism. However, there is a large group of people where body image plays a smaller and sometimes non-existent role in eating disorder development. It is often overlooked that eating disorders can develop for a multitude of complex psychosocial reasons: genetics, food insecurity, depression, mental health challenges, etc. For me, it wasn’t about body image. But I did have one persistent unseeable demon that would eventually push me into an eating disorder: anxiety.
I had my first panic attack at the age of eight, and continued to have them into my teenage years and early adulthood. Imagine being in the worst pain in your life, nauseous, sweating, gasping for breath, and knowing that no one could help you–this is what a panic attack felt like. As a child, I had no concept of what anxiety was, but it managed to infect every single part of my life. I dreaded field trips and hated going to movie theatres and restaurants. I avoided anywhere that I could possibly have a panic attack and embarrass myself in front of others. I missed countless experiences because I was afraid of losing control. Unsurprisingly, this constant state of fearing panic, or what I later came to know as panic disorder, had devastating impacts on not only my mental health but also my digestive system.
Anxiety can have very intense impacts on appetite. For some people it can increase appetite, and for others, it can completely diminish it. I fell into this latter category. I felt nauseous all of the time and the sight of food made my stomach turn. Unconsciously, I started eating less. To add fuel to the fire, I had also been taught in school that exercise was a fantastic and socially acceptable way to reduce anxiety.
The effect was surprising when I ate less and started exercising. The panic attacks suddenly stopped. Miracle cure? At the time I thought so, but later learned it was not the miracle it seemed to be. It turns out that when you’re starving your brain is more focused on keeping you alive rather than processing overwhelming emotions. It wasn’t that I stopped being anxious or that I was magically cured from my anxiety. I was just numbing all the painful emotions that I was not capable of coping with through exercise and food restriction. My starving brain was not interested in processing intense emotions. The anxiety was not gone, I was just numb to it. When you think about it this way, eating disorders are not too different from using drugs, alcohol or smoking to escape reality. I can tell you first hand, this emotional numbing effect was addicting. For the first time in my life, I didn’t feel afraid. I wasn’t anxious about social gatherings and I didn’t care what people thought of me. But this came at a very heavy cost. It wasn’t that I had just stopped feeling anxiety, I had stopped feeling anything. No joy, satisfaction, or emotional intimacy. Nothing upset me, but nothing made me happy either. I had no close relationships in university, and I often felt completely alone, not to mention tired. I had no interest in anything else besides exercising and food restriction to control my anxiety. It took priority over social events, relationships, and even school. I never once thought I had an eating disorder because I wasn’t trying to lose weight and I didn’t ‘look sick’.
It wasn’t until I received formal cognitive behavioral therapy (CBT), an evidence-based treatment for both anxiety and eating disorders, that I began to recover fully. CBT taught me how to manage my emotions and catch unhelpful thinking patterns that often overwhelmed me and sent me into a panic attack. When I learned strategies to help me cope with my anxiety, I was finally able to let go of my numbing addiction. It wasn’t straightforward, and giving up my effective but detrimental coping mechanisms was a painful process. I often had to eat in the absence of hunger cues, despite nausea or lack of appetite. But gradually as I learned to better manage my anxiety, I regained my appetite cues again. I could start to tell the difference between being hungry and being full, something I was not able to do for a long time. I also regained my life back. I started to go places again without having to worry about having a panic attack. I stopped waking up with the intense need to exercise to relieve my anxiety. I am able to work a job where I sit for a few hours without having to pace or be constantly moving. I am okay with missing workouts to socialize and eat with others.
Eating disorders are coping mechanisms that can mask underlying mental health issues. But that’s all they do — mask it. They don’t cure anxiety, depression, or any other mental health challenges. But there are evidence-based strategies like CBT that directly address these issues and make life worth living, instead of just survivable. There are effective and safe ways to cope with anxiety that don’t cost your relationships, health, and life. These other coping mechanisms are worth exploring.
Used with permission by NEDIC (August 2021), www.nedic.ca