TREATMENT WITH ASTERISKS

Free again! I was discharged from hospital yesterday after spending six weeks in a treatment program for people with eating disorders. It’s hard to know if it made a difference. Already this morning I’m restricting food again and obsessing over what my exercise will be. The habits of the disorder are so entrenched that it almost seems foolish to think a month and a half of interruption can have substantial impact. There’s deeper work to be done.

“Can’t you just eat more?” I’ve had that question posed by my mother and by my best friend.

Others have said, “But you always eat when we go out.” True. The eating disorder likes to be secretive. It’s my own thing. I do it when no one else is around. It’s why I turn down a lot of dinners. (Being vegetarian makes for a surface excuse, no questions asked. I don’t know if it was just a coincidence, but at one point during my hospitalization, six out of seven patients on the unit were vegan or vegetarian.)

Even during my stay, I was straying from program whenever I could. I got daily passes to go home and, instead of taking the bus to and from as directed, I’d walk the three miles at a brisk pace, passing other pedestrians at every opportunity. While the program required three meals and three snacks per day, I’d skip the snacks while at home and reduce my meal. I figured two full meals and two snacks represented enough progress. And enough calories.

I had longer home passes on weekends and, while exercise was forbidden—full symptom interruption, they called it—I managed to fit in three moderate exercise sessions per week. This was as radical a change as I could tolerate. I told myself I was making the program my own.

Really, I lied. Just like an addict. After every pass, I said I had no struggles. I said I ate according to my meal plan. I told them I did not exercise. I had to lie so I’d keep getting passes. The daily trips off the ward were what kept my sanity. I told them what they wanted to hear. I left as a success story.

So what was the point of it all? Why did I give up six weeks of freedom? In spite of my cheating, my body took in more food and more variety. To a regular person, eating peanut butter or mayonnaise would not be a victory, but higher fat foods were real challenges. Heck, even the amount of water they made me drink was a challenge. My exercise was severely reduced. The miracle is that I didn’t gain weight even though that was my constant fear.

What most people focus on is the outward signs of the eating disorder—amount of food intake, bingeing, purging and exercise. These are clear things to follow when assessing progress. But if it were simply about eating more and exercising less, treatment would be relatively simple. What many people overlook are the psychological reasons for why the eating disorder developed and continues to be fiercely maintained. Issues like self-esteem, perfectionism, betrayal, abuse and neglect come into play. The eating disorder represents control, self-discipline, even comfort. As my eating disorder has gone on for decades, it’s far trickier work uncovering the roots of it so that real, lasting change can occur.

I may be out of hospital but more work remains, on my own and with professional support. Nasty bugger, this eating disorder.