ALL SHAPES AND SIZES
How one woman’s eating disorder was almost missed
While weight loss is a leading symptom of anorexia, you don’t have to be underweight to be suffering. One writer shares how, after years of battling with the number on the scale – and resisting help – she was able to stop the disease from defining her life
I made the doctor’s appointment simply to convince everyone that I was fine. For the first half of 2012, my mum had been on my case about my decreasing weight and bizarre eating habits. She even uttered the words no one else dared: anorexia relapse.
I laughed in her face. How could that be, when my weight was completely normal? I’d struggled with an eating disorder in my late teens and twenties, but my weight had crept up over the years and, for the most part, my unhealthy behaviours had subsided. It meant that when I started restricting food and over-exercising again, the weight loss wasn’t obvious. I told myself that this wasn’t anorexia, and I scheduled a check-up to prove it.
‘Anorexia, hm?’ the doctor murmured, as I sat in my paper gown while she reviewed my health history, which included being hospitalised for an eating disorder several years earlier. Glancing up from the stack of papers, she looked me up and down. ‘Clearly, that’s not still a problem.’ My cheeks flushed with embarrassment, but I still felt a twinge of satisfaction at hearing an expert confirm that my mum was wrong.
Except, of course, I did still have a problem. My hair was thin and I felt weak and light-headed when I stood up – residual effects, I told myself, of my history. But, rather than ask if I was presenting any disordered eating behaviours, the doctor simply glanced at my outward appearance and thought: ‘Case closed.’ If I wasn’t underweight, I was fine, right? The next few years of micromanaging calories and fretting over weight gain told a very different story.
It was only after a second relapse in 2018, when doctors told me I was on the brink of heart and kidney failure, that I checked myself into a hospital that specialised in treating eating disorders. There, I learned I was one among millions of people who fall into a diagnostic subcategory called atypical anorexia. Because we look bigger – we might even qualify as overweight on a medical chart – we’re often diagnosed later, because doctors don’t take us seriously. And despite being heavier, the problems we develop from anorexia – low heart rate and low blood pressure, brittle bones, cardiac and kidney problems, even risk of early death – are just as severe.
Historically, to be diagnosed with anorexia, you had to display harmful eating habits and also be clinically underweight. As a society, we’re conditioned to view anorexia as a weight-loss issue – not the life-threatening mental illness it is. If you don’t fit the stereotype? You can forget about a diagnosis. Yet according to an Australian study in the Journal Of Eating Disorders, while 0.5% of the population suffer with ‘stereotypical’ anorexia, 2.5% fall into the atypical anorexia category – that’s five times as many.
Of course, this doesn’t include the large number of people who don’t seek medical attention for fear of facing weight bias – which is part of what kept me away from the doctor after that awful appointment in 2012. From experience, I know how it can fill you with shame – even terror – to reveal a mental disorder like this to a medical professional when you don’t think you look ill enough. Not only did I personally feel I’d failed to lose enough weight to have a ‘real’ diagnosis, medical doctors didn’t believe I had an issue, either. In the past, one therapist tried to convince me I had a binge-eating disorder because I was overweight. Back in my twenties, when I first got treatment and was hesitant about putting on weight, more than one provider assured me they wouldn’t
‘let me’ get fat – as if fat was something to fear. Over and over, professionals reinforced stereotypes about eating disorders when they should have been challenging them. These old myths about anorexia drowned out the few genuinely helpful voices.
‘I personally felt I’d failed to lose enough weight to have a “real” diagnosis’
I still consider myself one of the lucky ones, though. When I checked into hospital two years ago, at 37, my husband and family rallied around me with unconditional support. I found a treatment centre with staff who understood me and I spent five months there nourishing my body and learning new coping mechanisms – like the ‘health at every size’ philosophy: a set of body-acceptance principles that taught me how to look after my wellbeing without pursuing weight loss. But it also helped to learn that there are others like me; that I’m not the only one struggling with anorexia who doesn’t look the part.
I weigh more today than ever before. But I’m coming to terms with the fact that my size is only a tiny part of who I am. Just as health can exist at every size, so, too, can this deadly mental illness. Silence breeds shame, so I’m raising my hand to tell my story in the hope that this pain – experienced by millions, in secret – won’t remain invisible forever.