Myth #1 – as voted for by you! “Anorexics never eat.”

Here it is! The first of (hopefully) many posts! I don’t even know where to begin on this one. So I’ll just start off by saying that the notion that “anorexics just don’t eat” is completely false. Whilst in some extreme cases – this might be true – it certainly isn’t commonplace amongst Anorexia Nervosa (AN) sufferers and it certainly isn’t a very long-term behaviour. If someone were to “never eat” it simply would not be sustainable for a long period of time, and it would probably lead to one or more of the following options:

  1. If things got critical – then medical intervention would be required through tube-feeding, peg feeding, drips, a general hospital admission and/or an inpatient hospital admission to a specialist ward etc.
  2. The person’s survival instinct would kick in and their body would lead them to find and consume food (through reactive eating or binging).
  3. Death.

Anorexia Nervosa sufferers do not simply just “not eat anything” – but rather, they restrict what they do eat. This might be through calorie counting and not taking in enough calories to sustain a healthy, optimum body (and mind). This might be through restricting whole food groups. This might be through only eating X amount at X time of day. In fact – some sufferers might eat a normal sized meal that appears perfectly balanced, but that could be the extent of their daily intake. It differs from individual to individual and no two eating disorders are exactly the same.

A popular and very apt analogy that I’ve come across through being in the services for an eating disorder is that the body is like a car. In order for it to keep going – it absolutely must have fuel in it. If you don’t put any fuel whatsoever into it, then it will not be compatible with life over a long period of time because instead of burning petrol, the car starts burning the body work (fat), the interior (muscles, organs) and then eventually, the engine (the heart, which is also a muscle).

Furthermore, I think it’s probably a good time to mention that within the diagnosis of Anorexia Nervosa – there are subtypes. The one that people generally associate with Anorexia Nervosa is the “restricting” subtype. However, there’s also Anorexia Binge/Purge subtype. I found a source online that explains the diagnostic criteria for both subtypes:

  • Restricting type: During the current episode of anorexia nervosa, the person has not regularly engaged in binge-eating or purging behaviour (self-induced vomiting or misuse of laxatives, diuretics, or enemas).
  • Binge-eating–purging type: During the current episode of anorexia nervosa, the person has regularly engaged in binge-eating or purging behaviour (self-induced vomiting or the misuse of laxatives, diuretics, or enemas).

(http://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/psychiatry-psychology/eating-disorders/).

So whilst it is true that Anorexia Nervosa (AN) sufferers do restrict, starve and deprive themselves – the claim that they “never eat” (ever) is not true. I’d also like to add that in the diagnostic criteria for diagnosing Anorexia, there are no specific numbers/calorie amounts, figures, or list of foods that must be adhered to with regards to intake. So when reading through the diagnostic criteria, you won’t find anything like: “to be diagnosed with Anorexia Nervosa, the individual must only eat X calories a day or less.” (You can find screening tools online by searching for Anorexia Nervosa diagnostic criteria).

Even restriction to a very extreme level is somewhat unsustainable because eventually, something’s got to give – whether that’s because the body gives up, or the person ends up engaging in “reactive eating.” What this means is that when the body has been starved for so long and has gone into deficit – possibly even feeding off itself (muscles etc) in order to stay alive and keep on ticking – evolution and instinct can kick in. The body overpowers the mind, so to speak. This can lead to eating quantities of food that may (or may not) feel like a lot to the individual, and they might possibly even eat food that otherwise the individual would not have allowed themselves because it is not classed as “safe.” (No doubt I will do a post explaining the notion of safe/none safe foods so don’t despair if you’re unsure of what this means).

This is quite hard for me to admit, but for the sake of trying to make a point, I’m going to admit to it anyway: After periods of severe restriction, I myself have experienced “reactive eating.” It felt like I had absolutely no choice in the matter and it was incredibly stressful. It led to a lot of panic, stress, guilt, self-loathing, shame, worry, paranoia… Need I continue? In a nutshell – it’s not a pleasant experience at all. I’ve heard it being described by others as an “out of body” experience. I completely agree with this because I personally felt such a loss of control. As survival mode kicks in, you almost go onto autopilot as your body desperately tries to make up for what it’s lacking. For me – this has only happened a few times and it certainly isn’t a consistent phenomenon for me. For some however, it can carry on right up until they are weight restored. If you take us back to our caveman days for example – there would have been times where food was scarce due to famine, cold winters and so on. During this time, humans would have probably lost weight. However, when the better days came and food became available again – people would have probably eaten to “make up” for the deficit, and then continued to eat generously in order to “prepare” for the ongoing threat of future famine. A more modern day example of this is the “Minnesota Starvation Experiment” whereby men volunteered to be starved over the course of a few months – and then refed again to see what happened to their mental and physical states. That’s a very basic explanation and I definitely urge you to read more about it here: http://www.zoeharcombe.com/2009/12/the-minnesota-starvation-experiment/ because it really is a very interesting topic.

Although as a little side note, not all restricting type Anorexics experience this (although more often than not, they do). For those who don’t – it can be for a whole host of reasons. The main one that I’ve found is that whilst still severely restricting and not taking in enough nutrition to maintain a healthy body – they’re not doing it to an extreme, unsustainable degree. What I mean is they might simply be “eating more” – despite that “more” simultaneously not being “enough” for their bodies. This reduces the risk of reactive eating or binging because the body, whilst still deprived, isn’t as deprived as it could be.

Anyway. I do hope that I’ve managed to explain this effectively! Long story short is that the idea that “Anorexics never eat” is wrong – because they do. It’s just that their intake is insufficient with keeping their bodies nourished, healthy and happy!

Thank you so much for reading. I really hope that this post wasn’t boring or anything. I’m going to leave a poll for you to gauge how you felt about it. If there isn’t an option on the poll that sums up your thoughts, or you have anything you’d like to add/say – then do feel free to leave a comment below or message me on Facebook! I’m really interested in hearing your feedback because then I can improve on things for next time.

Have a lovely day!

Lucy.

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