Weekly Update 1

This is the first of what will be a series of weekly updates about how I'm coping and whether I slip up.

I mentioned in my first couple of posts that I went to the supermarket last week and bought supplies for a binge. The good news is, I didn't binge. The bad news is, I showed no self-restraint whatsoever and the last of the food went yesterday.

I'm just trying to cling on to the fact that I didn't eat it all in one go.

On a brighter note, I went to the shop again yesterday because I was out of milk and low on vegetables. The most unhealthy thing I bought was a packet of low-fat, wholemeal biscuits. They're sitting in a cupboard in the kitchen and I'm determined to eat them gradually.

I've been to the gym a few times for a couple of hours at a time. The sessions have been tiring, but I've not been pushing myself too hard.

Overall, I've gained a couple of pounds this week, but I can cope with that. Everyone goes through bad patches and I'm not about to start starving myself over this one.

Non-purging bulimia

When people think of bulimia, most of them would think of the classical pattern of binging then throwing up. A lot of people don't realise that there's far more to it than that. Plenty don't even imagine there are different forms that bulimia can take.

Even in groups that deal with eating disorders, when people talk about bulimia, they usually mean the purging kind. When people talk about the dangers of bulimia, they mostly consider the dangers of repeated, induced vomiting. They don't consider that there are other actions that lead to the same disorder. So I'm going to explain a little about a different form bulimia can take.

The definition for bulimia talks about binges – eating vast quantities of food in a short space of time and feeling out of control while eating. The definition also talks about feeling of guilt follow such binges and self-evaluation being based on image and body shape. Then it mentions purging behaviours.

Purging behaviour can include vomiting, laxatives, diet pills, fasting or excessive exercise.

Note the "or."

It is completely possible to be bulimic without throwing up.

I'll explain a little about how I used to act, but I don't believe for a moment that this is the only pattern non-purging bulimia can take.

I used to binge. I would buy a load of junk food and then stuff my face. A binge would usually be a bag full of biscuits, sweets, crisps and cake. Sometimes I would buy a microwave meal as well. Sometimes, I'd stop by the sandwich shop and buy a sausage or a bacon sandwich. If I didn't have enough food, I would eat something from the fridge or the larder as well. I would eat until I felt stuffed but I wouldn't be able to stop.

Then I would hate myself for being so weak and greedy.

So I would focus once more on my diet and be determined to be even stricter with myself to make up for my behaviour. My diet consisted of skipping meals whenever possible. My mum went (and still goes) away on business quite a lot. Once my sister started university, it was my job to cook dinner. I always tried to time it so that I would finish cooking a few minutes before my dad got home. That way, I could pile most of the food onto his plate and leave just enough on mine to make it look used. Then Dad would get home and I'd just be finishing up the last bit of carrot or piece of broccoli. When I mistimed things, I would be careful about serving things out, so I would get more vegetables and he would get more of everything else. But I couldn't do it too much or he'd notice, so I absolutely hated those meals.

At school, I would make a show of eating. I would obviously go to the vending machine and make jokes about how I ate quite a bit. I knew I wasn't losing weight. I would rather my friends thought me slightly greedy than guess that I must be binging and know that I was a disgusting pig. So I made certain they saw that I was eating... then I would throw away the packages with almost all of the food still in them.

I never ate breakfast. When I had to eat other meals, I tried to make them as low fat as possible and threw away anything I could get away with.

And I exercised. I played a lot of badminton and went to two different clubs. This let me play for at least five hours a week without anyone being even slightly suspicious. I went to the gym with my mum one evening a week. And I went jogging. I would get up early on a weekend morning and go out running. I tried to do this before anyone else was awake, because I didn't want them to realise that I wasn't losing the weight that I ought to be doing. I would rather my family thought I was lazy and didn't exercise enough than guess that I must be eating so much sugar and fat when they weren't looking.

Then, in the privacy of my room, I would do sit-ups and lunges and any sort of exercise I could given the confined space. The rest of the time, I would worry about how many calories I was burning. I would sit in my lessons at school and twitch my legs or wriggle my fingers or anything to give just a little bit more movement.

I bought myself an ab belt. It's one of those machines that you put over your stomach and it promises to give you more definition and a flatter stomach. The one I had said on its instructions not to use it for more than half an hour a day. I used it for at least three on full power.

I took diet pills. I tried loads of different brands and varieties: thermogenics, appetite suppressants, fat metabolisers, detoxifying complexes. I was careful about how many I took, because I didn't want to accidentally overdose. I would follow the instructions for each packet carefully, taken the maximum recommended dose. But I would be taking at least two different brands at the same time. Again, I was worried about overdosing, so I was careful to take brands of different types. I'd happily take a dose of detoxifiers and one of an appetite suppressant, but I wouldn't take two different thermogenics.

I also tried cold baths. I'd heard that people burned off loads of calories keeping warm, so I would run a deep bath of cold water. Sometimes, I was able to sneak some ice cubes from the freezer to the bathroom and put those in. I would sit in the icy water for at least an hour, shivering like mad and delighted that I was burning off fat. It usually took me ages to get to sleep after that, because I'd be lying in bed still shivering. But at least shivering used energy!

Then, after maybe a day or so of this, I'd be famished beyond belief and craving sugary, fatty food. I'd smell something delicious and lose all control and rush to the shop to buy another hoard of junk.

But I didn't often throw up. I only stuck my fingers down my throat on less than half a dozen occasions and, generally, it didn't work. The times when I did throw up, it was usually unintentional. I'd just eaten too much for my body to cope with. This particularly happened if I binged late in the evening and then went to bed with my stomach still too full.

I didn't believe I had bulimia, because I didn't stick my fingers down my throat after each meal. I didn't force myself to vomit so I didn't fit the standard pattern.

I want people to understand that there's more to it than just throwing up.

Look at Me

I thought I'd go for something slightly different today. For ages, I've made music videos for shows and films that I like. I thought I'd make one a little more personal.

This video reflects my feelings back at the start of my recovery, when I was desperate to hide what I was doing and wishing so hard that I could be happy again.

Help

I picked up a leaflet yesterday. It's called "Beating eating disorders." The leaflet contains very general information about eating disorders, mainly anorexia and bulimia, links to a website, a helpline number, and some advice for sufferers or friends and family of sufferers.

One of the pieces of advice for sufferers was to go to a doctor as soon as possible. It advised the reader to seek out professional help because it's hard to recover without it.

I've never had professional help for my disorder, so naturally I started thinking about this. The main reason I didn't seek medical help was that I didn't believe I had a disorder until I'd already begun to recover and was considerably better than I had been. Another reason was that I was thoroughly ashamed of what I was doing. Even now, I struggle to even mention my illness to people I know in real life.

There's a lot of stigma attached to eating disorders. Too many people don't believe they're a real illness and think that people pretend to have them to get attention. Seeking help and getting a professional diagnosis means being labelled forever as an ED sufferer. Even when people do understand, they may watch what you eat in a way that's intended to be helpful, but is actually torture. When you turn down a cake, they will be watching and wondering if you're just lying when you say you're full. I can understand not wanting that sort of pressure. The fact that I've hidden for so long is proof of how terrifying the idea of being labelled can be.

So, am I advising people not to seek help? Not at all.

I was lucky. My disorder was nowhere near as severe as some people's, even for its type. And I believe that non-purging bulimia is probably one of the least damaging physical of all the eating disorders. You don't suffer all the myriad of conditions that afflict anorexics and you don't get all the problems from constant vomiting that most bulimics suffer from. The worst that happened to me was that I was found to be borderline anaemic and that was after four years, by which point I was already over the worst. Four years of skipping meals, and then binging on junk left me low on a few nutrients, but not in any danger.

The affects of anorexia, purging bulimia or COE would be a lot more noticeable and pose a much higher long-term threat.

If you have an eating disorder that is associated with more severe health risks, the slow route to recovery alone is probably just going to leave you at risk for longer. It would be hypocritical of me to tell every sufferer that they ought to go and get help, but it's something to think about.

It never occurred to me to seek out an eating disorder specialist or attend a support group, but if you know you have a problem, it would be worth at least seeing what the options are where you live. Particularly if you know your disorder is linked to serious physical health problems and long-term damage.

Misconceptions

Plenty of other blogs have mentioned the whole John Prescott thing, but I feel it doesn't highlight an important issue.

There are so many misconceptions about eating disorders. A lot of people assume it's all about teenage girls trying to be thin. They don't have a clue about the deeper, emotional issues behind it and they don't even guess that it could affect older people and guys.

That makes me wonder, what about the people who suffer?

How many guys have an eating disorder but don't know anything about the subject, and so don't believe that they do? For several years, I didn't believe I had an eating disorder, simply because I didn't know enough about them. In my mind, anorexia was not eating, bulimia was throwing up a lot, and EDNOS didn't exist. Since I didn't make myself throw up, I didn't think I was bulimic and I obviously wasn't anorexic. So I thought I was just weak and greedy.

I can't be the only person whose lack of knowledge blinds them to an illness. There must be plenty of people out there, whether guys, or older women or girls of the average age who don't follow the usual pattern, who don't know what they're suffering with. Because they don't guess it's an eating disorder, it doesn't occur to them to read up about them.

And then there are the healthy people who no a disordered person. I remember reading a comment online from a guy saying he had no sympathy with anorexics. If they wanted to starve themselves to death, he didn't see why people should fuss about trying to make them eat. Unfortunately, this attitude is far too common. People don't understand the disease and assume it's just about wanting to be thin.

There are too many misunderstandings around these illnesses. The pro-ana cults really aren't helping those of us who are suffering, but that's a separate rant. There are just too many people who assume it's dieting gone too far who don't bother to read about the problems to learn the truth. Maybe that will change.

I hope that Prescott's admission will open people's eyes and make them realise that it's about deeper issues than that.

I hope that people who don't fit the clichéd pattern of eating disorders will look at their lives and realise they have a problem.

Most of all, I hope Prescott manages to recover completely. He did an incredibly brave thing in admitting to his problems and I wish him all the luck in the world with his fight.

Boundaries

I was in the gym. I went through my usual exercise routine, which involves quite a large amount of cardiovascular work. Then I wondered if I should do a short session on the rower, as well as what I would normally do. As someone who's recovered from an eating disorder, I always worry about falling back on bad habits. Over-exercising to compensate for binges was one such habit.

I spent several minutes wondering if it would be a sensible reaction to do a bit more exercise, since I'd eaten more than I normally would, or if that would be a minor form of purging.

The problem is, there's no way to draw a barrier between exercise and over-exercise. One more minute on a treadmill doesn't suddenly change something from a healthy pastime into a danger. While I'm certain I could have done ten minutes on a rowing machine without putting my body in any danger, I didn't. The reason I didn't (aside from the fact I was already tired from an hour and a half of other exercise) was that small things lead to big things.

That can be taken as a general statement about eating disorders. A person doesn't switch overnight from being normal to being disordered. Looking back on my life, I can't tell you when I developed mine. I know there was a time when I ate normally, though perhaps with a tendency to snack when I was upset. I know there was a time when I would binge and hate myself and hide food wrappers where my parents wouldn't see them, and try and skip every meal I could to make up for the binges. But, seven years later, I can't see how I moved from one to the other.

Everything involved with eating disorders is a mixture of grey areas and blurred boundaries.

I had a comment conversation with someone in a lifejournal group were we discussed the different categories of eating disorders and the fact that many sufferers are classified as EDNOS while suffering almost all the symptoms of anorexia or bulimia. They were left out of the category because of a "loophole." We came to the conclusion that the official definitions for anorexia and bulimia weren't quite right. I think the problem is they treat these illnesses in the same way as they might treat a virus. But you don't suddenly go from being healthy to being infected.

Let's look at the diagnostic criteria for anorexia nervosa. This is taken from the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. A person must have all four of these before they can be considered anorexic.

A. Refusal to maintain body weight at or above a minimally normal weight for age and height (e.g., weight loss leading to maintenance of body weight less than 85% of that expected; or failure to make expected weight gain during period of growth, leading to body weight less than 85% of that expected).

B. Intense fear of gaining weight or becoming fat, even though underweight.

C. Disturbance in the way in which one's body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.

D. In postmenarcheal females, amenorrhea, i.e., the absence of at least three consecutive menstrual cycles. (A woman is considered to have amenorrhea if her periods occur only following hormone, e.g., estrogen, administration.)

The definition is very clear cut. If your body weight is 86% of what's considered normal, you're not anorexic, even if you starve yourself, exercise, take diet pills, think you're fat and have every other possible behaviour pattern of an anorexic. The day you lose that extra pound, you suddenly shift from being EDNOS to being anorexic, without any change in behaviour.

Let's take a hypothetical person. She was extremely overweight and began showing some of the symptoms of anorexia. These symptoms grew from an occasional skipped meal to full starvation. She began exercising furiously. She tried taking laxatives and diet pills when her parents made her eat. She developed an obsession with how much she was eating and how many calories she was burning. She dropped pounds and pounds of weight in a dangerously short amount of time. Now this person is slightly below average weight for her height and has missed a period. She eats only when forced to and tries to throw it up again afterwards. She is clearly ill and disordered. But this hypothetical person doesn't class as anorexic, because her body weight isn't low enough.

The official diagnosis criteria don't take into account the weight she was when she started.

Let's consider another hypothetical person. She was a ballet dancer, who kept a low body weight by careful eating and plenty of exercise. She was athletic and healthy and made sure to eat the right balance of nutrients to give her energy for performances and practice. She was very aware of her body and how to treat it right, but maintained a body weight about 13% below what would be considered normal for her height. She was given a large role in a performance and this involved a lot of extra practice. She didn't eat much more to compensate for the extra exercise and so lost a few pounds over the course of a month or so and reached the 15% below normal limit that is required for anorexia. But she doesn't display any of the other symptoms and is quite happy to eat, albeit carefully.

I feel that the body weight shouldn't be given in such a fixed way for the diagnosis. There is nothing special about the number picked. They could have chosen a percentage either way, and it wouldn't change who has the disorder and who hasn't. While I agree that a definition of a disease such as anorexia nervosa ought to have weight as one of the factors considered, but it shouldn't be given as such a fixed boundary. Doctors ought to be asked to consider starting weight before giving prognosis. Besides, all definitions say that this is a mental illness, so why do the definitions focus so much on the physical aspects such as weight and menstruation?

The definitions are a little better for bulimia, but they're still very clear cut. You either have it or you don't, according to the definitions. I think the medical dictionaries need to be reassessed to take into account the huge grey areas around starting a disorder and the blurred boundaries between them.

The same problem applies outside the realm of disorders as well. Just take a look at one of those BMI charts. It divides into neat segments of healthy, underweight, overweight, etc. If you're on one of those lines, half a pound either way could be the difference between healthy and fat. Those clear boundaries aren't real and shouldn't be applied to a process with such gradual changes. But we apply them anyway.

We judge ourselves by labels slotting us into one category or another, when really we should look around and see that the walls between those categories are as flimsy as the paper the medical books are printed on. As soon as you leave the text book and enter real life, there are no lines that separate the healthy from those who need help.

Yesterday

This is what happened yesterday, which made me think about starting a blog.

It wasn't really a binge, but it was a bad sign.

A friend invited me and others round because she was cooking dinner and she made the suggestion of bringing more food. I asked what kind of food and she suggested a vegetable side dish. I thought about this and decided what I'd bring. But, I wasn't sure how many people were going to be there and wanted there to be enough, without using up all the vegetables I had in the fridge.

So I went to the shop to buy supplies. Perfectly reasonable.

I wasn't feeling bad yesterday, at all. There was a slight guilt because I'd not been doing the university work I should have been, but I had no reason for feeling depressed. Just the day before, I'd been feeling really optimistic about my fitness test results.

So why did I fill my basket with loads of junk?

It's the big question. I knew it was stupid at the time, I knew I'd regret it. But I piled in the crisps, sweets and biscuits. I bought some hot stuff from the deli section as well. And then I checked out.

I know I'm better than I used to be. The time was, I'd have eaten half the food before I even made it back to my house and then I'd have kept eating. As it was, I ate the hot stuff, at a pace that most people probably wouldn't have considered particularly fast. Then I started eating this cheese straw thing I'd bought from the bakery. I decided I didn't like the taste and I threw it away.

It seems crazy that that's a big deal. But I decided I didn't like the taste of something so I stopped eating it. There were times when I was at my worst when I'd have eaten anything and I wouldn't have stopped for something so minor as taste.

I ate some of the chocolate when I got back but there is a bag in my room that still contains two packets of Pringles, a packet of biscuits, some Go Ahead bars, some fruit flakes, some chocolate and some sweets. I didn't eat it all. I didn't even eat half of it and what I did eat yesterday I didn't shove down my gob in one sitting. I can clearly see the improvement, but it's still depressing that I have these tendencies to go out and buy loads of unhealthy food and to eat when I know I'm not hungry.

I may have eaten more than I was supposed to yesterday for no particular reason, but I don't think it was a binge. It's just worrying that, even after all this time, I still do things like this.

I didn't throw up.

I'm not going to starve myself today because of it.

I am going to go to the gym, but only because I'd planned to anyway and I want to keep fit.

The title of my blog starts "still hoping." So, I'll keep hoping that there will be a time when I don't get urges like this.

Getting started

I used to have an eating disorder. Most of the time, I consider myself recovered, but I still have my bad days and still suffer from some of the tendencies I had when I was at my worst.

I suffered from non-purging bulimia and my eating disorder, combined with pressure at school, drove me into a depression serious enough that I attempted suicide when I was fifteen. I have never been officially diagnosed with an eating disorder and I have never been professionally treated. For years, I didn't believe I had a disorder because I didn't know enough. As far as I was concerned, bulimia meant throwing up after meals. Since I never deliberately threw up, I thought I wasn't ill. I was just weak and greedy. It's taken me a long time to get out of the cycle of binge-eating and then starvation, self-hatred and over-exercising.

Recently, I came to terms with what I've been through and decided that I would try and help others who have eating disorders, who are recovering from disorders or who have had disorders and are worried about relapsing. I also want to help increase understanding of what eating disorders are and how the effect those who suffer from them. There is a lot of misconception out there around these illnesses and I hope to show people how things really are.

One of the things I have done is to join online communities. I wanted to be there to offer advice to people who are still struggling with the things I've gone through. After all, what was the point of climbing out of hell if I can't help those who are still struggling down there?

Another thing I did was to start writing a novel. I have been writing stories for as long as I can remember, but this is the first time I've written something so deeply personal to me. The setting and characters are completely fictional, but there's an awful lot of my experiences and my emotions in the central character. I may be sharing extracts from the story here and asking for feedback. If I can get the story published and help spread the message, I think I'll have done a good thing.

I decided to write this blog because I want to talk about what I'm still going through in more detail without drowning the communities with endless posts. The main reason for coming to this decision was that two days ago, I was pleased with the result of a fitness test which pronounced me much improved on previous tests. Then yesterday, I went to the shop, bought a hoard of food and ate way too much, for no apparent reason. I'm still doing things like this, even years after my supposed recovery and I feel the need to talk about it somewhere.

My plan for this blog is to write a weekly update of how I've been in terms of eating and exercise, to show my progress towards being healthy. I will also write about my feelings and actions when I have either a very good or a bad day. I will also write about issues that I feel are important to people with eating disorders.

I hope that this will offer information to those who don't know enough about disorders and hope to those who are suffering or recovering.