Unbeknownst to the majority, eating disorders aren’t really about food, weight and shape. Here’s what my ED is really about.

When I tell someone I have anorexia nervosa their initial response often consists of them reassuring me that I am not fat, that I shouldn’t worry about how I look and that I should just eat whatever I want.

By their reaction, I assume that their knowledge of the illness is as follows:

I am a young teenage girl who, like most, is self-conscious about her body and has consequently taken dieting too far. Why? Because my biggest fear in the whole wide world is being fat.

I would like to preface this article by saying I am not afraid of being fat nor am I (really) afraid of food. I think the diversity in bodies around me is beautiful, I am one of the last people on earth to encourage diet culture, I am an avid supporter of the Health at Every Size (HAES) movement and believe in the healing nature of intuitive eating. I would prefer 100 times over to be what society considers to be “fat” and free of my ED thoughts than be thin and still suffering from my mental disorder. 

The fact that people have such little understanding of my illness initially angers me.

When this anger hits… I remember to breathe.

A lot.

Secondly, I remind myself that this person’s ignorance is due to the fact that they haven’t had experience with an eating disorder and this is a blessing.  

Anorexia is not a simple illness. I always knew there was more to my illness than the professionals were asserting. Doctors explained my suffering as a purely psychological coping strategy to deal with childhood trauma and societal pressure to be thin. 

This made sense to an extent. Yes, there is trauma in my life. But what made my trauma any different from anyone else’s? Why didn’t all people who experienced trauma get anorexia? Yes, I live in a fatphobic society. But everyone else does as well, why didn’t they get sick too?

Psychoanalysis was just not cutting it for me.

I was doing things and thinking things that I logically knew to be false but the impulse to do and think these things outweighed my logic. 

It felt to me that my ED behaviours and ED thoughts were coming from a more primitive place than where my ‘higher order thinking’ took place. Even more primitive of a place than where my internalised trauma and fatphobic ideals were harboured. That’s why when I found Tabitha Farrar’s book Rehabilitate, Rewire, Recover (2018) my life and perspective of my illness changed.

Tabitha’s hypothesis draws from research studies which seem to help explain why someone may develop a restrictive eating disorder. And… surprise, surprise – it has nothing to do with an egocentric desire to be thin. 

Her work outlines a model of anorexia nervosa where first and foremost, anorexia is a maladapted biological survival response called migration (i.e. not. a. choice.). 

It explains that this migration response is only triggered in those with the genetic predisposition by an initial ‘energy deficit’. Energy deficit is when someone is using more energy than they are consuming. Migration manifests itself in the sufferer as a compulsion to eat less and do more under the illusion that this is what is best for one’s survival. 

Whether this energy deficit is initiated by a diet/desire to lose weight and be thin is irrelevant. This is why eating disorders existed before modern society’s idealisation of thinness did. The reason why I was suffering (and others seemingly in the same boat weren’t) was now revealed to me. The key seems to be in someone’s genetic makeup. The anorexic response was out of my control. 

My brain believes, due to this maladapted evolutionary response to starvation, that the behaviours it encourages me to do will aid me in survival. These urges become instinctual, as instinctual to me as the urge to breathe. The fear I feel at not being able to engage in a behaviour is equivalent to the fear anyone would feel if they were prevented from breathing. It’s like being scared of a scary movie – you know it isn’t real but you still get the involuntary response to a jump scare. Every. Time. No matter how prepared you are for it.

Of course, I logically know these things are doing the opposite of helping me survive (like one logically knows they are not threatened by a movie) but my unconscious, instinctual fear trumps this conscious logic.

From this biological foundation of my illness – my brain now adopts and encourages thought processes (like diet culture) which strengthen the fear response and in turn my adherence to the urges. This is where, for some sufferers, a desire to be thin and fat-phobic ideals are (wrongly) conflated with anorexia, anorexia merely uses these ideals to keep itself alive.

Self hate and trauma are also things which are sometimes conflated as causes of my illness. Overall, whatever strengthens the likelihood of me listening to the anorexic response, is strengthened. These perpetuating factors should not and are not what made me anorexic in the first place, my genetics and an initial energy deficit to trigger those genetics did that for me (Farrar, 2018). Basically, Tabitha’s book validated my hunch that something uncontrollable and explicable was happening within me, and it had nothing to do with wanting to be thin or my trauma. She also provided me with hope of full recovery. For anyone suffering, or interested, I can’t recommend her book highly enough. 

Anorexia also developed and magnified a sense of worthlessness within me and has used that, like it uses internalised fat-phobia, to perpetuate itself. My illness is a survival instinct and I am trapped by my low self esteem in that; the less of me there is, the less of me there is to despise. The more I believe this, the more I’ll listen to this survival response.

The rules my eating disorder sets out for me only apply to me. To put it simply: I can’t do or be x, y, z because if I do, my life will be in danger and I am the shittiest person on the face of the earth. Everyone else can do and be x, y, z because they are not in danger by doing such things and they are also not shit people (or at least not as shit as me). To put this in context, my head has realised the benefit in equating me with a person who is more Satan-like than Hitler… for no solid reason at all… it just so happens that as long as some irrational part of my psyche fundamentally accepts this as a truth, I will continue to listen (or at least part of me will want to listen) to my illness in the punishment it has set out for me, merely because I exist. All of this just so I continue to listen to the primitive part of my brain that thinks my behaviours will literally save my life.

My illness became an all encompassing addiction. If I can focus on the amount I eat and continue to stick to it’s strict rules, then I don’t have to think about my trauma. If I don’t have to think about my trauma, then I don’t have to feel. This is alluring because when I “feel” I really feel. All of the emotions on the spectrum. 

My illness was one of usefulness, my brain not only thought that the behaviours it compelled me to do were aiding my survival, it also allowed me to cope and execute self punishment in a socially acceptable, virtually undetectable way. Until I got too sick. Now it isn’t useful at all, in fact it’s a major bloody nuisance, but I’m sick which means I don’t really get a definitive choice about when I get better. I’m stuck with it, for at least a little while, all I can do is keep plugging away at its underpinnings until it finally falls away.

 Now, out of fear of re-traumatisation, my brain won’t allow me to let my ED go despite knowing the harm it does to me. Part of me still feels like it’s my only safety. I need to learn to calm this part of me. This ‘terrified self’ needs love and repeated exposure to the fact that food and weight gain won’t hurt me, in fact it’ll save my life. 

Healthy Audrey is not scared of food or being fat. In fact, I look at food and my healthy self is so wishing I could eat it all. I mean; cake, cupcakes, pasta, pizza, donuts… Yum. I look at my peers and not only wish for my natural, healthy body but wish for my life back. I wish, like them, that I could take up my rightful space as a result of actively honouring and nourishing the vessel which contains my soul. 

I’m lucky in that I can silence my eating disorder’s abuse long enough to be able to admit that, but in the dark recesses of my mind I can still hear it say… “you don’t deserve it like your friends do because… you’re an asshole.” The logic and consistency in that trope is just not present and I could easily “logic” myself out of it.  

But, logic isn’t the cure to a disorder which survives off of anxious, illogical thoughts and urges. The cure is in eating and turning off the survival response and never letting myself enter an energy deficit again. 

My eating disorder isn’t and never was really about food or shape, but it became about food and shape. A way to keep me ‘alive’ and then a way to escape when life seemed it’s most tumultuous, all centered around a preoccupation with food and shape.

Much like how an alcoholic’s addiction often starts from the desire to escape too. It isn’t about alcohol at first, it’s about wanting an escape, when the addiction takes over it becomes about alcohol and the role that vice plays in rendering their life unliveable. To recover, I (and the alcoholic) must abstain from our vice whilst facing the trauma which perpetuates our addictive coping behaviour. 

 I can’t wait for the day my primitive brain learns that my life is not in threat and I can then let my vice go and tackle all the other problems my eating disorder now hides me from. I can’t wait to take up my space in this world. To consume food and smile and know I deserve and need it like everyone else. Not just on a consciously logical level, but fundamentally, within that traumatised, primitive self inside. If people see my illness as a mere attempt to be in control of my appearance, let them bask in their ignorance, for that means they’re safe from this horrible, debilitating disease. 

I won’t ever reach their level of unknowing again but I can only wish and hope and continue to fight for the same peace and innocence around food and self-image as they have.