Oblivious to the dangers?
Laura's post yesterday on eye damage and eating disorders got me thinking. When I read articles about the health dangers of eating disorders, I almost have to laugh. Not because it's funny, but because of the tone of many of these articles, as if these straight-laced doctors can knock some sense into us silly ED patients, then the problem would be over.
Here's the thing: we are often well aware of the dangers. This isn't that we don't think it won't happen to us, or we've got it under control or we're not that bad, because we do. At least, I know I did. I was in the ER numerous times for low potassium from purging and dehydration. What did I do when I left the ER? Purge.
Yes, there's a bit of a disconnect. But in the moment, the dangers are irrelevant. What I always sensed as far more dangerous than heart failure was what would happen if I didn't purge, if I did drink that glass of water, if I ate that plate of food. Death was far-off. The food was right there in front of me.
My ability to ignore the medical issues wasn't a sign of how much I valued thinness--I knew water didn't have calories, but I was tremendously afraid of consuming anything. It added "weight" to my body, and that totally would freak me out. I took pathology, physiology, biochemistry classes as an undergrad and grad student. I knew exactly what was going on. And yet my eating disorder raged, raged against the dying of the light.
Sometimes, over the very short term, minor health scares would shake me up enough to get me to rein in at least the more flagrant of my behaviors. But these changes rarely lasted. They did nothing to arrest my illness.
I do think psychoeducation on the dangers of EDs are important, as is learning to deal with a wrecked body. I still blame myself for my crumbling bones, my uncertain digestive tract, my history of seizures. I know that I had an illness. I wasn't being stubborn or stupid or vain. Yet the pervading medical culture holds that if only I wasn't so freaking dense, I wouldn't have damaged my body.
I need to take charge of my health from here on out. I eat plenty of dairy and take a multi-vitamin. I take calcium chews when I remember. I keep my weight healthy and I take my Prozac every morning. I am well, now. Or at least more well than I was. Rather than wasting time scolding people, help them stop their symptoms so they don't have to face the health risks.
Remember this: we're not stupid. We're scared. There's a difference.
9 comments:
I agree with a lot of what you write here Carrie.. Even so, I must admit that I showed pretty huge cognitive dissonance when I was at my worst with AN.
Here is an example:
At a BMI of 14 I was still trying to do crazy amounts of aerobic exercise. This was difficult to achieve because of my very poor physical state (i.e. reduced muscle mass, including cardiac muscle mass; low blood pressure, reduced energy stores, dehydration, poor immune function). I knew the science through and through; I have a PhD in the Biomedical sciences.... yet I would get angry with myself for being unable to complete my exercise regime and even wonder why I couldn't do it.
When my AN was rampant my mind was almost divorced from my body. I could see that I was far too thin (no body image disturbance) but somehow I ignored it. It was almost as if the emaciated body I saw in the body was not my own - because it didn't feel like my own. I had this tremendous mental drive to over-exercise and restrict, yet I was starving.
None of this was related to intelligence. Rather, it was related to lack of perception. My body and mind were (sort of) 'disconnected', and I had continual battles in my mind about what I 'should' and 'shouldn't' be doing....
you bring up such a valid argument, carrie.
I know what I do to my body, I know I destroy it. I know I could even kill myself-- but that doesn't stop ED. ED only sees the instant gratification, ED blocks out long term consequences.
every single day is a battle to choose between what satisfies in the present, and what will hurt me later on.
such an insightful post, as always.
OMG.... i HATE when doctor start going on about health things... I'm just like I KNOW. I have taken nutrition classes biochem.... i know all the effects of starvation on a cellular level. I know what I am "supposed" to do. I know what my blood tests show. I know what BMI i "should" be at. Stop talking to me like I'm i MORON!
Yet, i usually would sit there smiling and nodding... and then go do exactly what I know I shouldn't do.
Doctors are stupid....
Thanks so much for posting this. You said exactly how I feel. People were always screaming health concerns at me and what would happen if I didn't do this or this. But I never listened because I never really understood. I was afraid of heart attacks but I kept going because at the time, being thin meant way more to me.
Now I'm on my way to being healthy and I don't work out very much at all because I'm afraid of damaging my heart.
if the AHA recommends 20 min. of cardio per day, why doesn't that apply to us? I'm told to stop exercising. Perhaps you can put it in words I can understand? Isn't it wrong to NOT exercise?
I think there is another unfortunate reason many of us ignore the damage we know we are doing or could do to our bodies. These things are further proof that we are "succeeding" at the ED, beyond the scale or BMI.
I think Drs are required to say these things. From the perspective of a doctor, you are obligated to inform the individual that their overexercising, restricting, purging, etc. is harmful and has consequences XYZ.
Most of us are aware of this, but at the time it never seems "real." I think it is part of that anosgnosia -- how could phosphate/potassium be low, etc. if we are not that sick? How could bone density show osteopenia or osteoporsis if we have never been "that" underweight, etc.
I still think that my DEXA scan is incorrect and my bone density is perfectly fine. . .
It's the nature of the illness to deny severity and this extends to both medical conditions AND weight.
I think a different way of thinking about it, would be to try to look at it from a perspective outside yourself. If my anorexic friend ABCD, was suffering from health problem XYZ, at BMI X, would I think she was sick? Would I think it was serious?
Understanding the severity of one's medical situation at extremely compromised states is difficult and certainly not natural, but I don't think it is impossible. . .
A:)
I think that knowing the consequences of our eating disorders is important. It's not in and of itself enough to enable us to change our behaviors. But, it is important to be informed.
At the same time, knowing that we have harmed our bodies already also has the potential to lead us to just say screw it and turn to our eating disorders even more so. That's what happened to me when i found out i had developed osteoporosis. I was upset. And, de facto, i went running and skipped dinner to deal with the feeling. Smart, huh...?
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