These are the things I remember from being thin: bruises along my spine from where the bones touched the back of chairs, legs so skinny that if I stood with my ankles together you could've put your fist between my thighs, always wrapping myself in long-sleeve shirts and wool sweaters because I was so cold all the time. Not being able to walk barefoot comfortably: the bones of my feet had no padding under them. Going to bed and waking even more fatigued, tiredness that followed me like a shadow. Needing several minutes to go from laying or sitting to standing up, my blood pressure so low that I'd become dizzy as I got vertical. A pulse that I could barely feel. The kids at the summer camp I worked at, asking why I looked like a skeleton, my best friend Sam coming up behind me and hugging my shoulders, answering for me, "she's sick but getting better."
This is what I remember the day I hit that magic 110 lb goal weight: I'd run for my allotted hour that morning, lifted and was standing now backward on the scale with Kelly fiddling with the little bars that balanced it like she did once a week. I was 18 and a senior in high school. She was in charge of not only coaching me and turning me into a decent runner, but monitoring my weight, and helping me with nutrition. She'd weigh me once a week, backward so I wouldn't see the number - though she'd tell me if I did want to know - write it on a slip of paper for me to bring home to my mom, and call my doctor. "Guess what, honey?" she said, softly, and I looked up tiredly. "110... congratulations."
I knew it was close to that, I'd been hovering just over 109 for about three weeks. But I hadn't expected when I stepped on the scale that morning to be at that magic 110, and I certainly had never thought about what would happen when I finally was recovered. I cried in the car on the way home. I remember the rain, pouring down on the windshield over my tears, and I didn't know why I was crying or what I was feeling, except the relief that it was over. It was April 21, 2005. I ran again that afternoon, because I was healthy, because I could.
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Swim season, 2001. I wish I could tell you the day it all started, or why, but it wasn't one day, nor one reason. I was a very healthy middle school athlete: I ran cross country and I swam with the high school team. I ate well, I was in the fastest lane at practice and everyone adored me for being so little and so fast, they were all waiting for two years later when I could race, anchor relays for them, win the distance free events and score team points. I glowed under the attention of the older swimmers. But I didn't have the star high school swimming career that they all predicted for me. I was fast but not fast enough, and at some point my freshman year, I think I got the idea that if I were thinner I'd move through the water faster, that I would swim better if I were lighter and didn't have any food in my body, that... I don't know. This is where it becomes murky, but I recall training my a$$ off, swimming 9,000 yards a day and not getting any faster, and I think I ate less as a way to punish myself for that, for not making the time cuts I wanted.
My parents noticed the weight loss and brought me into my doctor's office for a physical in May 2002. I knew something was up when both my parents went to the doctor's office with me. We didn't have a scale at home so I was surprised when my weight was 103, down from 115 the last time I'd been there. I never thought about trying to lose weight. That wasn't the point. My mind was just trying to be a little thinner, so I'd slip through the water easier.
My doctor diagnosed me with anorexia nervosa, and referred us to a woman who was a dietician AND a therapist. I gained the weight back, glad to be given by someone else the permission to eat that I had denied myself for many months, but we never talked about why I'd developed an eating disorder, and so in a couple months I was back up to 115 lbs, the thought tucked back in my mind that I could always lose it again.
Which, of course, I did.
And this time, it was because what I ate (or didn't) was a way to have some control over my life. I was a ridiculously good swimmer, I loved practice, but my parents would never let me go out with my swim team friends after, or to their parties on the weekend, or even ride with them to practice (god forbid I be in the car with a teenage driver. I walked from school to practice). An introvert, I'd never had many friends, and now I did, and wasn't allowed to hang out with them. I started swimming more, running more, eating less. The first two were a great way to get out of the house, probably a search for the happiness I was desperately missing, the last a silent scream to my parents, if you won't let me do what I want, I won't eat.
This time, I got dragged to the Mercy Hospital Eating Disorder Treatment Program. My parents suspected (rightfully so) that I was relapsing, and since outpatient treatment hadn't worked the first time, they wanted me hospitalized. Or - they didn't, really. My mom locked herself in the bathroom that morning, a panic attack over the fact that I might be admitted. Bitter teenager that I was, I shouted through the door at her, "but you WANT me hospitalized so why are you panicking over it?"
I wasn't admitted. I don't remember the person's name who did the intake assessment, but he was incredibly condescending, and I lied my way through it. I might've answered honestly to someone different, but this guy was just incredibly... condescending. I shudder writing this, remembering that day in details that I wish I could erase. I remember him wrapping his fingers around my wrist, trying to see if I were an ectomorph, mesomorph, endomorph - this is how they determined, with your height, what you were supposed to weigh. I wanted to pull away, from the awful touch of this stranger. I certainly did not want to put on a johnny and be alone in a small room with him to be weighed but I didn't have a choice. When he weighed me, I was 111 lbs, a pound over the minimum requirement for my height. They could not admit me - between that and my answers to all their questions, I was not "sick enough."
My parents were shocked, as they'd fully expected me to be admitted, and now I could throw back at them that I was fine, the people at the fancy hospital you just dragged me to said so (they hadn't said I was fine of course, but I'm good at twisting things). One point for Alyie. My parents' hands were tied... they did make me see a therapist at home. Another control thing, a person I didn't like and of course one that THEY had chosen, so if I talked at all, it was about small things.
By February my junior year, I was getting visibly thinner. My weight dropped to 105 and I was pulled off the swim team two days before our championship meet. I was livid, again the parental control, and while my parents could keep me from swimming, they could not keep me from running. My retaliation, then, was to start running 13 mi a day, and eat very little. I switched from vegetarianism (which I'd started in 6th grade, not ED related at all) to veganism (definitely ED - a way to control something again, and a way to eliminate more food groups).
When you starve yourself, your brain starts to short-circuit. Interestingly enough, I never had any trouble with school - I took all AP and Honors classes and eventually graduated valedictorian. Somehow I could focus on school things, it was, perhaps, a welcome distraction, another way to isolate myself, stay locked in your room studying all day. But the lack of glucose to your brain is, I think, what causes a lot of the weird eating habits. I developed a desperate need for everything I ate to match in some way, to be symmetrical - for instance, I'd have to eat the same breakfast and dinner but lunch could be different. Vegetables did not "match" anything, I wouldn't eat them. A bagel and cereal matched. I could have a bagel for breakfast, cereal for lunch, a bagel for dinner. Anorexics do eat. You have to - just a little, just enough to keep yourself from fainting. I remember one day having six, four-ounce soy yogurts, and that was all I was going to eat that day. You know how those yogurt packs come: you get three of one flavor, three of another. I had three strawberry and three peach, and I couldn't figure out how to eat them, how to separate 2 for breakfast, 2 for lunch, 2 for dinner, so it would be symmetrical. This caused so much anxiety, to not know the order in which to eat them.
The first morning of my senior year in high school, I ran 4.5 miles. I went to school, came home, ran 9 more. At my doctor's appointment after that, I weighed 97 lbs. I am 5'6".
This is what your life becomes, when you have a severe eating disorder: an endless cycle of appointments. I saw my doctor every week (weighed, vitals, questions about what, if anything, I was eating). Therapist every week. Blood panels drawn once a month (they always came back fine, and this was another thing I shot back at my treatment team: if I am so sick, why are my electrolytes and protein levels fine?!). Between school, all the appointments, homework, I had no time for anything else. At the same time you are trying to recover and break away from the disorder, you are forced to live and breathe it constantly.
When I got to 93 lbs, I was threatened with hospitalization again. A place in Massachussets this time - I was not taken for an assessment, but told point-blank that if I were to become medically unstable, I would be in-the-car-and-taken-to-Walden-instantly. This is not a treatment hospital, but one for medical stabilization (think: feeding tube). Because my heart rhythms and bloodwork were always fine, they wouldn't take me. My parents were waiting for some test result to come back abnormal, praying for this I think, so I would be out of their hands and in a hospital.
I really, really didn't want to be hospitalized. Everyone kept telling me, "if you do not gain weight, you're going to die." Dying didn't scare me too much - the possibility was too surreal. Being hospitalized, a much realer threat, scared the sh*t out of me.
One September afternoon, I called Kelly. I don't remember what spurred this phone call. She is the manager of the local gym, and I knew her from volunteering at blood drives there. I also knew she was a runner, and because of this, I thought she'd be sympathetic to me. Goodness knows my parents or doctor didn't get the athletic side of me, didn't understand that running was the one thing that made me happy (yes, I was still doing it, still the 13.5 miles a day, somehow.) I told her quickly over the phone that I needed to gain some weight and was hoping lifting would help, could she set up a lifting program for me? She said sure, come on in, so that afternoon I met her in her office, eventually broke down about the eating disorder and told her, "look, if I don't gain some weight, my parents are going to hospitalize me. I'd rather recover from this on my own."
Kelly was the angel who finally helped me turn things around. I didn't know her very well but I put my exercise in her hands - it was nice for me to finally have someone take care of me whom *I* had chosen, whom I liked. She was the first person to treat me as an athlete. To her I was not the anorexic girl who needed to gain weight - I was the runner who needed to gain some muscle so she'd run faster. This perspective shift was huge, and it is a large part of why I finally recovered. Someone finally cared about me for the girl I wanted to be, an athlete.
Kelly became my ally. The first day, she asked if she could weigh me, so that she could monitor if the lifting-to-gain-muscle would work. I said, with trepidation, sure, but let me stand backward on the scale and for god's sake don't tell me the number. I realized that day that I wasn't anxious when she weighed me, unlike when a random nurse did it at the doctor's office. She thus got an additional responsibility: monitoring my weight, keeping the rest of my treatment team informed. My parents liked her, my doctor liked her, most importantly, *I* liked her. I also, in a fit of being assertive, told my parents I wanted a new therapist. I found one, incidentally the first one I called was a runner. SCORE.
I'd run for an hour, lift for an hour, every morning. My weight crept up slowly, half a pound a week. I got stronger. I got faster. Kelly negotiated with my parents to get them to sign some race waiver forms for me ("she's fast, let her race, she'll do well and it will build her self confidence.") She was, of course, right. I settled into a routine I loved - get up, go to the gym, see Kelly a couple times a week to check in, she'd always ask about how my running was before even starting with the eating stuff. I was happy. I had a hard year, trying to be a senior in high school and recover from an eating disorder, but it was a very happy year, glowing with the attention and new-found health.
In February 2005, my hips started bothering me when I ran. Kelly called my doctor on a hunch and asked her to schedule a bone density test for me. The hip problems turned out to be muscular, but she was right-on with the bone density test. Osteoporosis - common for anorexia sufferers, from a lack of estrogen. Luckily, lifting would help this. And I started taking birth control until my periods returned on their own (I'm still waiting for this to happen. Even at a healthy weight, you suffer the health consequences from anorexia - one of mine seems to be that my body just won't make hormones. And because of this, I will never be able to have kids. Not that I want them... the idea of being pregnant and fat scares the sh*t out of me. As a sidenote, my bone density has been increasing over the past few years, and is now classified as osteopoenia).
99, 99.7, 100.... 103, 105,... I never obsessed about numbers until they did... another instance of treatment making parts of the disorder worse. I never had a need to know what I weighed until other people started caring about it, and now I cannot escape this, the need to know once a week what I weigh.
April 21, 2005... 110.
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This is what I remember from getting healthier: my nails weren't as brittle, my hair thickened enough that we could tie it in French braids again. I could wear a size 32 swimsuit, rather than ones from the kids' section. Skin that wasn't so dry all the time. Standing up without being quite as dizzy (though this never has fully gone away). Eyes chased me at the beach still - but for my beauty, not for being skeletal. How good things taste, this rediscovery of food, new fruits and vegetables finally, and ohmygod yogurt. I remember being able to stay up past 8pm because I wasn't so tired. Walking barefoot. Looking in the mirror and seeing light in my eyes. Turning around and seeing a tan back, bruise-free. Running into Sam at the store, her hugging my shoulders again, "you look so beautiful!"
This is what I remember from getting healthier: Kelly handing me her book for marathon training, like a blessing, Alyie, go run.
maybe she's born with it, maybe it's chlorine
If you're injured and need some sympathy, PM me and I'm very happy to write back.
disclaimer: PhD not MD