Updated: Jan 14, 2019
For several years I've thought about sharing my struggle with an eating disorder in a public way, solely with the hope that sharing my story may help others reach out and seek recovery, to offer hope in what is one of the most painful and bleak struggles that a person can experience.
I've held off on sharing my story because of fear. I feared (fear) judgement, I feared the stigma associated with eating disorders, and I feared people finding out that I really didn't "have it all together" (which is the driving ideal behind most eating disorders). To be honest, that fear still exists, even years into recovery.
However, I have reached a point in my life where I desire nothing more than to be authentic (it's all the rage among us millennials) and truly practice what I preach. If I want to teach lessons on courage, vulnerability, and truly confront the stigma associated with mental health struggles, then it's time I put my money where my mouth is.
I will not bore you with the long history behind my disorder, but I will tell you that I was the perfect candidate for one. As a young kiddo, I experienced sexual trauma (outside of the family) that I internalized for years. It wasn't until I was married and 26 years old that I finally said aloud what I held in for so long, unbeknownst to my parents (who I didn't tell until 26 or 27). As far back as I could remember I felt deviant or dirty, like there was something wrong with me.
So I overcompensated.
I became an achiever and a perfectionist. If I got straight As, if I was well liked, if I was the best athlete, then I could hide my unwavering belief that there was something wrong with me.
Perfectionism and shame mixed with a long family history of depression made a perfect storm for an eating disorder when I reached college. As a perfectionist and achiever, I hid my depression and the fact that I started seeing a psychiatrist at age 16. I was embarrassed. It didn't fit with the image that I longed to portray.
My freshman year of college, I joined the tennis team. There was a huge focus on exercise (which I always actually enjoyed) and food. At the time, I was balancing my grades, tennis, social pressure, and looking a certain way through working out and to learning about "nutrition". It was a huge balancing act, and by the summer going into my sophomore year of college I took a deep dive into the world of over-exercise and caloric restriction. I read exercise and health magazines obsessively. At the time, I had been mourning my "first love" break-up, and found escape and control in exercise and food.
In looking back, it's incredible to realize how slippery a slope it was into my eating disorder. As someone who is wired a bit on the obsessive end of things, it didn't take long before my exercising became a necessity, and my "healthy" eating became an obsession with eating only what I deemed to be "perfect" foods. Slowly, my restriction on foods increased and my intake decreased.
The human body is not meant to starve. The more we deprive it of the things it needs for energy, like carbs and fats, the more it craves it. Not only does your body crave what you aren't giving it, but it can easily go into a frenzy. This is one reason why diets don't work. It becomes difficult to moderate consumption because your brain doesn't know the next time it will be allowed to have the "forbidden" food again. So you lose control and you binge. And then you freak out and can't believe what you've just consumed, so you try to get rid of it.
Close friends have asked me, "how did you think to binge and purge? That's such a strange thing to think of."
They aren't wrong. Had you told me at age 17 or 18 that I would be purging within a year, I never would have believed you. I will skip the gory details because I do not want provide ideas for how to binge and purge, but suffice it to say, that at a time when I was holding on so tightly to controlling my world - through controlling everyone's perceptions of me, my outward appearance, and my performance on all fronts, bulimia felt like the perfect answer. It became the way that I thought I could do everything while disregarding my own emotional and physical needs. I turned to bingeing to manage my emotions and numb out and purging to release. It nearly killed me. I had such little esteem for myself, that I didn't care how unhappy or unhealthy I was, just so long as everyone else thought I was perfect.
It's no accident that I work with people in addiction. I am fortunate to say I have never battled a substance use disorder, but the grip that bulimia had on my life was akin to any addiction.
I would spend seven years battling the beast of bulimia, often alone because I was too ashamed to let me people know what was really going on. When I say I battled, I mean it. It was about six months after I had started bingeing and purging that I sought help from a psychologist. I remember crying and admitting to her what I was doing, my body racked with shame and embarrassment. Surely, she had never heard of someone doing this to themselves before. Surely she thought I was a disgusting monster.
I'll never forget her response, "the good news is you haven't been doing it that long, it's good to intervene in these things as early as possible."
She was right, but unfortunately I didn't have enough intervention. I went to outpatient therapists while in college, but I couldn't seem to shake it. I was depressed, and lonely, and still fooling everyone into thinking I had it together on all ends. I was popular, getting As in analytical and physical chemistry, and playing the best tennis I had ever played. I felt like a total sham.
The psychologist I worked with in college encouraged me to tell my family what was going on. As long as I live, I will never forget that night, it was like an episode of the show Intervention. My mom got angry because she felt helpless, my dad got intellectual and tried to explain the genetic and chemical components involved, and my brother cried and felt guilty for teasing me for stupid (and non-related) things when we were kids. We were in my parent's family room over winter my sophomore year, and as they were crying, and yelling, and explaining, I finally yelled, "Stop it! It's none of those things, and it's none of your fault!"
My family went to painstaking lengths to support me over the next decade. One time when I was visiting home, I was in my parents bedroom and found "Eating Disorders for Dummies". It was just one of many books I would find as my family made every effort to understand and help. Watching my mom's journey from frustration and helplessness to having faith and giving my struggles to her higher power was a pretty amazing thing to see unfold.
Throughout college and the years that followed, I continued to see therapists, I continued to fight against the eating disorder, and I continued to outwardly live my life. I took the entrance exams for medical school, got the scores I wanted, got all of my personal statements and letters of recommendation in order, and was set to hit submit. My mother is a strong woman and on the night before I was getting ready to apply, she walked into my room, tears streaming down her face and said, "Sarah, I can't let you go to medical school, not like this. If you go while you're still sick, it will only get worse. You may not live through it."
She was right, and I'm so grateful I listened to her.
Eating disorders claim the highest mortality rate of all mental illnesses.
The malnutrition coupled with electrolyte imbalances make a perfect recipe for a heart attack, not to mention the potential for stomach ruptures that can occur with bulimia.
Shortly after I realized medical school was not going to be a good fit (for many reasons but most importantly my health at the time), I took a job teaching tennis in California at a Girl's summer camp, which led to a great job at a prestigious boarding school. Again, outwardly things seemed great.
I did not take lightly my role as a mentor to the teenage girls I worked with. I was 23 at the time and the girls, who were 16 and 17, were like little sisters. I took being a role model very seriously, and as such I made a point to model balanced eating, body positive ideals, and moderated exercise. I did not want any of these girls to look at me, look at my plate, or my exercise routine and get ideas. I could easily spot girls who were struggling with their body image and food, and had may conversations with these girls about the dangers of dieting, the importance of moderation with exercise, and why being thin did not always equate to being healthy. I did not tell them of my own struggles, but it was very important that I model health to them. I wanted so badly for these girls who I worked with to love themselves and to never fall into the isolation and pain of an eating disorder.
While I was having these talks with these girls, I couldn't shake my own battle. I was 23 and across the country from my family and lonely in a new way. I was tired of being a hypocrite and knew I had to finally put my recovery first.
I entered treatment at Remuda Ranch in AZ during the boarding school's winter break. It was an eye-opening experience to say the least. I learned a tremendous amount in my time there. The problem with bulimia, however, is that people with bulimia are really good at performing. So I was the perfect patient, and convinced everyone (including myself) that I could be discharged sooner rather than later.
Like any kind of treatment, real life and recovery cannot happen in isolation, it has to permeate outward into every aspect of your real life. Returning to the same environment is often the biggest trigger for any kind of addict, and it was certainly a trigger for my addiction to bulimia. Needless to say, I fell back into bingeing and purging and would struggle for the next several years until finally coming into full recovery from bulimia on October 22, 2014.
I attribute finding recovery to a combination of factors. 1 - moving back to be near family. 2 - having a partner, who I agreed never to lie to, who in turn agreed to hold me accountable every. single. day. 3- Failing health. 4 - Finally treating my chronic depression. 5 - Dealing with my past trauma with a great therapist and releasing my shame. 6 - Reaching out to support from tremendous friends and family. 7 - The unyielding desire to heal and to use my experience for good in the lives of others.
These factors did not occur all at once, but evolved over the course of my eating disorder recovery until one day they all came together and stuck. I wanted to recover and be alive more than I wanted to escape.
The past four years of recovery, as mentioned in the title of this article, have been non-linear. During the first year of recovery, my body lost weight as my metabolism re-stabilized. Our bodies go to some amazing lengths to save our lives. When you are regularly vomiting, your body will do whatever it can to hold onto what's in your system. As a result, my metabolism was actually slowed down while I was sick.
I spent the first 2 years of recovery persistently nauseated, trying to figure out what was wrong with my digestive system. As a result, I began to look sickly, which naturally, had friends and family concerned. This coincided with a very stressful time, as my husband and I lost five family members and two dogs over a year and a half AND I was working full time while in grad school. Stress does not help stomach issues caused by years of vomiting. As a result, I had intense nausea and acid reflux which made it difficult to eat and keep food down, which I was newly hell bent on doing.
Although the weight loss was unintentional, it did a number on my historically eating disordered mind. As my body became use to its new size, I began to develop a fear of gaining weight.
My best friend, my mom, and my sister in law all separately confronted me about their concerns about my dropping weight. I was in denial and blamed it all on my stomach issues.
I spent 7 years prior to this point living in extremes with food. Either I ate perfect or all was lost and I got rid of it. Now, knowing I wasn't going to rid myself of food, I still had the "eat perfect" mentality, which often meant restricting. I didn't know how to eat any differently. My whole adult life had consisted of what I had deemed as "perfect" eating, and I didn't realize that now that I was keeping everything it meant that I needed to add in the things I had been missing.
Thanks to daily conversations with my husband, who has been my greatest cheer leader, unconditional support, and accountability partner, in addition to my family, best friends, and an UNWAVERING sense of purpose for working with women has led me to this point. True and lasting, messy and progressing recovery.
Slowly, I began stepping out of my comfort zone and challenging myself in recovery. I leaned into doing the opposite of what my ED (eating disorder) voice would order. I didn't always succeed, but I never gave up. When ED says to run 5 miles when my hip is sore or when it's solely out of concern about weight, I fight and rest. When ED says to eat a salad for dinner, I order something more substantial.
There are days where ED roars, and it's typically when I'm feeling inadequate in some aspect of my life. We all have our red flags, and for me it's eating disordered thoughts. When I start telling myself lies about restricting or over-exercising, or find myself trying to relieve anxiety by limiting my intake, I stop, and I get curious. What is this really about?
It's never about the food and it's never about the weight. It's usually about control.
I celebrate the victories, no matter how small, and Io'm not alone in that celebration. I can't tell you the number of times my husband tells me that he's proud of me when I order something outside of my comfort zone. Most couples high-five over will-power and disciplined eating or exercising. We do the opposite, and it helps so much to have that support and accountability. For me, recovery looks like having a slice of pumpkin pie (and enjoying it) with the nurses in my office today. My recovery isn't always perfect. There are times when I eat a certain food because it reduces my anxiety or I emotionally eat. However, I don't let it keep me captive and I let it go. I don't binge. I don't purge. I live with grace and practicing LOADS of self-compassion.
If you are reading this and have been a part of my journey to recovery, I thank you from the deepest part of my being. While I would never wish anyone to go through addiction or depression, I do know that my own struggles have forever changed and shaped me, ultimately creating my path and strength. I am grateful for the mess and grateful for the lessons. Living in recovery is a gift. I have learned how to manage my emotions, how to let go of control, and how to show up with presence and without a mask.
In being public about my struggles, I hope that you take a moment to reflect on your own. What do you keep under wraps? Where are you ashamed? Chances are, you aren't alone. Addiction of any kind thrives in isolation. Whether or not you have a partner, a friend, or a recovery community, we all need support in fighting our demons. Reach out. Recovery is real and it is there waiting for you.
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