What It’s Like to Feel Like You Are 'Not Sick Enough’
I am here to tell you one thing and one thing only: When it comes to having an eating disorder, the twisted concept of feeling like you are “not sick enough” is one of the most dangerous parts of the disorder. Eating disorders are not a contest. You do not have to be “thin” to be struggling. (I used quotes because the word “thin” is so loaded with societal judgments that it has almost ceased to have meaning.)
You do not have to “look sick” to be so stuck in an illness that you cannot imagine living another day. You do not have to be hospitalized to be worthy of seeking treatment. You do not have to check off all of the diagnostic criteria listed in the DSM-V to “count.” There is no such thing as being “not sick enough.”
In the interest of full disclosure, I am writing this as much for you as I am for myself. For almost half my life, I have struggled with feeling like I am “not sick enough” to actually have an eating disorder. Concerns voiced by mental health professionals, coaches, friends, mentors and teachers over the years paled in comparison to the voice inside my head telling me that unless and until I lost [x] amount of pounds; unless and until I actually fainted upon standing instead of the world going fuzzy around the edges for a few seconds; unless and until I ate under [x] amount of calories a day instead of subsisting primarily on self-loathing, caffeine and nut butter, I wouldn’t be sick or “sick enough” to have a real problem.
Let me tell you a little bit about what it is like to feel not sick enough. It is having people praise your dedication and commitment to health and fitness, when it feels like anything but. It is receiving attention and approval based on your shrinking physical appearance, when attention is the absolute last thing you want. It is constantly being barraged with comments of “I wish I had your willpower,” “You look so good!” or the perennial favorite: “What is your secret?” It is rationalizing, manipulating, lying and ignoring. Perhaps most terrifying of all, it is actually wishing you were more sick so that your disorder could be “real.”
If you or someone you know has an eating disorder, call the National Eating Disorders Association helpline: 800-931-2237.
Nobody would knowingly ask someone with an eating disorder what their “secret” is. Yet, when you are outwardly healthy, you get asked that a lot. I never came up with a good way to respond, so usually demurred or laughed awkwardly. Not because I didn’t have a response, but because it would have been a little intense to respond as follows:
My secret? Do you want to know my f*cking secret is? My secret is all I think about is food. My secret is unless I exercise twice a day, my stomach would be so knotted in anxiety I would be literally incapable of functioning. My secret is I could not show up or be present in social situations involving food (Hint: all of them) without losing my sh*t. My secret is I was so intensely distrustful of and hateful toward my body I could not and would not allow it to tell me what it wanted. Hunger is something I understand, knew or listened to. My secret is the food you saw me eating had been meticulously prepared, logged, weighed, measured and planned days in advance. My secret is my life is spinning out of control, but it is fine. I was at a healthy weight; therefore (and despite all evidence to the contrary), I wasn’t sick enough to have an eating disorder.
There is a massive and dangerous dichotomy between the general public’s understanding of eating disorders and their harsh reality. Let me tell you, and tell you again in case you weren’t listening or ready to hear it the first time: eating disorders do not discriminate. They do not solely present as severe malnourishment in young, white females. They are not always (if anything, they are rarely) identifiable upon first glance.
They have little to nothing to do with a person’s weight. The number on the scale serves only to torment the person with the illness, and not as a gauge of their health or sickness. Because of this, countless people become more and more entrenched in behaviors that are killing them.
I hope this piece resonates with just one single person who may be on the fence between reaching out for a lifeline or continuing to struggle in silence. I said I was writing this piece for me, and I am. However, I am also writing it for you.
This piece is for the girls, the boys, the men, the women and the non-binary human freaking beings of the world. This piece is for anyone who has ever felt their struggles and their pain doesn’t “count,” because they don’t “look sick.” This piece is for the person who wants so desperately to believe they are worthy of help, love and wholeness, but still feels they need to get “sicker” before they have a “problem.”
This piece is for you. Because you matter. You are not alone. You do not have to show the world you are struggling with your food and exercise choices. You do not have to live the way you are living. While you may not realize it because the disorder is telling you otherwise, you are enough.
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