When Your Eating Disorder Says You're Not 'Sick Enough'

“I can’t be here.”

“This can’t be happening.”

“I don’t have a problem.”

“I’m most definitely not sick enough.”

These thoughts and many more crossed my mind while I was sitting in the waiting room of a hospital about to be assessed and evaluated.

Let me start off by telling you: I was mainly there to please my therapist. I had been fighting her for months about going to a higher level of care for my eating disorder and I wanted to prove to her that I was fine. I was convinced that I wasn’t sick enough for them to admit me. But I was.

I started a partial hospitalization program (PHP) in July of 2017, which my eating disorder convinced me was a joke; if I was sick enough, I’d be put into inpatient care. I went to PHP that Monday and began the program still thinking I didn’t have a problem, comparing myself to others and feeling undeserving of being there. I was only there for a week before going inpatient, not even able to go home and pack my things that day. Now I was sick enough, right? According to my eating disorder: wrong. 

I went into inpatient with stable vitals and the ability to complete my meals, which left me thinking, “This is silly, why am I here?” I cried because I had lost all of the control I thought I had in my life, not because I realized I was sick. In my experience, eating disorders are very competitive mental health illnesses. You are competing with your own head day after day, minute upon minute. Your eating disorder wants to convince you that you are not sick enough, and therefore, unworthy of help. I looked at all the other patients and compared myself them. It wasn’t until I began taking a longer time to complete my meals and agonizing over food that I realized I might have a small problem. I was sick enough now that I thought I had a problem, right? Wrong, again.

I made it through the week-long inpatient stay and was discharged back down to PHP for the next five weeks. Thinking that I was “cured” now, I left the program early to return to work. I made it four months before things hit a wall again, except this time things were way worse. But again, my eating disorder continued telling me that I still was not sick. From November to January, my depression hit hard, my anxiety was out of control and my eating disorder behaviors increased. I didn’t want to go back to treatment; I was just there six months ago. I had a career, things and people to take care of and I still didn’t feel sick enough. I was not skinny enough, like how eating disorders are portrayed in the media. I wasn’t in the ER and I didn’t think I had any medical issues. Or so I thought.

I was readmitted to inpatient on Valentine’s Day. I felt selfish and ashamed, yet unable to get out of my own head. Twenty-one days, two ER visits, many unstable vitals and multiple medication changes later, I was finally discharged. Even after a second admission, I didn’t feel sick enough.

I can’t express the importance of a good outpatient team. I left the program still being able to see my amazing therapist and incredible dietician. Once I began seeing them regularly, I started to realize that maybe I was actually sick enough to receive help. I don’t know when or how — it was not an epiphany I had — but something clicked over the past few weeks. I still don’t necessarily feel “sick enough,” but I finally feel dedicated to getting better.

Long story short, your eating disorder may never let you feel or think you are sick enough, so to everyone who feel the same way as I did: You can start the process of recovery at any time and at any stage you are in.

I can’t thank my outpatient team enough for helping me understand this. I’m in the process of finding the motivation to recover. I can’t wait to see what this new found motivation has in store for me.