Anorexia Nervosa

I’m a procrastinator — but not in the way you think. I stress about projects when I don’t start them early enough. I feel safe and comfortable when I know I have a head-start on my to-do list. There’s just one problem: I use the stress I feel about procrastinating on deadlines to procrastinate on eating . In college, I studied so diligently that I would convince myself to study five minutes longer — and then only 10 minutes longer and then just 15 minutes longer — before I ate dinner. As midterms and finals drew closer, I’d find myself reluctantly preparing dinner at 9 or 10 p.m. because I had spent so long doing anything but eating. And when I had too many extracurriculars on my plate, my dubious eating habits would seep into lunchtime — and I wouldn’t eat until the late afternoon. I didn’t see my habits as unhealthy — I was simply too busy to eat in a typical timeframe. At the time, though, I was completely unaware I had a full-blown eating disorder — and my fashionably late meals were just another symptom. When I lugged textbooks, kitchenware, and apartment décor home after my college graduation, my “food procrastination” followed me back to my hometown as well. I couldn’t seem to eat lunch on time, and eventually, my untraditional schedule as a respite care worker meant I could continue to procrastinate on eating. I wasn’t working a 9-5 job with a set lunch break, so I could eat whenever I wanted — and my eating disordered-mind took full advantage of my schedule. I know my behavior wasn’t “typical,” but I assumed my internal clock was aligned later than others’ were. It was all just a quirky personal habit — not anything serious. A couple of years later, I received the shock of my life when I was diagnosed with anorexia nervosa. The diagnosis didn’t feel like it fit me because I was missing so many of the hallmark anorexia symptoms. The reality, though, was that I was subconsciously scared of weight gain, I didn’t eat enough to adequately fuel my body, and I delayed meals so as to avoid triggers. However, I had not yet arrived at the realization that my late meals served a dangerous purpose, so I carried on with putting off every meal until the last possible minute. When I entered eating disorder treatment, meals were highly regimented. Breakfast at 7:30 a.m. Lunch at noon. Dinner at 5:30 p.m. No exceptions. I was blown away at how early every meal seemed to be skewed, but come mealtime, I ate every bite. I was determined to be the “perfect” eating disorder treatment client — even if it meant giving up my late lunches and dinners. However, when I left residential eating disorder treatment, my “food procrastination” came back in full force. I had no one telling me when to eat anymore, so when I wasn’t in my part-day treatment program, I took full advantage of my freedom. As I began chipping away at the motivation behind my eating disorder behavior, though, I began to fully realize that I procrastinate on eating meals. Entering treatment brought new triggers — and a renewed desire to distance myself from the complex feelings that ignited my eating disorder — so delaying meals was a surefire way to avoid thinking too much, feeling too much, and recovering too much. Even now, three years into my eating disorder recovery, I still struggle with “food procrastination.” On days when I feel emotionally numb or struggle with eating disorder thoughts, eating meals on time feels especially daunting. Even buying food at the grocery store can feel like too much to handle — especially if I know I need to buy potentially challenging snack foods. I tell myself that if I postpone the inevitable food challenge outing or grocery shopping trip long enough, it’ll be “too late” to go, and I’ll simply need to cope with the triggers later. I force myself to believe that eating meals late is more recovery-oriented than not eating them at all — and in doing so, I reinforce my eating disorder. I still tell myself that I’ll eat “after I finish this homework,” “after I’m done working,” or “after this YouTube video ends,” but I also know I have accountability. My family gently encourages me to eat meals in a “typical” timeframe, and my friends hold me accountable for picking up my favorite foods no later than when I say I will. I also remind myself that food is necessary, and delaying inevitable triggers may just increase my anxiety. Sometimes I wonder if I’ll ever stop procrastinating on eating — but I’m now aware of why I delay meals and snacks, I have support, and I’m working hard to kick this eating disorder behavior to the curb.

Since I first met my partner back in 2018, I’ve watched her make incredible progress in her recovery from anorexia nervosa. Even though my partner is in fairly solid recovery at this point, she still deals with body image issues from time to time. Because of this, I am trying to find more ways to compliment my partner without making it about her body. I know I’m not the only person with a partner in recovery from an eating disorder. I also know that it’s hard to shift into a mindset of offering compliments that have absolutely nothing to do with a person’s body image because it’s such a common occurrence in modern society. However, I hope this list of 40 compliments can help others give their partners a confidence boost without triggering body image issues. You’re an incredible person. I admire your strength. Your face lights up the room. You’re so smart. I love your sense of humor. You’re such a great listener. You always know just what to say. I really admire that about you. I always appreciate your honesty. You have so many talents. I love your smile. You’re so down to earth. I love that about you. You make me so happy. I love the way you make me feel. You’re so fun to hang out with. You have the best laugh. I love your resilience. You always make me feel less alone. Your kindness is contagious. You make me feel safe. I really admire your work ethic. You’re such a great (insert hobby). You always make me feel so calm. I can’t imagine my life without you. You’re incredibly empathetic. You smell amazing. I can always count on you. You have such a big heart. Our conversations always make me feel better. You’re always so supportive. I’m so proud of how far you’ve come. You’re so dependable. I love the way you carry yourself. Your hair looks amazing. You always look great when you (insert activity). I love your fierce heart. You bring out the best in me. You’re a work of art. I admire your bravery. You bring so much joy into my life. I love you just the way you are. As you can tell from this list, there are lots of ways to compliment your partner without drawing attention to their body. It just takes a bit of creativity and thoughtful attention. If your partner has a hard time talking about their body, these compliments may help.

Why is early intervention for eating disorders so important? As with many illnesses, early intervention and detection play a key role in recovery. Research has shown that taking quick action improves not only the likelihood of recovery but reduces long-term symptoms. All of this combined can reduce the occurrence of relapse and improve the overall quality of life. There has also been evidence that when teenagers with anorexia nervosa are given family-based treatment promptly (within the first three years of the illness), they have a much greater chance of lasting recovery. Through adequate early intervention, medical issues presented by eating disorders can be addressed and dealt with quickly. It also allows the person experiencing the disorder to begin work on healing the mental impacts. This progress is arguably the most difficult to overcome, and therefore takes time and a significant amount of effort. Much like an addiction, kicking an eating disorder for good is more difficult the longer it’s present in the brain. But if the individual begins treatment early enough, it allows them to work on eliminating behaviors, addresses comorbid conditions, and helps them develop a relapse prevention plan. Eating disorders are preventable illnesses! There’s no doubt in my mind that eating disorders are entirely preventable when the right tools are in place. There are a variety of methods that can be used to provide training to medical professionals, and those who work closely with key groups. Training for general practitioners, counselors, therapists, teachers, lecturers, coaches, etc is particularly important. It’s thought that early intervention starts with prevention. This means that education and screening are at the forefront of stopping the onset of eating disorders. Beat Eating Disorder’s national officer for Northern Ireland, Nicola Armstrong, has this to say about early intervention: “Eating disorders are serious mental illnesses that impact around 37,500 people in Northern Ireland. We know that the sooner somebody with an eating disorder accesses quality treatment, the higher their chances of making a full and sustained recovery. That’s why it’s so important that our healthcare system is equipped to identify eating disorder behaviours quickly and that services are available to anybody who needs it, regardless of how long the person has been unwell. At Beat, we would encourage the Northern Ireland Executive to fund quality eating disorder training and staffing for healthcare professionals, so that they have the tools that they need to spot the signs of eating disorders quickly and signpost patients to support. We have also been campaigning for the 10 year Mental Health Strategy to secure its full amount of funding from the Northern Ireland Executive, which is crucial for improving eating disorder care across the nation.” What barriers prevent successful early intervention? One of the main barriers to early intervention is the focus on weight rather than the symptoms of the illness. Unless your physical weight is within a dangerously low category, help is often denied. Even if mental and physical health is at risk. Anorexia is often what comes to mind when you think of an eating disorder. However, there are a variety of other illnesses under the umbrella that are flying under the radar. These often receive little to no treatment, leaving patients without support indefinitely. Phoebe works on a psychiatric ward and has personal experience with an eating disorder. “Part of why a lot of people get denied treatment is on the basis of weight.” she states, “Since working on an acute psychiatric ward, it’s become even more obvious to me how absurd it is to measure someone’s mental illness on weight or physical observations. Someone could be highly distressed and disabled by their eating disorder. But if their blood sugar and pressure are OK, they’re dismissed. Meanwhile, we don’t measure the severity of someone’s schizophrenia or major depressive disorder by their physical observations.” Alongside weight stigma, there are many other barriers in the way of early intervention such as the following. There is a severe lack of funding for eating disorder research and treatment. This applies across the UK, with Northern Ireland being among one of the lowest regions for available funding. Partially due to funding is the lack of resources available.That includes treatment facilities, therapists, groups etc. As well as weight stigma, there is also a stigma surrounding eating disorders in regards to gender, race, socio-economic background and age. Lived experience with early intervention Thank you to all those who have lent their experience to this article. Everyone has a different experience with treatment, some good, others not so much. The purpose of this is to highlight the experiences of others and their thoughts on early intervention. Please be kind when commenting and bear in mind that experience with treatment is individual to everyone. My personal experience with inadequate early intervention As someone who has struggled with anorexia for years, I can clearly see the impact that inadequate treatment has had. While I received treatment as a teenager, their methods were, in my opinion, poor. Firstly, I had to travel 40 minutes from home for a simple one-hour appointment. I missed important classes, events, and time with friends who, at the time, were my lifeline. The guidance and support given to my parents was non-existent. It’s no surprise that they were unsure how to handle my illness! In the grand scheme of things, I can understand that this isn’t the worst-case scenario. I was very lucky to have any intervention, no matter how awful it was. Many from my home country have had to travel across seas for even the most basic of treatment. I was certainly one of the lucky ones in that regard. However, the level of treatment received was basic, to say the least. It was primitive, clearly generic, and carried out as quickly as possible. The key goal from day one was weight gain in order to complete discharge, even if that meant you were still mentally unwell. Adam’s experience I feel had we been given support when my family and I first reached out for help, we wouldn’t have suffered for so long. It would have also potentially prevented the physical complications I’ve since experienced. I’ve also had various hospital admissions and operations, all caused by me being so unwell. Not to mention the trauma we’ve had to endure. Early intervention isn’t just about increasing chances of recovery. It’s about preventing years of suffering, physical, emotional, social, and financial complications. Phoebe’s experience I wasn’t able to access “early intervention” when in a relapse despite having been hospitalized with anorexia a couple of years earlier. As the tale so classically goes, once they decided I needed treatment I didn’t want it and ended up in a worse state than ever before. It’s no wonder that people presenting with an eating disorder for the first time get turned away if someone with an established diagnosis can’t get help!