“I heard about your divorce. You must be doing fine, though, because you look amazing.”
I was not doing fine. I stared blankly at the woman, who was not quite a friend and not quite a stranger. It was at a work Christmas party, and these are the kinds of things that you say to people that you don’t know very well. She probably thought that this was my revenge body, and that I was posting ab shots on Instagram, confident and ready to hop back into the dating game. I knew she was a nice person who was just trying to be nice. But I was a fragile addict in recovery and I couldn't respond because how do you tell someone who's just paid you a compliment that you're borderline suicide hotline fodder and one well-meaning remark away from relapse.
Firstly because it’s not socially acceptable to talk about depression at parties and secondly because, in this culture, it is really not okay to admit that you look “good" (read: thin), but aren’t actually good. “A lot of people with eating disorders get a lot of positive social reinforcement,” says Lori Schur, the clinical training director for the Medical Stabilization for Eating Disorders at Torrance Memorial Hospital. “People assume that if someone is thin and they look good on the outside, they feel good on the inside.” This creates a feeling of incongruence, she adds, meaning that there’s a disconnect between a person’s experience and their appearance, and it feels exactly how it sounds: unmatched, unbalanced, and alienating.
I don’t actually have an eating disorder. When my wife and I separated last September, I just couldn’t eat. I couldn’t sleep. I was exhausted, but I couldn’t sit still. I already had a daily yoga practice, but I also started running. I hate running, but I hated my constant depressive and obsessive thoughts more, so I ran. Within 45 days, I lost almost 35 pounds.
While these are signs of disordered eating practices, the difference between me and someone who has a diagnosable disorder is that I wasn’t trying to lose weight, and when I did lose weight, I didn’t think I looked better for it. I didn’t have what Schur describes as a “disturbed body image.”
In other words, there was something wrong with me and I knew it and I didn’t think that I would look or feel better if I lost more weight. Someone with an eating disorder would likely be the opposite, as in, they might believe that they look and feel better the more weight they lost.
The difference between disordered eating and eating disorders is crucial to understand for people to have a compassionate conversation with someone going through either one, and to ensure that people with eating disorders are treated appropriately. It’s also important to note that while the effects on the body are the same, the causes can be quite different. A young woman starving herself to fill society’s expectations of her is very different than me experiencing the dissolution of my marriage as trauma.
“Emotional stress can cause your body to enter fight-or-flight, otherwise known as the sympathetic nervous system response,” says Natalie Zises, an New York City-based functional nutritionist. “During fight-or-flight, we're less able to understand our body's hunger and satiety signals. Our digestive processes during this time also shut down in order to preserve energy for the perceived threat of the stress. Your body can't tell the difference between emotional stress and a tiger chasing you, so it will conserve energy however possible.”
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More on this: A body in trauma response (i.e. constantly operating as though there is a threat) isn’t motivated to eat because running is more important to self-preservation. This is a pretty powerful evolutionary tactic because it means that if we need to run from an actual tiger, we won’t get distracted by What-A-Burger on the way. But because emotional stress is often more chronic, we can get stuck in a loop of starvation.
“When people lose their appetite, it is often because anxiety or sadness overshadow feelings of hunger," says Susan Albers, a clinical psychologist at the Cleveland Clinic and author of Eat, Drink, and Be Mindful says. "You no longer register the sensation or you are so overwhelmed you don't notice it. After a while, you get used to ignoring or tuning out hunger cues.”
Don’t worry—it gets worse. Not only do you get used to tuning out hunger cues, you get less able to tune into anything. “This is not just stress from what’s going on, it’s also a lack of nutrition,” says Beth Donaldson, medical director at the Copeman Healthcare Clinic in Vancouver. “With that lack of nutrition, you can’t use your brain properly. It impacts cognition and short-term memory. You’d also experience a difficulty multitasking and making decisions, and likely loss of sleep. At that point you’re really just not running on all four cylinders.”
Donaldson sums it up by saying, “If you’re not eating anything, your body can’t really deal with anything.”
That’s exactly how I felt, like I couldn’t deal with anything. I couldn’t deal with my divorce, for sure, but I also couldn’t deal with everyday stressors like traffic or minor disagreements with friends. The skinnier I got, the less emotionally stable I felt. That’s because I was starving, and when the body starves, the brain does too.
And what can begin as not eating because of stress can, over time, put the body in a state of starvation that becomes a vicious circle. At first I wasn’t eating because I was depressed, and then I was depressed because I wasn’t eating.
Here's how that happens. “The brain needs glucose and nutrients to make solid decisions. Sudden stops in eating cause the brain to begin to starve and act differently. It shifts into the biologically encoded survival mechanisms that are hardwired in that go with starvation mode,” Albers tells me. “Low vitamin D has been linked with an increase in feelings of depression. Low magnesium levels disrupt serotonin levels. Low levels of Vitamin B cause depression, irritability and fatigue. Low iron causes mental and physical fatigue.”
While nutritional deficiency and mental illness are not the same, the result of nutritional deficiency felt like severe mental illness to me: I felt fucking crazy. In fact, when I asked my therapist if she thought I needed more help, she said, “No. I think you need protein.”
Eventually, I listened to her and forced myself to eat. At first, I felt sick every time I ate a whole meal, even if a whole meal meant half an avocado on half a piece of toast, but eventually I started liking food again and eating more than one meal a day, like a regular human animal. Now, I’ve gained back 15 of those 35 pounds and I’m as happy and emotionally stable as any middle-aging queer nihilist, which makes me not the most fun at parties but still better than someone who mistakes you for a tiger.
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