By Ashley Nicole George
After entering a new middle school for eighth grade, I was targeted frequently by boys and girls because of the shape of my body. Like anything outside of the perceived norm, I stood out and became a bully’s bullseye. I wasn’t like the typical, stick-thin teenage girls that populated our wealthy suburban middle and high schools; I was already growing into my hips and height. It seemed all the girls around me attained the image of perfection for the early 2000s—too thin, tanned, and thick-skinned. They walked around with low cut jeans showing off tawny abs and protruding hip bones as accessories, t-shirts clung like a second skin that revealed just enough of an expensive push-up bra to let anyone desire a minor’s figure. They were popular and confident, not shying away from bodily attention or vulgar comments. I couldn’t help but start to compare myself: the way my pale thighs touched together and bulged far from my waistline, stomach rolls that accumulated like ripples of batter and wrapped around my back, and three numbers on our home scale staring back at me with glowing red eyes. A tendency for comparison quickly devolved into compulsion.
At age thirteen, I stopped consuming normal meals. It didn’t take long for the eating disorder to develop after that. Those first months at my new school were filled with what felt like endless days of cruel commentary—peers whispering about my body shape all around me:
“Should you be eating all of that?”
“Wow, she’s heavier than I thought.”
“No one likes a fat girl.”
These voices oscillated into a vortex of fatphobic, diet culture ideals constantly swirling around in my mind. This mental storm not only permeated my school life, but home as well. If I try hard enough, I can remember each person who made a comment like this, their mouths forming words that slowly devoured my mind for years. The word “fat,” repeated countless times in talk and tabloids, became a scar permanently engraved into my left thigh. I don’t blame anyone in particular for this mental demise. To tell the truth, I mostly blame myself—for obliterating the better part of my adolescence and refusing to ask for help while I self destructed my own innocence. Anorexia turned my once pudgy baby cheeks sharp and hollow along with my mind. Eating became a sick game. The outside voices were trapped inside now, whispering and screaming: “you need to be thinner, you don’t deserve those foods, you’ll be worthy only when you’re nothing.” Later, I learned that these voices were a form of self-punishment for the thoughts I actually believed about myself—disgusting, unworthy, pitiful. Withering away in physical form seemed a way to disappear from a world I felt unfit for. I didn’t have a full meal again until I was twenty.
During those seven years of being engaged to my eating disorder, life was consumed with calories, counting, and cultivating my body into the unattainable image of perfection I saw all around me. I left food on every plate put down in front of me, staring at meals once loving and nourishing as if they were poison. When everyone at the table emptied their plates, and at least half of mine was left uneaten, I felt victorious for consuming less. I feared eating in front of people because I truly believed they were counting every bit of intake as an extra ounce of “fat” expounded onto my body. Fat was no longer just a concept, but a regular feeling of existing in a shrinking space. This was only happening in my mind, but I swear I could see faces contort if I took a large bite or too long to chew. I could see what I consumed travel down to my stomach and thighs, enlarging areas of my body that could never be perfected. It was as though a foreign invader now resided in my mind and body, distorting reality to develop a destructive relationship with food. Each forced bite sent flames of disgust through my mouth. What couldn’t be discreetly spit out made its way into my stomach, where the swallowed demon celebrated while I revolted. I could feel even a small portion of food sitting in my stomach, like a rock, until enough time or activity had passed, and the wonderful feeling of emptiness returned.
I started to feel anxious if I wasn’t empty or in the process of emptying. If food wasn’t coming out after going in, I was in a state of panic. Suddenly, I was seeing the numbers everywhere—on scales, labels, and menus—becoming obsessed and learning tricks to avoid eating, or making it appear as though I had. As the intake lowered, I still felt the need to actively lose weight. Sitting inside unmoving, food felt like a toxin that was going to destroy me from the inside out. Every evening, I took three perfectly round, pink pills to forcefully evacuate anything left in my bowels. This seemed like a simple miracle at first—until I started to need more. The side effects worsened with each increased dose and I found myself becoming too familiar with restrooms. I was up to ten pills a day before I started emptying the other way. The quietest hours of the night were spent exercising alone, scrutinizing an unrecognizable form in front of the mirror. I wonder how many hours I’ve spent with my head in the toilet. The smell of briny water and the feeling of cold porcelain will forever give me chills. I still feel guilty for all of the wasted meals and money that literally went down the drain—for no reason other than a hatred for myself that manifested in the belief that I was unworthy of food. Looking at old videos and pictures, I can see now how sickly I looked. Yet, at that time, I would swear an obese, grotesque monster was staring back. The person I see from those recorded memories is not the same person I remember being or seeing at the time. I still feel a sort of dissociated familiarity with that part of my personality—I think it’s still difficult to talk about the past because part of it will always be too close, has already left too many scars.
***
Now, seven years into recovery, I sit at a family dinner, staring into a cup of soup I am desperate to finish, tears streaming down and dripping into the bowl of thick liquid. Earlier that week, a kind nurse begs me to finish a second cup of apple juice without throwing up so I can have testing done. I try to give my body what it needs, and it screams in contradicting voices:
“Feed me,”
“I’m starving!”
“But if you even put a bit of food near this mouth, everything around you will be covered in projectile vomit.”
I laugh at the irony, but once again feel removed from my body, like the foreign invader has returned, but reformed. It now forces a disconnection from necessary sustenance through physical symptoms. The return of starvation creates an intoxicating combination of bodily and mental emptiness writhing through my core, like a ghost past through my flesh, making residence again in my haunted digestive system. After devoting years to consciously changing my mindset about eating, using every recommended coping method, and rediscovering a love for food, I can’t deny I’ve feared the day this entity would return.
The ghost torments me with vivid flashbacks of the times I stared at food with loathing, recalling those formative years when I refused to engage in one of the most important life connections. Then, I was afraid of eating because I was scared of gaining weight and the opinions of others, a reflection of the fearful judgement of myself. Now, I am afraid of eating because of its physical symptoms—the nausea, unbearable pain, and more embarrassing reactions all occurring between those familiar restrooms walls I hoped to leave behind. I walk past couples and families in restaurants, dining and laughing, tasting and commenting on each other’s food, feeling ashamed when I sit down to order soup or plain pasta, to which someone usually replies—“that’s all?” Part of me wants to confess that I want nothing more than the most rich and delicious meal of my life; that once upon a time, I was terrified of eating anything that was fried, gluten, meat, or dairy. I want to tell them that I continue to win battles of fear daily, but I have also been endowed with incurable physical dysfunctions, exacerbated now by past mistakes. Instead, I politely say, “yes, thank you,” hiding my shame, along with the pain seething through my abdomen. Usually, I end up alone at the table, the last one staring at an unfinished meal long after everyone else has gone.
I am again afraid of eating in front of people because my habits are now forcefully odd. Aside from a lengthy list of foods to avoid in order to combat symptoms, I have to chew until a liquidy mush is created between my teeth. This impedes the ability to have conversations or focus on any task besides rotating my jaw until the joints are irritated, making sure the food is already semi-digested before each swallow, which is as disgusting to watch as it is to do. Only a few bites are managed before sudden nausea fills my mouth with saliva, tasting of dirty coins. The physical symptoms have brought back the mental traumas, the guilt from waste and frustration, especially when food insists on coming back up. If not a full regurgitation of the meal, then in the form of what I termed “vomit burps”—some violent form of acid reflux, an uncontrollable indigestion accompanied by chunks of undigested food or scalding stomach bile burning my oesophagus during its escape. Whatever decides to stay down, even the supposedly safe and digestible, becomes shards of glass penetrating my stomach and intestines until it winds up in the same place it always has.
Consumed food now causes a real, painful disfiguring, not like the mental dysmorphia that clouded perceptions of my physical body in middle school, but conspicuous bloating. Just a few bites or sips will swell my stomach from emancipation to pregnancy. The pain is noticeably different from the demon of the past—it is visceral, as if the food I swallowed had actually been poison. I’m still waiting on a verdict for the cause—some doctors blame the eating disorder; others on the wide array of recently discovered physical abnormalities or even medications used to manage these conditions. Some kind of persistent dysmotility seems to be causing the food to sit, unmoving, until it is, again, forcefully evacuated one way or another. Perhaps these fears I envisioned years ago have manifested—what was once a mental nightmare has now become a physical one. Could it be that the years of choosing to continue engaging the eating disorder have caused permanent damage? As if this illness is still my fault, and now I must succumb to the karmic punishment from all that time of self-inflicted harm? This collision of mental and physical diseases brought back a darkness I never wanted to be trapped in again.
***
The term triggered has become too sensationalized to use without cringing, but it’s exactly how I feel at an early morning doctor’s appointment, looking down at the LED numbers on the scale that show less than before. I shouldn’t be watching my weight again, but I have, and I’m scrutinizing myself in the mirror, checking the prominence of bones rising underneath translucent flesh. That same day, my mother says to me from behind, “have you lost weight?”
I stiffen, feeling my muscles tighten under the skin, “Yes…it’s the sickness.”
“Oh…okay,” I can feel her hesitation. She doesn’t say anything; but she doesn’t have to, her silence always speaks:
“Be careful. Don’t get carried away again.”
I want to cry, but hold it in. I knew when I admitted to having a problem it would be a permanent brand on my existence. Everyone now associates any changes in my weight with the eating disorder. When I get up too quickly to use the bathroom after meals, there is a brief look of panic across the other faces at the table before I reassure them, “I’ll be back quickly.” If I leave too much food on a plate, it becomes an intervention about symptoms and feelings. Confessing to the disorder traumatized those close to me. Though they could never imagine the trauma I went through, unless I spilled all the dirty, gritty details. I might have to keep some secrets forever. Even I still question if I bring these issues with food upon myself—don’t I still want to be that unbearably thin, fragile, and untouchable being again? I became someone that people envied simply because I was thin. I won’t lie, it was a power trip part of my ego loved, but it came with a heavy price I’m not sure anyone will ever understand.
Later that week, Mom says again she can see the weight loss in my jeans. Her perpetual concern of my relapse is clouded with comments that only contribute to an unhealthy mindset. She asks:
“Doesn’t it feel good?”
“No,” I say while laughing. The iron I’m flattening my hair with burns me—on purpose?
“What do you mean?” She seems genuinely confused.
My voice is robotic and far away, “I feel awful. I’m hungry. I have no energy.”
The correlation between weight loss and happiness is one of the most problematic influences society ever inflicted upon itself. Unfortunately, too many people become victims to this notion, whether they realize it or not. My childhood and adolescence are heavily seasoned with memories of family members, teachers, and doctors, encouraging weight loss, fewer calories, anything and everything that was smaller, shrinking, sinking into an existence where only numbers and superficiality matter. Looking back, it seems the events from eighth grade were just the spark that ignited the storm of disorder before eradicating my mind with a hurricane of disease.
Most people don’t understand what malnutrition feels like once it’s settled in. I’m not talking about feeling hungry after skipping a day’s worth of meals—I’m talking about weeks, months, years of a combination of factors that cause true starvation. Whether it’s mental or physical, not consuming, digesting, or absorbing enough nutrients slowly wears mind and body away. It’s not glamorous or enjoyable. It’s cold and brittle, a terrifying internal battle that most can’t see until the outside reflects what’s happening within. It’s not particularly uncommon to be overweight and malnourished depending on how much weight is lost over a period of time. Even though I’m not considered underweight, this recent flare-up only took three weeks to be considered malnourishment. Most people, physicians included, don’t want to take starvation seriously until the body reaches an emaciated state. People with eating disorders know permanent consequences can set in long before that happens; and not many who dance on the brink of death come back to tell the tale.
I’ve been through starvation many times. It takes a while to make itself known. Skipping a couple of meals will make anyone feel hungry; starving has a completely different set of symptoms. I thought I had forgotten the feeling—it’s like a flu, but without the head congestion. Fatigue is the first sign. No nutrition means no energy, which results in uncontrollable exhaustion, the kind that isn’t cured from days of sleeping and makes the eyelids feel they are constantly holding up tiny anvils. Rolling out of bed feels like exercise and getting ready is running a marathon. My pupils are rolling into the back of my head, even as I write this now, my body desperately trying to force quit after days of output without anything in return. Entering low-power mode becomes the body’s only way to ensure the whole system doesn’t collapse. I am immersed in an enduring chill—teeth chattering and fingernails colored periwinkle, even in thick cardigans and ninety-degree weather. Gums bleed inside of my mouth and goosepimples cover my legs and arms, signs of my body begging to be warmed with a dozen heated blankets that still can’t thaw these frigid bones. Even living in a place of eternal summer, once the cold of starvation has penetrated, it’s impossible to escape.
No one can see the haunted memories that return to me in these moments, enveloping me in darkness, a sickening reminder of all of those years consumed by anorexia. These were the same symptoms that I used to hide well, blame on other things, or make excuses for. Sometimes the line blurs between what is a choice and what is uncontrollable.
Has my mind really changed?
Did I not still feel a sense of accomplishment when I stood on the scale to see the tens digit go down?
Did I not feel butterflies in my stomach at the horrible beauty of weight loss?
The scary thing is that I feel like who I used to be. I wonder if any time has passed at all or if I didn’t put enough effort into my recovery and have now fallen back into the same spiral of bad habits. The emptiness of my stomach still makes me feel light and elevated, high above anyone gorging on delicacies. My past mind reminds me of the strength it takes to survive starvation. The voice says, “You don’t want to eat that anyway,” but when the delicious smells hit me, the fictitious border I created between good and bad food dissolves. The contradicting voice says, “You need to take better care of yourself…There is no such thing as immoral nutrition.”
Fried chicken was something I refused for more than a decade, and I remember feeling simultaneously happy and sad the first time I ate a Zaxby’s chicken wing after deciding to recover. We were in Tennessee and I told mom, if I was going to do this, I was going to go all the way. The diet of fear foods I restricted to eventually outnumbered what I allowed myself to eat. The regulations got more severe over those seven years—avoiding bread and meat evolved into an obsession with numbers and expelling anything and everything I was forced to consume. After years of starving, I craved the satisfaction of eating, but still refused to see it as nutritious instead of poisonous. Towards the end of this engagement, the compulsions turned into violent cycles of overeating and then disposing. This shift in destructive patterns is what eventually drove me to seek help.
In those last few months, my behaviors were more than erratic. I floated through life in a haze, hovering somewhere between life and death on an empty stomach and too many harmful substances. I saw a therapist in Nashville, before I voluntarily agreed to treatment, who told me point blank: “You don’t have much longer like this. You are either going to die from this disease or decide to get the help you need to survive it.” I originally made an appointment with her the first time I saw blood in the toilet. I can still recall the chill of fear, different than the cold from malnourishment, creep down my spine as I pushed bruised knees into the tile, a clammy cheek resting on the seat. I watched bright red blood fade to pink in the water, leaving my body as tears rained into the toilet.
I knew the horror stories of others who had died clawing their throats out over a porcelain throne, buried in their own shit, blood, and vomit from a cruel disease that isn’t about food at all. I looked down on myself, as if through a camera lens. I know the girl is me, but she looks unfamiliar—her skin is pale and mottled purple with every sharp bone trying to stab through the skin. She’s shrivelled, covered in bruises and open wounds, surrounded by emptied fast food and laxative boxes. Her fingers are curled up near her mouth, both covered with bits of undigested food and too much blood. She’s worse than dead—barely existing amongst the living, engaged to death, despair, disgust—an existence defined and determined by illness.
This person still exists; she is fossilized in film and frames forever. It hurts to make eye contact with her and know she was once me. The pain is cleverly disguised, but only just so. If you stare at her long enough, you can see the struggle in her too-thin frame, the way she holds her body, the glassy far-away gaze in her eyes. Rationalizing self-destruction and joy from a number on a scale eventually taught me that I would never move forward to true happiness without addressing the real hauntings of my mind. One thing that actually stuck with me through recovery was that my eating disorder wasn’t about eating or fearing food. It was about controlling my overwhelming emotions by recoiling from every inch of myself—past, present, future.
During my time inpatient, I was diagnosed with various mental illnesses, all of them causing some sort of issues with emotional control and self-esteem. The disease labels mattered less now that I understood the root of the problem wasn’t that I hated consuming, it was that I hated myself. I would have done anything to shrink from the world, disfigure until no one could see me anymore, until I looked as invisible as I felt. How I came to these conclusions is probably another story in itself, but I dove into the trenches of my consciousness to discover how to drown my past self and emerge, born again, into a new chance at living.
Another seven years have passed since I made an intentional choice to recover. So, I feel I must be a different person now, right? Is this illness the same…Am I again engaging with the monster inside of me? Or have I now succumbed victim to a disordered body?
***
I often wonder if these mental and physical diseases are related. If a genetic condition affects widespread tissue throughout the body, does that not also include the brain? How much of mental illness is related to genetics, predispositions, and environment? Too often, especially in medicine, people are quick to divide body and mind, using each to invalidate the other. What I mean to say is, in order to have my physical symptoms taken seriously, I have to leave out my more distant past with mental illness and focus on my experience with physical illness. I’ve yet to find a doctor who I could ask if my mental illnesses and eating disorder were twin flames with the physical dysmotility—a final puzzle piece connecting my dysfunctional set of genes that not only affects the way my body operates, but the way my mind does as well.
I learned a couple of important things on this recent journey: even if there had been no physical cause for what I was experiencing, and the anorexia was creeping back in, the symptoms still deserved to be addressed. Everything needed to be evaluated, which can be difficult with the discrepancy medicine created between treating body and mind. As it turns out, stress and anxiety from graduate school were contributing to the flare in physical symptoms, which lessened when the semester ended. Coincidentally, the flare in my physical condition heightened stress and anxiety about my already fragile health. In order to reach a solution, both issues had to be treated. I was lucky enough to be surrounded by a support system encouraging both mental and physical health. Those who know me well—family members, co-workers, advisors, and professionals—suggested lowering school-related stress and focusing on caring for my overall well-being so I can continue to enjoy recovered life without wearing down to nothing again.
The other thing I learned is more difficult to adapt. I have been on both ends of the weight scale—severely under and over what I “should be” for my height and age. This semester, I received so many compliments when I started losing weight. People assumed my physical issues were improving since I was getting thinner. It was difficult to reply with the harsh truth when all of these comments were intended to reinforce the seemingly positive endeavor of Losing Weight. Instead of tightening my opinionated mouth shut and smiling, I want to tell them this: “the social construction of weight is not an indication of physical or mental health.” The notion that only the emaciated deserve real help has negatively influenced the ability to properly address mental and physical issues. Any extra lbs or kgs that tick beyond subjective graphs of health are considered grounds to invalidate any other reason for symptoms, which is why doctors frequently prescribe patients to lose weight, exercise more, or eat better in order to achieve health. Too often, we are taught to strive toward perfecting an outer form, without considering our internal form. This terrible idea of weight as a catch-all for health has penetrated the minds of society and caused so much unnecessary suffering. Every body, in any condition, deserves to be cared for. No matter how much or little I’m eating, how much or little weight is on an arbitrary number scale, how much or little the symptoms are related to my past or current illnesses, I will persevere in the fight to radically love every part of myself, in spite of the world that tried to convince me I wasn’t worthy of it.
Ashley Nicole George is a native Floridian. She lives with her two dogs and is currently pursuing a PhD in Comparative Studies at Florida Atlantic University. She writes about her experiences with mental and physical illness to better understand herself and hopefully inspire others to embrace vulnerability. She enjoys spending time with her family, befriending random animals, and swimming in large bodies of water. One day, she hopes to retire to a farmhouse in the countryside away from the madness of capitalism.