“You know, you don’t have an eating disorder” she sighed assuredly–and with a hint of irritation–as she gently tapped her well-worn DSM-IV with her well manicured nails. I watched as it rested precariously on top of her pink and black yoga pants, which ended in her perfectly laced Nikes, while also hiding her perfectly toned thighs. She would, often times, wear her workout clothes to my session because she did not have time to change.
“I know” I said, absent-mindedly picking lint off of my paisley dress and pulling my cardigan tighter around my body. I secretly hated her for wearing workout clothes to my session. I did know one thing, though, I knew she was wrong.
“You don’t fit any of the criteria listed for Anorexia or Bulimia. Do I need to read them to you?” she asked with a tone of both sarcasm and pity; like I was pretending to have an eating disorder so I could sit in her office every Thursday afternoon of my senior year of college. Wrong. I had a lot of other things I would rather be doing than sitting with her every week hearing lecture after lecture about how I do not “know myself”, and am subsequently “making myself have an eating disorder” because that is “just an avenue I’m trying out.”
“I know,” I said again; this time through clinched teeth. I forced myself to make the words come out evenly in tone despite the tears of anger that were welling in my eyes. I am not sure what stung more: the anger of being accused of faking an eating disorder or my anger at myself for allowing her to think she was right.
“So, what do you think is the REAL issue here?” she prodded as she took a sip of her Diet Coke, leaving coral lipstick prints on the straw.
“Honestly, the real issue is that you refuse take my concerns seriously,” I wanted to scream, but I ended up just shrugging my shoulders in defeat. Maybe I am making it up? Maybe I am imagining my symptoms? After all, I did not tell her about my purging, and, although I was restricting, I was still at a higher than normal weight. If she was not going to listen to my concerns, why would I want to tell her about my behaviors? So, I conceded to her false accusations. And, in doing so, I allowed ED a temporary victory as well.
I ended therapy with her believing I was making up my eating disorder as an affectation of sorts to hold me over “until I discovered who I really was”. I was, subsequently, lead to believe that I was eating like a “normal” person, with intermittent bouts of purging, restricting, overexercise, and laxative abuse. I still wonder why I let myself fall into the trap of believing she was right, and why I put off treatment for so long.
But that is not the important part. The important part is this, 1) why wasn’t she educated on ED-NOS (eating disorder not otherwise specified) and 2) I went to Lindner Center of HOPE, and got an actual diagnosis that lead me to the treatment I needed…despite what she wanted me to believe.
For those unfamiliar with ED-NOS, it is commonly thought to be the most diagnosed eating disorder in clinical settings. Additionally, despite what my former therapist tried to tell me, it is in the DSM-IV along with a list of certain behaviors it can encompass. However, it also states that there are other behaviors that would fall in the category of ED-NOS, but could not all be included in the DSM-IV. Including all ED-NOS behaviors would be far too exhaustive to put into writing, and may still not include all the possible behaviors due to the individuality of each person’s disordered eating. Essentially, in the easiest to understand language, ED-NOS consists of disordered eating patterns that meet some or most of the criteria for Anorexia Nervosa or Bulimia Nervosa but not all criteria are not met. Meaning, a person could have severely disordered eating but, because they don’t meet one or more of the criterion for Anorexia or Bulimia, they will not be able to receive a diagnosis of an eating disorder. This further results in this person not being able to get the treatment they need, get their insurance to pay for services required, as well as allowing the eating disordered person to think that his or her disordered eating is nothing to worry about (like I ended up doing before I received the treatment I needed). By not having a diagnosis of an eating disorder: sufferers miss out on necessary treatment that could save their lives, they miss out on medical testing that could prevent certain ED-caused/related conditions from getting worse, and it allows their eating disorder to continue dominating their lives.
Additionally, due to society’s misunderstanding of the complexity of behaviors and medical severity of ED-NOS, it is often not taken as seriously as the more well-known eating disorders of Anorexia and Bulimia. Medial professionals may not recognize the symptoms of ED-NOS, or may not understand that ED-NOS is just as life-threatening as Anorexia and Bulimia. Suffers of ED-NOS may not think they are “sick enough” to warrant treatment as they do not fall into the specific diagnosis of Anorexia or Bulimia; having a diagnosis of ED-NOS may seem like a non-issue. Thus allowing the eating disorder to flourish and steal their health. And, those sufferers who do understand that their eating patterns are disordered, may be steered away from treatment by people assuring them that they do not have an eating disorder or by those implying that ED-NOS is not serious.
I am here to tell you this, ALL disordered eating needs to be taken seriously both by people with the disordered eating and those medical professionals involved in their lives. Families and friends need to be aware of the multifaceted world of ED-NOS as well, so they are better able to support and encourage the recovery of their loved ones. Most of all, though, if you or someone you know is struggling with suspected or known eating disordered behavior, there is help available. The National Eating Disorders Association has a 24-hour confidential helpline, staffed by trained professionals, which can be accessed by caregivers, friends, family, medical professionals, and those individuals with eating disordered behavior. The helpline’s number is (800) 931-2237. However, if you would prefer an even more anonymous route, an instant messaging version of the helpline can be found at http://www.nationaleatingdisorders.org/information-referral-helpline. Furthermore their website (nationaleatingdisorders.org) offers many free and reliable resources on eating disorders that can be used at any time.
Remember, despite what society or ill-advised yet well-meaning medical professionals may say, you know your body better than anyone else. Stand up for yourself, your health and your recovery. You deserve to live eating disorder free. You are worth living a life of love, grace and joy. There is hope. There is help. Recovery is possible for EVERYone.
Jeremiah 29:11 “For I know the plans I have for you,” declares the Lord, “plans to prosper you and not to harm you, plans to give you hope and a future.”