#ive now become sexier by 2 more factors

[infernalfae]

decisions were made yesterday

[pinteressay]

Sickly Skinny:  A mosaic memoir by Cristina Casas

“Have you lost weight?” was my grandmother’s way of saying “I love you”. The women of my extended family who developed type II diabetes from being overweight would constantly and relentlessly fat-shame other women as a way to hide their own insecurities about their weight. Both of my parents wanted to lose weight but couldn’t stick to a diet and exercise plan. But I was the one to develop an eating disorder at 14. The kid who had never cared what others thought, who put about five minutes of time into her appearance every day, who when she wasn’t in a school uniform was in her self-appointed uniform of solid colored t-shirts and dark washed skinny jeans. That was the kid that went from 135 lbs to 100 lbs in two months.

The Worst Things I Heard When I Lost 35 Lbs in Two Months at 15

1.   “Have you lost weight?!?!?!”

2.   “You look absolutely amazing!”

3.   “What diet are you on? And how can I do it too?”

4.   “I won’t eat unless you will too” - my best friend (soon to be boyfriend) who thought he was helping

5.   “What’s your secret?”

6.   “Let’s go shopping so you can donate all your old clothes that are too big!”

7.   “You’re so lucky to be a double zero!”

8.   “I’m so jealous of your size!”

9.   “You look so much sexier now.” - my 40 year old godmother

10. “Whatever you’re doing to look like this, keep it up!”

He’s never explicitly said it but, my dad had an eating disorder as a teenager. His situation was different than mine, his immediate family was extremely fat phobic, and he was a chubby child. As a teenager, he had a job working for Coca-Cola as a delivery person. He was part of a two-person delivery team, his partner would drive the truck, and my dad would unload the boxes of soda. When he talks about this experience, he focuses on that part of it; offhandedly adding that every single day he did that job, for lunch, he would have a snickers bar and a diet coke. When talking about this period of his life, he drops the fact in casually, but it is always included. He can’t talk about high school without mentioning the lunches of 0 calorie soda and a candy bar. I’ve seen the photos of my dad’s transformation - it wasn’t typical puberty baby fat shedding; he went from being an overweight kid to an underweight teenager. It’s sad. He played football but got injured so he had to quit and that’s when this started. My guess: he felt like if he was big but didn’t play football, he’d lose his popularity so he “became attractive”. I don’t think he knew he had an eating disorder; he may not even realize it now. There’s this stereotype that eating disorders are only for, well, people who look like me: skinny, relatively attractive, white girls with long hair. They’re not for boys, particularly not for Hispanic boys. 

Eating disorders can be genetically linked, so it’s not much of a stretch to realize he had an eating disorder as a teenager, despite us never explicitly talking about it. Eating disorders are much less sociocultural than people seem to think as they are neurological disorders, though they do have deep psychological links and triggers though. Both anorexia nervosa and bulimia nervosa are linked to certain genes, this research is still very new, but neurologists and geneticists are exploring. A study done on twins showed that pathological attitudes such as body dissatisfaction, eating and weight concerns, and weight preoccupation, show heritabilities of roughly 32 to 72 percent. While this isn’t the same as a parent-child relationship, it does show that eating disorders can be shared between family members. As with many mental disorders, it is difficult to pinpoint exactly how/why these disorders manifest in certain people as opposed to others but studies have shown that “greater than 50 percent of the variance in liability to eating disorders and disordered eating behaviors can be accounted for by additive genetic effects” (Berrettini).

Things I Wanted To Hear When I Lost 35 Lbs in Two Months at 15

1.   “We can see your ribs; are you okay?”

2.   “You aren’t broken.”

3.   “We accept you no matter what.”

4.   “We want to help you.”

5.   “We love you always.”

6.   “I understand what you’re going through.”

The DSM V categorizes five main eating disorders but when I was first diagnosed four years ago, there were four major eating disorders in the DSM IV: anorexia nervosa (binge/purge and restricting), bulimia nervosa (purge and non-purge), and eating disorder not otherwise specified (EDNOS) with binge eating disorder as a specific subcategory of EDNOS. I have EDNOS. People with EDNOS either have atypical anorexia or bulimia, mixed features of both disorders, or behaviors that are not categorized in either bulimia or anorexia (Psychology Today). Basically, if you have disordered eating to the point where it could be considered an eating disorder, but you don’t have one of the other three, you have EDNOS. My eating disorder manifests as a mix of both anorexia (restricting) and bulimia (non-purge). My own personal way of looking at it is that I am an atypical anorexic with the mentality of a bulimic person. Unlike typical anorexics, I am completely aware of my condition and even at my very worst never let myself go more than 72 hours without eating. Additionally, atypical anorexics, never drop into a weight range that would be considered underweight. I fully understand the health detriments, but it’s not something you logically choose - it's a neurological and psychological disease that you have to fight. Typical bulimics binge eat and then fast, but I tend to fast and then mildly binge, which at this point means eating a slightly larger than “normal” meal and allow myself to eat more sweets than I should.

EDNOS is the most prominent eating disorder, affecting 75% of people with eating disorders (Machado). It affects nearly 10% of the total population of the United States: 4.78% of adolescents and 4.64% of adults. The disorder is difficult to study because, like all other mental disorders, it is so highly individualistic; EDNOS doesn’t affect any two people in the same way. Since there is a range of subcategories of EDNOS, which are each highly volatile,  little can be said about the category as a whole. What can be stated is that like with other eating disorders EDNOS is widely under-treated and often undiagnosed, it also can lead to severe long-term health detriments such as potentially permanent kidney damage, heart damage, and brain damage if left untreated (Le Grange).

Things My Eating Disorder Made Me Do:

1.   Obsess over calories - something I had never even considered before

2.   Skip meals

3.   Completely stop eating breakfast

4.   Obsessively drink water

5.   Avoid kitchens and cafeterias like the plague

6.   Fight with my boyfriend about eating and anything having to do with food

7.   Become nauseated at the smell of most food

8.   Ignore the worsening of my chronic migraines - one of my migraine triggers is low blood sugar

9.   Rationalize binging after not eating

10. Fight all logic when it came to food and eating

11. Eat fewer than 500 calories a day

As children, people who later develop eating disorders are often characterized as “anxious, obsessive, perfectionistic and achievement-oriented,” I fit that description pretty perfectly, both as a child and now as a college freshman (Weir). These character traits certainly aren’t the reason I developed ENDOS, but once I had it they exacerbated it: I’m anxious about my weight and people noticing my odd eating habits. I’m obsessive about calories. I’m a perfectionist in so many aspects of my life that it causes me extreme emotional stress that I cannot gain enough control over my brain to be able to fend off this disorder. I am always oriented towards both finally freeing myself from ENDOS and giving in to achieve my “goal weight”.

I remember the day my boyfriend asked me if I was anorexic and I had a complete meltdown; denying vehemently to save face. I knew I had an eating disorder before we started dating, I had accepted that struggle as part of my life. That sounds passive, but like any other mental disorder, ENDOS won’t go away because you pretend you don’t have it, it’ll just get worse. I have never in my life thought I was overweight, but for some reason at 14 going on 15, my brain decided that the extra tummy pudge I had was no longer acceptable. I already had depression and anxiety at that point; and because they were unrelated, my eating disorder perversely helped me get over my depression. As I lost weight, I became less depressed, not necessarily because I was happy I lost the weight, that certainly factored in, but almost because my brain could only handle so many things so my eating disorder sort of absorbed the depression. If I was feeling emotionally shitty, my brain suggested I had eaten too much the day before and was feeling bad about that. Logically, I knew that not eating was probably contributing to the shitty feeling but like with most mental disorders, there is no room for logical though - my own or that of others. 

My boyfriend would try to convince me to eat with logical arguments such as “the human body needs more than 1000 calories a day Cristina, you’re actually killing yourself” and “Cristina, you know that when you fast you retain water so you gain water weight and you actually lose weight more slowly” and I knew all of these things in my brain, but the eating disorder always found a way to render them void. My responses to these very logical arguments were usually along the lines of “I’m fine” and “Look, I’m getting better really, I’m just not hungry right now”. Like my father, for a period of time, I would eat a candy bar for lunch; these “lunches” would be eaten around 2 PM, after my third class of the day when I would begin to feel a migraine coming on and would only eat so that I could make it through the rest of the day because raising my blood sugar often helps me fend off a migraine. I passed out three times from lack of food but I always blamed it on my migraines, which are equally serious, but wouldn’t warrant a call to the school psychologist. 

I developed a habit of lying about eating; I would tell my theater castmates that I was going to eat dinner once I got home from rehearsal and my parents that I had eaten dinner at rehearsal; I never told my mom about the skipped meals - to her knowledge I was getting three meals plus snacks every day. 

Battling an eating disorder has become a huge part of my identity because it’s hard for a mental disorder not to become a big part of who you are - there's a constant battle in my head between the disorder and my self; eating disorders shift your whole perception of yourself whether you want them to or not, no matter how hard you fight them. It plays a huge role in my confidence and general self-image, not just my physical appearance either. A large part of me is so outraged that I “allowed” the eating disorder to do this to me, I have spent the past four years so ashamed of it. 

Things My Eating Disorder Didn’t Make Me Do:

1.   Eat less shit/healthier

2.   Exercise

3.   Feel the need to purge

4.   Obsess over my body image to a degree of dysphoria

5.   Think that I needed to see my ribs to be beautiful - I was disgusted when I got to my thinnest and could see my skin suctioning around my ribs like cling wrap, but I couldn’t stop

6.   Deny having an eating disorder

The first step of recovery is acknowledgement, something I had from the get-go. Step two is actually wanting to recover, which was the hardest part. Unlike most other disorders, people are amazed and impressed with the physical results of an eating disorder. The amount of compliments I received after losing the weight, did not at all make me want to regain a healthier weight. So for two years, I stayed at 100-105 lbs. My senior year of high school, I snapped; I didn’t care what anyone thought of me anymore, about anything. I decided once and for all that I needed to actively change the way I thought about food and my eating disorder. I had gained a bit of weight over the summer and was up to 110 lbs, and I decided that instead of panicking like I did when I first saw the number on the scale, I would make this my new “acceptable” weight, I could live with being a zero instead of a double zero. It seems so dumb that I let the arbitrary numbers put on clothing define how I live my life, but to me, it matters, and I have made that my safe zone. I decided to start practicing yoga and eating in a less disordered fashion. The exercise certainly helped me become okay with gaining a little weight. Coming to college I have gained a little more weight but increased the level of exercise without trying due to the pedestrian lifestyle, so my clothing all still fits which helps put my eating disorder at ease. I am still in the recovery process, but I recently I have become increasingly happy with my body, and I can feel the disorder retreating, it’s not gone but the mental wounds opened by my EDNOS are starting to scar over.

Bibliography

Andersen, Arnold E., et al. “A Slimming Program For Eating Disorders Not Otherwise Specified.” Psychiatric Clinics of North America, vol. 24, no. 2, 2001, pp. 271–280.

Berrettini, Wade. “The Genetics of Eating Disorders.” Psychiatry (Edgmont) 1.3 (2004): 18–25. Print.

Bischoff-Grethe, Amanda et al. “Altered Brain Response to Reward and Punishment in Adolescents with Anorexia Nervosa.” Psychiatry research 214.3 (2013): 10.1016/j.pscychresns.2013.07.004. PMC. Web. 22 Nov. 2017.

“Eating Disorders.” Psychology Today, Sussex Publishers, 3 June 2017, www.psychologytoday.com/conditions/eating-disorders.Eddy, Kamryn T, et al. 

“Eating Disorder Not Otherwise Specified in Adolescents.”American Academy of Child and Adolescent Psychiatry, vol. 47, no. 2, Feb. 2008, pp. 156–164.

Elices, Matilde, et al. “Direct Experience While Eating: Laboratory Outcomes among Individuals with Eating Disorders versus Healthy Controls.” Eating Behaviors, vol. 27, 2017, pp. 23–26.

Foerde, Karin et al. “Neural Mechanisms Supporting Maladaptive Food Choices in Anorexia Nervosa.” Nature neuroscience 18.11 (2015): 1571–1573. PMC. Web. 22 Nov. 2017.

Kerr, Kara L et al. “Altered Insula Activity during Visceral Interoception in Weight-Restored Patients with Anorexia Nervosa.” Neuropsychopharmacology 41.2 (2016): 521–528. PMC. Web. 22 Nov. 2017.

Le Grange, Daniel et al. “Eating Disorder Not Otherwise Specified Presentation in the US Population.” The International journal of eating disorders 45.5 (2012): 711–718. PMC. Web. 22 Nov. 2017.

Machado, Paulo P.P., et al. “The Prevalence of Eating Disorders Not Otherwise Specified.”International Journal of Eating Disorders, vol. 40, no. 3, 2007, pp. 212–217.

Weir, Kirsten. “New Insights on Eating Disorders.” Monitor on Psychology, vol. 47, no. 4, Apr. 2016, p. 36., www.apa.org/monitor/2016/04/eating-disorders.aspx.