Then: I wouldn’t call it an eating disorder (ED). I called it disordered eating (yes, that’s different) and acknowledged that it wasn’t normal to not have a period. I didn’t want to consult a registered dietitian or a therapist. In my mind, there was nothing to diagnose, therefore nothing to cure. I just needed to work through some things. I did that on my own.
But I did have an eating disorder.
I struggled with it for at least one year. For a long time, I diagnosed myself with having orthorexia. Now, I’m learning more about eating disorders — how to identify and treat them, how to work with ED clients, and the range of eating disorders that can be diagnosed. Now I know that I may have been anorexic. It’s hard (and maybe ill-advised) to diagnose in hindsight, because my memory of those early years is jaded. But according to the Diagnostic and Statistic Manual of Mental Disorders (DSM), I had anorexia.
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DSM-5 Diagnostic Criteria for Anorexia
1. Restriction of energy intake relative to requirements leading to a significantly low body weight in the context of age, sex, developmental trajectory, and physical health.
2. Intense fear of gaining weight or becoming fat, even though underweight.
3. Disturbance in the way in which one’s body weight or shape is experienced, undue influence of body weight or shape on self-evaluation, or denial of the seriousness of the current low body weight.
(Orthorexia isn’t part of the DSM (Feeding and Eating disorders) yet, but some health professionals are working on that.)
It took me years to acknowledge that it was, in fact, an eating disorder.
I’m not trying to be hyperbolic. It took me years to acknowledge that it was, in fact, an ED (let alone one that diagnosed by the DSM-5). A few years ago I learned about Orthorexia and thought, “Oh yep, it was definitely that.” In school, I learned that someone with bulimia purged (via exercise or vomit) often, while someone with anorexia looked rail thin and only ate one cup of grapes per day. Or, at least that the impression I remember. There is a lot more to both of those disorders. It’s important to recognize that. If I did indeed have anorexia, as the DSM-5 criteria suggest to me now, I’m incredibly lucky to have recovered before I needed inpatient treatment.
Either way, my ED transformed into Orthorexia.
My “unhealthy fixation on eating healthy foods” was an attempt to justify the lingering food rules and aversions. Dietitians and recovering ED patients may be more likely fall prey to that; I happen to be both.
In the thick of it, I thought I was being healthy. For a long time, that justification lingered.
I had an eating disorder, and I have no shame in saying that now. (I talk about it often, because I think we should talk about it.) But I didn’t know it at the time. Not, “I didn’t want to admit it.” I did not KNOW. In the thick of it, I thought I was being healthy. For a long time, that justification lingered. Toward the end of it, I realized what I was doing was neither normal, nor healthy. I had an eating disorder. I wish I had known that earlier.
Do you have an eating disorder?
If you’re reading this and sense a “YES” trying to creep out from a corner of your brain, please listen to that. That voice may not be “science,” but it is your intuition. I think there’s power in listening to yourself. Start with that. If you’re unsure either way, or suspect a friend or loved one might have an ED, that’s reason enough to keep reading.
There are a few objective, research-backed ways to identify eating disorders (or a tendency toward disordered eating that may evolve into an ED). Consider these steps:
- Take the National Eating Disorder Association (NEDA) Survey (Screening Tool). It provides resources and a brief assessment at the end.
- Consult an eating disorder specialist, therapist, or dietitian. They will refer to the DSM-5 criteria.
- Browse the Alliance for Eating Disorder Awareness “Getting Help” page. If nothing else, read their “Debunking Eating Disorder Myths” section.
- Contact the NEDA helpline, or use their “Find Treatment” database to identify a local specialist you can work with.
Parents, coaches, teachers, and mentors, please be aware of the contributing factors for ED, diagnostic criteria, and resources above. You may need them. Someone you know needs you to be ready to help.
If you’re still reading and not sure where to start or what to do, get in touch. We’re here, too.
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