It wasn't until after i started writing a completely different post that i realized what i wanted to write about today. It's a topic that affects me personally and deeply, but also something that is very rarely talked about in the eating disorder community (both on blogs & in treatment or with mental health professionals, and even with friends).
There isn't exactly a "name" for this topic so, here, i'll try to spell it out for you.
Is Anorexia Nervosa a more serious, deadly, scary, real, or traumatic illness than Bulimia Nervosa or ED-NOS?
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| (source: thedownsidesofbeingawallflower) |
I don't mean the well-formulated answers that people think of, I mean the feeling that comes, the spark of thought that enters the brain or heart when this question is posed. (or when it is presented to your face- is there an image that comes to mind when this question is asked?.
I honestly am afraid of asking this question on my blog. I'm afraid of starting this conversation. Its one that I've never seen or heard out in the open, and I think it's time that it's brought to the table.
I, personally, as someone who has always had a "primary diagnosis" of bulimia, have always felt as though i need to "justify" to people that it is an actual illness, with physical consequences and harsh emotional ramifications, like anorexia, despite the fact that it often does not leave it's sufferers looking deathly ill.
My first-ever example of this was the very day that my mother confronted me about my "vomiting" when she said
"Well, I'm just glad you're not anorexic, I mean, those girls are really crazy."
At the time, I had wanted to jump out of my skin when I heard this and scream at her and lecture her on all the awful things running through my head, and how much I was tormented by this disease every day and every second, and could she please (f!#@ing) realize that this was serious, but of course I shushed myself and threw up to "swallow" my need to speak up.
I understand completely that part of this whole "complex" I have about bulimia not being considered as "serious" as anorexia has to do with my own eating disordered-mindset, and how I personally always feared that I was "not sick enough" as many sufferers do.
I would really like to emphasize however, that this dilemma, I think, reaches beyond that personal "fear" and, I think, is actually a really serious problem that still exists (albeit 'underground') in the eating disorder "sphere".
I honestly am astounded and appalled at the number of top New York City- area Eating disorder 'specialists' (usually with big titles & rather fat pay-checks to show for it) who have, in one way or another, implied to me (or to other patients or professionals) that weight & how someone looks and whether or not they have lost their menses is the most important factor in determining how "ill" someone really is. There was a psychiatrist at the first treatment center I was at who was almost notorious for telling bulimics that they didn't really have a problem, that being bulimic was just what someone did if they "couldn't be anorexic". (This is a man who did his residency at Stanford University Hospital under world-renowned eating disorder researchers).
I'd like to look at the researchers, and ask why there is always much, much more research done on Anorexia than Bulimia? Why when I type either one in on PubMed do I get over 22,000 results for anorexia and a less than 7,000 results for bulimia?
Why, when I visit a website that advocates for Maudsley (or Family-based treatment) , is there a video on the front page about how to treat Anorexia whereas I have to search for information about treating Bulimia? (I say this not to be a nit-picky complainer, but because these subtleties are important. this is how we are taught, in school, to read between the lines and to pick up on the editors' (or writers' or poets' or artists') message, to understand what is really being fed to us and to be conscious, educated consumers of information.
Why do I always find more blogs that are written by women/men recovering from Anorexia (or some {often restricting} form of ED-NOS) than Bulimia?
Is it shame?
Is it more shameful to say "I was bulimic" than to say "I was anorexic" ? Do you want my honest answer?
Honestly,
I think it IS slightly more shameful.
I hate saying that i was bulimic.
It seems like it's the difference between saying: Hello, yes, I used to stick my fingers down my throat all the time and I wasn't even skinny! or Yes, I starved myself, and my sick body looked similar to that of one of the highly paid fashion models who represent a sick & twisted beauty standard that is idealized in a very confused culture.
What would you rather say?
I'd like to clarify a few things, so that I am not hated by all the wonderful people who decided to read this blogpost.
I am not trying to say that being bulimic is harder than being anorexic, or anything RIDICULOUS like that. I am talking about the way in which culture (and yes, even our insulated culture in the eating disorder world- meaning those who are even EDUCATED & EXPERIENCED in the eating disorder field) tends to still idolize, or idealize, or freak out about Anorexia more often and more strongly than it does Bulimia.
This is separate from a persons personal experience of either illness, and is about how they are talked about & treated.
This is separate from a persons personal experience of either illness, and is about how they are talked about & treated.
Also, that being said, many (and I mean MANY) of my best friends (from treatment) suffered from Anorexia. I relate to and respect them, their struggles and their strengths, and talk to them about everything & anything under the sun and I love them to pieces. Many of the ED related blogs that I read are written by people who are recovering/recovered from Anorexia. This opinion that I am sharing has nothing (and i mean NOTHING) to do with how I relate to other ED sufferers in the world, it is simply a cultural nuance that disturbs and perplexes me.
I'm not trying to blame anyone. I wanted to bring this up because it affects me personally, and I feel very strongly about it and have never really had a platform on which to speak about it. I want us to move forward in the ED world, and learn how to move past "undercurrent" issues like this, so that there are no latent stigmatizations or unspoken judgements that are not out in the open, so that EATING DISORDERS are the only battle that we have to fight.
xo,
Rose
I loved this post, Rose!!!!!! You're right, this isn't something that is usually discussed, but I strongly agree that it needed to come out into the open and I'm so glad you wrote about it. I do believe that our culture is such that Anorexia is taken a lot more seriously than Bulimia, and it seems to me that Bulimia carries with it more shame, since a lot of people seem to admire the "willpower" of people with Anorexia- wow our culture is so messed up! I also can say that with a diagnosis of restrictive ED-NOS, I have had to deal with a lot of shame myself. When I was passing out and lost my period and losing my hair I didn't get the help I needed, b/c I wasn't underweight enough to warrant an Anorexia diagnosis so everyone thought I was fine. I definitely think that both ED professionals and everyday people need to have a better education about the seriousness of ALL eating disorders, regardless of the label.
ReplyDeleteAh girl i love your writing.
ReplyDeleteI have been both bulimic, more or less recovered, then fell into anorexia. For me there was a huge mindset between the disorders.
Here is my abbreviated answer, in my humble opinion: intense bulimia is more emotionally and physically demeaning. From one day to the next I just feel all together sick. Anorexia is more psychologically damaging. Something deep,somewhere near the soul- starving hurts that. I also think it's harder to recover from but I'm sure it's different for different people of course.
Few things anger me like people not taking a woman seriously because she's still in a normal weight state. Like Jess said ^ When I first told my stepmother I had an eating disorder she said, "Oh Bailey, you're not skinny enough to have an eating disorder."
They're just different disorders.
YES! This conversation needs to happen!
ReplyDeleteThis is the type of thing we sweep under the rug, in hopes that no one has to say what they really think. My first diagnosis was bulimic. When I heard that, I promptly shut myself off to all therapy and any hope of progress. I didn't "binge" the way I thought bulimics did, and I ate twice a week, period. The fact that I wasn't yet w/out my period meant I wasn't going to be treated for AN. I was...wait for it...ASHAMED. I quit treatment and lost 40 lbs until they HAD to diagnose me as AN. "Why?!" is a question I still don't have an answer to.
I think that people believe what they see. If you're emaciated and on the brink of death, then you're sick. If you're puking your guts out 5xday (in secret), not quite underweight but on the verge of heart failure, you're not that sick b/c you don't LOOK sick. I have no idea if this perception will ever change...but I'd like to think with enough conversations like this one, we can be the force of change and education.
Your'e exceptionally well-written and your blog is fantastic. I look forward to reading more! :D xoxo
Mandy
I really enjoyed this post.
ReplyDeleteYou write so well, and you have a skill of being able to engage your readers. I admire that.
I agree, that this is an issue which is so widespread in every facet of our society; not just the 'uneducated' people, but also those who are in the eating disorders field. Shortly after I was diagnosed at the hospital (my diagnosis is EDNOS simply because I wasn't quite underweight enough, and I didn't binge and purge like a bulimic, rather I just purged normal amounts of food)the family therapist told me that my eating disorder was only 'mild'. I've never felt more invalidated and belittled in my life.
I'm still ashamed that my diagnosis is EDNOS. because, really, what are you supposed to say? People with anorexia are anorexic, people with bulimia are bulimic, but what about EDNOS?
It's hard enough for people with eating disorders to accept that they have a problem, let alone if they're told that their suffering is effectively mild and not as serious.
I'm sorry, I've gone a bit off topic. But thankyou again for this piece of writing. I definitely think this is something which needs to be discussed more, and you've done a wonderful job of speaking about it.
~Genevieve. xo
I really commend you on writing this post. I'm not saying the blogging community is known for being judgemental or overly-opinionted, but I do know that it takes a LOT of guts to go against the grain and post from your heart when it's about something so controversial.
ReplyDeleteLet me start by saying that I've never struggled with bulimia. This response might be biased considering I've only ever struggled with anorexia, but I still want to give my opinion. Both are mental illnesses, and whether or not the sufferer is in critical condition physically, they are fighting the same mental battle and disordered thoughts every single day.
While anorexia might be a bit more serious in the sense that they can be unhealthier (and therefore have a higher risk of starving to death), I would argue that bulimia might even be more serious because it is easier to hide from loved ones which makes it harder to get help.
I think the points you made about our society and culture are valid, but I don't think it necessarily stops with bulimia. It's more about physical appearance than it is about which disorder the subject is suffering from... because even anorexics that have reached a healthy weight don't seem to be considered 'serious cases' to the majority of professionals out there. It's a sad reality that one has to be inches from death physically in order to make people understand how much they are struggling on the inside.
I hope you gain a little bit of peace of mind over this post, because you have no reason to feel like your struggles are any less serious than anyone else's. Eating disorders are horrible and heartbreaking, regardless of the specifics.
<3 Tat
I like all the others, commend you on writing this and putting this question out there. I was diagnosed with bulimia initially. On the lower edge of a normal weight. So i certainly looked slim but not necessarily underweight. The treatment reserved for bulimics in the UK is scant, to say the least. I think that is because it is not considered as serious as AN. I pointed this out to my therapist and told her that i did not understand it since people still die of EDs at normal weight. Bulimics can still get heart attakcs and die even as someone with AN can starve themselves to death. So why is one considered more dangerous?
ReplyDeleteWhen i eventually slipped into AN, i felt as though i was being taken more seriously. Added to that, i was underweight and still purging, so that added an extra element of danger. Then, i really felt that i received more help.
What saddened me most was the fact that if i had received the help i needed when BN was my primary diganosis, i feel that i may not have slipped into AN. It feels like i am in double trouble. Underweight, and purging.
If medical professionals don't take people with BN as seriously, what hope is there?? Well, i guess it is up to us to open out the debate as you have done here.
Thank you.
And finally, i always felt more shame saying i had BN than AN. Conversely, now that i am diagnosed as AN, i feel like a fraud cos truth be told, i still see myself as bulimic. I find it strange that some people with AN who do purge, never talk about that aspect of it. Instead, they will only talk about the restriction part of it. And when i talk about purging, heads turn and my shame is heightened. I am over it now. I speak my mind.
I had no idea that bulimia was treated with such lightness in the professional community... I would be interested to find out what percentage of bulimics attain a complete recovery vs anorexics? I'm talking long term. Maybe more bulimics acheive recovery?
ReplyDelete~Missy
Thank you so much for this post! I have EDNOS but also mostly bulimic, and I feel so many professionals that I have seen treat it very lightly.When I wanted to get more intense treatment it was always based on how low my weight was or if it was low enough to need help.I felt like saying, Binging/Purging is very dangerous and I want to stop the cycle and also in my mind ednos makes me feel as if I don't have an eating disorder sometimes due to I'm not anorexic or diagnosed bulimic.
ReplyDeleteThanks again for approaching this topic:)
This is such a good, insightful post.
ReplyDeleteI had the exact same issue, yet mine was the opposite around, I was told 'well at least you do not make yourself puke' A healthcare professional actually used the word puke! I think ALL eating disorders of any proportion are serious, that they require serious treatment, and that no one should decide how 'sick' we are simply by medical observations. As what is going on inside your head is so much more important, and that should be the defining factor.
I will continue to read your blog, and start commenting more, as you are so insightful.
Sophie x
This comment has been removed by a blog administrator.
ReplyDeleteAmazing post and seriously amazing video. I want to read the book now. It is so, so scary how ADS, SOCIETY, PEERS, MEDIA, etc., messes with our minds each day without us knowing.
ReplyDeleteThank you so much for this post! I have EDNOS but also mostly bulimic, and I feel so many professionals that I have seen treat it very lightly.When I wanted to get more intense treatment it was always based on how low my weight was or if it was low enough to need help.I felt like saying, Binging/Purging is very dangerous and I want to stop the cycle and also in my mind ednos makes me feel as if I don't have an eating disorder sometimes due to I'm not anorexic or diagnosed bulimic.
ReplyDeleteThanks again for approaching this topic:)
YES! This conversation needs to happen!
ReplyDeleteThis is the type of thing we sweep under the rug, in hopes that no one has to say what they really think. My first diagnosis was bulimic. When I heard that, I promptly shut myself off to all therapy and any hope of progress. I didn't "binge" the way I thought bulimics did, and I ate twice a week, period. The fact that I wasn't yet w/out my period meant I wasn't going to be treated for AN. I was...wait for it...ASHAMED. I quit treatment and lost 40 lbs until they HAD to diagnose me as AN. "Why?!" is a question I still don't have an answer to.
I think that people believe what they see. If you're emaciated and on the brink of death, then you're sick. If you're puking your guts out 5xday (in secret), not quite underweight but on the verge of heart failure, you're not that sick b/c you don't LOOK sick. I have no idea if this perception will ever change...but I'd like to think with enough conversations like this one, we can be the force of change and education.
Your'e exceptionally well-written and your blog is fantastic. I look forward to reading more! :D xoxo
Mandy
Ah girl i love your writing.
ReplyDeleteI have been both bulimic, more or less recovered, then fell into anorexia. For me there was a huge mindset between the disorders.
Here is my abbreviated answer, in my humble opinion: intense bulimia is more emotionally and physically demeaning. From one day to the next I just feel all together sick. Anorexia is more psychologically damaging. Something deep,somewhere near the soul- starving hurts that. I also think it's harder to recover from but I'm sure it's different for different people of course.
Few things anger me like people not taking a woman seriously because she's still in a normal weight state. Like Jess said ^ When I first told my stepmother I had an eating disorder she said, "Oh Bailey, you're not skinny enough to have an eating disorder."
They're just different disorders.
I really commend you on writing this post. I'm not saying the blogging community is known for being judgemental or overly-opinionted, but I do know that it takes a LOT of guts to go against the grain and post from your heart when it's about something so controversial.
ReplyDeleteLet me start by saying that I've never struggled with bulimia. This response might be biased considering I've only ever struggled with anorexia, but I still want to give my opinion. Both are mental illnesses, and whether or not the sufferer is in critical condition physically, they are fighting the same mental battle and disordered thoughts every single day.
While anorexia might be a bit more serious in the sense that they can be unhealthier (and therefore have a higher risk of starving to death), I would argue that bulimia might even be more serious because it is easier to hide from loved ones which makes it harder to get help.
I think the points you made about our society and culture are valid, but I don't think it necessarily stops with bulimia. It's more about physical appearance than it is about which disorder the subject is suffering from... because even anorexics that have reached a healthy weight don't seem to be considered 'serious cases' to the majority of professionals out there. It's a sad reality that one has to be inches from death physically in order to make people understand how much they are struggling on the inside.
I hope you gain a little bit of peace of mind over this post, because you have no reason to feel like your struggles are any less serious than anyone else's. Eating disorders are horrible and heartbreaking, regardless of the specifics.
<3 Tat
Great post. And video as well.
ReplyDeleteI'm bulimic, a binge-eater, overexerciser, and laxative addict. And every so often, a very restrictive eater. My eating disorder is complicated and my struggle to overcome all of my addictions and my self-image problems is a very long and intense journey. But it is an eating disorder no less.
I think that Anorexia is more widely talked about and more closely identified with eating disorder because on the surface, it is easier to diagnose and identify with the naked eye. Stand me, at 5'4", 123-130 lbs (it fluctuates daily), large B cup breasts, and fat cheeks, next to an Olsen twin, and who do you think society would identify as having the eating disorder?
Being that it's more difficult to identify someone with bulimia, it's also easier for us to hide our illness. We can blame an elongated bathroom trip on a too-sweet piece of cake, while an anorexic's untouched dinner plate is hard to miss. After all, for the most part, we bulimics look "normal". Yes, we may hate our body size and would sell our soul to lose weight, but our weight change doesn't for the most part change drastically. So if we're able to hide the binging and the purging and keep up our habits, why on earth wouldn't we keep it a secret?
Despite these differences, there is no denying though that Bulimia is an eating disorder just as serious as Anorexia. We all for whatever reason hate our bodies and we all take extreme methods to change them. We all hear the same messages screamed by our distorted minds and we all torture ourselves over what it tells us. We are all battling something so overwhelming, so forceful, and so cruel. We all feel pain, we all hurt, and we all cry. Whether we're depriving our body of food altogether, or stuffing it so full that you have no choice but to purge, you're still taking out your pain on your body.
I don't know if the way in which society views different types of eating disorders will every change, just as I doubt society's glorification of the perfect body ever well. And, frankly, I sort of don't care at this point. I'm still struggling to comprehend my own personal illness and I live it every day. How can I expect society to understand when I'm still trying to as well? I think the best we can do is educate ourselves, get help for ourselves, and overcome our struggles, so that one day we have the right tools to help others overcome theirs.
I just found this and I think it's a great post.
ReplyDeleteI have been diagnosed with AN and, now that my weight is healthier, EDNOS.
I have always felt personally that BN was the more serious illness. I have had lots of friends in treatment who were bulimic and it always scared me so much. I might starve for months or years--and I did--but any time these girls purged could be the time that killed them. Maybe this isn't how the ED community views it, but it's how I've always felt.
Hi,
ReplyDeleteNice video posted here..Really very awesome video posted here..
Thanks for posting this blog...........
I was diagnosed several years ago as having AN, which then "transformed" into BN, and has fluctuated between those two and recovery ever since. I shared the same feeling that you expressed: guilt of being bulimic. I felt disgusting for doing the things I did. As an anorexic, I remember feeling proud. It's harder to say that the simple fact of restricting calories and over-exercising (something that most diets entail, but this taken to an extreme) is gross. There's nothing really that gross about it. But purging, using laxatives, it's something that non-ED people don't regularly engage in. Most people have, for one reason or another, skipped a meal, restricted calories. Whether it was intentional, aimed at losing weight, or they were just too busy or just forgot. They've done it. But using enemas, laxatives, purging... they would say, "who does that?" The answer is: bulimics. The only time non-ED people throw up is when they are sick (flu, alcohol poisoning, whatever). The word "sick" in itself has a negative connotation. They never associate it with something pleasant.
ReplyDeleteThat being said, I do think that people tend to think that anorexics are worse (in terms of severity of the illness) than bulimics. Maybe that's because you don't see how much someone is throwing up a day, how many laxatives they take, etc, but you easily see the frail and malnourished image of the anorexic. The girl who looks like she would break if you touched her. Maybe it's that look that makes them seem more sick. The fragility of it. Bulimics can generally pass as looking normal, regardless of how torn up their bodies might be on the inside. I think that people tend to forget the behaviors that bulimics engage in because of the fact that they think it is gross. Some people throw up at the sight of another person throwing up. They don't like to think of those things. They don't like to have that image and they somehow block that association when they think of bulimia.
Having said all that, I remember the misery of bulimia. I think for me, the bulimia was worse. It was debilitating and incapacitating physically, but mostly mentally. I could function well with the calorie counts of the food I ate playing over in my head, the anxiety of having to hide another meal was actually powerful to me, it fueled my willpower and drive for perfection. However, there came a point at which this began to make me feel guilty. My family was suffering with the sight of me. The clumps of hair in the shower. My bones exposed for the world to see. So I decided I wanted to be normal. Turns out that "normal" made me lose control and in a desperate attempt to gain that control back, I resorted once again to bulimia. Anorexia was bad, but the agonizing thought of the binge I just had, the fact that I needed to get rid of it NOW, the knowledge that I fucked up again, killed me. And it literally almost did. It was after a night of complete dispair (and a huge binge) that I attempted suicide. I could not find an escape from the twisted trap of bulimia.
So that's my take on it, not sure if it's what you were looking for but that's how I feel about it... I was very impressed by your bravery to post this. It is something that I have always wondered, I think a lot of us have, just never had the guts to put it out there. Thanks for that.
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ReplyDelete