The rising epidemic of “hidden” eating disorders ["I'm disordered but not diseased"]

by Charlotte on June 23, 2014 · 27 comments

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At first I was going to use a picture of me from my “skinniest” sickest time – to illustrate the point that I still looked pretty normal – but then I realized that I’d rather illustrate this with a pic of me now. These guys remind me every day why I work so hard to be happy, healthy and present for them. I’m so glad I “failed” at anorexia!!

Well you never looked THAT skinny. In all my years of recovering from my various eating disorders, this was probably the most painful thing people said to me. It was as if people were telling me I wasn’t skinny enough to have an eating disorder. It was also a brutal reminder at how much I’d “failed” in my goal to get that skinny. I tried! I did all the stupid tricks you read on websites and magazine articles. (What, those cautionary stories aren’t meant to be how-to’s? Oops.) And while I did get pretty thin when you compared me to, say, Victoria Beckham or Angelina Jolie I looked like one of those human-shaped pillows for lonely people to cuddle with. And they live that way! For years!

It’s a phenomenon called “functional anorexia*” where women (or men) restrict calories and exercise just to the brink of severe unhealthiness. They are fashionably thin but not scary thin and manage through tight control – and sometimes pharmaceuticals – to stay in that place. And because they aren’t “sick” in the way we think people with eating disorders should be sick then they think they’re just fine. There’s a lot of ground between “not dead” and “thriving”, though.

I recently covered a story for Shape about a girl who suffered for years with anorexia but no one ever noticed.  “Just because my bone structure stopped me from being the size 00 everyone pictures, doesn’t mean that I wasn’t in an incredibly unsafe and unhealthy place,” Brittany Miles said. 

I can totally relate to Miles’ sentiment. It’s one I’ve heard in every TV interview I’ve done about eating disorders. I’ve heard it from friends and family members. I’ve heard it from strangers on the Internet. And the worst part is that often the people suffering buy into the attitude as well, thinking they aren’t sick and don’t need help. I’m all for people living their lives how they want but I’m also all for people not beating themselves up over every calorie or pound.

This weekend I read the perfect description of functional anorexia when an awesome reader sent me this article called “You’re right, I didn’t eat that.” (Note: This article is massively triggering. Like the possibly the most triggering article about eating disorders I’ve ever read. It’s also thoughtful, insightful and makes some important points about society. Decide carefully if you want to read it.) The author, Alana Massey, is of course referring to the Instagram phenomenon “You did not eat that.”

“You Did Not Eat That” is set up to show the chicanery behind the chic. The anonymous account is run by a person who worked in the fashion industry for over a decade and finally got sick of seeing ultra-thin girls posing with decadent food tantalizingly close to their mouth but never in it. And when the trend trickled down to fashion and fitness bloggers she decided it was time to start calling them out on their hypocrisy. When I first saw “You did not eat that” I totally laughed. I’ll admit it. I’ve had the same thought before looking at pictures on some blogs.

 But it’s not about calling out specific people or even thin body types and setting them up for ridicule. “If you’re a size zero, and you’re frolicking in a tiny bikini on the beach, you probably did not eat the doughnuts that you posed with the sunglasses,” she says, echoing what the rest of us are thinking. “It’s just presenting this curated life that’s beautiful and perfect and totally unrealistic. More power to you for rocking that! You look awesome! Don’t lie about how you got there! It’s fine.”

It’s this kind of “curated life” that sets us up for functional anorexia, binge eating, bulimia, exercise addiction and other disordered behaviors that fly under the radar because they aren’t killing the person in an obvious way. Of course it’s not all the fault of media or dissembling images – there is a big genetic component to being predisposed to an eating disorder – but these things don’t help.

In Massey’s article she talks about how she used to be a normal size but when she had some problems in her life and lost a bunch of weight, she was blown away by how much more attention (both romantic and otherwise) she got. It was enough to convince her that she wanted to stay at this new low weight forever.

“I’m disordered not diseased,” she says of the complicated, fragile system she’s designed to keep her at this precarious weight. She points out that because her aesthetic is so desirable, people never think to worry about her.

She makes an interesting observation about the way her disorder complicates her personal relationships and how her loved ones inadvertently reinforce her behavior. “These symptoms do not aggregate into the appearance of a disease but rather, into a certain temperament. It makes them exclaim, “Relax!” rather than, “Get help.” The level of control the symptoms reveal hovers close to illness but [it] doesn’t cross far enough over the line so as to become sad — rather merely unattractive. And it is easier to walk away from someone who is unattractive than someone who is sad.”

The problem with functional anorexia or “hidden” eating disorders or whatever you want to call them - and I speak from experience – is that it’s not sustainable forever. Life happens. You get sick, you get a new job, you have a baby, you drop your guard for one moment and because you’ve been semi-starving yourself for years, all that food comes rushing back at you like a freight train. Because you restricted for so long, your body wants to binge. It wants to not be deprived anymore. And that is a terrible place to be. I still remember the day I realized that I no longer had the “self control” to restrict my food to that level. I just couldn’t do it anymore. I felt weak, disgusting, depressed and like a total failure. I needed professional help to navigate through that process and it was still grueling.

My message is this: You do not have to be thin to have an eating disorder. And an eating disorder doesn’t always make you thin.

“Weight can be an indicator of an eating disorder, but it certainly isn’t the only one or even the best one,” says Lynn Grefe, president and CEO of the National Eating Disorder Association (NEDA), adding that using weight as the only criteria for an eating disorder is incredibly damaging and demeaning to sufferers. She says the hallmark of an eating disorder is the mental component: How much time do you spend thinking about your diet, exercise or weight? Are you isolating yourself from others? Do you hate your body? It’s when the thoughts of food and dieting overtake the rest of your life that it becomes disordered. And that can happen at any weight. 

Hidden eating disorders may be a popular term in the media right now but they really aren’t hidden. We just don’t want to see them.

*I am NOT saying every thin girl has an eating disorder or that Victoria Beckham or Angelina Jolie do. I know there are plenty of people who are thin just because that’s the way they are built and I’m not trying to shame them. I’m not even talking about them in this article.

{ 27 comments… read them below or add one }

Emily June 23, 2014 at 2:28 pm

Totally agree with your assessment of that article as the most triggering thing ever written for anyone with disordered eating tendencies. I am ok to read things like this now (I think, anyway), but damn. It’s so depressing to read about the first date where the guy makes a fat joke, and is then terrified at the notion that she used to be “fat” (her description) and might gain it back someday. Ugh.

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Cindy June 23, 2014 at 3:09 pm

I have an eating disorder. My solution for it is that I will go on a program where my food for each day is designed by a nutritionist and delivered to my house either once a week or each morning. I have some choice in what I get each day. I don’t stay on this plan for more than a few months at a time but it gives me permission to give up the food anxiety and just eat what is assigned and know it is right.. I don’t usually lose any weight but it gets the crazy under control.

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Sonia Simone June 24, 2014 at 12:02 pm

Cindy, is that something that’s recommended to you by an ED treatment team?

I only ask because I’ve seen a lot of folks harm themselves by trying to treat their ED without the help of med professionals and a qualified therapist, and it so often backfires. ED is dangerous, it deserves a qualified team to help you work through it.

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Bethany June 23, 2014 at 3:18 pm

This line is the perfect summary of the problem:

“There’s a lot of ground between “not dead” and “thriving”, though.”

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Katie June 23, 2014 at 3:26 pm

Excellent, once again, Charlotte. I don’t know if this is a “new” problem, or if the internet/Instagram/Faceboook/etc just make it more transparent.

I argue that it isn’t necessarily just that “we” don’t want to see the problem, but that the people who suffer from hidden EDs don’t want us to see it and therefore are really good at hiding it.

I love that you point out that the disease isn’t about weight at all, it’s about hating your body and/or being unhappy. This also goes the other way though; just because a person is small, doesn’t mean they have an ED or are unhappy.

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Bethany June 23, 2014 at 3:30 pm

Just read that article. Wow. So well written, so honest. So sad that we live in a world that so affirms thinness that it is worth it to her to go through all that she does.

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Andrea June 23, 2014 at 5:01 pm

Just a note, Autumn Whitefield-Madrano didn’t write that article, it was a guest post by Alana Massey. It was the first in a series of articles on bodies and relationships by (I believe) several different people.

It was also one of the saddest articles I’ve ever read. The perfect example of why I decided long ago that being thin just wasn’t worth it.

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Darwin June 23, 2014 at 6:59 pm

As a guy, I feel totally justified in saying that generally GUYS ARE SLIMY SHALLOW SELFISH INSENSITIVE JERKS!

They trigger not only eating disorders but so many other forms of self-degradation WITH their degradation of others.

NOT actually worthy of any relationship, let alone a relationship that potentially involves “ever”.

AND…

…never worth bowing down to or kowtowing or accommodating their idiocy.

Any guy who says stuff like that…

…*fumes*….

…mentally cut the string on THAT “Chatty Kathy” and move on to someone else.

I was around when they sent out the memo that “thin” should entirely replace all the excellent female qualities of character, intelligence, wit, spirituality and competence…

…but I dismissed it as the immature ravings of some guy who thinks with their glands.

And a female WITH qualities of character, intelligence, wit, spirituality and competence…should have NO time for such an immature guy who thinks with their glands.

AND THEY ARE CERTAINLY NOT WORTH SACRIFICING FOR.

A lady should look for a guy who looks beyond their clavicle.

And their breasts.

The first thing I look at when meeting a woman…are her eyes.

And then I listen to what she has to say.

An intelligent man wants more of a partner in life, rather than a decoration.

Most men are not intelligent.

Here is an example of a partner-type of woman.

(*laughs* Her taste in beachwear run similar to Charlotte’s.)

https://www.youtube.com/watch?v=mn26NOoV_lQ

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Brooke June 23, 2014 at 8:06 pm

I can relate to this 100%. I dropped a massive amount of weight in a short period of time due to restricting and ended up in the hospital but because I never had the stick thin, skeletal figure, I never believed (and still don’t, really) that I have an eating disorder.

But this is very informative and I am so so so glad you decided to post this! You are a wonderful inspiration and you look absolutely fantastic now!

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Azusmom June 23, 2014 at 8:29 pm

In college I was bulimic and gained 20 pounds. In grad school I was anorexic, but had a “desirable” shape. No one knew I was taking a full (and very physical) class load (9 AM until 11 PM 6 days a week) PLUS working out 15 hours a week and restricting myself to 1500 calories a day.
Sundays weren’t my day of rest, they were my day of working out for hours at a time while I did laundry. All the other days I could only work out during our dinner break. At the time, I didn’t count our movement, dance, stage combat, and other physical classes as workouts. I didn’t include walking (or, more often running) from one side of campus to the other 8 to 10 times a day as a workout. I didn’t include fight calls, rehearsals, or any of the heavily physical stuff I “had” to do as a workout. So I spent all my spare time at the gym, and lived on bagels, coffee, and raw veggies. I was also averaging between 5 and 12 panic attacks a day.
I wasn’t super-skinny. I WAS praised for my physical appearance and discipline. And when the panic attacks came, everyone, including my instructors, told me that it was all just a part of being a grad student. I was “paying my dues” for the “privilege” of being a student.
And when grad school ended and I started getting better, I mentally abused myself for putting weight on. Since I was, at that point, an aspiring actress in Hollywood, I was no longer praised for my body. It was too big. Too NORMAL.
I look, now, at pictures of myself back then, back when I was told how “big” I was, and I think I looked fantastic. Strong, healthy, and happy.
Bit that wasn’t rewarded in that environment. So, eventually, I left.
Thank goodness!

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Darwin June 23, 2014 at 10:42 pm

So very glad you are alive!

(Also glad you left the unhealthy environment of Hollywood.)

True thing about not counting movement, dance, stage combat as workouts. I took those same classes…and I didn’t count them either.

I also did fight choreography for shows I was in (I threw in an “I am not really left-handed” SWORD-FIGHT move into PIRATES OF PENZANCE) and some shows I was not in.

I also didn’t count my rock climbing class.

I really cannot fathom why I did not count these things as work outs.

You got me thinking, Azusmom!

And like you I ran everywhere on campus, to and from campus (there were a lot of stairs) and everywhere in town.

And it was BYU…high elevation…foothills…

I also ran to the next town over.

BYU Campus was in Provo. University Mall was in Orem. Along with movie theaters and other stuff.

Never even considered those to be workouts. Just…travelling.

I was eating okay (supplemented by the vending machines) but I would hit the weights, go running. So I would get “exercise”.

I didn’t even count the martial arts and weapons training as work-outs.

Weird how the mind works.

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Matt June 23, 2014 at 9:59 pm

I took a class on eating disorders back in college as part of my nutrition education. I went in blind to the fact that my eating was disordered. It took a clinical perspective for me to realize that my approach to eating wasn’t healthy, but all the time through high school and college I thought I was “being good” and the ideal of discipline.

Now I want to jump in a time machine, back ot my high school self, and tell myself that all the hard work I was doing and the stress I was putting myself through was unnecessary and even keeping me from my goals.

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Heather C June 24, 2014 at 7:46 am

I had an ED in college. I had been throwing up food for months but then in the fall, when I went back to school, I put myself on a 600 calorie a day diet and dropped almost 20lbs in a month. My roommate called my parents who flew me home and slapped me in a treatment program where they diagnosed me as anorexic/bulimic. Even with all of that, I have always felt like I wasn’t a “real” anorexic because I was never skin and bones. I know plenty of women who hover just above the skin and bones state and are therefore able to receive lots of praise rather than people’s concern. When in reality, the outward appearance should be completely disregarded and the focus on what goes on inside the person’s head. Are they obsessive about food, afraid of social situations, shaming themselves for how they look, and so on.

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Darwin June 24, 2014 at 8:15 am

Heather C, both you and Charlotte reiterated the importance of the “mental component”… “what goes on inside the person’s head”.

Which means going beyond how they look and even what they say to REALLY paying attention to pick up the clues as to how they think and how they feel and what they believe…

…which as Katie above so accurately pointed out…”that the people who suffer from hidden EDs don’t want us to see it and therefore are really good at hiding it.”

This means we have the opportunity to become more invested in the people around us.

Lift our noses from the grindstone often enough to get a better sense of what is going on.

And not just duck our heads down wearing the accompanying blinders.

Opening our eyes and really seeing make the world a better place in a great many respects.

And you have given us things to watch for.

Thank-you.

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Sonia Simone June 24, 2014 at 12:03 pm

Charlotte thank you so much for talking about this! This is such a huge and growing problem, and it’s still invisible to so many people. Thank you for helping to get some light onto it.

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Jody - Fit at 56 June 24, 2014 at 4:42 pm

Great post & yes, weight is not an indicator plus it is such a complex problem as well, diseases & disordered & so much more. Thx for writing this!

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Diane June 25, 2014 at 5:26 pm

Great post. So many people (usually women) hide their ED’s. I’m trying so hard not to pass on my messed up view of eating/dieting on to my 13yr old daughter. Nothing is more attractive to me than a confident, strong women..no matter her size.

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Julie Smith June 25, 2014 at 7:44 pm

The problem with us nowadays is we all are addicted to media. Sadly, we live in a media saturated world. They don’t control nor explain the message they are sending. They just care about the money they are making. Some people allow themselves to be consumed with media telling them how to look or even feel. Maybe it’s just me, but sometimes, I feel sad when I let my little daughter watch TV unsupervised. I just don’t want her to have a body image problem.

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Julia June 26, 2014 at 10:09 am

I don’t have a tv, I don’t read magazines, and I don’t visit celebrity websites, etc. I have disordered thoughts. I have no doubt that media contributes to body image issues for some people, but not everyone’s issue is media generated.

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Darwin June 26, 2014 at 11:24 am

The term anorexia nervosa was first established by Sir William Gull in 1873, as published in “Anorexia Nervosa (Apepsia Hysterica, Anorexia Hysterica)”, in which he describes the three cases: Miss A, Miss B, and a third unnamed (unlettered?) case.

So clearly those were not media related eating disorders.

I read that Miss A went from an emaciated appearance at 82 pounds in January of 1866 when she was 17, to 128 in March of 1868 at the age of 21. Apparently there are photographs as well.

So there was hope and recovery back then, and there is even more now. Professional help is the key.

Curious side note: Sir William Gull is also noted in association with Jack the Ripper, as a few theories focus on one of Gull’s prominent male patients (connected to the royal family) as a prime suspect. No fault of Sir William Gull’s to be sure, but interesting for those who love a mystery.

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Julia June 26, 2014 at 1:26 pm

I love this! I know it’s far more complicated than what I’m about to say, but it seems like pointing to the media is somewhat of a scapegoat or a shortcut. Maybe it was Miss A(norexic), Miss B(ulimic), and Miss EDnos ;)

Terrible joke. Apologies to the internet.

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Darwin June 26, 2014 at 2:02 pm

There are actually a variety of triggers…

I have been curious to know if they went so far as to identify the things that triggered in Sir William Gull’s patients. One would assume those would need have been addressed in the recovery process.

I think for many the media IS a shortcut to disordered thinking, especially if they are at all susceptible…vulnerable to that type of bombardment.

Your points are important Julia, as they help to dispel “one size fits all” triggers, and encourages people to look beyond the obvious.

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Sagan June 26, 2014 at 3:41 pm

Thanks for writing this, Charlotte.

This is exactly the issue that I’ve faced for so many years: I have some eating “issues” but they just aren’t “big enough” to get help for. People ALWAYS told me to relax when I restricted my eating (it was definitely never about getting help – they just wanted me to eat the same types and amounts of food that they were eating so they could feel better about themselves).

I find disordered eating so hard. Even when I’m eating a “normal” diet of fairly healthy food and reasonable portions, it’s the thoughts running around in my head that are the real problem. There’s so much struggle, and it constantly swings back and forth between restricting and binging. It’s so hard, and I’m so tired of it – especially if I DON’T have any of these thoughts for a few days, and then something tiny triggers them and it all comes flooding back. It really makes you wonder how many people have disordered eating without even identifying that it’s a problem.

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Lisa June 28, 2014 at 4:06 pm

I am so thankful that you failed at anorexia!!! Hugs

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Alana July 10, 2014 at 4:39 am

Hi, I just wanted to say that I’m the writer of “You’re Right, I Didn’t Eat That” and found this response helpful and insightful. Thanks for posting.

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Darwin July 16, 2014 at 6:16 pm

Hello Alana!

Just a blog-commenting fellow who wants you to know that I myself DID in fact note that YOU in fact wrote the article “You’re Right, I Didn’t Eat That” when I followed the link Charlotte provided, and read it.

You are a clever and insightful person with intelligent and funny writing to match AND I personally feel that both you and Charlotte would have acquitted yourselves well with the likes of Dorothy Parker and the other denizens of the Algonquin Round Table.

I would be the somewhat-cute-in-good-lighting-guy at the NEXT table, ordering more food and chewing ever so slowly, thus prolonging my stay in a blatantly self-indulgent manner… to facilitate my immersion in the overflowing witty repartee and fanciful phrasing of thought cascading from yourself, Charlotte, and the others.

And learn.

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Path July 26, 2014 at 6:54 am

Want to say this: YOU ARE ABSOLUTELY BEAUTIFUL!!! Okay, now here is the critique if you wish to take it that way. In your picture, why are you and your daughter all “dolled up”? The male consort in the picture is casual and also very nice looking. I also, have 3 boys and a daughter…. The message I believe you are inadvertently passing on to your daughter is that she needs to be fixed up to be beautiful. This begins the whole objectification process for both males and females…. The females think they need to be fixed to be beautiful and males learn to expect that they should be that way.

Take care and be well,

Path

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