Is complete recovery from an eating disorder even possible?

In 2007, an inexplicably irrational and frightening disease entered my life — anorexia nervosa. I was familiar with it, of course, although I did not have any close friends who struggled with anorexia or any other eating disorder, at least that I knew of.

My first contact with anorexia was with a two-sentence entry in my Abnormal Psychology textbook. It was the 1980s, and eating disorders just weren't getting a lot of attention. My next encounter with anorexia was in the early 1990s, when I was hospitalized at the University of Michigan Hospitals after a particularly bad bout with depression and anxiety. There was a young woman there, very thin and pale, who was on complete bed rest. I later found out that she had anorexia. I scoffed, eating my bacon eggs, that anyone would willingly starve herself.

Little did I know that years later, that woman would be me.

I developed anorexia after a bout with another frightening disease, hypoparathyroidism, caused me to lose a significant amount of weight. I found that I liked being that thin, and thus was kicked into anorexia and five years of utter hell.

There have been many fits and starts during my recovery, when I would go so far, only to jerk back and start clinging to anorexia like it was my best friend. I became a serial patient at my ED doctor's hospital, being admitted eight times between 2008 and 2012.

I still sometimes ask myself, will there be a ninth admission?

I started working seriously on recovery after my last hospitalization. I was discharged on 1 January 2012, and days later, I slammed my scale against the trash can and tossed it out. I have not owned a scale since.

But eating disorder thoughts still come and go, some fleetingly, others taking hold until I feel as if I am smothering.

Fat. Not so fat. Cellulite. Dimples............fatttttttttttttt.....oh so fat!!!!!!!! I wouldn't be caught.dead.in.a.bikini, said in a clinched tone. FAT FAT FAT FAT FAT, SCREAMING AT ME, GOD PLEASE STOP THESE THOUGHT NOW!!!!!!!!!!!!!!!

Of course, anorexia isn't really about weight and food and body image. And yet it is. My life is pretty stressful right now. I'm looking for full-time work after finishing graduate school. My living situation isn't idea. I feel like a failure after the twin disasters in December and June.

It is characteristic of me to turn inward, churning up self-hatred, berating myself for actually nourishing myself as a normal human being, hating myself for no longer being a size XX.

But all of this leads me to think, will I ever be completely recovered?

I mean, the truth is, I am at the high end of the acceptable weight for my age and height. I do need to lose some weight. I am risking my health, or I was, with all the sugar and simple carbs I've been ingesting.

So how does a recovered anorexic — if I am truly recovered — address possible health issues and the need to lose weight? How do I do it safely, or is it simply not possible?

Or will this simply trigger another relapse? Can I safely maintain my healthy, get to a healthy weight, without inviting anorexia back in?

Does anyone ever really recover from an eating disorder?

Confused

***TRIGGER WARNING***

I'm so confused right now. I'm hearing about size zero or two on the ED blogsphere, and now I'm thinking I'm fat. Before I was happy with my new figure — about 125 pounds and a size seven/small. But now...is that way too fat??? 

I remember when I became sick with hypoparathyroidism in 2008. I was about 130 pounds. Then I dropped to about 105, and a lot of people told me how good I looked, how "slim." Then came anorexia. And hell. And I quickly dropped into the low nineties.

Five years later, I feel like I am finally embracing recovery. It has been hard — I have struggled with anorexia, alcoholism, and drug abuse; I almost died this past fall. Mixing tranquilizers with alcohol. Not eating. Not caring if I lived or died.

And now? I want to be more than just my damn size!!! Recovery has opened a new life for me. A life of books and friends and family. A real life. I am more engaging, more connected to people. I think less  about starving. About drinking. About my size. I am able to think better, and write better.

Or at least I did until this week.

It is funny. The less I eat, the more I think I don't deserve to eat. I spent yesterday with my family, and I was able to relax and finally eat a meal after almost a week. Then I come home, and I fight with myself internally.

I am so frightened right now. I am forty-seven, and I feel this is my last chance at recovery. My body can't handle much more.

If I fail this time, I believe it will kill me.

Treatment denied (Blogging for Sofia)

Sofia Benbahmed as a toddler.

The joy and wonder of life shine in the face of this little girl; dark, tousled curls framing her face, eyes closed and the warmth of a summer day embracing her as she clutches a daisy in each hand. There was a time when this little girl felt comfortable in her body. She didn't worry about weight and calories and body image. She was free like all little girls; running, playing and secure within herself and her world.

But at some point, something shifted within Sofia Benbahmed and she developed an eating disorder about twelve years ago. Now a young lady, she is struggling to overcome her illness and create a normal life free of fear and anxiety. She began residential treatment at Monte Nido in California in November. She spent three weeks there, healing and beginning her journey of recovery.

Sofia wrote, "During my time there I began to feel myself changing and rising to the occasion in a way I never had before. It was as though all of these years I have been  in a room with no doors or windows, and suddenly doors began to appear — and not only did they become visible, but I began to walk through them."

Then her insurance company denied further treatment.

Many of us know how it feels to be trapped by an eating disorder, looking for a way out and praying for recovery. I have struggled with anorexia nervosa for four years, and residential treatment was recommended for me about two years ago.

My insurance does not pay for this type of treatment. Furthermore, when my treatment team recommended partial hospitalization (the highest level besides hospitalization that my insurance will cover) this past spring, I was denied treatment three times even though I was at my lowest weight and was quickly becoming medically compromised while the various powers-to-be at the insurance company debated with my doctor about the necessity for this level of care.

I was finally admitted to a PHP after my doctor told the insurance company I would soon end up in the hospital. I remember my own fight with the insurance company; how it wore me down and made it harder to focus on recovery.

It is because of my own experience that I am taking the time to write about Sofia, someone I've never met. Sofia's treatment team has recommended that she return to Monte Nido and receive the full treatment necessary to recover, but her insurance continues to deny her.

Sofia Benbahmed continues to fight for recovery in spite of the fact that she is becoming sicker every day. To contribute toward the costs of her treatment, go to GiveForward.org. You can read Sofia's complete story there, and see what a brave and determined young lady she is and how she takes full responsibility for her recovery; it is not easy for her to ask for financial help to pay for the treatment she so desperately needs. You also can find more information through Miss Mary Max's blog; she is the one who spearheaded the "Blogging for  Sofia" campaign.

Everyone deserves the treatment their doctors and health professionals recommend. Insurance companies have no right to play God, deciding if this person is worthy of treatment while that person is not.

I am honored to have a small part in this effort to gain treatment for one person with an eating disorder. I just wish that appropriate treatment would be readily available for everyone who needs it.

Sofia Benbahmed today.

Now is now (The fallout of anorexia nervosa)

Dialysis
Even the word scares me. The thought that I might need dialysis in the future scares me even more. But the functioning level of my kidneys has significantly declined in the past few months. My blatant mistreatment of my body through anorexia and laxative abuse has taken its toll.

The first hint something might going wrong came up several months ago. I was badly relapsing and using multiple dosages of different kinds of laxatives to purge myself of even minute quantities of food. I craved emptiness and felt so clean after all food was cleared from my body. (Or so I thought. I've since learned it does not work that way and some of the food stays in your body. That was very clever of God to design our bodies to work that way, and it probably has saved me from worse problems.)

That was in February. I was hospitalized for a week with a NG feeding tube and this should have been my wake-up call. I thought I had hit rock bottom with my eating disorder, but I soon learned I was wrong.

Tests results showed minor problems with my kidneys just before I left for the PHP at River Centre Clinic. My doctor thought the problem would correct itself once I was eating properly again. No worries. The rest of my tests were fine and I was medically cleared to go to RCC.

I am tested weekly for all sorts of things via my blood and urine. I resumed both treatment with Dr. Sackeyfio and his tests after I left PHP. (I didn't receive any physical tests, except blood pressure and temperature checks, while at RCC.)

Then two weeks ago I went to see Dr. Sackeyfio. He pulled out the test results the minute I walked in — NOT a good sign — and told me my kidneys' functioning had "significantly declined" since the last tests two months prior. It really is a puzzle. RCC had me eating almost 3,000 calories daily for weight restoration and I have not once used laxatives in almost three months.

The bad news got worse this week. The damage is starting to show in my blood as my potassium levels have dropped. Low potassium levels can put me at risk of cardiac arrest, a leading cause of death amongst anorexics.

What's going on?

Damage from anorexia and laxative abuse. Damage that might not be reversible through conventional means, i.e. eating healthy. Damage which I feel I caused.

I am scared. Right now we are going to see if eating properly will reverse it. But ... I looked at Dr. Sackeyfio on Friday and asked if I could need dialysis in the future. He said yes.

Then there is food ... I have struggled with eating since leaving RCC. Eat well. Eat but not too much. Eat but avoid fattening foods. Eat but restrict a little. Eat but restrict a lot. Eat as little as possible.

Lose weight. Gain weight. Stay at the same weight. Fat. Not fat. Fat stomach and thighs. Not really hearing people when they say I am still too thin. Not seeing it myself. Nope. Nothing wrong with me. I'm just fine.

Looking at my gaunt face in the mirror. Feeling some days as if I have no future. Then becoming angry and declaring that anorexia WILL NOT WIN. Not this time. Then I plot how to eat less food each day ... Back and forth it goes.

My mind continues to swirl and I wonder why this doesn't shock me out of my complacency. I mean, dialysis for God's sake! Even the fact that it is just a possibility frightens me. And yet ... This should be rock bottom for me. What am I waiting for? Dialysis to fail and then need a transplant? Being rejected for a transplant? What then?

I feel as if I have squandered my future. I have so many dreams, and anorexia seems bent on killing them one way or another.

I try to tell myself that anorexia is an illness and I did not chose to have it. Something in my brain snapped about four years ago. I keep waiting for it to snap back, for something to click back into place and finally, finally give me the strength to let go of this and LIVE.

Many mornings, I wake up just as dawn is rising. I see the hint of the still blue-black sky and hear the small noises of birds readying for the morning. I look over at my husband, sleeping peacefully. I think about how much he loves me and how much he has believed in me through the past fourteen years.

I think about the friends and family who love and support me and the times we have spent together and the things we have shared. I think about graduate school and everything I have discovered there, from a love of children's literature to the pride I feel by finally understanding just a little about literary theory and criticism.

Sometimes I remember my days as a journalist. I remember when I flew in a hot air balloon and felt as if I could touch the clouds, that I could just leave the balloon and fly all alone. I remember the dips and shakes as I rode in a four-seater airplane, feeling scared and excited at the same time on that cold winter day. I remember the grief on the faces of family members who laid to rest a young soldier who lost his life in this inexplicable war in Iraq.

During these brief moments, my heart often races and I wonder if this time it will happen ... I lie still and try to calm my mind, but often my last thought before going back to sleep is that real life is behind me. I feel as if I am lost, lost in a demented fairy tale in which there is no cure from the evil witch's curse and I will forever be under her spell.

I wonder if I ever really appreciate how full and wonderful my life was before anorexia? Did I ever have even a hint of what was to come? Did I ever stop to think of the beauty in the ordinary? Did I know what was coming in the recesses in my mind? Or was I oblivious to the fact that the life I was living was soon going to fly off its tracks?

Did I ever tell the people in my life what they meant to me, what they still mean to me to this day? Do the people in my life really know how much I love them and that the thought of maybe not seeing their faces someday ... Why did it take anorexia to realize how important love and friendship and everyday, ordinary life is?

Each night, I lean against the back of my husband as I struggle to sleep. He already is sleeping; the peaceful look on his face makes me happy. I think of the future, in which anorexia is just a bad dream and recovery is so strong nothing can break it. The darkness begins to falls and I struggle not to let it ensnare me. I drift off thinking about possibilities ...

Then dialysis floats in my mind. But I try to let it go for the night, and bring myself back to the present. Now is now. I have no control over the past nor the future.

I tell myself I can still turn this around. That it isn't too late. I can return to health and life. That I have a future. I lean further into David's warmth, wrap my fingers through his thick wavy hair and then drift off.

(Postscript - Today I received word my mammogram showed "several abnormalities" in the right breast. I go see the radiologist tomorrow (July 13). I feel as if God is trying to teach me something ... Hopefully I will hear Him and follow His will.)

Disconnected

I will eventually feel better, right?

Today begins my fourth week at the River Centre Clinic in Sylvania, Ohio. I am trying to learn and grow. I am trying to overcome my desire to dive back into my safety net of anorexia nervosa. I am confronting my demons and anxieties.

BUT IF I HAVE TO EAT ONE MORE BITE OF FOOD I AM GOING TO SCREAM!!!

I feel full all the time and I hate the feeling. My stomach hurts constantly and I am often nauseous. The amount of calories I eat in one day sustained me for more than four days during my most severe restrictive periods. I am eating mechanically; the concept of enjoying food is completely foreign to me. Frankly, I can't wait until bedtime when I don't have to eat anymore.

This worries me. I am still in the weight restoration phase, in which I am trying to reach what both the clinic and my doctor agree is a minimum healthy weight for me. Most likely I will not reach that weight before I return home and thus, I will have to continue to eat that many calories until I do. I also have learned from past experience that as a severe restrictor anorexic, I will most likely have to maintain a higher-than-average caloric intake in order to stay at a healthy weight.

I also hate the inflexibility of meal planning. It causes me a lot of anxiety on the weekends when I bring my meal plans home and have to make substitutions for one reason or another (mainly because our small town's grocery stores lack some of the foods on my weekend meal plan.) It also makes me feel weird to have to take my own food to social functions, like brunch at my brother's last week or lunch at church today.

It makes me feel disconnected from what's going on around me.

That is a real problem. I live in Sylvania during the week and at home during the weekends, and I often feel lost between the two places. One morning last week, I woke up and instinctively reached out for David. I was half asleep and started to panic as my hands couldn't find him. Then I realized I wasn't at home.

It really was the start of a very disconcerting week. Everyone there has their own issues, and sometimes it is harder to deal with some issues than others. I often wished I was a turtle, able to withdraw into a protective shell. I am trying to absorb such things as distress tolerance and mindfullness, or being in the moment.

But sometimes my emotions start spiraling out of control and it becomes hard to calm myself down. My anxiety can reach such a high peak I feel either like I am going to die or I want to die. The only other outcome I can envision in these moments is me literally exploding.

I have decided I need to change some things about myself in order to both recover and live (as oppose to just existing.)

I cannot let people push my buttons. The week also started with an anonymous comment that said in effect that I was not that thin and I am an Ana wannabe (I deleted it, as I will delete all comments that I deem are triggering to either myself or people who read my blog.)

But I allowed that comment to stay in my head and the eating disorder part of my brain had a field day with that, constantly whispering that this person was right and what I really needed to do was go home and lose more weight.

So I veer between feeling disconnected from my body (am I too thin? or do I need to lose weight? who is right? why can't I see the reality of my physical being?) and trying to trust those who tell me I need to remain in treatment and that I have not yet reach a healthy weight.

Trust. Who can I trust when I can't trust my own eyes nor my own thoughts at times?

It's a very confusing time.

604 calories

(Warning - This post could be triggering to those in recovery. Please do not read this if numbers or descriptions of restricting would be harmful to you.)
604 calories.
That is what I consumed yesterday. I made sure I got up too late for breakfast. I had my morning coffee sans sugar. I called myself a pig for drinking 230 calories of heaven in the form of an ice-cold McDonald's orange pop for lunch to accompany my four nuggets (trying to ignore the Happy Meal slogan on the box, which reminded me this amount is meant for a child.) I measured exactly one-third cup of rice and one-third cup of peas for dinner.
I went to bed hungry. I felt guilty because millions of people, in particular children, go to bed hungry without choice each night. And I have a choice. Or do I? Who is in control here, anyway - me or anorexia nervosa?

98.2 pounds.
That's what I weighed yesterday morning. The ritual of the scale hasn't stopped for three years. It's always the same: get up, blurry-eyed and sleepy, then go to the bathroom before stepping naked on the innocent-looking white box which decides each day whether I will restrict or eat. I would like to drop kick my scale across the room, set it on fire, smash it with a hammer or hurl it off the tallest building I can find in this small town. (I have many fantasies of revenge for this hated symbol of my descent into anorexia; I've destroyed several over the years, only to go buy another one.)

I am a hypocrite. For weeks, I have been posting on a pro-ana blog deploring the very behaviors I am doing, trying to convince these young girls to stop and think before some of them become sucked into the hell of anorexia. I tell them they don't want to do this; that anorexia can't be ditched as easily as a bad diet. Several others also have posted on this particular site and one woman (Marge of Lake LaBerge) was particularly blunt with them, calling them (freaking) morons and telling them they will look worse than the heroin junkies hanging out in her Vancouver neighborhood.

So why can't I stop doing this to myself? I am the freaking moron. I worked so hard last year to gain weight. I had to consume about 3,000 calories of food and Ensure to reach 110 (which still is too low, but much healthier I was.) It was sheer hell; the whole refeeding process was one of feeling bloated and fat and moody and I could hardly stand myself.

I ended 2009 with the incredibly positive post, "Leaving ED- one year later." "I dream of the future, one filled with love and teaching and writing and learning." I thought I had it all wrapped up. I thought 2010 would be the year I would conquer all my eating disorders fears and behaviors, and put the whole damn thing behind me.

Things starting falling apart by January 2. Happy Freaking New Year's! My words and my hopes make me want to throw up. I try to help others and support them when they are struggling,

I called The Renfrew Centers after my one-week IP stay in February. I tried to eat more after I was discharged, but soon ditched that plan when David went to Florida for two-weeks (Ana was just ecstatic about this, rubbing her hands with glee at the thought of restricting and cutting and oh my!) and haven't stopped restricting since. I am convinced if I don't do something more, my next trip to Beaumont Hospital will be to the morgue.

I have completed my assessment and plan to be admitted to Renfrew's 30-day treatment program (so sorry, insurance doesn't cover residential) the second week of May. The program is designed to help me overcome my fear of food and weight, and then dig a little deeper through various groups and programs. The idea is to teach me healthy coping skills to replace my all-time favorite, restricting.

So if I am doing this (and borrowing thousands of dollars from my father to pay for my living arrangements), why have I been trying to basically destroy myself the month before I go? To prove how sick I am? To make sure I am at a low enough weight so any gain will feel less traumatic? To sabotage any chance at succeeding?

Or because deep down I am a hypocrite who really doesn't want to get better? Am I really pro-recovery? Or has my past associations with pro-ana sites and my current campaign to convince a few pro-ana girls triggered me? Am I falling again for the message that I need to be thin, so thin you can see my ribs and clavicle and protruding spine? So thin that it hurts to sit in most chairs?

So thin that I get sick again? Is that I want? To become so sick I can't go to Renfrew? Why do I try and sabotage any attempts at recovery? (I've done this for years. I continue "Bargaining with Recovery.")

Am I a hypocrite? I've always tried to be honest here. But I can't yet write about what is underneath the anorexia. Exposing the roots would be too much, too violating. What's underneath, at least as far as I have explored with my doctor, feels dirty and slimy and too ugly to ever trust telling anyone else. And I can't seem to stop restricting, especially after we talk about what's underneath; what might be the root causes of me developing anorexia.

590 calories.
That's what I consumed today. I want to go lower, but I know I need to go higher.

Who is in control here, anyway? Because right now, I feel out-of-control.

Haiti

My heart is broken. I went to Haiti when I was my sickest - about 92 pounds. Now everything I knew there is destroyed, and I don't know if the children I held are dead or alive.

I wasn't suppose to go to Haiti. My doctor told me I was too sick. My mother cried and begged me not to go. But I felt Haiti calling me ...

And in the end, Haiti saved me. The children there were honest, and told me I was too thin. The pictures of me shocked me, and helped open my eyes to what anorexia was doing to me.

Here are a few pictures. I am very proud of them, because it shows that I went outside my eating disorder and was still Angela underneath the bones and the unrelenting obsession with food and calories and weight. I was still me, and anorexia had not stolen my love for people and helping them. I just wish I could have given Haiti more.

My body I hate

As I move through recovery in fits and starts, I find my body doesn't fit me anymore! My jeans are too tight. My jeans are too baggy. My underwear rides up or sags down. My sweaters either make me itch, choke me or squeeze me. If I could, I would wear a loose toga, draping my body in soft cotton comforts as I go through the process of adding weight to my skinny little body.

Maybe there should be specially made clothes for those recovering from eating disorders. Loose, comfortable clothes that don't cause one a major anxiety attack when the number goes up (or down), one that doesn't cause choking breathes when the waistband pinches. In other words, one that doesn't remind us we are in recovery; clothes that don't point - I have an eating disorder I'm desperately trying to beat.

This body of mine feels foreign - I look in the mirror and it's either too thin (arms spindly, chest caved in, breasts soft, clavicle showing, butt nonexistant) or too fat (oh my God, those thighs spread to Europe! that stomach looks like it either has a baby or 10 pounds of gas in it!) Where is the smooth curve of my concave stomach? I can still see my ribs and the bony knobs along my spine - but look! are they being enveloped in, I can't believe it, something resembling roundness!

I miss the body anorexia gave me; and I mourn it's loss. I miss loose fitting size 0 jeans and T-shirts. I miss putting on anything, knowing it wouldn't - gasp! - feel too tight. I miss gliding through life, knowing I was small and light and airy. I long for the empty feeling inside, that cool, clear and light feeling; it was safe, even as it was deadly.

I avert my eyes, walk upstairs and go through the long process of trying to clothe this foreign beast of a body. I long to live in Tahiti or the Bahamas, anywhere I can drape a loose fitting summer dress and feel more fluid, more like me.

The anxiety of this new, and hated, body gets to be too much. I can only escape its confines when I sleep.