The language of things
Orthorexia nervosa: an obsession with healthy eating with associated restrictive behaviors, which may lead to malnourishment, loss of relationships, and poor quality of life.
Anorexia athletica: the use of excessive exercising behaviors in order to either compensate for eating or give themselves “permission” to engage in eating
I am (and I believe, will always be) in recovery from these two specific mental illnesses, but I did not have the language to name them until this morning. I was listening to one of my favorite humans, Glennon Doyle, talk about her own most recent eating disorder diagnosis, and it got me wondering what mine were called…in medical terms, anyway.
You see, I was not officially labeled with either of these conditions by a psychiatrist, although I have been officially labeled with depression and generalized anxiety disorder. Thanks to Effexor, among several other things, am doing incredibly well managing both.
The seed of an idea that there may be something else going on with me, below the surface waves of my depression and anxiety, was planted by a health coach I was seeing in late 2020 as part of a virtual, holistic, concierge medical service. Why was I shelling-out $300 a month to have 18 vials of blood drawn and analyzed, stool samples collected (and shipped via the USPS!), and sold unnecessarily expensive supplements that were supposed to improve my gut health? Well, I was trying to figure out why I wasn’t losing weight, despite working-out daily and limiting my food intake to 1100 calories, all of which were mostly carb-free and high-sugar-produce free. (You see, earlier that year, in another attempt to lose weight, I had been told by a nutritionist that carrots and apples and sweet potatoes had too much natural sugar in them and should be avoided, and that I needed to basically only eat lean protein and green things. Clearly, she should have been avoided, too.)
Somewhere inside of me, I probably knew that what I was doing wasn’t healthy. But every time I’d tried to change my body in the past—whether it was trying to fit into my wedding dress without spending $600 on alterations at age 24 (and dropping to 98 pounds in the process), or losing the baby weight after my son was born (I did Whole30 for over a year), I had been successful. I am one of those lucky humans (if you want to call it luck) who can set her mind to something, and 99.9% of the time, make it happen. So at the ripe old age of 38, when every attempt at getting back to my size 25 jeans and 102lb badge-of-honor failed, I started grasping at everything and anything I could to fix it.
Or, I guess, fix me.
If I’m being honest, this is not when my orthorexia and anorexia athletica started. My gut and my heart tell me that they’ve always been part of me.
They’re exactly how I successfully fit into my wedding dress back in 2007. I didn’t have a calorie-counting app back then to track my macros, but for months, I dined on a strict regimen of egg white frittata and fruit for breakfast, a small cup of protein soup for lunch, and lean meat and veggies for dinner. I biked for 30 minutes every day, spent another 15 minutes doing crunches, pushups, and weights, and ran 10 flights of stairs in my office building twice a day.
Excess meant success.
In 2014, after my youngest was born, the weight didn’t drop the same way it had with my daughter three years earlier. I embarked on an incredibly long Whole30 stint, making everyone in my orbit insane in the process. I got my weight back to where I felt “healthy,” but still hated the way I looked in the mirror. It wasn’t my weight at this point, but my shape. My stomach muscles had been separated beyond therapeutic repair from my two pregnancies. Apparently, it’s pretty common with petite women who carry all the baby weight up front. But heaven help me, I was not going to let biology win.
Here’s where I admit the thing that only five other humans previously knew about.
In 2015, I underwent an abdominoplasty to have my separated muscles sewn back together, and tighten-up things in general in the process. It’s an incredibly complex surgery with many, many weeks of grueling recovery, limited mobility, drains, high-potency painkillers, an artificially reconstructed belly button, and a pale-peach scar that stretches all the way from one hip to the other. I was so desperate to get my flat stomach and petite body back that I spent $12,000 and 10 weeks of my life in elective agony. If you ask me today if I’d do it again, though…I’d probably say yes.
A few months after the surgery, I was feeling amazing. Like “holy shit, I’m back to myself again!” But in true disordered fashion, that didn’t last. I was supposed to have these incredible washboard abs now, and instead, I felt like I still had a little baby kangaroo pouch right below that artificially-new belly button. I went back to my plastic surgeon to get his take on things, and he assured me that the sweing couldn’t have come undone. His suggestion? Try losing a few more pounds and see what happens.
Mind you, I weighed 102lbs at this point. My magic number! But if a doctor tells me to try something, goddamnit, I’m going to give it my all.
This was the start of Whole30 marathon number 2, which dropped me to 98lbs again, but only made my stomach the slightest bit flatter. This time, I resolved that it wasn’t about losing weight, it was about building muscle! For the next…I dunno, maybe 6 years?…I shifted back and forth between insane workout routines and more insane restrictive eating regimens, all culminating in that fateful day when the virtual health coach told me that she didn’t think the issue was with my physical health, but with my mental health, instead.
As I mentioned, when a doctor or healthcare professional tells me I need to do something…I take it as seriously as a national security directive. Well, unless it’s completely the opposite of what I want to hear, and then I go for a second and third and fourth opinion until someone finally agrees with me.
I guess I was ready to accept that I had some disordered shit going on at this point, though, because I didn’t fight the coach’s insinuation.
I started looking for help.
Admitting to yourself that you have an eating disorder (or a few, whichever) is a little bit like being on The Truman Show, and finding out your entire life is not what you thought it was. Your pride over being small enough to fit into carry-on luggage? Disordered thinking. Your 6-days-a-week workout discipline? Disordered thinking. Your clean-eating-at-all-times superiority complex? Well, that one was easy—disordered thinking all over the place. Everything I had come to embrace as part of my identity wasn’t me. It was my my disordered mind trying to control my already perfectly ordered body.
Fast forward 18 months to today…
past the therapy
and life coaching
and Intuitive Eating work
and body image podcasts
and uninstalling my macro-counting app
and starting to eat carbs again
and giving away my scale
and boxing-up all my “skinny” clothes that no longer fit
and cancelling my Amazon Subscribe-And-Saves for metabolism boosters
and tossing out the laxatives
and going cold-turkey on exercise (I struggle with moderation and tend to be all-or-nothing)…
I am 20lbs heavier and two waist-inches-larger and genuinely healthier than I have been since my college days, when I ate pizza because it tasted good, and exercised because I played hockey.
But this morning, finally having language for what I was battling all those years before—orthorexia nervosa and anorexia athletica—shifted something inside me to an entirely different level of understanding and acceptance.
I am in recovery from something real and diagnosable and documented that has a name, not something vague and amorphous and destructive that was a simply a character flaw.
I feel silly saying that it legitimizes so much of what I’ve struggled with. But I guess, in my mind, at least, it kinda does.
These parts of my journey have brought me to where I am. And while they aren’t the shiniest parts, they’ll always be part of me.
Now I know what to call them.