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I had an eating disorder that wasn't easily classified. Here's why you shouldn't ask someone in recovery which disorder they had.

Brooke Metz   

I had an eating disorder that wasn't easily classified. Here's why you shouldn't ask someone in recovery which disorder they had.
  • After I share that I'm in recovery from an eating disorder, people often ask me which one I had.
  • While I was diagnosed with anorexia, it sometimes presented as bulimia.

Sometimes when I disclose my struggles with eating disorders, an unfortunately common follow-up question is "Which one?"

The spectrum of eating disorders spans much more than people realize. My official diagnosis, for example, is anorexia, which for me presented as severe restriction and anxiety around food. But at the worst of my eating disorder, my symptoms aligned closely with bulimia: purging episodes, laxative use, and excessive exercise.

While everyone's recovery is different, I don't find discussing my specific diagnosis helpful for a few reasons.

People may feel shame around their diagnosis

While I've recently felt more comfortable opening up about anorexia, I rarely mention bulimia. I thought this was because anorexia was most recent, but my reluctance probably has more to do with my shame around bulimia.

When I arrived at my first inpatient treatment center, I thought I was bulimic. The treatment team told me I actually had anorexia, and I felt pride, which now feels kind of messed up. I didn't want to be the patient who made herself sick; I wanted to be the one who could resist food.

These labels are a waste of time and sound ridiculous looking back. It's embarrassing to say you starved yourself, but it's even more awkward to discuss the binge-and-purge cycle of bulimia. Even with dietitians, I hated sharing which foods I considered "binge foods" yet could easily list the "safe foods" anorexia allowed. I felt humiliated when asked about purging, but I didn't experience the same shame when asked when I'd last had an actual meal.

In treatment we often compare diagnoses and symptoms, but wanting to be the sickest doesn't help. Instead of getting caught up on which disorder I had, I needed to focus on my health.

People may feel attached to their diagnosis

I'll never forget when the psychiatrist at a residential treatment center said he didn't think I was thin enough to have anorexia.

After the meeting, I left his office shaking and crying. It was also confusing, because my official diagnosis was indeed anorexia and I was at my lowest weight. His comments reemphasized the worst: Even at my sickest, it was not enough.

While I would've loved to stop seeing that psychiatrist, because of the residential treatment setting it wasn't up to me whether I saw him, and I had to continue with routine check-ins. Unfortunately, he's not the only provider who's made cruel comments to me. But I reminded myself that the situation was temporary and that I wouldn't always be in a place where people treated me with such disrespect.

Providers should know better when it comes to discussing eating disorders, but friends and family may not. I've found it helpful to educate those around me about what I find triggering to protect my recovery. But the most effective approach has been just ignoring a lot of what people say. I try to remember that a lot of people aren't familiar with what triggers an eating-disorder patient and that they don't mean to offend.

Anorexia and bulimia aren't the only eating disorders

While anorexia and bulimia are often discussed, they aren't the only eating disorders — others include binge-eating disorder and avoidant restrictive food intake disorder. Most of my fellow patients fell into one of the first two categories, but there's a lot of overlap between them, as there was in my experience. The other two disorders matter just as much.

Regardless of how the specific disorder presents, the struggle beneath it remains the same and deserves care. No one should have to feel like their world revolves around food and the anxiety around it.

Now that I know more about these other illnesses, I've realized I likely dealt with binge-eating disorder initially. At the time I assumed I had no self-control around food and needed to lose weight to solve my issues. But using food to cope with emotions is a major part of eating disorders.

Most people in my life avoid the fact that I've had these struggles, but that may be because they just don't know how to approach the subject. Removing the focus on specifics takes the pressure off the patient and the person talking with them. What people in recovery appreciate the most differs from person to person, but I've found that a genuine question about how I'm doing goes a long way.


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