Illness Without Diagnosis: Was I Really Anorexic?
I remember vividly the first time I was called fat. I remember the name of the person who said it, where it was and what I was wearing. We were having a kickabout in the park, and a lad who I used to play football with said pretty much word-for-word; ‘You used to be really good at football, but now you are just fat.’
It hit me suddenly, like a head cracking into a doorframe you didn’t realize was so low. At that point I had never thought of myself as fat, I was just an 11-year-old kid playing football in the park with his mates. It may seem dramatic, an overreaction the size of Belgium, but looking back my entire conception of self was changed with that throwaway, if brutal, comment.
The Puberty Expansion
From the ages of 11–14, I gained a lot of weight. This was mainly due to poor diet; my Mum worked late nights and given I was only 13, my cooking skills were not exactly Gordon Ramsey level. They were only marginally better than chippy and cafe owner Ian Beale from the British TV soap Eastenders. This meant I ended up eating a lot of ready-meals, especially chicken nuggets and curly fries, and I had a John Keats-intense love for all things sugary.
I was a very non-sexual teenager, which except for a long-term relationship, has somewhat carried on into my adult life. I didn’t kiss anyone until I was 16. I considered myself an ugly, fat, spotty, weirdo and had an almost sickness-inducing anxiety at any social interaction, especially with girls.
I slowly became disgusted with how I looked, afraid to look in the mirror and terrified at the thought of having my top off in public. I became panicked buying food in front of people, worried they were judging everything I ate. This anxiety continued through my 20s; I have literally hidden from some of best friends in supermarkets for fear of them peeking into my basket.
In my mind, my lack of sex was completely down to how much I weighed, that any right-thinking person would be appalled at the idea of my belly.
The Second Year Shrinking
During the second year of university, this years-long toxic mess of body image issues finally burst forth and my weight became the overriding obsession of my life. It started by skipping occasional meals, which then grew to eating once on a good day. I started extreme calorie counting, knowing by heart the intake of a single piece of bread or a single tomato.
The scale in my shared bathroom soon became my constant companion. I would weigh myself at least 20 times a day, each time a digit was removed from the scale it sent a surge of joy through my body I had barely experienced before, like the first time you heard the riff of ‘Just Like Heaven’.
At the start of this period, which lasted approximately a year between 2012–2013, I weighed roughly 13–14st (83–89kg) and at my lowest I was 7st 3lb (45.8kg). Half my body eroded, lost not to sea but the blank expanse of an empty plate.
I used to stand in front of the mirror, watching myself contract inch-by-inch. I thought I had never felt so happy or looked so good. The further my ribs protruded out, pushing firmer against my skin, and as my stomach became flatter and flatter, I became convinced that a sparkling coat of beauty was covering my body.
No Diagnosis, No Problem
I never sought out any medical help for my apparent anorexia nor my debilitating clinical depression, which had caused me to fail my second year of university. I had an utter conviction that I was not ill, so why would I need help? This was what I wanted, I wanted to be as thin as possible, to make barely a blemish in the world. To me, thinness would lead to an El Dorado of sex and happiness, and I would be freed from the shackles of being me.
Anorexia is almost unique in its ability to distort a person’s worldview without lost lucidity, deforming it until the reality of their choices is long lost. As I grew thinner and thinner, I remember a friend begging me to start eating again. My response was simple: ‘I don’t need to eat.’ As Jenny Stevens, Guardian editor and anorexia sufferer wrote, ‘restricting what I ate made me feel invincible: if I could conquer this basic human need then I wouldn’t need anything or anyone.’
As I never sought medical attention, I obviously never received any diagnosis. This, in some ways, has haunted me in the years since I recovered (except for an eight-month relapse during a particularly bad depressive episode, I have never starved myself again) and cast doubt on the legitimacy of my claim to be anorexic.
I Was Anorexic. (I think).
By any objective measure, I was 100% suffering from anorexia during this period. According to a set of guidelines written by the NHS for diagnosing and identifying eating disorders, my symptoms qualify for 16 out of 22 diagnostic criteria. Had I actually sought treatment from a GP or an eating disorder specialist, it is hard to imagine I would not have received a diagnosis of anorexia.
Yet to this day, doubts still gnaw at the back of my mind. Was I really that ill? Given the speed of my recovery, which only took a couple of months following a literal intervention from my friends, is it grandiose for me to claim this label? Am I hoisting my experience atop a flagpole where it does not belong?
For me, the lack of diagnosis will always cast a faint shadow of suspicion over this period. I can never fully commit to saying I was anorexic; I always hedge it by saying I’m using the word as an adjective rather than a clinical term.
Given the average waiting time for access to NHS mental health services is three months (with some people waiting an astonishing FOUR years), a lack of diagnosis is inevitably going to impact many people. Without a diagnosis, you can fall back into internalizing society’s age-old prejudices against mentally ill people — that it doesn’t exist, that you aren’t ill, that you are wholly responsible for how you feel. In some cases, diagnosis can give validation to their feelings and symptoms, allowing them to accept they have an illness and begin rejecting the idea that their current state is a result of personal deficiency.
Of course, diagnosis can be negative, particularly if administered poorly, and can potentially lead to increased symptoms due to fear and anxiety of what these specific clinical terms mean, and how it might affect them in the future. For me personally, diagnosis has been helpful. When I received my diagnosis of Major Depressive-disorder, I felt something shift — a sense of identity formed, and I had a new language in which to describe myself.
We can sometimes fall into the trap of thinking things published on the internet are scrawled in ephemera, words with the substance of breath on a mirror. But they aren’t, they are printed in bold, permanent ink. So, I will say, without hesitation or hedge, I was anorexic.
Header Image Source: Diana Polekhina on Unsplash