UGly Parts (content warning eating disorders)
I was standing in the Kramer Books store during the spring of my freshman year at GW, scanning the “Staff Favorites” display, when my eyes stopped on it. A thin, pale, naked woman, her torso crunched and limbs twisting into a knot, graced the cover of the book. In a bold, skinny font read the title: “APPETITES,” and directly below, a quote: “The smartest anorexia memoir ever written and a fascinating journey along the torturous pathways of female desire.” The book was written by Caroline Knapp, posthumously published after she died 2002, only months after being diagnosed with lung cancer. She was 42.
Intrigued – and hungry – I bought it and finished it within days.
The best and worst thing about eating disorder memoirs is their honesty. The sicker the person, the more vivid the disordered thoughts, the better the story. The authors are praised for their ability to recount in horrifying and fascinating detail the art of destroying the body. They’re smart, and like most any one that’s suffered from an eating disorder, they’re self-aware. A symptom of eating disorders is intellectualizing every mundane aspect of life in an attempt to somehow control it, and often it’s this high-level interiority that makes the memoirs enticing. But it’s exactly this brilliance, too, that can make writing about an eating disorder almost as destructive to others as the writer’s own issues themselves.
I read Knapp’s memoir and marveled at her discipline and control, how truly smart she was. Whatever redemption arc Knapp narrated lost itself on me, eclipsed by the allure of how she once, cautiously and intensely, starved herself down. Watching her weight drop page by page, I envied her. Eating disorder memoirs, even the best, can become how-to manuals for those already dabbling in the practice of self-destruction.
I wanted to feel how Knapp said she felt, walking past a bakery and passing all of the “normal” people enjoying croissants and scones and turnovers at the outdoor patio. I wanted to write like that, think like that, have some sort of sophisticated way of explaining why what I had been doing for a few months, and the addiction I felt to it, wasn’t just an average diet. I wanted to feel outstanding.
Reading that memoir paved the way (I thought) to reaching some high ground, either a physical, moral, or intellectual one, that it seemed I’d spent the majority of freshman year endlessly climbing towards. When I came to GW, like most first-year college students, I felt like a small, unnoticeable dust bunny being pushed around by a competitive, wealthy, uber-successful Hoover vacuum.
January 17, 2017 Journal Entry
So far, I haven’t been feeling amazing about being back. I was eager to leave home, and I was so convinced this is where I needed to be. As soon as I got back, I realized how out of place and alone I feel here. I don’t have many friends and the friends I do have make me feel shitty about myself. I’m not a good writer and I don’t have a talent. I’m not outgoing, my insta feed isn’t aesthetically pleasing, and I don’t work out as much as I should. I’m looking for a work study job, and I don’t want an internship on the hill or at some government agency. But at GW, I feel like I don’t belong if that’s not what I’m going for. The other night (redacted) & (redacted) said they both won most likely to become president in high school. That’s not me. I don’t feel like I’m as good as these people and it’s starting to show. I wake up in the morning and I want to be back home, something I’m terrified to admit to anyone here. I feel like a failure in all aspects. I want to cut again. I hate myself and every day it’s just another day of being forced out into this environment that makes me feel even worse. My NY resolution was to be happier and more positive, and most of all stop hating myself. It’s been tough so far.
I remember standing in line at the printer in the Thurston basement, and noticing the girl’s backpack in front of me. I don’t remember the brand name, but it was leather and boxy, with little “M” logos all over it. I had seen them all over campus, so I Googled “leather backpack M logo brand,” just like months before, I’d googled “black jacket goose logo?” The backpack was $700. (!) I grew up in a middle-class small town where wealthy meant your mom or dad worked for the local chemical engineering plant and maybe drove an Acura instead of a Subaru. My high school was a run-of-the-mill public school with giant graduating class, where normally one or two kids made it to an Ivy (and when they did, they usually got a profile in the local East Penn Press.)
I never really thought any of these things mattered, or thought much of them at all, until I came to GW. I didn’t think anything of the fact that I’d never travelled beyond the East Coast, much less left the country, or that my dad was a truck driver, or that I considered Olive Garden a “a special occasion” restaurant (I still do!) It’s tricky to explain feeling ashamed about these things while also acknowledging the immense privilege I grew up with. Even writing it out feels tone-deaf – “white girl complains about elite university.” I had a bedroom of my own growing up, took piano lessons, vacationed at the beach for a week most summers, and had two parents that were still together. But between graduating high school and spending my first few months at GW, I developed an insecurity towards everything about me, where I lived, what my parents did, what I liked to read, the music I listened to. It all screamed “normal” to me, in a place where I maybe overdramatized the pressure to be exceptional. My body and what I did or didn’t put into it became a way to be better.
Knapp’s words served as a road-map to get to that place of superiority I sought after. The more drastic the symptoms of her disorder, the more convoluted her thought process, the more I wanted to embody that. Her book sat in my head more as an elegiac ode to the absolute absurdity of her illness than a cautionary tale to dissuade me from my own nascent, anorectic behavior.
t’s a bit meta to be critiquing an eating disorder memoir as I draft what feels like a miniature version of my own – but that’s the thing about eating disorders, trying to write about them, and why people want to read about them. Eating disorders function solely through overthinking, questioning every fleeting thought of desire and agonizing over it until one part of the brain – the one consumed by rigidity, or the one that’s begging to keep the body alive – wins out. It’s hard to maintain an eating disorder without being completely self-absorbed, and maybe this is why they can transfer onto the page in a way that’s interesting to read, especially those seeking some sort insight into their own twisted thoughts. I was pouring over the pages of Appetites anxiously waiting to see what Knapp’s new low would be. If I could reach it, it would be another step past mediocracy.
January 29, 2017 Journal Entry
It hasn’t gotten much better here since the semester started. It still feel like a piece of shit all the time, like I’m not a good person anymore because everyone is here is better. I’m not a good friend, or a good writer, or a smart person, or a funny person, because there’s someone who is all of that and some at GW. I just feel so much pressure all the time to be amazing when that’s not who I am. I’m average, not amazing. Fuck the Colonials, I’m over them.
t’s a bit meta to be critiquing an eating disorder memoir as I draft what feels like a miniature version of my own – but that’s the thing about eating disorders, trying to write about them, and why people want to read about them. Eating disorders function solely through overthinking, questioning every fleeting thought of desire and agonizing over it until one part of the brain – the one consumed by rigidity, or the one that’s begging to keep the body alive – wins out. It’s hard to maintain an eating disorder without being completely self-absorbed, and maybe this is why they can transfer onto the page in a way that’s interesting to read, especially those seeking some sort insight into their own twisted thoughts. I was pouring over the pages of APPETITES, anxiously waiting to see what Knapp’s new low would be. If I could reach it, it would be another step past mediocracy.
But what the rational part of my brain knows, and maybe what I am still trying to fundamentally believe, is that there is nothing intellectual about not eating, or eating a lot, or eating a lot and then throwing up. The disordered thoughts, and the excuses, the new lows that are followed by those even lower, are not and probably shouldn’t be written about in some tortured-yet-beautiful way. Everything about an eating disorder is actually pretty ugly, so here are some of the ugliest parts, that ironically have nothing to do with what I look like.
The “rules” of my disorder, which I’ve been forced to write down numerous times in therapy, run pages long. They’re nonsensical, strange, and impossible upkeep while living any type of mentally or spiritually fulfilling life. Inside my head, they’re comforting. But when brought into the real world, social situations, or really any instance that disrupts the disorder living in the brain, they’re awkward, and embarrassing.
The summer after my freshman year, I dedicated most of my brain-power to perfecting the ritualistic habits I’d developed that spring. I was working at my local pool as a lifeguard with a predictable schedule that I could easily craft my disorder’s routine around, while also hiding it from my parents. As I spent between eight and ten hours, nearly every day of the week at the pool, the behaviors didn’t go unnoticed by my coworkers, and they’d drop occasional comments. However most of them just fed the superiority narrative that satiated the disorder. “You’re so good for always bringing a salad!”
At one point that summer, my boss, Alice, and two of the fellow head lifeguards wanted to go to Texas Roadhouse after the pool closed early for a storm. Texas Roadhouse, a chain restaurant that prides itself on its complementary dinner-rolls slathered in vats of butter and heaping sides of mashed potatoes or mac n cheese, was an anorexic’s hellscape. Without an excuse, and after already denying several dinner outings with my coworkers, I went reluctantly, assuming I’d order a Diet Coke and say I wasn’t hungry or that my stomach hurt.
When the waitress came to take our orders, I waved her past me, saying I was “good with just the Diet Coke!” but Alice insisted I order.
“Please no thank you, I really don’t want anything.”
I hadn’t even looked at the menu, but I knew there was no possibility anything would be below my daily caloric limit. Alice turned to the waitress, and said “she’ll just have the same thing as me,” which was (I remember exactly) a chop steak, covered in sautéed mushrooms, onions, and cheese, with a side of fries and green beans. My face hot, I scanned through the sides on the menu looking for the lowest calorie option, the cooked vegetables, and told the waitress I’d have that. She looked uncomfortable.
I don’t even remember what we talked about during that meal. After already having made a scene, and now eating a cup of cooked carrots and green beans as a meal while my coworkers ate full plates of meat and carbs – real sustenance – I felt seen, but in an embarrassing way. I finished the cup of vegetables, and ate half a bread roll to hopefully dispel anyone’s suspicions.
I dropped off my coworker at his house after dinner, and despite having already gone to the gym for a four mile run that morning, I pulled into the Planet Fitness parking lot again. I took my daily laxatives, and pounded out six more miles until the screen on the treadmill showed I’d burned off everything from Texas Roadhouse, and some.
What I thought made me superior, eating the least of every one at the table, denying every social opportunity that has the slightest chance of including food, taking eight bites of a single Wheat Thin to make it last longer, was incredibly weird and embarrassing. It’s ugly and disordered, and doesn’t translate well into some elaborate metaphor about control like Knapp somehow constructed. They’re just problems of the disorder that make it hard to live a real life. The rules consumed me in a way that made my insides much uglier than my thighs or stomach ever were.
The Bathroom Was My Best Friend
Starving and fasting isn’t that ugly. It’s why there’s movies like To The Bone with beautiful actresses in the lead role to “spread awareness,” about anorexia, and low-budget reality TV-shows to make a spectacle of binge eating disorder. For most people outside of an eating disorder world, anorexia means thin (although BMI is not included in the DSM diagnosis), and thinness is applauded. #Thinspo blogs on Tumblr or Instagram (I even think it’s a trend on TikTok now, too), are filled with grey scale images of (usually white) women wrapping both of their hands, from pointer fingers to thumbs, around their thighs. It’s all very beautiful and delicate and romantic.
What’s left out of thinspiration is the binging, the distended stomachs, the sore throats from self-induced vomiting, and the underwear ruined from having an unexpected bout of diarrhea from a poorly-timed dose of laxatives. It’s not romantic or glamorous and no deceptive feeling of “emptiness” can really overshadow the disgusting nature of what eating disorders are, in reality – often a series of physically repulsive behaviors.
July 13, 2017
It’s hard not to take them now, especially if I feel like I ate too much. I take them at night, so that at around 6 a.m. I am woken up by cramps. I’m writing now as I’m cramping.
July 14, 2017
I stopped writing last night because the cramps hurt too bad. I know I shouldn’t be taking them. When I’m hunched over my knees shake and my toes start to tingle, and I think this isn’t how it’s supposed to be. Every day I say this is the last time but twelve hours go by and I eat and don’t feel light anymore and all I want is to flush the shit out of my system.
A week or so before I left to return to GW for the fall semester of my sophomore year, my family went to the beach for a week, like we have for nearly every summer I can remember. Not wanting to switch up my routine for an entire seven days, I stayed home for three, and joined my family for the latter-half of the week.
Now having to share a bathroom with my parents in a tiny-but-charming beach house in Virginia, my laxative routine was upended, and I lost complete control of my pooping schedule. I was no longer “going” right when I woke up in the morning, and the fear that the pills may not be working properly only led to me to consume more throughout the day. (Laxatives don’t actually lead to weight loss.)
I sat on the beach during that vacation with my shorts and t-shirt on, a towel wrapped around my midsection, refusing to reveal how bloated my stomach had become — a side effect of laxative abusive. I made the trek across the sand multiple times a day to the parking lot Port-O-Potty, where I’d sit for sometimes half an hour, doubled over in cramps, as straight liquid poured out of me.
Forcing it out the other way, isn’t much easier to stomach (pun very clearly intended). Throwing up is the characteristic behavior that typically defines a bulimia diagnosis. When I was using laxatives, I thought purging was only the act of self-induced vomiting after consuming a significant amount of food. I vowed, at the beginning, that I’d never stoop as low as I imagined the images of purging in my mind — creeping around a kitchen late at night, plastic wrappers and plates and napkins scattered about a bedroom like a tornado of junk food and processed carbs had uncontrollably swept through, then kneeling before a toilet to erase the damage. This notion of superiority within eating disorders is common; those with consistent restrictive behavior often feel as though they’re higher on the eating disorder hierarchy than those who “lose control” in a cycle of restricting, binging, and purging. (This sentiment has been explained to me by the E.D. professionals I’ve seen.)
But bodies are much smarter than I think I ever knew, and after my first five to six months of intense restriction came the uncontrollable waves of non-stop eating. Still functioning within the framework of my rules, I was too scared to eat filling foods, like pasta or pizza or fries, so I’d pour five bowls of low-calorie cereal, mechanically eat four granola bars, plow through an entire sleeve of rice cakes, and then repeat the sequence, until my stomach bloated to the point that I couldn’t stand up. I needed faster relief than laxatives, so I started throwing up. The need to look beautiful or delicate or small or whatever false line of thinking I followed necessitated the ugliest behaviors – shitting my brains out and washing vomit out of my hair.
None of this made me more desirable, or virtuous, or beautiful, and it didn’t make me thinner either. I was emotionally and psychologically dependent on the emptiness that came after the pills had run their course through my intestines, or after I watched my bran flakes swim down the toilet. But stripping away that twisted dialogue in my head, I wasn’t doing anything poetic or delicate. I wasn’t infinitely more interesting because I could give myself explosive diarrhea. I was literally just spending hours on the toilet getting hemorrhoids and bruising my knees from kneeling on a tile floor. My face would often be beat-red and swollen. That all wasn’t pretty, just ugly.
I Messed Up My Insides To Make a Better Outside
In one of my first sessions with my therapist in D.C. – the one I’d started seeing in the fall of my sophomore year, I learned about the Minnesota Starvation Study. Conducted in 1944 amidst World War II, researchers studied the effects of starvation on 36 young and physically and mentally healthy male volunteer subjects. For a 12-week control period, the subjects ate a normal diet of 3,000 calories per day. This followed a six month period of semi-starvation, where the men’s intake was roughly slashed in half – 1,570 per day. (Many famous diet plans for women have recommended a daily intake of much less). During the starvation period of the study, three men ended up dropping out.
The researchers noticed profound results of the semi-starvation diet on the men’s minds and bodies, many of which my therapist, Heather, noticed I often brought up in our sessions. The subjects demonstrated an abnormal and consumptive obsession with food. They poured over cookbooks, discussed recipes, and fantasized about feasts and dense spreads. Several of the participants took up smoking, most all of them drank coffee continuously throughout the day, and some chewed up to 30 packs of a gum in a single day until it was banned from the study. When meal times came, the men were irritable and demonstrated idiosyncratic behavior with their food. Pouring water over their potatoes, cutting up their food into the small bites, holding food in their mouths before swallowing — some took up to two hours to finish a meal. Their sex drives, intellectual capacities, and ability to find pleasure in anything outside of meals, disappeared, and overall muscle strength deteriorated.
“Stayed up until 5:00 A.M. last night studying cook-books. So absorbing I can’t stay away from them.”
-Participant during month 5 of restriction
Heather told me to research this study not only to provide me with an explanation of why my brain felt the way it did, but also to show me what happened after these men stopped “semi-starving,” on the restricted diet. They were refed over a period of 12 weeks on a “restricted rehabilitation diet,” which consisted of four different subgroups, each with a different caloric increase. While they began to physically recover, the preoccupations around food remained consistent. It wasn’t until men were set free, released home to feed themselves, that the men binged, fully restored weight (some overshot their starting weights), and felt as though their brains had returned to “normal thinking.”
For 1944, this study was decently ground-breaking research, but in 2020, most of these finding might be “duh” realizations. “Hangry,” (the crankiness of being hungry) is a cute design screen-printed on cringe-worthy t-shirts, and overeating after a diet is harmlessly known as falling off the wagon. But the nuances of the participants’ behavior – drenching potatoes in water, taking over two hours to finish a meal that could probably be eaten in 20 minutes – are anecdotal manifestations of the way a starved body and a shrinking brain work to keep a person alive.
In my attempts for self-improvement, I actively destroyed the one thing I needed to be a human – my body. When in “starvation mode,” the metabolism slows to preserve the little energy it receives, and the brain shuts down its normal communications to the rest of the body telling it to eat. The heart rate decreases to preserve energy, and the production of the hormones needed for ovulation in a woman stops. It’s a strange and probably overused irony in eating disorder recovery that the supposed “better” body on the outside is a dying body on the inside, but in simplest terms, that’s what it is. The feeling of achievement that came from reaching those markers of my illness came from a brain that was just as sick as the rest of me. I remember when I saw that my Fit Bit said my heart was beating less than 50 times per minute one night during my relapse, (I normally have a high heart rate between 80-90), I thought about Knapp. She had once gone to the doctor and had a heart rate of 48 bpm. I thought I’d earned a gold star, I guess forgetting that Knapp also ended up dying at age 42.
“Today we’ll have menu No. 1. Gee, that’s the smallest menu, it seems. How shall I fix the potatoes? If I use my spoon to eat them I’ll be able to add more water. Should I make different varieties of beverages tonight? Haven’t had my toast yet today. What kind of sandwich could I make? Maybe I’d better write these ideas down so I don’t forget them. If I eat a little faster the food would stay warm longer - and I like it warm. But then it’s gone so quickly…”
-Musings of a participation during restriction.
“Fuck Thoughtful Thursdays. I am constantly trying to pick which options are the lowest. At first I picked two pieces of cinnamon raisin toast and cottage cheese and a pear. But then I saw Paige eating cereal and I really wanted it. So I went back and decided to get cereal even though the yogurt to go with it is 170 calories, which is more than the cottage cheese. Now I’m nervous for weights tomorrow. I will probably not finish lunch and restrict at dinner.”
-Musing from journal during day treatment.
I was 19 the first time I saw my Dad cry. He’s always been, for lack of a better term, emotionally illiterate. Any negative emotions – sadness, stress, frustration – are usually channeled into angry outbursts in lieu of tears. He lost both of his parents when he was a teenager/in his early 20s and lost touch with his two brothers, so I think his emotional capacity stunted after that. Growing up, if I was crying, he gave me a hug or left me to be alone with my mom, who knew what to say and how to handle everything. She’s a nurse and knows how make things feel better.
It was the fall of my sophomore year, and my parents had come down to GW for a weekend. I’d just walked out of my dorm building to meet them on the sidewalk after they drove down from Pennsylvania. They were also meeting my therapist, Heather, that weekend, because she felt that I couldn’t be trusted to give them accurate information about our meetings. Heather needed the three of us (me, my mom, and my dad) to agree that if I didn’t gain weight I’d go to a higher level of care.
He walked up to me for a hug on the sidewalk, and choked out something about my arms as he grabbed them. I don’t remember saying anything, but I remember thinking I should’ve worn a sweatshirt. My mom, awkwardly hovering three feet behind him, mumbled something like “I told you not to do this.” I pictured them driving down together, my mom prepping him on what to say when he saw me, like a doctor leading a family to the bed of a critical patient, “just so you know, they’ll have a lot machines hooked up to them,” except I was the thing making me sick.
October 10, 2017
My parents visited this weekend and when my dad saw me he started crying. He grabbed at my arms and shook them while his voiced cracked out “you’re so skinny.” I didn’t know what to do. I hate that I’m doing this to them. I have until November to gain ** pounds before November or Heather will put me in a 9-2 program. I don’t want to leave but I also don’t want to gain weight either. I really have been trying to eat more but everything is scary. Eating before 11 am, carbs and meat and cheese are monsters. I’ve like penned this rule book for myself. Don’t give in. Keep control. Sometimes I want to give in and just binge until I never want to eat again. It’s like I feel the “binge beast” creeping up inside saying “eat another bowl of cereal.” If I let it win I’ll lose control.
That weekend we sat in Heather’s Dupont Circle office as she referred to me in the third person, as if I wasn’t sitting there on her couch between my parents. “Colleen may be deceptive.” “Colleen will need a lot of support.” “It’s rare that a case like Colleen will recover outpatient.” She recommended them books to read about eating disorders, and how to deal with a kid that has one. I was as much their patient, it seemed, as I was Heather’s.
During the years following that weekend, every trip home, holiday, and meal time hung about with our house with muted apprehension from my parents. They tip-toed around, weighing whether they should tell me to put more food my plate with the risk of a potential meltdown. Over Christmas break my sophomore year, I was forced into a day-program about an hour from my house, with my parent’s agreement that I couldn’t return to school for the spring semester unless I went through four-weeks of intensive outpatient treatment and gained weight. A few days before Christmas, the nutritionist at the center called our house to tell them my weight went down two days in a row.
My mom was making pasta for dinner (a challenge), and my dad had answered the phone. After he hung up, he walked to the garage, came back with a chocolate Boost in hand, and slammed it on the counter, screaming “drink it!” I proceeded to eat my pasta an hour later while crying, my dad eating in his room, and my mom across from me dabbing her face with her napkin. A week later, a similar scene unfolded, and my Dad sat with his head in his hands at the dinner table, asking why I couldn’t just “eat the fucking lasagna” that I was picking apart in front of me. My mom blew up at him for being insensitive, and he blew up for not knowing “what the fuck they’re supposed to do,” and I still sat there, picking at the left-over Christmas lasagna.
I don’t blame them for their behavior, or how they responded to mine. They tried to understand it and did all of the things I think good parents do. They read all of the literature Heather gave them and sat in on all of the family therapy calls, but there’s no convenient how-to manual that can teach a parent how to start re-feeding their then 20-year-old daughter.
During a family group therapy session while I was in residential treatment, a few months after that Christmas, my mom asked the therapist what she and my dad did wrong. She felt that everything was somehow their fault. My dad, following her, said he felt guilty for “not fixing it.”
And among all of the things I’ve done to them, screamed at my mom for buying the wrong low-calorie yogurt, lied about “just being in the shower too long,” ruined Christmases and birthdays and vacations, the ugliest is making them both question everything they did for me.
They never pressured me, made me feel less than, or created this approval-seeking complex that my eating disorder fed on. They never taught to me feel anything short of worthy; my dad always rested his elbows along the fence at the finish line of the track, even though the 2-mile was the last event of every meet and he usually had to go into his work shift at 2 a.m. My mom sat through every one of my painfully boring clarinet and piano performances since fourth grade. Never once did they berate me for a bad grade, and I don’t even know if my mom knew the log in to check my grades in high school. There were no comments about food, or what I looked like, or what I wore, or any seed they planted that made me feel like I needed refinement, or like I wasn’t enough.
And yet there I was at GW, a school that they sat through hours of planning and financial aid advising meetings to send me to, resenting the “average” place we came from. There I was, sitting at a meal my mom had made to help me get better, actively rejecting her, yelling at her for cooking it in the first place. Thinking about that, and writing it down, makes me feel more disgusting than I think any binge probably ever has.
The Real Ugliest Part
What makes writing a cohesive narrative about eating disorders hard, and often makes my own feel ingenuine, is that the narrative arc is nonexistent, and the timeline is messy. I can’t follow a smooth upward trend of healing and weight gain, or plot months of treatment against a similarly rising slope of mental and physical improvement.
Going away to residential treatment, for me, was not a climactic part of my story, and the years after my stay at Renfrew Center weren’t a series of a falling actions that resulted in a conclusion of triumph and victory over the illness. I’m not sure if that’s how it worked for any of the women I’ve been in treatment with either.
I was one of the few women out of the 30 or 40 of us there that was in her first residential stay. One woman, Mary, was 42, and it was her eighth or ninth time in residential treatment. Aside from constantly stirring up drama in the dining room and picking fights whenever there was nothing good on TV, the most annoying part about Kelly was the way she touted around her various treatment stays as trophies of her illness. She was her therapist’s only assigned patient, a fact that she joked made her “the craziest out of all of us.” Eating disorders are notoriously competitive, but that drive to be the best at being the worst amplifies when 30 people who all secretly want to be sickest are stuck in one place. It’s good we have each other, but treatment can also keep people trapped. Kelly arrived a month before me, and I’m not sure how long she stayed after I left. I don’t know if she ever went back either.
When I withdrew from GW to go into treatment, I was actually at a healthy weight (after months of secret-binging with damage-control-purging) than I’d been since I started restricting. A majority of the residents there, like me, were actually visibly healthy weights. None of them had linear progressions of their illnesses that followed a downward trend in weight, and that didn’t make them any the less disordered or sick or hurt. Their stories, like mine, are probably confusing and muddied, filled with peaks and valleys, two steps forward and ten steps back.
The youngest patient in Renfrew with me, Rebecca, became a close friend during my stay. We both discharged on the same day, and I ended up driving her back and forth from our step down program in the weeks after residential. She’d stay at my house after treatment, often not wanting to go home right away. Rebecca, who had just turned 15 before her stay in residential, has diabulimia.
If anorexia is the poster-child of eating disorders, and binge eating is the forgotten middle sibling, diabulimia is the long-lost cousin that no one in the family even knows exists. People with diabulimia are diabetics who stop taking their insulin to lose weight. When insulin is not taken, the blood sugar their bodies can’t break down is released through urinating, often leading to rapid weight loss or diabetic ketoacidosis. Rebecca came to Renfrew directly from the hospital, where she had stayed for three weeks after passing out during the middle of her high school field hockey game.
During that month and some weeks in treatment, I watched Rebecca sit at the nurse’s station, getting her hand bandaged after she’d punched a brick wall outside during a walk in a fit of rage. I watched her sit in the singular chair next to the common bathroom where nurse’s sat while they monitored someone’s bathroom break, rocking back and forth and hyperventilating. She had frequent panic attacks, and often had the phone taken away from her when she would get into screaming matches with her mother on the other line. She was caught several times falsely recording her carb counts in order to receive lower levels of insulin.
I also saw Rebecca cause the entire dining room erupt in laughter, run about the first and second floor yelling that the new Jersey Shore episode would be on in five minutes and everyone must convene in the DLR, and push herself down the hallway in one of the stray wheel chairs that lingered near the nurses station before a counselor stopped her. Her bandaged hands and scary panic attacks looked wrong attached to this girl, still a kid, in this place that she didn’t belong.
Rebecca discharged when her insurance ran out, on the same date as me, and continued to struggle throughout day treatment before she was discharged for being non-compliant.
This past October, I was scrolling through Instagram before bed when I saw a picture of a resident, Holly, posted by another girl we’d been in treatment with. Holly was Renfrew’s in-house make-up artist, scheduling appointments in her room whenever a resident was leaving on pass for a meal out. She also played piano, and Renfrew allowed her parents to drop off her keyboard a week into her stay so she could play it in her room.
The caption under the Instagram photo of Holly read something along the lines of “rest easy angel.” I immediately Googled Holly’s name, and found her obituary. She had taken her own life the day before, alone in her freshman dorm room at Texas State University. She was only 18.
For Holly, and Rebecca, and Jenna, and Catherine, and Mary, and all of the other women that were sick before Renfrew and still sick when they left, their narratives aren’t palatable feats of redemption. Behind the extremes that we (ED patients) often wear as medals, is the nonnegotiable fact that Holly died, that Jenna, a young mom, has left her son three times in the two years that he’s been alive to seek treatment, that Rebecca has already spent half of her high school career in and out of hospitals and treatment centers.
These are, I think the ugliest parts of any eating disorder, the way it drains a life out of someone. What I was doing, or what Rebecca and Jenna were doing and maybe still are, isn’t making us special, or extraordinary, or interesting. It’s not making us memoir-worthy. It’s just making us sick. Holly is isn’t here anymore, Caroline Knapp isn’t here anymore, and another person every 62 minutes isn’t here anymore as a result of an eating disorder.
The memoirs I would hope to read instead, and would find more extraordinary, would be Rebecca’s about helping raise her nephew, or Jenna’s about being a single mom, or maybe even mine, about literally anything other than being hungry. A good title would be, “prettiest parts,” I think.
All names have been changed to protect other's privacy.