Last week I saw an Eating Disorder meme which indicated a person thought they were Anorexic yet had a BMI which put them into the obese category. I know most of the people following this blog have EDs thanks to my totally awesome survey but I’ll just break it down for people who might not be familiar with BMI.
BMI (body mass index) uses a person’s height and weight to calculate whether a person is at a healthy weight. Below 18.5 is underweight, between 18.5 and 25 is healthy, 25-29 is overweight and over 30 is obese.
I love Eating Disorder memes but it seems there are a lot of opinions flying round between ‘wannerexics’ (wannabe Anorexics), people offended by parodying Eating Disorders and now, apparently, obese Anorexics.
I was torn when I saw the meme and read the responses. On one hand I completely understand what’s funny about it. From the aspect of the diagnosis for Anorexia Nervosa in the DSM which requires a person to be underweight and have a pre-occupation with losing weight despite being underweight, it does seem kind of silly. It’s pretty clear by the DSM that a person should not be diagnosed Anorexic if they are a healthy weight, let alone classed as obese.
As well as these body and weight requirements, an Anorexic must restrict or binge and purge. So if a person is obese, surely they can’t be restricting or binging and purging to the extent required for a formal diagnosis. After all, people suffering with Bulimia Nervosa often stay at a healthy weight according to BMI, despite unhealthy behaviours.
As well as these medical requirements, I think it’s difficult to ignore the impression the media gives us about Anorexia. There are countless newspaper articles and programmes about Anorexia, focusing on the most extreme cases, showing before and after pictures. I can understand why the media does this; it is fascinating to see a mental disorder written all over someone’s body, such as Georgia Davis.
However, I can also understand how someone may think they are Anorexic with a BMI of over 30. For years before I realised (was told by a counsellor) that I had EDNOS (not as represented in the DSM, but I think a way of acknowledging that I had a mix of Binge-Eating Disorder and Compulsive Overeating, thus allowing me to have CBT) I connected with Anorexia in a way I can’t explain. I was fascinated and envious, not in a wannerexic I want the gap between my thighs (Ha! Try telling my thighs that. All they seem to want to do is huddle together for warmth) but I was envious because we seemed to have the same fear of fat, and yet they were reaching their goal weight and I was not. I hate my body, despise it, it’s fat and worthless. I wanted to starve myself, I actively restricted and lost weight but then binged it all back on. I didn’t think I deserved food because I was fat, so food became a comfort – I’d comfort my hatred of my weight with food. Because Eating Disorders make so much sense.
So I wanted to be Anorexic, not as a diet, but as a way of punishing myself instead of bingeing.I wished I could switch Eating Disorders. I was so out of control with binge-eating, being in control healthily didn’t do it for me – I wanted to have complete, unwavering control. I saw it as if I was going to have issues with food, I might as well have Anorexia. Again, Eating Disorders make so much sense. I think, thanks to the infamous (in my mind) Doritos, dip and chocolate binge which made me vomit for hours, I knew that I had an irrational love/hate relationship with food, but I didn’t know about Binge-Eating Disorder or Compulsive Overeating.
I thought there were 2 eating disorders – Anorexia and Bulimia. I didn’t throw up after I ate (this was my understanding of Bulimia at the time) but I did restrict.
The only problem was – and I now know this – I hated the feeling of my stomach being empty. I still do, to a certain extent. Part of me feels empty and hollow, but the other part can feel the stomach rumbles and I feel a sense of pride, like I can feel my stomach eating itself (bear with me) and that means I must be losing weight. Losing weight = happiness in my mind so, it’s sort of a good.
I find a lot of my disorder is very conflicting:
I want to lose weight: I overeat.
I want to starve: I binge.
But I have a diagnosis now, I understand my disorder much more and I know I’m not Anorexic. I would never have called myself Anorexia, I knew I wasn’t, but I did feel a strong connection with it – I could understand why a person would do these things to themselves, because of their low self-esteem, their fear of being fat.
I think there are some people out there clutching at straws to understand their minds – why do I feel this way about food?! I’m so fat and I hate it, other people have lost weight and kept it off, why can’t i? Is there something wrong with me? People don’t eat a family size pack of Doritos and dip and stuff in 2 big Dairy Milk slabs of chocolate as well. Tomorrow it all stops. Tomorrow, I starve.
Although obese Anorexics might be difficult to understand, and I don’t think you can have an obese Anorexic for long (obviously… they’d lose weight) but I hope this gives an insight into how devastating the lack of information is about Binge-Eating Disorder and Compulsive Overeating is. It can cause you to misdiagnose yourself, for need of some understanding of your problem.
What do you think? Do you agree that a diagnosis is an important first step in battling your disorder? What do you think of obese Anorexics?