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By cruel design, a person who is in Anorexia recovery must eat much more than an average person of their BMI in order to maintain their weight. This is a fact that is the result of the condition called Hypermetabolism. My metabolism was so inactive and askew before treatment that once I started consistently eating any food at all, it roared back into action with intense vengeance. The very thing that I dread is now something I must do near constantly, it seems. If I don’t, it only takes a few days for me to feel it in my entire body.
The system that it hits first and hardest is that of my bones. My pelvic, wrist, and knee bones in particular are the earliest to ache. I’ll notice it in my pelvis when descending the stairs from my room to the main floor, where the kitchen is ironically located. I’ll notice it in my wrists when typing assignments on my computer. I’ll notice it in my knees when I’m sitting down and my crossed legs apply too much pressure on my knees, even.
The next system to be rapidly hit is that of my muscles. In particular, my back and upper thigh muscles are rendered weak and trembling. If standing, I double over onto my knees to try to alleviate the creeping but acute ache in my back. This, of course, instantly puts excessive pressure on my wrists, and I need to sit, only to discover that crossing my legs, or even leaving them uncrossed, puts unbearable pressure on my knees. It’s a maze of pain that reacts best to lying supine, though when I’m a few days into eating poorly, a supine position makes my back sore by the time I wake in the morning.
I did this to myself. It’s not a matter of blaming. I know I couldn’t control it, that the illness had me, but there is a frustration I can’t shake over the fact that the uselessness, helplessness that this induces was technically self-imposed. I think back to the occasions on which I put on hiking boots and ran in two feet of snow and ice, how powerful that felt, and it feels so incongruous with the weak and frail state I’m stuffed into, today. I want to say that I wouldn’t have done it all had I known what would become of me, but I know I would have, anyway. I wanted to be so small I was invisible, so small that no one could even lay eyes on me. I could have known this would accompany my efforts to do that.
Osteoporosis, which is the condition that is affecting my bones, is a symptom common in adolescent girls who suffer from Anorexia. Early intervention is important, for it strikes early in the disease. There is no cure for osteoporosis, and when it’s experienced in mid to late adolescence, it can stunt bone development permanently. This is what has happened to my bones. There are ways of managing and improving but there is no cure. And when I don’t take the time in my daily life to attend to my nutritional needs, I will feel the wrath of this condition.
Given how drastically malnourished and nutritionally barren my body was, it began to eat itself in order to stay alive and functional. My organs and muscles depleted, symptoms that result in one of the leading causes of death in Anorexia sufferers: cardiac failure. As a result, my muscles are weak and atrophied. Mere days of eating even just less-than-desirably will turn certain muscles into quivering masses.
All of these symptoms are both a burden and a blessing. Obviously, they are burdensome first and foremost; I don’t enjoy being relegated to my bed while re-nourishing myself with large helpings and nutrition drinks, becoming bloated and nauseous before my body rights itself enough to be functional again. However, this process serves as a great disincentive to restricting, one that is so dramatic and inconvenient that it’s impossible to ignore for long enough to be tempted to fall back into restrictive patterns.
I’m lucky. My recovery is going swimmingly compared to many. My treatments can be counted on one hand and I haven’t gone through any traditional relapses. I’m experiencing minimal urges to restrict and haven’t fallen back into any old eating patterns. What’s presenting as a relatively mild challenge (compared to battling my own head) is having to eat significantly more than someone of comparable height and weight. When faced with that prospect, being able to remind myself of the consequences of eating less (a skill called Remember the Pain in DBT) is a valuable resource, especially given the state of my body with only a few days of reduced caloric intake.
Recovery is really freaking hard. There are many steps involved and it seems to be designed to be the most challenging that it can be. Resentment and frustration abound. Burps embarrass and bones protrude. Back aches and muscles shake. It takes a lot of energy and persistence to stay functional, and I’m finding myself afraid that others will judge me for the time I need to spend, in perpetual cycles it seems, re-feeding myself. If I’m busy for a stretch, neglect breakfast, or even reduce snacks for enough days in a row, I need to be intentional in a few days of “catching up.” Catching up involves being reclusive and somewhat sedentary, for I’m focusing all of my emotional energy on willing myself to eat large quantities and resting my bones and muscles. Ultimately, once I’ve eaten enough, light exercise will be a crucial element of my daily life in order to rebuild muscular and bone strength. It’s simply not possible- nor is standing, even- when I’ve neglected to prioritize eating.
That’s the grand, sick twist of recovery. Where you once spent an inordinate amount of time focusing on the world of not-eating, eating must replace. The world of eating involves meals and snacks that are measured in the time they occur and the quantity, quality. It eats up time, too, being so aware of when and how to eat. When I don’t want to eat, or don’t want to eat as much as I think I’m eating, carving eating time into my daily life is daunting.
It must be done, yet. I want to be just as physically capable as the next person. Even more than that, I want to be happy and carefree, free being the most important. Freedom comes eventually, and it comes in not having to strongly consider eating at all, one way or the other.