Why I'm No Longer Saying 'Anorexia'
And what we need to understand about restrictive eating disorders.
It was never a word I was able to comfortably say. I’d see it falter in the mouths of others, and feel it buffer in my own. Anorexia. For me, perhaps because of the weight it carries (ironic pun not intended), it felt sinister, dark and mysterious. Much like the disease itself. It seems more threatening than the term ‘eating disorder’, perhaps because it conjures those images we’ve seen in the media. Skeletal white girls staring out through hollowed features from their halfway house of life and death.
Anorexia, in fact, isn’t a look or size, and it affects more people than most realise. Many of those that walk among us, our friends, maybe even our family could be suffering. It’s a secret disease. A private turmoil with much longer-reaching mental roots than physical ones.
The fact that we associate a certain look with anorexia is because eating disorders in general are still so incredibly misunderstood, depressingly even by many health professionals. Eating disorders have the highest mortality rate of any mental illness most likely for that very reason. The chronic loneliness and internal confusion, met only by the bafflement of the outside world. One such misunderstanding can be found in the word ‘Anorexia’ itself, the definition being ‘without appetite’. Etymology of Latin from Greek; an (without) orexis (appetite).
Without appetite. Dear God the rage this stirs.
Anyone reading this with experience of disordered eating will surely balk at such lazy inaccuracy. Without appetite? I can guarantee that those suffering with so-called ‘anorexia’ have not only an appetite but that their every waking moment (and many sleeping ones) are plagued with thoughts of food. It isn’t lack of appetite but obsessive punitive control over appetite. Suppression of need. Power over natural urge. A dictatorship of the body. ‘Anorexia’ by definition is an absurd claim, for without appetite there’d be no kingdom to rule.
I no longer find the word difficult to say, yet now it’s one I simply wish was taken out of circulation. Its false definition only reinforces misconceptions that those with restrictive eating disorders simply don’t wish to eat or have no interest in food. Rather than understanding the truth in the contrary, and the behind-the-scenes manic obsession of the disordered. The preoccupation with what to eat, how much, when, and whether it’s deserved. The heart-racing panic and hot fat tears of self-repulsion that come with breaking a fast unplanned, or eating more than was mentally allotted. It won’t always show on the outside. It likely wont present itself in company, in restaurants, at parties. Food can be eaten as long as it’s accounted for. Public appearances can be made with careful calculation of the daily or weekly ration. Menus will be sought in advance, with as much attention paid to what wont be eaten as to what will. And in most (that’s right, MOST) cases of so-called anorexia, it won’t show in physical weight. Those severely underweight cases are in the minority. The majority exist in a high-functioning, high punishing realm of secrecy. Living outside of their natural biological set-weight, depleted, under-nourished and mentally tormented on the inside, yet seemingly a ‘normal’ or even ‘over-weight’ body type by today’s social standards [*shudders].
I can’t stress enough that eating disorders are a mental illness, the physical representations of which we need to stop focussing on if we ever want to help those who suffer. I’ll often lambast the nineties as an era that promoted such dangerous body ideals, yet despite the body positivity movements of more recent times, cases of eating disorders have risen 84% in the last 5 years. And that’s in hospital admissions alone. It doesn’t include the countless individuals kept outside of statistics by their private shame. What makes it all the more horrifying is that sadly those who do reach out are often rejected by the system for ‘not being underweight enough’ to be treated. I myself experienced countless instances (both on the NHS and privately) where I was starting to recover physically but was at my worst mentally - dangerously dark days - only to be looked up and down and told ‘well, you look healthy to me!’. So off I’d go, deeply ashamed to have voiced my secret only to be made feel like I was trying to opt-in on an eating disorder - and hey, if medical professionals don’t think there’s a problem then I must be fine! [cue being admitted to hospital 2 months later when my kidneys failed after yet another relapse].
I think collectively we’re starting to have some really healthy and helpful discussions around mental health, becoming aware that mental suffering is rarely visible on the outside. The statistics around eating disorders seem shocking because people can’t see what’s right in front of them, and the label ‘anorexic’ is still reserved for those who look like Skeletor. Changing the terminology might not do much, but may at least start the right conversations about how eating disorders manifest and how we can offer the right support for healthy recovery.
The Takeaway
Eating disorders are a mental illness that can exist in people of all shapes and sizes. Anorexia is NOT just being severely underweight.
Due to the restrictive nature of some eating disorders (e.g. anorexia), the brain is constantly looking for food, so will think of nothing else.
Appetite is not suppressed through an eating disorder, it is dangerously abused.
Eating disorders are a secretive yet lethal illness that most often wont show on the outside. Even those diagnosed with anorexia at an extremely low weight who now appear to be weight-restored may still be critically at risk. Never judge a book by the weight of its cover!