Editors’ note: due to the sensitive and important subject matter, we have broken our practice of requiring names for editorials in order to share this Juilliard student–submitted essay. Also note, we at the Citizen Penguin are not doctors and the advice herein is based solely on the author’s individual experience.
**Trigger Warning: Details of specific eating disorder behaviors ahead (not graphic).**
National Eating Disorder Awareness Week 2018 runs from February 26 to March 4, and NEDA’s theme this year is “Let’s Get Real.” So let’s do that. Let’s have a real conversation, starting here at Juilliard, about food.
Around three years ago, I began using bulimia as a mechanism to cope with my emotions and everything else in my life I felt I couldn’t control. This was a very hard thing to admit. A year into therapy, I would still say to myself, my therapist, my doctor, and my parents, “I don’t have an eating disorder, though. That’s not what this is. I just get stressed sometimes, and I’ll do something stupid, but it’s fine…I’m done with that now.” Although I have gotten to a point today where I can fully acknowledge my problems with food, it is still very hard to talk about, and I am not comfortable enough to attach my name to this essay. I realize that a call for more open and honest discussion pulls less weight coming from an anonymous writer, but I am still dealing with my own internalized guilt and shame. I’m just not ready to handle the very real stigmatization and othering that can sometimes accompany a public admission like this.
I was in so much denial because I was terrified of what it would mean to be someone with an eating disorder. What did that make me? Was I really so vain and shallow? I also feared that if I ever admitted my problem to other people, they wouldn’t believe me. I hid my behaviors well, I never looked sick, and I was nowhere near “thin enough.” I know now that those thoughts were not rational. They were coming from the very part of me that is responsible for my eating disorder. The part of me that is full of negativity and will do anything to protect the disorder and keep me sick. One thing I’ve learned through psychoeducation in treatment, my own research, and listening to other people’s stories, is that eating disorders thrive on internalized shame, social isolation, and lies. This has definitely been true of my own disorder, which is why it was so important for me to find people to talk to, but also why it was extremely difficult to do so.
My reality may have been easier to come to terms with had I been able to find positive and inspiring representation I felt I could relate to, but there is almost none out there. In TV shows, books, and movies, eating disorders are rarely discussed, and typically anorexia is the only illness to get attention. Anorexia is often portrayed as a type of vain hysteria affecting a very small subset of the population. Basically, the story goes, a young white woman wants to be thin and pretty, so she goes crazy trying to do it. At the same time, many anorexia narratives focus on the extreme physical appearance of the sufferers to the point of fetishization and glamorization. Binge Eating Disorder, on the other hand, is almost never mentioned, even in many conversations about obesity and related illnesses. Meanwhile, bulimia is sometimes a trope used to represent jealousy between women, and sometimes an edgy punchline in a sorority movie. There are too many examples of eating disorders—which have the highest mortality rate of any mental illness—being erased or trivialized.
Anyone can have an eating disorder, and everyone who struggles with food and body image deserves help. Athletes have eating disorders, as do soldiers, and doctors, and certainly college students who are performing artists.
Media representation can seem like a petty complaint, but insufficient or bad representation has real-world consequences. Many mainstream media sources tend to handle eating disorders only by voyeuristically ogling tiny waistlines, or rolling their eyes at vapid drama queens with a “fake” disease “made up” in the 1970’s. And if these types of narratives dominate the discussion, how can the average person recognize and appropriately face an eating disorder in themselves or others?
The reality is that people have had troubled relationships with food for a long time. While rates of diagnosed eating disorders in many countries sharply increased in the later 20th century, and seem to rise in accordance with food overproduction in a society, disordered eating behaviors have been around for hundreds of years. In fact, according to Psychology Today, the first documented cases of eating disorders occurred as early as the 12th century.
An even more important reality? Anyone can have an eating disorder, and everyone who struggles with food and body image deserves help. It isn’t just for the blond, rich, skinny cheerleader with her head buried in a teen fashion magazine. Athletes have eating disorders, as do soldiers, and doctors, and certainly college students who are performing artists. People of any gender, class, age, race, and size can and do have unhealthy relationships with food. Such relationships can affect a person’s quality of life, and can become more and more serious when left untreated.
Eating disorders are hard to define. The Diagnostic and Statistical Manual of Mental Disorders (DSM) has updated its diagnostic criteria with every new edition, and clinicians are working to better recognize different kinds of eating disorders. But how helpful are these criteria for anyone who is not a health professional? As a layperson, I’ve found it makes much more sense to understand behaviors, thought patterns, and beliefs as existing on a spectrum. On one end of the spectrum is a person whose relationship with food is completely healthy and comfortable. At the other extreme is someone whose severe eating disorder has drastically impeded their ability to function, or has put them in a state of medical or psychiatric emergency.
There are a number of maladaptive behaviors that can be symptoms of a clinically diagnosable eating disorder, but can also be a part of someone’s life anywhere on the spectrum. Some such behaviors that I have either experienced personally or known someone who has, include emotional eating, bingeing, restricting, fasting, excessive or compensatory exercising, vomiting, laxative abuse, diet pill or diuretic abuse, supplement or steroid abuse, body-checking, calorie counting, obsession with a “healthy” diet or “clean eating,” chewing and spitting food, hiding food, and using caffeine, nicotine, or other substances to suppress appetite. One of the biggest red flags is a general feeling of anxiety or lack of control around food.
Too many of us, if we’re being honest with ourselves, probably exist somewhere in the grey area of the spectrum, and have used at least one of the above behaviors at some point. Maybe we feel like we need to “earn” our food by working out a certain amount every day. Maybe we look in the mirror and see a body that is too big or too small. Perhaps we eat far past our physical comfort level at a buffet, because we just can’t resist when there is unlimited choice. Any of these examples on their own would not constitute a clinical diagnosis, or even necessarily indicate an unhealthy lifestyle overall. However, for myself and for some of the people I met in treatment, behaviors that started out as seemingly innocuous or “normal” ended up spiraling out of control and becoming very dangerous habits.
Disordered eating behaviors do not come out of nowhere. Usually, they are a way to cope, or are the product of stress, social insecurity, and/or lack of control. At a competitive performing arts school like Juilliard, managing crazy schedules, trying to build a reputation in the field, and taking auditions are all a part of day-to-day life. For me, dealing with these situations can be mentally, physically, and emotionally wearing. Meanwhile, I find myself, as an artist, constantly striving to be better, reaching towards an unattainable perfection in my discipline. I know this is part of my own artistic journey, and it is what will hopefully allow me to achieve my creative potential. However, this constant reaching started to become harmful when I tried to apply those same impossible standards to the rest of my life, and determined my self-worth based on how close I was to “perfect.”
If you believe you or somebody you know may have symptoms of an eating disorder, it is important to know that you are far from alone, and that help is possible. This can start with a simple conversation. Sharing your struggles or worries out loud is a huge step towards reducing shame and stigma—and in being more honest with yourself. Disordered thoughts will make any number of convincing excuses for staying silent, one of the most common being, “I’m not sick enough.” Know there is no such thing.
Anybody on the disordered eating spectrum can benefit from talking to a counselor or a nutritionist, both of which are available through Juilliard Health Services—free of charge! It is important to note that sometimes, information regarding eating disorders is not widely known in the medical or therapeutic communities, so if possible, try to make sure the professional you are seeing is experienced in this area. There are tons of highly qualified therapists and dieticians who specialize in eating disorder-related issues all around New York City. Many professionals take various types of insurance, and will often work with clients on a case-by-case basis to establish a sliding-fee scale for private pay. If you already see somebody but are concerned that you may not be getting enough care, there are a number of treatment centers in the New York City area, including the one where I was lucky enough to be able to spend 12 weeks over the summer. These facilities may offer options for care such as support groups, intensive outpatient programs, day/partial hospitalization programs, and residential treatment programs.
Although formal treatment is not for everybody, and may not always be accessible, my experience was transformative. The structured environment disrupted my unhealthy routines, allowing me to form new patterns. It became a safe place where I was able to explore my scariest thoughts and feelings and try new things. Perhaps most important, I connected with other people in the group setting who were going through similar experiences. I felt understood and accepted in ways I had never felt before. Together, we learned from each other and shared our triumphs, our frustrations, our boredom and our compassion, and we reminded each other that none of us was alone.
My advice to anyone on their own recovery journey unable to access formal treatment, or for whom treatment is not enough? Find another way to incorporate that sense of comradery in your life. Whether it be through an affordable or free support group, family and friends, or online recovery spaces, make your voice heard. And have hope. Whatever you may be going through, you don’t have to do it on your own. We are lucky at this school to have so many resources available, so don’t be afraid to use them! And if you find some resources to be lacking, build and seek help from your community. Listen to friends with non-judgmental ears. We’re all in the same boat, trying to make it through young adulthood here at Juilliard, and doing our best to grow as artists and as people.
Choosing recovery has been one of the scariest things I’ve ever done, and no part of it has been easy. I still have bad days. I still slip up. I still need to keep track of my mental health every single day. Ultimately, though, I know that recovery will have saved my life. I already feel happier, more motivated, and more alive than I did a year ago, before treatment. Change is possible. And thanks to my support system of friends, family, and health care providers, I have a whole network of people who are reliably there for me, and whom I am comfortable reaching out to whenever I need.
Getting real will always be hard, but it doesn’t have to be lonely.
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EATING DISORDER AND MENTAL HEALTH RESOURCES
Free Counseling, Nutrition, Medical, and psychiatric appointments through Juilliard:
https://www.juilliard.edu/campus-life/health-and-counseling-services
Eating Disorder Education:
https://www.nationaleatingdisorders.org/
https://www.nationaleatingdisorders.org/screening-tool (Free, confidential self-screening tool)
https://www.psychologytoday.com/blog/evolutionary-psychiatry/201112/history-eating-disorders
https://www.allianceforeatingdisorders.com/portal/what-are-eating-disorders
https://www.anad.org/
http://www.feast-ed.org/
http://glossary.feast-ed.org/2-eating-disorders-symptoms-and-behaviors/body-checking
https://www.edinstitute.org/
https://www.youtube.com/user/KatiMorton (Therapist who specializes in ED’s and makes informative mental health videos)
Eating Disorder Treatment:
https://www.eatingdisorderhope.com/treatment-centers/new-york-ny (List of possible treatment options in the NYC area)
https://www.eatingdisorderhope.com/recovery/support-groups/new-york-ny (List of support groups in NY)
https://www.psychologytoday.com/us/groups/eating-disorders/ny/new-york (Support groups)
http://eatingdisordersanonymous.org/index.htm (Free meetings in local areas across the US)
http://renfrewcenter.com/ (Treatment center for women only)
http://www.montenido.com/mn_locations/new-york-ny/ (Treatment center for men and women)
http://www.centerfordiscoverynewengland.com/ (Treatment center for women only)
Mental Health Crisis Resources:
https://suicidepreventionlifeline.org/
https://nycwell.cityofnewyork.us/en/
https://www.nami.org/