When you see a loved one knowing they’ve been ill or in hospital, the natural thing to say is something along the lines of “you’re looking well” or “you look so much better.” Obviously, you wouldn’t say “you look really awful” even if it was true. You might encourage someone whether they have had a broken leg or a long term illness such as cancer. For most people, being told how fit and well they look is a compliment but for someone with an eating disorder, this could do a lot more harm than good.
It’s not about weight
When I went into an intensive recovery programme for my anorexia, one of the requirements was to follow a meal plan and meals were monitored measuring the correct amount of energy which we strictly had to eat. With a non-negotiable rule like this, weight gain was predictable and since I was following a meal plan of three meals and three snacks a day, weight restoration happened pretty quickly. Gaining weight to achieve a healthy BMI is actually the easy part of recovery as anorexia was never about the food; control over food was a symptom of the difficult emotions erupting underneath. When I had reached a healthy weight and plucked up the courage to socialise again, I received plenty of comments on how healthy I looked even though I was still very unwell. Hearing these comments made me feel angry and disgusted in myself and guilty for progressing in my recovery. I punished myself as I thought I was a failure to my eating disorder and for this I hated myself. An eating disorder consumes someone’s life so much that they find it difficult to part with because it becomes such a huge part of their identity. I wasn’t, and in some cases still aren’t ready to part with my illness as it is my safety net where I feel in control and indestructible. All I assume when people say I look better is “I must look fat.” I’ve become much stronger at challenging that thought now but before I would have reverted back to my old habits and let the eating disorder take over, all because of someone assuming they were saying the right thing.
Although I can tolerate those comments better in the moment, they still cause me a huge amount of distress. My mind goes a million miles an hour, overthinking and trying to unpick what people mean by the word “better.” I would describe the stage I am at now as being on the fence or walking a tightrope. I want recovery and know that is where my life belongs except there is a strong pull tugging me back towards the eating disorder. It is something I know I will have to let go of yet I am terrified!
I often worry that people assume I am fully recovered because I have reached my target weight. I hate the thought of being fully recovered because truthfully, I am not ready to let go of my anorexia. This thought process alone proves I still have a lot of issues that need addressing and is evidence that gaining weight is no indicator of full recovery. When others comment on the wellness of my physical appearance I feel the need to explain myself or prove that recovery is still a long way off. Equally, I hate it when people say “it’s amazing you’ve come out the other side” when the other side is still far in the distance. I feel invalidated because it disregards the struggles I still face which provokes thoughts of “I’m not sick enough therefore, I must lose more weight.” It seems ridiculous that someone wants to be told they’re ill but the reality of eating disorders is this is the case which isn’t always understood. Eating disorders, such as anorexia, are known as being a treatment resistant disease meaning, although recovery is quite obviously the better option, the person doesn’t necessarily want to achieve it as it goes against everything that the eating disorder wants. Unlike any other disease, for example schizophrenia, an eating disorder can actually make you feel amazing by making you believe you are indestructible and powerful; which of course, is a complete lie. This complex is why being told you are doing well or looking healthy is so uncomfortable to hear as it means you are parting from your illness. Recovery is a chance to let go of all the awful and devastating aspects of your eating disorder but, you must also be prepared to let go of the good things which is why treatment can be so difficult to engage in.
Building your resilience
In no way am I telling people to completely refrain from commenting on someone’s progress as the reality is it can’t be avoided. I can fully appreciate that these comments come from a meaningful place as it is natural to tell someone they are looking well if they’ve recently been ill. It might be difficult to realise but, they are saying it because they love you and they are relieved to see you at a point less life threatening. Further down the line in my recovery, I am able to accept the comments with an understanding that it is with good intention. As I said, it is inevitable that people will say how healthy you look and we can comprehend it is simply just a lack of understanding that this might be upsetting for someone to hear. Psychological illnesses are incredibly complex so we should excuse the fact that not everyone can understand what is the right or wrong thing to say – in my experience you can’t say anything right unfortunately. Building up that tolerance to accept the comments and having the ability to voice why it might be making you feel uncomfortable will not only build your resilience to an inevitable conversation but, also educate that person so they will be mindful with what they say. I often thank the person and then explain where I am at with my recovery and the challenges I still face. As distressing as it may be, we must build our tolerance and understand why we shouldn’t get angry or defensive; I can assure you, it will get easier.