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Fear and loathing in anorexia

Posted Sep 22 2009 10:08pm
At this year's NEDA conference, I attended a session titled "Dangers and Phobias," which was a three-fer session: the first part was on the dangers of eating disorders, the second part was a whirlwind tour of neurobiology that even I could barely follow, and the third part was about phobias and eating disorders. Now, an eating disorder isn't just a simple phobia of food, but a food phobia is a major part of an eating disorder. This phobia takes on different forms in different eating disorders (it might be a phobia of eating carbs*, or a phobia of not throwing up, etc), but this phobic response is almost always present.

Maybe it's because I also have a hellalotta anxiety issues outside of the anorexia, but this presentation on the relationship between eating disorders and phobias really hit home for me. I became anxious around food, so I started avoiding it. This decreased my anxiety to a point, but then the anxiety came back. So I avoided it more. And so the cycle continued. Each time I avoided food, it cemented that fear. If I eat, I thought, something really bad is going to happen. That "something bad" could be a magical mysterious weight gain of 100 pounds, it could be I would feel like crap, it could be that I "ruined" the day. When nothing bad happened (as it usually did), I linked that to not eating. That tiny shred of self-esteem from watching the scale go down? That was because of my not-eating. The stylish new jeans I let myself wear? Not-eating. The (seeming) decrease in fear around food? Not-eating.

Eating would somehow erase all of that. Eating and gaining weight would remove the whole foundation on which I had built my life. That's a pretty big fear.

I discussed this fear in therapy a lot, which was much more enjoyable than facing the fear. I learned where it might have come from and what purpose it might be serving. All of this discussion did precious little to alleviate these fears. In fact, the longer I went on not-eating, or purging, or over-exercising, the more these fears cemented themselves in my brain. Many aspects of these phobias turned into habits.

I've been facing these fears head-on in the past few months. Not dissecting them, not just introducing myself by with stickers saying "Hello My Name Is" and then moving on, but having the kind of staring contest with them that even my cat would envy. Did I gain weight when I started eating again after this relapse? Yes. I also needed to rather badly, but still, weight gain was an element. Did my world fall apart? Yes, but it fell apart because of the fears, not from facing them.

Do I have my moments? Um, yeah. I'm not happy-go-lucky about food, nor do I think that would be a reasonable goal for me. For that matter, I don't want to be totally nonchalant about food. When I get sloppy, I start skipping meals and then minimizing the negative effects of said skipped meals. Paying attention isn't a bad thing.

I don't know sometimes if I'll ever be totally "over" this fear. I hope and believe in a time when it won't rule my life, but my years with anorexia have profoundly changed me. There's no going back, but there is the moving forward.

*Blogger spell check doesn't recognize the word "carbs." Can I tell you how excited that makes me?
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