I have lost count of how many times I am told anorexia is “not about food”. It is true that it is triggered and maintained by other factors, that anorexics often absolutely love food and it is not a problem of appetite. But recovery is absolutely about food. Therapy plays a big part, but its twin sister is Food. Enough of it to gain 1kg a week in an inpatient setting. Most seasoned dieters will know this means 1000 calories in excess of your daily allowance. Around 3000 calories. An unimaginable amount to an anorexic.
When L first became ill, I wanted her to feel in control of her recovery. To choose foods and devise meal plans with me. To some extent it kept her eating, from a position where she ate virtually nothing and vomited once or twice each day. But with an anorexic child, choice is a loaded gun. Ed sits on her shoulder and hisses to go for the lowest calorie, the lowest fat and the smallest portion. I have a job which involves negotiation and have done for twenty years. The toughest negotiations I have ever faced were with L and Ed.
As a modern parent I want my child to have choice and control. As a parent of an anorexic, those are potentially toxic until we have seen off the Eating Disorder. At a critically low weight L will not respond to therapy. No counselling, group therapy or psychoanalysis will work on the brain dulled by starvation. The aim of the first stage of treatment is to feed and remove choice. L and another inpatient joke that Stage 1 is the Death Prevention Stage. I am not sure if they know how right they are.
I thought that when L started Stage 2 she would enjoy the choices. Instead, it scares her. Even though there are only 3 options, she hovers and hesitates. Ed is still there, urging her to think about fat and calories. L herself knows she still needs to finish and wonders what will be easiest. But at the heart of her dilemma is that this means she Chooses To Eat. She is no longer a victim of Ed or the clinic. She, L, is making a conscious decision to eat a certain food and is standing up to a powerful illness.
I have seen recovery described in so many ways, but it generally focuses on feelings, attitudes, self-belief. Those are true, but it is also about eating. L’s periods will not return by her believing she deserves a life without anorexia. Her bone density will not improve by bravery alone. Her tooth enamel is not worn by anxiety and fear, it is worn by the acid in the vomit of the food Ed told her she didn’t deserve. To use LadyEm’s Wizard of Oz analogy, it turned out that the terrifying wicked witch could be vanquished by water. And so anorexia can be vanquished by food. Not alone, but without food, no therapy will work. Today I offer my own Recovery Epigram:
Eat, Enjoy, Repeat