Motherhood, mental illness and beyond

Posts tagged ‘eating disorder’

Sugar and spice and all things nice…

My daughter is 4 years old. Because of her age she receives a free drink of milk at school each day; once she turns 5 DH and I will have to pay if we wish this to continue (only 22p a day as it’s subsidised). I don’t know what the take-up rate for this is but today the company that provides the milk (Cool Milk) held an assembly at the school. From what DD tells me it was a fun assembly with singing and a bit of dancing. At the end of it each child was given a sticker to wear and a booklet was put in their bookbags for them to take home. The booklet had a comic strip in as well as a quiz, poem etc.

However, at the back of the booklet was this:

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Now, you and I know that too much sugar isn’t good for us. And I’m all for encouraging healthy eating in childhood. But do 4 year olds really need to be worried about how much sugar is in their drink? That’s for parents to worry about, surely? As a result of reading this booklet DD is now convinced that consuming sugar will make her fat. DH and I have tried to reassure her, explaining that our bodies need sugar for energy and that some sugar is ok. This is the stance that we’ve always taken, that everything is ok in moderation, but I don’t know whether we’ve reassured her or not.

I’m livid about this. Children live in a society where appearance is valued above all else and this has enough of an impact on them. A survey carried out last year by GirlGuiding UK found that 71% of girls aged 11-21 would like to lose weight and that a fifth (a fifth!) of primary school girls have been on a diet. I have no doubt that similar pressures are felt by boys as well, though probably to a lesser degree. Children need to be encouraged to value who they are as individuals, to value substance over appearance, and yes they do need to learn about healthy, nourishing food. However they do not need to be fretting at the age of 4 about whether what they eat and drink is going to make them fat. They certainly don’t need to be told things like that by a company who are merely trying to increase their profits by encouraging children to keep drinking their milk. (I concede that there may be a genuine desire here to help and educate children stay healthy but my cynicism leads me to suspect that money is the overriding concern).

Statistics from the Health and Social Care Information Centre show that in 2010/11 more than 6,500 children were treated for eating disorders (up from 1,718, in 2007/8). This includes 79 who were less than 10 years old when they began treatment, and 56 children who were aged 5 or under. Of course the causes of eating disorders are many and nuanced, but idiotic marketing ploys like Cool Milk’s certainly aren’t going to help matters.

I appreciate that these children are far from the norm, and I also realise that I may be over-reacting a touch here. But I was one of those children who don’t make it into the HSCIC’s statistics, the ones who have an eating disorder but remain undiagnosed. I’m not sure when it began but I clearly remember secretly bingeing at the age of 7, gorging on any kind of food I could lay my hands on. I also remember tightening the belt on my school dress until I could barely breathe, convinced that I was fat. I don’t want my children to walk the same path as me and if that makes me over-sensitive to things like this booklet then so be it.

I am, therefore I eat

Fat. Greedy. Obese. Disgusting. Pathetic. Ugly. Stupid. Weak. These harsh, hurtful words are all hurled at me on a daily basis. Not by family, friends or even strangers in the street but by me. My self-loathing spilleth over. Two of these words are incontrovertible – I am fat and I am obese. There is no proof for the accuracy of the others but I know that they’re true. Well… I have always been convinced that they’re true but lately chinks have begun to appear in the armour of my certainty.

I wrote here about the discovery that I apparently have an eating disorder, specifically binge-eating disorder or BED. At the time I was reluctant to apply the label of having an eating disorder to myself but I was able to admit that my eating is definitely disordered. I think about food all the time, from the moment I wake to the moment I go to sleep. I eat 2-3 meals a day and I graze in between whether I am hungry or not. Sometimes I will invent an excuse to go to the shops just so that I can buy chocolate or biscuits, either to eat in the car before I get home or to hide away and eat in secret where no-one can see. If there isn’t anything sugary or fatty for me to graze on I begin to panic and until I find something acceptable to eat I am unable to focus on anything else. If there is food around I’ll be picking at it.

So why haven’t I admitted that I have an eating disorder? Because I honestly believe that I am just greedy. I’m deeply ashamed of myself for this and for my lack of self-control but to label it an eating disorder seems an overreaction. Even considering the possibility makes me feel like a fraud, as though by comparing myself to people who really do have eating disorders I’m belittling their struggles. It feels like attention-seeking.

And yet… Friends who are far more knowledgeable and experienced in this area than I am are adamant that I have an eating disorder. A psychiatrist said that it was BED. The NHS website has a section on binge-eating which says:

In diagnosing binge eating, your GP will ask you about your eating habits and look for three or more of the following signs:
1) you eat much faster than normal during a binge
2) you eat until you feel uncomfortably full
3) you eat a large amount of food when you are not hungry
4) you eat alone or secretly due to being embarrassed about the amount of food you are consuming
5) you have feelings of guilt, shame or disgust after binge eating

Three or more? Well I tick all five boxes. So why am I still so reluctant to acknowledge this?

I’d like to say that it’s due to a lifetime of internalising society’s disdain for the supposed weakness and greed of the overweight and obese. I’d like to say that years of seeing people mocked and targeted purely because of their size and presumed inability to eat healthily has had a profound effect on me and left me able to only blame myself for my problems with food. And there may be some truth in that. But in reality I had issues with food long before I became aware of these things.

I wasn’t an overweight child but I was convinced that I was. I remember crying in the playground because I didn’t want to be fat any more. I remember binging from the age of 7 or so and guiltily hiding the evidence. I remember almost flooding a childminder’s bathroom once when I panicked and tried to flush a handful of chocolate bar wrappers down the toilet. I remember my first year at secondary school, when I would barely eat Monday to Thursday but on Friday spend my entire week’s lunch money on a mountain of food. After one of the staff told my mum about that I began taking packed lunches and supplementing them with food from the canteen when I wanted to binge – a much more subtle approach, I felt.

I have no idea what caused my problems with food (I had a happy childhood, I was well-fed, looked after and loved) but I doubt that the emergence of these issues at around the same time that I began to self-harm is a coincidence. Whatever the reason, I have been doing this for about 25 years and it is time to face up to this, to allow myself to admit that this problem may be greater than I have believed for the last quarter of a century. I need to be kinder to myself and recognise that perhaps I am not as weak as I think, that maybe the root of my obsession with food is related to my mental health rather than a character flaw.

My name is Sam and I have an eating disorder.

Is this year’s theme for Mental Health Awareness Week a bit of an own goal?

This week is Mental Health Awareness Week in the UK. Each year a different theme is chosen and this year the Mental Health Foundation have chosen physical activity. Their website says that “This year’s Mental Health Awareness Week aims to shift our motivation for physical activity to something we choose to do to increase our wellbeing”.

This makes sense, as it has become conventional thinking in recent years that exercise and other physical activity can increase the production of endorphins in the brain. And of course exercise doesn’t necessarily mean a 5 mile run – as this helpful page from the MHF website explains physical activity can include housework, gardening, going for a walk etc.

Unfortunately this theme for the week doesn’t seem to have been properly thought through. For a start the message being promoted through social media already seems to have shifted from ‘choosing to do physical activity to increase wellbeing’ to ‘exercise will help your mental health problems’. The Twitter hashtag #letsgetphysical is being used to enthuse about the benefits of gym visits rather than gardening. This isn’t the fault of the MHF of course, but it could have been foreseen and it isn’t helped by the MHF’s use of the the quote “It is exercise alone that supports the spirits, and keep the mind in vigor” (Marcus Tullius Cicero) in their leaflet about physical activity.

Another problem with having physical activity as the week’s theme is that there are many people who have both mental illness and physical disabilities. Whilst a lot of these people will be able to undertake some form of physical activity there will be a significant number who can’t. And what of those whose mental illness is severe enough that they struggle to get out of bed, let alone go for a walk? As I understand it the idea that physical activity can help mental health only seems to apply to relatively mild conditions.

In fact, increased physical activity can actually have a detrimental effect on some people with mental illnesses. Those with ‘invisible’ disabilities such as CFS and fibromyalgia may well find that increased physical activity increases their fatigue which could put them at greater risk of depression. Speaking as someone who struggles to walk for more than a few minutes and at times finds it impossible to do any kind of housework, being repeatedly told that I need to increase my levels of activity is unhelpful as it makes me reflect on my increasing loss of mobility and lowers my mood. Those who suffer from eating disorders may also find this advice counter-productive, if not downright dangerous.

Some have already complained that this focus on physical activity as a kind of panacea for mental illness is almost akin to victim-blaming. There are already tweets under the #letsgetphysical hashtag asking why, if exercise is so good for mental health, sufferers wouldn’t get off their backsides and just do it? (Note again the confusion between exercise and physical activity). The implication seems to be that those who aren’t out pounding the pavements in order to beat their mental illness obviously don’t want to get better. This is damaging.

The final problem I want to discuss is that for some people exercise and other physical activity simply isn’t that effective. Some years ago I was enrolled in an ‘exercise prescription’ programme where I was able to use a local gym and go to classes for a pound a time. It was good and I enjoyed it – but it did nothing to help my crippling depression. For me, medication and a great support network are the most effective form of treatment and I know I’m not alone.

I’m not saying that the MHF shouldn’t have chosen this as their theme for Mental Health Awareness Week; it’s obviously quite successful in getting people talking and I’m sure there are many who will be helped by the message. However those who cannot partake in physical activity and those for whom it is a risky or ineffective treatment are being ignored and excluded by the very organisations that are supposed to support them.

Oh and one last thing. The #letsgetphysical hashtag means that I’ve been humming Olivia Newton-John for the last 36 hours. Not cool, MHF. Not cool.

Food glorious food…?

This post follows on from My big fat problem.

I have had issues with food for almost as long as I can remember. When I was a young child my mum kept a large tupperware box of chocolate biscuits (Club, Viscount, that kind of thing) on top of one of the kitchen cupboards. I used to wait until I was the only person downstairs then drag a chair into the kitchen, clamber up and get down the box. I would rummage through to find my favourites; sometimes one or two, sometimes half a dozen. It was a fairly big box so I knew I was unlikely to be discovered. At the first opportunity I would sneak my pilfered biscuits upstairs and hide them under my bed. Then after bedtime, when I should have been sleeping, I would sneak them out again and scoff them; I can vividly recall the glee, delight and guilty pleasure I felt. Then I would hide the wrappers in my shoes, and bury them at the bottom of the kitchen bin at the first opportunity.

I don’t know how old I was when I began doing this. I suspect it began around the same time as my self-harming so I would have been about 7. It makes sense to me that these behaviours probably began together as I have long suspected that my binge-eating is merely another manifestation of my urge to self-harm. Certainly the urge to binge and the urge to cut are both triggered by strongly negative emotions such as anger, despair, grief, unhappiness, frustration etc. Since I finally managed to stop cutting in early 2011 my binging has become more and more of a problem.

I’ve mentioned before that the psychiatrist I saw a while ago told me I was a compulsive binge-eater. After talking with some very kind and knowledgeable Twitter friends recently I found myself googling binge-eating today and was directed to this page on the NHS Choices website. It’s extremely informative and eerily familiar – every aspect of binge-eating that it describes applies to me. Eating excessively quickly, eating large amounts when not hungry, eating alone or secretly, feeling out of control, experiencing feelings of shame, guilt and disgust after a binge… This is what I do. This is me.

Despite having been given a good (and kind and helpful) talking-to by my knowledgeable friends on Twitter (you know who you are!) I still don’t feel that I have an eating disorder. Eating disorders are serious illnesses, while I just have no willpower. No self-control. I am greedy. I don’t have an eating disorder. Except… These experienced, knowledgeable, lovely people say that I do. The NHS website says that I do. The psychiatrist said that I do.

So. I may not be ready to admit that I have an eating disorder but I know that my eating is disordered. The difference just be semantics but for now that’s as much as I’m comfortable with. I’m waiting for a referral to a Cognitive Behavioural Therapist for my anxiety and I will definitely be mentioning my problems with food.

In the meantime I am not going to follow any faddy diets, no Atkins or Slimming World or 5:2 or anything like that. Partly because I can’t afford to but mostly because I know that they will not help me stop binging. I need to focus on my binging, not my diet as a whole. I need to arrest the impulse to binge before I act on it and I need to get into the habit of examining why I want to binge each time.

I’m not going to set myself any big scary weight-loss targets, even though that is a major part of why I need to get my eating under control – I am 5 stone overweight and that’s affecting my health as well as my happiness. For now though my only goal involving scales is to weigh less each week than I did before, even if it’s just a few ounces less.

I expect I shall blog about this again in the future but for now this is it. I know what I need to do. I know why I need to do it. I think I know how to begin doing it. So here I go…

Why we should pity Samantha Brick, not revile her

Samantha Brick is a columnist for the British newspaper the Daily Mail. She’s known for writing aggressive and confrontational columns that provoke lots of outrage, and therefore lots of publicity both for her and the newspaper. There is some debate about whether her columns reflect her true personality and opinions or are merely provocative parodies intended to increase revenue for the Mail.

Today’s column (I’m loathe to give the Mail traffic but it’s reasonable to assume that you’ll want to read this for yourself) was about women and weight. Specifically how Ms Brick has been on a diet for most of her life and disapproves of any woman who doesn’t do the same. Some memorable quotes from the column in question include:

For three decades, self-denial has been my best friend. And one of my biggest incentives is that I know men prefer slim women. I have only ever dated men who kept a strict eye on my figure. My partners are not only boyfriends but weight-loss coaches. My first love continually reminded me that one can never be too rich or too thin, and my husband of five years frequently tells me that if I put on weight he will divorce me.

…in my mid-teens I decided to lose my puppy fat, transforming myself as I lived, for the best part of a year, on Marmite on toast (no butter).

At college I invented the Polo diet. Eating a pack of mints for breakfast and another for lunch, I could make each one last hours. I am 5ft 11in and slimmed down to a size 8.

As I see it, there is nothing in life that signifies failure better than fat.

Predictably there have been howls of outrage across the internet as both women and men react with outrage, anger, insults and mockery. But does Ms Brick really deserve the vitriol flung her way?

Read the quotes above again. Read (if you don’t mind giving the Mail yet more traffic) the column. According to her own writing Ms Brick seems to seek out controlling partners who reinforce her belief that her worth is measured by bathroom scales and tape measures. At the age of 14 she apparently ate only bread and Marmite for a year – and presumably nobody noticed. At university her disordered eating continued and today she equates fat with failure.

Like many Western women I have body-image and self-esteem problems. However I am fortunate and have no idea how it must feel to assess your value as a woman purely by whether you are able to wear a certain pair of trousers. I can’t imagine how terrifying it must be to know that if your body changes the person you love will walk out on you. That you are only worthy of their affection under certain conditions. That even if it’s not your fault, even if you develop health problems or need medication that causes you to gain weight, you’re on your own.

I had a friend once who was prone to attention-seeking behaviour and boasting about how beautiful and clever she was, how amazing her life was. Then one night she drunkenly confessed that she was utterly miserable, that she was deeply insecure and loathed herself. Ms Brick reminds me of her. Whether she is a caricature, a parody or genuine, she deserves our pity not our insults.

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