worksheet #1

Typing is easier than writing, and if I'm going to write this for my group therapy I'm sure as heck going to give myself credit by blogging it.

1. Please describe the progression of the eating disorder, beginning with the first time you engaged in disordered eating. Describe what it felt like and your first thoughts associated with the ED.

The first time I had the conscious thought of being overweight and feeling ashamed for it was in 3rd grade, 9 years old. Kids compare everything, and most of the time being the most extreme of anything is the best - the last name that is closest to the start or end of the alphabet, the biggest or smallest shoe size, etc. But I knew that I weighing almost 90 lbs was much more than my classmates, and that this was a bad thing that would not win me accolades. (I didn't realize until much later that I was also 4'6" at that point - I wasn't slender, but I was perfectly within a normal weight for my height).

The first time that I engaged in disordered eating was maybe when I was 10 or 11? I was staying at my Dad's apartment for the night, so that meant that we had bought dinner at the grocery store because he didn't know how to cook. I had finally convinced him to give up the Tuna Helper or frozen kids meals, and selected a nice healthy salad for myself. We ate in front of the TV. As I had been taught, I "cleaned my plate," or in this case, my bowel.

My dad had gotten up to go work on something in the other room, and when he came back he made some comment in surprise at how much I had eaten, that "a salad that big is usually supposed to be shared by 2 people." I don't know if he had expected to have some too or what the motivation behind the comment was, but I do remember feeling ashamed, and distinctly afraid that having eaten too much was going to make me fat, which was something I definitely didn't want. So how could I get some of that "too much" salad back? I went into the bathroom and tried to make myself throw up. It was gross, but I was proud of myself for figuring out a solution. My dad caught me, of course, and told me to not do that to myself. He seemed so upset, so I promised I wouldn't.

For a long time, I didn't.

I continued to be very self-conscious about my weight and body shape, but somehow I didn't connect that to food choices. In middle school when I was home alone, particularly in the summers, I would binge - cheese melted on toast became cheese melted on rice (when I ran out of bread), which became just a bowl of melted cheese eaten with a fork when I ran out of leftover rice. I would feel a little guilty, but the food just tasted so good. Halloween candy would be pilfered, spoonfuls of peanut butter and honey, butter and sugar sandwiches...I wouldn't do it with other people in the house, but when I was alone I just grazed continuously. I was painfully embarrassed by my body, by the way that "cool" clothes and brands that fit my classmates never fit me, but I didn't know how to ask for help or what I could possibly do about it.

In high school I pretty actively started engaging in overtly disordered behaviors. I was self injuring, and around 16 or so I started consciously restricting and purging. I read "thinspo" blogs and tallied up my calories for the day on my own blog, collected images of bony-thin women and dreamed of the day I would live alone so I could put a lock on my fridge to control myself. I was jealous of those girls who could eat 300 calories a day, ashamed at the 900 calories I just couldn't seem to stop eating. I would be mad at myself if I ate something I didn't plan on eating, and would be entranced by any available foods in group settings where someone had brought snacks (almost always something delicious and sugary, like cookies or cupcakes). I would eat pizza at a lunch meeting at school and then sneak away to the bathroom to purge, choosing the one that was the most out of the way, the least likely to be disturbed.

It worked. I was losing weight, I felt more confident in my body. People were noticing. I only remember one person seeing it as a negative, the school administrative assistant. Clare was like everyone's favorite aunt. She had a ready smile and welcoming hug, tampons and ibuprofen stashed where we could get it ourselves without having to ask, and the answer to almost any question about school or life. I don't actually remember what she asked or said, but I do remember blushing and ducking the question, but suddenly being afraid that maybe she had heard one of my bathroom purgings - I tended to favor the one that happened to be closest to the teacher's lounge. I was afraid she would stop me, but kind of also glad to think that it might mean that she cared, that someone saw what I was doing and made me acknowledge to myself how unhealthy it was.

Then I went to college. And the food was amazing, and unlimited, and I was on crew so that meant I could eat whatever I wanted, right? I hadn't weighed myself for years at that point, but I'd estimate that I easily gained 40lbs my freshman year, if not more. Some of that was muscle, certainly. But a lot of it was not. When our coach asked us to get a weight so we could do weight-adjusted rowing scores, I was shocked when the scale went over 200lbs. In later years when I worked at Target over the summers I would routinely lose about 15-20lbs over 3 months. At that point I didn't know a quantity but I did know that I had lost weight, and I still was 205? I told my coach 197. I had been purging occasionally my freshman year, but now I was more aware of what I was eating, and purging much more frequently. That just became how I managed my weight. I would try to make good food choices, I obsessed over the calorie counts for the online menus and tried to plan my meals in advance, tried to listen to my body's needs. Then I would find myself going back for thirds at the dessert bar. It truly felt like it wasn't a choice, it was something I just did. Because.

At graduation I was probably around 170-180, only a bit more than my high school weight. I was even fitting into some of my high school pants! And then I left for Peace Corps.

I did binge frequently (or rather, I overate, but it felt like binging) when I was in Burkina, but I only purged twice in 2 years - I just felt such guilt when hunger was too close to be ignored. I gained weight and felt self conscious about it, but I was a little more gracious to myself - I had been prepped to expect this by some of the more seasoned volunteers, that this is just what happens when all you eat is pasta and fried dough and rice. Somehow being deliberate about letting food be my emotional comfort in this very foreign place made the weight gain slightly less of an emotional burden.

When I got back to the US I was newly single and heartbroken. I was starting to take community college classes to prepare for grad school, I was living in a town where I knew no one but my parents, so I decided that I was going to get in shape. I dramatically changed my eating and exercise habits, and as I progressed in my required nutrition class I refined my diet on a constant basis to hone in on the "right" diet for me. I was closely in control of my intake, and exercising 1-3 hours/day almost every day - going to the gym between classes, going to zumba and yoga, going for hikes and walks. I lost a lot of weight quickly, going from 190 to 160 over about 4 months. It wasn't unreasonable weight loss, but a lot of that happened very quickly and then plateaued - it wasn't a steady decrease of 1/2 - 2 lbs/week. Every time the scale went down I was elated. Every time it went up I was depressed and tried to restrict even more, although I did soon realize that my body needed at least a minimum amount of fuel to be happy.

I was skinny, I was confident, and I was suddenly the new queer darling of Tucson. I was the center of attention and even though it was mind-bogglingly strange for me, I embraced it - hadn't I worked hard to get to this point? This must be what it was like to grow up skinny and pretty! But then as I stopped losing weight and even started gaining a few pounds I got scared - I couldn't ruin this. So whenever I would eat something I "shouldn't" I would purge. And then I started thinking that I could eat anything I wanted as long as I threw it up.

It got particularly bad when I was living at home alone over the summer. My parents wanted me to eat up their uneaten foods? Throw out the things that were expired? It felt wasteful to just throw out the food, but somehow it was acceptable to binge and purge that same food, sometimes over and over in a day. I would buy food at the grocery store specifically to binge and purge - cookie dough and ice cream were favorites. I would petsit for people and binge and purge their food, then have to go and buy more to replace the foods I'd stolen. I dreaded meeting a new family and hearing them say "please help yourself to any of the food," when if they had told me to leave their food alone it would have helped me so much. I couldn't control the part of me that had to eat that food, but it was so much easier if there was a voice in my head telling me that I was disobeying a rule.

When I went road tripping I gained some of the weight back, to the point that I had to buy new pants near the end of my 5 months. I was embarrassed and ashamed, but honestly didn't have many opportunities to purge. So when I got home, I did. It was a little harder, I was living at home and with my girlfriend while going to school and working, but I still had time to be alone in one place or another almost every day. There would be stretches where I wouldn't do it for days, weeks even. But then I would have that binging urge in a time and place where I knew I would be able to purge, and would start again. Stopping was so hard, but once I started up again after a break it just escalated faster and faster.

It got particularly bad over the last year. I would get home before my roommate and binge, then either purge and feel guilty, or she would come home and I'd be stuck with this almost overwhelming anxiety and guilt of having binged without the relief of having purged. When she would go to bed I would sneak food out of the kitchen, going back and forth over and over before finally bringing the container of food in with me and eating it all, purging as my stomach got painfully full. I was so full of shame and guilt - the weeks when I didn't b/p I was always so amazed at how much less my groceries would cost because I still had food in the fridge and cabinet from the week before. After the first time I gave myself a minor sinus infection I swore I was finished - the thought of going to student health and asking for antibiotics for my self-induced infection seemed too embarrasing to contemplate. And I promised myself I was totally finished after the first time I looked down in the toilet and saw a little bit of blood from where I'd scraped the back of my throat and irritated it with stomach acid. I said the same thing after the second time, and the third, and the fourth, and the times after I stopped counting. I promised I would stop after I found myself throwing up in friends houses, or scouring campus for an out of the way bathroom, or going into a store to throw up, or driving somewhere specifically to purge. After I threw up in a bag in my car because my roommate had come home. After my grandma caught me in a lie on vacation as to where I had been after dinner. I finally had to admit to myself that I was never able to stop.

I've told this story to about 2-3 people in the program now, so it's a little easier than it was, even though saying it out loud (or writing it down) is still majorly embarrassing and feels shameful in a way that is hard to describe.

2. List 5 ways that your life has become unmanageable due to disordered eating.

I spend too much on food that I intend to binge and purge - it's wasteful and it's killing my budget.
I obsess over what I eat and feel guilty over deviating from my plan, which is a baseline worry I don't need.
I have to lie to people about where I am or what I'm doing.
I isolate myself in order to avoid being around food or to be alone with food.
I have a hard time concentrating on other people and their needs when I'm so focused on eating/not eating/finding an excuse to leave to eat or purge.

3. Give 5 examples of ways you have attempted to manage the disordered eating, ie diets, programs, eating at certain times, etc. 


Delaying breakfast/eating as long as possible so that I "save" calories for the end of the day when I tend to binge
Making promises to myself that I will stop, starting Prozac again
Planning out my meals and calorie tracking obsessively
Only buying "healthy" foods so that if I don't have binge foods in the house
Living with roommates to have someone around so I can't purge and thus decreasing my ability to satisfactorily binge

4. Give 5 examples of when you lied, distorted, or manipulated the truth about the disordered eating behavior.

All the time. To myself, to friends, to family. Telling myself I will never do this again. Lies to explain the missing food. Lies to explain why I can't go out with friends. Lies to explain why my voice is horse or my eyes are watering. Lies to explain why I need to leave the party early (I really do feel sick, but it's because of guilt, not because of the ceviche). Manipulating family members to explain where I disappeared to.


5. Give 5 examples of how the eating disorder has affected your health.

Weakness, dizziness, vomiting blood, gum and sinus pain, headaches, constipation and diarrhea. Probably some dental problems. A very sore jaw the next day. Guilt compounding depression and anxiety.

6. Please describe your food rituals.

Buying food to binge. Making sure that there was going to be a way that I could purge. Serving myself small reasonable portions but over and over until the whole container was gone. Thinking of food and my current calorie tally all the time. Planning my meals for the day in advance, which gives very little flexibility and would make me panic if I did eat something off my plan. Limiting my access to food. Watching TV while I purged to distract myself from what I was doing.

7. Give 3 examples of when you avoided family, friends, or social events because of the eating disorder.

Frequently - I would say I felt sick and couldn't go out. I would avoid events with potluck style meals because it was too easy to graze. There were times when I had the opportunity to go out and see friends, but I preferred to stay home and binge and purge instead (?!)

8. List 5 times you belittled, or were critical of yourself related to disordered eating.

I still do this a lot. When I told my therapist. And my psychiatrist. And my PCP. And Rachel on intake. And myself, when I would purge. I think it's ridiculous that I'm such a stereotype - a type A, privileged, upper middle class white girl who has very little to be upset about in life, but who is still somehow depressed and feels like she's never good enough so she takes control of the only thing she can - her eating. Except clearly I'm not in control of that either. It feels like I should have the self control to stop this.

9. Describe 2 times that you have felt spiritually bankrupted because of the eating disorder.

I don't know how much I agree with the wording of that question, but I have felt guilt over my binging and purging regarding the waste of food and resources that it represents, and the waste of time when I could be doing something productive and enriching instead of mindless and self-destructive.

10. Describe what you have given up to maintain a relationship with the eating disorder.

The ability to eat without analyzing it, to have a guilt-free meal. Time with friends. Money for other purposes - socializing, traveling, etc. My sense of self as self-determining, as having a strong self-will and the ability to depend on myself for help. I haven't gone to a dentist in 2 years because I've been too afraid that they would know my secret.

11. List any secrets you have kept associated with disordered eating.

The fact that I have a problem. I've hinted to a few friends that I struggle with food. I told my ex that I "used to be bulimic" but that I had stopped when that was really more of wishful thinking and hoping that if I said it I could make it true. I've told one person that I'm in this program, a lover in another state. I've lied about where food has gone. 

12. How do you imagine your life will be different without the eating disorder?

I'm not sure. Right now I haven't binged or purged in 11 days. And I'm very proud of that. But I'm still anxious about food, although it feels better to be doing it in order to "stick to my meal plan" instead of just to obsess over the number of calories going into my body. I hope that I will get to a point where I can enjoy food for the sake of it being delicious without the accompanying guilt. I would like to be able to realize when I am full and then have the ability to stop eating without feeling guilty for not finishing, or feeling the urge for "just one more bite."