Written by Kelsey Rideout 



I remember a conversation I had with a good friend of mine last summer. As we filled each other in on life’s ups and downs, we began to talk about our family and friends, and not long after we realized that both of us knew of loved ones who were facing a similar problem. I was relieved to hear that she could relate to the frustrations that I was feeling, but also a bit saddened that she too had to endure the process of seeing someone close to her suffer. We talked about its widespread nature, and the lack of resolve for most of the individuals we knew who were living with it, agreeing that the term “epidemic” may not be an exaggerated description. It wasn’t cancer that we were discussing, even though its prevalence rate remains exhaustingly high. It was eating disorders. Up until that conversation, I hadn’t fully realized just how pervasive eating disorders have become, and how many lives have been directly or indirectly affected by the illness.

According to the Wellington-Dufferin-Guelph Eating Disorders Coalition, eating disorders affect up to eight per cent of Canadians.

“Another 20 to 30 per cent may have some of the symptoms of eating disorders. 10 per cent of those with eating disorders are male. We know that no particular age, social class, ethnicity, or gender is immune to developing an eating disorder,” explained April Gates, Program Coordinator for the Eating Disorders Program at Homewood Health Centre, at a recent community event. Perhaps most alarming, described Gates, is just how many lives are lost due to the illness. “We also know that eating disorders have the highest mortality rate of any psychiatric disorder.”

Clearly, this is a serious and often life-threatening problem worthy of further exploration. Hopefully this piece can provide a glimpse into the reality of eating disorders, and through sharing stories of those who’ve struggled, showcase another sometimes-contested truth; that recovery is indeed possible.

Life with an eating disorder
      


Eating Disorders Awareness Week took place from Feb. 6 to Feb. 12 across Canada. The Wellington-Dufferin-Guelph Eating Disorders Coalition held events throughout the week, including a panel discussion entitled “Faces of Recovery.” The discussion featured five individuals who had personally been affected by eating disorders, and invited them to share their own journeys with the public. Each of their speeches bared witness to the power of recovery and detailed the misconceptions that continue to circulate around the intricate illness.

The evening began with perspectives from a young, athletic male. 22-year-old Andrew House from Goderich, Ontario, described how an onset of weight preoccupations began when he was 16 and became more heavily committed to sports.

“I picked cycling as the main sport I want to focus on and excel at. I started to become really aware of my body at that time. I noticed that other pro-cyclists and good athletes seemed to be a lot leaner and smaller than I was. And I thought that if I wanted to be faster, that’s what I had to do.”          
 
House explained how his eating disorder started slowly and that he refused to acknowledge the problem, even as it persisted.

“I started to cut back on my meals. I started to train really hard in order to lose weight. I did and I thought that was great. I started to get a lot of attention from other bikers at races and they’d tell me how good I was looking and that kind of just fed it on.”

Eventually, the symptoms got worse and House could no longer hide his eating disorder from others. Friends and family started noticing major changes and became worried.

“I kept just going downhill from there. People started to notice that I was abnormally thin now. My skin was becoming discoloured at that time, which told me that my liver was starting to get stressed. You could really notice it in my hands, my feet and sometimes my face. My parents became very concerned because of this.”

After seeing many doctors, House was finally properly diagnosed with an eating disorder. He reflected on a conversation he had with a dietician who had dealt with eating disorders throughout her career.

 “She knew from my thinking patterns that something was wrong. She basically told me that if I don’t make some changes now this is going to get out of control, [that] I’m going to get to a real serious low and end up struggling for my life in a treatment centre somewhere, and I said, ‘No it’s not going to happen to me.’  I still didn’t want to come to grips that there could be a problem.”

After years of denial and resistance towards treatment, House was eventually taken to Homewood Health Centre, a specialized mental health treatment centre in Guelph. He completed the program only to leave and relapse, and his condition worsened more than ever.

“At this time, I was struggling with six different eating disorders, three behavioural problems and doctors basically gave up hope. And nobody knew what to do. My doctor said, ‘You got less than maybe a week or two weeks to live.’”

House’s competitive nature was part of what saved his life and triggered an urgent need to survive before it was too late. 

“I took on a challenge to prove [my doctor] wrong. That’s where I really turned around and made my decision that I wanted to recover. And from there on, I didn’t seem to struggle. When I wanted recovery, the struggle was different.”

House described the uncontrollable thought patterns he endured while suffering from his eating disorder. Ashlean Richardson, a university student at the University of Western Ontario, explained how eating disorders might appear to be physical but actually stem from deep mental struggles.

“I guess my main message is that an eating disorder isn’t a statistic. It’s not a phase and it’s not a certain list of symptoms. It doesn’t define me and it doesn’t define any of you. I promise it doesn’t define who we are as people. An eating disorder is a mental illness and it gets widely stereotyped,” said Richardson, who is recovering from bulimia nervosa.

Courageously, Richardson read from a journal entry she wrote the night after her family had found out about her eating disorder, which described some of her own negative thought processes.

“It’s nights like these that get to me. The nights which are becoming increasingly frequent where I lie awake in bed and I just can’t turn my brain off. I don’t know who I am anymore…No matter how long or hard I search, the feeling of not being understood just won’t go away.”

The psychological elements attached to eating disorders make them especially difficult to overcome without treatment.

“What people don’t know is what goes on inside a person’s head,” explained Gates. “The constant chattering and the eating disorder voices. It doesn’t mean that they’re psychotic. This is just a part of their eating disorder. They have a lot of rules that they have to follow. Their eating disorder tells them to do this and do that, or don’t eat this or eat that. It’s very complex.”

Each panelist who had suffered from an eating disorder had received professional help and credited the external support as playing a large role in their process of recovery.  

Recovery and treatment

 “Recovered. It’s a powerful word to me. It means eating three regular meals without hesitation. It’s being able to eat some chips without feeling guilty. It’s having Christmas chocolate still in the apartment a few weeks after Christmas. It’s taking care of yourself, mind, body and soul, and wanting to be healthy in order to survive and live the life you want. My name is Tracey and I’m recovered from my eating disorder.”

These inspiring thoughts about recovery came from Tracy Hamilton, a university student and Guelph native. After years of experiencing a very contentious relationship with food while undergoing the loss of several loved ones, Hamilton sought professional help and finally began to heal some of her deepest, most debilitating wounds.

“I’ve taken the power back from the food,” shared Hamilton. “I used to associate certain foods with certain feelings. I would feel emotions when I saw these foods all over again. The good feeling foods I would enjoy eating and eat a lot of them. And the bad feeling foods I would avoid and feel very anxious around. Working through the pain that I have been protecting myself from, by using food, was a long hard journey, but it has healed me in so many ways. I had been avoiding my depression by numbing out on food.”

I went to Homewood Health Centre to learn more about eating disorder recovery programs by talking with professionals in the field. I was met by Gates, who, as previously mentioned, is the Program Coordinator for the Eating Disorders Program, and Monika Krau, the Recreational Therapist on board.

I asked them to describe the process of treatment administered by Homewood for patients with eating disorders. With an interdisciplinary team that includes a dietician, a horticultural therapist, a psychologist, an occupational therapist, a social worker, nursing staff, a family therapist, a chaplain and a pharmacist, Homewood’s approach to enabling recovery is nothing short of holistic. Two major components of treatment include Cognitive Behavioural Therapy, a type of therapy that helps patients to identify and change harmful thinking, behavioural and emotional responses, and Dialectical Behavioural Therapy, a more skills-based approach to treatment. Krau further explained the significance of the community for patient recovery. 

“We’re a group based program…the community milieu is really an essential part of our program. [In] realizing that they’re not alone, [patients] share their stories and are able to build in the community. We always say that you alone can heal and be in recovery but you can’t do it alone.”  

Gates explained the need to be upfront with individuals when it comes to their understanding of where Homewood fits into their recovery.

“We always tell the patients when they come in the door that Homewood is not the cure, not to expect the cure…It’s similar to building a house. You have a good solid foundation, and that’s what we hope to provide at Homewood and building the rest of the house is the further work they need to do in the community with their support system.”

Although the staff collaborates to provide the best possible outcome for incoming patients, individuals who are unwilling to participate may be asked to leave. This can be hard on the staff.

 “Secrecy is the cornerstone of an eating disorder,” said Krau. “So [we need to] appreciate that there’s a lot of shame and guilt connected up to a lot of behaviours that are connected to eating disorders. I always think of it as going into an environment where you’re talking about your most personal things, you don’t know everybody here, you’re in a new sleeping environment, [and] how difficult that is, and really I think the tough thing for the team is when the secrecy element is there…and [patients] not [letting us] know that they’re struggling.”

Gates and Krau commended all of those who have participated in the program for their courage, describing it as an honour to be able to work with them throughout their pursuit of recovery. 
           


A smattering of support 



While many individuals with eating disorders are forced to encounter serious, life-threatening battles, governmental support remains low and organizations find it challenging to secure consistent funding. At Homewood Health Centre, there currently exists 13 beds for patients with eating disorders, which is down from 20 beds that were available at one point. There is a waiting list for incoming patients, and an even longer waiting list for the few beds covered by OHIP, our provincially funded health coverage.

“We know from the number of people we have coming out of province, they’re very, very lacking in services there too. There needs to be a lot more money put into eating disorders, especially when the prevalence of eating disorders is so high, and the mortality rate is so high as well,” urged Gates.

Some of the changes that Gates hopes to see is an increased number of in-patient programs for eating disorders in Canada.

“I think even looking up 10 to 20 years ago, there are a lot more opportunities for treatment. Not so much inpatient but certainly outpatient…As far as residential inpatient programs such as ours, Toronto Hospital and Ottawa are probably the closest programs that are similar to ours. There’s not a lot.”

Krau would also like to see a daytime hospital set up in Guelph to better enable Homewood patients to effectively transition back into the community.

“A day hospital in our community would be fantastic…To have that step down in the community seems to be a gap in general. It would be great to be able to come and see us during the day and then to ease into that [transition] slowly.”

Although there remain challenges for rallying up support, Gates and Krau believe that the issue of eating disorders has been gaining ground and are hopeful that it’ll be increasingly recognized as a serious problem by the government and society at large in the future. 

Life is worth fighting for

The journey is a long and difficult one. If you or anyone you know has ever encountered an eating disorder, it’s safe to assume that recovery required an enormous amount of time and energy.  Some of the panelists suggested that it is a lifelong struggle, still finding days where strength is needed to overcome thinking patterns and emotions that would typically manifest into the eating disorder before treatment. It is a battle, but by no means a pointless one.

House urged concerned family and friends not to lose hope, even though individuals suffering from eating disorders may be very resistant to treatment and change. Having a loving family and supportive friends who stood by throughout the self-induced pain and relapses was integral to his eventual recovery. House recalled the time that he was in Homewood and was debating whether or not to leave the program. One night, another patient sat down with him for three hours to listen to House’s fears and uncertainties, encouraging him to stay in the program despite how challenging it may be. House was reminded that “someone seriously cared” and described the conversation as a key reason as to why he ended up living. 
 
Educating ourselves about this illness, and understanding that it is a multi-faceted problem, rooted in many deeper, unresolved issues, may help individuals begin to feel less shame and more support in getting the help that they need. Challenging the media in their projected notions of beauty and skewed body images is another action needed in shifting the dominant and misleading paradigm about weight. Lobbying for better funding and programming will help to ensure that there are places for those with eating disorders to turn to, regardless of their income or area of residence. It may be a long road ahead to seeing this kind of widespread change, but like anthropologist Margaret Mead so eloquently once said, “Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has.”

 

Examples of Eating Disorders

Anorexia Nervosa  People who have anorexia nervosa are obsessed with controlling their eating. The reason for their obsession is the belief that by controlling their bodies they can control their lives. This obsession is usually achieved through starvation.

Bulimia nervosa is characterized by cycles of bingeing and purging. As with anorexia, this behaviour is driven by a desire to regulate feelings, and with worries about body weight and shape.

Binge Eating Disorder (BED) Individuals with binge eating disorders eat excessive amounts of food at one time.

Anorexia Athletica (Compulsive Exercising) Anorexia athletica is a condition where people over-exercise because they believe this will control their bodies and give them a sense of power, control and self-respect.

- Obtained from NEDIC, National Eating Disorder Information Centre

Resources

Student Health Services: www.uoguelph.ca/studenthealthservices 

Counseling Services: www.counselling.uoguelph.ca/counselling

The Wellness Centre: www.uoguelph.ca/studenthealthservices/wellness

Homewood Health Centre: www.homewood.org

Wellington-Dufferin-Guelph Eating Disorders Coalition:  www.eatingdisorderscoalition.ca

National Eating Disorders Information Centre: www.nedic.ca

Quotes:

“Eating disturbances (dieting, disorder eating and eating disorders) and low self-esteem have been shown to occur in up to 25 per cent of university women with the number of men being affected is increasing steadily each year.  Some research findings suggest that the risk of developing an eating disorder increases with higher education. Eating disorders are not really about food or weight but rather are about underlying issues such as perfectionism, a fear of failure and a need for control to name a few (remind you of any university students you know?) and can be a way to cope with or avoid one’s problems.  There is also a lack of understanding and resources available for special populations (e.g., minority groups, the LGBTQ community, individuals with a disability) and their unique issues associated with body image and eating disturbances.” – Ashley Skinner, Senior Peer and coordinator of Acceptance Without Limits at the Wellness Centre.

“An eating disorder isn’t a statistic. It’s not a phase and it’s not a certain list of symptoms. It doesn’t define me and it doesn’t define any of you. I promise it doesn’t define who we are as people. An eating disorder is a mental illness and it gets widely stereotyped.” – Ashlean Richardson, eating disorder survivor

“Secrecy is the cornerstone of an eating disorder.” – Monika Krau, Recreational Therapist at Homewood Health Centre

“Our society views body image dissatisfaction as a normative discourse and that is a huge problem. Jiddu Krishnamurti once said, “It is no measure of health to be well adjusted to a profoundly sick society.”  I have met so many beautiful people (inside and out) that think they are worthless and deserving of poor treatment because they don’t fit an ideal.” – Ashley Skinner, Senior Peer at the Wellness Centre   

 

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