Published in Mental Health / Featured - 12 mins to read

Content warning; food, eating disorders, self harm, depression, anxiety

My relationship with food is not good. I don’t think it’s ever been good, but it became especially apparent to me just how not good it was when I moved to London last May. I suddenly found myself living on my own for the first time amidst the stress of a new job, having moved from a tiny island to a massive city and as you might imagine, the wheels fell off a little. Having wanted to write about it ever since, it turns out writing about this stuff is difficult.

We’ve all made a lot of progress in talking about mental health during the time that I’ve (somewhat involuntarily) taken an interest in the discourse on it. We’ve taken meaningful steps towards removing the taboo around anxiety and depression which is great. There’s a problem though - currently our conception of “mental health” goes something like this:

Obviously, I’m grateful that things aren’t as bad as they once were, but equally obviously, we’re clearly missing the vast majority of the picture here; lots of problems aren’t going to be fixed by a single round of meds or talking therapy. There are conditions whose names we throw around all the time, like OCD, ADHD and PTSD, without having much of an idea of the reality or implications of these disorders. Others we daren’t even speak of, like postpartum psychosis, which affects around 1 in 500 mothers. There are personality disorders, which we still actively retain a powerful stigma against, despite being more common than you might think. And of course, there’s eating disorders, which exclusively affect underweight white teenage girls.

It’s great that men can cry now, but the thing is, we still can’t make ourselves throw up. And so, in a way that is at least partially motivated by my own selfish interests, I want to talk about my experiences with disordered eating, in the hope that one day I can have an actual conversation about it with someone without being overcome by shame and having some kind of acute panic attack.

We’re all obsessed with how we look. It’s even worse if you’re a woman, and it’s already terrible if you’re a man. I don’t want to go over that too much here as I think it’s well-trodden ground, but if you need convincing then some light googling ought to set you right. My own obsession with my appearance and weight began shortly after I started secondary school, when other kids made fun of me for being fat. Honestly, I don’t begrudge it of them; not only were they literal children who were emulating the behaviour they observed around them, but even if they hadn’t called me fat, I’m sure I would’ve come to that conclusion on my own soon enough. My self-esteem plummeted between the ages of 11 and 13, and part of that was that I began to conceive of the notion that my body was something that ought to be hidden from sight at all costs. When I first started having therapy at 16, my bulimia was seen as a secondary symptom rather than a primary issue, which is probably fair enough given how desperate I was to kill myself at the time. My parents went through a phase of making me sit in awkward silence at the dinner table for 30 minutes after meal times, which felt punitive and shameful (not to mention the fact that this is clearly never going to be a successful intervention). I felt like I’d let them down. So I pretty quickly learned to stop telling anyone about purging.

And, to be fair, I haven’t done it that much in the past 10 years. Definitely not enough that I feel particularly comfortable labelling myself as bulimic, nor do I think, on balance, that it is a problem I need to invest significant resources into fixing. Forgive me for preaching to the choir, but making yourself sick is horrible. I know that I’m damaging myself physically and psychologically (and, as a subset of physically, dentally, which often bizarrely feels like the strongest deterrent), and so I try to avoid it as much as I can. Like an addict might, I rationalise every time I stick my fingers down my throat by saying to myself that this is the last time, I’ll just do this once more and then that’s it, I’m quitting cold turkey. Naturally I hope that the last time was indeed the last time, but the pretentious wannabe-rationalist in me knows that the probability of that hypothesis being true is exceedingly low.

Fortunately, purging only shows up for me in times of intense stress or anxiety, unlike its more-common-yet-equally-ugly cousin, binging. Binges are a little more difficult for me to wrap the logical part of my brain around, and I experience them quite differently to purges. They are clearly triggered by some kind of emotion, and often occur as something akin to an out-of-body experience. I know that I am feeling the urge to eat; in the moment I am aware that this is not linked to hunger or satiety but is in fact purely emotional. I don’t want to eat to deal with these emotions, and would rather use a productive coping mechanism instead. But I can’t. It’s very difficult to explain reasonably why I can’t. It’s a compulsion, and I’d hazard that it’s something similar to the feeling experienced by smokers trying to quit. If I don’t initially give in, then I cannot focus on anything else; any time I try to divert my attention, even to something else that would usually capture it fully, I cannot think of anything other than food. There’s a strong physiological response too, and I will sit there salivating profusely, despite usually already being uncomfortably overfull. Inevitably I give in, and can quickly easily go through 5000kcal of sugary, ultra-processed foods in just a couple of hours before feeling awful, physically and emotionally, for at least a day or two afterwards.

Binges aren’t the only thing I think about in calories - in fact I’m constantly thinking about them. I’ve been tracking my food on and off for years in MyFitnessPal on my phone, and I think I’m significantly better than average at guessing how many calories are in a given meal or snack. The message from the fitness and weight-loss industries is that counting your calories is the bottom line when it comes to losing weight, although there are plenty of studies (like this one, this one, and this one) that link these behaviours to eating disorders (author’s note - after finding those studies to link here, I’ve now uninstalled MFP from my phone). I’ve also extensively tried things like intermittent fasting and keto as ways to reduce caloric intake, and even spells of vegeterianism and teetotalism have been ultimately motivated by a desire to lose weight more than any other potential benefit.

When I moved to London, I tried really hard not to buy a scale, but caved after three weeks. My rationale was that without one, I wouldn’t be able to hold myself accountable, and my weight could balloon before I had a chance to realise something was amiss. I am mortally afraid of gaining weight. I reflexively label foods either “good” or “bad”. A lot of my eating happens in secret and in shame, and my diet can look very different when I’m with my partner and when I’m not.

My desire to lose weight is a big part of the reason I wanted to get into ultramarathons; the reason I signed up for my first one last July was in order to make sure that I kept running and didn’t put on a significant amount of weight after moving to London. Losing weight has been a focus of my preparation for the EUT, and it’s a struggle. Trying to exercise for on average ~2 hours a day while limiting myself to 2000kcal is tough on the body, and the mind. I’m not an endocrinologist, but it seems like my hormone balances have shifted as a result of my attempts to eat below maintenance and are now duly demanding that I eat more. This has led to mini-binges, where I end up eating more than I had planned to, to the point where I have roughly consumed my maintenance calories for the day, and then I feel all the same guilt and shame as if I’d had a 6000kcal day.

I think of these behaviours as forms of self-harm; they function in my brain as pretty similar to that of cutting, except there is no physical manifestation of them for anyone to see. I don’t cut these days, not because I don’t have the compulsion to, or because I have found healthier coping mechanisms, but because people end up seeing cuts, and they’re awkward and difficult to explain. If I cut and my partner sees it, she’ll feel sad because of me. If I binge-eat 12 Krispy Kremes and then throw them back up in between sobs, then she’ll have no idea.

By a lot of metrics, I’m pretty physically healthy. About 80% of my clothes are a size “medium” and the other 20% are a size “small”. My resting heart rate is around 55 BPM according to my Garmin watch, which puts me decently below the average for men (NB - being below average in this instance is desirable!). I exercise every day, have no existing physical health conditions and eat something that I believe balances out to be a healthy diet. But I’m still obsessed with losing weight. In fact, on some level, I think it’ll solve all my problems; I’ll find true love, along with my perfect job and untold riches when I finally get to some magical number on the scale. I’ll go from a self-esteem zero to a self-esteem hero; my social anxiety will disappear completely when I suddenly feel worthy of actually talking to people; my mental health problems will disappear in a puff of smoke.

My biggest inspiration for writing this was hearing a close friend recount their own struggles with eating issues before, to paraphrase their words, taking responsibility for putting in the hard yards and working on solving them, and that’s what I need to do too. I briefly looked into seeing a therapist specifically for eating issues last year, but after a GP referral I discovered the waiting list for the South London and Maudsley Eating Disorder Service is nine months long due to the COVID backlog. It’s not their fault, and I’m sure they’re doing their best (as with all things, I’m going to choose to blame it on Boris Johnson. If you read this Boris; fuck you), but I obviously couldn’t wait nine months. I had one initial meeting with a private therapist but didn’t feel like we clicked at all, and combined with the expense of private therapy, that was enough for me to give up on my search.

Eating as a coping mechanism is so deeply ingrained in me that simply having an awareness in the moment of it happening is not enough to stop it, but I still have to try and stop it. My plan to get better feels flimsy and unmeasurably, but it’s the best one I have, and I’m hoping that it’ll grow into something more robust with enough time and energy. I plan on writing more about eating, talking more about eating, and learning more about eating. I’ll keep writing in my journal and perhaps here, if I think there is enough to warrant a follow-up post. I’ll talk to my partner and close friends about things in concrete detail rather than vague waves of the hand, and my colleagues and manager at work about these things affect me. In fact I’ll talk to anyone who’ll listen or has anything to say, really. But learning will be most important I think; there is a wealth of resources out there, from inspiring stories of recovery, to comforting accounts of people who are just like me, to scientific literature laying out which interventions are most likely to succeed. I am particularly keen to understand more about my endocrine system, and how changes in my diet affect it, and how it might be responsible for a lot of the compulsions I feel. Similarly, I want to continue to understand it from a psychological perspective, not only by continuing to try to break down my own patterns, but by reading what practitioners and researchers have to say eating disorders and disordered eating.

The point I really want to get across here is that for many, eating is a vector through which to invisibly self harm, myself included. It’d be great if we could all get to a place where people don’t feel the need to inflict so much damage on themselves, and I want to start with myself. And of course, hopefully one day it’ll be socially acceptable to talk about all this, just like some physical malady, rather than it taking nine months for me to muster the courage to post this.