Shifting from someone concerned about making health-conscious food choices to a person with profoundly limiting orthorexia was subtle. My decompensation slowly progressed over several years, though my caloric restriction and weight loss were fairly dramatic and abrupt. When I first entered treatment for my binge eating disorder, I couldn’t even acknowledge my underlying anorexic and orthorexic tendencies. I freely admitted to my use of disordered overeating and binge behaviors. This history of using food to numb and avoid strong emotions, discomfort, or pain was a maladaptive coping mechanism that traced back into my childhood. However, I refused to allow that my actual eating disorder began as a predominantly restrictive problem. My adamant denial was so powerful that I actually convinced myself that my nutrition was balanced and adequate when I wasn’t actively binging. (FALSE!) Though I was deeply ashamed of the label “binge eater,” it was easier to identify with that diagnosis than to face the truth that my restriction, over-exercise, and weight-loss obsession was dangerous, unhealthy, and unsustainable. The fear of relinquishing control over my food choices and the threat of the weight gain that might result were unbearable.
Withholding information and bending facts in an effort to create reality as I desired it to exist and my attempts to manipulate the outcome of my treatment only resulted in setbacks, frustration, and despair. As I experienced failure after failure, I begrudgingly revealed the full depth of my disorder. I reluctantly pulled at the threads of my story, picking apart one strand at a time. Finally, eight months after being diagnosed with BED and a month after my discharge from partial hospitalization, my nutritionist was able to weave the complete tapestry together. She was the first to verbalize what I intrinsically knew to be true about my eating. My binging did not exist in isolation. I was also a restrictive eater with underlying orthorexia.
My task is now to unwind the tight tangle of fear, limitation, avoidance, and control. Undoing the knot takes place even more gradually and inconspicuously than the act of snarling it up. Perhaps the subtlety of the process is itself a marker of my improvement. The fact that sampling a “new” food does not always involve a climactic battle against apprehension and anxiety is a victory. This is a pretty stark contrast to last Fourth of July, when staring down a table of make-your-own ice cream sundae fixings filled me with so much panic that I nearly passed out. More recently, I am observing that when I spot a different or novel food, I may just eat it. Whether I am motivated by hunger and a lack of other choices, or by curiosity, or both, the result is the same.
At a Memorial Day cookout with friends back home, both need and intrigue were factors when, rather unceremoniously, I reached for a cheeseburger. Ok, ok. It wasn’t really a cheeseburger. A friend was grilling sliders, those smaller medallions of ground beef, which he topped off with a slice of cheddar folded into quarters. There was no flourish, and hardly anyone noticed when I wandered into the kitchen, observed that these miniature beef patties were my only protein option of the evening, and placed one on my plate (without a bun or condiments). Even I barely registered that this was an unprecedented and unusual action for me. It was only my friend’s half-startled, somewhat awkward, but abundantly considerate and compassionate comment, “There’s more food in the fridge if you need anything else,” which triggered my introspection. Why would I need anything else? I wondered. Why is he concerned? It took a few minutes before it dawned on me… It wasn’t long ago that I DID need my own special meal EVERY time we ate together.
There are still many occasions when I opt for a peanut butter sandwich tucked into my purse instead of lunch at a restaurant when I’m on the go, but I don’t view this as a symptom of my orthorexia. Though my goal is to loosen my restriction, I am still allowed to be health-conscious (and budget-conscious) in my choices. The reality is that I am much more comfortable eating a wider variety of foods when the occasion arises, and my trepidation and self-consciousness about eating in front of others is also improving. Last June, I left the church picnic after 15 minutes, because I couldn’t bring myself to eat a hamburger, and because I was so insecure about not knowing anyone with whom to socialize or talk. A few weeks ago, I attended the same annual picnic, and passed a delightful afternoon, chatting and eating until the cleanup crew began to pack their gear away. I won’t be making hamburgers and cheeseburgers a staple of my regular diet, but I I continue to add experience after experience that reinforces this truth – there is more to food than what I stare at on my plate. This is what nourishes and sustains me – the people I love, in the places close to my heart.