How I felt after I told my therapist about my ED

I feel like you must hate me. I know what I told you last week makes me a bad person. I hate myself for it. I hate myself in general. I’m weak, I’m awful, I’m lazy. I’m also scared. I’m scared of being forced to eat something and I won’t have my toothbrush or be able to get to a bathroom or something will prevent me from vomiting. 20 mins after eating is the ideal time to vomit, but what if I have to wait half an hour? What if I mis-time it? How much of the food will I absorb? Will that mean the scales won’t go down the next day? What will THAT mean? I’ll feel terrible. Ill die. I feel scared when I eat big amounts of food. But I don’t binge in the traditional sense, eating a regular meal, like a sandwich, makes me feel like I’ve binged. I also feel scared with small amounts of food- like a couple of berries or an egg. Sometimes I skip meals because I’m too scared that I won’t be able to vomit effectively. What if there isn’t enough food to come out? What if I’ve already digested it? And sometimes I don’t want to vomit because it can be a pain for only small amounts of food so isn’t really worth it. Other times I feel too terrible to eat- like the way I did last time I saw you.

I plan my day around being able to eat by myself – not necessarily in secret, but alone in cafes where no one will challenge what I’m eating. I have a good brunch food to eat with friends – eggs – they’re soft so they come up easily and the bit of protein I absorb sustains me through the day. But I don’t really have good lunch and dinner food. Being able to get to a private bathroom is also critical for me. That way I can take my handbag with my toothbrush in it and vomit without anyone else hearing. When my parents were staying with me I relied on Dad having the tv up loud after dinner, putting the fan on in the bathroom and running the tap to drown out the noise. They didn’t suspect anything. It will be harder over easter – I’m going to Uluru with my parents and am sharing a room with my mum. What if she hears? We’re having dinner one night outside and there may not be any bathrooms – what will I do? Will that be the start of the return to my previous eating habits?

I vomit after every time I eat because I’m scared of not. I’m scared about letting myself eat a couple of berries or some vegetable because it feels like a slippery slope to eating a big amount and not vomiting or to eating like I used to and getting further away from my goal.

I’m also worried about my latuda dose. I take 40mg but it needs to be taken with 300 calories. I’d barely consume that in a day, let alone in one meal. Now that my mood is stable I don’t want to upset the medication balance but am too scared to talk to A (my psychiatrist) about this to get advice on whether I increase the dose to 80mg to compensate for not having the calories to absorb the meds with.

Sometimes vomiting makes me happy. Especially when it’s brightly coloured – like after raspberries or blueberries or blackberries. It’s pretty. I imagine after some gelato flavours – like watermelon – would also be bright and pretty and make me happy too. Eggs are boring but it’s such a good food – it ticks all the other boxes so I’ll have to push through. Sometimes it’s difficult though – it hurts the back of my throat, I push the back of my throat hard with a toothbrush 9-12 times a day. It feels like it’s bruised. On the pro-Mia sites, contributors talk about being able to vomit by tensing their stomach muscles. That would be amazing. I feel like people will become suspicious of me carrying my handbag to the bathroom 20 mins after eating every meal.

You asked me why I was telling you when I told you. I’ve reflected on this and know I didn’t provide a very compelling response. I feel like that question had two parts – why YOU and why NOW. I can answer you better now. Why you – because I thought you’d take me seriously and you’ve believed other things that I’ve told you in the past. And I needed someone to listen to me while I organised this in my head. It feels chaotic and incohesive. And if I tell my GP she’ll try and change me; I don’t want to worry my best friend; I’m not sure how A (my psychiatrist) will respond – he might try and change me too and I don’t want to change, I’m happy on this path. And why now – because making a public commitment is more likely to see me reach my goal. If I’m the only one who knows about it I can become weak and give in. If you know, you’ll expect my body to change so it’s incentive to keep going. I have to keep going so you don’t think I’m weak. It’s like an accountability method.

I’m also addicted to weighing myself. I’m still only doing it once a day. I’m scared to weigh myself at the end of the day – what if I’ve gained weight or haven’t lost as much as I thought? I love watching the numbers reduce. It’s addictive and rewarding. Sometimes I lose 1.5kg over night. I know a lot of this will be fluid but some of it must be fat too. It’s so satisfying when I drop into the next number bracket.

I’m looking forward to reaching my goal. I feel like then people will accept me and I won’t have to feel ashamed. I feel like my life will be better. I won’t be judged. I won’t feel guilty. People will like me. People will love me. I’ll be a better person. I’ll be smarter, stronger, harder working. I just need to stay strong and focussed.

You asked me about the hunger, and the reality is I don’t really feel it much. It’s like a switch has flicked inside me. I feel so disconnected from my body. This is bigger than me. I’m not in control. I feel too guilty to eat, and the vomiting is automatic. Not like it happens naturally, but in the way that I walk to the bathroom on autopilot after I eat and push the toothbrush down my throat. I also think because this isn’t pure restrictive eating that I’m able to control my hunger better through satisfying it – it’s the perfect balance – in the past I’ve only been able to fast for 5-6 days. That’s a hard way to go. Even in 2016 when I lost 30% of my body weight in 6 months I nibbled on small amounts of food once a day. This time I am eating, it’s just small amounts and then I’m vomiting. I don’t think I’m vomiting it all, maybe 30%. I feel ashamed to admit how small that is – some girls spend half an hour in the bathroom vomiting til it’s all gone. They have complex systems of marker foods etc. I don’t have time for that. Maybe I’m not as committed as them. Maybe as I get closer to my goal I’ll need to do that, but right now what I’m doing is working for me. My theory is if I restrict AND vomit that will give me the best chance of reaching my goal. It isn’t the fastest rate – the fastest rate would be to go full restriction, only eating once every few days. But this is sustainable. I still get to feel satisfied, but the food doesn’t get a chance to get absorbed so I can see myself moving towards my goal. I also sip water and Coke Zero through the day, this way my stomach always has something in it. But at other times I quite like the hunger sensation. This is what it was like in hospital. I didn’t eat for days and it felt really good – made me feel really strong.

I’m really struggling with whether the amount I vomit is enough. If I eat 120g of raspberries (60 calories) for lunch, wait 20 mins and vomit twice, am I removing enough from my stomach to reach my goal? I wish there was someone I could ask who could provide technical advice. I can look on promia sites but they all refer to binges – like 2000+ calorie binges – and mine are max a couple of hundred (like when I eat eggs). I feel like I could ask a dietician but I’m worried they’ll tell me to stop vomiting and I’m too scared to stop. I don’t think I can. I’m scared of loosing control of my eating.

It also makes me feel really strong. Like when I eat with my colleagues and I lie about needing to make a call or go to a shop after and I go to the bathroom in the cafe across the road to vomit instead. When I come back and I know my stomach is basically empty but I’m functioning normally with my manager and my colleagues. I like this hidden part of me. I don’t want to share it with people. I like that people would see me as bright and bubbly even though I’m completely obsessed with avoiding my next meal and where I can vomit. It’s a strange, but addictive, way to live.