Living with Ed

A medical student shares the experiences of living with anorexia

I love medicine. I love the challenge, the variety, the opportunities, the excitement, the people, and the patients. I love the discussions, the sense of community, and the team work. But for the past two years there has been someone on my team who is destructive. He interferes, meddles, and messes. He is always there. He is always by my side. His presence is relentless. His name is Ed. Ed is my eating disorder.

Ed is secure: I know I can depend on him. Ed is always there for me. Ed makes me feel in control. Ed gives me confidence. Ed tells me that I do not deserve food and that I am unworthy, and he leaves me guilt ridden if I do eat. Ed is manipulative and dangerous. Actually, when Ed is around, he is in control, not me. He is powerful and can easily deceive. He makes me lie, and, however much I try, there is no getting rid of him. He cannot be trusted.

Dominant Ed

I have been lucky. I have managed, so far, to keep going with medicine and not allow Ed to take over completely. The medical school has advised me to take time out, to recover and return, instead of limping through. Time scales and options have been discussed and the school has been flexible and supportive. But I will not be persuaded. To me, having a break now is truly giving into Ed. He will have won for sure.

Ed has made his mark—holidays missed and excuses for meals out and birthdays. He has narrowed my world, restricted my freedom, and made me highly dependent on my family. I have had tremendous care and encouragement from a wonderful team of people, my family, and friends. Without them, my short stint of inpatient care would have been far longer and my discharge non-negotiable.

My experience as an inpatient was short, two weeks. My consultant hoped that a brief admission would help me get into the habit of eating regularly, challenge some of my beliefs and fears about food, and break my rigid routines. I enjoyed the contact with other patients with eating disorders and benefited from group and intense individual treatment. I wanted to change, and I put immense energy and effort into my admission, but Ed had other plans. After my discharge, he was stronger than ever, and I instantly shed the small amount of weight that I had gained.

Now I am closely monitored— weekly weigh ins and therapy and my care is continually reviewed. The whole process is time consuming. My life seems a blur of food, eating, and therapy. My diet is altered to keep pace with my changing metabolism, and I have to meet interim target weights. The pressure is on. I am getting there and I am improving and gaining in mental strength against Ed, but progress is slow. My consultant reminds me that with Ed still on my case, I may pass my finals and qualify but prove to be unfit and unsafe to practice. Will Ed leave me in time? My future seems uncertain.

Battling Ed

Being in the grips of an eating disorder is tiring. It is a constant battle. Sometimes the battle against Ed is too great, he cannot be overcome. Half a sandwich is thrown in a nearby bin or a cereal bar remains unopened, untouched all day in a bag. Trying to converse and compromise with Ed is boring. Believe me, if long term patients could “just snap out” of their eating disorder—a common misconception—they would. Anorexic people are sometimes portrayed as creating their own self indulgent problem. Given the choice, they would instantly give up Ed. To be rid of Ed means freedom, choices, opportunities, and a life.

I try to see the positives. Now that I am not so gripped by the illness, my picture of things is less clouded. Maybe my anorexia will make me a better doctor, have a greater understanding of people, and make me a stronger person. Maybe I have brought my family closer together and have really grown to know myself and let people know me. One thing I have learnt is deep knowledge, understanding, and immense empathy for anorexic people and their families. Sharing my experience is important. Raising the profile of anorexia, offering my story, and using my new skills will make my anorexia a more positive experience. If I can prevent just one person travelling the long road that I have travelled, it will be worth it.

Being aware

My advice is simple and relevant to medicine but also to life. Be aware. Be aware for symptoms and behaviours in your patients, your friends, and also your colleagues. Do not ignore an abnormal and obsessive exercise routine combined with a disproportionately low intake of calories. A person with anorexia may purposefully become excessively busy to avoid food, hunger, and meals or may throw large amounts of food away, never fully finishing a meal. They may enjoy watching and encourage others to eat, perhaps cooking elaborate meals, yet never take a mouthful themselves. Look out for dangerous and altered food habits—a plate piled high with vegetables, almost to the exclusion of protein and carbohydrates, never ending excuses for having eaten earlier, a fear of fatty and “indulgent” foods, and, most of all, frank denial of weight loss.

Acting suspicious

Act, if you are suspicious. There is no harm in a gentle confrontation or innocent conversation. People with anorexia reject the idea that they have a problem, making a sensitive situation impossible. Nevertheless, do not be shy, dismiss or ignore symptoms, or give up on a person. Keep a watchful eye. Let them know that you know they have a problem. It may be a long while before they themselves can confront and admit to say that they have an Ed. Contact the Eating Disorders Association for help and advice and encourage the sufferer to do the same. Most of all, be there for them. Wait and don’t leave. They will need you. You may be the one who catches them.