I am here to tell you one thing and one thing only: When it comes to having an eating disorder, the twisted concept of feeling like you are “not sick enough” is one of the most dangerous parts of the disorder. Eating disorders are not a contest. You do not have to be “thin” to be struggling.
You do not have to “look sick” to be so stuck in an illness that you cannot imagine living another day. You do not have to be hospitalized to be worthy of seeking treatment. You do not have to check off all of the diagnostic criteria listed in the DSM-V to “count.” There is no such thing as not being “sick enough.”
In the interest of full disclosure, I am writing this as much for myself as I am for you. For almost half my life, I have struggled with feeling like I am “not sick enough” to actually have an eating disorder. Concerns voiced by mental health professionals, coaches, friends, mentors, and teachers over the years paled in comparison to the voice inside my head telling me that unless and until I lost [x] amount of pounds; unless and until I actually fainted upon standing instead of the world going fuzzy around the edges for a few seconds; unless and until I ate under [x] amount of calories a day instead of subsisting primarily on self-loathing, caffeine, and nut butter, I wouldn’t be sick or “sick enough” to have a real problem.
Let me tell you a little bit about what it is like to feel not sick enough. It is having people praise your dedication and commitment to health and fitness, when it feels like anything but. It is receiving attention and approval based on your shrinking physical appearance, when attention is the absolute last thing you want. It is constantly being barraged with comments of “I wish I had your willpower,” “You look so good!” or the perennial favorite: “What is your secret?” It is rationalizing, manipulating, lying, and ignoring. Perhaps most terrifying of all, it is actually wishing you were “sicker” so that your disorder could be “real.”
Nobody would knowingly ask someone with an eating disorder what their “secret” is. Yet, when you appear healthy, you get asked that a lot. I never came up with a good way to respond, so I usually demurred or laughed awkwardly. Not because I didn’t have a response but because it would have been a little intense to respond as follows:
My secret? Do you want to know my f*cking secret is? My secret is all I think about is food. My secret is unless I exercise twice a day, my stomach would be so knotted in anxiety I would be literally incapable of functioning. My secret is I could not show up or be present in social situations involving food (hint: all of them) without losing my sh*t. My secret is I was so intensely distrustful of and hateful toward my body I could not and would not allow it to tell me what it wanted. Hunger is something I understand, knew, or listened to. My secret is the food you saw me eating had been meticulously prepared, logged, weighed, measured, and planned days in advance. My secret is my life is spinning out of control.
I was at a “healthy” weight; therefore (and despite all evidence to the contrary), I wasn’t sick enough to have an eating disorder.
There is a massive and dangerous dichotomy between the general public’s understanding of eating disorders and their harsh reality. Let me tell you and tell you again in case you weren’t listening or ready to hear it the first time: Eating disorders do not discriminate. They do not solely present as severe malnourishment in young, white females. They are not always identifiable upon first glance.
Sometimes they have little to nothing to do with a person’s weight. The number on the scale serves only to torment the person with the illness and doesn’t work as a gauge of their health or sickness. Because of this, countless people become more and more entrenched in behaviors that are killing them.
I hope this piece resonates with just one single person who may be on the fence between reaching out for a lifeline or continuing to struggle in silence. I said I was writing this piece for me, and I am. However, I am also writing it for you.
This piece is for the girls, the boys, the men, the women, and the non-binary human freaking beings of the world. This piece is for anyone who has ever felt like their struggles and their pain don’t “count” because they don’t “look sick.” This piece is for the person who wants so desperately to believe they are worthy of help, love, and wholeness but still feels they need to get “sicker” before they have a “problem.”
This piece is for you.
Because you matter. You are not alone. You do not have to live the way you are living. While you may not realize it because the disorder is telling you otherwise, you are enough.
Jacqueline
I cannot even begin to explain how much I relate to this post. I have been hiding for years because I fear others will say my struggle was not real, that because I was never hospitalized that it really wasn’t that bad, that because it doesn’t fit the movies and book’s images of eating disorders that it’s not real. Thank you for this. Thank you so much. This gave me so much courage to share my story. Thank you.
Sarah
Thank you so much for this article. This is my life story, struggled with an eating disorder and cutting for years but since I’m an expert at the “act and mask” and I’m actually overweight no one notices or says anything.
Tracey zuzek
What an amazing read. Thank you for this. I suffer from hep C and I am told I am not sick enough to get the cure. Reading this made me feel great why your honest is beautiful. Keep going. Keep writing. Your beautiful just as you are.
Mirella Keast
I still vividly remember being in an eating disorders unit and being told by one of the other girls there that I didn’t look skinny enough, on my first day there. I still feel that I’m not “…. enough” to need/deserve help.
Gabriella Hadfield
Thanks for this, I don’t have an eating disorder but I do suffer from anxiety/depression. I was told last week that I had to go and see a phycologist but I didn’t think I was “sick enough”. This really helped, thanks!
Jules
This price found me in a time I needed it badly. This hit hard and it has reinforced my drive to continue to fight to be healthy. Thank you.
Angela
I don’t have an eating disorder, but I’m pretty darn sure I have an anxiety disorder. The problem is no one really takes my anxiety seriously because I seem fine. My panic attacks are never so bad I cannot function. My anxiety doesn’t keep me in bed all day. But it’s still there and it still makes me feel like crap. It still makes me do things I later regret. I just want to ask someone for help but I’m so scared they’ll dismiss it. I’m so scared they’ll just think I’m vying for attention when in reality I just cut myself for the first time yesterday because it was all just too much to handle. It’s so hard pretending to be okay because that’s the only thing the people around me will accept. I just want to be open with people around me and have them be understanding instead of screaming at me that they’re not the source of my “anxiety”. (Looking at you mother dearest) I’m just so tired of crying behind closed doors because I’m ashamed. I’m so tired of thinking that my feelings make me look like an attention whore. I’m just so tired.
Carlynne
Hey Angela. My name is Carlynne. I have experienced anxiety and depression and I am in recovery from cutting. I haven’t cut in about 5 years but it is something I will be in recovery from for the rest of my life. When I want to cut I call my friends or tell my fiancee. I need to be open about it. I know if I go back to it I will eventually die, and i don’t want to lose myself. I know what it is like to have anxiety and depression, and to be scared about getting help and wondering if what I am experiencing is enough to get help. The answer is that it is ok to get help just the way you are. If anyone tells you otherwise, if anyone tells you that your pain is not enough, do not listen to them. Please get help just the way you are now. Please do not continue the path of cutting and instead get help. I know it can be difficult and be very hard, but I want you to know that you can do it. I want you to know that your life is worth living, that you are worth getting help just the way you are now, and that you are not alone.
Andrea Dominguez
From a very young age i began to “starve” my self. It was the only thing i could control. In middle school and high school i was a swimmer,other teammates would make themselves vomit to look skinny for swim meets. I ofcourse became a bulimic. I noticed senior year i myselfne damage to myself.
Heart mummers,tooth enamel ruind by years of vomiting and excessively bloating when i ate or drank anything. Im a mother of three now. Disgusted by my body daily i now find my self binge eating. Eating in the midnight hours. Sometimes i go back to not eat. My eating habbits have not always been about my weight. They have also been a way to hurt myself. At times i feel ashamed. At times i feel better being self destructive. Eating will always be a issue for me. A way to deal,cope and hurt. It is so much deeper than wanting to be thin.
Becky Ebert
Andrea, thank you for sharing your story and your struggles. Body image is a common issue for many people, such as yourself. Especially starting at a young age. We hope that you will consider seeking professional help. You deserve to feel good in your skin. You deserve to not punish yourself in any way. Please visit our help page for more information: https://twloha.com/find-help/local-resources/ OR text “TWLOHA” to 741-741 to be connected with a trained counselor.
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colette
I do not feel or believe that I am enough. I can’t ever be enough. I am a fucking waste of space. That is all i am.
Becky Ebert
You are enough. You are not a waste. Please try to offer yourself the same kindness and love you give to others. You deserve it. You deserve respect from yourself. If you ever need to talk, or need someone to listen, you can always reach out to us at [email protected]. Or, if you want to be connected with a trained counselor, text “TWLOHA” to 741-741. We hope you will reach out.
Lauren Carter
I needed this. I needed this more than I’ve ever needed to hear anything else in my entire life. Thank you.
Erin
Thank you.
Robyn
Thank you for writing this! When I was dealing with an eating disorder a few years back, the therapist I was seeing at the time said that she didn’t want to diagnose me with a disorder because it wasn’t serious enough. That only spurred me on to say “Oh really? It’s not serious enough? Then let’s make it serious enough.” I thought I was crazy for thinking that way, so it’s very comforting to know that someone else has thought the same thing, albeit in a different way.
Samantha
Thank you so much. I’ve struggled with self-harm and disordered eating for almost three years now. Two years ago last month, after almost taking my own life I told my mother that I think I might be depressed. She dismissed it and said that I was just a teenager and it happened. After that, I haven’t reached out for help again, being that my own mother, someone who struggles with depression and anxiety herself would tell me that I wasn’t in enough pain to be depressed. Things have improved since then, but thank you so much I really needed to see that. Maybe now I can find the courage to get help next year when I go to college.
Gwen
I cannot thank you enough for this post.
I was diagnosed ED-NOS nearly 20 years ago, and struggled then when I was literally 5lbs away from meeting the diagnostic criteria for anorexia. After battling the insurance company for almost a year, I was finally able to get the help I needed.
15 years later, and I have been struggling for at least 6 months. I’ve lost a very significant amount of weight, go days at a time without solid food, feel like I’m going to faint almost constantly, and have a fractured foot which won’t heal because my body isn’t receiving the nutrition it needs. Yet, people keep telling me how “good” I look, and the doctors keep telling me it’s ok, because I’m not underweight (yet). It does make you feel like unless you’re near death, no one cares enough to help.
PeaceofaPuzzle
I have ED-NOS. I struggle greatly with eating at this point in time. 2 “meals”…not full meals…a day are what I get in. I tried to go back to the Eating Disorders Program I was in before but they told my Dr. I was having the same problems I was having before so they couldn’t help me despite the fact that they told us in group that some had to go through the program 2 or 3 times before it took hold…I guess I ate in a healthy manner for 2 years after my hospitalization and 2 years after the program I mentioned above. It is so frustrating! Thanks for posting though to remind me even if I am at a healthy weight, I can still be sick.
Eleanor
Thank you, thank you, thank you for this post. I have also struggled with an eating disorder for about half my life now, and am often haunted by thoughts of not being “sick” enough, worthy of or justified in trying to get better. They are lethal and consuming. What you do within the confines of an eating disorder will never be enough or the best or make you worthy of recovery, finally. Looking beyond and outside of it is the only way, I think, but not easy.
Leonie Janssen
Even when the parents of my boyfriends’ discussed with my parents that I desperately needed a doctor, they still said no. I was standing there, his parents were supporting me and giving me so much hope and I lost it all again. I was already so tired of fighting, it hurt deeply.
I think this is a great story for us all to read!
Mary Pearson
thank you
Mary Pearson
thank you so much guys
Jess
this is everything i needed to hear to feel like i mattered even though i didn’t think i was “sick enough…yet”
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Katie Harrison
Hey, I think this really sums it up. The views that unless you don’t have anorexia, or are at a healthy weight, you aren’t sick, and the belief that people with eating disorders hate food. I’ve just written a piece on the realities of living undiagnosed, and would be so grateful for any comments on the piece. Hope you’re doing ok. Katie
Emilia
Thank you for this! I’ve heard probably 2-3 times from different therapists I’ve seen over the years that “I don’t think we should continue seeing anymore because to me you look totally fine..”, and this always happens after a couple of appointments. Like wtf?! I had anorexia and depression when I was 14-16. I’m now 22 and I’m still not completely healthy. I’ve been struggling with daily/weekly depression, anxiety and panic attacks about 2 years now but therapists think I’m fine, I will survive, I’m an adult and smart. I fucking hate it when they turn me down. I don’t wanna just wait until I can’t function anymore. Bad outcomes should be prevented.
TWLOHA
Hi Emilia,
We’re sorry to hear that you’ve been feeling frustrated and unheard. We want you to know that we see you and hear you. We completely agree that preventative care and asking for help at any time is always a good idea.
Your story matters and we are so glad you are still here and still fighting. Sometimes different types of help work for different people and we hope that you will continue to seek the care that you deserve. If you want to look for other options or someone to talk to right now, we list resources and help lines here: https://twloha.com/find-help/local-resources/.
If you’d like some encouragement from our team, please email us at [email protected]. We’d love to send some your way.
Keep fighting Emilia, we believe in you.
Brooke
Wow. I have been sitting at my computer trying to find articles written from the perspective of someone like me. Someone that has been told by my therapist that I have an ED, but doesn’t believe it because I am not underweight or completely starving. I was an athlete all my life and I became very invested in health and fitness for the last few years. Friends are constantly telling me I look great and that they wish they had my dedication around food and all I ever want to say is “I wish I didn’t”. When people compliment me I wish I could say the things I do to myself and think are extremely unhealthy. That I want to tell my mom and sister about it but I feel that I could just “stop” if I wanted to so I don’t think I am sick enough to tell them. I feel as though people won’t believe that I purge because they never see me do it, or because I still have a lot of muscle. I fear that I am making all of this up in my head for attention because I feel so alone in the world and that telling someone will just make me seem dramatic. I seriously think my biggest fear in all of this is that I am making it up, but then the urges come, and it happens, and I get lightheaded or my stomach hurts after eating because of the distress so I just skip the meal. I truly can’t thank you enough for writing this honest and incredibly relatable piece. It is beyond helpful to know that others have the same thoughts that I do.
TWLOHA
Hi Brooke,
Thank you so much for sharing part of your story with us, we are so glad this post resonated for you. You are strong and courageous for opening up, if you want to share more of your story with us we would love for you to connect with our team at [email protected] . We would love to send you some encouragement!
We believe you matter and your feelings are valid. You deserve love and help to find healing. If you feel like you need resources or someone to talk to right now please look here: https://twloha.com/find-help/local-resources/. Even on the hardest days, there is still hope. There is hope for healing and there is hope for better tomorrows.
We’re rooting for you Brooke!
Kim
Just…. wow. Incredible
Rj
I tried to get help from my therapist recently because I’ve been trying to fix myself for years without professional help, but the thoughts and the things I do to make the anxiety around my body go away are killing me. When I voiced my concern to the therapist they told me it wasnt a real concern because I’m not currently underweight. Is there anything I can or should do? I’ve tried to hard to just stop by myself but everytime I do it just makes the thoughts worse and worse. Any advice? Please. I really dont want to do this anymore, I cant handle it
TWLOHA
Hi Rj,
We’re so glad you decided to comment and reach out. We hope you know that we’re inspired by your bravery to be honest with your struggles, and it’s amazing that you’re getting professional help. We would love to offer you some encouragement and support, so would you email our team at [email protected] so we can learn a bit more about your situation? You deserve to find and know peace, to move toward healing.
With Hope,
TWLOHA
Rachel Dulaney
This resonances with me so much that it actually hurt to read. I haven’t read something so truthful… beautifully written. I couldn’t have said it better, it was like she was speaking for me. I normally don’t comment, but this article was great.
Misty
Thank you so much, I am 51 and I have had this illness for 34 years and I am exhausted. You said you wrote this for you and for me and for everyone who is struggling with this. And you did. You wrote exactly how I feel. Thank you so much. I am going to pass this along to everyone I know that is struggling with an Eating Disorder and to those who may know someone with an Eating Disorder and they are trying to understand what it is like to be “not sick enough “. God Bless You.