You Are Sick Enough

By Mary NikkelJune 24, 2024

Note: This piece mentions fatphobia and body dysmorphic language, and covers the topic of eating disorders. Please use your discretion. 

“You’ve lost weight. Whatever you’re doing—keep it up!”

A well-meaning adult told me this when I was 16, noticing the way my outline was eroding, collapsing in on itself.

What I was doing was starving myself. What I was doing was getting very, very sick.

I’ve always loved how the poet Blythe Baird said it:

“If you develop an eating disorder when you are already thin to begin with,
you go to the hospital.
If you develop an eating disorder when you are not thin to begin with,
you are a success story.”

I have had Anorexia Nervosa in a wide range of bodies over the 23 years since it first found me, a vulnerable 9-year-old. As a teenager, I was in a larger body, one that allowed my illness to be undetected—and praised. I became life-threateningly unwell, and my mortal wound was celebrated as willpower.

That experience provided a backdrop for me to see the stark difference when my eating disorder once again became life-threatening 10 years later.

This time, I shrank into a body that the medical establishment deemed as having finally gone too far. The thing that I’d been praised for became pathologized. I was only given a formal diagnosis of Anorexia and C-PTSD at the age of 28—nearly 20 years after those disorders began presenting in my life. I was hospitalized, put through the process of weight restoration, and compelled to eat as much as I could bear.

What this tells me is that most of the time, our culture only allows certain bodies to be sick. I used to have the wrong kind of body to be allowed to be in pain; now I have the right one. I used to be a goddess of discipline, applauded for trying to erase the wrong that was my body shape; now I am a patient needing constant intervention.

But my behaviors have stayed the same. My thought patterns have stayed the same. My intense need to create safety through the predictable control of starvation has never wavered. Seeing the way the world responds to me change so dramatically based on size just confirms one of my worst fears: that many people will measure the significance of my suffering based on my body.

If anything, the early invalidation pushed me deeper into my disorder, desperately wanting someone to see the pain I was in. Even once my diagnosis was confirmed, documented, and stamped on the paperwork, it often felt like it was not enough. While receiving inpatient care, insurance often drops my benefits the moment I hit a certain weight that they deem represents “not sick anymore.”

That can cause my disorder to assert itself more forcefully: “See me, please. Believe me. It hurts.”

My experience has illuminated for me how profoundly unjust this system is for anyone trying to get help for an eating disorder. It’s the luck of the draw, what genetics and life circumstances mold our precious, singular skin. We don’t get to choose how we physiologically respond to eating disorder behaviors. But based on these factors we never could have chosen, we’re deemed “sick enough”—or not.

The truth is that this hierarchical approach to illness does not only impact eating disorders. We still live in a world that demands justification for suffering. The subtle demand that we “prove it” can make it hard to believe we deserve care. It can present in a host of subtly invalidating statements:

“You have so much to be grateful for. Why are you depressed?”

“Some people had childhoods much worse than yours. Yours wasn’t really traumatic.”

“You’re exaggerating.”

“You’re self-centered.”

“You don’t know what you’re talking about.”

These messages can undercut our sense that we are worthy of therapy, of medication, of gentleness and love.

I have spent a lifetime trying to own my need for support. Seeking care for my eating disorder (and the closely related C-PTSD) has taught me that it’s a better world when we don’t gatekeep who deserves care, and who gets to be sick. 

Our pain should be the only witness anyone needs.

I’m here to tell you that if you feel pain, in your body, your spirit, your brain: You’re sick enough. If something hurts, it’s a wound. Your suffering is telling the truth.

You deserve care—even in a world that might be telling you otherwise.

If you have ever wanted help, I hope this can be a moment that invites you to seek it. For myself? Honestly, I often still feel like the 16-year-old girl whose sickness is dismissed as a lie I’m telling. But every appointment I show up to is a defiant act that’s saying, “No, I am a truth-teller.”

We encourage you to use TWLOHA’s FIND HELP Tool to locate professional help and to read more stories like this one here. If you reside outside of the US, please browse our growing International Resources database. You can also text TWLOHA to 741741 to be connected for free, 24/7 to a trained Crisis Text Line counselor. If it’s encouragement or a listening ear that you need, email our team at [email protected]

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Comments (3)

  1. Safeatlast

    Thank you beyond words for your post!!
    When my brother was very ill, no one in my family believed that my suicidal depression/CPTSD was life threatening enough to matter. I kept my own bone marrow.

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  3. Alea Dean

    I can relate to this all the way around. I struggle with C-PTSD, eating disorders and various addictions, the very first being kleptomania in junior high, self harm in high school and drugs/alcohol starting beginning 20’s-late 30’s. My journey with the mental health system started when I was 17. I had family, friends, society and health care providers all day in their own way I’m not “sick enough”. My family would say I’m seeking attention, friends would say, “others have it worse”, counselors and even state hospital staff would say “I’m a mild case and I’d be able to get off disability and have a job within a year. There ARE plenty of mental health professionals that have validated me…. even helping me by explaining how trauma affects the brain, how borderline personality is a real disorder, how I’m not CHOOSING this and I’m NOT pretending.
    “People fake being happy, they don’t fake being unwell.”

    I’m currently 40 years old and still struggling most days but it’s one day at a time. Most importantly find those who do believe you and drop those who don’t!

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