Tuesday, November 26, 2019

Happy Thanksgiving and I Have an Eating Disorder

When people think of eating disorders, they usually visualize a teenage girl who is far too thin but feels she's overweight. Like countless others, I don't fit that narrative.

According to the National Eating Disorders Association, one third of people with eating disorders is male. And of those men and boys, up to 42% identify as gay. It's a major problem that is largely being ignored. In fact, while trying to find help, I couldn't find a single health center in my state of Tennessee that treats men, either as inpatient or even outpatient. 

What confuses people, too, is that I don't think I'm overweight. I do not have anorexia nervosa or bulimia. I know very well that I am underweight and would absolutely love to gain weight. The problem is that I have no appetite and a fairly unhealthy relationship with food that began in childhood and has followed me all the way into my 30s.

Today things are better than they were two years ago. For one, I'm actually acknowledging the fact that I have an eating disorder, and that in my quest to gain weight I was indeed able to gain some. You see, two years ago I was so thin that we were actually worried I would end up in the hospital if I got something like the flu. I likely neither had the energy or reserves of fat to fight it off and risk losing another pound or two. At the time, my BMI was 13.7. A "healthy" BMI for my height is over 19.

What many would love to do, lose a few extra pounds, would have been extremely dangerous for me.

Recognizing I was at this danger point, and because I knew I couldn't do this by myself, I opted to begin taking a medicine that increases appetite. After a year I was still technically underweight, but my BMI had jumped to 17.2. I was clearly on the right path.

Unfortunately, that medication comes with side effects - especially for men. Not just embarrassing ones but also things like waking up drenched in sweat every single night, multiple times a night.
My goal had been to use the medicine to gain enough weight to where I was healthy again and, in the process, learn eating habits that I could stick with so I could keep that weight gain and then stop taking the meds. That hasn't worked out.

I still weigh more than I did when I started but I'm down 10 pounds from the high and I had to lower the dose of the medication to address the side effects, so it's not working that great anymore. In fact, it's a daily struggle to just try to maintain my weight at any given moment. Heaven forbid I get depressed or a bad cold because *poof* there goes another pound, and I can't seem to get it back.

So how did I get here?

A lot of people with eating disorders can point to a traumatic event, like assault, that led them down an unhealthy road. But I didn't have a single moment. My problems developed over years with a mix of good intentioned but oblivious adults when I was a kid and then with major physical issues that began in my early twenties.

I have always been skinny, always. My dad was also skinny, as was my grandfather, so there was never much of a chance of me becoming buff or fluff. Adding to that is the fact there's also plenty of food that I flat out don't like. It's not being picky, it's me finding certain things legitimately disgusting. However, people can't seem to mind their own business. A skinny kid isn't a problem and he certainly isn't your problem to try to fix.

Any time I was at a family gathering (like Thanksgiving) or any gathering of any kind where food was served, I would fill up my plate with what I wanted to eat and the amount I wanted to eat so I didn't waste anything. Evidently, that wasn't good enough. Loving aunts and uncles would prod me, "is that all you're getting?", "why don't you try this instead?", "you'll never become a man if you eat that little".
Instead of just leaving me alone to eat what I knew I could handle, situations involving food became a bad thing. I wasn't eating enough so it felt like I needed to be punished by being called out and made to feel ostracized. 

That didn't encourage me to eat more. It encouraged me to find quiet places in the house or church or school where I could eat in private and avoid being pestered over what should have been nothing but was constantly blown up into something. And eventually, it encouraged me to not even bother eating much at all during gatherings because it would never be enough for those around me.

Still, I managed. By the time I was around 21, I still dreaded eating with people and was still skinny but I also weighed the most I ever had, and I was generally healthy overall.

Fast forward a couple years and things began to get worse. I started having severe back pain, was no longer able to work, and my stomach (of all things) also decided it was going to mess up.
There were stretches of time where I was so sick, I would throw up every few days and would go a full week without having a single meal because I couldn't keep anything down. Any time I'd try, I'd get sick.

These periods were intense and frightening. I physically felt like I was dying from the pain and my emotional health began to suffer a lot, too.
It took years to figure out what was wrong with me and for us to finally learn I wasn't dying - I just had bad luck with my back and GI system.

But over the course of those years, my desire to eat fell dramatically. I had spent all of that time fighting to keep food down and slowly developed a bit of a fear of eating "too much" (which was never actually much) because whenever I happened to eat a legit meal, I felt like death soon after.

I was able to get on a good regimen of medications, I went to therapy to address the depression (but not eating issues), and I started to be able to reclaim some semblance of a life. Unfortunately, during all of this time I had dropped a lot of weight and my relationship with food was worse than ever. I was able to gain weight but would lose it. Gain it again, goodbye. 

This see-saw life meant that I was never able to gain weight and finally hold it. I still, ever so slowly, lost a pound here and another there. I could maintain my weight until I got sick or had a very stressful time, and then it would disappear. 

And that leads me back to the beginning and freaking out over having a BMI of 13.7.

People still "lovingly harass" me over my weight. At the same time, idiotic and cruel rumors popped up and even "friends" coldly tossed around bombs like "unattractive starving Ethiopian". None of which helps. At. All.

I have managed to overcome severe depression, survived a suicide attempt, and have been able to make a home with a loving partner, but here I am, two days from Thanksgiving feeling compelled to admit reality while also feeling rather lost.

I have been going to a therapist to deal with some social anxiety issues, but her expertise isn't eating disorders, it's anxiety. So I sit here with no substantive professional help anywhere near me. I'm also sitting here two days from Thanksgiving - an entire day dedicated to eating and overeating.

I genuinely envy people who get excited about food. People who have no problem eating everything off of their plate and maybe going back for seconds. I would love to take real enjoyment out of breaking bread with loved ones. But Thanksgiving, Christmas, Easter, birthdays, going to dinner....it's always a minefield. 

Am I going to get judged for not eating the "right" amount? What if there's not much on the menu I can eat or hate what the host made? What if I don't feel well? How about eating before I go someplace so I can at least get needed calories and then pretend to eat at the restaurant/house to not come off as being too rude? 
Do I just get an appetizer, or should I get an entrée knowing I'm wasting money but at least I'll fit in? How much food should I try to "hide" by moving it around the plate, so no one asks about it?
Ugh, and now here comes the waiter asking me if everything is OK or would I like to talk to the manager since I haven't eaten.

While I fantasize about being a foodie and enjoy looking at well-toned Insta models, I have to come back to the reality of my life. Consistently getting over a thousand calories a day is like trying to climb a mountain. Sometimes it feels so daunting that I just give up for the day. This isn't just a problem for when I'm going someplace, either. Figuring out food at home isn't much easier and additional facets come into play like, wanting to be "attractive" (whatever that means) and then failing to live up to the expectations I place on myself and that I think others place on me as well.

And then there's the constant parade of know-it-all's who tell me I just haven't had food prepared correctly and that if only I applied myself it really isn't that hard (it really isn't so simple). They tell me to try this new fad diet and what about meditation...

I belong to me. The only memories and experiences I have are mine. Every victory and every struggle, mine. I know what I have tried. I remember the breakdowns over dinner. I know the amount of effort I have placed into trying to make my life better and body stronger. 

Thanks for trying, but that type of caring isn't helping. Instead of telling ME what I have or haven't tried, how about you acknowledge me and my truth? Be there for me emotionally. And if I happen to ask you for your dietary opinions, then give them, but don't shout them at me when I never asked.

"JuSt eAt mOAr!" has never helped anyone with an eating disorder.

Another moral of this story is, don't be a busy body. You might think you're just being caring, but the person on the other end of your interrogation certainly doesn't feel your good intentions. They feel embarrassed at best and attacked at worst.

Obviously this can be tricky. People try to hide their eating disorders in all kinds of ways, but just being skinny or not gorging yourself until you can no longer fit into your jeans isn't a bad thing. There's nothing wrong with moderation. There's nothing wrong with not wanting a salad or passing on that second piece of pie. And if the bulk of your holiday interactions with that shy nephew boils down to "what's wrong with you", you're probably making him feel less worthy and risking a quirk becoming something worse down the line.

So here I am, Jacob with the eating disorder. It hasn't and won't define me, just as other aspects of my life don't define me, but it is something that's going to take a lot of work to overcome. And it's going to take a family, of my own choosing, to help be my support structure.

As for the holidays, thankfully, for this Thanksgiving I get to spend it with real friends who respect other people. No one expects me to eat four plates of food. They'd be thrilled if I just finished one, and I'd really like to do that, too.

--Jacob Bogle, 11/26/2019


  1. So you know I read this and care. I have no substantive words yet. I love you.

  2. Man you are a great writer; and have shown me another broadening part of the 'eating disorder' spectrum - It's not necessarily something confined to specific diagnostic points.
    Incidentally they now have the term "neurodiversity" - which your hindrance reminds me of; as it is so asunder from the classic cases which we associate.