Since I was little I learned to have disgust and aversion over my body. My parent would frequently express both in private and in-front of my friends that I was ugly, disproportionate, and unattractive. They would also comment that I should "do something with my face" by putting on makeup or redo my hairstyle to their standard. Additionally, the very first time my future husband was invited into my childhood home, this parent told him that he should choose someone else that was more beautiful than me. These comments were in fact examples of emotional and psychological abuse (two types of Adverse Childhood Experiences).
As a child, my parent was very displeased about my determination for not wanting to continue ballet when I reached the third grade. Instead I wanted to join martial arts with my younger sibling, which my parent detested because ballet was a "more feminine and beautiful sport." They hated that I chose martial arts where we were always sweaty and wore clothing that did not accentuate the body. As an awkward teenager and one of the only females, I became more self conscious about my own body. Surrounded by the beauty standard of society, I wanted to be pretty, but was constantly battling how much I should be hiding or showing my developing breasts under my uniform.
Intense physical training three times a week for 3-5 hours at a time led me to become underweight. Unfortunately I did not have mentors who taught me how to properly eat to compensate for the vast amount of exercise I was doing. Therefore, sometimes I would go home and eat non stop, trying to fill my stomach and body with all the calories I had lost. However, my parent would complain about my eating and figure which led me to go to my room and continue my exercises to become muscular and lean. On the outside, one might normalize this behavior, however, this could easily be considered an eating disorder. However, I never recognized this behavior for what it was until I went to college, and stopped my daily martial arts training and rapidly gained 20 pounds. My increase in weight, exasperated my self consciousness, and brought another wave of disgust over my body. I was so used to my body being lean and muscular, that my new body looked chunky and disproportionate. Using the Internal Family Systems Model (IFSM) of trauma therapy, the "protector part" of my mine was dominating my internal dialogue. It actively judged myself on how my body should look with the goal to protect myself from continues hate and disgust from my parent and peers,
My senior year of high school, my height was 5ft 4in and fluctuated around 100 lbs. If one calculates my BMI using the height and weight and using a teenager calculator I had a BMI of under 17.2, which is in the 5th percentile of female teens, and classified as underweight. This low weight should have raised a flag with my medical providers (however I rarely had the opportunity to go to one) as a very high risk of developing or already suffering from an eating disorder. Thankfully, my preoccupation with my pre-medical studies and leaving my toxic home environment helped me gain a healthier weight. In college my new weight of 120 lbs was actually a healthier weight and was a BMI of 20.6. As I continued on my adult life journey where I sometimes increased weight because of life stressors, hormones, or decreased weekly exercise, I remembered that I should NOT use my weight NUMBER but should use my BMI as a determining factor of if I was truly overweight.
A "multivariate analyses adjusted for lifetime comorbid psychiatric disorders revealed that emotional abuse independently predicted higher eating, shape and weight concerns and lower daily functioning, whereas sexual and physical abuse independently predicted higher eating concern" (Guillaume et. all 2016). Therefore, the emotional abuse I experienced in my home led me to be more hypervilligent in how I viewed and treated my body. This came to fruition by having an underweight BMI, excessive exercising, inconsistent eating, and continued pica like behavior of eating ice. Thankfully, even though I gained weight in college and in medical school I turned my anxiety toward my academic pursuits. Over time, I stopped suffering from an eating disorder through educating myself on healthy eating and exercise habits and developing a healthy form of self-worth.
Each body is different and has varying proportions. A BMI is a quick and easy way for physicians to help determine if an individual has a "healthy weight." A variety of chronic health conditions have been found to be correlated with individuals who have a BMI that is considered overweight and obese.
For more information on BMI, how it is calculated and interpreted visit: https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html
Calculate your BMI by using this calculator on the CDC Website or this great BMI Calculator that mentions specifics on individuals of different ethnicities, athletes, pregnant individuals, post menopause, etc.
There are two subtypes of Anorexia Nervosa:
Restrictive: a person severely limit the amount and type of food they consume.
Binge-Purge: a person restricts the amount and type of food they consume then they binge-eat (eating large amounts of food in a short time) followed by a purging episode — vomiting, using laxatives, diuretics, or extensive exercise to get rid of what was just consumed.
Comorbidity of Eating Disorders with another Mental Illness:
Adults who suffer from an Eating Disorder have a higher risk of also having another mental health disorder. The highest co-morbidity of a mental health condition & an eating disorder is Anxiety Disorder.
For more information on Eating Disorders check out this PDF article on Eating Disorders from the National Institute of Mental Health: EatingDisorders_NIH.pdf
If you or someone you know is in immediate distress or is thinking about hurting themselves, call the National Suicide Prevention Lifeline: 988 or toll-free at 1-800-273-TALK (8255). You also can text the Crisis Text Line (HELLO to 741741) or use the Lifeline Chat on the National Suicide Prevention Lifelinewebsite. If you suspect a medical emergency, seek medical attention or call 911 immediately.
Guillaume S, Jaussent I, Maimoun L, et al. Associations between adverse childhood experiences and clinical characteristics of eating disorders. Sci Rep. 2016;6:35761. Published 2016 Nov 2. doi:10.1038/srep35761
BMI Calculator for Teens: https://www.cdc.gov/healthyweight/bmi/calculator.html
BMI Calculator for Adults: https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html
Info on Eating Disorders: https://www.nimh.nih.gov/health/statistics/eating-disorders
Eating Disorder Infographics: https://www.nimh.nih.gov/health/publications/lets-talk-about-eating-disorders
Eating Disorder Definitions & data: https://www.nimh.nih.gov/health/statistics/eating-disorders
***This Blog Post is for educational purposes only and is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. This does not imply a doctor-patient relationship. All opinions are the opinions of the writer and not reflective of any institution or employer. Please follow up with your health provider and therapist for any additional questions or support.***