Food Council Maintains Meal-Time Regulations, Despite Minor Rebellion from Patient #00-03-96

This Just In!

People with eating disorders (ED) use certain coping tactics to deal with the anxiety created by food and eating. Thus, meals here are highly regulated. While this makes sense to anyone with a minimal comprehension of the world of eating disorders, I realized (in talking with my parents) that many people are completely unfamilar with ED strategies. Having rules help to alleviate the stress and inclination to ED habits but seem totally absurd to others. To me, patient's coping strategies are actually a demonstration of the wonders of the human cognitive processes. The strength these people show in their resisting or altering their meals is awe-inspiring. It makes you wonder the other amazing things they could acheive, if only they could direct that strength elsewhere...If there's one thing I've already learned, it's that ED patients aren't weak. They're just mis-allocating their resources.

Every day we eat three meals and three snacks. After every meal we sit at the table and go through "process," where we discuss the table ambience (was it conducive to eating? Were there triggers?), the challenges and successes of the food (I mentioned the copious amounts of butter I consumed this morning), and our feelings. In the morning and evening we include with our "intention" for the next hours (a goal) and in the evening we meet before the meal to discuss our fears and intentions for dinner in particular. Dinner is the hardest meal of the day: we're tired from the day's emotions and may still be struggling with something that came up earlier. Plus, we might still be full from earlier meals.

As you can see, meal-times are immensely stressful situations for people with ED. In the hours before patients obsess about the meal, stressing about it's contents and trying to come up with little ways to eat less, burn calories when they do it, cut it entirely, etc. Meals themselves bring so many emotions: some people feel like everyone is watching them eat. They may be given a food they deem "bad," something so morally degradable that they literally feel worse having eaten it. Or they may be hungry, and resent themselves for feeling like they "need" something. They may want to keep eating and eating until they "finally feel full," having no understanding of their body's true needs. And that's only three of the possibilities. For me (so far) finishing and enjoying my meal is no problem. Outside of lockdown, I tried to eat only as much as a I needed, the bare minimum to propel my internship, exercise, and activities. In lockdown I am so dedicated to gaining weight that I finish every meal "100%." It's easy because I don't have any other options, and that's easy because that's the option I chose. It's actually been such a liberating experience: my day used to be dominated by my obsessions over the time, nutrition and content of my next meal. In here I can focus on what makes the obsessions instead of using the obsession as distraction. But that fact is what makes me scared: when I leave here I will have other options, like eating less and exercising more. I will learn how to navigate the temptations. For now, watching the other patients fight every bite makes me feel so strongly for them, but eating my whole meal and distracting them with conversation and support is something that I will be forever grateful to have experienced.

As you can expect, I've learned most of the meal-time rules because I've broken them. Being that I don't have a specific food-related ED I do things normal eaters do without thinking, like putting my cheese on my crackers and dipping my Oreos in my milk. People with ED use tactics like these to eat slower or burn more calories or buy time. Playing with food, hiding food, scraping your food across the bottom of the plate, etc., are all ways ED patients cope with the anxiety of the meal and try to eat less. So, we're relegated to eat in a way that eliminates these possibilities. Hands, napkins and utensils are always kept on the table; only salad dressing can go on salad and milk in cereal; you can only cut your sandwiches once and must eat them with your hand; you can't break up anything that doesn't need to be broken; condiments can only be put on the appropriate food; and there will be no talking about food or our ED for the duration of the meal.

Last night with dinner I got Oreos. I haven't had a guilt-less Oreo in three years. The last one was with Maggie, when I decided to sacrifice my diet in order to teach my sister one of the finer things in life: Oreas in peanut butter. Last night, 4 delicious, crunchy, frosting-filled cookies centripetally pulled at me for all dinner. I finished my sandwich, picked up an Oreo, dunked it in my milk, and took a bite. Then, I understood: it's not the marketing that keeps people eating Oreos. Um, they're like, yummy. We eat our meals with aides who are there to facilitate conversation, help struggling pateints through, and act as the food police. My food police watched me eat one Oreo, milk sloshing up my grimy paws. As number two hovered above it's milky bath, she sweetly said, "Emily, I can't let you do that." Bummer. "Okay, I get it, but what about if I twist it and suck the frosting off?" That didn't fly either. When I told my parents and Maggie the story they balked. "That is so not fair!" I agree; dunking Oreos in milk is practically an American pastime. But I can't feel resentful or irritated by this. To the other patients here this simple action can trigger a myriad of emotions and actions.

The fact that any action in life can be so utterly effective is awesome in its own right, deserved of the utmost respect. That they have the mental capacity, capability and willpower to infuse a passing gesture with such intense emotion is not a testament to fallability but the dynamism and power of the human brain. So while I might have felt a little self satisfied in my attempt at rebellion, I am more than happy to respect the regulations of treatment.

In lieu of psychology, I learned some very intriguing information on the cranal processes of ED patients in comparison to all you "regular" people. When a person with ED looks at food, especially if it is a trigger food, they analyze the food using their cortex. This is the outside edges of the brain. It takes information sent from the inner core of the brain (where the spinal cord meets the mid-brain) and categorizes it, objectifies it, and relates it to other understandings. When a person without ED looks at a food, they only use the core area of the brain to think about it. People with ED don't simply see and comprehend food; they attach it to all the other ideas in their cranium. This is where I most relate to the other patients. I don't simply see food; I see and think about it, categorize it, deem it good or bad based on the other factors in my mind or day or life. It's the same with exercise. I don't just feel the exercise or enjoy it, I think about it and plan it and desire it and hate it and use it. We just think and think and think and think. All this thinking requires energy, which we get from the nutrients in food, or in the case of ED patients, don't get. It creates this perfect storm of thinking too much and not getting enough and then we're huge jerks and totally erratic. And tired. Which is why I'm ready to stop. It's fascinating to learn the science behind the process. It's also inspiring and beautiful to see others on their path to recovery. Although I'm not proud of the state I've brought myself to, in some ways I am so grateful for this opportunity. How many people can say they've lived all over the world, graduated college, enjoyed an amazing set of family and friends, and, oh, yah, been to treatment? I can!

Te quiero, mis amigos.