*The following story is a fictionalized account of the effects anorexia nervosa can have on a young woman.
Caitlyn’s parents never thought they would see their daughter enter anorexia nervosa treatment in Boston. Her parents also never thought they would be visiting their daughter in an emergency room for treatment of life-threatening anorexia nervosa symptoms. But Caitlyn’s story isn’t unique. Nearly one percent of all U.S. women will suffer from anorexia nervosa at some point in their lives. Most will need either inpatient or outpatient anorexia treatment to recover from this serious eating disorder.
This is Caitlyn’s story. It’s also a story mirroring the stories of millions of other young women struggling with an eating disorder. An only child to a father who worked for a government contractor and a mother who owned a fitness center, Caitlyn told her eating disorder counselor she has strong memories of her mother constantly dieting.
“Mom took great pride in her appearance. She kept digital scales in just about every room in the house–kitchen, bathroom, her bedroom, even right by the front door. Although she never once commented on my weight, I always felt like it was an ‘unspoken order’ coming from her that being overweight was one of the worst things anyone could be.”
Caitlyn in Middle School
Since her father’s work involved weekly trips overseas, Caitlyn interacted with her father infrequently. When he was home, they would sometimes go camping for the weekend at a nearby state park. During one of these camping trips, Caitlyn remembers her father arguing with her mother about the food she brought on the trip.
“My father would be upset because Mom only packed fruit, lettuce, and vegetables in the cooler. Dad ate like most people eat–a mixture of healthy food with the occasional dessert or snack. He’d get so mad at Mom for insisting on eating only ‘diet’ food that he and I would drive 10 miles into the nearest town to eat at a restaurant where they served actual meals–meat, potatoes, pie and ice cream.”
Caitlyn said it was around this time that she became friends with Macy, a new girl at school who was obsessed with being a model. “I don’t know why we became close friends,” Caitlyn says. “We didn’t have that much in common. The first time I brought her home, my Mom complimented her profusely for being so thin and ‘in shape.’ That’s when I learned Macy exercised several times a day.”
Caitlyn in High School
When she was 15, her parents separated. She and her mother remained in the home while her father moved to a nearby city. She suspected her mother had discovered her father was having an extramarital affair before they separated. It was also about this time that Caitlyn’s friend Macy introduced Caitlyn to “binging and purging.”
“Just like any typical teenager, my favorite foods were cheeseburgers, French fries, soda pop, and snacks. I also had a weakness for cakes and cookies. Anyway, I started having difficulty zipping up my jeans without sucking in my stomach or lying flat on the bed. I confided to Macy that I was afraid if my Mom found out I was gaining weight, she’d be angry at me. That’s when Macy showed me how to eat fattening foods but not gain weight.”
The “binging and purging” trick worked. Caitlyn lost the 10 pounds she had gained by forcing herself to vomit after eating high-calorie foods. In addition, Caitlyn started exercising with Macy after school and on weekends.
Caitlyn also began weighing herself on her mother’s scales. “At 5′ 4,” I weighed 100 pounds as a junior in high school,” Caitlyn recalls. “But I hated throwing up after eating–the smell, the mess and just the feeling of vomiting. So, instead of purging, I began severely restricting my food intake.”
To stave off hunger pangs, Caitlyn said she drank a lot of diet soda and munched on apples and carrots. “I only ate enough to lessen the hunger pangs, not to get rid of them. But as my stomach shrunk, they eventually disappeared altogether. I can’t believe now that I was actually ecstatic about not feeling hungry anymore.”
Early Stages of Anorexia Nervosa
Caitlyn describes the onset of anorexia nervosa symptoms to her therapist as evolving from cutting out all desserts to weighing her food:
“When I stopped purging, I stopped eating anything with sugar in it. No more cookies or cakes. I wouldn’t even allow myself one small bite of anything remotely sugary. Then I started limiting myself to two small meals a day–lunch and supper. Breakfast would consist of a glass of water or diet soda and a banana or apple with saltine crackers. Lunch was a salad (no dressing) with carrots, tomatoes, and cucumbers. And another banana or apple. Sometimes I would allow two or three pieces of oven-baked chicken or turkey in the salad. Supper would be weighed portions of whatever my Mom served–usually baked chicken, fresh vegetables and a salad. I tried to keep my caloric intake under 1000 calories per day.”
During the onset of her anorexia nervosa symptoms, Caitlyn said she had no health issues and felt fine physically. However, her psychological and emotional state was deteriorating.
“I was so anxious about gaining a mere half a pound that I would lie awake at night and obsessively count the number of calories I consumed during the day,” she says. “I was sick with worry every morning before I stepped on the scale. If the needle went up, I would skip breakfast. When I was 17, I weighed 95 pounds. I should have weighed around 120 or maybe 130… But my mom never said anything about my thinness nor did my best friend Macy. She was just as skinny as I was. We both planned on going into modeling once we graduated from high school.”
Macy moved to another state during Caitlyn’s senior year.
Three Months Before Starting Anorexia Treatment
Caitlyn remembers thinking she may die if she didn’t start eating. She knew she was suffering from anorexia nervosa but could not control her compulsive behavior.
“I was eating less than 800 calories per day. My grades plummeted, I couldn’t focus on my schoolwork and my brain felt like it was enveloped in a heavy fog. I felt dizzy and light-headed throughout the day, I wore heavy sweaters and oversize pants to hide my thinness and used cosmetics to camouflage my hollow cheeks and dark, under-eye circles. At school, I would run to the bathroom after every class to look at myself in the full-length mirror. Fear and anxiety drove me to mirrors. I was always terrified I would look in a mirror and see rolls of fat bulging from my hips, stomach, and thighs.”
Caitlyn stopped having periods. She suffered heart palpitations so bad she thought I was having a heart attack. During a palpitation episode, Caitlyn would have panic attacks. She started obsessively checking her pulse rate whenever her heart started fluttering.
Even when she weighed 90 pounds, Caitlyn’s mother never said a word. “She never asked me why I was wearing sweaters in 80-degree weather. Never asked me why no food was ever missing from the refrigerator. Never asked me why I meticulously weighed everything I ate on a kitchen scale. She spent 12 hours a day at her fitness center. My dad called me on the weekends. I was alone and being consumed by a terrible eating disorder I felt powerless to control.”
Interlude–What is Happening to Caitlyn’s Body?
By drastically reducing her calorie intake, her body is rapidly breaking down tissues for fuel. Muscle tissue is initially targeted because it contains the most protein and other nutrients. The heart is the body’s primary muscle. This is why Caitlyn’s blood pressure and pulse experience extreme fluctuations as it tries to keep blood pumping throughout the body with little energy to reserves to utilize. Heart failure is a real risk faced by those with anorexia nervosa as blood pressure falls to dangerously low levels.
Caitlyn’s brain is also suffering from malnutrition. Neurons need a protective layer of fats called lipids to signal other neurons. She can no longer focus or think clearly because her brain is essentially starving to death. In addition, this lack of fat intake interferes with the ability of the brain to communicate with the rest of her body. Her nervous system is gradually shutting down.
Severe dehydration combined with an electrolyte imbalance causes Caitlyn to experience muscle cramps, headaches, dizzy spells, flaky skin, and overwhelming fatigue. Untreated dehydration will cause seizures and kidney failure as the body frantically attempts to rid itself of toxins through nearly nonexistent urine.
Caitlyn Describes the Day She Almost Died of Anorexia Nervosa
“I had made no real friends after Macy moved. Just acquaintances I chatted with at school in the hallways. I can barely remember talking to anyone at this point. Everything looked gray, colorless and sounds seemed muffled, as though I were wearing headphones. All I could think about was how fat and hideous I looked in full-length mirrors. I saw rolls of fat under my chin, rolls of fat hanging under my arms and rolls of fat making my thighs look enormous. It never occurred to me that I was wearing size 14 in girls’ clothes or that the dark circles under my eyes made me look like a corpse.”
Caitlyn describes the day she almost died: “I was sitting in history class, listening to the voices in my head informed me that I was not skinny enough, that I was not perfect enough. They never stopped droning on and on, those voices. I couldn’t feel my hands and feet. My mouth felt like it was lined with cotton, my head was pounding, and my heart was palpitating like crazy. I was trying to concentrate on the lecture but the loud buzzing noise inside my head drowned out my thoughts. I wasn’t even sure of where I was. Nothing looked familiar, everything seemed foreign, ominous. At times, I felt so depressed and desperate I thought about suicide. I considered eating a doughnut (I had never stopped craving sugar) taking a whole bottle of Tylenol and just going to sleep permanently.”
“The bell rang indicating class was over. I heard the bell but it sounded like an alarm clock being muffled by a pillow. Everything sounded muffled and far away. I stood up, steadying myself with my hand on my desk, waiting for the dizziness to pass. Suddenly, I started feeling extremely anxious and frightened. Nausea swelled in my stomach. I thought I was going to throw up but there was nothing in my stomach to throw up. My vision became distorted like I was surrounded by funhouse mirrors. Then, the strangest thing happened. I became aware of standing outside my body. I thought I was watching myself have a seizure. I later found out this is a common symptom reported by people who have had seizures.”
In the Emergency Room
Caitlyn’s heart stopped on the way to the hospital. An EMT shocked her heart into beating again. She remembers nothing from the time she was in class until she woke up from a coma 24 hours later.
After spending two weeks in the hospital, Caitlyn entered residential anorexia treatment in Boston. In addition to cognitive behavioral therapy, Caitlyn, her mother, and her father are involved in family therapy.
“I am slowly regaining my physical and psychological health,” Caitlyn says. “I’m still suffering the health consequences of anorexia nervosa. But I feel stronger every day. In fact, I’ve never felt so optimistic about life before. I don’t want to live my life obsessing about food. I want to live a normal life.”
If you know someone like Caitlyn, please contact us today to learn more about our eating disorder treatment centers.