Did you know that patients with eating disorders have the highest mortality rates of any psychiatric disorder? The first week of February each year is recognized nationally and provincially as Eating Disorder Awareness Week. All eating disorders (EDs) are serious mental illnesses with significant life-threatening medical complications regardless of an individual’s weight.

The Renata Elizabeth Withers Centre for HOPE program is an intensive outpatient program for eating disorders operated by Eastern Health. As health-care staff who work there with patients, we can tell you that early recognition and timely intervention – based on a developmentally appropriate, evidence-based, multi-disciplinary team approach – is the ideal standard of care. An eating disorder can sneak up on you and you don’t even realize it as a former client of the provincial HOPE program, explains below.

My Life with ED

I am a young male who is very thankful for the enjoyment and peace I feel for myself, as I sit here today. Life wasn’t always this way. There was a time when negative feelings steered my mind and sucked the life from me. I had a relationship with a friend named ED.  However, the majority of time I spent with him resulted in dullness for life, a withdrawn personality, a feeling of loneliness that never left, and an obsession with food and weight.  ED is, in fact, my eating disorder.

Junior High

Like many young people, when I was in junior high I was very self-conscious. Every feeling I had at this age is amplified and your social status is the most important asset. If I was sad, I was really sad, and if my social life was not going right, it really felt like the end of the world. I did not cope very well with the transition from elementary school to junior high, and all it took was a couple of cruel jokes from other students and rejection from prospective lady friends, to make me feel ashamed and lonely.

This is where my self-image began to change, and I started to view my looks and personality in a negative light. I became very quiet and withdrawn, and I began restricting what I ate. My diet lowered my weight and what I thought, improved my self-image. I was very emotional during this period and constantly lashed out during sporting events; fought with siblings; and even confided to my parents that I did not want to live anymore. ED would develop a strong hold on my life.

High School

Transitioning into a new environment, I was pleased to have a new opportunity to really be myself – a loving, caring and funny person. Classmates and teachers entered my life and gave me confidence to be myself again. They greeted me each day with a smile and a warm embrace and made me feel valued.

However, through this uplift in confidence and social status, I was still struggling with my body image and emotions. When my friends went out for lunch at the mall and ordered burgers, sandwiches and fries, I would have the “self-control” to get the small chicken and veggie wrap. However, I felt as if I was winning in life, and I was always making the “healthy choice.”

Post-Secondary

The days of refusing to eat take-out in junior and high school, developed into something more. As I left the domain of organized high school sports, I began taking up other ways to exercise by myself or with a partner, such as running, biking, weight lifting and swimming.

As a university student, I had become very curious in self-help books, articles, and essentially anything online that centered on improving oneself. A majority of the information I was reading on a daily basis was focused on weight loss, getting thinner and feeling better.

By my second year of university, I was extremely thin, eating very “healthy” and consuming very few calories. I thought I was being the healthiest person I could be, and at times I felt like I was a role model of a healthy person to family and friends. The deeper I dug into this hole, the more withdrawn and anxious I became around food and anything to do with food. About 99.9 per cent of my life involved me planning, thinking and controlling my food intake.

I began increasing my exercise routine by running more frequently. Many of my running peers called that hard work and did it for the joy and pleasure. I did enjoy the mindfulness and camaraderie of running, but my motivation was much deeper. I was exercising to burn the calories I ate and to get rid of the shame of eating a meal or eating something “unhealthy.”

Sadly during this time, friends, family and school all took a backseat. I became withdrawn from my closest relatives; I lashed out at my parents and siblings for not eating the proper food; for being sedentary; and essentially for just enjoying themselves. They had smiles on their faces and were comfortable with themselves, and I was not. I became resentful and frustrated when others were having fun. At my age, I should have been out meeting new people; taking on new experiences; but I stayed home, away from the food and away from people.

Rock Bottom

Finally, I hit rock bottom with ED. I was smaller than I had ever been, I had a heart murmur and a low heart rate.  I could not focus; often shook with hunger; and my body was shutting down. All I cared about was food, weight and exercising.

As a result of my extreme lifestyle, I was producing very low levels of testosterone, and therefore, had zero sex drive or muscle. It took one important day, when I decided I was not fit to go to my job and that it would be best to take a trip to the family doctor. I described my ailments to the doctor and explained that I was really unhappy.

The doctor quizzed me on my lifestyle, diet and weighed me. She asked me if I had ever considered that I may have an eating disorder, and I said “no, definitely not.” However, she continued to question me and we went over a checklist of behaviours involved with eating disorders. The doctor diagnosed me with anorexia nervosa.

After the diagnosis and once I learned I was going to start attending the HOPE Program, I felt relieved. I had reached a turning point to change my life and get back to the real me.  I knew it would be very difficult – I was super nervous, but I was not going to let this opportunity slip by.

Being one of the few males in an eating disorder treatment centre definitely was not easy. The vast majority of people receiving treatment are female and every day I walked in there, I felt ashamed or embarrassed, although I realize now the privilege I had to be surrounded by very caring and supportive people.

                            The program’s education group room

The staff and other clients at the HOPE Program are a major reason I am a fun, loving and compassionate person again as I am able to see the beauty of life, and the pleasure it is to have amazing family and friends. I was able to slowly build connections again with those close to me and I now have a new girlfriend who gave me the confidence and strength to be myself again.

What next?

I learned that it is important to appreciate various body types and to move away from shaming people based on weight or what they eat. I am very happy to be “recovered” from an eating disorder following my discharge from the HOPE Program, but I still have bad days where I struggle with making the right decisions and ED guides my behaviours.

With the coping skills and support, ED  is now a much lesser part of my life, and I have a love for life, people and food that I never thought possible. I have my family, friends, the HOPE Program staff and clients, and my family doctor to thank. Without their hard work and support, I would not be here today.

                          Eastern Health Hope program staff
Standing (l-r): Nancy Rogers, Ashley Walsh, Kelly Yetman, Michele Neary, Cynthia Burt, Jennifer Marshall, Dr. Anna Hofner
Seated (l-r): Andrea Hann, Krista Wade, Kelly Maloney, Jennifer Vickery
Missing: Dr. Bridget Picco, Doreen Kelly

If you or a loved one are struggling and are wondering if you may have an eating disorder, talk to your family doctor or other health-care provider. Some indications that you/they may require help include:

• Excessive concern or preoccupation about weight, shape and calories.
• Menstrual periods being irregular or stopping.
• Missing meals, strict avoidance of certain foods.
• Avoiding eating in public, or wanting to eat alone.
• Large amounts of food disappearing unexpectedly.
• Believing they are fat when underweight.
• Exercising excessively.
• Cooking and preparing food for others, but not wanting to eat it themselves.
• Going to the bathroom immediately after meals.
• Using laxatives and vomiting to control weight.

To seek help, contact your family doctor or other health-care provider, the Eating Disorder Foundation of Newfoundland and Labrador, Eastern Health’s HOPE program, the Janeway Children’s Health and Rehabilitation Centre’s Adolescent Medicine Program.

This story was written by Krista Wade, a mental health and addictions program manager, Kelly Maloney, a dietitian and clinical lead, and Ashely Walsh, an occupational therapist, with Eastern Health’s HOPE program. ■