A Strange Onset of Anorexia

Emily eats a similar looking "sandwich."
Photo By: Parhan Sadhi/CreativeCommons

Runt. Runt-a-ta. Runt. Runt-a-ta. Runt. Runt-a-ta. The ball bearing rollers of Emily’s Pilates machine pumps up and down in rhythm as she exercises. Over and over. The sound is Emily’s mantra, and sometimes it lasts five hours. With each rep, more sweat pools at a spot on her shirt and her bones crackle like elastic bands snapping in synchronization. Her blue eyes squint and her sunflower blonde hair whips as she reaches the pinnacle of exhaustion.

After the workout in her apartment, it is time for lunch: turkey sandwiches. She takes a slice of cucumber and places a thin piece of turkey on top of the cucumber slice, folding it carefully as if she was tying a bow. On top of the turkey, she squeezes out a dollop of Dijon mustard. She doesn’t bother covering the sandwich with another cucumber slice. She generally has no more than three of these sandwiches in a day, and only scraps of food in between.

This is a day in the life of Emily, a 20-year-old with anorexia nervosa.

About 14 months ago, Emily developed anorexia nervosa, or simply anorexia. It is a life-threatening disorder with symptoms that include an intense fear of gaining weight, which can lead to the restriction of food intake and an unhealthy amount of exercise.

Knee Surgery

“I had to get knee surgery,” said Emily. “I tore a bunch of things in my left knee. My ACL, MCL, meniscus. I fractured the ends of the bones. And my knee cap was dislocated.”

Emily had been training to be a competitive weight lifter. Emily is 5’6” and at the time, had a lean, muscular build.

“I was always thin, but I had so much natural muscle,” said Emily. She had thick quads and firm buttocks. During one of her training sessions in 2012, she performed a clean and jerk that resulted in her knee collapsing.

Emily needed surgery to repair the torn ligaments and as a result, months of physical therapy.

“Immediately after the injury, my leg atrophied,” said Emily. “It went from having a ton of mass, to being a toothpick.” As a result of not working out, the rest of her body followed suit, and the muscle mass disappeared.

In fact, she lost roughly 60 pounds in two months.  

Resenting Weight Gain

Emily attributed this event as the mechanism that set in motion her anorexic compulsions.

“As I rehabbed in physical therapy, I noticed the weight was coming back. I guess at that point I had gotten used to how skinny I was that I kind of resented the weight gain.”

Emily’s resentment progressed to fear over only a few weeks. As she was able to recover from her injury, she was able to work out more. But it wasn’t her usual Olympic lifts, like squatting, power cleans and deadlifts-- it was extreme amounts of exhaustive cardiovascular exercise.

 “When I wasn’t in class or sleeping, I was trying to lose weight.”

 Mary Beth, Emily’s mother, was at first proud of Emily’s determination after surgery. “I was amazed that she was working out so hard,” said Mary Beth. “I told her to wait until she was at full strength to work out, but she said she needed to. I guess I thought she was just determined.”

Emily’s diet changed as well. She not only began restricting what she ate, but even on occasions, would purge by vomiting to lose quick pounds.

“I just thought it was a logical thing to do if I wanted to lose weight,” said Emily.

“It was so hard to tell something was wrong, because it seemed like she had lost all the weight from the surgery,” said Laura, Emily’s older sister.

Laura recalled when she started wondering if Emily was anorexic. “I remember going to lunch when I visited her,” said Laura. “Normally, she has an outrageous appetite, but when I ordered a massive sandwich, she got a coffee and a side of asparagus. I knew then that this was not an unusual occurrence.”

At that lunch, Emily knew her secret was out. “I think that’s when she noticed something was wrong. Truth is, I only got the coffee because I knew it was a diuretic,” Emily said.

Still, it wasn’t easy for Laura to approach Emily about her concerns. Laura watched her sister melting away. She didn’t know what to say to help Emily. Laura felt that if she complimented or even addressed Emily’s appearance in any way then Emily would feel that the eating and exercise habits were working. Conversely, if she said something negative about Emily’s appearance, Laura feared that Emily would increase her habits. It took awhile but they eventually had a hard talk, which helped Emily realize she needed support to change her ways.

Her Body’s Changes

Throughout this process, Emily’s body has undergone immense changes in the past several months.

“I went to the doctor during spring break and she told me that I am not producing enough estrogen, because I do not have enough body fat,” said Emily. “I don’t want to say what it is, but it is under 10 percent.”

The American Council of Exercise (ACE) research shows that the average body fat percentage for a woman is 26 to 31 percent. For an athlete, like Emily, the range should be around 14 to 24 percent. ACE research says that 10 to 13 percent body fat is the minimum amount of fat necessary for basic physical and physiological health. Anything lower could be dangerous to a person’s health.

“My hormones aren’t working correctly. I’ve had to switch birth controls and am on extra estrogen. Low vitamin levels. I am anemic as a result, so I am on extra vitamins, which I like taking as opposed to eating.” It is common for women with eating disorders to stop menstruating, according to the National Institute of Health.

Emily’s mom Mary Beth has felt helpless through the whole process. “It kills me that I couldn’t do more for her. I don’t know what I could have done. Maybe I could have caught it earlier on. Maybe I could have given her more self-confidence through her injury or at some point. I just don’t know.”

Working on Recovery

Emily is seeing a clinical therapist for counseling on her eating issues. For Emily, it is an issue of trying to accept her body for what it is, to simply try to eat more, and resist her compulsions to over-exercise.

Emily is still in physical therapy for her knee, and she is using the help of various physical therapists to control her over-exercising. “Usually they tire me out in 45 minutes or so I really don’t have enough energy to work out more,” said Emily.

The family still struggles how to best help Emily, especially her mom. “It is heartbreaking, knowing that your daughter has a poor self-image,” Mary Beth said. “I think she is beautiful, and it kills me that she thinks she needs to starve herself to feel better about herself.”

Posted By: Torey Darin