The first journaling question in Journaling in Eating Disorder Recovery is about body image. The author asks you to journal about what your eating disorder is doing to your body. She also asks you to contemplate whether your body image is worth these effects.
My eating disorder mostly involves bingeing, which is good for neither my body nor my body image. After all, it not only causes me to be nauseated after a binge and get acid reflux (I believe this is also triggered by bingeing and not just by purging), but above all it has caused me to gain about 40lbs in a two-year period. As a result, I am now about 30lbs overweight. This of course results in poor body image, because, you know, I don’t just think I am fat.
I just googled the physical effects of bulimia, and some I find are related to bingeing. For example, people who binge get a bloated stomach and stomach pains. The bloated stomach causes it to take longer before you feel full. A severe binge can even lead to a ruptured stomach.
I also purge on a semi-regular basis. While I don’t purge nearly as often as some bulimics, I do vomit significantly more than people who are sick every now and again with a stomach bug. Purging can have the following effects:
- Tooth decay.
- Erosion of dental enamel.
- Irritation of the esophagus.
- Sore throat.
- Acid reflux.
I have many of these symptoms.
Of some symptoms I found, it isn’t stated whether bingeing, purging or laxative use causes them, but I have them whichever is the cause. For example, one source listed acne as a possible effect. I use to think I’m too old for acne, but nonetheless I do get an eruption when my eating disorder is particularly severe.
Effects that aren’t mentioned, are the long-term consequences of obesity. Think, for example, type 2 diabetes. I don’t know where he found this so can’t check the source, but my husband says that eating lots of sweets is now thought to actually lead to type 2 diabetes because of leading to a chronically elevated blood glucose level.
Is my body image worth these consequences? Of course, my body image is damaged by my being obese, but what if purging actually causes weight loss? Note in this sense that in my case it hasn’t led to weight loss, but just suppose it did. Then, still, I would have to say that health is more important than outer beauty.
I do, however, sometimes believe that purging can’t hurt while obesity can. In this sense, I weigh the health risks rather than the effects on my body image. Or do I?
After all, people’s encouraging obese people to lose weight for health reasons is generally coupled with a lot of shaming of people’s fat status. Even if other people don’t say so, I tend to think that I need to lose weight to be good enough. I still tend to think my husband doesn’t find me attractive even though he’s stated a few times that his reason for encouraging me to lose weight is my health. Other people, like some staff, do more clearly fat-shame. For example, we get metabolic screenings, including waist measurements, every six months to a year. At my last screening, the nurse took my measurements and then commented I really need to lose weight. So far it could still be interpreted as pure concern for my health, but another patient was next. She took this woman’s measurements and then commented to me: “See, it can get worse.” That really was an unnecessary comment that instilled shame rather than motivation to get healthy.