Thursday, September 30, 2010

Insanity or recovery?

Insanity is doing the same thing over and over and expecting a different result. Einstein

With mixed emotions I told Jamie not to schedule a follow up appointment. 

Yes, Jamie need not return to see me. It wasn’t that she was difficult or non-compliant. On the contrary. Jamie was done. She had truly recovered from her eating disorder. She not only knew what to do—how to eat to meet her needs, how to get back on track when she slipped, but she did it. Consistently. And she no longer needed me to guide her.

In May 2004, at the age of 18, a college freshman, Jamie presented after leaving her Ivy League university to move back home to work on recovery. She had struggled with bulimia for an entire year before seeking treatment with a therapist, and had now realized that it needed to be her full time job. She compulsively exercised. And vomited daily. She hated the purging, she “knew it was wrong”, but felt it was the only way. Her periods were irregular (not a major concern to her at the time), but she complained of feeling low energy and was frequently lightheaded. She binged and restricted her food intake. And binged again. And so the cycle went.

She chose the lowest calorie foods she could find and avoided “risk” foods. And the list of those were growing rapidly. On most days Jamie’s intake was way too low, particularly given her over-exercising. And yet her weight was higher than it needed to be, by about 15 pounds, a source of much frustration. As far as she was concerned, it could never be low enough to please her.

Fast forward to today.

Jamie has gone about four years without purging. And yes, she’s eating. Quite normally, I might add. Observing her you would never know she had had an eating disorder, as she chooses a range of foods and caloric beverages (although I think chocolate milk is her favorite!) She eats regularly, sometimes every 2-3 hours when she can grab a snack or sit down for a meal on her busy shifts. 

It took time, and trust in her providers to slowly break the cycle of nutritional self-denial through poor intake and over-exercise, which resulted in binge eating. And her weight has appropriately dropped to a very healthy place and has been stable within a pound or two for some time.

Now she occasionally exercises, but working many hours as a nurse is about as much exercise as she manages to find time for. And it doesn’t seem to faze her. Given the choice, I could see that Jamie would much prefer to spend time playing—with her almost 2 year-old daughter, that is. And she feels great about her modeling. Behavior, that is, for her lovely child who asked “Mommy snack too?” as the little girl fed her mother raisins in my office.

Jamie owes her success to “becoming comfortable with who I am as a person, the result of much therapy”, she acknowledged. And she knew that to do the work, to think clearly, to control her impulses, she needed to nourish herself. And over time she began to trust herself. And her body, and its signals. And it certainly helped when she knew she was responsible for another life when she was pregnant. And  in preventing a 2nd generation of eating disorders from developing.

There are times that body image issues reemerge, but Jamie can manage it. And she now periodically checks her weight, first assessing her situation, and then correcting any emerging patterns that need to be addressed. She knows the door is always open if she needs nutrition guidance and support. And she knows how to open it.

For those of you struggling, I write Jamie’s story to show you that recovery, full recovery is a reality. And not just for Jamie. Regardless of how different Jamie may seem from you, recovery is within your reach, regardless of where or if you went to college or what job you hold. If you think that Jamie had some advantages that enabled her to recover, or that this recovery was quick and easy, think again.

If you’re frustrated with your eating disorder progress, your weight management or your relationship with food, consider this. How many years have you been living with and maintaining your unhealthy behaviors? As Einstein said “Insanity is doing the same thing over and over and expecting a different result”. Maybe it’s time to try something different. Do you need to call on other supports? Family? A therapist? Nutritionist? A support group? A higher level of care, such as an eating disorder program?

And how long have you been working on change? If you’ve lived for 10 years struggling with your situation, but have only been addressing the issues and behaviors for 10 months, be patient! Just like a toddler may experience one developmental change at a time—walking or talking, but not both in the same week—you may similarly be making one shift at a time—changing your thinking versus changing your actions, for instance.

I hope this gives you the inspiration to spark your progress and to recognize the progress you are making. Please feel free to share a piece of your story with us!


  1. I am exactly like Jamie....every detail...except I am a little underweight, and need to gain. My heart rate is very low and I have really bad anxiety. I've been trying to recover for about a year, and things aren't looking up. Everyday is a battle and most days I end up giving in, telling myself that 'this is the last time I purge.' This story is inspiring, and I hope to be like Jamie one day.

  2. I think it's inspiring, yes, providing hope for struggling patients, yes, BUT... I will share with you the guilt I felt after reading the part about being pregnant and taking care of yourself, that Jamie worked hard so she could prevent a next generation of eating disorders. Hmmm. What about those suffering so badly and/or silently and they can't get better even though they try their absolute hardest?

    Here you have this Ivy League "role model" to share this inspiring recovery story with... but how many of us are Ivy League material? So she's brilliant, she suffers from bulimia for a year, has the intelligence and finances to seek help from a therapist, a nutritionist, seems to glide through both, and PRESTO, she fully recovers! ? Isn't this a little fairy-tailish??!?

    I feel like you chose this person to share a "full recovery" story yet does it really depict the general population of those who are recovering or fully recovered? What about the "average" person... Or the person who has suffered years or decades with an eating disorder who is of "average" intelligence... or the "average" person who didn't have the supports while carrying a child and maybe who didn't or couldn't make all the "right" decisions about keeping themselves properly nourished (which is probably more the norm bc how can you suddenly stop ed behaviors the second you learn you're pregnant?

    I know I have come really far, I do know that, but I feel like it is taking me forever and I felt so much frustration reading the blog bc this was a seemingly text book recovery. So here you have Jamie, this Model-beautiful Ivy League Perfect Mother Intelligent Nurse Perfect Recovered Bulimic... and then there's me. … I did absolutely everything to keep my babies healthy and I DID work hard at putting aside all ed behaviors…

    Re: preventing another generation of edz: “…it is something I have worked very very hard at bc my daughters mean the world to me. Yes I have not done a perfect job, yes maybe it took me a couple or few months into pregnancy to make necessary changes, but I did it. I was alone with it all, but I did it.”

  3. Thank you both for your honest responses. I will do my best to respond to many of the points you made to hopefully share a different perspective. And please note that I did edit one of the last paragraphs of the blog post, in response to Anonymous’ comments.
    There is no typical, average recovery, just as there is no typical eating disordered individual. But generally speaking, those who work on recovery earlier in their disease tend to have an easier time and to recover sooner. And treatment has many aspects—medical, nutritional and psychological, addressing thoughts, feelings and behaviors. So if you have had an eating disorder for many, many years, and you don’t feel “good enough” compared to Jamie, please take a moment. Stop and try to assess the progress you have made, perhaps against all odds. And consider the need to get additional supports to help your progress.
    Anonymous, you express your guilt about the pregnancy experience. And yet it sounds like you, too, rose to the occasion for the sake of your children, and did what you needed to. And have even been mindful of taking the steps to prevent the birth of another generation of eating disorders. You have much to be quite proud of! It’s not surprising to me. Even patients who are not doing well prior to pregnancy seem to be able to push themselves to provide for the nourishment of their growing child, as if that life is worth more than their own.
    And yes, it is unfortunate when resources fall short. Not just health insurance coverage, but emotional and physical resources as well. But it is equally unfortunate when the resources are there and they are not taken advantage of. I do realize there are many obstacles to moving forward with treatment, and I certainly don’t want to oversimplify the process.
    And a final note, be careful of what you project onto the statements here! There was no mention of Jamie’s physical appearance ( but “model-beautiful” was injected into the comment). And just as her intelligence didn’t stop her from developing an eating disorder, it wasn’t her intelligence or Ivy League schooling that secured her recovery.
    Hope this helps.

  4. I found this post hard to read - but not for the reasons that Anon did. It took me 4 goes to get past the full recovery is a reality bit, because my brain kept going 'yeah, right'. But I'm glad I finished reading (eventually) because I have found my inability to be 'fixed' instantly frustrating and disheartening (1 step forward, 2 steps back). But even though most days I still have trouble seeing that there is a problem, deep down I know there is, so I will keep plugging away.

  5. Awareness and acknowledgement of the problem is already taking the first step! As many of my readers know, recovery can take many, many years--but it really can happen, even for you : )

  6. Thank you - some days it's really nice to hear that! I'm feeling really positive about change at the moment, but I will hold onto that thought for the more difficult days to come.

  7. Dear Anonymous,
    The story, length of illness, and recovery time are certainly different for everyone, and I think Lori tried to state that. But there is nothing fairy-tailish about Jamie's story. And there was no PRESTO in her recovery. Jamie comes from a very average, middle income family. Her eating disorder started in high school. She had always worked very, very hard and put all kinds of pressure on herself to be the best at everything she did. She didn't feel good about herself if she wasn't the best, in fact she felt like a failure. Getting in to an Ivy League school was a goal she set for herself early on, and is undoubtedly one of the many pressures she put on herself that led to her eating disorder. She got into that school based solely on hard work, not finances, and is paying back large college loans now.
    She suffered for close to two years before she came to the realization that she needed help as she couldn't stop the harmful behaviors on her own, no matter how hard she tried. She was fortunate enough to have health insurance that covered some (but not all) of her therapist and nutritionist bills.
    I feel the need to explain all this, not so much to defend Jamie, but so you realize that Jamie really is just the average young woman. Perhaps it's unfortunate that Lori even mentioned the Ivy League school as that's what you seem to be stuck on. Jamie could well have been any college freshman at any school. And Jamie had to work very, very hard to get to where she is today, almost 8 years since it all began. Recovery didn't magically happen the day she sought help and guidance. It's been an ongoing process over the years. And we are very, very proud of her.
    Obviously not everyone will be able to relate to Jamie's story as everyone's life and circumstances are so different, but if even one person is inspired by Jamie's story to keep trying and have hope, then it's a very good thing.

  8. Thank you for posting inspiring stories like this, Lori! They are very helpful! I would love to see more posts about eating disorders/recovery/support in the future! (I know that you like feedback and suggestions!) :) Thanks again!

  9. I'm writing again so I can elaborate a little more on my earlier post. To Jamie's mom... I sense how supportive you are to your daughter, and do you know what? Jamie is very fortunate to have you for a mom. I've battled an ed for over 20 yrs and I did not have a mom who supported and encouraged me through recovery and hospitalizations (in fact, she herself continues eating disordered behaviors and will actually encourage them!) I projected my own frustration with hopes for a full recovery in that post. I really am thrilled that Jamie is well now and I wholeheartedly understand that it wasn't a presto recovery... I guess I wrote that because that is what I would ideally want in my own ED recovery, a "presto" recovery. Unfortunately no such thing. I do recognize that Jamie had to endure much hard work and face many challenges to get to the healthy place she is at right now. Without a doubt she is absolutely an inspiration.
    You are to be commended as well, for being there for your daughter... I am certain Jamie appreciates every bit of support you have given her. She is very lucky.
    My earlier post was a knee-jerk reaction not towards Jamie's recovery, as it appeared to be, but more with frustration towards myself and my own recovery process. I am and have been working very hard at fully recovering (just ask Lori!) but I can see I still have some work to do - but... I have to continue to remember how far I've already come.
    I, like Plain Jane, would like an instant fix! Would love it and welcome it with open arms! However, I recognize that being ed-free is a process - with patience (for ourselves) being an important component.
    For now I must go, my peanut butter and jelly sandwich awaits...

  10. I'm sitting here at my computer wracked with stress, having just returned to my gp after nearly 2 months of hiding from her, looking through Lori's old posts for some calming inspiration so I don't revert to my panic-and-hide response - but I found my inspiration in Anon's brave 2nd comment here. I think I too will take a step back and analyse the way I'm feeling right now as a knee-jerk reaction to my fear of recovery. I hope the sandwich was yummy :-)

  11. Hello there! I saw your comment on my post and had to come over and see yours. I haven't ever been to your blog before (so our Einstein and food references are really just coincidence - don't worry, I always credit my follow bloggers for inspiration!), but it's a terrific introduction. I'll be popping back again for sure!! x

  12. I must admit that my first thought as I read about Jamie's story was the same as "anonymous". I was more stuck on the length of the ED. However, I've encountered many young sufferers during my times in treatment. I remember their struggles and know how difficult it is for them as well. I remember how much I admired them as I watched them leave the programs so much healthier than when they started. However, I always had that jealous feeling that I wish that was me. I wish I was still that young and someone cared enough to get me help. That's the feeling I had when I read this story and I think that is a normal reaction. I totally understand Anon's first reaction. I'm also a sufferer for many years.

    1. Consider reaching out for additional support at recovery oriented sites, including ASPIRE (see link on the left). I have seen first hand that recovery can and does happen, even after living with an eating disorder for many, many years. So please don't give up--seek out a qualified treatment team to help you move forward.
      Thanks for reading and for commenting.