Nutrition Facts

As promised, a continuation from last week. Click here to read Part 1.

Prior to walking in the front door of this building, any knowledge I had about in-patient eating disorder treatment came from network television. Documentaries, fictional films based on real events, after-school specials; I obsessively watched each and every one after being introduced to the genre in an eighth grade health class. Real or staged, they all depicted extremes in order to captivate the audience and act as a cautionary tale to deter its viewers from going down the same path. The main character(s) were always skeletal; ribs and collarbones prominent, with hollow cheeks, sunken eyes, near translucent skin, and brittle, thinning hair. In spite of their appearence, these poor individuals hid their food in the drywall of their hospital room and jogged in place while hooked up to a feeding tube.

Although I was told repeatedly that these narratives were exaggerated and stereotypical, I came into this experience resigned to the fact that I would be the most overweight eating disorderd patient in the program. A thought that haunted me, because everything in my life was about comparison and competition. At all times I felt like I was under a microscope; being judged in every way by the people around me. And right now I squirmed under the gaze of two other residents who bore an uncanny resemblence to the stars in those movies I watched ad nauseum.

Bea stood next to a girl named Cara, who I’d learned earlier was a 28-year-old that hailed from Denver, Colorado. Her face, long and thin and pallid in color, made her appear much older. In a short amount of time I noticed that Cara didn’t speak unless required, and preferred to disengage from the group whenever possible. When we made eye contact, she gave me a slight nod and, just for a minute, the corners of her mouth turned up slightly. My first instict was to talk; make a joke, ask a question, fill the silence.

“Can someone please tell me what ‘offered’ means?” I said it conspiratorially as there was a palbable feeling in the air of “us vs. them” when it came to patients and staff. My intention was to lean into that energy so as to be welcomed onto the right team.

“They have to say that,” Cara’s voice was deep and raspy. “As if it’s a choice. If you don’t agree to the drinks, they will tell your insurance company, and it will be considered a failure to comply with the programming.”

“You will eventually get kicked out or your insurance will drop you,”Bea chimed in.

It was the only threat they could impose in a treatment program for adults. Our admission was voluntary, and because each one of us was over 18, nothing could happen without our consent. Nonetheless, the fear of failure was perhaps the only motivation comparable to what drove my eating disorder. I felt my chest stretch tightly at the thought of disappointing everyone simply because I could not follow the rules. After all, this disease preyed on perfectionists; in almost every area of my life I was programmed to please. But when this intrinsic need for accomodation overlapped with the demands and obligations put in place by the eating disorder, the dissonance was unbearable.

“Chocolate or vanilla?”

Megan stood in front of us once again, this time with multiple cartons of a drink with a banner on the side that said “very high calorie” in enormous block letters. And next to that, the numbers; 530 Calories, 52 grams of carbohydrates, 13 grams of sugar, 26 grams of fat. Bea took two of the vanilla from the tray and Cara one of the chocolate and they both flopped onto chairs within eyeline of the nurses station. I could not take my eyes away from the black and white panel with the alarmingly high nutrition facts; everything else blurred as it continued to be the only thing I focused on while a war waged in my head, making it impossible to take any action.

“I’ll take one vanilla,” I heard myself say, staring at the floor, terrified of seeing any reaction from Megan. It was the only compromise I could stomach as I did not have the capacity to enact a full rebellion.

The first sip went down my throat and then immediately came back up. It may as well have been melted ice cream; a familiar taste and consistency to someone who had suffered from bulimia for so long. Ice cream was one of those foods that was easy to purge. It didn’t hurt your throat and came up without needing much provacation; the same was most likey true of this meal replacement shake, but I wouldn’t have the luxury of finding out. The nausea I felt must have been all over my face because Bea took the opportunity to say, “It’s better to just eat the food they give you,” as she slung back her own drink with the expertise of a frat boy chugging beer.

With each painful sip, I fought off visions of myself leaving here weighing twice as much as I had when I entered. But what else could I do? The more that I fought the programming, the longer I would have to stay. After just half a day, I wanted to get out of here as soon as possible. My heart broke every time I thought of the two tiny, tow-headed children I left behind. How could I explain to them that I was too attached to my demons to work on getting back to them quickly? I didn’t come all this way to continue to fight for something that might take away the only good things in my life.

I closed my eyes and tipped up the carton, forcing the last of the chalky substance down with the conviction that this would be the last time that I put myself in this situation. From now on, I would do what they said, eat everything put in front of me, tell the therapists what they wanted to hear. I was going to be the perfect, model patient and get out of here in record time.

Authentically Yours,