Diet pills/ appetite suppressants… another side of eating disorders we don’t readily talk about. We should.
Over the years I have used many forms of products that were labeled as either “diet pills”, appetite suppressants, detoxing or laxatives .
I probably started using them well before I developed a full blown eating disorder. Raising the question for me, are they a gate way drugs to eating disorders?
Taking diet pills is disordered in itself. I trialed all sorts , I bought them without really knowing what the active ingredients were. Which for me, is completely against my personal values. I’m a scientist and to be so driven to take something purely for the goal of weight loss is baffling. I’m the kinda gal that has to know the how, why and the risk/ benefit of anything. However diet pills were different.
I remember buying my first diet pills in secondary school. I thought it would be a “quick fix”. They are addictive.
Soon diet pills became a part of my ever expanding routine and rituals.
I would hide this behaviour from others, which means I knew what I was doing wasn’t normal. I was incredibly secretive about this behaviour. It eventually expanded to other drugs including laxative abuse.
Neither diet pills or laxatives result in weight loss. The weight loss associated with laxatives is water weight. It’s purging and extremely dangerous.
I felt cleanest when I was emptiest and high from ignoring hunger pangs, and even more euphoric if the hunger was suppressed. Sometimes I felt superhuman. But I wasn’t. Looking back now, I only felt happy if I was empty. I wasn’t happy outside of this. I was numb.
I’m fortunate I don’t have lasting effects from the laxative abuse. Many are not so lucky. Laxative abuse is not something to be scoffed at or ignored people can be rendered incontinent or dependent on laxatives for life in order to be able to poop.
Diet pills are also dangerous. Not only do I believe they encourage disordered eating and other behaviors they can be harmful in themselves. Many of the diet pills or appetite suppressants are widely available without prescription or worse over the internet without any safety regulation. That means many of the products have not been approved for use in humans let alone approved as safe. You do not know what is in many of them. The drugs that are rigorously tested and checked require approval from the Food and Drug Agency (FDA). Anything without out this approval stepping into completely uncharted waters and potentially very dangerous. I had signs of liver inflammation when I started recovery and signs my liver was struggling. When we don’t know what we are putting into our body we really are playing with fire. Thankfully my liver recovered.
Social media is rife with adverts selling these hazardous products. Companies that sell them are also cunning and as soon as a drug is labeled as dangerous, they rebrand the same product. I bet you have seen celebrity’s used as promotions for such pills, claiming celeb X had a miraculous result to their product without any ill affects. When in reality I am willing to bet, the celebrity NEVER takes them. But people who engage in disordered eating or want to fit into the societal norms are easy targets. I was. You name it I tried it. I have intentionally omitted the product names of anything I took, as I do not wish to trigger or promote disordered actions. Frankly I know that when I was in the depths of my eating disorder if I heard about a new product, I was onto it as soon as I read about it, and so I know what goes through some of our eating disorder brains.
I want you to see that it’s something we don’t talk about enough in the eating disorder community. However, I am confident it’s a hell of a lot more common than we think.
I’m not going to pretend stopping this behavior wasn’t difficult. It was but it is completely possible. I can’t imagine putting something I had no idea the content or safety of into my mouth now (unless it is food).
I went cold turkey- I flushed my pills and binned all the detox teas. It was one of the first behaviors I tackled in recovery ( that and the Fitbit, which is a post enough in itself) Fitbit aka handcuff.
Now when the adverts appear on my social media I either report them or remove them.
Diet pills are an odd one, but if you want to recover they have to go. They don’t work and who know’s what damage they’ll do.
Let’s make this discussion part of eating disorder recovery and bring it out in the open.
We have just returned from a few days holiday, which I feel incredibly lucky to be able to do for numerous reasons, 1. We live in a place we can travel at present and secondly my eating disorder was not allowed to dictate my behaviour for the first time in many years.
Why are holiday’s so hard for people with an eating disorder? Often in the midst of an eating disorder we use behaviours to cope with uncertainty, change or triggering situations. Firstly, you are away from home, your regular environment. This can be full of uncertainty and planning can go out of the window. Tonnes of food challenges can arise. Challenges you may not have foreseen, such as not being able to follow a regular schedule, a meal plan. Eating out and experiencing new dishes. All of these things can be extremely triggering. It’s hard to imagine if you’ve never experienced an eating disorder.
Here’s how a holiday for me used to look like:
Weeks leading up to vacation:
Enormous anxiety and dread. Escalation in behaviours in response to increased thoughts and fears regarding the uncertainty of said trip. I would buy into the “ prepare for the summer body diet culture crap” and it would set my eating disorder into a frenzy.
Then the event would arrive, no matter how much “ event restriction/ compensation” I had undertaken I would still feel ridiculously out of control and fearful that my constant was about to change. I would not be able to predict every meal and therefore calculate my intake. Holidays can be inactivity. This used to terrify me, how was I going to hide my “craziness’, fit in my ridiculous workouts in new territory? All the while Hitchhiker ‘HH’ would be telling me I was disgusting. How can anyone be present and relax on holiday when this is going on?
Changing experience of holidays’ with time and at various points in recovery;
Once I commenced recovery the anxiety around the trips shifted to a different kind of anxiety. When you start recovery, especially early on, you need to eat very regularly. Holidays can make important established routines very tricky to follow. I would worry if I would be able to eat the food available. Eating in front of people can be immensely anxiety provoking and largely, trips involve eating out. It’s a point where you are challenging ‘fear’ foods and there’s all kinds of food challenges that can happen on trips which for the person experiencing an eating disorder is overwhelming.
Some restaurants very unhelpfully have nutritional values on their menus which can be a minefield for those of us trying to recover from an eating disorder. Trying to do the “ right thing for recovery” when in an already stressful situation and then presented with your demons on a plate, in every sense is really freaking hard. I used to use one hand to block out the numbers. Or ask someone I trusted to look at the menu, find something I’d like and pick until I could deal with this. Until I got to this point, my eating disorder was too strong and it would not allow me to choose what ‘I desired’. This adds to the stress, feeds the eating disorder and makes the time really challenging. It gets better, I promise.
You can’t switch your calculator of a brain off overnight. It takes time and practice and many situations and repeated actions until your brain doesn’t equate the numbers with relevance. But it can be helpful to go to places you don’t know the nutritional value, because your well trained brain sometimes doesn’t switch off for familiar items. Now I can go to a restaurant with the nutritional values and choose what I desire without coercion. It irritates me that the diet industry even seeps into the catering industry and influences our choices. (I spent ages in recovery with a black marker pen scrubbing out nutritional values on boxes etc) Now I don’t automatically read or know the content of EVERYTHING. IT is possible to train your brain to stop paying attention with effort. Black marker pens are brilliant for this.
ALSO, FOR THOSE WHO NEED TO HEAR THIS, I’M GOING TO SAY THIS ONCE: CALORIES IN DOES NOT EQUAL CALORIES OUT. OUR BODIES ARE WAY MORE INTELLIGENT THAN THE PEOPLE WHO CAME UP WITH THIS LIE.
What my life would look like after I returned from a holiday:
A completely false sense of guilt for the “loss of control”. I say false because, I was not in control on any of the trips. I had abided by my eating disorder rules and stipulations. I might have eaten something slightly outside of ‘HH” rule book and paid an enormous price of guilt, shame and most importantly regret for all the things ‘HH’ made me miss out on because I listened.
I would return from holiday, unhappy, compensate for my warped view of the trip and over value I placed on it and nothing would change because an eating disorder is a constant event planning, life of restriction.
A Vacation now:
Leading up to the holiday, the old neural pathways are fragile and the ‘HH’ thoughts do get louder. The thoughts around compensating return. But the big difference now, I know these thoughts are lies. The do not lead to me feeling happier, more confident on my holiday, more relaxed and present. No the complete opposite. Therefore, I have to be vigilant I have to make an effort to do the opposite.
Vacations are a trigger. Knowing triggers, helps you plan and prevent slips or relapses or in the event of either recover from them quicker.
My husband and I talked about the trip prior. He knows my triggers pretty well now.
For me, this meant, making sure we always have ample snacks around incase we get caught somewhere ( we spent 6 hours driving and quite remotely at times).
We knew some of the foods would be challenging- so I set myself some food challenges. Like eating spontaneously on the road, eating foods that are deemed as “unhealthy”. When realistically no food is unhealthy it’s all fuel.
It was going to be the first time on a beach in my togs since I weight restored. This was a huge one. Putting on swimwear for the first time, since weight restoring is a whole new chapter in recovery. I’ve gotten used to wearing larger clothes to my previous weight restored body. That was a challenge in itself. But putting on swim wear is next level discomfort and vulnerability. Society tells us, to go to the beach we need to be “bikini/ beach/summer body ready”. Just putting it out there now, “bikini/summer body’s” do not exist. It’s a societal fat phobic term, the body you inhabit in, is beach ready whenever. If it can get you to the beach, it’s ready!
Learning to adapt. This has been a massive one for me. Whether it’s adjusting to body image, which is something that naturally creeps in on vacation. Being surrounded by different body sizes, it is important to feel as comfortable in your skin as you can. Wearing clothes that make you feel comfortable helps. My body is very different now in recovery, feeling confident and comfortable is hard. It is possible my friend, you shift your focus to the activities you are participating in, rather than the body you are in. I am grateful to this body because it’s this body that allows me to enjoy rather than fixate and agonise. No matter what body you are in in the midst of an eating disorder you won’t be happy.
But for the body image stuff: I tried to think about it this way..
Why is it, the least interesting thing about someone, their appearance is what we judge them on so heavily?
Personally, I think I have nice eyes, but that is one of the least interesting things about me.
There is nothing interesting about your, shape, weight or appearance. I don’t care how much you weigh or size jeans you wear.
This has helped me this week when I found my thoughts drifting to judging my recovering body. Instead I know I was mean on a paddle board, I am funny and a kind person, that’s way more interesting than worrying about the other crap.
I’m at a place in my recovery where I can eat out, and this can be regularly. I found this really difficult previously. Even so, my old thoughts were there on occasion but each meal I challenged them and moved on. That doesn’t mean I found the holiday as easy as someone who has never experienced an eating disorder. I still had to choose recovery at least 3-6 times a day and not let those decisions impact upon my plans or activity. But I did not engage in the ‘HH’ thoughts.
The holiday was more free and flexible. I felt present. I wasn’t bone cold in 25 degree heat. I wasn’t calculating. Goofy yes, calculating no.
This level of flexibility and freedom is something that has come with persistence and time.
Holiday’s are a time for rest and recuperation from the craziness of our day t day lives, for people with eating disorders they can instil extreme anxiety which diminishes any prospect of relaxation and enjoyment. But there are ways of managing them. As outlined above I think some of this will depend on the stage one recovery to the extent of planning and support required around them. But they should not be as stressful, so I hope if you are someone with or supporting someone with an ED, you can find someways of reducing the anxiety.
Things that I have found to be helpful when planning trips:
1. Talking with your treatment team before (and after)
2. Planning for potential triggers
3. Identifying potential triggers and a plan in the event of trigger-what’s in your toolkit
4. Planning food challenges for the stage of recovery, with appropriate support.
5. If following a meal plan, how the trip might be helpful or detrimental and planning around this
6. Wearing clothes that make you feel good.
7. Making sure you always have appropriate fuel available
8. Do you need to know where you are eating? (again I think very individual) I did at some stages.
9. What activities will you be participating in
10. Who are you going to be travelling with, are you supported/ triggered by them.
All of these are or have been part of my own trigger prevention and plan. This is growing/ changing as I encounter potential triggers or progress through recovery. You might have some similarities but you WILL have your own.
Before and after pictures are harmful on so many levels.
Firstly you see the diet industry, so called “wellness” industry’s using pictures to market their false products.
The premise of the so called before and after picture in this setting, suggests that image and weight is the marker of health. Which people, if you have read any of my blogs or IG posts you know this is bullshit. Like the Bullshit Mass Index (BMI).
None of these elements reflect a persons health and the idea that manipulating your body, or image is a way to get healthy in most instances is simply ludicrous.
Before and after pictures in the eating disorder community are extremely dangerous. They are often posted on social media. Without a trigger warning, monitoring and to the most vulnerable of audiences. They serve no place in recovery. Why?
1. It promotes the unhelpful myth that eating disorders affect only the emaciated. Sadly this is still the image the media portrays of someone struggling with an eating disorder. Which is not helping to raise awareness, reduce stigma or educate about Health At Every Size.
2. They inadvertently promote ‘thinspiration’. For those of you not familiar with this colloquialism it’s a term well recognized in the eating disorder community that encourages thinness and can lead to very unhealthy comparisons and behaviors. For this reason alone no matter how well intentioned before and after pictures are dangerous.
3. Just because someone has gained some weight, or lost it’s not reflection of health status. You have no idea of the physical or mental state behind the picture.
4. The can invalidate a person’s recovery. Seeing someone’s pictures may make an individual question their recovery and why they haven’t “recovered” like the post. The pictures do not portray the enormous effort, energy and mental struggle involved in recovery. They are not true depictions.
I have written on previous posts, mentally I was at my most screwed up, difficult place when I first weight restored. To show a before and after picture at this point declaring my “recovery” would have been incredibly inaccurate. This is not helping to raise awareness that weight restoration is only part of the recovery process. Mental recovery takes far longer.
When all consumed by my eating disorder there was barely a day went by that I didn’t take a photo to “check” my progress. It was almost a big of an issue as the scales and weighing. People with eating disorders use the camera as a form of body checking. Body checking is not a healthy behavior and does not help in recovery.
Photos-are personal. For some people keeping photos of themself at their sickest can maybe act as a reality check, or reminder of why they recovered. For others I can imagine it would be detrimental, like holding on to “sick clothes” regardless the photos should never be shared to show ‘before and after’.
Social media is a mind field for ‘before and after photos’ and it’s feeding the fat shaming, stigmatizing society we live in. So please if you’re thinking of posting a before and after pic, think before you do.
Why and who are you really doing it for, what message are you really trying to convey? If in doubt don’t share.
For some people their work relies upon social media. It has so many roles and uses in today’s society.
Social media can be helpful to us in our recovery, but it can be a minefield. I actually removed myself from most social media accounts early in my recovery. I don’t believe there is a right or wrong solution to this, but I believe an awareness of the impact social media has on you personally and whether it is helpful or detrimental in your recovery is the most important question. Your motives for following particular accounts, whether they serve you, or your eating disorder.
If you look for it, there are tons of recovery orientated social media platforms. But, it’s not always easy early on to identify motives of some and whether they are 100% pro-recovery.
Some platforms, target our vulnerability. Ads, pop ups etc all follow your history and if you are trying to move away from certain paridigms it can be really hard being constantly reminded about the latest fad-diet or exercise programmes etc! You get my point. Equally you can’t control what people post/ talk about. Your friends, family and colleagues may post things that are particularly sensitive for you. So sometimes taking some time away from this can help at least until you are in a stronger place.
Social media can be anxiety provoking, for those in lockdowns, isolation the conflicting and unhelpful messages can impact upon mental health. It’s not surprising around the world the new diagnoses or relapses of eating disorders that have occurred during the pandemic. Social media I believe plays a large part in this. Adding to pressure around health, diet and exercise. As well as the change to routine and access to normal resources. Knowing that not everything on social media is real, or as it appears on there I think can help.
I am glad I didn’t grow up in the ‘Tik-Tok’ era, and facebook/ instagram was only really around when I was late teens. I feel for teens and young people now with the pressures of social media. This really worries me for future of their health.
It’s the time of year where the diet and fitness industry try their hardest to sell their products. So social media is swamped with diet culture and all the shit that goes with it. I am now in a place where I can mostly see this for what it is, selling a product. This industry generally targets a vulnerable population too, people like myself. However I am aware of it, and I’m aware of the impact it can have on me. I will not be deleting my social media accounts this year. Last year I needed to, to escape this onslaught. Instead I am using my social media to promote the ‘fuck it diet attitude’, following positive influences that are pro-recovery. If an ad pops up, I will simply reject it. Friends, family and colleagues dieting that’s up to them, I can choose to ignore this. But if you are in a place where this is going to be damaging to your recovery, a social media holiday can help. I found it quite liberating and realised how reliant upon social media we are. Returning to social media has been a big test in my recovery.
Quash stigma not fat: ED recovery blog 