Eating Disorder: A True Story
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| Laxative abuse affects thousands of teen-age girls nation-wide. |
"It felt like I took in so much bad during the day, and this was a way to get rid of it," said the young professional career woman during an April 10 interview.
For 10 years, "Tina" took increasing quantities of laxatives and became dangerously thin. She was diagnosed as having anorexia and was hospitalized four times between the ages of 13 and 23.
Eating Disorder Treatment Denied By Most Insurance
And she is using an alias because most health insurance companies refuse to pay for eating disorder hospitalizations. So Tina was forced to check into a New England-based hospital that lacks an eating disorder program as a suicidal person on two occasions to receive treatment that insurance would agree to cover.
"And that right there makes me sick, that insurance companies won't cover this," she said during an April 10 interview.
According to national data, about seven million American females and one million American males suffer from an eating disorder. Eating disorders are identified as having the highest death rate among mental illnesses. Anorexia is the third most common chronic illness among adolescents and 95 percent of those diagnosed with eating disorders are between the ages of 12 and 25.
They are, in fact, much like Tina.
A Need To Control
She was about 13 years old when her parents separated and a sibling left home to attend a higher education program, Tina said. Her parents marital woes coupled with the sibling absence left Tina feeling alone and stuck in the middle of her parents difficulties.
She can't remember what she looked like then but does know that her initial laxative use was not rooted in poor body image.
It was rooted in a need to take control and keep it.
"I remember reading an article about a girl in college who'd taken laxatives and I remember thinking I should try it," she said. "I didn't start out with laxatives, I started out using Epsom salts."
After a few months -during which Tina began shaping her daily routine around the amount of time required for laxatives to "kick in" and learning where public bathrooms were no matter where she went - Tina swapped Epsom salts for laxative medications in pill form.
Nobody Knew
"Nobody knew what I was doing," she said. "When you first start [using over-the-counter laxatives] you are using maybe two pills, and then, in a month, it's doubled."
There was a point when Tina said she was taking hundreds of pills on a regular basis. Like any addictive behavior, the habit grew costly.
Tina admitted that she did sometimes shoplift the pills and estimated that she spent about $15,000 on laxatives over a decade.
There were weeks when Tina did not eat much but the reason might surprise some people. An eating restriction wasn't brought about by a need for weight control but because laxatives, when taken in large quantities, often generate nausea and vomiting. There were also regular bouts of excruciating cramps that left Tina racked with physically agonizing pain, she said.
Affects and Effects
Weight loss was more side effect than goal and after Tina had dropped about 40 pounds, her mother found laxatives in her bedroom. She remembered that her mother was upset by the discovery and when questioned, Tina told her family that she was depressed and believed she needed help. She was almost 15 years old and had shaped her entire existence around laxative use and the resulting bathroom needs. Because she was a good student who posed no disciplinary problems, teachers did not question her frequent requests to use the bathrooms, Tina said.
"My school life was affected," Tina said. "The first time I was hospitalized I weighed 98 pounds and I was in the hospital for a month."
After discharge from the facility, the laxative use resumed.
"I really don't have a lot of memory," she said. "I know I blacked out time. I went shopping for a prom dress and then, three months later when I went to pick it up, I couldn't remember the dress. I was like, 'this is the dress I picked?'"
When her potassium level was found to be dangerously low, she was hospitalized again.
"I could have gone into cardiac arrest," she said. "I was 18 years old."
Prayers And Promises
Tina said that it can be very difficult for people who've never been impacted by something like anorexia to understand the illness or even feel compassion for those who appear to deliberately ignore their health.
"I wasn't scared at all," she said of her precarious health status. "You don't think about things like [dying] when you have something like this that totally consumes you. I do remember being in bed, being in so much pain from cramps and praying, promising that if I could get through this one night, I'd never do it again. I'd get through the night, and the promise wasn't kept."
Two subsequent hospitalizations did not result in changed behavior but a move to a new state and unfamiliar surroundings did deliver a fresh perspective and an end to the abuse, Tina said. The move involved a new personal relationship and a deep desire to change her life.
A Fresh Start
"I did bring laxatives with me [when she moved] but after about a month, they were flushed down the toilet," she said. "I haven't taken them since. For me, the move to a whole new place with a whole new person was like a real fresh start. "
Stopping the laxative use after 10 years wasn't without challenge. Tina's body had grown dependent on the products and regular bowel habits did not resume until several weeks had passed. The process was of re-establishing normal body function was not easy or comfortable, she noted.
Tina has since married and has a child, something she said would have been extremely risky if not impossible while using laxatives.
"My mind set is all on my family," she said. "As long as my family is healthy and happy, I'm happy."
One Month Of In-Patient Treatment:$30K
According to information available at several Internet web sites, including sites about mental health, about 80 percent of those who receive treatment for an eating disorder do not receive the level of care required to remain in recovery. Many of those who are participants of in-patient programs are discharged well before the recommended treatment time has passed.
According to information posted on a South Carolina Department of Mental Health site, "Treatment of an eating disorder in the U.S. ranges from $500 per day to $2000 per day. The average cost for a month of inpatient treatment is about $30,000. It is estimated that individuals with eating disorders need anywhere from 3-6 months of inpatient care. Health insurance companies for several reasons do not typically cover the cost of treating eating disorders. The cost of outpatient treatment, including therapy and medical monitoring, can extend to $100,000 or more."
Tina noted that there are complicated factors associated with treatment that people may not be prepared to handle.
For instance, after her first hospitalization, Tina was extremely reluctant to be by herself because of a new and heightened sense of anxiety. While an in-patient, she said she was part of a group known as "the ED [eating disorder] girls" and "all the ED girls got to eat by themselves so that no one could watch you eat. And while you were an in-patient, there was a different kind of support system. There was group therapy and individual therapy."
But once discharged from the facility, the intense, trained support staff and system were no longer in place, Tina said.
Who Can Believe What?
Eating disorders and the causes are not the same for all people and a one-treatment-fits-all approach is unlikely to increase recovery success rates, she said.
"It's not always about a need to be thin or a body image," she said. "And it's all so confusing now. There are all the stories about obesity and all the stories about eating disorders and being too thin. One week it's 'eat this and this', the next week 'this' and 'this' are bad for you. It's very hard. I am honestly saying that I am glad I have a son and not a daughter. I know that boys can get [eating disorders], too, but it's more often the girls."
"How does anyone know anymore what's healthy and what's not? I do know it's expensive to eat the way people are supposed to eat. It's pretty sad when milk costs five times more than soda."
10 Hellish Years
She does not see herself as a "role model" and confessed that she had concerns about sharing her story. Her own laxative use began after she read someone else's "story," she reiterated.
"I don't think I have the authority to say anything to anyone, I'm not the best example," she said. "I had 10 hellish years. I was a teen-ager and I didn't have normal teen-ager experiences. And I can't get that back. At the time, it was awful. It's just too simple to say to someone 'just ask for help.' The person who needs the help doesn't believe they need help and they aren't going to ask for it. If you think there is something going on, there probably is. Talk to the person about it. There were a lot of times when I felt people didn't talk to me because they really didn't want the truth."
Because some eating disorders are based on poor body image, the population should become accepting of a variety of body types, and the media and fashion industry should deliver more than lip service to the issue, Tina said. She noted that a person with wide hips isn't necessarily "obese" and a person with a slender body type isn't necessarily "beautiful."
"I do not look at my weight and I don't allow nurses [at doctor office visits] to tell me," she said. "I really don't care what my weight is. If I were still sick, I wouldn't have my family or my child. And I do know that weight is not the true measure of a person."
Additional information about eating disorders is available at a www.eatingdisorderscoalition.org Internet web site, a www.state.sc.us/dmh/anorexia/statistics.htm Internet web site, a www.sadd.org/stats.htm Internet web site and a http://win.niddk.nih.gov/publications/binge.htm Internet web site.
