An Apple a Day (29 page)

Sometimes everything in life happens at once: the good and the bad, love and conflict, all raining down from the skies.

* * *

I think it's worth mentioning these pressures, because they form the backdrop to this story. Perhaps they explain why everyone's advice of “Just relax, let yourself heal, look after your body, feed yourself; time will do the rest” has been almost impossible to follow.

My path to motherhood is no harder than for some other women, just different. I know of couples with “unexplained infertility” who try for years to conceive, at huge financial, emotional, and physical cost. While some people battle with polycystic ovaries, or low sperm count, or even just finding the right partner at the right time, I'm so aware that my own situation is largely self-inflicted. “But you're not infertile, just underweight” is simultaneously the most hopeful and frustrating piece of advice from my GP.

And I feel guilty for causing all this worry to others, and damage to myself. But I've kept going, and I suppose that shows strength. Despite what I've admitted about my shaky foundations and self-hatred, I must at some level have believed in myself to carry on when it looked hopeless. I haven't conceived, but I haven't really had the chance yet. Now that my period is back we can start trying for real.

This morning I cycled up to the drugstore and bought three boxes of their most expensive conception supplement—a present to myself! I felt idiotic, sort of furtive, like a teenage boy buying condoms, but the cashier didn't seem to notice. Obviously I've been taking folic acid for months, just in case, but this supplement is the real deal: it's called Mum-to-Be and shows an image of a
woman cradling her massive baby-bump. Is any woman ever ready for the physical reality of pregnancy until it happens? The picture of that swollen stomach freaks me out.

* * *

“
Things do not change; we change
.”

Henry David Thoreau

I never thought I'd change. Since the age of nineteen, I have dedicated myself to starvation. It's an unkind, destructive, pointless form of punishment. The psychologist who called anorexia “self-harm” was right. Now for the first time I am focusing on personal growth: Yes, I have grown; I take up more physical space in the world. Not only do I weigh 15 pounds more than I did at the start of this book, but I'm also an inch taller. I can't pretend to understand the science behind this, but it's true, I'm taller—and I know of other anorexics whose feet have increased a size as they've recovered! Perhaps it's just that everything gets proportionally larger with weight gain—as Dr. Robinson told me years ago, “there's just slightly more of you.” And I'm fitter, not fatter: I cycle around town these days and every muscle in my body feels strong, not exhausted. Putting on weight is not pain-free, but there's something satisfying about having the confidence to accept that there is more of me. Nutrition is important now, for me and for a baby.

It's as though for the last fourteen years I refused to accept that I had needs and appetites like anyone else. It was a long process of waging war against my physical self, of detachment from my body. This will sound hopelessly “new-agey,” but I am learning to reattach myself to this body, to live inside my body and nurture it, to “be” my body, not just a chaotic bunch of feelings and
emotions inhabiting a physical shell. My body isn't just outside me, it
is
me.

During the last year, nothing much has changed in the wider world in terms of women and their bodies; if anything, the pressure has intensified. Today's
Daily Mail
reports:

This headline takes me back to the start of my journey almost a year ago; only it's me who has changed, not society. The general obsession with celebrity culture increases, the cosmetic surgery industry flourishes, airbrushing of images continues, unsafe diets proliferate, and disordered eating, body dysmorphia, and self-hatred become the norm. Only last week there was a media flurry over reports that girls as young as five are being hospitalized with severe anorexia. The
Daily Mail
called it “a shocking illustration of how early they can become obsessed with body image,” and commented, “in today's looks-obsessed society even the tiniest girls are internalizing media images that tell them . . . that thin equals perfect” (1 August 2011). Similar scare stories popped up in the media all summer—but we should keep the figures in context: a total of ninety-eight children in the U.K. between the ages of five and seven have received treatment in the last three years for eating disorders (
Daily Mail
, 9 September 2011). That's a tragedy for those families, but it is an infinitesimally small number in our population of 62 million (and there are reasons apart from anorexia why young children may struggle to eat). To me, of far greater concern
is the explosion in childhood obesity; there are predictions that, if we carry on as we are, 90 percent of today's children could be overweight or obese by 2050 (NHS,
Help Stop Childhood Obesity Before It Starts
, 2011). The U.K. now has many, many more morbidly obese five-year-olds than severely underweight ones—and we shouldn't forget that being overweight as a child stores up even more long-term health problems than being underweight. Seventy percent of overweight eleven-year-olds go on to be obese young adults. Nonetheless, it seems that the sight of a very thin child still horrifies us more than the sight of a very fat child—as if we find overfeeding more acceptable than the look of starvation.

While society may be moving in the wrong direction, it looks like science is moving in the right direction. Among the inaccurate media sensationalism about eating disorders, some interesting research has started to emerge. A few days ago I was sent a pre-publication copy of the Ravello Profile, which is an international neuropsychological test investigating the cognitive profiles of people with eating disorders. The Ravello researchers have identified specific patterns in brain chemistry that may indicate a genetic predisposition to anorexia. Looking at the activity and functioning of the brains of those with eating disorders, they find that anorexia is “a diagnosable illness and not a behavior choice.” In other words, the anorexic is not to blame, and nor are parents or the media. Earlier research has also highlighted neurological differences between anorexic and nonanorexic patients, and a significant degree of heritability. Johnson states that “anorexia, like schizophrenia, is a genetic disease . . . an individual is twelve times more likely to develop the disease if a relative has the illness” (Johnson, “Genetics Research: Why is it important to the field of eating disorders?” taken from
www.eatingdisordershelpguide.com/genetics.html
, 2006).

This research, although inconclusive, really matters. For too long eating disorders simply haven't qualified as serious diseases that merit funding and treatment. They have often been dismissed as faddy diets or food hang-ups; selfish, silly, female concerns. I can only repeat the statistic: up to 20 percent of anorexics will die from their condition. If that's not serious, then what is? There's no question we need more understanding of this complicated illness.

On a personal level, what difference do these findings make? Is it a relief to discover there's an “underlying malfunction” in my brain circuitry, that it's not my fault? Am I alarmed at the neurological findings, or do I feel vindicated? Does it help me come to terms with all that I've wasted, and lost, over the last fourteen years?

Oddly, not really. I've always sensed—however unscientifically—that something is broken inside my head. Now I know I'm not going crazy, that anorexia really is a brain disease. I never understood why most women can diet and exercise and not develop anorexia, whereas I did. It turns out there may be a reason after all.

I don't anticipate a miracle treatment for anorexia anytime soon. But honesty is a powerful weapon in fighting this condition, and I know that I've helped some people—fathers and daughters, sisters, even adult couples—to have those first conversations. An inpatient in her early thirties recently emailed me from an eating disorders clinic.

I just got married and am desperate to conceive a baby too. In the last six months my weight has plummeted and I'm now receiving professional help in hospital for the first time. Throughout this my husband has stood by me, struggling to understand the illness. Your column, in many respects, has been his education
. . .

She ends:

And if you find the secret, from a purely selfish perspective, please don't keep it to yourself
.

Of course I don't have the secret. Now that my period has come back, now that my BMI is healthy and my weight is higher, am I recovered? Not yet, no. But writing about anorexia has taken away some of my fear.

* * *

And yet, some fear remains: fear of food, fear of change, fear of commitment, fear of loving and being abandoned; more than anything, fear of life without anorexia. As illogical as it sounds, I'm waving goodbye to something that is a huge part of me. My life has revolved around this eating disorder for fourteen years now. I still shudder at the label “anorexic,” but I can't deny that it's part of my identity. There's a sense of loss.

Before I leave it behind I've been trying to understand what it has meant to me. What was the significance of anorexia, an illness that has lasted nearly half my adult life? Despite destroying so much, did anorexia have any purpose? There is no question it held me back professionally—I missed so many career opportunities, unable to socialize or network in eating situations—and emotionally, I squandered countless relationships. The collateral damage of anorexia is incalculable: intimacy, honesty, peace of mind. But are there any positives?

I think there are. I'm a different person from who I was pre-anorexia. Before, my life was rather gilded; I had a tendency to take my health, my good fortune, even other people, for granted.
After, I'm quieter and more reflective; I've learned what it is to be alone, to be sad, to feel frightened. Before, I was surrounded by people; I was sociable, lively, but sometimes thoughtless. After, I have fewer but closer friends. The illness made me vulnerable but also more resilient.

Anorexia sent me to the dark side. And when you've been there—whether through depression, cancer, divorce, stroke, violence, injury, bereavement, pain, or trauma—you tend to look around you with renewed wonder at the world you nearly lost. It may be facile to say that those who have known suffering are kinder, better people, but on the whole I've found it's true.

So anorexia was not pointless. I refuse to believe I wasted the last fourteen years. I never had an actual nervous breakdown, but the gradual physical breakdown forced me to stop, to look inside myself, to admit that I was struggling, that I was lonely; finally, to ask for help. I found deep oceans of support and kindness I never knew existed in those closest to me. I came into contact with total strangers. I discovered a new kind of respect for my body and began to understand that it needs fuel and care in order to function properly. These last few months, in particular, on this slow road to recovery, I'm even learning to be patient. I can distinguish what matters—family, love, health—from what doesn't—ambition, success, appearance—in a way I couldn't before.

Nothing in life is wasted; everything is experience. Mental illness, too. In the oddest way, anorexia got me back in touch with myself. I can't pretend I would have chosen to take the path I took, but I think I'm finally getting to where I need to be. I remember that my dad used to tell us one of Leonard Woolf's sayings: “The journey not the arrival matters.” I didn't understand it as a child, but I'm starting to now.

Chapter 16

As One Door Closes . . .

S
unrise over London, early autumn now. I find myself thinking back to that other dawn when I walked in the snow, sipping my coffee and eating that first momentous Kit Kat. It's less than a year ago and yet it feels like a lifetime. I'm standing on my balcony in cut-off shorts, pink flip-flops, and a white T-shirt, with a French-press of coffee. I woke a few hours ago, showered, and packed the last of the boxes. Now I'm waiting for Tom to arrive with the rental van. So am I scared? Excited? Yes and no, to both.

But that's OK. I'm starting to see that life isn't always black and white: it can be good and bad, perfect and imperfect, happy and sad, all at the same time. I'm starting to understand that most of us are just feeling our way through. We all have ups and downs—moments when we feel confident, moments when we feel like failures, fat days and downright sexy days, relationships that flounder, and secrets that shame us. No one has the instruction manual for life—how to feel, who to love, or what to do next. I'm trying to take it one day at a time.

There has been a lot of talk recently about seasonal confusion—it's been a really strange year for weather. Winter dragged on long into March, and then suddenly summer arrived in early spring. April was hot and dry, August was cold and rainy, and I feel as mixed-up as the seasons. Standing on the balcony I touch the
bracelet on my left wrist and smile. “All shall be well, and all shall be well . . .”