It was an argument I’d made dozens of times. I never allowed myself to doubt it, or to acknowledge all the other times I’d said I would stop. I’ll stop when I reach X kilograms. I’ll stop when I’m back at my lowest ever weight. I’ll stop when I’m 5kg under it. To acknowledge that I might not stop would mean acknowledging that I might not be in control.
Weeks later, when a digital test showed the word “pregnant,” I was as thrilled as I had been with my first two children. But behind the excitement there was also fear. I knew I wasn’t well. When I showed my husband the positive test, he laughed and hugged me, then warned, “You know you have to eat properly now, right?”
I avoided eye contact as I said, “I know.”
For a few days, the thought of the developing fetus motivated me to try to eat whenever I felt hungry. Then I looked at the scale. The digit after the decimal point grew, and so did my insecurities.
You’re going to regain it all. I couldn’t shake the thought that I needed that number to shrink, so I returned to keeping my behavior secret.
As I continued to lose weight, the physical toll became more than a thinning body and the occasional dizzy spell. I had heart palpitations after the slightest exertion. Even when I’d just woken up and was still lying down, I felt like I might faint. My eyes became dark and sunken. My hands shook uncontrollably.
I noticed these symptoms with growing trepidation, but still I kept restricting my food. As time wore on, the hunger evolved to a gnawing emptiness rather than pain, but it was ever-present. If I wasn’t hungry, I felt sick from bingeing. I associated feeling full with failure and shame, and was comforted by an empty stomach – a reminder that I had “achieved” more hours without food.
I knew things were bad, but I was afraid to confess how bad. Central to my eating disorder was an illusion of control. I believed I was choosing to do this to myself, and it seemed like a choice everybody would judge. What kind of mother would prioritize her weight over her baby’s health?
One day, I met with my pastor and told him about the physical symptoms. I mentioned a fact I had come across: anorexia has the highest mortality rate of any psychiatric disorder, with the heart at particular risk.
“I mean, I don’t think I’m going to die,” I rushed to clarify.
“–but that’s where this ends,” he said. The bluntness of the comment threw me.
“I’m not that bad yet.”
“But if something doesn’t change, that’s the inevitable end point,” he reiterated. “Do you think you need to go to hospital?”
In the end, it wasn’t the eating disorder that put me in hospital. It was depression, an illness experienced by more than half of those with an eating disorder. One in five deaths among those with anorexia is the result of suicide.
At first, the pregnancy was a protective factor. Killing myself would mean killing a baby, too. I didn’t think I could go through with that. But then my suicidal ideation reached a crisis point. My husband stayed with our older children and our pastor’s wife drove me from one hospital to another as the mental health team explained that, yes, I should be admitted, but unfortunately there were no beds.
After three nights in a locked ward, I was released to round-the-clock supervision by family and friends, and placed on the waiting list for a private hospital’s mental health ward. I arrived there when I was 15 weeks pregnant.
In the hospital, I saw a psychiatrist three times a week, a dietician weekly, and had nurses checking on me every meal. I set goals, starting with “eat at least once a day.” The only scales I had access to were with the nurses, where I was weighed once per week only – a drastic change from life on “the outside.”
At my psychiatrist’s advice, I began a self-help program. “A goal of weight loss is incompatible with recovery” the opening page warned. But for me, it was worse than that. Recovery didn’t just mean letting go of weight loss, it meant accepting inevitable weight gain. And while I did want to recover, I also didn’t feel like I had a choice.
There was a baby at stake.
After my time in the hospital, I had periods of relapse and mornings where I wanted to cry while I scrutinized my reflection. In addition to my swelling belly, my breasts increased two bra sizes, my collarbone became less defined and it grew harder to see my ribs. But with support, I managed to eat well for the majority of my pregnancy.
My daughter was born a few weeks premature, but a good size.
Within days of the birth, I began staring in the mirror again. I searched for the scales my husband had hidden, desperate to know how much I had to lose to return to “pre-baby weight.” At one week old, we took our daughter to church to introduce her to friends.
“Is she adopted?” joked one. “Because you look like you were never pregnant!”
I bit down words I’d been suppressing all pregnancy: my body is not up for public discussion! I didn’t want to know who was looking at the size and shape of a body over which I had no control. Of course, he was trying to compliment me, so I forced a laugh and offered my newborn up for a cuddle.
The average duration of an eating disorder is seven years. Only 46 percent of patients fully recover. Right now, I need to eat well to produce breast milk. But even when the physical dependence ends, my children will need me to be mentally healthy.
As I look at my baby girl, I hope she won’t live a life marked by my illness. When she’s hungry, she cries and feeds without hesitation, worry, or guilt. I hope that instead of her learning from me, I can be the one to learn from her.
I’m not there yet. But I will be.