I’ve debated writing a blog post about the need to be “sick enough” because it’s raw and honestly I still struggle with it at times; however, I then remembered I created my blog to be real and raw and share the joyful parts of my life as well as the not so joyful parts. So, with that being said, I am writing this as much for myself as I am for you.
It is common when dealing with an eating disorder (ed) to believe that you’re not “sick enough.” This has been something I’ve struggled with for years and as I’ve been going through recovery, it is so much more common than I thought. I would constantly think, “I’m not sick enough to have an ed,” “I’m not sick enough to be in recovery, “I’m not sick enough for people to care” the list could go on and on. I would think that because I looked “fine,” I didn’t have a problem and I didn’t have an ed. I follow a lot of recovery accounts on instagram and someone posted before, “I remember thinking “I wasn’t sick enough” until I read that a healthy person doesn’t wish to be sick at all.”
I asked a few friends from treatment what their experiences were on needing to be “sick enough” and this is what their responses were:
Friend 1: “Looking back, I don’t think i would have ever been “sick enough” in that mindset until i was dead. Then I llearned it isn’t healthy to wish to be sick in the first place. I stopped focusing on the question of “how sick am i” and switched it to “why do i want to be sick?” It helped tremendously to change my perspective.”
Friend 2: “Well in regards to my thoughts on not feeling sick enough I know the constant comparison to others as being much skinnier than me and not having an ED made me feel less validated that there was actually something wrong with me. So comparison played a big role.”
Friend 3: “When you feel like you have no idea who you are or what you’re doing in life, ED likes to try and fix it for you by convincing you that you aren’t “sick enough”. When you spend all your time trying to prove you are “sick enough” by comparing yourself to everyone around you, there is no space for your worries and fears. In recovery, I have to remind myself every day that “sick enough” is a lie, that it is an unattainable trick ED plays to keep you trapped. That there is no line you cross where you suddenly become “worthy” of recovery because no one deserves to suffer.”
For the past [X] years, I have struggled with feeling like I am “not sick enough” to actually have an eating disorder. For the longest time (even a couple weeks into starting treatment), I couldn’t vocalize that I had an ed because I felt like I wasn’t “sick enough.” I would just say I had “eating issues. etc.” I couldn’t see that I was underweight. I couldn’t see that I had a problem. Concerns voiced by mental health professionals, doctors, friends, mentors, and teachers over the years paled in comparison to the voice inside my head telling me that until I lost [x] amount of pounds; until I actually fainted upon standing instead of the world going fuzzy around the edges for a few seconds; until I ate under [x] amount of calories a day instead of sustaining primarily on self-loathing, caffeine, gum, and nut butter, I wouldn’t be sick or “sick enough” to have a real problem. When my labs came back not so great, somehow I still thought i wasn’t “sick enough.” When will it be enough? When I’m dead? The eating disorder won’t stop until death comes–which is scary.
Let me tell you a little bit about what it is like to feel “not sick enough.” It is having people praise your dedication and commitment to health and fitness, when it feels like anything but. It is receiving attention and approval based on your shrinking physical appearance, when attention is the absolute last thing you want. It is constantly being bombarded with comments of “I wish I had your willpower,” “You look so good!” or my personal favorite, “What is your secret?” It is rationalizing, manipulating, lying, and ignoring. Perhaps most terrifying of all, it is actually wishing you were “sicker” so that your ed could be “real.” Nobody would knowingly ask someone with an eating disorder what their “secret” is. Yet, when you appear healthy, you get asked that a lot. I never came up with a good way to respond, so I usually disagreed or laughed awkwardly. Not because I didn’t have a response, but because it would have been a little intense to respond as follows:
“My secret? Do you want to know what my secret is? My secret is that all I think about is food. My secret is that unless I exercise [X] times a day, my stomach would be so knotted in anxiety and I would be literally incapable of functioning. My secret is that I could not show up or be present in social situations involving food (hint: all of them) without losing my sanity. My secret is that I was so intensely distrustful of and hateful toward my body I could not and would not allow it to tell me what it wanted. Hunger is something I understood, knew, or listened to. My secret is the food you saw me eating had been consciously prepared, logged, weighed, measured, and planned days in advance. My secret is that my life is spinning out of control and I don’t know how to stop it.”
This train of thought — the undeserving and not sick enough thoughts — is an example of the eating disorder talking. The twisted concept of feeling like you are not “sick enough” is one of the most dangerous parts of the eating disorder. This thinking traps you in the ed and keeps you from getting help. You do not have to “look sick” to be so stuck in an illness that you cannot imagine living another day. You do not have to be hospitalized to be worthy of seeking treatment. You do not have to check off all of the diagnostic criteria listed in the DSM-5 to “count.” There is no such thing as not being “sick enough.” Eating disorders are competitive. When we are constantly competing and trying to become “sick enough” for our eds to be real, what is the prize?
When someone thinks they’re not “sick enough” based on the criteria the media and diet culture proclaims to society, they are less likely to speak up, get help, and will eventually die.
There is a massive and dangerous division between the general public’s understanding of eating disorders and their harsh reality. Let me tell you and tell you again in case you weren’t listening or ready to hear it the first time: eating disorders do not discriminate. They do not solely present as severe malnourishment in young, white females. They are not always identifiable upon first glance. Sometimes they have little to nothing to do with a person’s weight. The number on the scale serves only to torment the person with the illness and doesn’t work as a gauge of their health or sickness. Because of this, countless people become more and more entrenched in behaviors that are killing them. I hope this piece resonates with just one single person who may be on the fence between reaching out for a lifeline or continuing to struggle in silence. I said I was writing this piece for me, and I am; however, I am also writing it for you.
This piece is for the girls, the boys, the men, and the women. This piece is for anyone who has ever felt like their struggles and their pain do not “count” because they do not “look sick.” This piece is for the person who wants so desperately to believe they are worthy of help, love, and wholeness but still feels they need to get “sicker” before they have a “problem.”
This piece is for you.
Because you matter. You are not alone. You do not have to live the way you are living. While you may not realize it because the disorder is telling you otherwise, you are enough. You are worth a full and meaningful life. You are worth recovery.
National Eating Disorder Association (NEDA) Helpline: