Just how bad can an eating disorder really be?
To look at her now, you’d never guess Megan Higgins once avoided eating and didn’t care if she lived or died.
But for years before her parents realized she had a problem, Megan was rarely eating, and purging when she did, because that was the one thing she felt she could control.
She is hardly alone.
The reality is somewhere around 30 million Americans from all walks of life will be affected by eating disorders in their lifetime. And twice, maybe three times, as many suffer from what experts call subclinical eating disorders. That doesn’t mean they’re not potentially just as harmful, but just that they may not meet all the criteria to get a psychiatric diagnosis.
Yet when we think of eating disorders, preteens aren’t normally what immediately comes to mind. White upper-middle-class teenage girls? Perhaps. Models and Hollywood starlets? Most likely.
Loss of control
Megan, a 21-year-old senior at Columbus State University, was just 12 when she started restricting her food intake to cope with her parents’ divorce and later, the stress of moving from a private to a public high school.
"I couldn’t control what was going on around me, but I could control what I was eating," she explained recently.
By her sophomore year of high school, it had started to take a toll on her physically and mentally. Instead of depriving herself of food, Megan began vomiting to purge. Although she was never clinically underweight, she appeared pale and swollen-faced.
According to Laura McLain, site director at the Renfrew Center in Sandy Springs, eating disorders can run the gamut, but binge eating is the most common, followed by anorexia, restricting one’s food intake, and bulimia, typically engaging in binge eating and restricting episodes and compensatory behaviors such as purging, exercising, and abusing laxatives.
When Megan’s father confronted her about his suspicions, she broke down crying. Her secret was out.
The family sought help at the Renfrew Center, the first residential treatment facility for eating disorders in the U.S., which has an outpatient location in Sandy Springs.
Just two weeks after her arrival there, Megan’s therapist discovered she wasn’t following the rules. She was eating at Renfrew but continuing to avoid meals and purge at home.
"At that point, it was how I coped with everything," Megan said. "I wasn’t ready to give it up."
New coping skills
Doctors decided Megan would benefit more from Renfrew’s residential treatment center in Florida, where she could be under constant watch.
From breakfast to dinner, she was never alone. When it was time for bed, the door to her bathroom was locked.
"Once I was forced to stop and could see I was surviving without it, I finally realized I could live without my illness and develop new coping skills," she said.
Five weeks later, Megan was well enough to return here to complete the program. Instead of restricting her food intake or purging, she learned to speak up for herself and worry less about what people thought of her.
The crowning moment, perhaps, was when Megan, a senior class officer, opened up about her illness during an address at her graduation ceremony in 2015.
"A big part of what feeds eating disorders is secrecy," she said. "Don’t make it everything you talk about, but don’t ignore the elephant in the room. The sooner you get comfortable talking about it, the better."
Secrecy might explain why eating disorders remain the deadliest of all mental health disorders.
"Every 62 minutes, at least one person dies as a result of an eating disorder," McLain said, quoting the National Association of Anorexia Nervosa and Associated Disorders.
And if it doesn’t kill, it’ll wreak havoc on your entire body.
One of the longer-term effects includes bone loss, which, she said, can happen either from extreme weight loss or from the weight cycling of purging that can be part of an eating disorder.
During the teen years, that can mean a lifelong risk of osteoporosis and potentially fractures down the road. There’s also a risk of fertility loss, gastrointestinal issues, and dental problems because of the effects of purging on enamel and tooth erosion. And there is a particularly high mortality rate among teenagers.
In 2014, Megan completed the program at Renfrew and is doing well now.
March 4 marked the end of National Eating Disorders Awareness Week, so you might think this is a little too late.
But it’s never too late to recognize the importance of one’s true self.
"Far too often, individuals — especially adolescent girls and women — lose touch with their true selves to conform to the image of who others expect them to be," said Adrienne Ressler, the foundation’s vice president of professional development. "The more you put aside your true self in hopes of gaining acceptance, the more you are abandoning the real you and the greater your risk of being physically and emotionally unhealthy."
It took years, but Megan Higgins knows that now.
When she summoned the courage to tell her story at her high school graduation three years ago, she hoped it would make a difference.
"A woman came up to me later to say, ‘Thank you for saying what you did, I really needed to hear it,’" Megan recalled.
There’s a good chance someone needed to read her words here today, too.
What are eating disorders? What are the risk factors? How can you protect your kids? When is it time to see the doctor?
Find answers to these and other questions at Mayo Clinic's website: https://tinyurl.com/y8dxk4ph .