Anorexia Nervosa, Philosophy, and I: A Confession of the Flesh

Reader discretion: the following essay entails the lived experience of severe anorexia nervosa in unsparing detail, including numbers. These passages may be triggering for some and distressing for others, but I hope to be pardoned, because I have come to realize that the best way to write the unwritable and possibly to heal from it is sometimes just to describe what happened. The essay was proofread for ethical reasons by the psychology student B.F.]

 

I remember the day I became anorexic. It was the 13th of December 2019 – I was 17 years old, 185cm tall, 81kg. Suddenly, as if it were a minute’s revelation, I became aware of my own enmity towards my body, and I couldn’t run from it. Even worse, I couldn’t lock or ignore this visceral disdain I felt for myself, and so action to bring it about ensued. For four years, I dropped to 40kg; in the heat of summer, I shrouded in layers of clothes; I fainted in the dorm’s bathrooms in the early morning hours; my heart faltered with unsteady rhythm under the strain of starvation; I lost interest in sexual things; hypotension made little blue flies and spirals appear in my eyesight; and I ignored those who I cherished the most, my caring friends and my family. Needless to say, nobody knew. I kept a regime of silence with everyone, and having the highest academic achievements – I felt condoled and justified to wage onwards my inner war. Until it all crashed down, and my body gave up.

This essay is a personal testimony of what it is like living with anorexia nervosa; how it came about; and how reaching out might end up being just “the thing” that saves us from this slow suicide. In other words, a philosophical testimony of when my life became the limelight of starvation.

What is Anorexia Nervosa?

            But what is anorexia, precisely, in my case, anorexia nervosa? According to the DSM-5, there are three criteria for someone to be diagnosed with such a condition. To put them more simply, they are – 1). Persistent energy intake restriction (not eating food), 2). Intense fear of gaining weight or being fat, 3). A disturbance in self-perceived weight or shape.¹ From this, one’s immediate impression might be that anorexia nervosa is a simple diet gone out of hand, but this is far from being the case. As Clarie Beeken, someone who battled with anorexia for 13 years, writes:

“There is a common misconception that anorexia nervosa is just a diet that got out of hand. But an eating disorder is not a slimmer’s disease; rather, it is the symptom of stress or other profound emotional damage or psychological problems.”²

Katie Metcalfe, another victim of anorexia nervosa who at the lowest weighted only about 30kg, experienced it as a semi-auditory fantasy (which she later made it synonymous with the “Devil”)³: and there are studies suggesting not only “Holy Anorexia” of medieval nuns (with anorexia mirabilis and “there is no fat in heaven”), but also that anorexia itself is largely a religious induced experience through starvation.⁴ Tara’s case, another countless “someone” who dealt with anorexia in our modern age, is ridden with a predisposition to fall into depression, but also as a loss of control over one’s own life.⁵ “A need for control over one’s own life. . .” being another big issue of someone with anorexia nervosa. An everyday control over calories, exercises, steps, days without food, body-image: ultimately, a minute-to-minute discipline of the mind’s want over the body’s need. Or as Foucault might have said – “the mystique of the everyday is joined here with the discipline of the minute.”⁶ To not say anything how we are everyday bombarded in social media, – back in the day magazines, – with men and women models of an ideal body type (the fact that body type charts, boob type charts, vagina type charts, penis type charts, nose type charts even exist), to whom all of the above cases fell prey to!

Therefore, anorexia nervosa is something much more than food restriction intake, it entails a deep disturbance of one’s own psyche: prior physical or mental abuse, experience of someone’s suicide, a breakup, bullying, ideals in one’s social group and environment, sexual harassment, rape, difficulties with stress and anxiety, overprotective or intrusive parents and such similar cases. Just as alarming is the news that anorexia nervosa is a condition effecting primarily the youth, with a rise (much like schizophrenia) after the industrial revolution.⁷ And it is also not altogether a voluntary thing. For anorexia nervosa while being temperamental (when a child, for example, has early-on anxiety disorders or displays obsessions, they are at an increased risk to develop anorexia nervosa) and environmental (relating to a particular culture and how much this culture values thinness); it is also genetic (higher risk of having it if someone is the biological first-line of an individual who had it).⁸

Statistically, anorexia nervosa is (probably) most prominent in post-industrialized high-income countries, with the highest rate amongst the Caucasian population, having a higher prevalence amongst young women, with the ratio of women-to-men being 10:1.9. Though this ratio is because men are less likely to talk about it or just straight out ignore it. Based on the recent statistics of European countries, about <1-4% of a given country’s female population deals with anorexia nervosa.10 The hypothesis can be raised, though with the lack of a proof statistic,11 that in my country (Kosovo), given that there are around 790,000 women,12 around 7,900 to 31,600 of them are dealing with anorexia nervosa, with the ratio of men being around 790 to 3160. The number overall is around 8,690 to 34,760 of the population who are dealing with anorexia nervosa. That is 1 in either 183 or 46 people are dealing with it! These, of course, are imaginary numbers based on general statistics, and one never knows the pain that is hidden in the cracks of the given facts, especially when anorexia nervosa requires unique treatment for every unique patient who deals with it.¹³

There has been much talk on why women suffer more from anorexia nervosa and there is a common conclusion that, since anorexia nervosa halts the menstrual cycle, sags the boobs, removes the libido drive, and removes much of those soft layers of “fat” that girls experience during puberty in their bodies, that it is a “war against femininity.” And passages from Beeken and others (also from my talks with women friends who have dealt with anorexia), seem to suggest that there is a correlation of anorexia nervosa with the want of reducing prominent sexual features in the female body.

“I hate my boobs,” Claire Beeken begins her testimony of the thoughts that ignited her anorexia, “because he likes to touch them [her grandfather], and my periods because they excite him. My body feels infected and dirty, and when I catch sight of myself in the mirror, I am disgusted by it. My classmates are right – I am ugly, and I probably do smell. I hate my body, I hate my life, and find myself looking at other boys and girls and wishing I could be them instead of me. God forgive me, I even wish I had cancer like Yvonne [her friend].”¹⁴

But I do think that theorists should be careful about calling this side of anorexia “a war on femininity,” whatever this term even means. I think that the question and the shift that our psyche had with the industrial revolution should be addressed first.  My impression is that this “war on femininity” is creating an unwanted ideological war in dealing with an already difficult and personal thing such as anorexia: and we have first, given that there are men (the number is low, but it is there) with anorexia too, to ask ourselves – are these perceived wars a symptom rather than the cause of this condition? However, this might be. I think that we do need to have a conversation about this, and just generally about anorexia nervosa in our society too.

This isn’t to alarm the public, but much needs to be done to offer people with anorexia nervosa (which has the highest mortality rate of any mental disorder)15 places, groups, or even translated books of people who dealt with it. But we needn’t also hurry and fall into this popular idea that “the public needs to be aware.” This sort of idea only pushes people who are dealing with the said problem into alternative cultures¹⁶ that we neither can empathize and help, nor can they leave this much-needed warmth of being left alone from the naked eye of the public’s awareness. The naked eye that has brought here and elsewhere nothing more than the politicians’ electoral mongering hooks; countless media debates with people whose only problem is to be watched; and utter religious naivety. We are already alienating someone when we want to make the public “aware,” thereby putting the scapegoat mark over their “abnormal” activities. In other words, we have become a culture of the sabbatical priestly confessions, who, much to the opposite of doing our job as we should (in silence and with God on our side), we get a megaphone and make a spectacle of buzz words to the only modern God – the public. And in turn, we ask this public to direct us towards things, the reverence for which, as Nietzsche says, we ourselves individually would never offer.¹⁷

From the Village to City – a Suicide

The language of someone with anorexia nervosa is uniquely militaristic, for there is a known enemy – the body’s fatness.¹⁸ Prior to anorexia, I never had this sort of language in my mind. After our family got back from Norway, I was raised quite modestly, – and many times in financial tightness, – in this small village with only two other houses nearby. I can recall the early memories being those of the trees and very green and blue fields. My family had always put education at the forefront of my priorities, so much so that they skipped two nearby rural schools just so that I could have a better education at one of the schools near the city center. We moved, as many farm families did, from the village near the city around the 2010s.

I think my problems with anorexia nervosa stem from what this move did to me. I was used to a reclusive life in school, and given that I had no other friend of my age in the village, my only friends were quite honestly the trees. When my family moved near the city, my world changed and was shattered. I do remember that what formed most of my thoughts back then was seeing this ugly urbanization, where, within two years, near my new house, 40+ other houses got built. I was afraid of change, and I was afraid that the only things I had (trees) now were being turned into people I did not know. I was finding places to fit in, making new friends: one of whom became my best friend (since the wish of the family was to hide her name, let’s call her Th.), with whom we did most things together and who introduced me to reading books as a fun thing, playing basketball, and Christianity too. But again, it took me about seven years to settle into the new house. To this day, I haven’t dreamt even once of this now 15-year-old house, but I do dream of my old house in the village often.

High school, with the whole moving schools and choosing a “profession,” brought back the same impression as the old village-to-city move. I felt unwanted, and also, I did not have my friend Th. with me anymore. Actually, around this time, they dropped out of high school and married, after we had a major fight because I discovered they were cutting themselves (the fight was my fault). It was the second year of high school (2019), when I was dealing with another – now a more major – move: the move to college, when I got the horrible news that my childhood friend had committed suicide and left me a note forgivingme  for the fight I had caused. It was by the end of this year, when I wasn’t playing any sports, and I was doing just schoolwork every hour, that I became anorexic. I always felt too guilty to drop my grades, and I did enjoy studying, so they were always as good as they could be. But I didn’t feel guilty, nor did I hate the feeling of hating myself; hating my static life; hating feeling so out of control with all these changing places, leaving people behind, and life taking away people I loved so dearly.

After my anorexic revelation, my life became a regime of silent submission. I think one of the reasons, also, why men do not confess their anorexic tendencies is because of doing what I did. I knew about anorexia nervosa from my readings, but I refused to learn more about it. My strategy of lowering the body weight was simple: every week, drop the food intake till I basically consumed nothing. If I did it too fast, people would know something is wrong. I didn’t want to be a burden, though I later became one. I also wanted my body not to drop on me, so I stabbed it a little bit every day. In the first year was the journey from eating almost a loaf of bread in a day, to half of it, to a quarter, then to none, together with exercises, step counts, and also conditioning myself that if I don’t read or do something productive with my day, I am not allowed to eat.

The second year of my anorexia nervosa, and the year I started my campus, was the year I started to actually feel like my mind was winning the war. I had dropped to 65kg. My humor had become dark. I used jokes to get along with the unmet need of wanting to make friends, but also avoiding them so that I don’t become attached and lose them as I did. I didn’t even want to have a simple coffee with anyone: I cherished being alone much more than losing them. Around this time, I even published a piece on Britmi i Parë, now a disabled domain. The whole piece was a fictional short story that ended with “I will go there [to my old village house], if I don’t kill myself that is.” This story was read by a professor I soul-crushingly admire and later mentor of my thesis on Fairies and Jung, A. Salihu. I saw the concern in his eyes when he mentioned the ending, and I remember that I just wanted to crumble and tell him what I really meant. I was 50kg in my second year of campus. I was eating only once a day, and as minimally as I needed. Actually, had it not been for the said professor and his care of my writings, I would not have eaten at all, but I had to, so that I could have energy to write more, as childish as this reason might sound.

The day I had collapsed in the dorm’s bathroom and marked my 40kg, was the day I had a presentation on the German philosopher Hegel at the campus. I adored and loved Hegel’s works because they made me think and kept my mind from eating. This is how I got through almost all of his works and even came to know, ironically, that he loved food. The presentation was given by one of the assistant professors, L. Kelmendi, and I even got applause at the end. But nobody knew I had made them culprits of my inner war. I over-achieved so that I could hide the utter failure of actually having a conversation with them or even keeping my body alive. They were pawns that my anorexia nervosa made through Hegel, which is rather concerning because this reflects what Hegel says about the Mind of the World (yes, Hegel will convince you that the world has a mind) and how it makes pawns of its destiny our human minds too. I had the control – I was the Anima Mundi through Hegel that day. At my worst physiological state, I could fool everyone, including myself, into thinking I was still alive. My food intake was almost zero around this time: I felt like I was eating only from smelling the ironing of the clean clothes I had worn. I was like a drug addict, without any drugs. And the worst thing, I had fooled one of the kindest and hardest-working professors who actually suggested to me Hegel in the first place. I even remember this situation when I wrote my first fantasy story and gave it to one of my other assistant professors, T. Gashi. He was so nice about it and even gave me notes on what he liked most. But I never said thank you to him, even though I still have his notes framed in my room. I failed him, too.

Close to the end of 2022, the fourth year of my anorexia journey, when I probably was below 40kg (I hadn’t weighed myself in a long while), and when I exhibited all the stark tolls anorexia nervosa takes on one’s mind.¹⁹ One day, when I got back to my house after campus, I collapsed – my heart had given up. And my concerned mom had to see for the first time the body she brought in life: the body that I had schemed to take away every minute for the past four years. I actually remember the last words I heard in my mind. They were a remark that my professor H. Ilazi had made in one of her lectures – “you never know how many things you have eaten until you start to take note of them” – that is quite true, and I wish I had just taken note of the things I had eaten and not done all that I did. I always felt ashamed in front of Professor H. Ilazi after this. She was yet another one of my idols I had utterly failed. To turn back to Hegel once again, if he thought that philosophy is the owl of Minerva that takes flight as the dusk begins to fall, then my philosophy was a death-wish awaiting no dusk to even fall, and no idol I could save myself from failing. And through all of this, I thought myself sensible. In a way, I was even proud.

Anorexia Nervosa meets Philosophy: An Echo-chamber

            “Any eating disorder is a cry for help,” writes Caryn Franklin.20 This is quite true of anorexia nervosa, bulimia nervosa, or any type of other eating disorders, and they shouldn’t, under any circumstances, be idealized. Anorexia nervosa is an identity, mind-body, religious, and also a suicide problem. Even after getting treatment for it, this was before starting a two-year-long relationship; once the breakup happened, thoughts of it started to linger around. “I can always just be anorexic, and my weight will be good again: I can just become anorexic, and I will be in control once again,” hummed the echo chamber in my mind. But I have become conscious enough to know that anorexia nervosa is not me, and if I let this tragic hour when I seem to get possessed by these thoughts go by, I will do just alright.

I think that every tragedy passes us in silence. It can never give us answers (hence why there is a need for closure). And maybe it never should. One may find solace from anorexia nervosa in the Black Sabbath’s song “Killing Yourself to Live,” or even get reminded by it on Mitski’s song “I Bet on Losing Dogs,” or get into a positive thinking that life is riddled with flowers and rainbows. But I think that what it taught me is not to have “hope” or “conviction,” but to have a belief that there is actually something beyond this echo chamber, – my own mind, – that won’t absolutely shatter me to pieces if I crunch my teeth in a simple sweet chocolate bar. And maybe there is nothing beyond, but at least you will have this relief that there is, and go beyond needing to be in control all the time.

You cannot win a war if you don’t view it as a war, but do everything that a soldier does. The words you use always dance before you, while the body remains with their traces. I do believe, though, that “belief” is what can make us recognize this, and one of the arguments I have for myself is how much proof do I need when I have to have a “belief” to see that I actually am killing my own body. Here, I use “belief” as a neutral term for the willingness to think of reality as an ever-changing presence. One that doesn’t teach us to set a wall, as our fanatic religious convictions or overly optimistic hopes do (and exactly as anorexia nervosa does also), but sets us the challenge of seeing the other side, because everything will someday pass. And maybe the only consolation that we have in the face of this human temporality, when our unreplaceable and unconditionally loved best friend dies, is that the grief we feel is a sign of the eternal love we’ll always have for them. I think when I realized this, that religions like Catholicism have it in their heart, I realized why I was anorexic, and what I have to do to stop being one in the future.

To end it all: there is nothing holy about anorexia. There is nothing philosophical about it. There is nothing of a mystical nature hidden in it. Whether one chooses to be honest with oneself or not, that doesn’t deny the fact that anorexia nervosa, pure and simple, is a slow suicide. – (Now that I think about it, I don’t know for whom I stayed alive during those years.  I probably should throw the name of A. Bekteshi here, to whom I owe many laughs and good late-night talks: not too long ago, she even reminded me of drawings I did of her during those years, and I don’t remember them at all. But I do recall the feeling that my friendship with her felt important.) – You will do damage to your bones that cannot be undone. You will ruin your teeth and height. If you think about having kids, they will always have problems and be prone to them. You yourself will be haunted by it for the rest of your lifetime. The minute its militaristic language sets foot in your territory, everything becomes militarized, and the Foucauldian discipline kicks in. You become a ticking time bomb that will kamikaze yourself with the “noble goal” of ultimately being ungrateful, utterly selfish, and blissfully ignorant towards the love of life you do actually feel. Ultimately, not being the person of that all too familiar feeling that anorexic people feel, “to be loved unconditionally.” A belief to reach out, if not for anyone, for your own self. Just for the sake of seeing, once and only once, that there might be something more out there. That there might be someone. That there might be even a new you. Because sooner or later your body will reach out, and the belief you didn’t have in it will be the eternal echo-chamber of an unlived life that met an unwanted early death.

 

Link to the references