I don’t know anyone who has had an eating disorder of any description and not questioned whether they are sick enough to ask for help.
But that’s one of the most dangerous things about them – they will never let you believe you are sick enough. It will always remind you that you could be thinner, that other people are sicker and more deserving, that maybe your symptoms don’t feel severe enough or frequent enough. Maybe no-one knows you have disordered eating, maybe you’re not underweight, maybe from the outside your life appears entirely normal.
Not one of these things means you aren’t deserving of help or support. When my referral got declined initially for my third round of treatment with the eating disorders team last year, I was devastated. It was a clear sign to me that I wasn’t ill enough to warrant support. But I feel lucky that I know the system well and I am assertive about what I think I need, so I asked for another referral. Things had massively deteriorated by that point and my referral was accepted, but I still had niggling thoughts that I was going to be laughed out of my assessment when I got there, even though the team know me well. What actually happened is I was diagnosed with anorexia on the spot and ended up skipping outpatient treatment entirely, going straight into day patient and narrowly avoiding an inpatient admission. Yet despite all of this, those thoughts have never left me.
The thing about anorexia is that you will never be ill enough to satisfy it. You can never be the best anorexic because the best anorexic is dead. Despite being in the worst relapse since my inpatient admission years ago, I still thought I was doing better than I was. The weeks leading up to day patient all I could think about was how everyone was going to be thinner and sicker than I was, and that they’d made some sort of mistake accepting me. Even laying in a hospital bed being told how ill I was by doctors and nurses, I felt like they were lying.
I’ve been in and out of eating disorder services for a long time and sadly I know that they perpetuate this idea that you need to be underweight to get help. That definitely isn’t true of all services and I have previously been offered treatment when not clinically underweight. Please don’t let those thoughts stop you from seeking help. I can’t guarantee you that you’ll get treatment if you do reach out, but what I can guarantee is that if you are sat questioning whether you have an eating disorder, you deserve to find out if you can get help. If you don’t ask you’ll never know. Don’t sit around waiting for things to get worse. You are worth more than letting disordered eating rule your life.
So in answer to my original question – are you sick enough? I say let someone else be the judge of that, because you will never think you are. The earlier you can get support, the better the prognosis. But it’s also important to remember that even if you can’t access support, your eating disorder is valid. Services in the UK are incredibly underfunded and can’t treat everyone as much as I’m sure they would like to.
Give yourself the best chance at a life free from being trapped in an eating disorder. Reach out.