And Then What?

This is my dietitian’s favorite question to ask me. Every time I express a desire to restrict or over exercise, she asks me, “And then what?”

And it’s a good question.

“And then what?”

So I give in and I restrict, or overexercise, or an unfortunate combination of the two, and reach a weight that once again requires me to be placed in treatment.

“And then what?”

I’ll be put on a weight restoration meal plan, have to have my weight and vitals checked every morning with routine blood work done every week, and sleep in a bed that isn’t my own.

“And then what?”

I’ll either adapt to the weight restoration meal plan slowly but surely and progress my way through treatment, or begin to regress and require higher levels of care. To play devil’s advocate, let’s pick the latter one, since the results of the former are rather obvious.

“And then what?”

I move to a higher level of care, experiencing even further limits on what I am and am not allowed to do and an even greater intensity of activities (or lack thereof) designed to cause weight restoration to occur at a safe rate. Let’s say I don’t get well. I don’t cooperate.

“And then what?”

I waste away to almost nothing, tied to the rock that is my eating disorder and sinking far, far below the surface.

“And then what?”

I die.

Usually, I say this, and then cover my mouth, astonished at the starkness of its truth. Because eating disorders are deadly. When I was in the hospital, it was because I was at such a low weight that I required round-the-clock care and maintenance. I had to have blood work done every day and ate my meals in the hallway, every moment observed by a keen-eyed staff making sure I didn’t attempt to use any behaviors. Had my eating disorder had its way with me, I wouldn’t be where I am today. I would be dead.

Would I die happy? Would I cease being with a smile on my face, contented with the way things had turned out?
No. I would be miserable. I would be depressed. I would be a shell, a shadow, of the person I am now.

So why is recovery so difficult? Why isn’t it easy to look at the terrifying reality that these have ridiculously high mortality rates and make the decision to do everything in your power to avoid that end?

Because recovery isn’t always sunshine and roses and rainbows. Actually, 99.99% of the time, it’s horrible. Every morning I wake up, place my arm over my stomach, and attempt to see if I can wrap my hand around my waist or not. Usually I’m just unable to do so, yet a feeling of revulsion that is so incredibly strong works its way up my throat and settles there like poison. Then I get up and shower, making sure not to glance at myself in the mirror or spend too long under the water, as both of these decisions would only strengthen the potency of that poison. Afterwards, I do my makeup, because I cannot stand to walk around with my face bare; it makes me feel ugly and incomplete. Then I wander into the kitchen, set up the coffee machine, and pull together whatever items I need to make what I’ve decided to have for breakfast. I cook, stir, and mix whatever needs preparing, put it all together on a plate, and snap a picture to send to my dietitian as proof that I’m getting in all my exchanges. Then I pull out the chair, sit down, take a deep breath, and begin to eat. This is done with mindless, robotic precision, and usually done in the same order every single time. When I used to really struggle with eating anything at all, I would have issues completing more than half of what was on my plate. Therefore, I consume half of every item before preparing myself mentally to finish off the second half. I keep my brain purposely blank; where before it used to be consumed with numbers and calculations, now nothing crosses my mind. The irritating byproduct of this, however, is that this heavy guilt sets in afterwards as the full realization of what I’ve just done hits me. Then I am consumed with desires to restrict or overexercise at the very next opportunity I have. And each time, I have to bargain with myself. Just get through this next meal or snack, I’ll tell myself. Just hold off exercising for an hour. You can do that, can’t you? 

And most of the time, the answer is yes. But this isn’t because making the decision is easy. It’s bar none the most difficult decision I’ve ever had to make, because every little atom in my body is screaming at me to just give in and undo all the hard work that I’ve put in. My eating disorder romanticizes the idea of treatment, making it seem like a wonderful place where all my meals are prepared for me, there is staff available at any given moment to offer encouragement, advice, or a listening ear, and I’m surrounded by others who are going through the same trials and tribulations.

“And then what?”

It leaves out all the negative aspects. It neglects to mention that I have to wake up every morning at six a.m. to dress in a hospital gown and wander into the little conference room where they keep the scale and blood pressure cuffs behind a locked closet door. It refrains from reminding me that I have to sit at a table with my meal in front of me and a staff member at the end, watching my every move. It refuses to tell me that I have to ask someone if I can use the bathroom or my razor or my hair straightener, which are simple things I take for granted in my daily life. It avoids the fact that I am kept away from my family and friends and instead am treated to several hours of groups on CBT and DBT skills per day. It makes sure that I don’t remember how I have weekly meetings with a case manager, a dietitian, and a doctor, all monitoring my progress for even the slightest sign of backwards movement.

And so a lot of the time, it’s very easy to listen to the voice. It’s easy to look back on my months and months in treatment with rose colored glasses.

But what happens if I do?

“And then what?” 

That’s the eternal question.

After we discuss what happens if I give in and use behaviors, she then asks me what it is that I want to have happen. “And then what?”

The answer is always, “I will be happy.” Because ultimately, this is what I want. I don’t want to be stuck in the misery of recovery forever. I don’t always want to be relegated to a meal plan. I don’t want to be uncomfortable with the way I look and feel. I don’t want to wake up in the morning and perform rituals designed to bring myself down.

I want to be happy. And no matter how hard anorexia tries to convince me that it can make me happy; that it will solve all my problems and put a permanent smile on my face, I know that deep down, under all the misery and tears and struggles, recovery is so, so worth it.



3 thoughts on “And Then What?

  1. My counsellor had a similar conversation with me once and realising it ended with “I die” broke me and I didn’t recover from the conversation for days. Recovery is a bitch but it can be done. Hang in there xx


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