Eating disorders tend to come with an increasingly uncontrollable obsession with numbers. The obvious one is the number on the scales – the daily moment when the slightest increase or decrease sets the course for an entire day, not only for eating, but for everything else happening that day too. For some people, the torment is even more frequent than once a day.
Other numbers often become the focus of obsessions too. The torment is increased by the counting of calories, fat units, and perhaps now the sugar content of food too given that sugar is the current food ‘enemy’. Unfortunately, these numbers are emblazoned everywhere. So even when I managed to avoid scales by having none in my home and blanking any I encountered outside, I couldn’t avoid the dreaded traffic light symbols on food packets, or the calorie counts written on many menus nowadays.
I still hate the traffic light system with a passion – the hours of my life wasted checking how many reds, ambers and greens were on the product I was almost brave enough to try. I still have to work hard to control this reaction now. I wonder how useful this labelling system is, and even whether it’s doing more harm than good. It seems that both obesity and eating disorders of all types are increasing despite all this supposedly helpful labelling and messaging telling us how to make our choices.
My head is still full of numbers and I have to fight hard to push them to the back. My dream is to make them disappear, while my goal is to push them so far to the back that they barely affect me at all. Unfortunately this goal is even harder to achieve in these surroundings.
Numbers in Treatment
Eating disorders treatment is also very much focused on numbers. Yes, numbers are important in monitoring the physical effects of eating disorders and checking that a patient is re-gaining his/her health, but I think numbers are the focus of too many treatment conversations.
Take BMI – it’s a rough indicator of the state of someone’s health and whether or not s/he is recovering, so it is important. But current guidelines tell GPs that numbers shouldn’t be the only measure of the severity of an eating disorder. The intense focus on BMI meant that I received no support for a decade, and it has led to many others being refused support, or being placed at the end of long waiting lists. I remember when I finally got an urgent referral, I was afraid that if I didn’t keep my BMI down, I would be turned away after my first appointment. That didn’t happen, but the very fact I had that fear shows how ingrained the impression that it’s only serious when it shows in BMI has become. And that’s completely wrong.
On entering treatment, I was given more numbers – new numbers that I hadn’t really focused on before. These came in the form of a portion guide. It wasn’t a portion guide for someone trying to recover from anorexia, but rather one for the ‘average’ person, whoever he or she is.
I was told that it was an Australian portion guide so the numbers might be a bit different. This raises some interesting questions that I’m still pondering today…Why do Australians and Brits think they need different portions? But more importantly, why doesn’t an eating disorders support service have its own leaflets tailored to its clients? Is that down to lack of resource? Or lack of organisation and care? Or both? I haven’t found the answers to any of these yet.
The portion guide proved disastrous for me. I actually lost more weight as I tried to follow it. It became a new set of numbers to add to the traffic lights and menu calories. This meant my choices became even more restricted. Even I realised this was getting out of hand when I found myself standing in the kitchen squeezing a packet of cereal one morning trying to work out how much I should have, with my portion guide on the counter beside me. With the support of my mum, the guide went in the bin. We sat down and worked out something sensible, trying not to get into any more detail on numbers than was necessary to make sure I was eating enough. I count that as the start of my real recovery.
Numbers in Society
Beyond eating disorder sufferers and treatment, society as a whole is becoming obsessed by numbers when it comes to food and exercise. The evidence is everywhere, from 5/2 diets, to 5-a-day fruit and veg, to the wearing of wrist devices to monitor steps, pulse, and heart rate. We seem to be medicalising ourselves to the max.
I find this both sad and dangerous. It’s sad as the numbers take away some of the enjoyment and passion from our lives. We can’t simply enjoy eating an apple or banana; we have to note its contribution to 5-a-day. We can’t just go for a walk to feel the air on our skin, our muscles awaken and develop, and our well-being improve; we have to monitor how many steps we took and how fast our heart rate was. And yet, we don’t seem to be getting any healthier. In terms of diet and exercise-related health, our society is much less healthy than previous generations who didn’t do all this counting.
The numbers are also dangerous as it can be all too easy to go from the kind of counting described above to the obsessive counting of an eating disorder. Anorexia reduced my life to numbers and I used the numbers to replace and control difficult feelings and emotions. I think a big part of eating disorder treatment should be about release from this, rather than plunging deeper into it. And people who do lots of counting need to be warned of the risks of developing an eating disorder.
I wonder why we need all these numbers. Why isn’t it enough to simply have a rough idea of how much we’ve eaten, what kinds of foods we’ve eaten, and whether we’ve done some kind of exercise – just enough of an idea so that we can look after our health? Then we could simply enjoy eating, moving, feeling and living.