You know you have a sustained lack of appetite if…

  • you forget what hunger feels like
  • you feel this deep pain in your body and your first response is to stop eating; after three to five days pass, you realize that what you feel is actually hunger and the correct solution is to eat; except now your body can only process small amounts of food at a time
  • after such a realization, you remember that this entire sequence has happened at least once, and one time, you and your psychiatrist just started laughing at the ridiculousness that is the observation that a person forgot what feeling hungry meant
  • you are best friends with your GI doctor whose number one metric is not your blood pressure nor your lab work but your weight, fair and simple
  • the best part about breaking up with the boy is that you no longer have to deal with his annoying habit of forgetting to eat lunch, which had meant that during several dates you had to sit in a cafe and watch him eat lunch while trying not to have a panic attack or throw stuff at him
  • when you were dating the boy, you let him take you out to eat a grand total of ONE time (in a two month period)… and you almost bailed from the ice cream shop because it was so overwhelming
  • your GI doctor found you formula to supplement your diet when you are in so much pain that thinking about food is off limits; it’s marketed for toddlers who suffer from “failure to thrive” (and you think it is a brilliant idea)
  • your GI doctor loves your teenage sister because when you lived at home, her favorite thing to do was knock on your door and ask you if you ate recently
  • your local friends know that you’re going through a hard time so they invite you over for dinner or take you out to eat; they let you ramble while they’re eating but they tell waiters to go away because it still looks like you haven’t eaten anything and part of being your friend means making sure you’re properly nourished
  • you go to church potlucks but half the time you just look at the food and don’t take anything
  • if you eat dinner at someone’s house and actually like the food, your friends hand you leftovers because it’s such a rare occurance
  • people ask you what your favorite dish is and you haven’t the slightest clue
  • eating is a chore like brushing your teeth; you’re supposed to do it on a regular basis, but technically it’s still optional
  • your doctors have categorized ice cream as a healthy food because it has calories and you need them
  • you make dinner but by the time it’s cooked it’s the most disgusting thing you’ve ever seen and there’s no way you’re even eating it
  • you look at the clock and realize that it’s bedtime and you haven’t even thought about dinner
  • sometimes you start to eat dinner and after an hour and a half realize that you’re never going to eat the food in front of you and throw it away; then you realize that while you’ve accomplished something (throwing away the food that you were supposed to eat), you still haven’t accomplished the original thing you set out to do which was to eat dinner
  • when people ask you what kind of cake or food you’re going to serve at your wedding, you tell them that (a) you’re not getting married yet and (b) you would prefer to skip the food altogether
  • when you tell your GI doctor that you have a new boyfriend and that means you need his help because food comes up a LOT when you are dating, he thinks about it and says that while usually he would encourage you to just avoid encounters with food, he could see how figuring out how to deal with it might make social interactions easier so we can brainstorm. He also recommends that I give the boy time to adjust (aka this problem will not just go away.)
  • people feel bad when they learn that you have food sensitivities and can’t eat food with gluten or dairy in them because now nothing they’re serving for the party is friendly; no problem, you think, it wasn’t like you were about to eat anything anyways; plus, eating is a need, not a want
  • Thanksgiving and Christmas are holidays where you listen to older folks tell you their life stories and when you volunteer to do the dishes (not holidays where you cook or eat or otherwise think about food)
  • people ask you what you like to order at a coffee shop and after the longest time you answer: water
  • when people invite you to happy hour, you kindly explain to them that you can’t drink alcohol while in your mind you know that any activity that lasts for an hour and involves food is the opposite of happy and why would you want to spend your free time doing that anyway?
  • people ask you what restaurants are good in the area and you have no idea but can point them to the good gas station, the local library, the best shopping malls, the local bookstore, and even the ideal backdrop for photos
  • the bottom line is that you think about food as little as possible and only as a problem that has to be tackled

So, yeah, I suffer what medical professionals properly term as “anorexia”, that is, a sustained lack of appetite.* My body does not digest food properly (yay! functional GI disorder). Therefore, food often leads to more pain, which leads to an inclination to avoid food altogether. Eating is the opposite of relaxing and is simply something I do only because I have to. I’ve been dealing with this since 2007 at least.

Dr. Leo and I have put our heads together and decided that we can be a little bit more proactive about managing the situation. I’m already on an antispasm medication (dicyclomine) that’s specific to the GI tract. That’s helped a little bit. The formula has been a lifesaver for when I’m really busy or when I’m emotionally exhausted but still need to eat. But like the rest of my disease, there are seasons. Some months I struggle with one thing more than another. And food is currently a big issue for me. I can’t take more medication because I weigh so little to begin with, and my body doesn’t digest medication very well either.

Dr. Leo has given a big thumbs up to all my local friends who have been having me over for dinner and dropping off snacks and just generally making sure that I’m doing okay and that I’m still eating. We’ve resigned ourselves to the fact that sometimes that means that I’m using the formula, which isn’t ideal but will work for now. And he’s also enrolled me in a psychotherapy program specifically targeted to anxiety related to eating and digestion. It won’t make the underlying problem go away, but perhaps there are some techniques that I could learn that would help in those moments when it all gets overwhelming and I hit fight-or-flight mode.

They say what doesn’t kill you makes you stronger. I’m still not sure that I believe them. But I do want to gain a semblance of control over my life again. And not panicking because there’s an activity involving food would be a nice change. Dr. Leo calls it better quality of life. And as long as someone else is helping me fight, I can see myself taking this on.

With hope for what the future can bring,
Abigail Cashelle

*In medical parlance, “anorexia” refers to a sustained lack of appetite. A specific type of anorexia known as “anorexia nervosa” is commonly abbreviated as “anorexia” by lay persons. Anorexia nervosa specifically describes an eating disorder characterized by excessive weight loss and unusual concern for body image.

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