Warning: This work has been rated 16+ for mature content.
Anorexia is one of- if not THE most- misunderstood mental illnesses. Akin to OCD or Bipolar- everyone’s heard of it, everyone talks about it, but nobody truly knows what it is or what it’s like to have it. It’s perpetually glamorized by the media while those who suffer from it are demonized beyond recognition. But what does it mean to really suffer from anorexia?
To preface, anorexia nervosa (aka anorexia or simply “ana”, as coined by internet users) is a restrictive eating disorder characterized by an obsessive desire to lose weight. This could stem from poor body image, a need to be in control, or a number of other factors. Anorexics may fast or eat small, calorie-controlled portions of food to achieve this. Many are obsessed with counting calories, and some with over-exercising. Gaining weight and eating “normally” (This definition will vary from sufferer-to-sufferer, for some it may mean to eat 1,500 calories and not exercise after, for others it could mean to eat more than one meal a day, and for others it may mean to quit fasting) causes an immense amount of agony and stress. How anorexia manifests varies greatly, but how it feels to have it is relatively the same.
Part 1: The Life Cycle.
(The honeymoon, the Point of No Return, Rock Bottom and the Breaking Point.)
These stages can happen in any order, and many will repeat stages, or not enter certain stages at all. This is just a basic model to understand the four main stages anorexia goes through. Very loosely, the honeymoon is the first stage and may last between a few months to a year though typically never longer than 5 years. Anorexics who relapse frequently will go through this stage often, and may appear to never enter the three others.
Regardless of the reasons for its development- and trust me, scroll through any number of anorexic forums and you will see for yourself how vast those reasons are- every anorexic has a “honeymoon” phase with their eating disorder. This may be shocking to some, but most anorexics enjoy their eating disorder during its beginning stage, or “the honeymoon”. Though they will most likely not admit they have disordered eating, under the false impression that they still have “control” over their new “diet”. This is an incredibly difficult stage to recover in. Anorexia still makes them feel good, and depending on how long this stage lasts, has not affected them physically. Starving yourself brings with it an elated feeling akin to hypomania. You are light and energized, you feel “good” about yourself for perhaps the first time in your entire life. It really does feel like you have unlocked a super power; the key to being thin. This makes perfect sense. If anorexia was “all bad” no one would develop the illness in the first place. Acknowledging that ana can feel good and can make those who have it happy is important when having discussions about it. It’s akin to abusive relationships: an abusive mother will not always degrade or manipulate you, she can also be kind and empathetic. We must view anorexia in its entirety, the good and the bad.
When painting anorexia as a 24/7 horrible illness we tend to demonize those who suffer with it. I have been told- by two very close friends of mine- that I was choosing not to eat. They viewed this starvation as a selfish act I was imposing upon myself, one I could retract at any given moment. That because I had access to food and was not eating it, my suffering was not real suffering. When this just wasn’t true. It wasn’t even necessarily that I enjoyed the feeling of starving myself (Though this was admittedly an element) but it was also that eating would make me feel worse than starving ever could. See, after that honeymoon phase is over (When starvation tastes like “skinny” and fasting fills you with more energy than you could ever hope to have) the Point of No Return sets in. This is the tip of the “bad” iceberg. This is when recovery goes from difficult to a near impossible feat.
The Point of No Return happens when all of that starving and over-exercising starts to take a toll on your body. Many anorexics develop their disorder in their teen years (their bodies are still able to bounce-back from whatever hell they’ve put them through) so this isn’t nearly as bad as it gets. But it signals the end of an era. Starving comes easier, there is less of a struggle to eat under a calorie deficit, food loses its appeal and eating feels more like a chore than anything. This stage happens after the honeymoon (when the rose colored glasses have fallen) and either before or simultaneously with the Rock Bottom. Those who continue on past this point do so not because of the joy their eating disorder once brought them, but because it is easier to continue to starve than to eat. Gaining weight becomes the most heart-breaking, life-crushing thing in the world, but losing it never feels like enough. It is around this point in one’s disorder that they may hit a “weight block”. Or, hit a weight and find it near impossible to get even slightly below it. They aren’t necessarily underweight at this point (some anorexics never are, either because they don’t lose a lot of weight or they started at a significantly higher one than the rest of the population) but they typically are. They may cope with this by pushing themselves farther or by binging.
Now, the latter may seem counterintuitive to what anorexia is at its core. It is a restrictive eating disorder. But nobody can withstand perpetual starving for long periods of time. Your body will snap. Almost as if you have entered a black-out state, you will eat & eat & eat and you never feel full. Some anorexics will binge for weeks or months straight, gaining back any weight they had lost. Others will incorporate it into their already existing disorder. Ie, having a weekly or monthly binge that has been planned and calculated to the T. They may begin to fast or exercise (if they previously did not) to burn the calories from the binge. Some may even start to purge, dropping their anorexia completely for bulimia or having a nasty combination of the two. Others, still, will go down an even darker path and develop an addiction to stimulants. These stimulants burning off any weight gained from the binge. It is a lethal addition to an already deadly illness. These anorexics have the highest “death rate”, because they will most likely not die as a direct result of their eating disorder, but from an overdose. Any anorexic who uses drugs has a greater risk of overdosing than a non-anorexic drug user (Even if the non-anorexic is using “deadlier” drugs) because being underweight or just not functioning with the proper nutrients your body needs to survive causes drugs and their effects to hit “harder”.
Most anorexics have binged at least once. For most it becomes a pattern, but for those of whom it doesn't, they become “the lucky ones” in the anorexic world. Regardless, this is when we hit the Rock-Bottom. Or, the Loss of Self. It is just what its name infers, the anorexic will be completely consumed by their disorder. There are two ways this can happen: you become obsessed with your illness, it consumes your every thought from the minute you wake up to the minute you fall asleep. Your mind is perpetually occupied by calories and food and numbers, the scale and your bones and your food plan. Eating is somewhat of a religious activity. Every single detail of the meal, carefully planned and crafted and logged and counted. The second is when you lose your “soul”. It sounds melodramatic, but anorexia really is a parasitic worm. Any personality you had has been taken from you. In some extreme cases, even stringing together sentences is a challenging endeavor. You don’t really have any thoughts or opinions, you are empty. While simultaneously painfully aware of this emptiness.
Most anorexics (specifically low-calorie deficit or low-weight anorexics) have some combination of the two but not all anorexics ever enter this stage (or any of these stages for that matter, but very specifically this one) because not all anorexics are non-functioning. Some can be at very very low weights and still be able to have healthy relationships and the ability to carry out day-to-day tasks, but this is incredibly rare. For even if you retain your sense of self, you may not retain your ability to use your muscles or certain organs. One’s ability to function depends on a number of different factors, but most are in the “non-functioning” category just by the very nature of this disease. How can one function if one’s brain isn’t even getting proper nutrients?
Here is the final stage: the Breaking Point. This can go one of two ways: death or recovery. Death usually happens when the anorexic’s illness is not visible. Those who fit into the “functioning” category, or those who are not underweight, may not appear sick. Therefore, it will be significantly more difficult for their needs to be met. They will not even be diagnosed with anorexia, instead “atypical anorexia” (The exact same illness, but without being dangerously underweight). Anorexia is a mental illness, not a physical one. Though it will have negative consequences on one’s body, that might not include being underweight. These anorexics, more often than not, will commit suicide. It could be a need to prove they are “sick” (If they can’t “prove” it by being underweight, they will prove it by other means) or because they are not getting proper help and they feel this is their only escape. Or something else entirely. Most anorexics have other mental health issues, and anorexia might not be the main one they even struggle with. Some non-functioning anorexics may also die from suicide, rather than their disorder. Usually because their illness has left them so isolated and alone, with no support network in site. But it is typically the ones you least expect who will die. Those who have the most health issues because of their disorder most likely will not die first because they are a “priority”. They will usually have round-the-clock care from nurses, doctors, friends and family. It will be much harder for them to die when they are being looked out for. But obviously, there are exceptions, and regardless of how hard the anorexic and their loved ones fight, sometimes the disease will win. But in most instances, these anorexics will in fact recover. And because they suffered the “worst” they will more often than not become somewhat of a poster child for eating disorder recovery. There is no solid “rule” to tell how an anorexic’s Breaking Point will go, but in most cases where an anorexic dies from suicide or from their disorder, it is because they are alone. Anorexia is an incredibly isolating illness, those who develop it in childhood/teen years will miss out on many of the core experiences their peers are having. Like relationships, friendships, sex, parties, ex. Many are desperate for connection and love but do not have the social skills to know how to seek it out. Others do, but are turned off by sexual intimacy. Even when anorexics have friends, these friends typically do not share their disorder. So even among close friends, they may feel isolated and like they do not belong. They may distance themselves from loved ones (Especially if they are depressed or have an insecure attachment style) and spiral further into their illness as a means of respite. Others, still, will cling on to these relationships but have them drift away because they are unable to recover from their illness. If they have been suffering for long enough, friends and family may give up on the anorexic, often becoming resentful and distant.
Then there are others who do not go down either route. They do not have a Breaking Point. The anorexics who never make a full recovery, but who never die either. For whatever reason, their bodies keep going along with their brains. They are typically not fully functioning, but not necessarily non-functioning either. They usually occupy a hellish middle ground- their disorder has left them alive enough to live, to breathe, to eat (For the most part), to work, but they can never fully escape it. These anorexics will have a support network- though it may consist of only one or two people- but a myriad of mental health issues that make completely recovering impossible. They typically will have a handful of years in “recovery” followed by spouts of relapse that could last from a couple of months to a year, though usually never longer. They tend to stay “recovered” long enough to remain semi-functioning, but relapse often enough to remain in their illness.
Part 2: How Anorexia exists Online.
(The glamorization, the demonization, and the concept of Proana.)
The way eating disorders interact with online spaces has dictated how the general public views them for the last twenty years. By that I am referring to the phenomenon that is known as ‘Proana’. Many have heard of it, but if you haven’t existed in those spaces your understanding of it is incredibly limited, even if you think yourself an “expert”. I’m going to do you the honor of pulling back the curtains, as someone who has been a member of these online forums for the past five years and heard from those who have been a part of them since their creation.
To preface, there is no known creator of the term “Proana”. Which, for the uninitiated, stands for “Pro Anorexia”. And in the early days it really was. Those old school forums (circa 2005) were loudly, proudly, and openly for anorexia. Back then, the community largely didn’t view it as an eating disorder but rather a “lifestyle” choice. Granted, this is incredibly harmful but is also in-line with the stages of anorexia. In the honeymoon phase, sufferers for the most part are in a great amount of denial. Many believe they can recover any time they please, some don’t even believe they are sick. This may seem silly- everyone knows about the dangers of anorexia. It is the most deadly mental illness and for the most part this information is very accessible. But it isn’t about accessibility or awareness.
There is an unspoken commonality among sufferers and that is that anorexia is personified. Not literally, of course, anorexics are aware that their disorder isn’t its own unique, conscious entity, but it certainly feels that way sometimes. If you peak on any forum or any “proana” tag, you can see numerous posts all with one through-line: they address “ana” as if it is a person, sometimes even using “she/her” pronouns to address it. This is in part due to its romanticization (Which we will delve deeper into) but also something else. Perhaps just the nature of the disease itself, or maybe something in common with all sufferers that they feel the need to personify their illness. Like loneliness or a subconscious need to rationalize it. Whatever the case, their disordered eating becomes rationalized in their minds and they are unable to grasp the severity of what they are doing.
These early days were the wild west. Anything was permitted, including tips. Members would actively encourage one anothers disorders, sharing tips on how to purge or fast, which “ana diets” (Incredibly low calorie “diets” members would follow for a week or two, every day had a very specific calorie deficit and acceptable foods to eat) worked the best, how to fast as an athlete or student, how to hide purging from parents, etc. Recovery wasn’t encouraged, and in some extreme cases even looked down upon. If you were a higher weight you would be furiously ridiculed, and if you were severely malnourished you would be looked at as an “ana god”. It was a competition to see who could starve themselves the best. Again, this makes sense. Anorexia at its core is an incredibly competitive illness. It's what separates it from other mental illnesses and eating disorders. All anorexics (to varying degrees of severity) want to be the “best anorexic” or the “thinnest person” at all times. It is a desperate attempt to prove that they are sick and that they are hurting. They want that inside hurt to become visible. So if they see someone who appears “sicker” than they are, or “more anorexic” than they are, they view all of their suffering and progress as futile or invalid. Which then causes them to spiral further. In that realm, those websites were (and are) incredibly triggering.
But that was really the whole point of them. At the start, and in the present. As the years went by, Proana forums became more “tame”. As members grew up, those rose colored glasses would fall and their disorders would eventually reach the Breaking Point. Those founders of Proana are most likely dead, or recovered, very little of them still left in the space that they had created. New members of course take their place, but new forums are few and far between. Internet censorship cracking down heavily on these websites. The ones that still exist though have a very different culture to those early forums.
They still may label themselves as “proana” though not as viciously and with a very different meaning. Proana, in its modern incarnation, means any eating disordered person that does not wish or is not ready to recover. This doesn’t mean those original “proanas” don't exist, but they are few and far between. Websites now have safe spaces for overweight anorexics and those with high calorie deficits, along with people with EDNOS and even recovery-centric spaces. For those in recovery or looking to recover, the culture on these forums is largely in support of them. Tips, nowadays, are incredibly taboo. Those looking for tips on forums will not be helped and in many cases their discussion posts will be deleted by moderators. The few forums that remain are spaces that those who suffer with eating disorders can go regardless of their relationship to their illness or what part of the journey they are on.