Stop the Nonsense

Living with Bulimia: An Interview

TRIGGER WARNING: This content deals with an account of  an individual with bulimia and may be triggering to those struggling with an eating disorder.
—–The identity of the person interviewed has been changed for purposes of privacy.—-

We’ve just finished bentching and are about to go on our Shabbos afternoon walk.  It’s our shana rishona, and today we won’t be headed for our usual stroll around Riverside park.  We’re walking 100 blocks north on Broadway to visit a dear friend at the eating disorders clinic at the New York State Psychiatric Institute at Columbia University.

Maya is one of my wife’s closest friends. Passionate, positive and energetic, you would never guess Maya is bulimic. I remember, when we were first dating, my wife mentioned that Maya, a good friend of hers from her hometown, had just been diagnosed with bulimia.  I had never met anyone who had an eating disorder before.

Maya has been in the unit for a few weeks. She officially withdrew from the University of Maryland to enroll full-time in rehab. She came across the clinic online in a search for cheap inpatient programs. Our visits would come to be part of our Shabbos afternoons – explaining to the security guards yet again that we couldn’t write down our names. We would be let into the facility with guest tags and meet with our good friend whom we loved so much.

Now, it has been almost two years since Maya was released from the hospital.  She’s married, enrolled in school part-time, working full-time, and receives therapy regularly.  After hearing about The Beacon’s issue on eating disorders within the Modern Orthodox community, I considered reaching out to Maya, wondering if I would be crossing boundaries as a friend. After consulting with family and friends, I reached out to Maya, asking her if she would be interviewed. The answer was a resounding yes. The following are excerpts from our conversation.

Maya first realized she had an eating disorder the summer after her senior year of high school.  Struggling in school with appearances and weight felt like normal high school girl “stuff,” but for Maya it became exacerbated during that summer, binging and purging almost every day.

She planned on taking a gap year, like many of her peers, before starting at Maryland. She moved to New York City and had started taking classes at Drisha when her roommates at the time called up her mother at home, letting her know there were spots of vomit on their toilet.  When Maya came home for Rosh haShanah, her mother scheduled an appointment with her childhood pediatrician.

“When I went to the doctor, I already knew,” Maya said. “Finally, I just had to say it aloud:  I was bulimic.”

She shared the news with her parents that day, who in turn told Maya’s siblings.  Slowly it was named aloud: “bulimia.” She told some friends immediately, but others she hadn’t told until relatively recently.  Many in her extended family – aunts, uncles, cousins – didn’t know until her bigger relapse in 2010.

“I remember my mom crying when I told her about that first doctor’s visit,” Maya said.  “And eventually it led to withdrawing from Drisha and moving back home that year. Looking back, it was my first year after high school, where I was supposed to be independent. One month into it, it felt like I was going home because I couldn’t take care of myself.”

“I felt like my family didn’t know how to talk about it with me, but neither did I. No one really understood it. My sister was at Barnard at the time, and I had gone to spend a few nights with her. I had binged and purged while I was there and had eaten a lot of her cereal.  We were on the train leaving New York City, and she asked me if I had eaten her food. ‘Of course not!’ I lied, saying maybe it was a roommate. That exchange was the first of many and showed a lot. At that point, I wasn’t able to be open about it. No matter if someone was even providing a safe space, it just wasn’t something I owned or wanted to talk about.”

After living at home for several months, Maya traveled to New Zealand, which she said felt like an “escape from life.” Her sister got married that summer shortly after Maya’s return from traveling abroad, and Maya started at Maryland later that August.  Maya registered for classes and attended at first but things quickly worsened. She was missing more and more school and started flunking academically. At a certain point, she could no longer hide.

“I came to a point where all day, every day, I was binging and purging, feeling hopeless,” Maya said. “Life just wasn’t worth living.” The straw that broke the camel’s back, though, was her bank account. Maya had zero money. “When my bank account was literally zero, I realized I couldn’t keep up this facade any longer.”

“I called my sister first who had just gotten married and finished her masters in psychology.  I asked her if I could ask her a psychology question, as a psychologist, and not as my sister.  She listened and said I needed to call mommy and abba.  I said, I knew, I just needed to talk to you first.”

“My mom didn’t believe it,” Maya said. “I said I’m coming home tomorrow. . .she realized how serious this relapse was.  .  .I think it’s a day she will always remember. She always talks about it when it comes around to December,” when Maya first told her. “For her, more than me, it was shock. I knew what was going on all this time; my mom had no idea.”

The whole semester Maya considered asking for help. She had worked as a counselor at camp the summer before, when she felt like her disorder was “out of control” and she would sneak out after hours to binge and purge. She tried to get her life back on track that semester, and every time on the phone she would think, “Maybe this time I’ll tell mommy, maybe this time I’ll tell my sister, or a friend.” She needed a reboot, a place where she couldn’t binge and purge. That’s how she found the research program at Columbia.

“At the unit, they ensured therapy and ensured that you would never binge and purge in their facility, under their watch,” Maya said. “It was a state program and so it was free.”  Maya visited, went through preliminary exams and interviews, and was quickly admitted.  She spent a week or so beforehand living with her sister at the time, as she would go to the hospital for her visits. Her sister would come home noticing food missing or spots in their bathroom, and there were occasional conversations about this between them.

When my wife and I would visit the hospital, it felt like leaving Manhattan. I remember the artwork on the walls and the weekly calendar posted on the whiteboard. We were always interested as to how the days went by and what therapy looked like. I would use the restroom and notice that the door didn’t have a lock. All bathrooms in the facility were like that. Maya’s time at the unit provided her with a solid two months of not binging and purging and allowed her to start to explore her eating disorder in a way she never had before.

“The episodes when I would binge and purge – these moments are filled with so much shame, and afterward, you don’t want to talk about it with anybody. I’m self-aware as I go through episodes. If I’m having an episode, I’m not listening to what my body or emotions are telling me. I turn my brain off. I’ve come to a point where logic and reason no longer work, so I turn to food, and everything else numbs out.”

When I asked Maya if she had a sense as to why food, she took a long pause and then answered.

“Food is something I can control,” she said. “Growing up, there were a lot of things I couldn’t control, like playing soccer on Shabbos or going to shul every week or what you wear. Food was something within my power. It’s why I’ve always loved food, loved cooking, and loved to eat. Like I said, I had typical teenage girl problems with eating. For some people, they have them and then know how to eat normally. For me, it went too far.  I didn’t really get a handle on it, and it went out of control.”

There were people from all different religious and cultural backgrounds in the clinic. Maya connected with one girl who came from a very frum family in Borough Park. “The pressures placed on her from her family and who she was expected to be versus who she wanted to be played a part in her eating disorder, and that was something she was constantly struggling with. She wanted to see her family but at the same time didn’t want to because she’d have to put on a long skirt,” Maya said. It seemed like her struggle resonated with Maya, although Maya was quick to say that her friend’s situation was much more severe.

One afternoon, when Maya and her friend were allotted a couple of free hours, they joined us for Shabbos lunch. Her friend was a talented pianist and loved to sing. It was one of the first times we got to see Maya not in the hospital, and the act of sharing the experience over zemiros – singing “l’hitaneg b’ta’anugim, basar v’dagim v’chol mat’amim” (rejoicing in all delicacies, meat, fish and other dishes) – took a new meaning for me personally as we harmonized.

I asked Maya if she ever felt like she turned to God or religion as a resource when she was in the unit, though I knew she hadn’t been religious for a few years now.

“I don’t think so,” she said slowly. “There were moments when I would connect to nature.  Those were my spiritual moments. I remember one Friday, far into my time in the unit, maybe four weeks in, and so I had the ability to leave for an hour at the time. I went for a walk, and there was tons of snow outside. I walked on the side of the Hudson River, and there weren’t a lot of people out. My feet were crunching in the snow, and there were all these things I had to climb over because the snow had gotten so high. I just remember feeling the air, and feeling really alive. That’s a time where I might recognize I’m feeling connected to some sort of spirituality or God. Hiking, long walks, dancing – I love to be physical.”

I asked Maya if she felt like there was a correlation between her love of the outdoors and gymnastics – that type of physicality – and her eating disorder.

“I’m seriously harming my body when I binge and purge. I really am,” she acknowledged.  “I have no false pretenses about that. But moving, exercise, dancing – these things all feel like you’re doing something really positive for your body. They bring me a calmness of mind, whereas when I binge and purge, it’s like a terror, an unsettling, gut gross feeling in my stomach that is like, ‘I can’t believe I just did that again.’ It’s the total opposite sensation of being at an amazing dance party or zumba class.”

Maya felt like the program, therapists, and friends from the unit were tremendously helpful for her at the time. “Getting to talk about what you’re going through with people who have similar experiences is really invaluable,” she said. “After the program, though, you don’t see these people again, or your therapists from the unit. You’re on your own. I use some DBT (dialectical behavioral therapy) techniques I learned there, but all in all, it was the people I was close with on the outside of the unit as well as my therapist I met after the program that really helped me get to where I am today.”

The program at Columbia is generally 4-6 weeks, though they never instruct a patient that she or he has to leave. There are some patients who were there for 6-7 months, but Maya started to feel ready to get out. The hospital was starting to feel confining.

“I’d have to get a pass to go outside, but that would be only after a certain period of time,” she said. “The whole thing was very structured, very scheduled, and it eventually came to a point where I went stir crazy. This isn’t the real world. I know I’m not dealing with my issues in a ‘normal setting.’ I came to a point where I just wanted to get out, and start practicing my recovery on my own.”

After the unit, Maya said she didn’t know what to do with herself. She had planned to go to an outpatient program, but quickly felt like it wasn’t a right match. “Those first few weeks were hectic and crazy,” she said. She lived with her sister at the time, would still binge and purge, although less often, and started seeing a therapist.

“In therapy, I began to realize that my eating disorder masked another facet: not knowing what I wanted to do with my life. Bulimia became my focus and had to be dealt with. But at the same time I was avoiding a whole other slew of questions: do I stay in school? Do I stay in New York City? My eating disorder covered my insecurities of not being confident in making my own life decisions. I relied on my eating disorder on getting out of answering life’s big questions.”

Maya met her husband through her sister and brother-in-law and started dating towards the end of her stay in the psychiatric unit. Eitan knew of Maya’s eating disorder from Maya’s family, and so even on their first date, he knew where she was coming from. “It wasn’t like dating someone for a few months and then all of a sudden you have to tell a big part of your life. We started out talking about it,” Maya said. As they dated more and became more serious, they also talked about what it might mean for their hypothetical marriage.

“It’s a complicated thing to share with somebody else because for most of your life, it’s yours, your issue. And then all of a sudden you’re in a relationship and it affects someone else a whole lot and plays into what you share, what you don’t share. . .I couldn’t ask for a better person to be open with about, to be supportive, to listen when I’m having a rough day, to just say, ‘okay, you need to take a step back.’ But it’s hard. You don’t want to bring the other person down, you don’t want it to be the defining part of your relationship, but it can be overbearing.”

Almost two years after moving out of her sister’s apartment and leaving the clinic, Maya is working and back at school, but says her overall mood depends on the day. “Sometimes I feel really good and confident and like I’m moving in the right direction,” and other days she feels less sure of herself and where she’s headed emotionally and academically.

How she views her disorder, though, has changed drastically. When she was a teenager, she thought to herself: “When I go to college I want to have zero symptoms. . .Bulimia is something I can fix and will go away. . .now I realize you can be symptom-free for a while, but food is something you need to be super conscious of if you have an eating disorder. The desire will always be there, it’s a question of control. I may not want to binge and purge anymore, but if I let myself get too stressed, I know that’s what I’ll turn to. Not alcohol or drugs; food is my coping mechanism.”

Maya’s relationship with religion and God has also been challenging and changing since her time in the unit. She thinks of herself as a spiritual person, but not in the way her mother might think. Maya doesn’t go to shul regularly. She enjoys knitting with music on, or the candles lit. “Sounds stupid, I know,” she says, but then she quickly acknowledges her projection. Maya doesn’t blame God for her bulimia. She doesn’t believe God has such a personal hand in things like this. “If there is a God,” she added.

Maya wasn’t personally frum when she started at Maryland, and this caused and still causes friction with her mother. “Growing up, I didn’t even feel like I had a strong relationship with God. Sometimes I would talk to Him or Her but more in the ‘I need something kind of way, can you be there for me now?’ It wasn’t like a relationship where I reached out in good times and bad. More like, I want to win this soccer game or other immature wishes. . I don’t know if I believe in God and I don’t know when that started. For me, I have a very negative association with religion right now. . .I think it’s because it’s hard for me to distinguish between what I grew up with, what my family expects of me, and what I personally feel, believe, and want. Instead of dealing with those issues, though, and piecing together my own religious affiliation and observance, I shy away from it. I try not to think about it. I don’t go to shul. I just don’t engage with it at this point.”

“Growing up in a home that kept Shabbos and kashrus and that sort of thing, food is definitely a big factor in an Orthodox person’s life,” Maya said.  “And the idea of Shabbos can be really hard. You have three big meals which have tons of food, and you’re supposed to eat the right amount, but no one really tells you what that amount is or exhibits healthy eating.  Growing up, Saturday night we never ate dinner because Shabbos lunch was so big. People didn’t need dinner because most of us weren’t hungry. Some families do have shaleshudes, but in our house we never did.”

Maya gives her home kitchen growing up a seven out of ten. She acknowledges the difficulty of modeling healthy balanced eating when you have two working parents with four kids who each have extra curricular activities and lives of their own. “I think my mom is very food conscious,” Maya said, and certainly doesn’t blame her upbringing for her own disorder.  “But my mom would skip breakfast in the morning, and you’re not supposed to do that. And then I started to skip breakfast. She doesn’t anymore, and she has since remodeled her behavior, and has learned eating in the morning is good for you.”

She acknowledges the stigma of eating disorders within the modern orthodox community, “as in any other community,” she says, but asserts that it’s the role of families to exhibit normal eating patterns and habits. “Not just healthy food, or just junk food, but a variety. Saying no one eats past 9pm just isn’t realistic. People snack at night.”

Thinking back to where Maya was two years ago, it’s powerful to hear her talk so openly about her disorder with such ownership. When we spoke, I asked her if she would be comfortable sharing when her last episode was. “Yesterday,” Maya said. She had an incredibly stressful day and was supposed to head to therapy, but instead went home and binged and purged. She knew what she was doing as she was doing it, she said. Today she felt stupid and miserable about it.

“There is one thing I would like to say,” Maya offered at the end of our conversation when I asked if she’d like to add anything.

“There are a lot of people with eating disorders who don’t share and go for years without telling a soul,” Maya said. “No one knows they’re struggling. And I have to say, I’m thankful to God, I got found out and got help. Even though it’s been a long journey, I have no idea where I’d be right now or if I’d even be alive. And yes, there’s stigma, and embarrassment and shame when you have to come forward and say, ‘I’m struggling with this.’ But any other way is much more terrible. I urge people with eating disorders: if you’re denying it, really take a second look at yourself. Just try to be truthful and honest. Take away the baggage that may come along with it, and just answer this question: are you having trouble eating?  And if the answer is yes, go out and find somebody, a friend, a family member, someone totally random, just so you can tell it. Because it will catch up to you, no matter how long you try to hide it. It won’t get away. Your life will be better if you get help.”