Being Told “You’re Not Sick Enough” (Guest Post by Emily Kopacz)

Trigger warning: eating disorder behaviors mentioned.

A lump formed in my throat as I walked towards my college’s wellness center. Two days prior I had had my first appointment with a nutritionist at a practice specialized in eating disorder treatment. The nutritionist, horrified specifically by my laxative abuse, advised that I get a blood panel as soon as possible and that the easiest way to get one was to notify my college’s health center and go from there.

When I was called in by the nurse practitioner, I felt my stomach tie itself in knots. I did not want to tell my eating disorder story again to yet another medical professional. The more I had to explain my eating disorder, the more I questioned if I even had one.

“What brings you in today?” The nurse asked me as I sat down on the crinkly paper seat covering.

My chest tightened; my heart raced.

“I need to get a blood panel done. Are you guys able to do that here?”

“Why do you need a blood panel?” The nurse asked, now looking me up and down.

“I was recently diagnosed with an eating disorder and was advised by my nutritionist to get a blood panel done,” I said, all in one breath.

“I really don’t think you need one,” the nurse said dismissively.

“What?” I said, taken aback.

“You are not thin enough to be anorexic, so honestly, I am not concerned. Also, blood panels are expensive. I do not want you wasting your money on something that is not medically necessary. The only thing I can think of that will show up on the panel is that you might be iron deficient. Otherwise, I really do not think it’s worth it for you.”

Tears welled in my eyes. I could not believe I was being invalidated by a nurse who had no knowledge of me or my medical history. But… perhaps she was right. Perhaps I was not sick enough after all to have an eating disorder. Perhaps I was wasting my time and money on therapy. Maybe I should have tried to lose more weight before asking for help. Maybe then I would have been taken seriously.

Except, I already had a diagnosis. I had been diagnosed with Eating Disorder Not Otherwise Specified (EDNOS) by a medical professional just five days prior. Even though I was not anorexic, if my nutritionist strongly advised a blood panel, I was going to try my hardest to get one.

“I may not be anorexic, but I still have an eating disorder. I restrict my food, overexercise, and abuse laxatives. Just because I am not stick-thin does not mean I do not have something wrong with me. I would still like the blood panel.” I said, my voice warbled as I held back tears.

“Okay, just know that I warned you how expensive they are,” she said.

“That’s okay. I really need this done,” I replied, standing my ground.

The nurse ended up sending me to the clinic across the street for the blood panel. At the clinic, I was pricked four times by a couple of different staff before I was told my blood could not be drawn and to go home. I did not end up getting a blood panel until months later when I committed myself to a partial hospitalization program at Walden Behavioral Care. Walden staff had no problem drawing blood from me on a weekly basis.

From my blood panel, my team learned that I was at risk for cardiac arrest because my body was overcompensating magnesium production from my laxative abuse. I was low in iron and vitamin D due to my restriction and laxative abuse. And my blood pressure and heart rate were consistently worryingly low. It did not matter that I did not have an Anorexia diagnosis. My eating disorder diagnosis was just as valid, and I experienced just as serious consequences from it.

Although I was never hospitalized or committed to an inpatient program and although no one ever made me get help, my eating disorder was still killing me. Deep down I knew it was killing me. I knew I was doing damage to my body and mind- even if no one else could see it- even though some days I couldn’t even see it, I knew I needed help.

And this took years. I did not have the courage or confidence to seek help until I began experiencing increasingly worrying physical symptoms from restriction and laxative abuse. My digestive system stopped working properly. I would look down in the toilet and see chunks of undigested food. I had many close calls going to the bathroom because I had lost control of my bowels. I experienced random and frequent vertigo attacks. I felt weak. All the time. And even when I experienced these symptoms, I still questioned whether it was “bad” enough to be worried. I could not bring myself to get help until months more of these symptoms.

It took reading Rachael Steil’s book Running in Silence to spark my confidence to seek help. It took seeing that, yeah, what I was experiencing was bad and I was not alone in it. If I could root for Rachael in her journey and believed her experience and her diagnosis was valid, why couldn’t I do the same for myself?

That is when I broke free from my “not sick enough” insecurity. I came to understand that I was never going to believe I was sick enough or skinny enough to seek help. I had to grab recovery by its horns myself because no one else was going to do it for me.

I was lucky to get a diagnosis. Many people who suffer from eating disorders never get a diagnosis. This is can be due to peoples’ own “not sick enough” insecurities, society’s normalization of disordered eating and diet culture, medical discrimination, lack of insurance, and subpar health care.

This needs to change not only in the mental health field but also in the physical health field.

Getting help is hard. It is even harder when people around you tell you that you are fine or that “it isn’t that bad.” But they do not know your body. They do not live in it. You know your body. You live in your body. Your pain, your emotions, your experiences are valid; they are important. You are important. Do not let anyone convince you otherwise. Keep advocating for yourself until you find answers. I promise you, you will find them, and it will be so worth it.

Emily Kopacz graduated from Saint Michael’s College with a BA in English and minor in Music. She ran for the women’s college cross country team and was a SAAC representative. Emily is pursuing a career in mental health and currently works as a paraprofessional at Colchester Middle School. In her free time, Emily discusses her personal experiences surrounding mental health on her blog at https://littlgrasshoppr.blogspot.com. You can follow her on instagram: @littlgrasshoppr.