Editor’s note: Rebecca is a pseudonym to protect the source’s identity.

It began in seventh grade.

After years of listening to her parents telling her to lose weight, Rebecca began to agree. 

Looking in the mirror, she saw a 12-year-old girl who was “too fat” staring back at her. In that moment, she knew she was willing to do anything to be skinny. 

Now, three years later, she is dealing with body dysmorphia but so far has not sought help for it.

According to Mayo Clinic, body dysmorphic disorder occurs when people obsess over flaws in their appearance, which results in shame and anxiety. People who have body dysmorphia often search for temporary measures to rid themselves of discontent over their appearance but are hardly ever satisfied with the results. 

What started as a year of dieting to lose weight for Rebecca morphed into going days without eating at all. During the summer before her freshman year, without the routine of school to keep her occupied, Rebecca found that she regressed into even worse eating habits, including not eating for days. Still, she was not ready to accept there was a problem. Rebecca was charting a path toward anorexia nervosa, which according to Mayo Clinic is an eating disorder in which patients severely restrict their own food in order to lose weight.

“I didn’t admit to myself that I had an eating disorder for a long time,” Rebecca said. “I told myself that I was just dieting and being overdramatic.”

Initially, by skipping meals, taking diet pills and following workout videos, Rebecca lost 10 pounds quickly. Rebecca’s friends at school were shocked to notice her weight loss and lack of eating.

 While they encouraged Rebecca to eat more, they tiptoed around the phrase “eating disorder,” and according to Rebecca, they felt too awkward to ever bring it up. Besides initially voicing their support, her friends haven’t brought it up since they found out about her issues. 

Over time, Rebecca began to feel the effects of poor nutrition and weight loss. Her metabolism eventually slowed, and she began to feel unwell much of the time. 

Despite this, Rebecca has yet to seek medical care, and continues to struggle. 

“I experience a lot of hair loss and dizziness,” Rebecca said. “I’m always tired and find it really hard to find the energy to concentrate throughout the school day.” 

She remembers barely making it through many of her sports practices, unable to endure the physical strain of the activity due to not eating all day. 

Meanwhile, Rebecca’s parents are not aware of their daughter’s eating disorder. While they know Rebecca is cutting down her portion sizes the way they’d suggested, they have not seen the downside of her new habits.

“I feel like if I told my parents about my eating disorder they’d be more angry than supportive,” Rebecca said. “They’d accuse me of hurting my body.”

Professional advice

Asked about the problems with eating disorders generally (and not Rebecca’s problems specifically), CASSY therapist Sarah Lauterbach stressed the importance of having a supportive family, especially when a child suffers from an eating disorder.

“The family should not freak out and instead should validate and empathize with the fact that their child needs extra support,” Lauterbach said. “They should look to an eating disorder specialist and consider family therapy or an in-patient recovery center.”

So far Rebecca has remained resistant to seeking traditional help. At some point, she said she may discuss with her parents the option of taking something called selective serotonin reuptake inhibitors (SSRIs), a form of antidepressant. She had done some research, and thinks that increasing her serotonin levels might help her block out negative thoughts about her body, and similarly, increases in serotonin would make her feel happier. 

While SSRIs have not been scientifically proven as an effective treatment for curing eating disorders, according to a scientific journal by Current Clinical Pharmacology, many clinicians use these medications in combination with nutritional support and psychotherapy.

Still, she’s not optimistic about her chances of receiving the treatment.

“As much as I want to consider taking SSRIs, my parents wouldn’t understand,” Rebecca said. “They think these pills are only taken for depression, and if I take it, then I’m depressed.” 

Rebecca has tried self-care activities such as using face masks, taking baths and going on walks, but she always relapses back into her negative thoughts, which holds her back from recovery.

CASSY counselor Lauterbach compared eating disorders to what those who have addiction issues go through.

“It’s a tremendous loss when you give up that way of life that you've been engaging in,” she said. “There's going to be a grieving process, but you have to make the choice to live.”

Rebecca feels that so much of her energy and time has been put into becoming skinny. 

“I’ve wanted to be thin for so long, and I’ve already invested so much into losing weight,” Rebecca said. “If I don't follow through and get to my goal weight, then I feel it would have all been for nothing.” 

She suspects, however, that she won't be content with the way she looks, even if she reaches her goal weight. 

“The problem with suffering from body dysmorphia is that I’m always hyper-aware of my body,” Rebecca said. “I can feel when my thighs are touching, and I can literally feel the fat on my body.”

This feeling of guilt and discomfort is only heightened when the feeling of hunger becomes too much and Rebecca finds herself binge eating to compensate for starving herself. The binge typically lasts for 10 minutes before Rebecca goes back to dieting due to shame.  

According to Mayo Clinic, binge-eating disorder is characterized by uncontrollable excessive eating. Those who binge eat cannot control the urge to eat, and they end up consuming much more than they normally do. 

Rebecca wishes she could warn her past self about how quickly eating disorders can consume someone. 

“I’d tell my past self that starving isn’t worth it,” Rebecca said. “Eating disorders are scary — you either recover completely or suffer for the rest of your life. It’s just not worth it.”

While Rebecca is still struggling with her eating disorder, she says she’ll consider seeking treatment when she’s ready. ****

If you or someone you know is struggling with an eating disorder, call these hotlines:

National Eating Disorders Association Helpline: 1-800-931-2237

Something Fishy: 1-866-418-1207

Hopeline Network: 1-800-442-4673

National Association of Anorexia Nervosa and Associated Disorders: 1-630-577-1330