I’m Anorexic — But I’m Also Fat

You can be both.

  • Holly Case

Written on Mar 30, 2022

woman grabbing belly fat TongTa25 / Shutterstock
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What comes to your mind when you think of an anorexic person? If you’re like I was, it’s probably a waifish, slender ballerina, the kind of woman who always looks younger than she is. The kind who can wear a long-sleeved, scoop-neck t-shirt that shows the prominence of her collarbones.

That’s what I aspired to be like throughout my teens and early 20s. My vision of the ideal female body has never progressed past Kate Moss and Winona Ryder, who were both very thin, and the societal definition of attractiveness when I was that same age. I maintained my weight of 92 pounds by eating 3 meals of only breakfast cereal a day (and smoking lots of cigarettes.)

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But that’s not what I look like anymore. I clock in at slightly above 50 pounds from my “ideal weight” and no one would ever describe me as “waifish.” Yet I’m an anorexic anyway.

I also have severe body dysmorphia; I consistently estimate my weight to be about 100 pounds more than it actually is.

How being anorexic and fat works

Doctors have written the directive to “lose weight” on my medical charts for as long as I can remember. Yet not one of them has ever asked me about how I actually eat or else they maybe (??) wouldn’t have done so.

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On an average day, I consume far less than 1,000 calories a day. According to most calorie-counting websites, this is supposed to be enough to lose weight. These websites even recommend this amount for weight loss, which is a totally different matter, considering that it’s the same as the recommended caloric intake for a toddler.

On most days, I eat a Larabar, have something small for dinner (like a bowl of ravioli or a chicken breast and broccoli), and a daily smoothie. My smoothies contain oat milk, baby spinach, frozen berries, and a banana. And that’s it. I quit smoking years ago.

I don’t consume much dairy or meat. I’ve eaten McDonald's once in the past year, and even then, it was only a 4-piece McNuggets and small fries. I don’t drink any soda or alcohol. Yet any efforts I’ve ever made to lose weight have failed.

Since I’ve been dealing with grief over my husband’s death, I have actually lost about 10–15 pounds, but that’s only because I’ve had entire days when I ate nothing at all.

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What my health looks like

I’ve recently had my annual physical, so I just got all the results of my blood work back.

My cholesterol is on the high side of normal. My HDL, LDL, and triglycerides are all good. I’ve had my A1C levels checked annually ever since having gestational diabetes with my last pregnancy 19 years ago, and I’m 0.1 percent above the healthy cutoff. Even my vitamin D levels are finally in the 50s for the first time ever, which is amazing since they’re usually in the teens.

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Yes, I am mildly anemic, even despite consuming 2 cups of spinach a day and taking an iron supplement.

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I’ve seen several specialists in recent years about the fact that I have chronically very low energy. I can’t stay awake through an entire day. It probably has to do with the fact that I’m not eating enough but they’ve never mentioned it.

Why haven’t they mentioned it, when it’s such an obvious and likely answer to my low energy? I’m talking that my energy is so low that it actually interferes significantly with my ability to function.

Instead, all my doctors always say the same thing: I need to lose weight, like it would instantly cure me of everything.

This is what a lot of “normal” women eat like

I was venting on Facebook recently and discovered that I eat like a lot of women do. I’m truly not hungry to eat any more than I do. Even if I feel “snacky” sometimes, I might eat a handful of chips or Cheez-Its, and then I’m done with it. I don’t have sugar cravings at all.

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I think this is the natural outcome of growing up in a diet-obsessed culture. I know that I shouldn’t eat a lot, so I don’t. I also don’t deny myself an occasional piece of birthday cake but I never have too much (and I never include ice cream with it.) In general, I never have second helpings of anything.

I know that I would probably be at a healthier weight if I could just eat a bit more and maybe get more regular exercise. But I can’t just make myself eat more due to a lot of factors — not the least of which is my belief that eating more will make me gain weight, due to decades of social conditioning.

I often see things online (especially in doctors’ and nurses’ forums) that express absolutely horrible views about fat women. They say “just put down the fork, fatty” or “stop eating at McDonald’s for every meal,” but the thing is that neither one applies to me.

I look like almost every other woman in my family, save for one female relative who maintained such tight control of her weight that she never gained it in the first place, even despite going through a couple of pregnancies. She still maintains rigid control of her weight through a lot of mechanisms that seem more neurotic than healthy and it consumes a lot of her thoughts.

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I come from hearty Polish and Irish peasant stock, with a body designed to conserve every last pound. And that’s just what it does unless I skip eating for entire days.

Maybe instead of shaming women for their weight, doctors should start asking about what women actually eat. And maybe we should be more accepting of the wide range of what real women’s bodies actually look like.

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Holly Case is a newly widowed mom of three young adults, trying to figure out her way in the world. Follow her on Medium.