Content warning: The following deals with topics centred around disordered eating.
Between the ages of 16 and 20, I was missing a vital aspect of my health: My menstrual cycle. If this predicament ever came up in conversation, people expressed concern for my well-being, but I was quick to brush it off.
I used every excuse in the book to explain my strange situation: “I’m an athlete. Many female athletes lose their period,” or “my mother lost her period in university, it’s probably just genetics,” and, worst of all, “I feel great and I’m not planning on having children soon, so what’s the big deal?”
Little did I know, it was a big deal. Missing a menstrual cycle has profound negative impacts on bone density, cardiovascular health, and can increase psychological stress. The medical term for missing a period due to disordered eating, psychological stress, and/or excessive exercise is hypothalamic amenorrhea (HA), and I was its poster child.
When I lost my period, I was deeply entrenched in diet culture. What started in the tenth grade as a bid to lose weight for a vacation turned into a four-year battle with orthorexia.
Annyck Besso, a registered dietician at Sooma Nutrition Counselling and Therapy Montreal spoke with the Tribune about orthorexia.
“[Orthorexia] is an obsession with eating healthy, [like] eating natural foods, natural ingredients,” Besso said. “It can present itself [as] a compulsiveness to be healthy and seek health in your eating habits and exercise habits. [Orthorexia] is not officially recognized in the DSM-5 […] but I would say orthorexia is a lot more prevalent [as of the last five years, and we have learned more about it.]”
The pervasiveness of diet culture in the media contributed to my disordered behaviour by pushing the narrative that thinner was always better, regardless of the costs.
Julia Caddy, the Students’ Society of McGill (SSMU) Mental Health Commissioner, U3 Arts, expressed that media messaging can play a large role in the development of disordered eating habits.
“Eating disorders are so closely tied with perfectionism and […] when you have a society and media that posits losing weight and looking a certain way and eating a certain way as good, and the opposite as bad, and you combine that with perfectionism, it makes sense that people develop eating disorders,” Caddy said.
For me, losing weight through over-exercising and food restriction became addictive. Each time I stepped on the scale and the number dropped, I breathed a sigh of relief. People in my life began to notice that my desire for control was becoming out of hand.
According to Besso, this obsession with control is prevalent among people suffering from eating disorders.
“I would say that eating disorders are typically misunderstood to be superficial disorders, but they really are disorders of control,” Besso said. “Emotions and circumstances are sometimes out of our control […] so if it’s difficult to sit in that discomfort […] focussing on controlling your body does feel really productive.”
In the eleventh grade, I had a harsh encounter with reality when I visited the doctor for a routine check-up. After running some tests, the doctor informed me that my blood pressure and hormone levels were shockingly low. She warned me that if I continued down this road, the consequences would be ugly.
That year, I started working with a therapist and slowly started to break the food and exercise rules I clung to so religiously. I was fortunate that, by the time I arrived at McGill, my relationship with food and my body had improved.
Cody Esterle, general coordinator at the SSMU Eating Disorder Resource and Support Centre (EDRSC), explained that the university context can be extremely triggering for many suffering with disordered eating.
“Part of it is […] having no parental supervision over food […] and the whole concept of the freshman 15, and these pretty toxic ideas about the way your body should look,” Esterle said. “Life is very overwhelming and managing food is an additional thing [….] Students are pretty tight on money [and] the stress and amount of work that McGill puts on us makes it harder to put yourself first and your needs first.”
Despite the progress I had made in university, I was still over-exercising and my period had not come back. I remained in a state of quasi-recovery for over a year.
Besso described quasi-recovery as the point when someone starts refeeding and breaking some of their disordered rules, but does not fully commit to recovery.
“The quasi-recovery is in committing to changing some of your habits, but very much staying grounded in some form of control and eating disorder rules,” Besso said. “You’re still restricting and your body is still malnourished, though it feels like you’re eating a lot more than you were before.”
One of the biggest detriments to my recovery was the external validation I received for my thin appearance. Esterle described how the glorification of thin bodies in the media makes it much harder for certain people to recover.
“It’s seen as an accomplishment [to lose weight, so] the type of eating disorder voice that’s developed in one’s head is harder to fight back against,” Esterle said. “Diet culture makes it a lot easier to get an eating disorder […] fatphobia is a part of diet culture and plays a huge part in eating disorders.”
It was not until I discovered the book No Period, Now What? by Dr. Nicola J. Rinaldi that things started to shift for me. The book offers a science-based, comprehensive guide for how to recover from HA and anecdotes of other women’s recovery journeys. Reading other women’s success stories inspired me to take action.
In March 2020, I went “All In” to recover from HA. As described in the book, the All In approach involves eating to complete satiety every day and reducing exercise until one has three consecutive menstrual cycles. No foods were off limits, and there was no maximum number of calories you could eat per day.
The experience was extremely challenging, but also liberating. I had the freedom to eat every food I had previously demonized without guilt or shame.
Letting go of the size I had idealized in my head was difficult, but moving beyond my physical appearance gave me an opportunity to express gratitude for all the things my body did for me. Whether it was keeping my heart beating, helping me hug my family, or allowing me to dance, my body was working for me everyday.
For Caddy, recovery meant reconnecting with the things she loved again.
“The true ingredient in recovery was finding my identity again and filling in that gap that used to be filled with the eating disorder,” Caddy said. “For me, the defining feature of recovery is, when I face any opportunity to engage in a behaviour or obsess over certain things, it’s making a decision [….] Am I deciding between being sick again or being myself and living my life with all of these things that I love?”
My work eventually paid off: I regained my period right before my twentieth birthday and it has been regular ever since.
While I still struggle with my body image from time to time, I have cultivated a relationship of respect and appreciation with my body that has helped me overcome the tough times.
What I did not expect when I gained weight was that I would also gain confidence, vitality, and happiness. Recovering was the best decision I have ever made because my life is so much richer than when I was confined to such a small box.
Sooma is a team of registered dieticians and psychologists that specialize in eating disorder treatment and sports nutrition. They can be found on Instagram at https://www.instagram.com/s.0.0.m.a/.