March 3, 2021, noon
My current morning coffee: double-strength espresso with an unmeasured pour of oat milk, the vanilla one. It begins.
On any given day, I’ll grab my first cup of coffee and clutch it tightly as I breathe in the sweet warmth. I’ll head to my room, sip the temporary solution and scroll through the day’s lineup of news. Most days, I’ll make it this far without any side jabs from a whispering voice of anorexia, but some days, especially when coexisting illnesses are flaring, she will emerge. A sliver of her past reigns in my present. In my coffee cup. In my head.
The American Heart Association and recent research published in the Journal of the American Heart Association says we should limit our daily sugar intake, as women, to less than 8 teaspoons, or 25 grams, a day. That’s less than an average soda, or, in the case of this coffee creamer, it is 6.25 cups of coffee, conservatively speaking.
As a full-time freelance health writer and someone who overcompensates for the fluctuating fatigue accompanying depression and fibromyalgia, I may drink anywhere between 1 and 4 (big) cups of creamy coffee per day.
I know this is not considered a healthy habit. I know sugar causes inflammation and inflammation is the route to all pain and health problems. I know I am taught to feel guilty about these foods in order to encourage better eating habits, and I know if I think too much about it, I may spiral.
I can choose healthier options, or reduce my intake, but I really can't think about it too much.
In my teens, the concept of healthy eating was simple. Black coffee. Fewer calories. Less fat. Better life. Nothing processed equals nothing fake equals an authentic life. But what we eat and drink doesn’t determine our worth. If only I had known this earlier.
After learning the numbers, the recommendations for so-called healthy living, including daily allowances and percentages and measurements, adhering to them became my religion. I submitted willingly, praying for salvation from chronic depression through skinniness. I attempted to stay within acceptable margins, hoping to achieve a social construct of perfection, but instead, the deadly disease that is Anorexia Nervosa was triggered within. For three or so plus tailwind years, I shrunk smaller and smaller until my illness made me so sick, I did not see food anymore. Just numbers. Aisles of numbers, cupboards of numbers, spoonfuls of numbers.
Fortunately, I was paired with an experienced and knowledgeable mental health professional who had helped girls and women with various types of persistent eating disorders. Talk therapy, cognitive behavioural therapy, reading about other people’s experiences, and hours of homework in workbook printouts from my counsellor helped me through, but I had to be the willing participant on the other side. I had to do the work.
As a part of that recovery work, I wrote a personal memoir called Ana, Mia & Me. It’s a tell-all of what was going through my mind during the long course of initial recovery. I wrote it at seventeen years old, and at the time, writing something over 10-15 pages was a massive undertaking. The one printed copy remained known to me, my mother, and three other people for thirteen years. I recently published it in order to raise awareness about eating disorders, which have the highest mortality rate of any mental illness.
Part of what was so difficult about recovery for me was this pull between healthy eating, good and bad foods, and associating worth or value with the quality of foods consumed. Punishment. Suffering from chronic digestive and pain issues means I have long-since associated what I eat with how I feel and how my body responds. When food can easily and sometimes unpredictably hurt, it is difficult to think of it as anything but punishment. But I have learned that a little inflammation beats starving yourself. Every single time. If it comes down to it, if it means that following food guides and nutritional recommendations to a tee may trigger unhealthy eating behaviours like starvation, which is the healthier route? Eating. Eating is always the healthier route.
You see, while excess sugar is associated with an increased risk of heart disease, starving yourself weakens and deteriorates your heart muscles and consequently increases your risk of heart failure. Anorexia hurts the heart, too. It can be fatal faster than you’d think.
There is a balance, but anorexia can easily skew it and so sugar can’t be a survivor’s first concern. Neither can fat. Or protein. Or carbs. We cannot isolate and divide and collect and count. We just need to eat and remember that food is medicine.
So if your illness is making you think you have to decide between one or the other, choose consuming. Choose the creamer. Every time. Stop denying yourself, start listening to yourself, and be gentle with your journey.
As I recovered, I had to stop assessing before consuming. This was the hardest part, and it still takes practice at times. I can remember sharing my food diary with my counsellor and her saying that while eating anything is better than eating nothing, there really is no reason for me to be eating low calorie Weight Watchers bread. Or measuring my Special K cereal. It’s okay to have a doughnut and not hate yourself or binge. A doughnut does not define you.
But that means I had to start thinking about food differently. I had to give up the dichotomy between good and bad foods. I had to listen to my body and let it reteach me what it needs to survive and thrive. I had to stop searching menus before leaving the house and thinking about carb contents and fats and meal planning. I had to remove the bathroom scale from my residence. I had to stop going to the gym as much and when I did, I lost my passion for it entirely. I am an all-or-nothing person.
Eventually, the relief of silencing the voice of anorexia began to outweigh the feelings of achievement that I initially got from staying within the daily nutritional allowances or limitations or restrictions. She lets up and lets me live and for a long time, and I forget how bad things have previously been...until I start thinking about the sugar in the creamer that goes into the coffee. Quitting sugar. Healthy living. My heart. Counting grams. It begins.
And so, the story goes that I have to avoid obsessing over the everyday nutritional advice by not even keeping tabs lest it lead me somewhere I never want to go again. Don’t get me wrong, I eat healthy foods and take the best care of this body that I can, but the guilt that comes with consuming sugar when you have chronic illness is something that runs deep within me. That guilt can set into motion a series of unfortunate events that begin with truly the best of intentions but end with food anxiety. A dangerous and deadly slippery slope. So instead of letting myself obsess about coffee creamer, I sip my coffee, enjoying it and feeling grateful I’ve come to a place where this is possible without the repercussions of food-punishing for the rest of the day.
I can sip in peace.
Michelle Pugle is an expert health writer with nearly a decade of contributing accurate and accessible health news and information to authority websites and print magazines. First published in her preteens for writing about depression, she then wrote and published the memoir Ana, Mia & Me to provide hope and advocate for recovery from eating disorders through professional treatment.
She has a Master of Arts in Women's Studies and Feminist Research, a diploma in Holistic Herbal Therapy, and a double Bachelor of Arts in English Literature and Sociology. She has completed the LivingWorks Start training course for suicide prevention and is currently studying for the Mental Health Praciticioner designation.
Her work has been featured on top digital health publications like Healthline Media and Verywell Health and her health narratives and essays have been published on a variety of platforms from The Mighty to Michael Landsberg’s Sick Not Weak to Thought Catalog.