Why This Woman Didn't Realize She Had an Eating Disorder

Staying healthy and fit are common goals, but anything in excess can be negative for your body. Eating disorders can manifest themselves in subtle, unknown ways. Our friends at Shape explored one woman's journey to discover her own eating disorder and how she didn't know for so long.

At age 22, Julia Russell began an intense fitness regimen that would rival most Olympians'. From two-a-day workouts to a strict diet, you might think she were actually training for something. And she was: to feel good. The endorphin high helped her cope with an unfulfilling, post-college job that she took after moving back home to Cincinnati, OH. Between dealing with a miserable office life and missing her college friends, she made the gym her happy place, visiting it before and after work every day for seven years straight. (Did you know Runner's High Is As Strong As a Drug High?)

"My workouts were pretty intense. I became obsessed with counting calories too—I was eating less than 1,000 calories a day and doing two-a-day workouts, like boot camps, high-intensity cardio, spinning and weight lifting," Russell says. Despite having low energy that made her extremely irritable, she stuck to this rigid routine from 2004 to 2011. "If I had to skip a day, I would get very anxious and feel very bad about myself," she admits, though at the time, she kept her frustrations to herself.

"I never told anyone how I felt. I was also getting a lot of compliments, like 'Oh, wow, you've lost a lot of weight,' or 'You look great!' My body type is athletic, and although I was thin, you wouldn't look at me and say, 'That girl has a problem.' I looked normal," says Russell, who grew up doing gymnastics, practicing synchronized swimming, and playing tennis. "But for my body type, I knew that was not normal. So it was very deceiving for me and the people around me. In my mind, I didn't have a problem. I just wasn't skinny enough," she says, revealing that being slim was a notion she had been chasing for as long as she could remember, as far back as pre-kindergarten.

During those seven years, only one friend—an acquaintance, really—expressed concern for Russell while they were both attending graduate school at the University of New Hampshire in 2008. "Sometimes it's the people you're closest to who don't say anything. This stuff happens gradually so they might not notice. Also, in our society, everyone is so health-obsessed that nobody thinks it's weird. But this girl at school thought I was too workout-obsessed and too thin," she says. Though Russell brushed off her comments at first, she eventually visited her school's psychologist. "I went one time, cried through the whole session and never went back," she says of her session with the counselor. "It was too terrifying to confront. A part of me knew something was up, but I didn't want to deal."

And after graduate school, people actually congratulated Russell on her weight loss and talked about how jealous they were that she had such self-control. "That made me feel superior and made me want to engage more in the dangerous exercise and dieting behaviors," she says. Plus, "I was in grad school. I had a boyfriend. From the outside, I was doing just fine. Other people have way worse problems than me. I was just being emotional. So I dissociated and moved on."

It wasn't until Thanksgiving in 2011 that Russell's denial caught up with her. "I hadn't been able to keep a relationship for a while. I was always canceling on dates because I didn't want to go out to dinner or because I wanted to work out. I had eating disorder things to take care of. Also, I was a very stressful job working at the public defender's office. I felt like part of my life was failing," she says. That November, Russell invited people over for a Friendsgiving potluck before a night out on the town. When she got home later, she was so hungry, she had some leftover chocolate cake...and couldn't stop eating.

"I literally ate half of it and made myself throw up. I had never thrown up for that reason before. I remember sitting in the bathroom crying. At that moment, I realized things were not right. It had gone too far. I called my best friend and, for the first time, told her what was happening. She was so supportive and told me to see my doctor. My primary care physician referred me to a psychiatrist who referred me to my psychologist, who then referred me to a dietitian and group therapy," she says. Even after being diagnosed with an eating disorder—a condition that affects 20 million women and 10 million men in the U.S. alone—Russell wasn't convinced she had a serious problem.

"I remember her telling me that I was anorexic and I responded with a sassy, 'Are you sure about that?' I do things that are healthy. I work out, I eat well, I don't eat dessert or engage in bad diet habits. Maybe I have some anxiety and depression, but an eating disorder feels too farfetched. Those people are extremely skinny and look disgusting. They don't have any friends. I didn't think that that was me," Russell recalls. "When I started going to group, I was around 10 other girls who had very similar lives to me. That was really shocking. Some were bigger than me, some were smaller. They all had friends and came from good families. It was just a realization. It was so overwhelming." (Read how another woman's Healthy Habits Turned Into an Eating Disorder.)

For the next two years, Russell worked with her team of mental health and nutrition experts plus support group to learn how to get to a new happy place. She didn't enter a facility, but rather kept her full-time job to help pay for her treatments and squeezed in appointments into her busy schedule. Four years later, Russell finally understands what it truly means to be healthy.

"Now I try to work out maybe three times a week—in only fun ways. I ride my bike. I do yoga. Exercise is good for you, but I don't let it become a chore. I have no idea how much I weigh. I haven't stepped on a scale since 2012. Also, I try not to restrict foods. All foods have good and bad things; it's all about proportions and ratios. And I live with my boyfriend of two years. We have a healthy relationship that's awesome," says Russell, now a 30-year-old MBA student at DePaul University in Chicago. Despite her excellent progress, Russell continues to see her psychologist every other week to avoid a relapse and keep daily stresses from leading to harmful thoughts like, 'You're fat. You need to work out. You have to count your calories.' (Fat Shaming Could Actually Lead to a Higher Mortality Risk.)

One of the most surprising lessons Russell learned from her experience is that eating disorders don't discriminate. "There's no weight requirement. People with eating disorders come in all shapes and sizes. No one looked the same, but we all had the same problem," she says of the women in her support group. When it's not visibly obvious that you might be taking your fitness and diet routine too far, then it's easier for your extreme measures to fly under the radar—that is, until you suffer severe medical consequences, such as an increased risk of heart and kidney failure, reduced bone density, tooth decay, and overall weakness and fatigue.

Eating disorders are tricky to notice and diagnose. So we tapped psychiatrist Wendy Oliver-Pyatt, M.D., an active member of the National Eating Disorders Association, to point out three seemingly subtle signs of unhealthy behaviors that can pass off as "normal" but could actually lead to developing an eating disorder.

— Cristina Goyanes

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