You Will Never Be “Sick Enough”: Choosing Recovery Anyways

Disclaimer: This article was written by a student sharing their personal experiences, not an expert. This should not be taken as professional advice or support. If you or a loved one is struggling with disordered eating, check out the National Eating Disorders Association for help and support.

I vividly remember the medical intake phone call from when I started seeking treatment for my eating disorder. 

This was only my second time talking about my symptoms with a stranger, and in gruesome detail, and the fourth time overall. 

Pretty immediately we dove into the standard questions. Do you have a primary care physician? When did you last see them? Do you have a dentist? When was your last visit? Which of these symptoms do you experience? Yes, no, yes, no, yes, no, no, kinda? 

My intake specialist commented, “Awesome, you’re the healthiest client I’ve talked to today.” 

That was the worst thing she could have said to me. 

The second I got off the phone I crawled into bed and had one of the worst panic attacks of my life— I couldn’t calm down for hours. I don’t say that to garner sympathy, but so you understand how detrimental simple comments can be for people struggling. 

When my doctor started floating the idea that I could have an eating disorder, I genuinely couldn’t believe it. I had spent years rationalizing every action that I took, every reason that I wasn’t bad enough to receive help (yet). I had also spent years secretly hoping to get to that point, because of how much pain I was in. When I finally started getting the help I desperately needed, my brain was pushing it away. I asked every doctor I spoke to if they were sure that I had an eating disorder, if I was actually sick. My treatment team almost certainly got so tired of me asking for validation, but they met me with warmth and understanding every time, and that made all the difference in the slow journey of accepting that I needed – wanted – help, and that now I had access to it. 

I do not blame my intake specialist for her comment— I know she didn’t mean it in the way that my brain took it. If anything, I hope that she was happy for me— EDs cause long term, sometimes irreversible health issues, and no one wants that for someone. 

I do not blame myself, either, for taking it the way that I did. “You’re a failure at having an eating disorder, can’t even do that right.” “Why even bother going into treatment if you’re going to be the healthiest one there.” “Everyone knows that you’re faking.” Even today, if I let my eating disorder take over, I could talk for hours on how I don’t really need to follow my meal plan because of X Y Z reasons. 

Not feeling “sick enough” is a key characteristic of many eating disorders. Restrictive-based EDs tend to be particularly competitive. I spent so long thinking that if I gained X symptom or reached Y weight, that is when I would finally be worthy of treatment. But spoiler alert: You will never get there. 

I qualified for a level of treatment that my sick brain couldn’t have thought possible, and that still hasn’t been enough. On bad days I feel invalid for recovering because I never went to residential treatment. Even leaving PHP was emotionally complex because it meant I was getting better. And if I got better, that meant that I never had a real ED in the first place. But even if I was stuck in PHP forever, I wouldn’t be the sickest one there, because someone else would look worse, or act worse, and I was still invalid. And if I had ended up in residential care eventually, that would still be true. The goalposts are always moving to keep you trapped in your illness. 

This article frames the idea of “sick enough” in terms of eating disorders because that is the most recent experience I’ve had with this harmful mentality. But don’t let that restrict you to applying it to other things as well. When I was deep in depression I had the same issue, delaying therapy because I wasn’t sad enough, was still able to function at an acceptable level. My debilitating anxiety? Fine. Normal. Because I was able to “get over it”, I didn’t need the medication recommended to help me manage it. (Shout out Lexapro!) 

Let me ask you this reader: Why do you not want to help yourself? 

Oftentimes it comes from a deeper issue of a lack of self-compassion, or a desire to punish yourself for some perceived fault(s). One of my favorite tools to use is double standard: If a friend came to me and told me that they had been feeling this way, would I tell them to wait? Would I say that it isn’t bad enough yet? I certainly wouldn’t, and I sure hope that neither would you. 

We live in a world where self sacrifice is admirable, and often boasted about. Even the simplest things, such as sleeping the least to study out of your friend group, can turn into a competition. And that’s hard to break out of! But a few things to keep in mind: 

1. Who benefits from you struggling? Are you a better friend or family member because of your pain? (Probably not).  
2. Who is harmed by you seeking help? Me choosing eating disorder treatment was a big choice, and did cause some disruption in my personal life. But in the grand scheme of things? No one was suffering every day I woke up and went to my sessions. 
3. Is no progress (or the risk of getting worse) better than a little bit of progress? If you’re at a 5, but think you shouldn’t ask for help until a 7, why not? If seeking help at a 5 will help you, you should do it. The truth is that by the time you get to a 7 you may not want help, or that help may have to be more intense, and recovery may take longer. If something will help you, you should do it. 

Sure I started recovering from my eating disorder at a point where I may not have physically looked the way I wanted to, or felt miserable enough that giving up would be “worth it”— before I reached a mysterious quota that my brain would have finally been approved of. But I’m happier anyways. My relationship with food is better. I’m able to focus my energy on other things rather than chipping away daily at my body, my brain, and my heart. And the better I feel, the more I want to recover. It’s a decision I have to make every day, and it’s one that I will continue to choose, every day easier. I hope that you can make that choice too.