Do you think this girl has an eating disorder (ED)?

By Mona Iguchi, BS-Honors, MS, Japan

Nearly 100% people would say, “No”.

So did her insurance company.
So did the medics on the ambulance.

No wonder though. She looks quite healthy and happy physically and mentally (except for the fact that this picture was taken at emergency room when I busted my knee (of course by accident) for the second time and got an apple-sized knee!).

But the truth is… not only is she suffering from an ED, she is majorly depressed, she is cutting herself and thinking about overdose (OD) and other suicidal behaviours almost 24/7. And, I know that very well because this is me, two years ago, 2014, about two months before I hit the bottom both mentally and physically.

But the truth is… not only is she suffering from an ED, she is majorly depressed, she is cutting herself and thinking about overdose (OD) and other suicidal behaviours almost 24/7. And, I know that very well because this is me, two years ago, 2014, about two months before I hit the bottom both mentally and physically.

Why do I mention my nationality?

Recently, Dr Nishizono-Maher wrote a great article describing how people get surprised to know that there are people with EDs in Japan.

This article describes the situation accurately. And ED is not understood in Japan. I have met many Japanese who had not heard the term “Eating Disorders” ever in their lives. However, the fact is there are many Japanese who struggle with EDs, just like Dr.Nishizono-Maher says in her article.
I had at least four classmates at my high school who obviously had an ED and they are Japanese. So am I. I am Japanese and I did have an ED.

EDs do not discriminate

The thing with EDs and many other illnesses is that we can hardly tell if and how much someone is struggling. That’s why I said obviously earlier.

In this picture, I look just fine. Just a random Asian girl, smiling at the camera relieved after being told that my knee which was operated 1.5 years prior to this day was just inflaming like crazy.

But two months later, I found myself sitting and shaking in a freezing room at ER of psych unit, to where I was sent after taking an OD two days before my 22nd birthday. It was a traumatic experience in many ways, and I spent my birthday of that year at psych unit, but that still did not stop my ED, major depression and suicidal thoughts from taking over my life.

In fact, only two weeks after that, I was frantically running around the campus and town to sort out final exam schedules and for other errands, while making many calls, and boarding the plane to get to the ED inpatient/residential treatment center.

The paramedic said: You don’t look like you have an ED

I was that sick, but nobody could see that coming except for my life-saving therapist, because I didn’t look like I was ill and my symptoms were pretty much invisible. On the ambulance, paramedic told me, “You don’t look like you have an ED. Hmmm, might… be… bulimic or something, yeah?”

Even though I was quite drowsy from ED and OD, I heard what he said very clearly.

Again, EDs do NOT discriminate.
The paramedic got lucky, but he could’ve been wrong because I could have looked the same with a diagnosis of “atypical anorexia nervosa” instead. But even many medical “professionals” are not aware that EDs do not discriminate.

BMI does not tell anything about one’s mental health or struggle

After a few weeks into the inpatient treatment, I got Notice of Denial from the insurance company saying, “Your current weight and BMI are not medically compromised at this time”. I was literally shocked by that reasoning of denial to cover my treatment cost. I could not believe my eyes because I thought “professionals” would know that BMI des not tell anything about one’s mental health or struggle. In fact, it can be quite inaccurate even as a physical health measurement.

A couple months later I left the treatment center, I got a large bill (the cost there was $1500/day, so it’s easy to assume what the total would be like…) not only once, but three times, even after I and treatment center were told that the cost would be covered.

Luckily, I was able to figure things out and six months later when I left the center, I did not have to pay, but the fact that I got a denial letter with such an unprofessional reason does not change. And this needs to stop happening. Again, EDs DO NOT DISCRIMINATE.

World Eating Disorders Action Day, June 2

If I did not work on my recovery in the U.S., I honestly would not be alive now. The frequency of ED behaviours and duration I had ED was long enough to be categorized as sever and enduring. However, there is nothing available in Japan and there is ridiculously long waiting-list in the U.K. (unless you are able to pay privately).

As a recovered and bilingual individual who luckily got exposed to ED fields in multiple countries, both as a patient and as a student-to-be-clinician, my hope is to keep raising awareness and to help people gain non-biased right understanding so that the best possible treatment in each country/culture become available and accessible one day, hopefully sometime soon.

That is why I participate in #WeDoAct and #WorldEDDay.

About Mona Iguchi
(Translator/Interpreter, BS Biology-Honors, MSc Eating Disorders and Clinical Nutrition, Mentor at MentorCONNECT)

I suffered from multiple types of EDs, mainly BN, for a decade and am now fully recovered. I am originally from Japan but received all of my ED treatments in the USA while I was an undergraduate student there. Now, I am a MSc student in Eating Disorders and Clinical Nutrition at University College London. My aim is to become a registered dietitian specializing in EDs; meanwhile I volunteer at ED organizations as a mentor and helpline/e-mail supporter to mentor/support/empower people to be a warrior. I also recently translated a book, Eating in the Light of the Moon, by Dr Anita Johnston into Japanese, which will be published in June 2016.

Japanese blog: http://ameblo.jp/naia415/
Twitter: @MonaiaRecoverED

Join Mona in supporting World Eating Disorders Action Day. Be sure to follow along on Twitter @WorldEDDay and hashtag #WeDoAct, #WorldEDActionDay, @WorldEatingDisordersAction on Instagram and World Eating Disorders Action Day on Facebook.