Stigma: Or Why I Can't Shut Up About It

It's funny, in a way. I've spent the bulk of my career trying to reduce stigma around mental illness and behavioral health.

But somehow it's different when it's yourself. 

Which almost makes it feel worse. Because wow, I spend all this time breaking down stigma, and yet I won't discuss it. 

No more. 

I used to think that I covered behaviors really, really well. But then you notice those things from others that reflect that you aren't covering as well as you think. 

• When you're out to dinner with someone you're meeting in person for the first time... and she pegs you as having issues with food restriction when you start breaking the pieces of your entree apart. 
• When a colleague preemptively suggests that they'll split a cookie with you so you don't have to get it on your own.
• When it's your last day at your job, and the manager apologizes for not bringing in doughnuts, so you laugh it off as "I wouldn't have eaten them anyway!" ... and your colleagues laugh in agreement. 
• Or when your new boss asks a week into the job, "So what do you eat?"

Here's the reality: I'm a real-life, full-fledged nearly 38-year-old professional who has issues with food. 

And no, in response to the second therapist I saw in Pittsburgh, I don't binge. But that was enlightening to see the bias even among practitioners -- that there was/is a perception that if you're not thin, you must binge. When the reality for me is that I'm quite on the opposite end of the spectrum. 

Like I've explained to provider after provider: It's not that I don't think I need to eat. I just don't think I need to eat as much as everyone else thinks I need to eat, and my life as it pertains to food tends to involve a series of very precise calculations. The odds are good that if I'm out with someone, and I'm eating a full meal, that I'll have nothing the rest of the day. Or that I'll have a small salad, with precisely weighed lettuce and a bit of organic turkey. Or that I'll go out for a long run -- or that I'll have just come from a long run.

That's the part that gets exhausting after a while. 

Always doing the math. What have I burned. What can I burn. What have I eaten. What can I eat. 

Whether I've gone for a run or a swim or to barre, and whether that balances everything out. 

What I'm going to do if I travel, or if I can't make a workout. How I'll mitigate that anxiety if something interferes with my plans or calculations. 

The almost funny thing is that when you're in this way of thinking, but you've gone from being on the heavier side (although apparently still far below the U.S. average ... not that anyone has ever accused me of being average) to the slimmer side of the healthy weight spectrum, no one seems to really notice what's going on -- and really, I don't blame them, since I maintain the issue is that it's just the thought process that's paralyzing. 

Where stigma comes creeping back in? The mental math gets more power, since I figure that hey, if this were an issue before now, someone would have said something. But instead, since dealing with a resurgence of issues over the past few years, I've been commended for losing weight and making "healthy choices," lauded for a "fitness transformation," and praised for having an almost encyclopedic knowledge of food. 

But now I'm finding myself back on the other end. Where now, apparently people think this is a problem, and there's no lack of opinions on my current weight or state of eating. And I don't tend to believe any of them, because from my perspective, I'm doing what I've always been doing, but with perhaps a little more precision. 

That's why it's time to talk about it. Because the media and social media show an eating problem as being that emaciated anorectic, or the 600-pound individual with binge eating disorder. Or the bulimic who binges, and then purges to make it all go away. 

But there's more to it. And that conversation needs to happen. 

And if I can't break down misconceptions, who am I to ask anyone else to do it?