CONTENT WARNING: Some listeners may find parts of this story talking about eating disorders difficult.
Tim Bromley is the director of Behavioral Health outpatient departments at OSF St. Francis Medical Center.
Bromley said eating disorders are unhealthy coping skills in people who may be dealing with anxiety and a lack of confidence. He said people who struggle with eating disorders often think and talk negatively about themselves.
“With that negative self-talk, they're often very negative about their body and about themselves as a whole, as a person. Quite contradictory, many of them are quite successful. They're good academically. Because they're more people pleasing and people oriented, they sort of look for outside measures to feel better about themselves, but all of them are fleeting, because they don't really change the way they feel about themselves in whole,” Bromley said.
Bromley said eating disorders are tangible ways for many people to gain control over parts of their lives.
“They say ‘well, if I lose weight, then I know I'm doing something, well. If I only eat 500 calories a day, I know I'm doing something well.’ So, becomes this tangible, measurable thing that they can kind of rely on a little bit to give them feedback about whether they're doing it well enough or not,” Bromley said.
Developing an eating disorder does not happen overnight.
Bromley said because of the “diet mentality” that everyone faces in day-to-day life, there are many societal messages that tell people to control their weight and their eating starting at young ages.
“...anorexia is developed usually in young adolescents, and then bulimia and other diagnoses come a little later, late adolescence or early adulthood. So, that's usually very formative years that they're trying to also figure out their identity, their self-image and all those things. So, those pressures and images that they have about trying to be perfect in that kind of way make it right for eating disorders to develop,” Bromley said.
Eating disorders impact millions of people each year. In the United States, the National Eating Disorders Association estimates that 20 million women and 10 million men will suffer from an eating disorder or eating disorder behavior at some point in their lives.
“Typically, eating disorder patients often do worse when they spend time only in their own head because all they hear is negative, and so they tend to isolate anyway. Some of them avoid eating situations, avoid comparison situations. COVID has really made it much more normal to isolate. So, with that we've seen a spike in people developing or having more significant difficulties with eating disorders.”Tim Bromley, director of Behavioral Health outpatient departments at OSF St. Francis Medical Center.
Bromley said the Peoria regional area is not immune to eating disorders. He expects more than 100,000 people struggle in the region.
He said the pandemic contributed to more challenges for people struggling with an eating disorder because of the isolation.
Bromley said, “Typically, eating disorder patients often do worse when they spend time only in their own head because all they hear is negative, and so they tend to isolate anyway. Some of them avoid eating situations, avoid comparison situations. COVID has really made it much more normal to isolate. So, with that we've seen a spike in people developing or having more significant difficulties with eating disorders.”
Bromley also said in the Peoria area over the last five years, there’s been a broader age range of patients.
“It's been it's becoming more common that people midlife develop eating disorders, which when I started 25 to 30 years ago, was not really very common. So, people are having different times in their life where they're sort of feeling insecure or reevaluating their sense of self and struggling with it,” Bromley said.
Peoria is a medical hub for Central Illinois patients...with outpatient care programs for people of all ages struggling with eating disorders.
The major in-patient eating disorder programs in Chicago, St. Louis, or Iowa City oftentimes have long wait lists.
Bromley said at OSF, 80% of patients are treated on an outpatient basis. This means patients have the options to see a therapist and receive nutritional counseling dietician services.
Bromley said there are two main outpatient programs for Peoria-area patients at OSF. The intensive outpatient program, or IOP for short, provides patients with two meals a day and in-person treatment during weekdays.
OSF’s Partial Hospitalization Program, or PHP for short, is a five day a week program that covers all three meals during the day.
Bromley said there are other community resources and therapists in Peoria that can also help.
Skylar Garey is a junior at Monmouth College. She was a patient in OSF’s PHP program last winter after struggling for years with behaviors which developed into a life-threatening eating disorder.
“I was diagnosed with anorexia. It never came from a point of necessarily bad body image. Growing up, I was always pretty confident in my body. I've always been an athlete and participated in sports my whole life,” Garey said.
Garey said she started to develop what she calls disordered eating when she was in high school running track and cheerleading.
Garey said, “Track and field and cross country are more of an aesthetic sport, meaning when an outsider looks on the TV, all the girls are usually lean and very muscular and tiny. So, that's when I kind of noticed that my body in my eyes did not fit the description of what I thought a runner and a cheerleader should look like.”
Garey said COVID hit when she was a senior at Metamora High School. Garey said being isolated at home allowed her more time to control what she ate. She said her journey with disordered eating began with comparing herself to professional athletes and battling orthorexia.
“…it's basically simple terms healthy eating to the extreme – healthy eating to where it's unhealthy pretty much anymore. I would eat, but I would only allow myself to eat certain things at certain times because I have this idea of, ‘Oh, if I eat a slice of pizza, then I'm automatically going to gain 10 pounds.’ ‘Oh, these pro runners don't eat cake and brownies every night. Well, I'm not going to do that,’” Garey said.
Garey said when she began her freshman year of college in 2020, she was undereating so much that she developed binge eating disorder. That's when people have episodes of eating large amounts of food in short periods of time.
Garey’s mindset about eating changed when she began her sophomore year of college.
“In my brain, my mindset was, ‘if I run, then I can eat,’ like ‘I can only eat if I run or workout X amount of minutes or hours.’ I was pretty lean. Then, like I said actually entering college on campus, I just had this huge fear of the dining hall,” Garey said.
Garey then had a Quad injury that stopped her from being able to pursue running. She said she felt like she lost everything when she became injured.
“I kind of had an identity crisis. So, I took on this coping mechanism of restrictive eating. Then, I started creating rules. I started isolating myself. I was diagnosed with severe anxiety and depression, OCD. I honestly just didn't want to be on earth anymore,” Garey said.
Garey said she became malnourished after her injury.
“It feels like you could break at any minute, like physically snap in half. You are so weak. You have literally no energy, like no energy to brush your teeth, to take a shower, walk to class because it feels like you could just fall because you're so malnourished,” Garey said.
Garey said anorexia means having brittle nails...and hair that falls out each time it’s brushed or washed. She said sleeping is difficult because your body only thinks about needing something to eat.
Garey said her parents made her enroll in OSF’s Partial Hospitalization Program. Before she began the program, she didn’t realize she needed help.
“It feels like you could break at any minute, like physically snap in half. You are so weak. You have literally no energy, like no energy to brush your teeth, to take a shower, walk to class because it feels like you could just fall because you're so malnourished."Skylar Garey, former PHP patient at OSF St. Francis Medical Center
“It was a really rough first day. But after we ate breakfast all together, we started talking with each other. I remember I first thought ‘wow, there's other people like me in this world.’ It was so comforting, knowing that I wasn't alone in this journey, and I wasn't the only one experiencing this kind of pain. Not so much physical pain, but just mental and emotional pain,” Garey said.
Garey said she had a wakeup call during one of her first days in the PHP program when the nurses were doing labs and blood tests. Garey’s blood sugar level was dangerously low.
“She [the nurse] said, ‘Okay, well, yours is at 30,’ and I said, ‘Okay, what does that mean?’ and she said ‘that means that you can die.’ She said ‘if you would not have come in here when you did, you could have easily died in your sleep,’” Garey said.
Garey said recovering from an eating disorder is a difficult process filled with ups and downs. For her, the first month in the PHP program was the hardest.
“It was so brutally awful. Eventually, when you start the refeeding process, and then you start getting more nutrients in your body, and you start gaining in that little bit of weight, you're able to think more clearly. Then it becomes so much easier, but that first month is very difficult,” Garey said.
Garey finished the PHP program in February. She said the support during the program is much greater than when you’re quote “in the real world.” But Garey said one thing that still helps her is separating herself from her eating disorder.
“So, I actually gave it a name. I call her Edna because it's helps me [be] able to differentiate Skylar from my eating disorder. Because Skylar loves brownies, Edna does not,” Garey said.
Garey said she goes to therapy weekly to continue fighting her eating disorder. She said it doesn’t matter how much you weigh … what matters is how you think about the recovery process.
“One of the phrases that I always repeat in my head is ‘no food will harm me as much as my eating disorder will harm me.’ That's one of the ones I like. Another one I love is ‘if I had the strength to stay in my eating disorder, then I have the strength to pull myself out of it.”Skylar Garey, former PHP patient at OSF St. Francis Medical Center
“One of the phrases that I always repeat in my head is ‘no food will harm me as much as my eating disorder will harm me.’ That's one of the ones I like. Another one I love is ‘if I had the strength to stay in my eating disorder, then I have the strength to pull myself out of it,’” Garey said.
Garey said she is a much more confident person now than she was a year ago, and that starts with addressing trauma instead of ignoring it.
Garey said, “Because you’re never going to heal from it if you just use drugs, eating disorders, excessive exercise, whatever it is to numb yourself from the pain of what you're feeling. You have to go inside of yourself and figure out ‘Why? Why is this happening?’”
Recovering from an eating disorder starts with finding people who can support one another.
Tim Bromley from OSF said two thirds of Peoria area patients typically recover pretty smoothly. He said the other one third of patients he sees usually can make significant steps towards progress even if they aren’t fully recovered.
“The majority of our patients go on to do great things. I mean, that that's one of the things I really love about this field is that we work with really talented and gifted people who just don't see it. And if we can help them to see it and help them get out of their own way, many of them do amazing things in their life,” Bromley said.
Bromley said treatment and recovery varies for each person, but usually, every patient has to address their fears, learn stronger communication skills, learn how to set boundaries, and prioritize their self-worth.
There are community groups in the area that can help people learn to think positively about their body. One group is the Body Project at Bradley University.
The Body Project is led by students at Bradley with the help of some faculty and staff. Danielle Glassmeyer is a Bradley professor who has helped coordinate events through the group for years. She said the Body Project promotes body positivity and challenges negative ideas and stigmas surrounding body image.
“The majority of our patients go on to do great things. I mean, that that's one of the things I really love about this field is that we work with really talented and gifted people who just don't see it. And if we can help them to see it and help them get out of their own way, many of them do amazing things in their life.”Tim Bromley, director of Behavioral Health outpatient departments at OSF St. Francis Medical Center.
“The students have a really strong sense of how to talk to others. When they have reached a good point in terms of body image and eating disorder recovery, if that's part of what their experience has been, they have a good idea about how to talk to each other,” Glassmeyer said.
Glassmeyer said the Body Project is not just for people who have faced an eating disorder.
Glassmeyer said anyone can struggle with feeling good about themselves and having a positive body image. She said it’s important to bring people together and encourage self-love in the fight against eating disorders and negative body image.
“The goal of anything that we do – exercise, thinking about mindful eating – that's about creating a space for ourselves where we stop focusing on appearances, our own or others, and start thinking more about the opportunities to be kind to each other, to celebrate each other, to make our world better,” Glassmeyer said.
Glassmeyer said it’s important to address stigmas about physical health and body image that can lead to negative self-talk and lead to eating disorders. She said to support one another, even beyond the Body Project, everyone needs to encourage inclusivity.
Bromley said society has a long way to go when addressing behavioral health stigmas, including stigmas about eating disorders. He said eating disorders vary per person, and people need to realize just because someone doesn't look sick doesn't mean that they're not struggling.
“I think people have a hard time coming into treatment, because they believe that if people find out they have a behavioral health disorder, they're going to be treated differently. So, we still are trying to overcome that stigma,” Bromley said.
Skylar Garey, a former OSF PHP patient, said recovery is not a perfect process for anyone. It requires baby steps towards putting yourself first.
Garey said, “I promise you that even telling one support person, one person that you trust, what you're going through and just finally admitting that you need help is going to change your life so much.”
Garey said any mental health struggle requires a support system, and she said it’s important to find people who can help you see your self-worth in the fight against an eating disorder.
The National Eating Disorders Association contact helpline can connect anyone struggling with an eating disorder with resources by calling or texting (800) 931-2237. The Helpline is not available 24/7, but anyone needing help can leave a message or text “NEDA” to 741741.