Seattle Children’s Eating Disorders Recovery Program diagnoses and treats children and teens with anorexia nervosa, bulimia nervosa and other eating disorders.
In this edition of On the Pulse, 19-year-old Emme shares her personal experience at Seattle Children’s – from diagnosis to ongoing recovery, and the lessons learned along the way.
[Content Warning: The following article describes a patient’s journey with an eating disorder and may be difficult for some to read. We encourage readers to prioritize their own mental and emotional needs in reading this story. Resources have been provided following the article.]
Unprepared for the sudden emotions that Dr. Yolanda Evans’ words would evoke, I felt a tear well up and roll down my cheek when she said, “Emme, you are a miracle.”
I looked her in the eye and responded with ‘thank you,’ as a powerful surge of hope and gratitude penetrated my outer shell.
Developing my eating disorder
Flash back three years prior to when my eating disorder journey began. It was March of 2020, and the spring of my junior year in high school, as well as college scouting season for high school track.
Determined to shave my times fast enough to impress Division I coaches, I began researching racing body weight. After a few quick Google searches, my naive understanding was that the lighter and leaner I am, the faster I would be.
Riding on this belief, I started tracking my calories using a fitness app, while simultaneously training harder with higher mileage.
Initially, my racing times improved. Countless people praised my willpower and self-discipline, impressed by my drive to push one mile farther than my competitors and vehemently adhering to cutting out all desserts and added sugars from my diet.
Unintentionally, their comments encouraged me to dig deeper into a pit and things snowballed quickly.
Losing weight became an obsession, and the onset of the COVID-19 pandemic only worsened my situation. In the isolation of quarantine, it was easy for me to hide myself from friends, teachers, peers, coaches and teammates as I whittled myself deeper and deeper into an eating disorder.
I felt my health diminish. I became chronically freezing cold. Food became the pinnacle of my mind, a mental craving. I noticed my hair falling out as I ran the comb through it. I felt fatigued on my runs. My race pace slowed, and workouts felt harder.
I also had trouble concentrating on schoolwork. I never felt like going out, isolating myself from my friends and family. TV shows, funny memories, stories and games that used to make me laugh could hardly draw a smile. I felt afraid.
First hospitalization
In August 2020, I was hospitalized at Seattle Children’s for the first time. Flagged for a critically low heart rate, I was unexpectedly rushed to the Emergency Department (ED). Entirely disoriented by the blinding lights, blur of nurses, vitals, EKG machines, IV drips and lab work, I felt cold, confused and terrified.
The physicians diagnosed me with anorexia nervosa. The prognosis was several weeks of bed rest, medical monitoring and nutritional restoration. Burdened by a diagnosis so riddled with stigma and misconception, I immediately rejected it.
I denied the physiological symptoms when the doctors questioned me, and I convinced my parents that I was fine. However, my feelings were suspended between two opposing parts of my mind: my eating disorder and myself.
While the eating disorder part of me fought the diagnosis, meal plan and bed rest protocol, simultaneously, the Emme part of me felt deeply relieved. Relieved to be forced to eat and rest. Relieved that there was indeed something medically wrong and I shouldn’t be feeling this way. Relieved that there were doctors who understood my condition even before I was willing to accept it.
The descent
After I was discharged from my first hospital stay, I attempted to continue weight restoration and recovery on my own at home. My parents prepared all my meals for me based on Seattle Children’s discharge meal plan.
As an emerging adult, this extra attention made me feel helpless. Meanwhile, my eating disorder began roaring louder and louder within me as I was urged to restore my weight. It began controlling my every decision, plaguing my actions with dishonesty and secrecy.
Throw away that granola bar while no one is looking. Tuck the bread roll under your napkin. Tell them that you aren’t hungry. Go work out in your room to burn off your lunch.
It only took a couple of months for me to realize that I was indeed suffering from anorexia nervosa. I felt a knot form in my throat as my eyes glazed over the WebMD symptoms. How could I tell my parents? How could I tell anyone?
After dwelling on it for a couple of days, I confronted my mom and dad. I told them that I had been sneakily throwing away the meals and snacks they prepared for me because I really didn’t want to gain weight. I told them that I was scared. It was hard for me to admit to myself and even harder to admit to my parents. All my life I wanted nothing more than to make them proud, and now I felt like the biggest disappointment.
Second hospitalization
A few months later, in November 2020, I was hospitalized a second time for bradycardia. Once again, I was sent to the ED — only this time I would stay in the hospital for a full month, double the duration of my first hospitalization.
As I huddled in my hospital bed, I felt suffocated by loneliness and shame. Yet it was during those weeks that I encountered the touching kindness of the physicians who cared for me: Dr. Sara Khan, Dr. Katie Kazmier and Dr. Evans. They were gentle and patiently answered all my questions about why my body needed this treatment.
Despite the profound distress of hospitalization, the staff engulfed me with compassion. For the first time, after months of uncomfortably suffering the effects of malnutrition, I felt safe, exposed and accepted.
My parents and the team at Seattle Children’s suggested I pursue higher levels of care after discharge but ultimately left the choice up to me. When confronted with the option of residential treatment, I immediately felt the same feeling of profound relief and gratitude.
Deep down, I wanted treatment badly because I felt afraid of the person I was becoming. I missed the happy, honest, compassionate, playful Emme, free of an eating disorder.
I was immensely relieved that the doctors recognized the severity of my condition and so thankful that they educated me and my family on the benefits of attending a residential treatment program. To this day, I am beyond grateful that my mom was willing to take a leave of absence from work to coordinate with recovery programs and support in every way possible.
Residential treatment
After discharge from my second hospitalization, I enrolled at the Eating Recovery Center (ERC) in Bellevue, Washington, where I spent eight weeks in residential treatment. During this time, I learned cognitive behavioral therapy, dialectical behavioral therapy, mindfulness, acceptance and commitment therapy, and acquired countless new coping strategies.
Most importantly, I encountered a community of incredible peers from diverse backgrounds all fighting the same battle alongside me. Our shared struggles united us in unique ways. Together, we were stronger.
Through nutritional restoration and cognitive therapy, I felt my body come back to life. I felt my energy and personality come back. I felt more present in the moment. My concentration improved. Laughs came more easily. I no longer fixated on food. I came out more resilient, authentic and joyful on the other side of the ERC.
My ongoing recovery
Nevertheless, recovery remains a lifelong journey. As a 19-year-old University of Washington student, I still struggle with food and exercise.
Each week, I meet with my therapist and dietician and visit Dr. Evans at Seattle Children’s. Dr. Evans is my guardian angel. She has stuck by my side throughout the entirety of my three-year eating disorder journey. In some of the scariest moments in my life, she has offered me her whole heart in empathy and encouraging support. With a gentle disposition and a warm smile, she gives me the courage to persevere.
In combination with my loving family and friends, my extensive support network has helped guide me through the highs and lows of my ongoing recovery; I am forever grateful.
My takeaways
While I would never have chosen this path for myself, I am grateful for the mindfulness and resilience I cultivated in the fight. We are only as strong as our hardest battles. I will carry the lessons I learned along the way throughout my entire life. Here are a few key insights I gained:
I learned the importance of human connection, love and a sense of belonging.
The isolation of COVID played a major role in the development of my eating disorder. Humans are biologically, cognitively, and spiritually and emotionally wired for connection. Without it, we break down.
I learned to do what makes me happy in the present moment.
Instead of doing what I think will make me happy in the future, I focus on what makes me happy right now.
I learned to never take my life for granted.
I have been blessed with loving family and friends, an exceptional education and a beautiful Earth to explore. While in recovery, I began a practice of writing down three things I am grateful for first thing when I wake up in the morning.
I learned that imperfection is part of the human experience.
Striving to be a flawless student, athlete, daughter, teammate, friend and sister only left me crushed by the weight of my own expectations. The fact of the matter is that perfection is not a prerequisite for worthiness. Every person is worthy right here and now.
I learned the importance of sharing my story.
Shame loves secrecy and hates it when we reach out and share our stories. Sharing my story with my family, friends, teachers and coaches makes me feel totally exposed and completely loved and accepted at the same time. While embracing my vulnerabilities is risky, it was not nearly as dangerous as giving up on love, belonging or joy.
The time I’ve had to reflect on what really matters has helped me realize that I was living like I was afraid to fail, avoiding rejection at all costs, and passing up opportunities that scared me. I measured my self-worth by my GPA, running times, weight, varsity letters and class standing.
But these numbers don’t speak to my values. Moving forward, I strive to learn from my experiences, embrace my vulnerabilities, live out my values and encourage those around me to do the same.
About Seattle Children’s Eating Disorders Recovery Program
Eating disorders are closely tied to a young person’s physical and mental health. Families come to Seattle Children’s Eating Disorders Recovery Program for medical and nutrition concerns, mental health concerns or both. The team provides care in several formats to meet families’ needs, including telehealth.
The Eating Disorders Recovery Program offers two main paths for clinic-based (outpatient) care. One path is focused on medical and nutrition care through the Adolescent Medicine team. The other is focused on mental health care through the Psychiatry and Behavioral Medicine team. In addition, Seattle Children’s also provides hospital-based (inpatient care) for applicable patients.
In 2022, the Eating Disorders Recovery Program with Psychiatry experienced significant expansion with the support of philanthropic funding. The team has worked hard to expand treatment offerings in both the inpatient and outpatient settings, which has drastically reduced wait times and increased capacity for wraparound care.
