Meghan Doll weighed less than 90 pounds. At five feet, two inches, even considering a small frame, even at the low end of the scale, even though she was just 16, the Yorkton Regional High School Grade 11 student was dangerously thin.
Despite that, what she saw was a fat girl.
"I was very self-conscious about my abdominal area especially," Meghan explained. "If I stood in front of the mirror and just focused on it and focused on it, your eating disorder kind of makes it appear larger. I wouldn't call it a hallucination, but I've talked to other girls who have gone through what I've gone through and have recovered just like me. We can all say we looked at ourselves and you see something different than what others see."
Eventually, Meghan would be diagnosed with Anorexia Nervosa for the second time—the first time, when she was just 10 years old, her parents, Michael and Lynne, were able to quickly deal with it.
But "Ed," as Meghan anthropomorphizes the disease, was still lurking, just waiting for an opportunity to creep back into her life. It is very difficult for people who have not been through it to understand the perceptual dissonance eating disorders frequently entail, but it is very real to victims.
"It's hard to wrap your head around and it's hard to explain," Meghan said, "Now, looking at those pictures of me, I'm like, 'wow, I did not look like how I thought I looked.' So, literally, you do see yourself differently."
Anoxeria Nervosa is actually a bit of a misnomer. Anorexia literally means 'loss of appetite' and nervosa makes it a 'neurotic' loss of appetite, but among diagnosed patients, those with actual appetite loss are a minority. More typically, they simply deny their hunger—or feed Ed instead of themselves as Meghan suggests in her nutrition and fitness blog "A Dash of Meg."
Meghan got very good at denial.
"I just wouldn't allow myself food," she said. "I just kept making little excuses for myself, like, 'I don't have a problem unless I start doing this,' and 'I don't have a problem unless I start doing that.' I never ever made myself throw up or anything, but it was to the point where I kept having those thoughts and then I had to keep convincing myself not to do it because I was, like, 'Meghan, you said you'd have a problem if you did start doing that.'
"So, I would never allow myself to do that. The times I came so close to doing that behaviour, I was, like, 'wow, maybe I do have a problem."
The point came that she couldn't deny it any longer. She and a cousin were watching a movie together and the cousin was snacking on one of their favourite treats, which she offered to Meghan.
"I physically could not put my hand in the bag," she said. "All my thoughts going through my head were, 'if I have some of those, M&Ms I think they were, I'm going to have to go make myself throw up and I knew since that was my only out, I had an issue."
The next day, she came clean to what her parents already knew. She had an eating disorder.
They took action immediately, the very next day.
"We found out through the health district there was a place outside of Saskatoon called Bridgepoint," Michael explained. "We took her up there and dropped her off. They just wanted to keep her for four or five days to see what's going on and we stayed in Saskatoon.
"That night she phones us and she's very upset. She says, 'I don't belong here' because it's sex addicts and alcoholics, druggies, all that stuff and that wasn't the right environment for an eating disorder."
Meghan figured she could do it on her own, but not without the help of a dietician. Her fear of food and extensive knowledge—what she calls "too much" knowledge—of the nutritional content of food made her untrusting of her parents.
"For some reason I thought dieticians, I'll be able to trust them," she said. "They could tell me to eat the exact same thing as my mom, but they have gone to school and they actually know what I should be eating."
Michael was not giving up on getting his daughter professional help, though. On the Internet he found a place in Brandon, Manitoba called Westwind Eating Disorder Recovery Centre. Meghan was skeptical based on her experience at Bridgepoint, but agreed to meet with Bryan Gusdal, a clinical psychologist and founder of the centre.
"We took her there," Michael said. "We had a family meeting with Bryan, then Meghan went into a room with Bryan. She was in there about an hour. When she came out her eyes were big and she said, 'he so gets it'."
For more than a year, Meghan was an outpatient at Westwind and continued to work with her dietician.
The causes of eating disorders are not well understood. Most experts believe it is a combination of genetic, psychological and environmental factors. Although there is little clinical evidence to suggest traumatic events may trigger an eating disorder's onset, Meghan can pinpoint the very day her spiral began with a death in the family.
"My grandpa and I were so close," she said. "I saw him that day and we were making plans to see each other at Thanksgiving and we had a phone call that he passed away. It was just a really twisted way of me coping with being depressed. It was almost like a felt like I didn't deserve to eat because I should be sad about my grandpa."
It became a vicious cycle of depression, low self-esteem and obsession, she said. Not eating would make her feel temporarily better, then the self-consciousness would kick in and feed the obsession not to eat, which would make her feel temporarily better and so on.
Today, Meghan, now 22, credits Westwind and her dietician with saving her life and turning her on to a completely different path. As depressed as she once was, she now brims with positivity and optimism. She shares her story unabashedly, reaching out personally and through her very popular blog, with the hope of helping others who struggle with eating disorders.
"I've never had an issue about being open about this kind of stuff," she said. "I'm not embarrassed because I never chose to have an eating disorder, it developed. It happened to me and I recovered and I can talk to people about it."
The road to recovery is long and difficult, however. In fact, it's ongoing.
"When I started with a dietician I was on a meal plan and I kind of stuck to a meal plan for five years," Meghan said. "Just recently, I kind of learned to eat like a normal person."
Next year, Meghan plans on taking her helping of others to a professional level. In September she will enter a program to become a Registered Holistic Nutritionist with the goal of opening her own practice in 2014, building on the four-year nutrition and dietetics program at Brescia University she just completed this past spring.
She also plans to add a personal training certificate to her qualifications so she can offer a complete nutrition and fitness package.
Beyond that, she wants to have a family, write a book and appear on TV "at least once."
For those who may right now be suffering, Meghan has the following advice: "You're never going to get anywhere unless you're uncomfortable. That's a big, big, big thing when you're recovering from an eating disorder. If something scares you, you better be doing it."