What really happens behind closed doors in an eating disorder psych ward?

As written by Meggie Sutherland Cutter

Trigger warning: This post contains details some readers may find distressing. For support Mamamia urges anyone struggling to contact The Butterfly Foundation.

I spent a couple months at a psychiatric hospital when I was eighteen. Where I was being treated, the eating disorder patients were treated separately from other patients. The facility I went to specialised in eating disorders.

I had no idea what to expect when I got there. When I first arrived and was checked in, I was evaluated physically from a doctor. They had to see how much muscle loss I had from malnutrition. They also had to take my blood pressure, get my weight, take my blood and get a urine sample etc.

I was also evaluated by a psychiatrist. Soon after I was taken to my room if I remember correctly. In my room, a nurse came and looked through all of my luggage. They have to check to make sure you aren’t hiding anything that you could self harm with. Mobile phones were taken away, as well as chargers or any cords you could possibly choke yourself with, no razors for shaving either. The door to my room had to be kept open at all times.

"In the private rooms, a nurse came to check on us every 15 minutes at night, every 30 minutes during the day." (Image: Instagram)

These were private rooms for new patients in the treatment centre. I also was not allowed to go to the bathroom by myself. There had to be someone present to make sure you weren't throwing up or self harming in some way. That was the first part of treatment. The new people stayed in that area, separate from the people who had been there for weeks or months. You could move into the house with the other women when you progressed in treatment.

In the halfway house everyone had a roommate. Some women lived there and only went to treatment for part of the day, and went to work for the rest of the day. Most of the women in the house were in full inpatient treatment however. If you were living in the house you had more free time, and on Saturdays there were scheduled group outings to places like Target, or occasionally a restaurant, always with a therapist chaperoning.


The first few weeks of treatment were more restricted. In the private rooms, a nurse came to check on us every 15 minutes at night, every 30 minutes during the day when we weren't going to groups. This was to ensure that I or any of the other patients hadn't killed themselves. Sounds gruesome, but this was a hospital treating people that were emotionally overwhelmed and struggling, so it wasn't that surprising.

Every morning they’d check my vitals, laying down, and then standing. This was done throughout the day the first few weeks. Then the dreaded weigh in every morning, which was stressful for every patient. Most were on blind weights, meaning the nurse didn't allow them to see how much they weighed. Knowing you were gaining weight, and then having to actually see it on a scale was way too terrifying for an eating disorder patient.

It sounds silly, but you have to look at an eating disorder like an addict. It's like being an alcoholic. If you are in an inpatient facility for an eating disorder, your life is definitely not manageable, and you have no control over your addiction. It's like a self destructive coping mechanism, just like an alcoholic uses drinking as a coping mechanism.

"For an eating disorder patient, knowing you are gaining weight and seeing it on a scale is terrifying." (Image: Instagram)

The addiction is starving your body and having control over something in your life, when you are emotionally living in chaos.

The newer patients still had group therapy throughout the day with the other patients. There were different kinds of group therapies, and individual therapy as well. I really liked cognitive therapy personally. We also met with a nutritionist every week to discuss our meal plans. As time progressed, more foods would be added.

We had set breakfast, lunch and dinner with three snacks. There were always volunteers, or therapists sitting at the tables. The volunteers were usually former patients. We were sat with at meal times for a few reasons. One, they monitored us to make sure we weren't practising eating disordered behaviour. Things like eating too slow, eating too fast, cutting up food into tiny pieces, or hiding food so you wouldn't have to eat it.


Listen: Meshel Laurie talks to a woman about her experience living with atypical anorexia nervosa (post continues after audio...)

People that have been struggling for a long time with an eating disorder are experts at appearing to be eating. The other reason was to encourage us and help us eat without having a full on panic attack. I've seen a lot of women sobbing just trying to finish a few crackers on their plate. It sounds nutty, but it’s a very real illness.

It was really horrible in some ways, at least at first, and really enlightening in others. The biggest adjustment for me, was the complete lack of privacy, and all of your freedom taken away. To be an adult stripped of all your freedom, and all your decisions being made for you is actually really frightening. It's hard to describe.

For me I kind of quickly snapped into survival mode. I did whatever I needed to do to get through it and get out. I learned how adaptable I really was in weird circumstances. The thing is, the lack of control was part of the process. Excruciating in some ways and at times, annoying, but beneficial in the long run.

"It was really horrible in some ways, at least at first, and really enlightening in others." (Image: Instagram)

I saw a few skeletal people that frightened me when I looked at them. I was sick just like them, but seeing someone who was in their early forties but looked like a skeletal eighty year old was jarring to say the least.

Everyone really gets to know each other because you’re in treatment all day long talking about anything and everything. All the traumas and abuse everyone's had in their life, and everything that you don't really discuss in general with people, is brought out to be talked about. You can form really strong bonds with people that understand exactly what you’re going through, which is nice. Most people you meet won't have any understanding of what an eating disorder is like. They’ll say things like, “ Just eat a cheeseburger,” so it's nice to find other people who don't judge you, and are empathetic.


It's not all gloom and doom. There's laughter, comradery, and joking around and the shared fears and struggles. One of my friends from treatment referred to it as hamburger jail. Occasionally even laughing at yourself at times for how skewed your thinking is.

"If you are really struggling with an eating disorder and you’re thinking about getting help, do it." (Image: Instagram)

The greatest moment you may experience is letting go of the fear, and finding relief. Relief that you are finally getting the help you need, and you aren't hiding it anymore. You aren't alone, and there's help out there. That is a really hard place to get to with this struggle, however. The first few weeks I was convinced I wasn't sick, and everyone in treatment was crazy and far more ill than I was. I think this is pretty common in the beginning.

I’d say the greatest aspect of treatment is the self awareness you gain. I actually think everyone would benefit from therapy whether inpatient or outpatient even if they aren't sick. You really learn so much about yourself, family dynamics and human nature, that it’s life changing in many ways. You get to the core of why you are sick, and learn tools to deal with your emotions.

If you are really struggling with an eating disorder and you’re thinking about getting help, do it. I would go to a treatment centre that specialises in eating disorders if possible. It's a very strange illness in many ways, and there are so many idiosyncrasies. Things like behaviour at meal times, nutrition, etc. These are things that are focused on in an eating disorder treatment program. I'm not sure if you’d get the help you need in a psychiatric hospital that wasn't focused on ED’s specifically.

This was my experience, I hope it was helpful.

This post originally appeared on Quora and was republished here with full permission.

If you or a loved one is suffering with disordered eating, Mamamia urges you to contact The Butterfly Foundation, here.

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