How anorexia nearly killed a McMaster nursing student

It was a nightmare scenario for a 13-year-old girl concerned with image, body weight and boys.

Marina Abdel Malak liked a boy who didnt like her back, and his reason was particularly cutting herweight.

Abdel Malak, 21, has never really been overweight. But she was in eighth grade when she got a friend to act as a go-between between her and a boy she liked.

He said, I could never date Marina because her thighs are too fat, Abdel Malak recalls.

That was tough for me, being 12 or 13 years old. I thought, No one is ever going to like me because my thighs are too fat.

Weight has been a chief concern of Abdel Malaks ever since. The McMaster University nursing student is recovering from anorexia, a condition that got so severe three years ago that she stopped breathing and her organs began to shut down. She has since written a book, Recipe for Recovery: How I Battled and Overcame an Eating Disorder and You Can Too!, about her experiences.

Abdel Malak grew up in a good family in Mississauga, but it was a family concerned with food. Her family was always dieting, always struggling with what to eat and when, and she had an uneasy relationship with food.

That became more uneasy in Grade 9, an age when girls measureand compare themselves withother girls. At her all-girls high school in Mississauga, the teachers publicly weighed the girls in her gym class. The girl in front of her weighed 80 pounds and everyone congratulated her, AbdelMalak said.

AbdelMalak, 53, stood on the scale and was 60 pounds more than the girl everyone applauded.With my weight, it was just silence."

She began dieting, eating mainly fruits and vegetables, drinking more water and resisting dessert. She lost some weight and everyone told her how great she looked.

I felt like if five pounds could do this, how much could more restriction do?

Too weak to lift her school bag

She cut out more and more foods, then started cutting out meals. When she began McMasters nursing program, she was in the throes of her eating disorder, but AbdelMalak absorbed herself in her school work to ignore the hunger pangs.

If I ever felt hungry, Id just say no, I have to study, she said. If there was ever an event with food, Id just say I have to study.

By April, AbdelMalak was eating something small forbreakfast usually one cookie, she said and a tiny snack at night. When she finished exams and came home, she weighed 55 pounds.

Her right leg was so weak that she dragged her foot when she walked. Her parents had to support her when she stood, and carry her up the stairs.

I couldnt get out of bed on my own because I was too weak to lift myself up, she said. I couldnt carry my school bag.

Near death

Her parents forced her to go to the emergency room, but still, she didnt want to get help. Help would mean admitting her problem, and admitting it would mean having to eat. And eating would mean gaining weight.

When the hospital admitted her, her kidneys were failing and she needed dialysis. She was also severely dehydrated and couldnt breathe. As a nursing student, AbdelMalak knew why this was happening.

After the body loses its supply of glucose, it breaks down proteins, she said.

The only muscle I had left was my diaphragm, and my body started to eat away at that too.

She entered an eating disorder program in Mississauga with a goal to get back to school in September. After a few weeks, she signed herself out of the program. She saw its validity, she said, but it didn't feel right for her.

'I haven't relapsed and I don't plan on it'

There was a lot of competition among patients in the treatment centre and that really got to me. There was a lot of measuring how much weight we gained each week, and our meal plans.

She returned to school in September despite her doctors advice, but she continued to be monitored. And she started to read.

She read all she could about her eating disorder. She began blogging about her thoughts. She gained more weight, and more weight, and working on what triggered it, she said. And here I am.

She now sees weight loss not in terms of body mass or weight, but in terms of being healthy, she said. And she thinks not in terms of dieting, but lifestyle changes.

I havent relapsed and I dont plan on it, she said.

Entering the nursing world

General Store Publishing House in Renfrew published the book. The volume is not only her reflections on anorexia, but research and resources she has found.

When I explain it, I explain it honestly, she said. If there were days when I threw my plate on the floor, its in there. If there were days when I cursed everyone and wanted to die, its in there.

Abdel Malak finishes at McMaster in December and wants to work in community health based. And she plans to keep writing.

The book has earned kudos from Jackie Grandy, an outreach and education co-ordinator with the National Eating Disorder Information Centre.

Marinas message that full recovery from an eating disorder is possible is inspiring, she said.

An excerpt from Marina Abdel Malak's book:

June 2003:I am ten years old. (Ever since I was a child, I was always on the chubby side, but I always loved food. I did not eat unhealthy foodsI thoroughly enjoyed a variety of different foods with my family.)

On this particular day, I am at a big party for one of my sisters friends sixteenth birthday. I am spending the time with my sister and mom, eating and enjoying the music. I smile as I put the forkful of pasta into my mouthit is so delicious! The waiter comes around and asks if we would like anything else. I nod, saying that I want more bread and butter. He smiles and says he will come back for more.

Meanwhile, I look out on the dance floor and see all the older girls dancing with their friends. One particular girl catches my attentionshe is younger than the others, but just a couple years older than me. Everyone seems to love her, and they all ask her to dance with them. She is dancing gracefully and everyone is pleased with how beautiful and delicate she is. I frown. Something doesnt feel right inside of meI feel weird. I instantly look down on my plate and notice how much food I am eating. Then, something pops into my head:They are dancing with this girl because she is skinny. She is pretty and thin. But they do not want to dance with me because I am fat. No one likes to dance with fat girls.Then I start to tear up. But I do not want my mom or sister to notice, so I quickly hold back my tears. I stop eating, but by now the waiter has returned with the bread. I do not touch the bread, even though I really want another piece. I tell my mom that I am full and do not want to eat more; but inside, I am dreaming of that soft, warm, piece of bread.....