Katherine “Katie” Seal, 19, sat in a Kayak's Coffee & Provisions eating a slice of zucchini bread and drinking a latte, recalling her life-threatening bout with anorexia and bulimia.
It's not something she likes to discuss. “It's blurry now,” says Katie, 19. “I just remember it was not about the food. It was more, eating bad foods made bad things happen.”
Annie Seal, Katie's mother, sat knitting a scarf. She remembers every detail.
HOW IT STARTED
Symptoms began about four years ago for Katie when she was 15. She began to get distant, angry.
“We just thought she was an unhappy teenager,” Annie Seal said. “Just normal mother-daughter friction. We bought books on parenting.”
Then her parents saw her eat less and less at home. She became obsessed with calories and fats. She saw herself as fat, even though she was a healthy weight.
Her mood changed. She isolated herself. She lost friends and enthusiasm. Her food choices became black and white, good food and bad food.
“We'd bring home a pizza and she wouldn't eat any of it,” Annie Seal said. “Bad food.”
The family eventually learned that Katie was eating about 500 calories a day, then purging -- vomiting her meals in private. The process had damaged her young body.
Katie was diagnosed only as stressed and anxious, her mother said.
Annie Seal still can't believe that the doctor issued that diagnosis without speaking with any family member. “When I talked to the doctor, I asked her if Katie had told her about (any disturbing behavior) and the doctor said no, and … she said maybe she should take another look at the diagnosis.
”That was just criminal, criminal.“
The misstep delayed Katie getting into treatment for more than a month, Annie Seal said.
A physician at Cardinal Glennon Children's Medical Center diagnosed Katie's eating disorder in January 2008.
The doctor ”said forget returning to school -- start treatment now or she's not going to finish school,“ Annie Seal said.
The family chose McCallum Place, a treatment facility in Webster Groves.
The insurance company would only pay for outpatient treatment, even though the doctor at Cardinal Glennon said she needed residential care.
By the time she got into treatment, Katie's digestive system had gone into chaos, retaining fluids, inflammation and numerous imbalances.
”Her digestive system had shut down,“ her mother said. ”It just didn't work any more. It could be fatal.“
Because of the imbalances, people with some forms of anorexia and bulimia actually gain weight, Annie Seal said.
”We don't discuss her weight now, just her health,“ Annie Seal said.
Katie started an intense 10-hour-a-day program.
Nerinx Hall, Katie's high school in Webster Groves, helped her keep up with her studies.
Meanwhile problems persisted with medical insurance.
Every time Katie would improve and progress to another level of care, the company would cut her off and say she didn't need more treatment, Annie Seal recalled. ”Then she'd relapse and we had to start over -- three times this happened. They see it as a mental illness and they won't cover it as a disease.“
EATING DISORDERS
Eating disorders have the highest death rates among mental disorders, according to the National Association of Anorexia Nervosa and Associated Eating Disorders.
But death rates are undercounted, the association said, because death certificates list heart failure, kidney failure, organ failure, malnutrition or suicide, but not eating disorder.
Misinformation creates a stigma that anorexia is an emotional problem, mostly of young girls who want to look like runway models and be popular, Annie Seal said.
Untrue, she said. ”The girls tend to be high achievers, people who push themselves,“ she said.
Katie added, ”Everyone thinks it's something rich white girls get.“ Patients at McCallum were black and white, she said. Some were older; some were boys.
”It's a predominantly biologically based disease,“ Annie Seal said. ”But we don't treat it like a disease. We treat it like a secret.“
‘THE WHOLE FAMILY IS INVOLVED'
Seven months after being diagnosed, Katie was back to being the person her family thought they'd lost.
”With anorexia, the whole family is involved,“ Annie Seal said. ”She went to therapy, the family went to therapy.
“We all were in this together. As a family, it's brought us closer.”
Today, Katie is a sophomore at the University of Missouri-Columbia, majoring in sustainable agriculture with an emphasis on community food systems.
Since her daughter's bout with anorexia, Annie Seal has been advocating for Missouri to require insurance companies to treat eating disorders like a physical disease. Legislation has languished three years, she said.
She's part of the Dahlia Partnership, affiliated with the National Eating Disorders Association. In February, she plans to help lead a rally in Jefferson City to raise awareness.
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