For nearly a decade, I struggled with an eating disorder I wasn’t sure I’d ever fully recover from. It’s been 15 years since I purged my last meal and I still sometimes wonder if complete healing is a goal I’ll achieve.

I’m kinder to my body now, and I don’t think I would ever again resort to the means I once used to control it. But my eating disorder is always in the background, a voice whispering in my ear that I’m never enough.

In the beginning, my eating disorder was more about control than anything. I had a chaotic home life, with an absentee mother and a stepmom who made it very clear she saw me as a black mark on her otherwise perfect family.

I was lost, alone, and broken.

I may have felt powerless, but what I ate and what I allowed to remain in my body after each meal — that was something I could control.

It wasn’t about calories or a desire to be thinner… at least, not at first.

Over time, the lines blurred. The need to control something — and the ability to control my body — became intertwined in such a way that a lifelong struggle with body dysmorphia was the inevitable outcome.

Eventually, I did the healing work.

I went to therapy and took the medications. I met with nutritionists and threw away my scale. I fought to get better, learning to listen to my body’s hunger cues and to never label any food as “good” or “bad.”

What I learned in eating disorder recovery is that food is just food. It’s sustenance for my body and a treat for my mouth.

In moderation, anything can be part of a healthy lifestyle. Pushing back against the voices that might say otherwise became a part of my path toward healing.

When I was diagnosed with stage 4 endometriosis a few years into my recovery, restrictive diets were suggested by doctor after doctor to help control my inflammation and pain. I found myself stuck between doing what was best for my body and still honoring my mental health.

Endometriosis is an inflammatory condition and research has, in fact, found that certain dietary changes can help manage it. I’ve personally been advised to give up gluten, dairy, sugar, and caffeine on more than one occasion.

My current doctor is a big fan of the ketogenic diet — a diet I hate to admit I have had great success on.

When I eat strictly “keto,” my pain levels are practically nonexistent. My inflammation is down, my mood is up, and it’s almost like I don’t have a chronic condition at all.

The problem? Sticking to a ketogenic diet requires a lot of discipline. It’s a strict diet with a long list of rules.

When I start applying rules to my eating habits, I run the risk of falling back into a disordered way of thinking and eating. And that scares me — especially as mom to a little girl I would do anything to protect from my past reliving itself.

My forays into keto always start innocently enough. I find myself in pain and feeling awful, and I know what I can do to fix that.

At first, I always convince myself I can do so in a reasonable manner — allowing myself room to slip up every now and again, without shame or regret, in favor of living my life.

Everything in moderation, right?

But that flexibility never lasts. As the weeks go on, and I embrace the rules more completely, it becomes harder for me to maintain reason.

I start obsessing over numbers again — in this case, my keto macros. Maintaining the right balance of fats to carbohydrates and proteins becomes all I can think about. And foods not within my guidelines suddenly become evil and to be avoided at all costs.

Even a decade removed from my eating disorder, I’m not capable of going down the path of food restriction without opening the floodgates to danger. Every time I try to control my food intake, it ends up controlling me.

According to Melainie Rogers, MS, RDN, founder and executive director of BALANCE eating disorder treatment center, what I’ve experienced is typical of individuals with an eating disorder past.

Rogers shares these reasons why being placed on a restrictive diet can be dangerous for someone with an eating disorder history:

  • Any type of food restriction can trigger someone into eliminating more foods than necessary.
  • The focus on food and having to be aware of what may or may not be allowed can trigger or worsen an obsession with food.
  • If someone has worked very hard to become comfortable and allow themselves all foods, the idea of now having to limit certain foods can be difficult to work through.
  • In our society, eliminating certain food groups can be looked at as dieting behavior that should be celebrated. This can be particularly triggering if, for example, someone is out to eat and chooses something that may be deemed “healthy” by diet culture terms, and a friend compliments their discipline. For someone with an eating disorder history, this can trigger the desire to partake in more dieting behavior.

For me, each of those points has been true in my attempts to embrace keto for my own health. Even to the point of people assuming that because I’m on a keto diet, I must be open to talking about weight loss, which, in general, is a dangerous topic of conversation for me to engage in.

My doctor doesn’t always seem to understand how dangerous restrictive diets can be for me. What she sees is a patient with a health condition that can be helped by making dietary changes.

When I try to explain why it’s hard for me to stick to it and why I feel my mental health wavering when I try, I can tell she sees excuses in my words and a lack of willpower in my unwillingness to commit.

What she doesn’t seem to understand is that willpower has never been my problem.

Harming one’s body intentionally for years takes more willpower than most could ever comprehend.

Meanwhile, my therapist recognizes what these diets do to my head. She sees how they pull me back down into a danger zone I run the risk of never escaping from.

My eating disorder was my addiction. That makes any type of food restriction a potential gateway drug.

So what’s the answer? How do I take care of my physical health while also maintaining my mental health?

“Doctors should be aware of eating disorder symptoms and any history, and hopefully understand the emotional and mental impact these disorders have long-term,” says Rogers.

When prescribed a restricted diet, she suggests finding a registered dietitian and therapist to work with while implementing these new lifestyle changes.

While I’ve spoken to my therapist about the struggles I’ve had, I have to admit, I’ve never gone quite so far in ensuring I had so many supports in place prior to starting a restricted eating plan. I’ve seen nutritionists in the past, but it’s been years. And I also don’t have a current psychiatrist monitoring my care.

So maybe it’s time to commit to my mental health and my physical health simultaneously in such a way. To build up the supports I need to embrace a restricted diet completely, while reducing the risk of falling down the rabbit hole of disordered eating as best I can.

I want to believe I’m capable of taking care of my mind and my body at the same time.

If this is something you struggle with as well, I want you to believe you’re capable of the same.

Leah Campbell is a writer and editor living in Anchorage, Alaska. She’s a single mother by choice after a serendipitous series of events led to the adoption of her daughter. Leah is also the author of the book “Single Infertile Female” and has written extensively on the topics of infertility, adoption, and parenting. You can connect with Leah via Facebook, her website, and Twitter.