"I'm doing this to help others see that recovery is possible. I once accepted that I would be purging for the rest of my life because I never understood recovery."
Feature Series by Shoshanna Rutemiller

In the previous four sections, Swimming World detailed Dagny Knutson's realization and the steps she took to combat her progressive eating disorder. We started the series at the moment Knutson decided to seek treatment, while at the Austin Grand Prix in January 2012. Then reflected back on the roots of her eating disorder in high school (2006 -- 2010), when she was severely controlling her diet. The third section talked about her time training in Fullerton, California (2010-2011) with FAST, when she began using eating as a coping mechanism. The most recent part discussed her time in Gainesville, Florida (2011-2012), including her gold medal at the 2011 World Championships in Shanghai, followed by the flooding in her hometown of Minot, North Dakota, that destroyed her childhood home. Today, we go back to the beginning, with Knutson on the plane departing the January 2012 Austin Grand Prix, heading back to Gainesville to seek treatment.

PHOENIX, Arizona, August 26. DAGNY Knutson let her thoughts wander as the landscapes morphed from Texas desert to Florida swamps beneath her plane back to Gainesville. Had she really just left the Austin Grand Prix in the middle of her finals swim warm-up? But as the twenty-year-old reflected on her decision, the anxiety building in her chest began to subside. She had made up her mind, and set her course of action accordingly.


"I was completely calmed down when I got [back]," she says. "As soon as I returned, I made the phone calls to a treatment center in Minneapolis, Minnesota, which would allow me to be closer to my family [in Minot, North Dakota]."

Over a year into her bingeing and purging, Knutson finally had an epiphany: she needed more intensive help to battle her bulimia. Obviously, the counseling she received in Gainesville was insufficient, as she continually retreated to the comfort that purging provided.

Knutson checked into the Minneapolis-based Emily Program in January of 2012. The treatment facility includes residential quarters for clients. The program is designed with individual and group therapy sessions, followed by an outpatient support system.

"I first saw a doctor in Minneapolis at the treatment center and was diagnosed with bulimia nervosa," Knutson explains. "At the time that is what I had, even though in the past I had characteristics of anorexia and binge eating disorder."

Knutson spent a month living in the residential quarters at the Emily Program.

"I had been trying to do it so long on my own," she says. "The whole time I thought I just wasn't disciplined ...That I didn't have willpower. My obsession was overtaking me and I didn't know why. I felt powerless over food, and just wanted to be normal."

From the website Psychology Today, compulsive tendencies in early development can lead to eating disorders later in life. According to this description, Knutson was showing symptoms of an eating disorder long before her official diagnosis. In high school, Knutson compulsively controlled her diet and swimming, leading to anorexic-type behaviors. As time progressed, Knutson's body began to crave the food it had been deprived of during development. Compulsive eating and a loss of control around food followed. She began purging to regain the control, eventually losing herself to the purge, as well.

"I would go fast food hopping, allowing the garbage to collect in my car and eat where no one could see me. I remember sitting in my car one time, so full, crying, and praying 'Why is this happening to me? Why am I so dependent on this? Why is food my best friend and worst enemy?' and I could only hope that one day this 'thing' would finally go away."

Knutson followed these compulsive eating episodes with purges. "Bingeing gave me a high. Purging emptied me. It relieved me of many guilty and shameful feelings. But eventually it made me feel physically worse and even more ashamed that I had resorted to it in the first place."

So Knutson departed for Minneapolis, hoping to finally be cured of her compulsion. After her initial consultation and diagnosis, Knutson began immediate treatment and therapy.

"[In therapy, we talked about] accepting my body (which allows me to do amazing things), the past, my decisions, etc. I didn't have to like [everything that had happened], but to accept it. I learned that there's no 'bad' or 'good' food. There's just food, and I can eat whatever I want in a reasonable amount," Knutson explains.

In patients diagnosed with bulimia nervosa, the guilt associated with bingeing rationalized purging. But in treatment, Knutson learned some shocking facts about bulimia. By continuing with her food addiction, she was setting herself up for a heart attack.

"Did you know at any given moment when you purge, you can have a heart attack? It doesn't matter if you purge for ten years, or it's only your third time, when you purge you're messing up the electrolyte, potassium and sodium balance in your body," she continues, "I broke down, scared, after hearing that one."

Heart attacks are not the only health risk bulimics face. There are numerous physical and mental health problems associated with the disease. Physical effects range from tooth decay and esophageal tears, to long-term bone damage (osteoporosis) and abnormal heart rhythms. Mental and emotional consequences, such as depression, anxiety attacks and thoughts of suicide have also been linked to people with eating disorders.

"The most concerning issue was my vitals when I first got to treatment," says Knutson. "My heart rate was very, very low and would spike over 60 beats when I would stand up. My blood pressure would also drop significantly."

Knutson had worn out her body with her abuse, and her body was signaling its distress. But therapy is never touted as an instant "cure-all." Knutson soon realized that merely checking into treatment and attending sessions was assistive in recovery, not magical.

"It's always an ongoing battle, but you have to give yourself credit for the effort you put in everyday. Progress is progress, and it takes a LOT of time."

For several months, Knutson has been debating releasing her story to the press. In June of 2012, news outlets took notice that she would not be competing at the 2012 Olympic Trials in July, despite qualifying in a number of events. USA Swimming had projected Knutson to represent the United States at the Olympics in several individual events and relays. Instead, Knutson quietly bowed out of the spotlight, retreating into treatment while releasing a statement that she would not be competing in Olympic Trials due to "health issues."

"I came to [Swimming World Magazine] with the story..." she says. "I knew I wanted to share my story but I didn't know how or when."

After several months into the Emily Program in Minnesota, Knutson's insurance coverage ran out. She moved back to Gainesville, Florida, and began treatment at the Shands Vista Hospital . By this time, the 2012 Olympic Trials were fast approaching. Even though Knutson was making consistent progress in treatment, the Trials triggered a severe emotional response; watching her teammates compete and qualify for the London Olympics without her became unbearable.

"I had a major relapse around the time of Trials," says Knutson. "I was vulnerable and depressed."

Now, several months out of the Olympic Trials, Knutson feels the timing couldn't be better, "I [finally] feel strong enough, and to be a voice for so many others."

Knutson recently moved back to her home state of North Dakota to train with her high school coach Kathy Aspaas. She has high hopes for the change, mainly because her two most successful years (2008 and 2009) were when she was training under Aspaas. Knutson is literally going back to her roots, but don't expect her to dwell on the past.

"The good thing [is that] I'm starting from scratch. No contracts, no deals, and unfortunately no funding because I decided to go to treatment. But a fresh start feels amazingly nice right now," she says. "Short term, [I'd like to] make the world champ team next summer, and long term the Olympics. But if that doesn't happen that's definitely ok. I've already saved my own life and that's more precious to me than any gold medal."

In order for Knutson to "save her own life," she had to first recognize her problem and seek treatment. According to the South Carolina Department of Mental Health, eating disorders have the highest mortality rate of any mental illness, and nearly half of all Americans personally know someone with an eating disorder.

Knutson has been free from her eating disorder for two months and counting, and hopes her story will help educate other young men and women with similar disorders.

"I'm doing this to help others see that recovery is possible. This is an issue that should be more verbalized because it's bigger than people think," Knutson says. "I once accepted that I would be purging for the rest of my life because I never understood recovery."

"No one heals without a struggle."

If you or a loved one is experiencing symptoms of disordered eating, we implore you to communicate your struggles with someone you trust and then seek the necessary help. Recovery is possible.

Below is a link to the national eating disorders website:

http://www.nationaleatingdisorders.org/

or for immediate support call 1-800-931-2237