From a young age, Sara Dreier thought she had to be thin to fit in. Over time, an obsession with body image led to unhealthy behaviors and multiple eating disorders. Sara recovered with the help of treatment and a strong support network, and she made a career out of raising mental health awareness and fighting stigma.
Sara’s problematic eating behaviors started when she was a teen. She always felt a strong need to be part of a group, but she didn’t feel comfortable in her own skin.
“High school was just an extreme sense of wanting to belong,” Sara told DrugRehab.com. “Image was definitely heavily pushed.”
She went to a small private school in Tampa, Florida, where everyone knew the details of each other’s personal lives. Her graduating class had 35 students, and there was always pressure to keep up appearances and to look or act a certain way.
“I remember kind of not really knowing where I fit, where I belonged, so I would mesh with whatever group I was in at the time,” Sara said.
She associated with a group known as the good kids, whom the teachers and parents loved. Sara always put pressure on herself to be perfect. Much of that pressure involved looking fit and thin.
“I never felt comfortable in my body,” said Sara. “I think that anyone with a struggle like that can relate to not feeling comfortable with yourself.”
Around age 15, she began scrutinizing her appearance and diet. She started using exercise and clean eating to improve her looks and cope with stress. Breakups and other normal causes of teen stress often sent Sara into bouts of extreme exercise and healthy eating.
“I felt like I couldn’t really show anyone I was hurting,” said Sara. “To cover that up, I just wanted to exercise more and eat more cleanly, and it really just became an obsession and excuse to control and a way to not feel. In my mind I associated it with … being the best at everything.”
Sara’s drive to improve her looks had escalated into unhealthy behaviors. She became even more obsessed with her diet. She started keeping a food journal and weighing herself multiple times a day.
She also began binge eating, which caused extreme guilt. Sara kept the shame to herself because she felt like she could not tell anyone about her struggles. She always binged in private.
Going out to eat with friends was an anxiety-inducing experience. She always felt like she had to order the healthiest option.
“Sometimes it would start in a social setting that would be kind of normal, like friends going out for ice cream,” said Sara. “And then I wouldn’t be able to focus on the time with my friends because I would just be thinking about what I was going to binge on next when I would go home and be alone.”
Keeping up with her eating and workout plans began to affect Sara’s mental health — especially when she failed to meet her own goals. At times, Sarah said, she had complete meltdowns.
“The word skinny, to me, was a motivator. … I was doing something right.”
By age 17, Sara had developed an eating disorder. It was especially difficult when the people she loved would reinforce her problematic behaviors.
“The worst part is that it was not addressed, and in a lot of places it was actually praised,” said Sara. “It was, ‘Oh, you look so thin.’ The word skinny, to me, was a motivator. … I was doing something right.”
Sara said that her need to be called skinny was a cry for help that no one could hear. This only added to the pressure she already put on herself.
“I embraced this persona as a health nut, and if I diverted from that persona, that meant I was a failure,” she said.
At this time, Sara struggled with orthorexia, an eating disorder characterized by an unhealthy obsession with clean eating and exercising. In college, her problematic eating behaviors intensified.
After graduating high school, Sara attended Florida State University. It was a big change from her small high school class. Although she was overwhelmed at first, Sara came to love FSU. Her eating disorder, however, was becoming more severe.
The binging behaviors that started in high school led to purging. Sara developed bulimia. She also engaged in other disordered behaviors, such as stealing or hiding food. She continued lying to friends and family to keep her illness a secret.
In spite of her illness, Sarah maintained a normal weight. She says her friends never suspected anything was wrong because she did not look underweight.
“No one even thought to ask is there something going on because it’s more stigmatized that you have to look thinner or emaciated for people to say you have an eating disorder,” Sara said.
Sara’s parents noticed her unhealthy behaviors when she was in high school, but they didn’t know how to help.
“They would comment on my weight, which was a problem because I think it was almost counterproductive,” said Sara.
Bulimia was severely affecting her mental health and ability to function. She soon lost all control of her eating habits and found it harder and harder to take care of herself.
She was irritable and began isolating herself. She did not want her family and loved ones to see her this way.
“Internally I was screaming because I didn’t know who I was, and I was stuck in this shameful cycle,” said Sara. “There were weeks when I didn’t want to get out of bed, and it became more dysfunctional.”
She couldn’t focus, and her grades started to fall. She considered herself a social person, but her condition left her unable to connect with anyone. She knew she needed help, but she didn’t know where to turn.
Sara visited her parents during the summer between her sophomore and junior year of college. One morning at 2:00 a.m., her dad caught her binging in the kitchen.
She melted to the ground in shame. Her dad said nothing, only held her tight as she cried and repeatedly said that she hated herself for an hour.
“I would say one of the lows is when my dad caught me binging,” she said. “I felt so exposed. It was horrible.”
After that night, Sara knew she had to get treatment. Her family was incredibly supportive. They helped her navigate her treatment options, and they were there for her every step of the way.
Sara decided to take a semester off from school to get better. Her biggest fear about treatment was feeling like she would be locked away in a hospital far from home. She wanted to be comfortable and close to her family.
“I would say one of the lows is when my dad caught me binging. I felt so exposed. It was horrible.”
She found the perfect treatment center nearby in Tampa. The residential center had the atmosphere of a home rather than a hospital. She felt comfortable there.
Sara wanted to be completely open about what was happening in her life after hiding it for so long.
“I posted on social media, ‘I’ve been dealing with this. I’ll be away for a while getting better,’” Sara said. “The outpouring of support was amazing.”
Hundreds of people reached out to Sara. Her inbox was flooded with positive messages from people with eating disorders and people close to someone struggling with the illness.
She doesn’t know how she mustered the courage to post about her disorder, but when she did, it felt like a weight was lifted from her shoulders.
Sara put all her trust in her professional treatment team. Going into treatment, she was excited at the prospect of working through the eating disorders she had faced in silence for so long.
“I was really self-motivated and ready,” she said.
The treatment program proved to be exactly the help Sara needed. The staff included a psychiatrist, dietitians and therapists who provided comprehensive care and addressed the underlying causes of Sara’s eating disorder.
She learned how to manage her thoughts and emotions, avoid triggers and re-establish a healthy relationship with food. The program also gave her space to figure out what worked best for her own recovery.
“For me what worked was independence, teaching me to go back out into the real world and live on my own,” said Sara.
Sara said group therapy sessions with her peers in the program were cathartic and crucial to her recovery. In one exercise centered on body image, Sara stood in front of a mirror while group members said positive things about her. She shared positive messages with the others when it was their turn to look in the mirror.
“For me what worked was independence, teaching me to go back out into the real world and live on my own.”
Almost all of Sara’s peers felt emptiness and self-loathing about the way they looked. The body image sessions taught the group that the world did not see the flaws they saw in themselves.
“I think if it would have just been a clinical team, I wouldn’t have had the same support,” said Sara.
She found that group therapy was healing and gave her a more realistic perspective on body image.
Sara left treatment with a strong recovery foundation and immediately found long-term support to ensure she did not relapse. Her friends were proud of her and did everything they could to help her succeed in recovery.
“They were incredible,” said Sara. “I’ll never forget when I came home. They choreographed an entire dance to a Taylor Swift song.”
She went to outpatient treatment three to five times a week while she adjusted to life in recovery. She attended 12-step meetings, and she even reconnected with a girl from high school during one session.
When Sara returned to FSU, she regularly met with her therapist and attended support group meetings to maintain the progress she had made. She said it was tough at first to adjust to the college atmosphere while in recovery, but she succeeded with support from her friends.
“I think with life changes, there’s anxiety,” said Sara. “[In] any kind of difficult life situation, the triggers can come up where you want to go back to those unhealthy behaviors, but I think I’m able to catch myself now.”
Sara’s treatment program made her realize how widespread eating disorders are. She says people — even doctors — largely do not understand the complexities of the disease, which creates barriers that prevent people from getting the treatment they need.
“I would say the biggest barrier is the stigma, the lack of understanding, from the medical community,” said Sara.
She says that many in the medical community do not know the signs of an eating disorder. Her own pediatrician never recognized the symptoms when she went in for checkups.
Sarah knew that if people in the medical community did not truly understand eating disorders, then the general public was even less informed. She decided to take action.
Sara became passionate about sharing her experience and raising awareness about eating disorders with whomever she could. She started by sharing with her friends, and the response was positive.
“It helped them realize you never know when someone is struggling,” said Sara. “They can be advocates themselves. I think that part is really cool. You don’t have to go through this yourself to be an advocate or to give someone else a voice.”
Sara also wanted to inform parents of the proper way to talk to their children who may be struggling with an eating disorder. Her experience with friends and family taught her that genuine concern expressed in the wrong way can trigger unhealthy behaviors.
“I want parents to know to try to address what’s going on internally or the actual behavior instead of saying things like, ‘You look like you lost weight,’” she said.
Sara graduated from FSU with a degree in communication. In her first job out of college, she wrote about her experience with eating disorders for a lifestyle and mental health publication in Tallahassee. She loved sharing knowledge with people experiencing the same problems she faced.
She later got a job doing outreach for a private practice therapist who treated eating disorders. She says the experience was remarkably rewarding. She not only worked with clients directly, but also helped the practice grow.
“I loved it,” said Sara. “It was incredibly valuable, and I learned so much. It was so beneficial to watch our clients as we gave them the tools for recovery.”
The experience opened new doors for her career as well.
While working with the private practice, Sara attended the Southeastern Eating Disorder Conference where she met former Miss Florida Allison Walsh. Allison had overcome an eating disorder and founded Helping Other People Eat, a nonprofit organization focused on eating disorder prevention and awareness.
“I want to emphasize that when I was struggling, I didn’t look like I was struggling size-wise.”
Allison and Sara had a lot in common, and they connected immediately. Allison recognized Sara’s openness and honesty about her struggles and her passion for helping people with an eating disorder.
“She saw that I was trying to be authentic,” said Sara. “It was cool because I came to find that when we’re honest, it takes you to places you never could have imagined.”
Allison, who is currently the vice president of business development and branding for Advanced Recovery Systems, saw great potential in Sara. She offered Sara a job as the community outreach associate for Blue Horizon Eating Disorder Services, a treatment facility operated by Advanced Recovery Systems in Orlando, Florida. Sara jumped on the opportunity and moved to Orlando for the new position.
Sara now spends her workweek in the Central Florida community spreading awareness about eating disorders and the high-quality treatment people can receive at Blue Horizon. She is particularly happy that she has the opportunity to speak with people in the medical community.
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“I’m talking to the people who helped me get better, or even the people who overlooked me, and trying to help them understand … the signs and symptoms [to look for],” said Sara.
She frequently meets people that remind her of herself while she was struggling with the disease. Hearing their stories and assisting them in their recovery motivates Sara to continue her work.
“I think it really gave me purpose, and it’s led me into a career,” she said.
Sara has dedicated her career to breaking down treatment barriers and eliminating the stigma associated with eating disorders. She knows this disease affects people of all shapes and sizes.
“I want to emphasize that when I was struggling, I didn’t look like I was struggling size-wise,” she said. “Eating disorders can affect men, women, all races, genders, ethnicities. It doesn’t matter; you can be any size.”
Sara says that almost anyone can relate to the hardships of those with eating disorders.
“I think that it just reminds us that we’re human and that no matter what, we’re all going to go through something,” said Sara. “It may not be an addiction or an eating disorder, but everybody has something, and I think we all just need to know that we’re not alone in it.”
She says the greatest barrier preventing people from getting treatment is isolation. Sara wants those who feel like they have nowhere to turn for help to know that there are people who care about them and want to see them reach recovery.
“You’re not alone,” she said. “No matter what you think you have done that’s too shameful, too disgusting, too private, you are understood and heard. Don’t wait to get help.”