Molly Wyatt discusses the misunderstood and stigma-ridden world of eating disorders from a personal perspective.
A seed planted behind the normalcy of everyday life and everyday thoughts, anorexia begins to grow, at first only developing into the areas where it goes blissfully unnoticed. Continually expanding, the illness has already taken a firm grip, yet remains hidden to the world. It takes residency inside your head, leaving very little room to find place for the other aspects in life; the branches continually sprouting into more complex fields and becoming your ultimate priority and focus. But by the time that people discover how poisonous this seed is, it has outgrown your head, branching out into a multitude of physical complications and other mental issues. It has gotten so out of hand, that by the time it is deemed an actual problem, when the physicality’s of anorexia have accumulated to an undeniable degree, too often it will feel too late. Anorexia has weaved its intricate web; it will feel as though it has completely robbed you of your identity and your entire well-being.
Too often anorexia is disregarded as a problem; left to culminate, until the physical issues are the evident, more ‘obvious’ issue and focus. This unfortunate ‘obvious’ issue tends to be an excessive weight loss. Anorexic and ‘skinny’ are frequently used synonymously, which perhaps unknown to many, can in fact feed an eating disorder; consuming you with thoughts of what you are not and what you must be. Furthermore, anorexia is not an adjective, something that particularly the media seem to be forgetting. Headlining female celebrities’ appearance on the front of a magazine as ‘anorexic’ is simply culminating all the misunderstandings of what anorexia nervosa actually is. In fact Anorexia Nervosa is an illness. It is an illness of the mind.
Yes, a sufferer of anorexia will suffer physical consequences, the illness ultimately magnifies all self-loathing and rather than internalising it completely, externalises it as an expression of how low one’s self worth is. In other words, anorexia consumes the person from the inside out. But what needs to be made clear is that the illness is not as simple as ‘being severely underweight’ or ‘not eating’. The connotations that tend to lie with anorexia are constantly being construed and presumed; from personal experience many have assumed that those with anorexia simply choose not to eat anything at all.
More so, aligned with this is the assumption that this ‘choice’ being made is either because we don’t like food or because there is a strong aspiration to be ‘skinny and beautiful’ like the models we see in magazines. And yes, in a world where we are incessantly bombarded with images that glorify the female form, there does exist a certain pressure to fit into the standardised body ideal that dazzles our Instagram and Facebook feeds. And these images carry one message; that in today’s society, thin is beautiful. But the stigma that exists suggesting that anorexia is based on an overwhelming desire to attain a body synonymous to the likes of Isabelle Caro, is misplaced. And as fashion models get bonier, and triggering comments from female icons such as Kate Moss whirl through headlines and pro-anorexia sites, there is truth in the belief that the media has glamorised anorexia as a fashion statement.
Let me tell you now, anorexics do eat. In fact, many eat a lot more than you may presume; it just may not be enough. However it is not as simple as that. The illness is wrapped around your brain, compressing your entire thought process. So, an anorexia sufferer may develop strict rules around food, food timings, food amounts, and so on. Starvation and Anorexia are very loosely used together, and indeed anorexia does tend to result in the body being starved of what it needs, but for those in recovery, or those not, sufferers do still eat. And with this standardized starvation anorexic image floating around means that the feelings of guilt and shame are magnified; usually making the normal and simple process of eating into a very secretive, obscured and anxiety ridden experience.
Even the smallest of actions, for example taking an apple out of your bag and biting into it in front of friends, can cause major anxiety and panic. Alarm bells ring incessantly and unforgivingly in the mind; cunningly telling you that ‘they are seeing you eat, you can’t be ill if they can see you eat, you’re fine, in fact you are MORE than fine, you ate it so quickly and now you look greedy! You can’t possibly be anorexic!” Yes it is very strange. It is also a living nightmare. From getting up out of bed in the morning, to going to sleep at night, every single action is entwined and manipulated by these disconcerting thoughts and thus feeding the all-consuming illness as it continues to warp your worldview and your mind.
The stigma that surrounds anorexia as a physical illness often results in professional diagnosis long after the illness manifests itself in the mind. And unfortunately, due to the nature of the illness; the shame, secrecy and denial that often overwhelms sufferers tends to accumulate to the point where hospitalisation is the only option. From May until September of 2015, I spent my time recovering from anorexia as an inpatient. I have always been aware that there are preconceived ideas about anorexia, but these last four months in hospital have opened my eyes to the fragmented, fractured framework in which anorexia sits amongst the NHS. I am truly grateful and fortunate to have been blessed with their services as it ultimately saved my life. However, whilst fighting an overwhelming personal battle, my eyes were opened to an array of gaping holes within the system.
I was first sent to a general psychiatric hospital in Cardiff where I was told I would be for just two weeks as I waited for a bed at a specialist eating disorder hospital in Marlborough, England. These two weeks turned into two months, and there was no denying that this hospital was out of its depth with me. This was an unsuitable environment for my recovery and nursing staff were ill-equipped to fully understand and treat my illness. Whilst under constant medical surveillance due to my physical condition, I soon began to comprehend the extent to which eating disorders are frequently separated from other mental illnesses. This echoes the lacking of knowledge, training and responsibility that a number of GP’s demonstrate. Patients are left feeling hopeless and often ‘not ill enough’ when being discounted as such, which can result in a downward spiral both mentally and physically; reverberating this silent cry for help. What seems to be somewhat lost is the amount of strength and will power it takes for anybody suffering from anorexia, or any mental illness for the matter, to go to the doctor with their problem. It goes against everything that is culminating in the brain.
However, when reaching out for help when things began to get out of hand during my first year of university, my GP responded to me by saying; “I don’t really know anything about eating disorders so can’t really tell you what to do. Eating disorders aren’t my area so you’re best talking to somebody else.” To be told this is was not only extremely frustrating but also scary; if a medical professional cannot offer their expertise or support then how are eating disorders ever going to break out of the stigma of not being a legitimate illness?
Fortunately for me, I was referred to SHED team (Service for High Risk Eating Disorders) where a sudden intervention to, at minimum, keep me on level as opposed to slipping further, was put into place. But to be referred to this service requires you to be within a certain threshold, below a certain BMI. In other words, if you’re not underweight enough, chances of immediate intervention are not as likely. This is a serious problem that needs to be brought to the forefront of debates surrounding anorexia and its diagnosis. Overstretched specialists are forced to prioritise anorexic patients whilst NHS waiting lists of up to 3 years mean that those untreated face the possibility of spiralling further out of control. This spreads the message that a sufferer must get sicker, thinner, to be seen at all.
Following my exams, I was essentially forced into hospital by the SHED team, but acknowledging and accepting of this being necessary, no section (being hospitalised against your own will) needed to occur. Yet there were no beds for me. My level of illness did not accumulate into immediate specialised care because there exists only 6 beds for all Welsh eating disorder patients in the entirety of Wales. This undeniably pathetic, and feeble amount of beds means the inevitability of being on a waiting list in order to be admitted is unavoidable. From meeting fellow Welsh patients in hospital who are not from Cardiff and therefore not under the SHED services, it became clear that support within the community was extremely minimal. It is grimly unsurprising then, that between 2013 and 2014 there was an 8 percent rise in the number of inpatient admissions. The funding and focus on eating disorders in the UK and in Wales in particular, needs to be addressed. If more attention is directed to evolving and developing the community support for those suffering from an eating disorder then admissions into hospital can be avoided. In particular, early intervention needs to be emphasised in reducing the development or worsening of an eating disorder and increase chances of recovery.
Of course a lot of these improvements cannot happen without more funding, meaning the lack of it can often mean that many turn to private therapy and treatment. Anorexia Nervosa has the highest mortality rate of any mental health disorder and affects a staggering 725,000 people in the UK. An inherent lack of understanding and support has had a detrimental effect on recovery rates; anorexia is an illness that remains in the shadows. Its damaging effects are glamorised in the fashion industry, misunderstood in the media, and shrouded with confusion under the very medical institutions that are supposed to offer vital care to so many who desperately need it. Bringing this misconstrued illness out of the dark, abolishing stigma, and simply speaking about it needs to occur, because anorexia is an immensely isolating and debilitating illness; these issues need to be brought to light and scrutinised, so that essential changes can take place.