"You are so fat and disgusting, look at you!"
"You are so ugly!"
"You are worthless!"
Imagine living with someone who constantly told you that you don't match up to others, pointing out every little difference and calling you these sickening names? Imagine this on a daily basis, every minute of every day. I know what you are thinking, you wouldn't accept it and you would pack your bags and move on... pronto! Society as a whole are better educated about domestic abuse and domestic violence than we have ever been, but what if it wasn't your partner who called you these names and tormented you, what if you were doing it to yourself?
Eating disorders is an umbrella term covering a range of conditions revolving around an abnormal relationship with food and eating. From the more well-known anorexia and bulimia to the lesser known diabulimia and rumination syndromes; instances of eating disorders have increased 15% since 2000 according to a study by King's College London and the UCL Institute of Child Health. The same study in found that there was a pronounced 27% increase in diagnosed cases of eating disorders amongst men.
Coming from a position of relative ignorance, I met Thomas, someone living with an eating disorder, currently categorised as 'eating disorder not otherwise specified' which in his case is a hybrid of bulimia and anorexia.
Thomas (not his real name) is a twenty-something medical graduate from Scotland who has lived with an eating disorder following a sexual assault when he was in his teens. Thomas explained that following the life-changing incident, he blamed himself for the attack and sought to put as much weight on as possible as he believed this would make him less attractive and less vulnerable thus, in his mind, less likely to fall victim to a similar assault in the future. Putting on a significant amount of weight, Thomas' life changed and he felt less vulnerable and tried to move on with his life but found his relationship with food was never, and would never be the same.
Three years ago Thomas started at the gym and reduced his calorie intake and the weight was soon falling off; little did his friends and family know he had embarked on a dangerous plan of eating less than 500 calories a day, counting every morsel which he ate and working out and exercising to burn off the little food that he was consuming.
Thomas said "I started taking slimming tablets, laxatives, slimming patches and appetite suppressants every day," he added "It was addictive, people would pay me complements and I started to feel good about myself."
Every meal was planned, every drink of water or coffee was logged in a smartphone app and everything consumed attracted a certain number of minutes of exercise to counter any possible weight gain. What started as a 'coping mechanism' for his sexual assault had warped his understanding and relationship with food and ultimately fuelled this relentless challenge... how to eat as little as possible while losing as much weight as possible? Fast-forward nine months and having lost over eleven stone and seriously underweight, Thomas was in a deep, unrelenting depression which brought him to the brink of suicide and led to him being taken to a mental health unit by the police. After initial treatment, the unit worked with him as an outpatient and tried to introduce food and change his relationship with food, treatment which has limited success.
When his eating disorder was at its worst his normal day would start with a visit to the toilet and weigh-in, followed less than half the adult's suggested serving of cereal and two slimming tablets. He would then briskly walk for at least thirty minutes before returning home and carrying out further exercise for two and a half hours in order to burn off his breakfast and increase his metabolism for his tiny serving of homemade carrot soup at lunch. Lunch is followed by an hour's brisk walk, two hours of relaxation and a coffee before a nap. Dinner is a military affair, following a weekly eating plan, with every ingredient weighed out and logged into his smartphone app. Dinner is given a few minutes to settle before another hours walk before three hours of relaxation before a snack and bed. Even though his condition and his management of his eating disorder has improved, Thomas' life, well and truly, revolves around food and every activity is planned around his meticulously weighed and measured portions of food and his ability to get to the toilet un-noticed to purge after mealtimes.
Eating disorders are complex conditions which start for a variety of reasons and their impact stretches way beyond weight-loss or weight-gain and Thomas told me that his eating disorder has left him with permanent oesophageal acid reflux, stomach ulcers, chronic stomach pains, mouth ulcers, severely impaired peristaltic motion, damage to teeth, blocked tear ducts, scars on knuckles, sore throats, hair loss and pale complexion. "Sometimes I feel prisoners have more freedom in jail, my body is my jail" said Thomas "I am trapped trying to measure my self-worth in numbers on my bathroom scales."
The internet is awash with websites which allow those living with eating disorders to share tips on how to purge (vomit after eating) effortlessly and how to increase the amount of weight one can expect to lose while dangerously limiting their calories intake. Thomas explained that he felt these sites should be banned and are "dangerous" and suggest "very harmful ways of inducing vomiting" including "punching yourself in the stomach and the testicles."
While this wasn't the case for Thomas, many young people are driven to try dangerous weight loss plans to achieve that unrealistic, airbrushed 'Hollywood' body, banded around in these celebrity magazines which are all too popular with teenagers. Lib Dem MP and equalities minister, Jo Swinson has long highlighted the potential harm young people face when bombarded with unrealistic body images, stories of 'miracle diets' and the promotion of dangerous or unethical exercise and 'fitness' plans while chasing that unobtainable and unrealistic body.
Thomas has explained that his eating disorder can be viewed in similar terms to that of an addiction. Substance misusers struggle to get a grasp of their habit and keep control of their life while Thomas battles with the constant need to weigh and log his calorie intake; eat as little as possible before purging while trying to keep his condition from those around him.
I asked, If he had a message for anyone sitting at home reading this who find themselves in a similar place to him and who may not have been diagnosed with an eating disorder. He emphatically said
"I would recommend that anyone concerned about their eating or the impact it's having on their health get help by speaking to their GP, speaking to their parents or to their friends. I honestly wouldn't be here today if it wasn't for the help I received, I would be dead. I know what my condition is and I attend CBT and I am slowly tackling my relationship with food. Since I have asked for help I have managed to control my eating disorder better and I can recognise when my mood is getting worse and I know how this will impact on my disorder."
There a number of organisations which provide support for people living with eating disorders and some provide free, impartial telephone helplines. Although I do not recommend one service over another I have listed some such organisations below for your reference.
If you are feeling suicidal and you need to speak to someone urgently you can contact Samaritans on 08457 90 90 90 (in the UK) or for those outside the UK for details of your nearest crisis helpline visit the Befrienders website.
For more information about eating disorders:
Beating Eating Disorders - http://www.b-eat.co.uk/get-help/get-support/helpline
Eating Disorders Support - http://www.eatingdisorderssupport.co.uk/helpline
A B C Care - http://www.anorexiabulimiacare.org.uk
The Only Way is Up - http://www.onlywayisupfoundation.com