A complicated path to recovery: The reality of Anorexia Nervosa

How can we have a meaningful, change-provoking conversation about eating disorders when we can’t even say the words?

Photograph courtesy of Patrick Emerson via Flickr

CW: This article contains references to eating disorders.

I was twelve. I remember whispering the diagnosis to myself in bed at night, over and over like an incantation. There were long months, years of Maudsley Family Therapy, supervised meals, good days, and bad days. 

I got stronger. Eventually, I would class myself as generally happy. Recovery, I found, was possible.

I didn’t think about my eating disorder for many years. It seemed like an unnaturally long time ago, and a few different worlds away. When it did come back, it was in spurts, like turning the tap on and off again. Until it came back all at once, and, as often happens, I relapsed. 

Back to hospital. Back to rules, rigidity, ritual. Constant supervision, yet total isolation.

I’m extremely lucky to have received help. Over one million Australians are suffering with eating disorders, with presentation starting younger and younger. Treatment options for anorexia are few and far between. Only one third of sufferers will seek and receive help, according to the organisation Eating Disorder Hope. 

Public health systems are overcrowded and underfunded, with patients reporting traumatic experiences. There are no private inpatient programs anywhere in Tasmania, Canberra or the Northern Territory, and only a handful in New South Wales, Victoria, South Australia and Queensland. 

The strain on the public health system, particularly during COVID, results in a system where only the most severely physically ill are admitted to hospital, leaving people to deteriorate until the point of medical emergency and reinforcing sufferers’ fears of not being ‘sick enough.’ This can support the inaccurate assumption that eating disorders have a certain ‘look.’ In reality, less than six per cent of sufferers are medically underweight.

This is a dire situation for what is the most deadly psychiatric condition. One in five people with anorexia lose their life to the illness, according to the Garvan Institute. Yet, eating disorders are profoundly misunderstood. 

Anorexia is not about vanity or selfishness. It is not even primarily about body image — in my opinion — and it is certainly not the image of a skinny teenage girl scrolling through Instagram desperate to look like the models. It is a deep, unnerving, almost primal instinct for control. A need to externalise feelings you can’t express verbally, to tell a story through your body. An untameable impulse to shrink for shrinking’s sake — not to meet some thin ideal perpetuated by the tabloid media. The worst thing is that most of the time these thoughts and behaviours are coming from inside yourself, not imposed on you by society. It is you who has come here, and you who must find a way out.

Barely anyone will actually say the words ‘eating disorder,’ much less ‘anorexia.’ I will admit that it is a cruel word. But how can we have a meaningful, change-provoking conversation about eating disorders when we can’t even say the words?

I firmly believe that a way out is possible. Even in the midst of all this, life offers up strange moments of happiness. Little reminders of beauty that appear like faded sepia photographs. They float in front of my eyes but do not sink all the way through my skin. On the train, the fat curl of a baby’s fist, her fingers like little pearls. On the walk home, the leaves stuck to the ground with the wet, their colour heightened like stained glass. Recovery is like that too – little patchwork moments that make no sense, then perfect sense. Ebbing, flowing, waxing, waning. But possible, if you just hold on.