One of the many factors that makes Anorexia so resistant to treatment is the fact that one can so easily hide what is truly going on.

These days, I spend my hours at work as a Physiotherapist counselling patients through dealing with their physical complaints. It may be a broken bone, a lumbar disk injury, a dislocated knee…..and invariably, it is a confronting and emotionally challenging time for these patients, who are usually in my case adolescent athletes who may be facing major injury for the first time in their chosen sport. There’s many things I can and make sure I do tell them to reassure them and steps are put into place to make sure their social life and mental health doesn’t take too much of a hit during the down time – things such as general nutrition, sleep, rehabilitation exercises and established social networks for support.

But here’s what I can’t say to them. I can’t say: you’re lucky – you’re only going to be broken for 6 weeks. There’s a definite end-point to your injury and a clear path for returning back to full level health and sports participation. People can see that you are broken, and as such they will expect less of you, be more supportive, understanding and helpful. Yes, you will have to make some adjustments to your lifestyle – different training and better nutrition to avoid weight gain and deconditioning, for a start – and that will be hard. But it will be hard for 6 weeks, and then you get your life back.

And that’s exactly what makes Anorexia so toxic. Yes, when one is very sick, it is often hard to hide that – although god knows we try so hard with layers of clothing and aren’t we great actors….. But once one has reached a reasonably healthy weight, we become invisible. It is all too easy for everyone around us to forget that we are still battling the demon within, day in, day out. That every meal can be a challenge. That we feel uncomfortable in this new body of ours. That simply getting dressed in the morning can send us into a tornado of irrational anxiety.

And possibly the thing that makes it even harder than being invisible is the unknown factor to recovery. No health professional can sit us down like I do with my patients and say “this will be better in 6 weeks”. No one can tell you when, if ever, you will be 100% free from Anorexia’s firmhold. They can’t reassure you that there will be a day that you will be “unbroken”. All they can do is give you the tools, help you gain the weight so that you are physiologically stable, and then send you off with best intentions and hope for the best.
The third part to the equation is that this invisibility allows one to slip back into relapse all too easily without a soul noticing. One can even fool oneself for a very long time if not careful. And by the time anyone else notices, you are very broken again and the healing time is long and arduous. This is not the case for my patients – if they do something silly, push too hard, don’t follow the program, I can see it loud and clear and there is no delay. The knee is swollen. The scan shows the fracture isn’t healing. The pain immediately inhibits the muscles from firing well. There is nowhere to hide.

All of the above reinforces the importance of diagnosing and initiating treatment in eating disorders from the earliest possible stage. They should not be allowed to fester, for the longer they go on, the more established they become and the more resistant they are to treatment.
I am the minority. I had Anorexia for 10 years. At that point, statistically, I had only a 20% chance of recovering. My odds of dying from complications increased by the year. And even today, healthy as I am, I would say that on average I am about 80-90% “Me”, and 10-20% “Anorexia”, depending on the day. The beast still lies within, and he still fights the good fight. Thankfully, I can still control my actions, make sensible decisions, and ask for help when I feel a relapse creeping up on me. I still have hopes that one day I will be 100% “Me”, but no one can tell me that.

I dream that one day we can have a world where no-one has to fight that beast, no matter how weak or strong it may be. In the meantime: help each other, look after yourself, be honest about how you are coping, and get help early, and often. Don’t be afraid to make yourself visible to the world.

K xo