What’s the first thing you do when you wake up in the morning. Check your Facebook? Make a cup of tea? Have a wee then sneak back to bed for 20 minutes? Or is that first waking hour of the day is spent obsessively putting potential meal options for the day into your calorie tracking app. But that’s just normal right? Obsessing over your calorie consumption is just what women do, isn't it? Even if that were true, at what point does a strict diet become disordered eating?
Unless you’ve been hiding in a hole all weekend, you’ll have been treated to countless pictures of super-thin models at fashion week, quickly followed up by all those pictures of female celebrities on the red carpet at the Oscars, looking totally phenomenal but rarely tipping over a size eight dress size. And so our view of what is and what isn’t an average body shape well and truly skewed, the number of eating disorders is a big deal.
One in 100 women in the UK will be clinically diagnosed with an eating disorder in their life, but some studies claim that over half of women in the UK have a ‘serious issue with food’ called EDNOS (Eating Disorder Not Otherwise Specified, i.e. one that won’t lead to a clinical diagnosis but will cause them significant problems if not checked out). So right now, this article may feel very familiar to you.
Which is why, to mark Eating Disorder Awareness Week, the National Eating Disorders Association (NEDA), the American equivalent of Beat, are running an awareness campaign called* I Had No Idea*. It aims to bust some myths about disordered eating and open our eyes to the tell tale signs.
I was convinced I was large, but looking back over pictures I can see that I was actually really thin
Your friend who constantly obsesses about calories; your colleague who lost a load of weight but hides it in baggy clothing; your housemate who eats alone and backs out of any social activities with food… Any of these people in your life could have an illness involving body image and food. And the reality can be far removed from harrowing images of young women with their ribs sticking out.
Dance teacher Gemma, 28, first started having problems with food at secondary school, aged 11. ‘Spending so much time dancing meant that I was acutely aware of my body shape’ she recalls. ‘I was convinced I was large, but looking back over pictures I can see that I was actually really thin.’
But it wasn’t until just two years ago that she was diagnosed with EDNOS – or Eating Disorder Not Otherwise Specified – the ‘catch-all’ term for those who fall between the strict criteria of anorexia or bulimia.
She added: ‘I was referred to a therapist who has worked with me on understanding my need to control and helped me identify ways I can help myself. I will always have problems with food but it's learning to deal with them without restricting.’
Eating disorders have been heavily linked to depression and stress (and as we’re constantly being reminded, twenty-something women are dealing with both in abundance). Dr Alex Hedger, also a Clinical Director and Cognitive Behavioural Therapist at Dynamic You explained the link: ‘About 50% of those experiencing disordered eating also meet the criteria for depression.’
While links to stress are harder to research, given the lack of diagnostic criteria for ‘stress,’ he added: ‘When viewed as an emotional experience, there is also certainly a close link between stress experiences and increases in problem eating patterns. This is often the case as people try to manage the stress using whatever tools they can such as modifying eating behaviour.’
Jean, a writer from London performed an intervention when she realised her friend's dieting had spiraled into disordered eating. 'We've been friends for ten years, everything was completely normal, and then she had a bit of a crisis of identity. I don't think she was enjoying work, and everything was messing up a bit and she just wanted to take control. She basically just stopped eating and she became obsessed with other people's body shapes and being quite critical of people who were bigger. She looked different and people were starting to notice, but if you mentioned or joked about it she just said she was on a diet and that was that.
Within a few months her weight loss started to define her - it was all she thought about, and it was all anyone else talked about when they discussed her.
'In the end I spoke to her, and told her I was a bit concerned. She admitted that it had gone too far - in fact, she was smoking 30 fags a day to try and quell her hunger a bit. She's trying to address it now and has put on a bit of weight - but I was shocked at how easily and quickly it happened. Within a few months her weight loss started to define her - it was all she thought about, and it was all anyone else talked about when they discussed her.'
Almost half of people suffering from an eating disorder have to wait six months or more for treatment, according to a report out today, commissioned by UK eating disorder charity Beat. That’s a lot of waiting around when you are ill. And that’s just those who admit to having an eating problem in the first place. Of the 500 people surveyed, two in five who realised they had an eating disorder, waited more than a year before even seeking help - others were in denial altogether.
The majority of people seeking treatment are actually more likely to have EDNOS than the more extreme anorexia or bulimia cases, according to Dr Philippa Wheeler, Clinical Director of the Dynamic You Clinic in London.
She explained: ‘NHS services are usually geared up to providing treatment for specific diagnosis areas. So if a majority of people are not given a diagnosis of either anorexia or bulimia, they are likely to struggle to meet criteria for treatment.’
She says patients often turn up for private eating disorder treatment at her clinic, having received help for stress of depression through the NHS but not the eating issues.
Every experience of an eating disorder is personal. According to today’s report, the annual cost of eating disorders to the UK is £15 billion. The figure adds NHS treatment, lost income and the financial burden on sufferers and carers. It’s a big deal, and with ever easier access to triggering images on social media and our body image obsessed popular culture, it’s not going away.
The report calls for more co-ordinated treatment and that the postcode lottery currently dictating what treatment someone gets needs to stop. Chief Executive of Beat, Susan Ringwood says treatment is ‘patchy at best, inadequate at worst’ and ‘unacceptable variability nationally is putting lives at risk.’
Early intervention of eating disorders can cut the chance of relapsing by half - which is why it's so important to be vigilant if you think a friend may be suffering from one.
Putting things down to being a fussy eater or just not that hungry, won’t cut it either, says Claire, 23. It wasn't until she moved away to study textiles in Dublin that she realised she was battling some serious food demons. She would cry with guilt after eating a few biscuits or a packet of crisps and she would punish herself by running around the local park until she felt she had 'sweated them out of her.' 'My flatmate was a lifesaver - literally,' she explains. 'I was having a really bad day, stressing about everything - deadlines, the guy I was seeing, lack of money, the usual. As strange as it sounds, food and exercise were the only thing I felt like I could control when I got in those states.
'I was feeling pretty lousy and my flatmate found me collapsed on the kitchen floor. She insisted we went for help. For years, I thought my food issues were pretty normal or made excuses for them. When I started to talk to a therapist, it all became clear to me that I had an illness, it explained so much and for me, that was an instant relief.'
Eating Disorders Awareness Week is here to remind us that we do not need to suffer in silence.
*For help and support, visit www.b-eat.co.uk or call the helpline on 0845 634 1414 (adults) and 0845 634 7650 (youth, under 25). *
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Picture: Maggy Van Eijk
This article originally appeared on The Debrief.