Anorexia, an illness that only affects teenage girls, or so I thought, until as a 35-year-old mother wanting to get myself in better physical shape before trying to conceive, I ended up living with life-threatening anorexia as I carried my second child.

It started rather innocuously, albeit against the backdrop of the stresses of being a new mum in a new city and the loneliness that comes with a husband working away from home. Portion sizes were reduced and controlled, calorie intake monitored, and a tracker worn to log my physical activity. Within three months I had lost a third of my body weight.

My cries for professional help were often ignored

Compliments soon flowed from the mouths of family and friends as my weight fell and a ‘healthier’ me emerged. The increase in self-worth that followed led me to believe that somehow this new me was a better version of myself and that I was more acceptable to those who knew me. But rather than feeling freer and more confident, I instead found myself trapped in the clutches of what I now know was the onset of my anorexia and the punishing rituals I felt compelled to stick to.

My mind was utterly dominated by the tormenting voice in my head that dictated what I could and couldn’t eat, which told me to punish myself with exercise to earn the right to eat or rest as others would and which convinced me that weight gain was quite literally a fate worse than death. The more the illness consumed my life, the greater the toll on my health and relationships. My periods stopped, I became irritable with loved ones, and I became detached from my life and the people in it. While I knew this damage was a result of anorexia, I felt I couldn’t tell my doctor because of the terror I felt at being asked to put on weight.

I became increasingly aware that I was beginning to become unrecognisable to myself and others and would need professional help to wrestle back control from this overwhelming force which seemed intent on destroying my life.

Six months after starting to lose weight I went to the doctor only to be dismissed because my BMI wasn’t deemed low enough to warrant referral to eating disorder services. My illness escalated and I went back a year later seeking the help I desperately needed, and again this time I wasn’t asked anything about my relationship with food or exercise, or my mental state.

Feeling desperate to have a second child, I somehow managed to summon the strength to put on enough weight for my periods to return and to conceive. Despite being pregnant the illness returned with such ferocity the rituals became even more punishing and my weight started to plummet once more.

My cries for help were ignored. One healthcare professional told me I should “park my anorexia until the baby was born”. There’s no way a pregnant cancer sufferer would be asked to pause their cancer, but it was assumed I could simply choose to ‘switch off’ my severe mental illness.

Additional training is necessary to improve care

Eating disorders must be more widely understood as complex mental illnesses which may or may not produce physical symptoms. Key to this is challenging the reliance on a low BMI as the primary factor for a referral to eating disorder services, as there are undoubtedly huge swathes of people missing out on life-saving treatment as a result. The changes in my weight and body were no more than a manifestation of the turmoil in my head that was driving me to make myself smaller and focussing only on weight does nothing to address the underlying causes of an eating disorder.

It’s clear that healthcare professionals need a lot more training in identifying eating disorders, as the Royal College of Psychiatrists has been calling for. I wouldn’t have lost years of my life to this illness had my anorexia been taken seriously from the outset.

Help only came for me some two years after my first visit to the GP when I expressed to the doctor my genuine fear that my unborn baby was going to die. I was finally referred to a multi-disciplinary team of psychiatrists, nurses, dieticians, and therapists in the care of community mental health services. It was such a relief to finally have people take my illness seriously. I am in no doubt that they saved my life and have allowed me to build back a life that’s truly worth living.

You can hear Abi talking about her experience of anorexia in the Royal College of Psychiatrists’ podcast published in March: Binge Eating Disorder in Young Men and Anorexia During Pregnancy (rcpsych.ac.uk)