This article deals with some sensitive topics, including eating disorders and suicidal thoughts. As per request from the interviewees, names have been changed to prevent identification of those who have shared their story. If you have been affected by any of the issues in this piece, there are advice contacts at the bottom of the page.
Anna* walks almost silently into the pub where I’m sitting having a drink. She sits opposite me and looks studiously at the table, fiddling with the sleeves of her sweater.
“Are you ready to talk about this?” I ask. She avoids my eyes and takes a few deep breaths before answering, “I don’t know. I guess I am. I have to tell someone eventually I suppose.”
She isn’t overweight but I can see that she has some generous curves, despite being swamped in baggy clothes, and her face is round. At first glance, Anna doesn’t look like a girl who is killing herself slowly with a deadly eating disorder. But she is. She is 21 years old, a performing arts student at Anglia Ruskin University. Green-eyed and tall, with a steady boyfriend and friends that she describes as ‘fierce and loyal’ and yet, the picture Anna paints of herself is bleak. Words that she uses continually during our interview are ‘gross’, ‘fat’ and ‘stupid’. Although I originally set up my interview with her to talk about mental health problems more generally, I quickly come to see Anna’s eating disorder is her focal point. “It doesn’t matter if I get bad grades, or if my Dad refuses to see me, or anything,” Anna says, “None of that can hurt me, because the person who’s hurting me the most is myself.”
Anna is one of an ever-growing number of university students who have turned to self-destructive methods to deal with the stresses in their lives.
“It’s definitely become worse since starting uni. I’m a performer,” she says, “There’s pressure there from my professors to lose weight to get the roles I want. I know you don’t see girls like me on stage.”
Anna describes daily binging and purging behaviours to me, fuelled by her anxiety. “It’s ruining my life,” she admits. And yet she questions, “Does bulimia count?” when I ask her if she has an eating disorder. And Anna is not alone in this question. When typing the words ‘is bulimia…’ into Google, one of the most-searched results is sinister: ‘is bulimia really that bad?’
In the public conversation about eating disorders, the image of the anorexic teenage girl wasting away to look like the models in magazines has long held centre stage. And report commissioned by leading eating disorder charity BEAT in February 2015 found that females account for around 89 percent of eating disorder cases in the UK. However, the medical journal Diagnostic Statistic Manual of Mental Disorders estimates that only ten percent of eating disorder sufferers are anorexic. It finds that bulimia, on the other hand, accounts for about 40 percent of known cases of eating disorders in the UK. A multitude of other disorders such as binge eating disorder and orthorexia make up the remaining 50 percent.
Bulimia can cause a host of scary or fatal complications. These include eroding teeth, irregular periods, kidney damage, fits, and damage to the heart. Boerhaave syndrome, where vomiting regularly with excessive force leads to the rupture of the oesophagus, is also a risk.
And Anna is experiencing many of these side effects already. “I’m always cold,” she tells me, “and so tired. My face and neck are all swollen from my glands. And I’ve thrown up blood more times than I can count.” It isn’t only the public that dismisses the severity of this eating disorder. Sufferers also detect bias among members of the medical community.
Anna said, “I went to a psychiatrist for a while. But every time I would try to talk about food he would ask if I was still having periods. I was, so he didn’t want to waste time on the problem after that.”
Dismissing eating disorder sufferers due to their weight not being low, despite all the other dangerous complications that can come from their continued disordered behaviours, is a trend that is both frightening and downright negligent.
The term epidemic does not seem to be far-fetched; The Joint Commissioning Panel for Mental Health estimates that over 1.6 million people in the UK are living with an eating disorder and millions more cases are falling through the cracks. This is especially a problem in those who may not ever become dangerously underweight, as is the case with many people suffering from bulimia.
StudentMinds is a student mental health charity that holds peer support groups for people with eating difficulties. They denied my request for interview due to confidentiality issues understandably, but I spoke to students that have attended their group. One of them is Olivia, 20, a Literature student at Anglia Ruskin; she has often encountered a similar attitude to Anna.
“I’m not skinny,” she said, although with her tiny legs and petite wrists I would certainly disagree with her. I wonder to myself during our interview if this distorted image of herself is a side effect of her eating disorder.
“My mum was so worried though,” Olivia tells me, “She took me to the doctor. But he just said to come back if I lost weight […] and that throwing up was normal teenage behaviour.”
When I asked about the causes of anxiety in her life, Olivia also cited university as a key factor. “I’m an international student and we don’t get loans. It’s so hard to juggle uni work and the job I need to have to help pay my tuition fees.”
Being away from loved ones has also taken away an avenue of support for Olivia. “My boyfriend has always helped a lot but I never see him because he’s back home. It makes it so much harder that I have to go through it all alone now,” she says.
This absence of support is a worry for prospective university students as well. Amy, 18, is from Gibraltar and has accepted a place to study philosophy at Durham University in September. “I’m supposed to be ‘recovered’,” Amy uses exaggerated air quotes, “But I’m scared to be honest. I won’t have my psychologist, or my friends, or my mum. The bad parts of brain are excited. No one’s going to be watching what I’m eating. I’m going to lose so much weight.”
One avenue of support that is often available for university students is in-house counselling facilities. Both Anna and Olivia have used the Anglia Ruskin Health and Wellbeing services. This service offers drop-in sessions for emergencies and six-week courses with a counsellor for those with situational difficulties that they wish to work through. Those with long-term mental health conditions, however, are often given a mental health advisor to see more regularly.
Although Anna describes the services as ‘okay’, she characterises them as “not the best. Especially the amount [of time] you have to wait.”
“I had to wait nearly two months to get an appointment,” Olivia tells me, “and I came so close to killing myself while I was waiting. And when I finally did get an appointment they only gave me six sessions to work with the counsellor. I guess I wasn’t sick enough.”
Despite our growing understanding of eating disorders, they remain shrouded in stigma. Both Anna and Olivia asked if I could change their names for my article. Olivia tells me, “I don’t want everyone knowing [about her bulimia]. They’ll definitely judge me. It’s disgusting, I know it is.”
By Robyn Robles
7th December 2017
Image Credit: Adobe Stock License
Disclaimer: The information in this article is from personal experience, and does not constitute professional, medical or psychological advice. Always seek the advice of a qualified health provider with any questions, or if any of the issues in this article affect you. Anglia Ruskin University has it’s own counselling and wellbeing service, you can find out more information here: https://www.anglia.ac.uk/student-life/health-and-wellbeing. The ARU Student Union are also running their Let’s Be Honest Campaign, to help reduce the stigma surrounding mental health.
We take the issues of mental health very seriously and use this platform to bring about a discussion and let others know it’s okay to be open and honest. Mental and Physical health are equally important, and should be treated as such. There are various charities and organisations that can help with recovery.
Statistics from the article: https://www.beateatingdisorders.org.uk/media-centre/eating-disorder-statistics
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