While often regarded as a 'disease of the young', eating disorders do still affect women in their 20s, 30s, 40s and beyond. As many as 15% of middle-aged women have experienced an eating disorder at some point in their lifetime, according to a study published in BMC. But for the women who suffer post-puberty it can feel like they're the only one at war with themselves.
In this extract from I Can Run (Yellow Kite, £14.99), the debut book from Women's Health digital editor, Amy Lane, she details how food demons really took hold in adulthood – and how running and a mindset adjustment helped her to break free.
At 20, after flunking my A-levels the first time around I decided to move cities. I'd recently gone through a bad breakup and felt somewhat lost. I thought I needed a fresh start. But, this big life change caused internal swell and disordered eating that had lurked in the back of my childhood came back with a vengeance and it wasn't long before, I was battling bulimia behind closed doors.
My new surroundings stirred up big, deep, emotional issues and it caused my confidence to crumble: it started small, like a few Rice Krispies falling from the side of a crackle cake, but after one term at a new college, those small crumbs turned into big chunks and I fell apart. For the first time in my life I fell victim to the negative self- talk that I now know affects so many people.
This critical commentary about how I looked followed me everywhere. I spent every waking moment hyper- aware of my appearance and what I could do to edit it. Before then, I’d barely contemplated that what you put into your body affects the way it looks and how it operates.
How my disordered eating took root
I was late to puberty which meant I’d stayed quite small and slight through my teens. As such, I never had to deal with the awkward emergence of bouncy boobs replacing my childish chest. I ate chocolate- covered everything and it never showed.
If you're dealing with disordered eating or an eating disorder, call the BEAT helpline: 0808 801 0677
I could binge on whatever I liked and still fit into my Kappa popper tracksuit and spaghetti string vest. So, at 20, when I decided to attempt to eat better to look better (I finally learned that five slices of half- and- half bread slathered with jam didn’t constitute a balanced diet) I didn’t realise I was running headfirst into my next episode of food chaos. Paradoxically, my problems all started with a commitment to what I thought was healthy eating.
I looked for lower-calorie foods and menu options that were light in fat. I ordered my burgers bunless and on nights out I would drink a Skinny Bitch (that’s vodka, soda and lime). This progressed to buying books including The South Beach Diet that promoted cutting out carbs to elicit rapid weight loss. It also promised increased heart health, but let’s be honest, that wasn’t top of my agenda.
Numbers 1 through 10 on my agenda at that time was getting lean AF. I devoured the headlines that vilified carbs and really did believe that breaking up with bread was the shortcut to slim. The problem was, once I began scrutinising my food and its nutritional makeup, I couldn’t stop. Rather than seeing the benefits of ingredients, I’d obsess over the sugar and fat content. It wasn’t long before my carb- free diet became my dairy- free, low- fat, low- sugar diet, too. The scariest thing is that no one around me batted an eyelid. Eating clean was cool.
My 'clean eating' took a dark turn
While some people could deploy these diets in a more measured way, I couldn’t. My ‘healthy eating’ became extreme, and for the next 10 years I would suffer through a psychological eating disorder. Writing those words still makes me wince, shudder and look away in denial. Jordan Younger, AKA The Balanced Blonde once said: ‘No one plans to develop an eating disorder,’ and she’s right.
But life doesn’t always go to plan. According to Beat Eating Disorders, more than 1.25 million people in the UK have an eating disorder. Of those, 75 per cent are female. However, the early warning signs of this illness often go unnoticed. For years, I ignored the signs. Despite knowing that eating multiple bowls of granola and then purging them all back up again wasn’t normal, it became my normal. I’d regularly go to the gym fasted, and work out until I could burpee no more.
Back at home I’d then binge on packets of cookies and family- size chocolate bars. Once full, I’d head to the toilet and throw it all back up again. I was one of the many adults who was simply unable to process the signs of an eating disorder; shockingly the average delay is three and a half years between falling ill and recognising that you have a problem. Spotting an eating disorder early on is rare. Out of 2,000 adults surveyed by Beat, nearly 80 per cent were not able to name a psychological symptom.
And yet, physical signs of eating disorders are often the last symptoms to show, happening once the mental illness is ingrained. It’s why many of you, I’m sure, can’t understand why I couldn’t see that being sick after bingeing on food was problematic. Well, that’s because by then it was already too late.
I tried to face my bulimia
I’d been wrestling with these issues in my mind for years and lost. By the time I looked up from having my head in the toilet bowl, I couldn’t help it. To be honest, the only reason I finally faced up to my issues and confided in a close family member was because I got caught out. We were on holiday in Ibiza and I’d been spotted going to the toilet for a third time during dinner. I had a choice: I either admit the truth or lie and have my family believe that I had a Class A drug problem. I chose to break my silence on my bulimia.
Understanding eating disorders if you’ve never suffered from one can be baffling. Comprehending why anyone would go that far isn’t easy. The only way I know to explain it is that, yes, I knew it was bad, but what was bigger than the fear I felt for the damage I was doing to my body was the disgust I felt looking at myself in the mirror. I no longer saw my true self.
Instead, all I saw was my body in visceral detail, and my mind was whirring, one step ahead and already plotting how it was going to shave off inches from my thighs and arms, and telling me what I could and couldn’t eat for the next 48 hours. It did this because at some point my brain had linked food and self- worth.
After my admission in Ibiza, I thought life would get better. I thought that by saying the words I would magically become fixed. I believed I would be too ashamed to puke up my food again and I would finally recognise the severity of the situation.
I wasn’t and I didn’t. Even when later that year I confided in two friends, thinking the extra eyes on me would help me to break my binge-purge eating patterns, nothing changed. For months I continued on with this behaviour, spending unnecessary money on food. I squandered my weekly budget on snacks and then watched as they – along with my self- worth – were flushed down the drain.
There were times when I managed to break the cycle and I’d go weeks or months without doing myself harm, and I thought I was ‘recovered’, but then when I experienced change, stress or disappointment the disorder worked itself back into my life. Throughout all of this, there were more problems lurking in the background. When I wasn’t gorging on granola or processed snacks I masked my disordered eating tendencies by subscribing to the latest new-age food cult to hit the internet.
I used fad diets to mask what was going on
I’d tell everyone this new way of eating was the route to better health, increased energy and glowing skin – not that I really gave a shit about that part; I was on a mission to get thin. Because, when I looked in the mirror I didn’t see the abs that so many people often reference – a genetic perk that I get from my mum (thanks, Mum!) – but the small pockets of fat that squished between my bra strap and armpit.
I didn’t see the strong legs that had carried me over a half marathon finish line, but the lack of a thigh gap and cellulite on my bum. I was deluded by what a healthy body should look like and so snacked on quick- fix advice to iron out my self- perceived flaws.
At many points in my twenties, I wasn't 'bulimic,' as such, but labels are tricky. When your symptoms don’t exactly match the list for anorexia, bulimia, or binge eating disorder it’s common to be diagnosed with “other specified feeding or eating disorder” (OSFED), which I’m sure, would’ve been given to me at this time.
That took a ride on the keto bandwagon
It was in 2016 I found myself with a mouth that stank like nail polisher remover, headaches so painful I had to call in sick to work and constipation so chronic that I was concerned that my faeces would eventually force their way out of the opposite end.
I’m talking about the time that I went keto. It was hellish. For two weeks I stuck to the extremely low- carb food plan in order to force my body to burn fat, not carbohydrates. As I weighed everything I ate to ensure I consumed no more than 20g of carbs a day, I would remember my PT at the time and his roster of clients.
His Instagram was full of bikini models who were so lean that a strong wind would blow them over. They looked super- human, like flesh- coloured Avatars – there wasn’t an ounce of excess flesh. And if the Skinny Bitch Collective could do it, then why couldn’t I? Well, apart from the side effects I’ve already referred to, not to mention urine that you could smell 2 metres away from the toilet, it only increased my avoidance of more food groups. Plus, there’s a major flaw in this food plan: you can’t pause keto.
If, like me, you eat this way for two weeks and then give up because the temptation of pizza is too strong, when you next step on the scales a few days later you’ll most likely register the same weight as you did before going keto. Naturally, this ended in a heavy dose of self- criticism and trash talk, which, inevitably, propelled me into the arms of yet another self-prescribed weight- loss plan.
What I wish I’d known before going keto is that the initial weight loss seen on the scales by going low- carb is not fat melting away, but the body ridding itself of excess water. So when you reverse your diet, your body restocks its empty reserves, and this once again shows up on the scales.
Simply put, I never did lose fat, just water. Not long after the keto catastrophe, I tried the raw vegan diet. While some people eat like this for ethical or environ-mental reasons, I of course ate nothing but raw vegetables to get lean. I chased the notion that if I got back down to 53kg (the lightest I’ve been as an adult) everything would be golden. So I set about filling my fridge and cupboards with nothing but vegetables, legumes, nuts, seeds and cold- pressed oils.
And then the raw vegan hype...
For the first 48 hours I really enjoyed eating raw. I spiralised courgettes and made cashew pesto. I blended cauliflower and made a raw pizza. I even made raw carrot cake ice cream.
It was working until a few days of juicing, blending, soaking, sprouting and dehydrating blew up in my face, literally. I had such bad gas and bloating that the only way to relieve the pressure was to go to the disabled toilet at work and get myself into a downward dog.
I spent 20 minutes burping and farting while at the same time contemplating how many toilet germs I was inhaling by having my nose so close to the bathroom floor. After that day, I threw out the spiraliser and Jason Vale’s juice book and instead vowed to leave raw veganism to Miranda Kerr and co.
It would be a few more years until I truly understood the benefits of a balanced diet. I was still indoctrinated in the school of ‘carbs make you fat’ and was suffering as a result. On reflection, the fact that I once weighed broccoli to log its carb content on My Fitness Pal was a sign that all was not well.
All the while I was still exercising hard and wondering why I had such sore muscles, felt fatigued and was SO. DAMN. HUNGRY. And then, after a night out, this intense need for food came back to bite me. I’d been out with friends in London and stumbled in some time after midnight.
I just about managed to smear some face cleanser over my skin before passing out in my room. I’m not quite sure what happened between that moment and coming around in the kitchen, but all I know today is that, somehow, I’d managed to sleep walk to the fridge. Totally naked.
The reason I know this is because, upon hearing weird scrabbling sounds in the kitchen, my best friend’s boyfriend (my landlord) clambered out of bed to check it out. He was confronted with me, stark no-bollock naked hacking away at an unripe avocado. I’d obviously decided in my drunk, hungry sleep that I needed food and beelined for the fridge.
To this day, we’ve laughed about it but I’m always quick to move the conversation on because, number one: who wants to revisit the story of their best mate’s boyfriend seeing their fanny? And number two: the fact that drunken me chose an avocado as a snack is so cringingly wellness.
Thankfully, not long after The Night of the Avocado Fanny a new breed of nutrition advice landed. For once, the new recipe books and diet manuals weren’t campaigning for more kale and turmeric, but instead championed the merits of carbohydrates for weight loss.
How I found my balance
Bob Harper (celebrity trainer and the guy from America’s Biggest Loser) published The Super Carb Diet. In it, he explains how going from a Paleo diet to a carb- rich meal plan can help prevent constant food cravings and feelings of deprivation. This was also around the same time that Joe Wicks started to bust the myth that eating carbs after 6pm will make you fat. Further research by Stanford Prevention Research Center in California agreed with Harper and Wicks: a low- carb diet is no better for life- long weight loss than a low- fat diet. The key is quality food.
Inspired, and intrigued by the new nutrition ideology, I chewed over the science. It turns out that after intense exercise the body’s biggest concern is replacing energy stores (glycogen). Sure, it needs protein to repair muscles but if you don’t restock your muscles with its favoured form of energy, then chances are your next workout will feel harder. Ideally you’d eat a 3:1 ratio of carbohydrates to protein after a workout.
I hadn’t been doing this. I’d removed oats, bananas and other forms of carbs from my post- workout shakes and instead chugged only protein powder and water. Without knowing it, I’d actually cut the food group that my body so desperately needed for intense exercise, and my AppleWatch recorded the results: my split times got slower, not faster. I’d unwittingly given myself a nutritional handicap.
Clearing up my confusion on carbs was a ‘holy shit’ moment. For years, I’d been led to believe they were bad. However, by understanding their function in a balanced diet I was able to stop seeing them as foe but a friend to my running. And when I started marathon training I truly understood their importance in fuelling success.
And the role that running played
I’m not crediting running with curing my bulimia or helping me leave disordered eating in the past – though I can happily report that my relationship with food has been far happier for around three years now – but from a situation where I was battling through the confusion of conflating food and body image, arming myself with the real nutritional knowledge that comes with fuelling fitness has helped no-end.
I'm also aware that although eating disorders and disordered eating are typically associated with teens, they're not the only ones suffer - I wasn't an anomaly and if you too, are over 20 and are struggling with your health then know, you're not alone. Women and men in their 30s and beyond do and can suffer from eating disorders.
Today, I don’t put a label on my diet or subscribe to a plan. I eat mindfully, thinking about what fuel my body needs to carry out the tasks I ask of it. I believe there’s a time and place for all foods, you just need to know why.
It's true that I can happily say that right now my relationship with food is good. But much like that ex-boyfriend who will always linger in your past, I feel like eating disorders are the same. You know they’re there but you also know that no matter how good they (he) made me feel at the time, ultimately, they’re toxic. The fallout is not worth the short term high.
What’s really changed though, is my relationship with myself. I’ve learned to be kind, careful and respect the body that I’m in.
The expert's take on disordered eating & eating disorders
To get specialist insight into the whys and hows of eating disorders, WH spoke to Dr Bryony Bamford, Consultant Clinical Psychologist and Clinical Director of The London Centre for Eating Disorders and body Image
What counts as disordered eating?
There are a number of different eating disorders, all of which have a different set of diagnostic criteria. Common to all eating disorders however is an inflated importance of shape and weight, that is shape, weight and food control are seen as central to a persons self esteem and worth.
This inflated importance leads to a number of behaviours (extreme dieting, over exercise, purging behaviours) designed to control shape, weight, eating or emotions. The range of behaviours used will vary from one person to the next, and will commonly change throughout the course of an eating disorder.
What distinguishes disordered eating from a diagnosable eating disorder is mainly about degree, and the amount of distress that changes to eating, weight or behaviour evokes.
The Diagnostic and Statistical Manual of Mental Disorders (DSM-V) recognises 4 different categories of eating disorder: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder, and Eating Disorder Not Otherwise Specified (EDNoS).
Symptoms of disordered eating may include the kind of behaviours that are commonly associated with the other three categories of eating disorder:
- rigid dieting or frequent limitation of the amount of food eaten
- binge eating (frequent or occasional loss of control of eating that causes guilt shame or distress
- purging (extreme attempts to get rid of calories e.g. via self induced vomiting, excessive exercise, or use of diet pills and/ or laxatives).
But, disordered eating might also include:
- body weight and shape being central to self esteem or self worth.
- A negative body image or disturbance in perception of body image (thinking that you look bigger than you really are)
- A rigid exercise routine combined with extreme guilt or anxiety if this routine is not followed.
- Obsessive calorie counting or ‘rules’ around calories e.g. ‘I can eat this only if Ive exercised first’
- Anxiety about or avoidance of certain foods or food groups
- A rigid approach to eating, such as only eating certain foods, inflexible meal times, refusal to eat in restaurants or outside of one’s own home
- Rigid ‘rules’ around eating such as ‘I will eat that only if I know I can go to the gym later’
Is dieting disordered eating? Do fad diets cause eating disorders?
Eating behaviours cross the line into an eating disorder when the behaviours used become extreme and actually detrimental, rather than beneficial to health. People will often be unaware of when they have taken these rules to an extreme and may still believe that their food behaviours are necessary or beneficial to them.
A more obvious sign may be that a person has started to prioritise their food rules over other aspects of their life, (for example socialising, relationships, other interests), or when the idea of breaking these food rules becomes extremely distressing to the point where they become phobic of any deviation from their rules.
Where can I turn for disordered eating and eating disorder advice?
We are extremely lucky that most areas of the UK have specialist NHS eating disorder services which can be accessed through a GP referral. For those that do not meet criteria for NHS treatment, need an out of hours appointment that may not be offered by the NHS or do not feel able to wait to be offered treatment, there is also the option of private specialist treatment.
In the case of an eating disorder, specialist treatment from someone trained and experienced in treating eating disorders, rather than generic counselling is crucial. There are also a number of eating disorder charities both at a national level or smaller local charities, many of which offer free eating disorder support guidance or treatment
- BEAT has helpful advice and offers one-to-one webchats, or you speak to someone over the phone
- The London Centre offers help and treatment for eating disorders and body image
I CAN RUN is out now.
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