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Elizabeth

Age at interview: 20
Age at diagnosis: 12
Brief Outline: Elizabeth was diagnosed with anorexia nervosa at 12. Through inpatient and outpatient care and CBT (Cognitive Behavioural Therapy) she has learnt to control the eating disorder. She wants to be well to have a successful career in journalism.
Background: Elizabeth is 20 and a second year language student at University. She is single and lives in halls of residence. White British.

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Elizabeth says she was always “funny about food”. She describes always feeling like an outsider among her peers; more mature and “world aware”. In order to stand out from her peers, she started controlling her food. At the age of 10 she started avoiding fatty foods and by secondary school was cutting down more and more foods. Elizabeth says it was a slippery slope; she was losing weight and feeling weak and faint.
 
By Year 8, Elizabeth was too weak to attend school. Her GP referred her to the local hospital where she was told she didn’t have an eating disorder. She was later referred to an adolescent mental health unit but contact was very infrequent. Elizabeth felt let down by the hospital and health care professionals and stopped caring herself. She was chair bound at home and experienced severe depression. Finally her GP referred her for an emergency consultation at a specialist unit in the next county. To her shock, Elizabeth was admitted as an inpatient. She stayed at the unit for 4.5 months.
 
After discharge, Elizabeth went back to school but was still struggling. She was under eating and felt horrible. She also felt a lot of anger towards the hospital for having made her put on weight. Sixth Form “changed everything”. Elizabeth felt more out of place than ever; many of her peers being apathetic and eating unhealthy foods and soon Elizabeth was in a punishing cycle of exercise, work, restricting food and not allowing herself any fun or enjoyment. Around her A-levels she was put on antidepressants and referred to an adult eating disorder unit as an outpatient.
 
Elizabeth got accepted to a top university but her consultant strongly advised her to postpone it for a year. She fought hard to be allowed to start with her peers, which she did. While university has been tough and pressurized, Elizabeth has also made some of her greatest friends there. Elizabeth has found CBT helpful; a turning point for her was realising that “I can’t have the life I want if I stay anorexic”. She is passionate about writing, working long days as the editor of the student newspaper and wants a successful career in journalism which requires her to be well and have energy. Elizabeth believes one can never really get rid of anorexia, but learn to control it so it will become dormant.
 
 

Elizabeth felt more grown up than others of her age and 'like an outsider'.

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I was always kind of living in a dream world when I was a kid. I was very much a kind of, wanted to live like my life like I read in stories. And pretended I was living a narrative kind of thing and my life was a little story that I made up for myself. And I guess I was quite precocious, as a child so that made me feel like kind of a bit of an outsider from that age. I never really liked doing the same kind of things as my peers at all ages.
 
I never really liked watching, I didn’t enjoy watching cartoons, and I played with Barbies earlier on and for not quite as long as all the other kids. But like quickly I grew out of kind of children’s things. And decided I wanted to be an adult and so I always got very frustrated when people were like, “No, you’re only, you’re only a child Elizabeth.” And you’re only sort of 9, 8 or 9 and whereas in my head I was 20. And I was this glamorous young woman, and I was actually only 7 or 8. And so that made me feel like a bit like I knew I wasn’t the same as a lot of other children. 
 
But then I kind of didn’t like myself for thinking, I didn’t think I was special, but there was something in me that kind of told me I thought I was special. So I kind of hated myself for that, being like, not, “You’re not, you’re no better than anyone else. You’re not special. You’re not, you’re not at all, you’re just a person.” I think the gap between myself and my peers was very, very much in evidence in my teenage years. Like when my peers were 11 they would, there were just sort of like I don’t’ know, lazing around watching cartoons and things like that, and playing with dolls even then, I’d much grown out of that by then. What did I enjoy doing? I was into like heavy metal music and I was, and I think that was my sister’s influence.
 
 

Therapy was “a turning point” for Elizabeth. It helped her revalue her life and realise that she...

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I started to see a specialist cognitive behavioural therapist who kind of worked through a lot of those issues with me and who I still see now about realising that actually there are other values in life apart from the anorexia that, that shouldn’t be one of your values in life. That there are other things to live for and that actually staying anorexic will have massive disadvantages for the rest of your life, like job prospects, friendship prospects, the time it takes. The sheer time involved in being anorexic is a lot.
 
And so it really sort of made me perk up and think, “Wait. I need to, if I’m gonna live as a, if I’m gonna live a successful life what do I want out of my life? And I can’t have the life I want if I stay anorexic.” And so that has really kind of been a turning point.
 
 

Elizabeth had ambitions to become a journalist and realised that she couldn’t be both good at her...

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To be honest like a lot of the time it’s just been I have to eat because I need the strength to do this. Like for example when I got made the deputy editor of the paper I had to like often do quite late nights on a Tuesday, a Monday and a Tuesday to get the paper done, for the deadline. And I just had to take like; I’d have to eat because I just got to the point where I just couldn’t concentrate anymore on like copy edit. Say I had to like sub-edit a, some news copy for somebody, I just had to eat because I just wouldn’t be doing my job properly anymore. So that was like the realisation that if I don’t eat, other people will think badly of my ability to do the job. And I just don’t want that. Like I want them to think I’m really good at my job. So like whereas in the past it would have been kind of I want to think that I’m really good at anorexia, now it’s more like important that there are other things in my life that I’m really good at. So that’s kind of that realisation and so I realise that I have to stop and eat.
 
Realising that other people, like I always thought that other people just don’t eat, like they just don’t make time for food. Other people just don’t eat whereas actually realising that people do say, “I’m gonna stop for lunch,” is quite handy.
 
 

Elizabeth said she needed to restrict food to compensate for having any fun. Feeling weak and...

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Restricting food is like restricting pleasure and it’s like a compensation for any kind of fun. So the kind of example I use is this sort of holiday periods where I feel I can’t control what I’m eating and I feel like having the freedom to wander off around Europe and like see loads of different countries and visit loads of different places that had to be compensated for by not eating. And to kind of punish myself for that, for that freedom. And that experience. I had to like I had to kind of dampen the pleasure of, the enjoyment of that by making it really hard and making it, making myself feel like I was gonna faint the entire time because I was too weak, and yeah just, yeah being self-disciplined and I kind of feel, believe quite strongly that people don’t really deserve to have like, I felt that people just didn’t deserve to have any pleasure in their life. Like why? Why would you? Like why should you? You have to earn stuff and if you haven’t done anything to earn eating nice food, then why should you?

 

Being diagnosed with severe osteoporosis was a massive shock to Elizabeth but also an incentive...

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I was diagnosed with quite severe osteoporosis last year, which was also a massive shock. It was also like I’ve got to do something with this because otherwise I will just break my bones and I will end up like with my back like that when I’m an old lady or even before I’m an old lady. And I, I don’t want that, I can’t afford for that to happen. I can’t afford to be in and out of a fracture clinic if I want to edit, edit the Times or be a massive like, I don’t know be successful in my life basically. I can’t afford to be in and out of hospital appointments and fracture clinics. And I never have broken anything, but if I was to I can’t afford, I just don’t have the time in my life to be in and out of hospital appointments for the rest of my days. So I can’t stay like this basically.
 
And so yeah I think I’ve still have osteoporosis because a year like, I had my bone scans last June and I spoke to my doctor just recently and they said, “Well you won’t see, like the bone scans won’t show a massive difference in a year. But you can build up your bone density with, to make sure that you, it’s strong enough.” ‘Cos like now is obviously the bone density building time of my life. You can build it up now before it’s too late, and that you’ll never build it up and so those holes in your spine, which I saw on the, on the bone scan (*DEXA scan) they did, which were quite shocking like kind of even shocked me, so that those holes don’t stay there forever. And so I think that was a kind of a, “Whoa, you can’t stay like this,” either.
 
 
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At university, Elizabeth found it much easier to make new friends than in school because people...

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I did make friends, I did, and I’m probably some of the resident hall people in my life now are like, I don’t know what I’d do without them. So I was just lucky to meet people here that I, that kind of understood far better than anyone else I’ve ever met. And that kind of made me realise that people aren’t, we’re not teenagers anymore. People aren’t going to react the same way, some people do, some people weren’t understanding at all, and there have been occasions that I’ll go into, that were really tough. But a lot of people were more understanding and kind of made me realise that actually adults don’t have the same attitude to, most, a lot, some adults don’t have the same attitude to eating disorders as teenagers.

 

Elizabeth didn’t like the feeling of being out of control when drunk.

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I can always like, you can make, one glass like if you forced into those situations where there’s, everyone is holding a glass of wine, you can make one glass like last a long time. And you can like, yeah I find it quite hard to kind of, getting drunk it’s kind of letting go of your body and I find that really hard. Because I’m so used to like utter control over my body, and so getting drunk is quite hard. I feel really disgusting like in, most people feel pretty awful when they’re hungover, but I feel like gross with myself. I feel disgusted by myself. Which I find quite hard, and I’m genuinely not very good at coping with alcohol either because I, for a long time like if I wasn’t eating much then that would be really hard. But even if I have a good meal now I’m just not very used to it. Somehow I’m not very good at coping with the alcohol.

 

Elizabeth said while most of her teachers were “horrible”, she had a fantastic Biology Teacher...

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Teachers, some teachers were amazing, other teachers were horrible. Some, yeah my form tutor was brilliant. She took me under her wing almost, and kind of cared for me. As you would do a kind of to a child almost I guess, as a daughter. I was, she was a biology teacher, I don’t know if that meant she understood any better or not, but she just seemed to kind of empathise and support. Other teachers were horrible, they were like “Oh, she’s not been here for a whole year, so we’re just going to give her a C because,” and I was a straight A student. Like I, you know, this was, before that I was like got A’s in everything. And so, “Oh, we’re just going to give her a C because she’s not really been here. So we don’t know what she’s like, so we’re just gonna like, we’re just gonna give the average,” really dismissive. Which I found really hard to deal with because it was like well they really obviously don’t care, and it made me feel like an even more of an outsider.

 

When Elizabeth was being treated by children’s mental health services she felt “very patronised”...

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I think the teenage ones were very patronising. Very patronising. They didn’t understand what my needs were and what, it sounds really bigoted, really they just, in the adult services they realised what were the key, what were the things that were important to me that are gonna be the big motives for getting better. Like my adult therapist realised that I want, I have a really good job and I want to have a close set of friends, but like having a baby or like having yeah, isn’t that important to me. So they’ve really like honed in on like, “Okay you need to get better so you can like survive like internships, and, “so you can like survive like a long day in the office or so that you can like see your friends.” They’ve realised that those things are important to me, whereas in the teenage services they just treated you like you were a child. And so they just like force fed you, and like said, “You need to get better.” 
 
So I think massively, I mean it might not be, I think I was, I think it’s fair to say I was quite a mature teenager, so I was quite shocked when they didn’t treat you as an individual, but treating each child more, realising what each child wants from their life more would massively help. And I also just think being less patronising. Speaking to you as a person rather than to your parents, or being very dismissive. And, yeah I think that’s, think that’s it yeah.
 
 

Elizabeth said her parents 'tough love' worked for her. This made her realise that she had to...

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So they [parents] always said to us from very early on it’s your illness and you’re going to have to get over it yourself. Ultimately we can help you but we can’t get better for you. 
 
And I think that was actually, it sounds harsh but it was a really good strategy because if I’m not the one who’s in, like who’s implementing change, if they’re doing it for me and I don’t actually really want them, I don’t actually really want it, then I’ve got to learn to, then I’m not, it’s not going to work and ultimately I’m gonna have to learn like that as an adult on my own. 
 
So that was massively useful. 
 
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