Age at interview: 21
Age at diagnosis: 16
Brief Outline: Francesca was diagnosed with anorexia nervosa in early teens, which later developed into bulimia nervosa. She believes people will only respond to help when they are ready to get better, not if forced. Francesca never thought that she could even be able to enjoy eating but says now her favourite food is Thai.
Background: Francesca is a full time student. She has four siblings and lives at home with her parents. White British.

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Francesca remembers at age 13 or 14 starting naturally losing her ‘puppy fat,’ and people complimenting her on her appearance. She had transferred to a large secondary school and it was the first time she felt recognised for something there. Francesca started cutting down what she ate and her friends soon noticed there was something wrong. Her parents were busy working and her anorexia went unnoticed for some time. 
When Francesca’s school realised there was a problem, she started to be secretive about her eating. After school contacted her parents, they arranged for her to go to a private psychiatric clinic, but Francesca says that she was not ready for treatment and managed to get discharged soon after. 
Back at home, Francesca started to eat a little more to make people think she was getting better and would leave her alone. As she put on weight, she decided to make herself sick and take laxatives. This soon became a habit after every time she ate. When Francesca noticed blood in her vomit, she realised that she needed help with her eating disorder and went back to the private clinic. She says this time she was motivated to get better. She had group sessions, different forms of therapy and she found family therapy with her parents very helpful, as it was a safe environment in which to share their feelings. 
After discharge, Francesca stayed as an outpatient to ease her back into life at home. She went travelling for six months with her boyfriend, who has been very supportive and understanding. She was anxious about the different foods that she might have to eat whilst away and says she had to adapt, but actually quite enjoyed trying new foods. When she came home, she had a ‘new sense of life’ and returned to university. Francesca also volunteers as a Young Ambassador for Beat (Beating Eating Disorders). 
Francesca advises parents and health professionals to be supportive but not pushy, and non-judgmental. The person with an eating disorder should feel that when they are ready to talk, someone is there to listen. Francesca says ‘I’m happy. I didn’t think I’d ever be able to beat an eating disorder and get over it. I thought it was just going to be me for the rest of my life, but for now, I’m definitely OK.’

When Francesca moved to secondary school she felt lost in the crowd. Comments from other people...

I guess it all started when I went to secondary school in the early years, I’d come from quite a small primary school where, you know, you were very well known individually, you know, you were recognised for your achievements, like I was really good at netball so, that was one of my specialities and then I was quite academic in the school.
And then I just think I went to secondary school and became very much in the crowd, like at the back , I think that’s probably one of the reasons I developed an eating disorder, like I think when I was thirteen or fourteen, those kind of years, I started to lose my puppy fat as I was going through puberty and my body changed, and people recognised and noticed and commented on it, which I think was the first time since going to secondary school I’d actually felt like I was recognised, for being something or doing something whereas, I don’t know, I just really shadowed into the background I guess. And then it seemed to spiral into an eating disorder before I knew it like, I didn’t intentionally set out to lose any more weight but I think that recognition and that bit being noticed sort of obviously sparked something in me and made me feel that I could be good at something. So, I guess I developed anorexia without understanding or knowing what was going on and over the next couple of years, friends noticed.

Family therapy was a difficult but hugely helpful experience for Francesca and her parents. They...

[Family therapy was] very, very difficult. Actually really straining and upsetting, but all of us involved but it was really quite important for me like. My Mum especially refused to do it for quite a while in the first few months, and like they tried to do it the first time I went to the Clinic and she absolutely refused, she was just like, “No way, it’s nothing to do with me.” And I don’t quite know how we managed to eventually convince her to do it; it took a lot of me and my Dad, like “Please come.” Like I think she was scared that she was going to be accused of being to blame for everything, and that wasn’t really what it was about. But obviously quite a lot of my issues with my eating disorder had been about family life. Again not that they were to blame, but just certain things had made me the way I was and have certain feelings and they really needed to be discussed and I, I was too scared to do it outside of therapy. I didn’t want to hurt her feelings you know, not at all, I love my parents to pieces and they’ve given me so much. You know they really are great but it, some things needed to be said. 
From them to me, you know, to me and me to them as well. We had a really good family therapist that we went to, and she helped and encouraged us to have the conversations we needed to have you know, and make sure that there was no blaming going in those contexts, you know, we just needed to be open and say, you know, that I needed my independence a lot, which my parents didn’t give me. I didn’t want to say that to them and also they needed to let me go a bit, ‘cos they were holding on too much to me and we just were kind of able to have these frank, open discussions but, as I said, it really was very, very upsetting like, you know, we’d sit there at some sessions and we’d all cry [laughs]. I’d just be like, “Oh I can’t believe [laughs] this has happened.” 

Although Francesca hated art therapy and her art work being “psychoanalysed” in art therapy, it...

I went to art therapy and absolutely refused to do art. I was like, “I’m not going in, I can’t do it, I hate art,” and like [laughs] I was crying and screaming the room down and they made me go in and I hated it, but I learnt from that issue that I have such a great fear of doing things that I’m not good at, you know, I was able to work on, you know, what my fear is and why I’m not able to do things I don’t know and you know, that, from just from that session they set me a lot of tasks and I now, I set works upon just doing simple things that I’d never done before and simple stuff I felt that I was, wasn’t good at and it was really breaking down all the different barriers. So I just, I don’t think there was one thing, I think it was everything put together in that way.
What is art therapy like?
Absolutely awful [laughs]. I hate it; I would never ever want to go again. It was, I don’t know if it’s different everywhere you go but for us, we kind of had an art teacher kind of thing that would set you a task. He’d just be like, “OK this is the theme,” like say some place would have, like he’d show us an Egyptian picture for example and he’d be like so I want you to look at it and think about it, and just draw something which your emotions are telling you to draw. I still to this day, don’t get the point of it; I don’t agree with it, I just, I don’t understand it at all. One day, just to annoy him, I just decided to draw a smiley face with nothing else. I just thought, “Well fine, if you’re going to make me do this, this is what I’m going to do.” I got so frustrated ‘cos then he tried to psycho-analyse it [laughs] so you know, I’d draw this smiley face ‘cos I was really angry and I was just trying to get everyone to leave me alone and [laughs] things like this and I just, I don’t agree with it, but it obviously works for some people, some people find it therapeutic, for me it just made me even more angry, which I didn’t think I was actually and it showed me that I obviously did have anger issues as well that I needed to let out. But as I said I was able to learn something from it and I focused on that instead of [laughs] what he psychoanalysed me to say.

Francesca had weekly mentoring sessions through the University's disability office. They worked...

What does the weekly mentor mean, how does that work?
It’s part of the disability scheme and they allocate it based on your need and, obviously when I had my first assessment, I was quite needy, safe to say. So I actually get allocated an hour and a half each week to go to the mentor and it’s kind of up to me and her what we do, like I work with her. Any anxieties or problems that I’ve got I work through, like she lets me if I have a presentation to do, like I can go there and practice my presentation, she helps me work out the timetable for the week so that I can make sure I get all my work in at certain times, and she also sort of, actually really encouraged me over the last year to make sure I have social time and time for myself which I think, what else do we do? If I have any problems, she’s just there to listen.
So, which is nice to know that there’s someone impartial that I can go to. But yeah it’s really just up to me whatever else I needed. If I need any help, she will contact other people for me, on my behalf, and help me do that, like when I had issues. This year I had to find accommodation again without friends, but she helped me do that and she helped speak to people on websites and all of that so, it’s just really whatever you need. 
So it’s very pro-active and very involved?
Yeah, really. If there’s time to that I just, she can see that I’m, I don’t want to be there she’ll kind of just be like, “OK, is there something I can help you with? What’s up?” And sometimes I’ve, I just, I just don’t need anything that week and she’s just like, “OK well, we’ll leave it at that, you’ve got my email.” And if I ever do go upset or have any issues, she’ll email me during the week before our next meeting just to check up on me. But she’s nice so I do always know that she’s there. That’s very helpful.

Francesca’s boyfriend was involved in her recovery and knew how best to support her without...

Actually he’s been very good, ‘cos I think there was always the fear that he’d take on a caring role and he’d be my carer, and we were both quite adamant that wouldn’t happen ‘cos I just thought it would ruin my relationship and you know, so I told him very early on about what was the problems even, you know, and I hadn’t told anyone else, he was probably one of the first people I’d told before I went into the, and I also said, I have got history and I am struggling but it’s OK, I don’t want you to get too involved like, just don’t force me to eat and don’t anything. So the first few months, a year, we went on like that, he was kind of aware, kind of, he’d perhaps encourage me sometimes but we’d kind of just try to focus on the relationship outside of that. 
You know we didn’t always do the typical, ‘let’s go out for dinner’ date thing. We just, I suppose we avoided it quite a lot in the first part of our relationship , but obviously when I told him that things were that bad and I went into the Clinic, that was very difficult for him, to say, you know, he’s got a girlfriend that’s actually going into a hospital for a mental illness. But he stuck by me, and you know, he was very supportive and always said he wanted to get involved in my treatment, you know, he was just like, you know, “What do I need to do, I don’t want to push you but I don’t want to watch you get this ill again.” So he was really inquisitive and very open minded actually and it’s been hard. I think there have been occasions where he’s slipped into that caring role and he’s had to say, “You need, you need, you need to eat.” But on the whole we’ve managed to kind of keep a balance. We’re just, we make an effort to do things outside of food and we make an effort to do fun things, and he’s been good at like trying to get me involved, like you know, we do go out for dinner quite a lot now and you know and he’s just like, “Well, you decide where you want to go, like it should be what you want.” And then if he knows that I’m choosing somewhere for a reason that it’s, you know, it’s got to be healthy, then he’ll say, “Oh don’t be silly, we’re going here instead.”
And it works, and it really, it works well. He’s tested me and he knows what’s good for me and what’s not. But yeah, very happy.
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