By Annabel McCarthy *
Warning: This story discusses eating disorders.
Opinion - Anorexia nervosa has the highest mortality rate of all mental illnesses. Yet somehow, in Aotearoa, eating disorders seem to be amongst the hardest illnesses to access treatment for.
Photo: RNZ/Vinay Ranchhod
I was first diagnosed with anorexia eight years ago, as a 14-year-old. I was hospitalised and received therapy. Treatment focused mainly on my physical symptoms - regaining weight, so I wouldn't suffer long-term complications. Soon after I reached a healthy weight, I was discharged from the service, despite not having mentally recovered.
Eating disorders are mental illnesses with physical repercussions. Weight restoration is important, but mental recovery is too. It helps prevent relapse and may have stopped that from happening to me.
When Aotearoa went into lockdown in March last year due to Covid-19, I subconsciously turned to old eating disorder habits as a way of coping with the stress, uncertainty and loss of structure that accompanied the change.
I spent almost every moment obsessing over how hungry I was - but I couldn't eat anything beside what the disorder deemed 'safe'. I was irritable, because my energy levels were so low. People described me as being "absent" and "unavailable" - I had little capacity to think about anything beyond what the eating disorder wanted me to.
Every time I stood up, I felt like I was going to pass out. I was dizzy, constantly had headaches and couldn't concentrate for longer than a few minutes. I felt like I'd never experience being warm again because, no matter how many layers of clothing I put on, I always felt cold. A thin layer of hair grew all over my body to keep me warm while the hair on my head fell out in clumps whenever I showered.
I was officially diagnosed with anorexia sometime after the first lockdown ended. "Everyone had lockdown coping mechanisms," my GP told me. "Yours was your eating disorder". I was underweight and on the verge of becoming medically unstable when I was referred to an eating disorder clinic in Wellington. But I wasn't physically sick enough to be seen immediately, so I went on a waitlist.
Being told I'd have to wait five to six months for the help I desperately needed was crushing.
Read more:
I later discovered that if I'd been hospitalised, I'd have been pushed up the list. This seemed illogical - almost as if I were being encouraged to sink further into my eating disorder just to get the treatment I needed. It felt like the severity of my mental illness was being determined based on physical symptoms alone.
Faced with a months-long wait, I searched for help outside the public system.
However, the few private providers out there were either not taking new clients or had equally long waits.
In the meantime, my GP monitored me weekly - weighing me, taking blood, and measuring my temperature and blood pressure. This treatment focused on keeping me medically stable and restoring me to a healthy weight. The mental symptoms of the eating disorder were never addressed.
Because I was underweight, I still hoped the clinic would offer me support and therapy, like I'd received when I was 14. But after a couple of months passed and I still hadn't heard from them, I realised if I wanted to recover I'd have to learn how to do it alone. I read what I could about recovery from anorexia and, without professional support, started working towards getting better. It was - and still is - one of the most difficult things I've gone through.
When, at the end of last year, the clinic finally offered me an initial assessment, I was no longer underweight. Because of this, they said it was unlikely I'd be able to access long-term care through the service. I withdrew my referral. The humiliating prospect of being assessed and told I wasn't 'sick enough' for help was something I couldn't bear.
I've now reached a healthy weight, but that doesn't mean I'm recovered. For me, the physical healing was the easy part; it's mental recovery that's the hardest. Though I've regained weight and regulated my eating habits, the loud, disordered thoughts are still there, just as loud as ever.
Anorexia is not the only type of eating disorder, and an individual's weight or size doesn't determine the severity of their illness, nor does their gender or race. A person can be malnourished or suffer from an eating disorder in any body, yet have the illness invalidated because they don't fit with society's image of what an eating disorder looks like.
I am someone who fits the stereotype. I am a thin, predominantly Pākehā, cis-woman with anorexia. Considering even I cannot access the right evidence-based, best-practice help and given the barriers we know to exist in the health system, there must be so many who are falling through the cracks, suffering in silence.
* Annabel McCarthy, Te Whakatōhea, is a student at Victoria University of Wellington and a contributor for student publication Salient Magazine.
Where to get help:
- EDANZ: Find support, information and treatment options online, call the helpline 0800 2 EDANZ / 0800 2 33269, fill in the contact form, or email (info@ed.org.nz)
- 1737: Free call or text 1737 any time to speak to a trained counsellor, for any reason.
- Lifeline: 0800 543 354
- Suicide Crisis Helpline: 0508 828 865 / 0508 TAUTOKO (24/7). This is a service for people who may be thinking about suicide, or those who are concerned about family or friends.
- OUTline: 0800 OUTLINE (0800 688 5463) every evening, 6pm to 9pm.
- Rainbow Youth: (09) 376 4155
- Depression Helpline: 0800 111 757 (24/7)
- Samaritans: 0800 726 666 (24/7)
- Youthline: 0800 376 633 (24/7) or free text 234 (8am-12am), or email (talk@youthline.co.nz)
