Anorexia, my daughter & my family

By Jan Langton

I asked my Mum to do a guest post recounting her memories of what it was like when I suffered from Anorexia Nervosa in my late teens. It’s a long read - and a difficult one, but if it helps even one other family going through something similar, them I’m very glad that we’ve shared.

*Note that some names have been changed, and though you know me as Bex, my Mum usually calls me Becca - so that’s what I’m referred to as throughout.

Early signs as a child?

I actually think Becca’s first ‘brush’ with issues with food happened when she was in her last year of primary school. Becca suddenly, and it seemed to be almost overnight, became anxious about mealtimes and virtually stopped eating. Packed lunches were coming home barely touched and trying to get her to eat an evening meal was a struggle.

There didn’t appear to be any specific reason, she just ‘wasn’t hungry’ and became tearful if we insisted she ate what was on her plate. This went on for several weeks. Becca didn’t appear unwell physically although she obviously lost weight. I did take her to the GP who suggested it was ‘something and nothing’, probably a virus, and that she would regain her appetite. Obviously we were worried, but in the short term, there was little we could do except hope the GP was correct.

As it happened, Becca did become quite unwell during a weekend and, on the Monday morning, I felt she wasn’t well enough to go to school (unheard of in our family!). Becca’s dad, Will, was on leave from his job & due to return to his ship the following day, so she spent the day in bed.

Will went back to sea the next day and, so that I could go to work, I enlisted the help of a neighbour who popped in to check on Becca mid-morning. I came home at lunchtime and, as I worked school hours, I was home again after collecting her younger siblings from school. This pattern continued for the rest of the week and, slowly, Becca became her ‘old self’. She began eating properly again and generally life went back to normal.

When Becca was diagnosed with anorexia at 17, I did discuss this episode with the dietitian and said I wondered if it had been triggered by her longing to go to boarding school and the fear that this may not be possible.  At the time we had talked with Becca about the logistics of her going and, realistically, the only way it was possible was if she was awarded a scholarship. Time wise, I can’t remember if it was while we were waiting to hear if she had achieved this that she stopped eating, but it was certainly around then. Becca was awarded an academic scholarship and, from knowing this, and that she would be going to the school she wanted, she was back to normal.

It started as a desire to ‘get healthy’

Becca was 17 when she went on the skiing trip she talked about and, although she didn’t just stop eating on her return, she became more conscious about what she was eating. Obviously, while she was at school, we had no way of knowing if she was cutting back on food or exercising more, but at home I initially had no real concerns as, although she was eating less, what she did eat was healthy.

Through the summer holiday, before Becca returned for her last school year in the Sixth Form, she seemed happy. I did notice on the family holiday to Spain that she was quick to refuse carbohydrates and would swap those on her plate with her brother’s salad. She returned to her last year at school apparently happy and looking very well.

The first half of the term passed, seemingly well, although when she came home for half term in October it was becoming more obvious about the amount of weight Becca had lost. I did talk to her about my concerns that she had lost a lot of weight but Becca said she was ‘eating healthily’ – which in our presence she appeared to be doing – and that was why.

The alarm bells rang a week into the next half term, early November, when Becca’s house mistress telephoned to say she was concerned about the amount of weight she had lost and how much swimming and running she was doing.  As I was going over to see Becca and her sister the next day, Saturday, I said I would talk with Becca.

That day Becca, her sister and I went shopping for a dress for Becca’s first formal event of her final year. We were horrified when she came out of the changing room in a black halter neck dress which showed exactly how thin she was. Her shoulders and collar bones were skeletal. Becca’s sister made a comment about it, which Becca brushed off.

When I had dropped her sister back to her boarding house, I went back to Becca’s to talk to her. She said she didn’t think she was too thin but I told her she was painfully so and I was very worried. Becca said she was ‘fine’ and, at that point, there was little else I could say although I resolved to call her housemistress on Monday. However, something must have switched in Becca’s mind as, on the Monday , she took herself to the school nurse.

Things started happening quite quickly after this. Her housemistress called me and said that, although not underweight, the medical staff were worried and had made an appointment with the school’s GP. I took her to the appointment and, after talking with her, he suggested she was depressed and perhaps anti-depressants would help. Becca refused outright, which I was relieved about. I said I was concerned that she wasn’t eating and he offered to refer Becca to a dietitian who had a private practice at a local BUPA hospital. During the two or three weeks that the appointment took to arrange, she lost more weight.

Getting an anorexia diagnosis

The first appointment with the dietician, Maureen*, both Will and I went along. Becca spoke with her first and we were then asked to join them. In no uncertain terms, the diagnosis was that Becca had anorexia.

I think I already knew so, in a way, it was a relief that we had someone who would be able to help us through the next stages of battling her condition. It was pointless asking ‘why’ or ‘how’ it was more about what was the way forward.

Exercising to the extreme

Becca had been exercising to the extreme. Swimming and running at school and also doing sets of exercise in her room at night. The first step was that no school sport or physical activity was to be undertaken. That was easy enough to monitor, but not so much what she was doing in her room.

However, one saving grace was that Becca was always a child who ‘stuck to the rules’. Maureen made it clear that if she continued to exercise and lose weight her physical condition would deteriorate rapidly and she was at risk of being hospitalised.

Becca was terrified at the thought of going to hospital. The school was very supportive and all physical activity was stopped. I know it took a while for her to be able to stop the exercising in her room, but one evening she sent me a text saying ‘am in bed and haven’t done my exercises’ – a major feat for her.

Telling friends & family about the diagnosis

We made the decision that we would tell family and friends about Becca’s condition. Will didn’t think it was necessary but I felt that, if she had a physical illness or a broken leg, everyone would know. A mental health condition is less obvious but needs as much support. It was hard telling people initially, but I was glad we did as it meant we weren’t struggling quite so much on our own and we weren’t being questioned about her weight every time we saw someone.

It was usually Will who took her to appointments with Maureen, mainly because it was fairly easy to book them around his work and I would have to take time away from my job. Also, he was able to be more ‘rational’ about the situation which I struggled to be. Maureen was so supportive. Becca was asked to keep a food diary which Maureen would go through with her each week.

She talked with her about the science of needing food as energy and also advised about how she need to make changes to ensure her body was getting the fuel it needed. She would talk to Will at the end of the sessions with recommendations for ways forward.  At this point Maureen also made a referral to Child and Adolescent Mental Health (CAMHS) for Becca to receive counselling. (The initial sessions with Maureen were actually paid for by Becca’s granny, who wanted to help in any way she could, but once the referral was made to CAMHS, Maureen was able to see Becca under the NHS umbrella.) At this point Becca was still boarding so it wasn’t possible for us to monitor what she was eating. She wasn’t losing any more weight but she wasn’t ‘recovering’ weight either.

Anorexia affects the whole family

The really difficult period began when the children came home for the Christmas holidays. Becca’s siblings couldn’t understand why she wasn’t the same person she had been, why she wouldn’t eat or, when she did, she took so long to eat a small meal.

I remember one morning Becca totally losing the plot with her brother because he was eating a large bowl of ‘her’ cereal. Whether it was the size of the bowl that upset her…or because she couldn’t eat with so little thought?

One thing we were determined to do was maintain family life during the holidays. We all still ate together (although I’m pretty sure Becca would have preferred not to), if we were invited out as a family, we all went – Becca was not going to shut herself away. However, routine was vital.

Mealtimes had to be stuck to – no missing meals – as if Becca missed one meal, she would use it as an excuse to miss another. We had a couple of Christmas parties to go to as a family and I made Becca’s meal for her to eat before we went as I knew she wouldn’t eat party food at the event.

Adjusting to life with Becca at home

Before the end of the holiday we all went to London to see ‘The Lion King’. We took a packed lunch to ensure that Becca could eat lunch at the right time and had booked a table at ‘Ask’ for dinner on our return. It was there that Becca’s dad and I realised that we couldn’t let her return to school as a border. She agonised over the menu, struggled to choose anything and we had to pick for her. We knew, left to her own devices, she would not manage to maintain the small progress she had made.

It was the best decision possible.

In January a new routine started for the three of us at home. Either Will or I would drive her over to school and collect her afterwards. If it was me I’d then head on to work. There wasn’t time for Becca to have breakfast at home before leaving so we organised everything she needed in her study to enable her to have it when she got there.

She had scales to weigh the amount of cereal she had to eat, bread and spreads for toast and a blender, fruit and milk to make a fruit smoothie mid-morning. Lunch she continued to have with her friends, who were very supportive and ensured someone stayed with her until she had finished eating. I would tell her what we were having for dinner so that Becca could make an informed choice about what to eat at lunchtime.

I learned quickly not to deviate on the dinner plan. One time, having told Becca we were having jacket potato with our evening meal, she had a complete meltdown when I served roast potatoes instead. She screamed at me that she would’ve had jacket potato for lunch if she’d known and that I’d ‘ruined the day’. It was a shock that things had to be as rigid as that but it was doable.

 I also had to make sure that Becca knew that I had weighed the portion sizes and they fitted with what she had been told she needed to be eating. At this point I was also grateful that Becca’s dad loved puddings as Maureen had made it clear to Becca that evening meal involved a main course and dessert – preferably steam pudding, rice pudding or a fruit pie or crumble and custard. I have never been a pudding eater really but her dad would eat the same as her and sit with Becca until she had finished everything – no leaving anything on the plate.

On top of this, Becca was also expected to have a piece of cake or a couple of digestive biscuits with a hot drink before bedtime. I think at this point Becca was also resentful that I didn’t have to clear my plate so I became careful not to overload it so that I ate everything. Will told me that Maureen did explain to her that I only needed food as fuel, she needed food as fuel and extra to help her body recover the amount of weight it had lost. I don’t think she always found it easy to accept.

Another meltdown episode happened during what I think was the February half term We had agreed that Becca could go to her part time job as a waitress for a couple of lunchtime sessions, providing she was able to take a break and eat lunch. This was agreed.

I explained to Becca that I would pack her the same lunch as I took to work and thought no more about it. The first morning she telephoned me, upset and angry that I hadn’t warned her there would be a yogurt as well as sandwiches. It was frightening how angry she was and, although she did eventually calm down, it took me a while to stop shaking.

Slowly, Becca was recovering

As the weeks passed Becca was slowly recovering weight and seemed happier. By now counselling through CAMHS had started and Becca saw a counsellor there about once a month. I usually took her to these sessions.  

As is the norm, we were not party to what was discussed although we were asked if we would like a family session. I talked with Becca’s siblings and the answer was a resounding ‘no’ from them. Becca’s illness, while they were all at school, did not really impact them greatly as they saw little of each other although of course, her sister especially was very aware of what was happening and they were both worried about her.

Also during this time we were making visits to university open days, taking packed lunches with us to be sure that Becca could eat at the correct time. She was working hard for her A Levels and continuing her driving lessons. At this point Becca had, unsuccessfully, taken three tests. Quite how she held it all together, I don’t know but she did.

Will and I were still very watchful and, at times I felt as if I was walking on eggshells around her. The months had been the hardest we had ever faced but somehow we were coming through it.

Turning the corner

A real sign that a corner had been turned was when, in April, Becca passed her driving test. It gave her such confidence to be able to drive herself to and from school and she was no longer quite as reliant on us.

Another breakthrough came one Saturday when she appeared in the kitchen and, very hesitatingly, said that she knew what she would like for lunch. I tried not to be too ‘over the top’ with my reaction when she asked for sausages and French bread as it should really have been the most natural thing to be able to do, but I was ecstatic.

Going back to school

After the May half term, Becca asked if she could return to school for the last few weeks as a boarder. We were obviously worried but, if she was going to be able to live a normal life again, we had to trust her.

She wanted to go to university and so, as terrified  as we were about the outcome, we agreed. She did seem to go from strength to strength although I’m sure it was hard for her. I took her for a review meeting at CAMHS as now aged 18, if Becca was to continue with the Mental Health team, she would need to be transferred to the adult service.

I was so proud of the way she spoke to the practitioners that day. She was very clear that she did not want to continue but would ask for help if she needed it. Afterwards Becca told me that, although some of the sessions were helpful, she gained the most from working with Maureen because she was able to follow the rules that were set.

Every parents worst nightmare

Although this sounds as if we sailed through the months and everything just fell into place for Becca and her recovery, it was a frightening time. It’s a parents’ worst nightmare to see a child struggling with an illness which could, in worst case scenario, kill them.

Early in her treatment Maureen recommended an excellent book about the condition which Becca read and we dipped in and out of. It was so helpful at putting issues in a different perspective from the simplistic ‘ eat for goodness sake’.  

It was a terrible time for us all but we survived it – owing mainly to Becca’s determination to get well and that Will and I were able work together to help her. Of course we, me especially, worried it was something we’d said or done but it wasn’t about us and we would do anything we could to help Becca recover.

It was exhausting….trying to maintain a happy family life when we were altogether, being very aware that Becca’s siblings needed things to be as ‘normal’ as possible while ensuring that we were doing everything that Becca needed to make a recovery.

We were lucky

Early on Becca acknowledged her illness, asked for and accepted help. She was determined to get better although, of course, mental health issues do not simply disappear. I also really believe that not hiding what was going on made a big difference as family and friends were able to support us all.

Naturally, we didn’t stop worrying and every time we saw her after she went away to university, I was anxious about how she would be. Her recovery wasn’t easy and such an experience never really leaves you but we survived it.

Further support

If you need help regarding anorexia or any other eating disorder, please seek support from your GP or other qualified medical professional. Beat and Mind are two charities which can provide additional support and have plenty of resources on their websites.