Understanding Anorexia: A Thin Excuse

By Naomi Hooke, The Independent UK. Posted October 1, 2007.

It was two days before Christmas, and for the third time in my 20-year-long existence I found myself having my blood pressure monitored, my blood taken for biochemical analysis and my mental state being assessed for risk of self-harm and suicide. Once again, I'd been admitted to an eating disorder unit, rescued from my own little world of self-destruction. The day before, I had filled my every hour with food (or rather the avoiding of it), exercise, my ongoing obsession with academic work, and fantasies about a future where I wouldn't be there to spoil everything.

My parents came to visit, my younger sister excited in anticipation of present-opening. It hurt to sit up, and hurt to lie down, yet I refused to believe that this was due to starvation and muscle wastage. My family brought me a stocking, but I couldn't understand how they would ever think I deserved nice things. I left the presents unopened for over a month.

I'd suffered from anorexia to varying degrees since I was 11, hiding food and concealing my body under layer upon layer of clothing, and once again it had caught up with me.

As London Fashion Week continues, the controversy surrounding "size zero" models is once again up for discussion. Prompted by the Madrid ban on models with a BMI below 18.5, fashion capitals around the world have undertaken enquiries into the links between eating disorders and the catwalk. Although any measure to protect models at risk of eating disorders is to be applauded, to believe that the fashion industry causes eating disorders is to completely misunderstand this most complex of illnesses.

At 11, I was showing early signs of puberty, and the prospect of an adult life ahead terrified me. I was afraid of responsibility, of a time when I would have to face the world without my parents' hands to hold. But most of all I was scared of men and sex.

Throughout my illness, even when I was motivated, I was convinced that recovery was impossible. But miracles do happen. I was in the grip of anorexia nervosa for more than eight years, but with a lot of help from family, friends and professionals I was able to turn my life around.

Anorexia has often been perceived as a quest for model-like beauty, as a teenage fad or as a diet gone wrong. It has even been described as a lifestyle choice. Seldom is anorexia acknowledged as the life-threatening medical condition that it is. Many anorexics detest their bodies, refusing even to pose for family holiday snaps. I, like many of the eating disorder patients I have met, never sought beauty; instead, I spent years trying to make myself look as ill as possible in order to avoid male attention.

As far back as I can remember, my self-esteem was low and I lacked confidence. Children can be cruel, and although they weren't the "cause" of my eating problems, the bullying I endured throughout my schooldays only added to my feelings of self-hatred.

It is often assumed that the distress in anorexia revolves solely around food and weight. However, the vast majority of eating disorder patients have numerous other difficulties, including low self-esteem or confidence, lack of self-care, and social difficulties. Sufferers are often presumed to pour over the pages of glossy magazines and starve themselves in their aspiration to become glamorous, thinner-than-thin sex goddesses. From my own experiences and from those of numerous other eating disorder patients I have met, I can say unequivocally that nothing could be further from the truth. Beauty has very little to do with eating disorders, and the desire to be thin is merely one of many symptoms. Rarely can a single "cause" be identified.

On the ward, Christmas had been and gone, and it was beginning to dawn on me that I would not be well enough to return to university. I was convinced that, once again, I had failed. During those weeks, I hit rock bottom. After years of pretending, I finally opened up to staff at the hospital, and began speaking about some of my troubling innermost thoughts.

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