Last week, I had the wonderful opportunity of talking with Therese Borchard about her recovery from an eating disorder. I hope to feature Q&As with individuals who’ve recovered from eating disorders regularly. If you’d like to share your story of recovery, I’d love to hear from you. You can email me at firstname.lastname@example.org.
I’m so pleased to present today’s interview with Kate Le Page, the author of GoodBye Ana, a powerful collection of poems about her battle with and recovery from eating disorders. Kate recently launched her own website, so be sure to check it out here!
1. How and when did your anorexia start? What do you think contributed to it?
I was 14 when I first started to realize that I felt uncomfortable in my own skin; I’d always been a picky eater but gradually the foods I felt able to eat started to diminish. The year before (1991) had been a difficult one as my grandfather had passed away quite suddenly and we then moved house so my grandmother could come and live with us. I had close friends in my old neighborhood and I found moving very distressing.
Another factor was that I began menstruating when I was in the middle of a 3-day swimming event. I remember feeling so angry at my body for betraying me and making me miss out on completing the event. School wasn’t going well at this time as I was being bullied for having such large feet that I wore men’s shoes. Nowadays, I couldn’t care less about what shoes I wear but when you are desperately wanting to fit in with your peers anything that makes you different is hard to manage. I began to truly despise myself for having this perceived imperfection and I even remember thinking if I could only lose more weight then maybe my feet would shrink! So, I’d have to say that it was a combination of several different factors that contributed to me developing the disease.
2. Many women with eating disorders are reluctant to seek treatment. Some describe their eating disorder as a friend and, as a result, tend to be very protective and secretive about it. What motivated you to seek treatment?
The first time I sought treatment I had been at school for several months with glandular fever (I think it’s called mono in the US?) and had become so weak as a result that I was barely able to get out of bed. I was really frightened that my anorexia was making the virus harder to fight and decided to see my family doctor. Unfortunately all he did was begin to weigh me every month and put me on various anti-depressants. This negative experience really put me off seeking further treatment.
By 1998, in my first year at university, my friends had begun to spot that something wasn’t right with my eating habits and they confronted me about it. My attendance was already beginning to suffer as I often felt so weak and exhausted that I would skip lectures. I had really gotten to a point where I knew the anorexia was preventing me from achieving my goal of getting a good degree.
3. Eating disorders are tremendously treatable but the key is to find the right treatment. How did you go about seeking services?
I went to see my university doctor and he referred me to the local hospital eating disorder service. This basically consisted of me talking to a dietician about once a month so predictably it had little impact on my illness. It wasn’t until after I’d graduated that I found a fantastic doctor, James Ray, who is still my GP today (and wrote the foreword for my book). Dr. Ray has previously worked at the Priory (a UK treatment Clinic) and knew more about anorexia than all the health professionals I’d previously seen. In 2002, I was referred to Marchwood Priory Eating Disorder Unit and since then I have been fortunate to have an excellent care team supporting me, consisting of a therapist, dietician, GP and eating disorder consultant.
Treatment can vary considerably depending on where you live but I would urge anyone with an eating disorder (or any other health problem) to change doctors if you’re not happy with the treatment you are receiving. Also, there are a number of excellent free support groups (I attended OA for several years) that can offer weekly support.
4. What led to your recovery?
The first hospitalization at the Priory led to my ‘physical recovery’ – I was discharged at my target weight of BMI 20. However, when I left the hospital, although I was then at a healthy weight, I was mentally probably worse than prior to the admission. Unsurprisingly, I was readmitted only four months later because I hadn’t worked on the mental side of recovery, and I had quickly relapsed back into a cycle of restricting and over-exercising.
My second spell in the EDU was longer and more intensive than the first. I was given a new therapist who was also the manager of the unit and was herself in recovery from an addiction. The group therapy sessions were really helpful and although I ran out of one session in tears (followed by my therapist running after me!), I was finally leaving my denial behind and accepting that I had to face the anorexia head-on if I was ever going to be well.
5. What were the toughest parts of your recovery and how did you get through them?
I think the toughest parts were when I was an in-patient as I had to consume 3,000 calories a day and the most torturous part for me was having to sit in the EDU lounge for an hour after each meal and not being able to exercise manically to burn off what I had eaten. The lack of privacy was also very difficult as you were weighed twice a week in your underwear and also had to ask at the nursing station for your bathroom to be unlocked. I remember one nurse pushing my door slightly open (to listen if I was vomiting) and I kept pushing it shut.
Last year I was readmitted with severe depression and this greatly affected my recovery as I stopped sleeping and was running on sheer adrenalin. My consultant kindly let me decide to stay on the depression ward rather than go back to the EDU. However, this meant I had to be responsible for my intake rather than the eating disorder team so it was a real battle. Thankfully, the depression team was also very clued up on eating disorders and together with the fantastic support from other in-patients, I found the strength to start eating again.
6. What led you to write and publish Goodbye Ana?
I had been journaling and writing poetry about anorexia for a number of years and gradually over the last two years I worked on putting a collection of my poetry together. After writing to a number of publishers and often hearing back that they weren’t accepting first-time authors, I searched ‘mental health publishing’ on Google and found Chipmunka who were interested in going forward.
The main aims for writing the book were simply to educate and support those impacted by this parasitic disease. Chipmunka Publishing specializes in promoting mental health awareness and thus reducing stigma and shame for sufferers as well as educating others. My heart is to see the stigma and sense of taboo surrounding eating disorders, as well as mental illness in general, be eroded through sharing my story.
7. Your book aims to challenge the many misconceptions about anorexia. Can you talk about some of those?
The media often portrays anorexia as being glamorous or something that is almost fashionable or a lifestyle rather than a disease. Also, many television programs dealing with eating disorders show someone becoming ill and then going into the hospital and magically, upon being discharged, is then portrayed as being 100 percent cured!
By writing about being in the hospital, I wanted to show that there is nothing remotely glamorous about spending months fighting a life-threatening condition. Another key misconception is that a person is recovered when they look ‘normal’ and are at target weight. Actually, as every sufferer knows, this is only the beginning of recovery. As Katharine Wealthall eloquently describes it in her book Little Steps, “If treating anorexia is like reading a big book, then target weight is just the introduction.” I still cringe when someone says you look well, as how can you see a disease that is predominantly mental just by looking at my appearance?! Also, it is important to recognize that a person can be seriously malnourished by vomiting/over-exercising whilst still eating a ‘normal’ diet.
8. Your book also aims to explain the cognitive distortions that accompany anorexia. What were some of the distortions you experienced during your illness?
The main distortion that accompanied my illness was all-or-nothing thinking…everything was black or white and there was no gray area in-between. I was either a complete success or a total and utter failure. For example, if I got ten A grades on a course and one B, I would automatically forget about all the A grades and despise myself for being so stupid for getting one ‘imperfect’ grade.
Also, tasks had to be carried out in my ‘perfect’ way or not at all. At one point last year, I would freak out if my husband loaded the dishwasher differently to me! Recovery for me has been about learning to be more flexible and also learning how to live with being uncomfortable; recognizing and accepting that my world will not collapse just because everything is not perfect.
9. Do you still struggle with eating disordered thoughts and behaviors? If so, how do you overcome them?
In the beginning of recovery, every day was a real battle, whereas now I have days, sometimes even weeks, of almost complete mental freedom from the disease. However, the key difference is now I am so much more aware at being able to spot changes in my thinking/behavior patterns and can now prevent a lapse or blip from resulting in a major relapse.
I still struggle with mirrors and if I’m having a hard time, I will deliberately avoid them. My medications (venlafaxine for depression, Quetiepine for anxiety) also help as does sticking to my menu plan. I would say that holding on to the menu plan and using CBT (cognitive behavioral therapy) and CAT tools is what primarily keeps me in recovery. At the moment, I see a Cognitive Analytical Therapist (CAT) weekly and see my consultant psychiatrist monthly.
10. What can family members do to help a loved one with an eating disorder?
I believe that family members are crucial in terms of spotting the illness early on before it really begins to take hold of the sufferer. It is really important that they do their best to create an atmosphere of support and provide times where they are able to sit and talk about general issues, to keep lines of communication open.
If you’re a sibling or parent, read up on signs/symptoms to look out for and be prepared to be met with total denial – this is very common. There are also many support groups available just for carers/relatives where much-needed advice and knowledge can be sought.
The most important thing is to separate the person from the illness – when talking to them, remind them that it is not them that you are frustrated/angry etc… about, but their illness. I feel it’s really important the sufferer doesn’t feel got at, or picked on, as they are already likely to be feeling isolated and alone.
11. Anything else you’d like readers to know about eating disorders?
Remember that if you suffer from an eating disorder, it does not have to define you as a person. As a Christian, I believe that God has a plan for each of us and we can use all our experiences, no matter how painful, for good. The best way to fight back is to educate, speak out and break down the stigma and shame associated with eating disorders and mental illness in general.
Modern medicine is evolving all the time – for example the medication I’m on now is so much more beneficial than what was offered in the late 90s. Never let go of hope that you can beat anorexia and live a fulfilling, productive life. Imagine if you used all the energy it takes to restrict, over-exercise, live with the illness and turned it around, what could you achieve?
Thanks so much, Kate, for opening up about your struggles and undoubtedly helping others!
With Kate’s permission, I’ve included an excerpt from the book below:
Can’t sit still,
Need to be re-active,
Got to stay on my feet,
Calories unconsumed left to cheat,
New thoughts swirling – left to greet,
Why can’t I just let go of the will
That path results in a dying girl,
perched on a middle court sill.
Trust the program all logic cries so clear,
Trust ME Kate, I’ll always be here,
Screams a familiar voice lurking in my ear
You LIE all the time about your games
If I listened to you I’d wind up insane,
Drown out your poisonous voice,
I’ll stand firm ignoring the noxious noise.
Hope for Tomorrow
The darkest night brings new light,
A world without anorexia, depressive fear,
New day is coming so don’t quit your fight,
It’s been a long hard struggle year after year,
Believing the dawn soon is to appear.
You can feel the warmth of many who care despite the fog threatening isolation,
Everyone says call or write but you don’t,
A self-willed cry of can’t or won’t,
It’s you that it hurts as tears begin to fall,
We forget there are others left outside.
My decision to hold on to a future and some hope,
The day is not the end just one to learn from,
So next time you fall to the end of the rope,
Remember how much easier life is without the ana-con.
Eating Disorder Resources
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Dr. John Grohol (November 17, 2009)
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What Eating Disorder Recovery Means to Me & More: A Q&A with Kate Le Page | Weightless (March 23, 2010)
Last reviewed: 17 Nov 2009