Eva

Age at interview: 17

Age at diagnosis: 14

Brief Outline: Eva started calorie counting and dieting when she was 14. It quickly became obsessive and she was diagnosed with anorexia nervosa. Although inpatient care saved her life, she found cognitive behavioural therapy (CBT) and change in her own attitude the key things towards recovery.

Background: Eva is 17 and a Sixth Form student. She's single and lives at home with her parents. White British.

More about me...

From a young age, Eva describes feeling “not fitting in”. She didn’t share the same interests as her peers and felt that although she worked hard at school, she wasn’t doing as well as others. Around her 14th birthday she started dieting and calorie counting. Though she first felt happy about losing weight, she soon started feeling more and more unhappy, quiet and withdrawn. Eva describes “The voice” in her head telling her she was “lazy and horrible”, criticizing everything she did and making her feel never good enough.

 

Over time, losing weight and thinking about food became more and more consuming and “obsessive”. She found encouragement to lose more weight from Thinspiration websites. She started restricting her eating more, recording everything she ate and developing eating rituals. She was also exercising a lot. Eva says she was so unhappy about who she was that she wanted to change everything about herself. Eva had chilblains, problems with circulation, was freezing all the time and couldn’t sleep. Sitting in the car would hurt and standing up for too long made her legs ache. Her period also stopped for a few years.

 

Eva’s mum took her to the GP who diagnosed her with anorexia nervosa. As her weight was dangerously low, she was first admitted to an adolescent psychiatric ward and from there to a specialist unit. She stayed there for a year and nine months. After a few months at home she got readmitted but to a different hospital. Eva says by this time her attitude towards recovery had changed as she was “sick of” having anorexia. Eva says once she admitted to herself that she was ill, and her relationship to food was not normal, she could start getting better. She didn’t want to waste anymore of her life and had 100 percent desire to get better. Eva says that although at the time she hated being admitted to hospital, it saved her life.

 

Now Eva is starting to do things she feels she’s missed out on; going out with her friends, going to parties, shopping and enjoying life. She is currently doing her A-levels and in the future, wants to become a psychiatrist. Eva says she wants “people to look at what I’m like and who I am, not seeing me as my eating disorder”.

 

When Eva was 14, she started limiting what she ate, recorded everything that she ate and drank and was visiting 'pro-Anorexia' (pro-Ana) sites regularly.

Shortly after like my fourteenth birthday I was wasn’t fitting in very well with my friendship group at school, and I felt very academically pressured in the school that I was in, like I’d always try really hard in my school work, but I never felt as though it was good as my friends’ work and I started to feel like quite competitive about that. But it was getting me down that I wasn’t doing as well as them, and especially as I wasn’t fitting in and it felt very lonely. 

 

In, like I was best friends with a girl, but we stopped being friends and a new girl came to the school and took my place as this girl’s best friend. And she was like quite skinny and she was really clever, so I started to feel like maybe if I’m more like her people will like me more because she was popular and everything.

 

So I got really interested in diets and stuff and I started to like count how much fat I was eating. But it wasn’t really working and I was getting more and more unhappy. So I started going on the internet and found all thinspiration sites and stuff and I started to use them a lot. I signed up to lots of them and would talk to other people on them.

 

And from there I just got really obsessed with what I was eating and I’d start to write, because on some of the websites it would say things like, write down what you’re eating. So you could like cut out things the next day. So I used to obsessively record everything that I ate and drank, even when it was just things like water.

 

And I’d started to halve it, and it got to the point where I was throwing my lunch away at school and like my Mum obviously didn’t know that, but she started to click on that I wasn’t eating all my meals and stuff. So she took me to the doctors, and the doctor said to me that I had anorexia but my Mum didn’t tell the appointment was for like to getting a diagnosis for that, she told me it was because I’d been a bit ill, so I just went along with it.

Eva explains how Cognitive Behavioural Therapy helped her see that her thoughts about eating and food were irrational.

In CBT they asked me things like is there anything that’s upset you, and I’d say yeah and then explain it. And they’d be like, “Why did it upset you? What?” And then you’d sort of break the thought down like, say you think, “Oh I can’t wear those jeans today, I look really fat.” And then they’d be like, “What,” like you’d break it down into like thoughts of why you think you look fat. And you’d be like, “Oh because I ate such and such yesterday.” Or, “I just do.” And then you’d realise, “I just do” isn’t really, you know like a valid explanation for it. And you’d think well why, because I’m exactly the same weight as I was yesterday, I can’t possibly have gained a stone in a day, sort of thing, and you think, “Oh maybe I am being irrational.” And it helped in that way to see it laid out like in three parts. Like the thought before, thought afterwards and sort of the rationale behind it. That did help seeing like logical, illogical conclusion sort of thing. It did help doing that.

Eva didn't find group therapy helpful. She felt that people fed off each other's negative attitudes and forgot to focus on their own recovery.

I didn’t find group therapy as helpful really because everybody’s at different stages of recovery so some people wouldn’t really want to get better and they’d be a bit negative in group, and then it’d, I’m one of those people that if somebody else is in need I’ll always feel like I need to help them, and so I started to feel like, I stopped focussing on myself really which is what you need to do when you’re in hospital. You need to focus on getting yourself better, but I started to think about how can I help such and such to get better, and so in that way I didn’t really find the group therapy as helpful.

 

If you forget about yourself there?

 

Mm. And sometimes it would remind me of bad thoughts that I’d been ignoring and sort of re-iterate them to me so.

 

Eva liked having a quiet, stress-free space in hospital where she could sit her GCSE exams.

And you sat your GCSE’s in the hospital?

 

Yeah.

 

But, well how was that?

 

It was quite good actually, because I hadn’t seen anyone from school for a really long time, so I think going in would have been a bit overwhelming, like queuing up to go into the big hall, and finding my seat and, because I was, I had special consideration because I wasn’t well obviously so, I was allowed extra time with my exams. 

 

I think that would have been stressful having that in school, because I didn’t want people asking questions about why I had extra time when I wasn’t dyslexic or anything, 

 

So it was nice to sort of have a bit of a quiet space and like, and I think, practically all of my exams bar one or two, a teacher from my school actually came and sat in the room with me, so sort of invigilate it. So it felt nice having them there because I knew that they wanted me to do well, and they were there to sort of keep me at ease. So that was nice having like a little room to myself to get on with my exam and not have to worry.

 

So you could just focus on that?

 

I could just pretend to myself it was a practice paper also, it didn’t feel as real because it wasn’t in the big hall and there wasn’t all the stern looking exam people peering over your shoulder to make sure you’re not copying so, that was better.

Eva describes how obsessions about eating and weight affected everything she did and thought.

The height of it for me, I would say that it was 100%, because it was everything to me, like even when I was talking to other people I’d look, I’d be looking at them, “Are they skinnier than me? Are they bigger than me? I wonder what they’ve eaten today.” And then I’d start to think about what I’d eaten that day, and then I’d start to think about, “Oh well maybe I should be exercising now.” And everything I did it had to, I’d even be thinking, “How many calories does this burn, what I’m doing?” 

 

And it was like really obsessive and even when I was in hospital if I’d have a meal, and then I would supervision and spend the whole, which is when you’re like you weren’t allowed to go to the toilet or anything for like an hour after your meal. And all I’d be thinking for the whole of supervision was, “I need to pace. I need to go in my room and walk around until I feel happy.” But that would be until the next meal and then I’d spend the whole meal panicking about what I was eating.

 

And then if my parents came to visit, I can’t believe how horrible this thought was I had at the time, but all I could think about was, “I want,” I wanted to go out, but it wasn’t, it was nice to see them, but I wasn’t thinking about spending time with them, all I was thinking about was using the time to burn as many calories as possible. Like if we went to the park we’d have to walk around it, and if my Mum had had a long day at work, and she was like, “Oh we’ll go slowly. We might have a sit down on the bench or something and get a coffee.” I’d be like, I’d get really annoyed and be like “No I want to, come on let’s go,” and if they were ever late, which because the hospital was like an hour or so away from where I lived, they’d, you know they would get stuck in traffic and stuff because it was rush hour when they came to see me. And I’d, if they ever came late I’d be horrible to them. I’d be in a bad mood with them for the rest of the visit, like, “Why are you late? I’ve been waiting for you.” And because I wanted as long visiting time as I could, so when they took me out I’d have time to get rid of as many as possible.

 

Eva experienced many symptoms associated with anorexia nervosa' feeling cold, poor blood circulation, aches and pains, insomnia, feeling dizzy and hair loss.

What about the sort of physical symptoms that you’ve experienced?

 

Being really cold, always have like since I got ill; always have problems with being cold. Feeling freezing when nobody else is and circulation problems as well, like my nails not, they’re not blue now but they’re normally blue. Like everything’s sort of like, I never had amazing circulation but it got a lot worse when I got ill and it’s not really repaired itself that much like, just my hands will be absolutely numb with cold and sometimes like it, I’d be so cold that my arm would just go dead, like I wouldn’t be able to move it, and if I did it would be like, “Ooh,” out of control sort of thing. 

 

And like aching as well. Feeling really achy, like my legs would be achy from standing up for so long, and my back would be aching from, don’t know, that was probably from standing up for so long as well. And probably from doing sit ups and stuff as well.

 

You won’t sleep very much because, that’s another symptom like lots of tiredness and loss of sleep. My sleep patterns were corrupt because I’d been hungry in the night. I wouldn’t know I was hungry, I’d try and tell myself there was no such thing as hunger, I’m not hungry. You know, I’m just imagining it. Don’t need anything to eat really but like I’d be awake in the night because I was hungry. And then I’d feel weak, sometimes I’d go a bit dizzy like I was gonna faint. 

 

But then there was times when I actually enjoyed that feeling, being dizzy because I thought, “Oh it means I am losing weight, its working.” Sometimes I’d purposely get out of bed really fast in the morning just so I would go dizzy. To see like, “Oh, yeah, I’m losing weight.” Sort of thing.

 

Like as well your veins can like really constrict, like with the cold and that. So like when I had to get blood tests, because my veins had constricted loads that they’d have difficulty taking the blood, and, like it would hurt a lot because they’d have to do it a few times to finally get a sample. And then, oh what else is there? 

 

Hair loss. I lost loads of hair. My hair went really thin. I’d be in the shower and there’d be like clumps and clumps of hair, I’d, I kind of noticed it more when I started to get better. That all my dead hair, old dead hair that had gone all brittle and frail from like not getting enough nutrients, that all fell out and I started to get new hair when I was eating a healthier diet, but hair loss is definitely one.

Eva had lanugo hair on her body. She felt horrified and tried to tell herself it was normal.

And I got Lanugo hair as well, all, on my body like it would be on my back, thick sort of, no thick it’s that fluffy, and your skin.

 

Do you remember noticing that, the first time?

 

I noticed it on my stomach first. And then I sort of felt like on my neck and noticed I had a lot of it there as well. But it was my Mum that pointed it out the first time. She said, “Look, you’ve got hair on you.” And I said, “What do you mean?” And she said that was a symptom. You know you’ve got Lanugo hair. And I was horrified really, I thought, “Oh God, I’m going to look like a man now, all this body hair all over me.” But at the same time I was sort of a bit like, “Ooh,” I kind of denied it at the same time because I thought, “Oh,” this, no I don’t know what it is, maybe it’s just, I don’t know.” I don’t know what I sort of told myself it was, but I kind of denied it to myself because I thought, “Oh I’m not ill enough to have that. She’s just saying that. You know it’s probably normal, lots of people probably have it.”

True friends will stay with you and be supportive.

They [friends] were really good about it and supportive and they really helped me through. And if you’ve got the right friends then they will be like that. They’re not going to be horrible to you about it, if you’re with the right group of friends and if they are true friends then they’re gonna be supportive of your problems. That’s what helped me to do it.

 

Emily confided in a teacher that she'd been bingeing and purging for 5 years. After years of not telling anyone, Emily was surprised how easy it was to talk and how much it helped.

I just thought I’d rather not at the moment sort of declare it openly because I don’t always feel comfortable with it. I think if I did tell them I’d need to make the time to answer all the questions and stuff, and because there is a lot of stigma attached to it, lots of people are so not understanding, they think oh you’re an attention seeker and things like that. And I don’t want them to think that of me. So that’s why I’ve not really, because I know declaring it, because I know there’d be stigma attached. So I’ve only really said it to the people I trust.

 

So you can just focus on doing stuff and being friends rather than going through it?

 

Yeah. And because like I want people to see me as being normal as well. I mean I think oh I don’t want people to look at me and think, “Oh there’s Eva, that anorexic girl.” I want them to think, “Oh there’s Eva, she’s the one that likes fashion.”

 

Eva describes how planning ahead was the key to enjoying social life and eating out.

The first time I went out for a meal since I got ill was a disaster. I didn’t know anything that was on the menu and when I got there nothing I felt comfortable with having, so afterwards I really panicked and was upset for a few days. But when I did find a place, I looked at the menu and I was happy to go there, and I went and I had a good time. And I did feel guilty afterwards, but after a few times of doing it I stopped feeling guilty which was great, because I could go with my friends and not feel bad and it’d be wonderful to not have that voice in my head saying, “Oh you’ve been so greedy eating all that.” It was like lovely to get that experience. 

 

Would you want to go to the same place, to the same restaurant again?

 

I go quite often. Yeah.

 

Because you know the menu and the food?

 

Yeah. I do need to try going to other places as well. Which is still something, that’s one of my goals to try exploring different restaurants and stuff. Like I was on holiday a few weeks ago and we went to a new place which I enjoyed, so I was proud of myself for doing that. I’d had a look at the menu there and thought, you know planned what I was going to have which is, I think, when you’re trying to recover I think planning is the key. It can, you know, make sure you, can help you to make sure you’re eating enough, can help you to make sure you not eating too much, like if you have binging problems and stuff, if you plan what you’re gonna eat then you don’t leave yourself the opportunity to binge. I’ve never actually had like binging difficulties myself, but I know of people that have had and they’ve always said that planning has really helped them. Like especially with like festive periods, like with Christmas and stuff, planning has really helped me this year.

 

Eva used to be scared of people looking and commenting on her eating at school. She's now realised people are much more interested in catching up with others than watching her.

 

But I thought well if I want to actually make friends and stuff I’m going to have to start, because lunchtime’s like a key social time for people at my school. So I thought, “Oh, I’m going to have to start trying to have lunch with them.” So I took it with me and I sat with a friend that I was quite, quite close to, sort of comfortable with and had it. The first few times sort of sort of had it on my own with her, or with a few other people that didn’t know, because then they wouldn’t be staring at me thinking, “Oh she’s eating,” sort of thing. 

 

But now I just have it in the sort of common room with everybody else and nobody ever says anything to me, which is good because I was expecting people to make comments and stuff. But that’s all in your head really, oh yeah everyone’s gonna be saying to me, “Oh I can’t believe you’re eating.” But nobody was like that, they haven’t got the guts to say it for a start, and it’s what everybody else is doing so it’s not unusual. It’s more unusual to sit there and not have anything. That’s when people are gonna notice.

 

Was that why you were uncomfortable eating in public? The sort of fear of people’s comments?

 

I was scared of people making comments on me and I was scared of them looking at me and thinking I was being greedy, or “Why is she eating that? She’s so fat.” But I’ve started to think well you know I just, everybody else is eating they’re not all looking at each other thinking that, “Why are they having chips? They’re fat.” Or whatever. People don’t really do that.

 

They’re more concerned about what they’re eating and talking about what’s going on in school, so just sort of now I’ll just have it, get on with it, try not to panic too much, and distract myself with what everyone else is talking about.

 

To make up for things she's missed out, Eva is now enjoying going on holidays. She balances out social life and work so as not to be excessive about either.

I feel like I’ve missed out on so much of my social life, now I want to feel like every holiday I’ve got to get everything in social wise, and I’ve not given myself the time to revise really so now it’s like, oh I have my exams and I’ve not dedicated enough time to working. So it’s definitely for me been kind of a see saw with balancing things, because I’ve not, one thing can be in excess and the other not, like this time it’s been the social life’s been in excess and school work’s been non-existent, whereas in the past I’ve said I’m not going out because I’m doing my work.

Eva's relationship with her parents changed. When she was unwell she used to be very dependent on them and get angry but now they all work together.

So I was like very dependent on their visits then. But it’s been rocky really because I hated them while I was in hospital because everything they did was wrong. But that wasn’t me that hated them, it was my eating disorder. I hated them if they were late, I thought, I remember they went on holiday once and I was livid with them because I wasn’t going too. But now I look back at it and think they needed time out, you know they shouldn’t have to put their lives on hold because I’m putting mine on hold. So I was like really annoyed at them then, and felt like, “Oh they’ve deserted me, they don’t love me really.” And all this, but they do because they’ve always been there for me.

 

And my relationship with them now is good, it’s definitely like improved a lot now. It was probably best when I was in the last hospital I was in because they saw that I did actually want to get better for the first time and I was working with, we were working with each other rather than I was working against them. Me thinking they were working against me, so that’s the best it’s been really.

 

Even though at first Eva was mad with her parents for taking her to the GP, she now feels thankful and says they did the right thing.

Well if the young person, like if the parent was worried about taking the child to the GP in case the child doesn’t like them, in the end they’ll thank you. I thank my parents now. And they won’t be mad at you forever. Even if they are mad initially, you’d rather preserve your child’s health than think oh I don’t want them to be angry at me, and then they get really poorly because of it, because of you not taking them. Because sometimes it can be hard for them to take the step themselves because they don’t believe themselves to be ill.

Eva says people don't understand eating disorders and she is careful who she tells about her experiences. She wants to be known as 'Eva, the one who likes fashion', not 'Eva, the anorexic one'.

And because there is a lot of stigma attached to it, lots of people are so not understanding, and they think “oh you’re an attention seeker” and things like that. And I don’t want them to think that of me. So that’s why I’ve not really, because I know declaring it, because I know there’d be stigma attached. So I’ve only really said it to the people I trust.

 

So you can just focus on doing stuff and being friends rather than going through it?

 

Yeah. And because like I want people to see me as being normal as well. I mean I think oh I don’t want people to look at me and think, “Oh there’s Eva, that anorexic girl.” I want them to think, “Oh there’s Eva, she’s the one that likes fashion.” She’s a, you know, I don’t want them to see me as that.

 

I think people might have, I don’t know whether or not my friends from my old school probably thought that of me at times like oh, when it became me and there was nothing else to me, they’d think, “Oh Eva the anorexic one.” They wouldn’t, because I didn’t indulge in any of my other hobbies, they all became non-existent. When I had to give up like doing my martial arts and stuff because I got chilblains and it hurt too much to run on the floor, things like that. But now I’d want people to look at me and think, think of me because of what I like and who I am, not what the anorexia’s made me.