This is potentially a very long story, so let me try and cut it short. Let’s go back to January 2001. I was back in Sheffield and I had spent around six years living with a binge eating disorder. My house had been re-possessed, I had been medically retired from my position managing social work in Edinburgh, the doctors had seen fit to make me take just about every anti-depressant, benzodiazepines, anti-psychotic drug in the BNF (doctors’ prescribing handbook) and I had been shot full of depot injections. Thankfully I was free of most of those drugs by then but my weight had rocketed to 35stones. I had spent all of those years binging on beer and the most unhealthy food imaginable.
So in January 2001 something inside me told me that if I carried on in this way I soon would be dead. There was a new drug on the market called Xenical. It was licenced by NICE (National Institute for Health and Clinical Excellence) and available for prescription by the NHS. I approached my doctor and she refused to prescribe it as there were very strict requirements for the drug to be given and she felt that at this time I didn’t meet them.
I was not deterred and spent a couple of months researching the drug and finally I bought some from a company in New Zealand. It was extremely expensive but even so, I imported two months supply. I had got everything in place for my diet and planned to use the Rosemary Conley low fat dietary approach. So on March 20th I went for a very large curry with my best friends, this was to be my last supper before my diet started. It was a gorgeous but extremely unhealthy last supper.
On March 21st my diet officially started. Xenical itself enforces certain dietary limitations. You cannot eat any high fat content foods. If you do, there are severe side effects where you are unable to stop going to the bathroom with a loose stool. It’s advised to keep your fat intake in foods down to 5%. In reality it is like a form of aversive therapy. The fear of the side effects keep you from eating too much, a little bit like antabuse, an aversive therapy drug used in the treatment of alcoholism.
The weight simply started to fall off me as I started to restrict my food intake. I religiously got weighed three times a day. After a month I had lost almost two stones and triumphantly went to see my doctor. She was amazed when she saw me. When I told her about taking Xenical she immediately gave me a repeat prescription. I was to see the practice nurse every two months and see the doctor every month between that. This was to get weighed.
Over the next few months the weight continued to literally drop off me. I was losing on average two stones a month. The reality was that I was barely eating anything at all with most of my diet being comprised of bottled water, fruit and veg. In October 2001 it was my best friend’s 40th birthday and we went to London to celebrate. This was to be the first time since March that I had anything meaningful to eat and the first time I had drank beer. I was so hungry that day. David and I had a great time eating and drinking. I vividly remember on the train home that evening looking at my reflection in the window. It was dark outside and the window acted like a mirror. David has fallen asleep just after we left London and I spent the whole journey looking at myself. My focus was on my stomach. As I looked at myself from every possible angle I felt fatter and fatter. I remember trying to hold my stomach in as hard as I could. But I could not stop feeling fat. I squeezed the loose flesh around my middle. This was what was left after I had lost weight. My rapid weight loss had left a roll of loose skin. I grew to loathe this skin and it was always fat to me and not loose skin.
Over the next couple of months I carried on dieting and by Xmas I was down from 35 stones to 13st 7lbs. I had been seeing my doctor throughout and taking my Xenical as prescribed. She was only amazed at my rapid and constant rate of weight loss. She never told me to slow down or stop. She never showed any concerns whatsoever about the impact the weight loss was having me. I had my two months supply to last me until January.
There were some very strange things going on in my mind and with my behavior. I constantly weighed myself. Looked endlessly at myself in the mirror. I would strip right down and examine all the imaginary lumps of fat on me. And I constantly felt fat. I was now afraid to eat for fear of gaining weight.
Then late in January it suddenly dawned on me. I realised that I had an eating disorder. I was anorexic. I went to see my doctor and told her that I had an eating disorder and that I wanted help. She told that my weight was too high so I couldn’t be anorexic and she gave me some more Xenical. I know, it is totally unbelievable. I was also seeing the practice counsellor at the time and I told him that I was anorexic and that I wanted help. He also did nothing.
Anorexia is primarily a mental illness that impacts on your physical health. It perfectly possible to be within the acceptable weight range of BMI 20-25 and be anorexic. But you try and convince the NHS and your doctor of that! The NHS diagnostic criteria dictates that you don’t have the condition unless you are a certain weight. In Sheffield at that time they refused to diagnose unless you were a BMI of 17.5 or less. I was around BMI 21. But I had come down from 35 stones to just over 13 stones in less than a year. In Sheffield their diagnostic criteria actually makes you need to lose weight to get treatment. If you are above a BMI 17.5 you won’t get any help from the Eating Disorder Service at ST. George’s until you reach that mark. Therefore the only way to access them is to starve further. And then when you hit their arbitrary mark you are magically accepted into their world. Yes, one moment you are not anorexic and the next moment you are anorexic. Lose one pound in weight then you suddenly anorexic. They are not interested in your mental state. Until you meet their target weight you are deemed not ill enough to receive treatment. Then when you hit 17.5 you are seen to be mentally ill enough to qualify for help. What a load of drivel…
So the only way I could get treatment in Sheffield was to make my anorexia worse and starve further. Can you really believe this nonsense? And yes, even today they have these arbitrary diagnostic criteria. In Derbyshire their specialised eating disorder service will not see you unless you have a BMI of 15 or less. I was in their office before Xmas and the manager herself told me this. At the same time she told me that I would not be able to help them in any way with my counselling service and I was shown the door. It was made clear that I was not to go back there. Appalling, truly appalling.
That was how it all started. During the coming months battles ensued with the NHS as I literally begged for help and got none.
This is a story that I am sure resonates with many of you out there. The very treatment the doctors offer here and the simplistic antediluvian criteria in the UK actually reinforce your eating disorder rather than alleviate it.