Warning: This article includes discussion of eating disorders and associated behaviours.

It was pancake day 2014 – the start of Lent. At our favourite cafe, my friend and I demolished our pancakes with cream. As a Catholic, Lent had always been a time to sacrifice. I had tried giving up things many times before all without much success.

This year, however, felt different. I had just dropped out of university, homesick, and my life had come tumbling down. I had a brainwave: I would give up food for Lent. My pancakes would be my "Last Supper".

My friend laughed it off: "Lauren… you won’t last a day!" I laughed, too, but I knew that this was my way of proving to everyone that I was "someone". I may have failed at university, I may not be pretty or popular, but this was something I could achieve: defying the biological need to eat.

This marked the start of my destructive spiral into anorexia. A relentless pursuit of not just thinness but emaciation – driven by an intense fear of gaining weight, which would keep me captive for the next decade.

At the beginning, I pictured myself skinny and pretty. The thought of people being attracted to me was enough to motivate me to start fasting. As a Black woman of Caribbean and white heritage, I had always felt different.

Seeing my white friends fitting the slender, Eurocentric body ideal, happy in their relationships while I was alone, only confirmed how unlovable I was.

"Changing my skin colour wasn’t an option. Changing my body seemed like the answer"

I needed somehow to fit in. I strove towards skinniness, desperately resisting the curves I inherited from my Caribbean mother. Since changing my skin colour wasn’t an option, changing my body seemed like the answer.

The first weeks were hard. I would smell my parents’ cooking and yearn for a bite or two, but I was determined to fight these urges.

To distract myself, I turned to excessive exercise, and I would chant to myself: "Pain is just weakness." The physical sensation of hunger – the sharp pangs in my stomach and waves of nausea – were tormenting, but strangely motivating, too. Soon enough, the hunger had become addictive and starving myself was easier than I imagined. Rather than craving food, I began to crave the feeling of hunger; it made me feel self-disciplined and strong.

Over the coming months, I ate practically nothing. I would make excuses to be out of the house during mealtimes, saying I was meeting friends or working late. My parents started noticing my weight loss, but I assured them I was just being healthy. I was constantly cold due to my lack of fuel, so I would alternate between lying in bed under my duvet and taking hot baths. But with the heat from the baths and lack of nutrients in my body, I would often collapse to the floor when getting out.

I couldn’t call out to my parents. I knew that if I did, they would force me to eat something. So, I remained silent.

"I was convinced that anorexia and I were a team"

I was convinced that anorexia and I were a team, oblivious to the fact anorexia was not on my side. The anorexic voice in my head became "The Headmistress" – a name I gave her because she instilled fear and obedience.

In some ways, I felt empowered, strong and more attractive as I obeyed The Headmistress’s demands; but a small "rational" voice was trying to scream,"Stop!" But if I listened to the quiet voice that undermined The Headmistress or broke any of her rules, it was at a serious cost; I was plagued by guilt and her "punishments" would get stricter – I’d have to exercise in my bedroom throughout the night.

Meanwhile, friends commented on how great I looked, and I noticed boys looking at me for the first time. I thought my weight loss was helping me to fit in, but in reality, I was distancing myself from everyone I knew, isolated in my own ever-diminishing world. As I became consumed by my obsessive compulsions, I became increasingly secretive and deceptive.

I would stare blankly as my parents begged me to eat, untouched by their pain and desperation, vacillating between a strange dissociative state and then overwhelmed by extreme emotion.

It was one evening when I was running at the gym, relentlessly exercising on "minus energy" levels, that I realised how much control The Headmistress had over me. I wanted to rest but it was impossible – I felt powerless against her. I was terrified.

Eventually, a few months later, my parents had me referred to a specialist NHS eating disorder service. But I was told that my BMI wasn’t low enough to receive help. This was so damaging.

In my head I heard that I was "too fat" to deserve treatment. Sadly I’m not alone in this; it’s common for people with eating disorders to be turned away from chronically underfunded services based on their BMI; they are forced to get sicker in order to meet the threshold for assistance.

Unsurprisingly, my rapid weight loss continued. Alongside the pounds, I lost my personality, my spark and my social life.

I had to stop working and became reliant on my parents again. I would spend all day in bed. I was disappearing from view.

My admission to a specialist unit became inevitable. The staff told me I wouldn’t have to stay in hospital for long – only a few weeks if I complied with my meal plan – but hospital only seemed to fuel my anorexia. Everyone looked skinnier than me and I felt that I didn’t deserve to be there. Patients competed to see who could be the "best" anorexic– deceiving the staff to prevent weight gain.

"Black people are the least likely to be diagnosed with an eating disorder"

My feelings of otherness were exacerbated by the fact I was the only Black woman out of at least 20 other patients. While conducting my doctoral research years later, I discovered that Black women often find our eating disorders are not taken as seriously by medical professionals, or the wider community.

Indeed, Black people are the least likely to be diagnosed with an eating disorder and to receive professional help; sociocultural models of eating pathology predict lower risk for eating disorders in Black women, perhaps because of the stereotype that Black cultures embrace voluptuous body types, which, theoretically, reduces the need for Black women to strive toward thinness.

This is fuelled by the fact that the current diagnostic criteria for anorexia – significantly low body weight, intense fear of weight gain and body image disturbances – are mainly based on the white population.

A YouGov poll commissioned by eating disorder charity Beat found that nearly 40% of people believed that eating disorders were more common among white people than other ethnic groups.

However, several studies suggest that this perception is not necessarily accurate. The idea that Black women are ‘immune’ to eating disorders ignores the wider pressures Black women face, living in a world of internal conflict as they try to navigate dual identities. Eating disorders in Black women may not be a preoccupation with appearance, but a strategy for coping with racism, stress, depression or trauma.

After nine months in hospital and several years working through the complex emotions that I had tried to numb with starvation, I returned to university to study for a doctorate. I’m now using my experience in my research exploring the emotional and psychological effects on Black women with anorexia.

"Crucial to my recovery was hope and resilience"

I believe we need to go beyond merely focusing on the physical manifestations of eating disorders and address the underlying psychological difficulties that individuals face.

Ten years post-diagnosis, I’m healthier than I’ve ever been. The thrill of hunger has been replaced by the joy of nourishing my body – and my soul. Crucial to my own recovery was hope and resilience – the conviction that one day, things would be better. Therapy has helped, but I’m also lucky to have a family who never gave up on me. The Headmistress’s voice is still there, but it has gradually quietened over the years, and now I can hardly hear it. While some people with anorexia may find that voice never goes away, I believe it’s always possible to unravel its power.



Everything you need to know about… anorexia: From the Mental Health Foundation

People often think anorexia is just about dieting, but it’s more complicated: linked to low self-esteem, negative body image and many other factors. Anyone can be affected. While young women are more commonly treated, anorexia is increasingly seen in men and boys, women over the age of 40, and children as young as seven.

The idea of recovery may be difficult or scary. Just remember, it’s possible to feel better, even if it takes a while to get there.

What are the symptoms?

You may feel afraid of putting on weight or being ‘fat’; preoccupied with your weight or food, or as though your body is bigger or a different shape than it really is; anxious, especially around mealtimes; lacking in confidence and self-esteem.

You may also underestimate or deny there is a problem, even after a diagnosis. The physical signs of anorexia include weight loss, hair loss, dizziness, feeling cold and weak, low blood pressure, difficulty concentrating and periods stopping or becoming irregular.

Anorexia can affect your behaviour, causing you to reduce food intake, stop eating, hide food or throw it away, spend a lot of time counting calories, eat very slowly, exercise a lot or make yourself sick. With other people, you may lie about what you’ve eaten and when.

What causes anorexia?

There is no single cause; it’s usually a combination of factors. You are more likely to develop anorexia if:

  • You or a family member has a history of eating disorders, depression, or drug or alcohol addiction.
  • You have been criticised for your eating habits, body shape or weight.
  • You’re overly concerned with being slim, particularly if you feel pressure from society or a job – for example, ballet dancers, jockeys, models or athletes.
  • You have anxiety, low self-esteem, an obsessive personality or are a perfectionist.
  • You have been sexually abused.

What help is available?

Living with anorexia can be incredibly difficult, but so too can the idea of recovery.

If anorexia has become a big part of your identity, you might wonder who you’ll be without it. You might be afraid of not being in control of your food or of how your body might change.

It can take time to feel ready to try to recover. Think about what recovery might look like to you and what the benefits could be. Change is possible, even if it doesn’t feel like it right now.

If you think you have anorexia, start by talking to your GP. They may not be an expert in treating eating disorders, but they will be able to assess any physical symptoms and then refer you to specialist eating disorder services.

Medication

You may be offered antidepressants alongside self-help or therapy to manage other conditions such as depression, anxiety or obsessive compulsive disorder (OCD). However, antidepressants shouldn’t be the only treatment offered.

Talking therapies

  • These can help identify feelings and fears that trigger/ed your anorexia and help you develop a healthier attitude towards food and your body. You may be offered:
  • Cognitive analytic therapy (CAT). This looks at past experiences and events to help you understand why you think, feel and behave the way you do now. You therapist will then help you develop new tools to cope in a healthier way.
  • Cognitive behavioural therapy (CBT). This focuses on identifying and changing thoughts and beliefs that may trigger your anorexia. A therapist will help you understand and change disordered thoughts such as, ‘Everyone thinks I am fat.’ There may be homework and goals to challenge unhealthy rules you have about food.
  • The ‘Maudsley Approach’ is for children and young people. It involves parents taking an active role in helping toget their child’s weight to a normal level, giving control of eating choices back tothe child and then encouraging them to develop healthy independence.

Inpatient treatment

If your weight is very low, you may be admitted to hospital. Your treatment could involve counselling, group and family therapy, and working with a dietician and mental health team.

Ways to look after yourself

There are things you can try alongside treatment and support. Beat has tips for recovery, and Mind has suggestions for self-care, including managing relapses, changing unhealthy routines and being careful online.

You may find support groups useful. It can be comforting to talk to others with the same experiences. Beat offers an online group for people with anorexia.

Other eating disorders

Anorexia is one of several disorders. Others include bulimia nervosa (an unhealthy cycle of eating a lot and then vomiting or taking laxatives to try to stop weight gain), which often comes with anorexia, and binge eating (where you eat a lot in a short period on a regular basis.

As with bulimia, you won’t feel in control of your eating). Around 5% of people with eating disorders have avoidant restrictive food intake disorder (ARFID), which can involve being very sensitive to the texture or appearance of food or concern about eating certain foods.

If your symptoms don’t fit those of these disorders, you may be diagnosed with an ‘otherwise specified feeding or eating disorder’ (OSFED), which is just as serious as the other types.

If you’re worried about your own or someone else’s health, you can contact Beat, the UK’s eating disorder charity, 365 days a year on 0808 801 0677 or beateatingdisorders.org.uk