‘I’ll leave the loo door open,” she said blithely. I was astonished. Until I read more about eating disorders I didn’t understand the significance of her remark.
We had just finished lunch. My granddaughter, suffering from an eating disorder, had come to stay with me and I was saddened at how thin and depressed she was.
The previous time I had seen her she had been busy with an interesting outdoor career and had been full of energy and fun. This was a different person, who dissected her lunch into minute rectangles and ate it painfully slowly.
What I did know at that stage was that I must not leave her as people with eating disorders are past masters at concealing unwanted food. Later I learned that anorexics sometimes go to the loo after meals and either purge or bring up food. Supervision is called for.
My granddaughter was brave and proactive and realised that she needed help and was determined to be admitted to a leading psychiatric hospital. For the first two weeks, patients are not allowed phone calls or outings.
They may not have cellphones but otherwise the ward is cheerful, homely and rather like boarding school. When the patient starts making progress in terms of eating and gaining weight, she is allowed visitors four times a week and can sometimes go out for tea or for a day.
So too, the boundaries in the lovely grounds are increased where patients and their visitors can walk. Anorexics often over-exercise in an effort to lose weight, so exercise is strictly controlled. They often seem to ‘jiggle” their limbs and hands — something quite irritating to the spectator!
I was also appalled at the amount of time taken to record every mouthful of food in a food journal, together with calorie counts. There seemed to be journals for feelings, for eating patterns and scrapbooks featuring skinny models.
Reading more on eating disorders, it is clear that patients are not being ‘naughty” nor are they ‘doing it to seek attention”. They have an illness as identifiable as measles but unfortunately not as treatable. It seems that there is a worldwide textbook that all anorexics subscribe to!
For one thing, there seems to be an anorexic uniform — baggy, funereal black clothes. Because of the lack of body fat, patients have great difficulty in keeping warm and often dress in layers of warm clothes on the hottest day.
Some develop fine hairs over all their bodies. Almost all stop menstruating and mood swings and depression are evident. I can’t speak highly enough of the psychiatrists and nursing sisters at the hospital whose patience never seems to fail. They seem to have a special kind of grace blended with firmness.
Now that Mary (not her real name) has been discharged and is an outpatient, we plan her food according to the meal plan supplied by the hospital. Gradually, she seems to be enjoying a bit of the food, though I don’t think she would admit to it.
From the outset she confided in me about ‘scary foods” — pizza being the scariest at the moment. What gives me hope is seeing the way she has started wearing makeup, choosing pretty colours for her clothes and making herself attractive.
She still asks me whether she looks fat in a particular garment but we have been advised to steer clear of such questions. I just tell her honestly that she is getting prettier by the day.
One practical thing that I have done with Mary arose from her endless talk about anorexia. I found it very tiring (and boring) and my hints fell on deaf ears.
So I gave her a voucher that said: ‘PAY MARY Half an hour of listening time, each visit during which I will listen, not judge nor interrupt.” When the time is up, then we talk about other things.
To the family of patients with eating disorders, I make a plea. Please try and find out as much as you can about the disease. There is a lot on the internet that is helpful.
While your patient is in hospital, if you cannot visit, please phone regularly and keep in touch with cards, postcards and little gifts. Being in hospital over a long period of time is very hard for the patient and the therapy is often tiring and painful for them.
This is a very serious, life-threatening disease and you can do your part in building up the patient. With your help, the expertise of the doctors and the patient’s desire to get better, a great deal can be done to manage the disease. It may never be cured, but living with it may be possible.