The Empire State Building lit up for Eating Disorders Awareness Week

Thinking of eating disorders conjures images of painful thinness, starvation and going to any lengths to avoid eating.

For many people, including a proportion of health professionals, eating disorders are represented by anorexia nervosa and the profile of a middle-class, young white female. However, people who experience an eating disorder and are diagnosed with anorexia are actually in the minority. Increasingly, sufferers are more likely to be male, diagnoses are seen earlier than ever before and people are maintaining or even developing eating disorders well into later life.

If we make assumptions about the types of people who struggle with eating problems, then we are at risk of making it more difficult for sufferers to see their often hidden experiences as real for them. This only helps maintain the shame and stigma that often goes hand in hand with eating problems and prevents people from accessing the support they need.

When I developed anorexia nervosa, people around me found it hard to recognise the cause of my shockingly thin appearance for what it was – not an underlying physical health problem but a deep psychological disease rooted in an array of predispositions and life experiences. Surely I couldn’t ‘want’ to look as thin as females with anorexia, because that body image isn’t upheld as an ideal for males. Perhaps my presentation could better be explained by another diagnosis – or even several diagnoses – because a boy with an eating disorder must be an inherently more complex case than a girl.

Also, how could an intelligent person be overwhelmed with something so outwardly irrational, and not think their way out of their mental illness? The refusal of others to accept something that didn’t make sense at face value, and their disregarding the emotional as invalid, ultimately led to me being denied any specialist treatment for six years (despite having a terrible quality of life and high level of physical risk during this time). The personal costs were huge.

Despite having stopped attending school, by the end of my A-levels I had a place at Cambridge to read Music. I never took it up. With each deferred year that passed without the support I needed, my eating problems became more and more entrenched, and my attempts to seek help failed. I was ‘too unwell’ for the treatment available: a ‘difficult’ patient. Rather than these being compelling reasons for treatment, the withholding of support undermined my sense of what was real and destroyed any hope of recovery.

The eating disorder could always be relied on, even if it came with the cost of having to withdraw from a degree, losing friends or ending up in hospital. Making the choice to replace a way of regulating difficult emotions with a more positive way of being has been a daily decision: one which step-by-step has enabled me to come to Cambridge eight years later.

There are so many ways in which going to university can be a challenging experience. Compared to the sort of great time we think we ‘ought’ to be having the minute we arrive in a new environment, the reality for many students is that adjusting is a struggle. How reassuring it is to discover that you aren’t the only one finding it hard to meet people, feeling an imposter or grappling with keeping up with the demands of your course. It can seem as though everyone around you is hitting the ground running and having the times of their lives, but there are invisible struggles, people whose inner reality is a stark contrast to their outer appearance.

This disparity is also a hallmark of those mental health problems which thrive on the combination of being hidden, major life changes and social isolation, and so it is no surprise that new students are especially vulnerable to deteriorations in their mental health. Making the transition to university is widely recognised to be an especially difficult time for people who have experienced eating problems. There are near-perfect conditions for maintaining disordered eating and every reason for needing something to rely on in the midst of so much pressure and uncertainty.

Having been through a recovery and being well-versed in the support and skills needed to be well, I still had a major relapse into bulimia after coming to Cambridge in October. Instead of meeting people or engaging with my course, things quickly became about living between trips to Sainsbury’s and spending hours on end in my darkened room eating until the pain of fullness was alleviated by vomiting. Getting back on track only happened following a sobering time in Addenbrooke’s, and vomiting copious amounts of black blood after damaging my stomach, when I was reminded of the fragility of recovery and decided to seek support.

Despite not hearing anything about mental health in the lengthy inductions at the start of the year (but plenty about bike thefts and Wifi access), I’ve found that excellent support exists in the university, from tutors and nurses to the Disability Resource Centre and Counselling Service. I would encourage anyone with current or past experience of eating problems to think more than I did about the challenges of university life and not be as ashamed as I felt for many years to seek help.

There is so much on offer more widely to tend to your wellbeing, from exercise classes to mindfulness meditation, with the most important thing being to do what works for you, irrespective of feeling the need to conform to traditions and timetables or any particular student lifestyle.

The struggle with eating problems isn’t confined to those arriving at university for the first time either. As well as being a centre of academic excellence, providing great opportunities for learning, working and growing as a person, Cambridge can provide just as much in terms of extreme pressure, lack of direction and loneliness. It produces disparity and intensity, along with encouraging perfectionism and lengthy periods of isolation interspersed with vibrant social functions which often revolve around food and drink.

The tradition of formal hall is an especially exclusive one; the institutional focus on eating and drinking means that a significant number of people experiencing eating problems potentially face barriers to participation. These events are currently a hugely important part of Cambridge life in terms of making connections, engaging in intellectual discussion and having a sense of belonging.

If the university is serious about inclusiveness then it must consider the huge challenges that that such central traditions might pose to the significant and growing number of people with eating problems, and think seriously about their place in the present day.

Eating Disorders Awareness Week this year focuses on eating disorders in the workplace, promoting awareness and reducing the stigma and discrimination faced by people with eating problems in their day-to-day occupations. With the highest mortality of any mental health problem and an often ‘all-consuming’ and debilitating nature, eating disorders are a serious and complex concern.

Living with an eating disorder and the process of recovery are enough, without additional barriers to working and engagement.

The existence of these problems needs to be very much on the radar of the university going forward if people with eating disorders are not to be disadvantaged in their occupation as a result of ill health.

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