Now Lizzie’s a doctor, she knows that so much about the way her teenage anorexia was treated was wrong

AN ESTIMATED 1.6 million women and men in the UK have an eating disorder. Here, in an extract from her new book, a young hospital doctor who lived with anorexia for ten years offers a powerful and sometimes shocking insight into this devastating condition and its effect on patients and their families.

She’s not going anywhere,’ the doctors told my parents. ‘Lizzie’s heart is struggling and she’s not stable enough to move.’

I couldn’t believe what I was hearing. I thought I was just going to the hospital for a check-up, and now they wanted to keep me in; not just in the hospital, but also in the bed — I wasn’t even allowed to stand up or walk.

But then, I couldn’t believe much of what the doctors had said for many months.

What was wrong with losing weight? That was how to be attractive, how to look good, how to be good. I thought the doctors had it wrong. I was 14, I could make my own decisions.

every few days — for months — I had been in a doctor’s surgery or clinic being weighed and measured, or in a consulting room being told about the dangers of what was happening to my body. And I simply couldn’t believe what was being said.

But now, in hospital, it was different. My dad was there, even though he was supposed to be away in meetings, and he looked worried. My mum, who had been firmly holding herself together for months, was very emotional.

The doctors were talking about dangerously low levels of electrolytes in my blood, about abnormal and irregular heartbeats and the risk of a potentially fatal cardiac arrest.

At that time, the anorexia had such a control over my mind I’d hardly eaten or drunk anything for days. I couldn’t even brush my teeth because intrusive thoughts told me toothpaste had calories.

When Mum tried to give me some water, I couldn’t touch it. When you are living with anorexia, you experience overwhelming fears that make you see the worst in everyone and everything, and I immediately thought she’d stirred sugar into the water so it was full of calories.

In hospital, I was scared, really scared. I didn’t want to be there. I would do anything I could to get out — except eat.

But if I ate, I could leave. so when they next offered me a piece of food, I forced myself to have it. Not because I wanted to get better, but because I wanted to get out of hospital so I could restrict my food intake again.

As a doctor, I can now see the difference between the way the hospital responded to my admission for what was fundamentally a mental health issue, and the way we respond to those with physical problems. T he focus on weight gain and an increase in food intake, without addressing the underlying cause, is the equivalent of treating someone with pneumonia by focusing on paracetamol and oxygen without antibiotics.

I wasn’t offered any help in addressing the thoughts and fears that had brought me to this point.

But over the many following hours Mum and Dad sat by my bedside, they encouraged me to talk and reflect on how it had come to this.

At the time, I thought it must have begun when I was 13, broke my leg horse-riding and had six weeks off school. My mum has always been a great cook, and while I was sitting at home all day, I was eating whatever she made.

I put on weight. I knew it. But when I got back to school, the general meanness and comments about it really got to me. Nothing I could do would make the other girls stop.

I moved to a new school. But the first thing someone said to me there was: ‘hello fatty.’

Later I realised the seedbed of my anorexia was more complex than that. I was born with a facial birthmark, a collection of dilated blood vessels on my left cheek. Although it eventually faded, Mum and Dad were always very keen to protect me from the harm others might do to me with their words.

I don’t blame them, but unwittingly some of this prepared the ground for the thought patterns in me that led to the development of anorexia: I simply wasn’t prepared for people making comments about how I looked.

As a doctor, I now know I’d developed what is known as ‘overvalued ideas’, where my beliefs about my own worth started to revolve around

the idea that I was being excluded from things (such as friendship groups) and that I had to change to be accepted.

Running in parallel with all this, I’d always set myself high standards, but struggled because of dyslexia.

This combination of high ideals and a thwarted desire to achieve, with overvalued ideas about rejection and a negative body image is a clear risk factor for anorexia.

But at the time, all I knew was that I had an overwhelming need to lose weight.

I lost it fast, so fast that none of my clothes fitted. But I couldn’t stop: losing weight had become like an addictive drug.

As well as obsessively exercising, at home I often ‘ate’ on my own in my room, under the guise of study, but threw the food away. Or I’d cut food into tiny pieces and push it around my plate to make it look like I was eating.

One time, I remember hearing my mum and dad talking in the kitchen and feeling revolted that Mum had used the word ‘anorexia’. How could I have anorexia when, in my mind, I was so fat?

Research shows that early intervention really is important with eating disorders. But Mum didn’t know where to turn, especially with something that doesn’t seem obviously medical.

Thankfully, there was one change that Mum thought gave sufficient reason to take me to the doctor: my periods stopped. Unfortunately, many doctors do not know enough about eating disorders because they don’t feature highly in medical training (as I discovered at medical school, where in five years we had just two hours on the subject).

And the GP was insensitive, making unhelpful comments. Then, just as we were leaving, she said: ‘Do you make yourself sick?’

Until that point I’d not thought about that way of losing weight, but now the idea had been suggested to me by a doctor.

Fortunately, the GP had agreed to Mum’s request to refer me to the Child and Adolescent Mental Health Services (CAMHS), and just over two weeks later I had an appointment.

But on the way there, while Mum was obviously pleased that at last there were knowledgeable people she could talk to, I remember looking at her, the person I trusted so deeply, and feeling overwhelming hatred: why was she turning on me like this?

The staff at the CAMHS clinic were amazing. But it was a whole different story at the GP’s surgery. Each week, a nurse took my blood pressure and weight and seemed to have no knowledge of the way anorexic patients lie and cheat.

I manipulated my weigh-ins, and when she saw that my blood pressure was too low, instead of calling in the doctor she told me to run up and down the stairs to give her the figure she needed.

Six months later, I was in hospital at risk of a cardiac arrest.

WHEn the consultant told me I could be discharged if I ate, I did; the motivation was to get out of there so I could get back to my old ways.

But eating again also offered me a moment — although very brief — of insight that it was possible to overcome my fears about food. If there had been some effective therapy at this point, perhaps I might have been able to recognise that this same determination could be applied to ridding myself of anorexia altogether. But without the therapy, I spiralled deeper into this dreadful disease.

Just how dreadful was demonstrated on Mum’s birthday. We couldn’t go out for a meal as usual because I wasn’t allowed to leave the house, so Mum planned a Chinese takeaway instead.

The thought horrified me, and led to another long dispute with my CAMHS consultant who set me the challenge of eating a plateful of this takeaway.

I refused it. In fact, I refused all my food that day. This caused a dreadful row with Mum, but I would not budge. I could not.

To this day I don’t really know why I did what I did next, except I was in so much pain and I wanted Mum to be in that pain with me.

I took a large pair of scissors and cut the sheets on my mother’s side of the bed into shreds. She dissolved into tears.

The next morning, I found she’d laid out a biscuit and a small muffin for me on a plate. It made me so furious that when my Dad tried to make me eat them, I grabbed the scissors, held them like a dagger and lunged towards him.

He didn’t defend himself. He just stood there, looking at me.

Luckily the human brain can work at amazing speeds. In that split second I thought, does my eating disorder have such a hold over me that I would stab my own father not to eat? I stopped, inches away from his chest.

In that moment, I had power over the anorexia.

If this were a film script, I’d have dropped the scissors and my parents would have joined me for a tearful family hug, the demon of anorexia exorcised.

But real life is not like that. There was much more that I, and my family, would face.

It was, however, one of the most crucial stages for me in my journey through anorexia. no matter how powerful the drive not to eat was, I knew I could take control of it.

AnD that, in my experience, is the key: the person must take back control and learn to use their determination to fight the disease, rather than fighting against the professionals and family members trying to help them.

not long after that, I went to a residential in-patient hospital. I was then 15 and had never really been away from home, but I felt so trapped in the world of anorexia and wanted to get well.

I was assigned to a Positive Eating Group with a dozen other people, but it was the first time I’d ever been with anyone else anorexic and it was traumatic.

We sat for hours in the dining room, each with a plate of food in front of us, and no one was allowed to leave until we’d all eaten everything. As if in some kind of surreal Mexican standoff, we sat for hours, refusing to touch our plates. Some days we never left the dining hall.

Like prisoners in a jail, we bonded, united against the common enemy of the staff.

I learned new tricks to make it look like I was eating and secretly exercised at night.

The rule was you couldn’t have therapy until you’d reached a certain weight — the argument being that your cognitive functioning was impaired by a lack of nutrition. But without therapy there was no improvement, and the days at the hospital turned into weeks, then months.

I found a way to cheat, making it look as if I was improving, and was finally given therapy. It was transformational. My therapist was a clinical psychologist with warmth and humanity, and she helped me look for practical ways to improve my state of mind and let go of negative thoughts.

I began to think differently about what was important in my life and I developed an increasing passion to qualify as a doctor and help others with eating disorders.

But it has been a long journey. While I’d like to tell you that at the age of 25, now married and working as a doctor, I’m fully recovered, with no overpowering thoughts about food or weight or negative cognitions about myself, I can’t. Life hurts, it still hurts me. But the difference is, I now want to live it.

Adapted from Life Hurts: A doctor’s personal Journey through Anorexia by dr elizabeth McNaught, published by Malcolm down on February 27 at £8.99. © elizabeth McNaught 2017. to order a copy for £7.19 (offer valid until March 7), visit mailbookshop.co.uk, or call 0844 571 0640. p&p free on orders over £15.