Content warning: This post mentions themes of eating disorders and mental health some readers may find triggering. Please call the Butterfly Foundation on 1800 33 4673 or Lifeline on 13 11 14 if you or someone you know needs assistance.

Imagine someone who has anorexia. I bet you are picturing a teenager girl 15 or 16 years of age, skinny, hiding under layers of clothing, avoiding the gaze of others. You probably think she was abused, bullied or came from a broken home; what else could explain the trauma, which would cause her to stop eating?

I also held those beliefs until anorexia moved into our home. Amy did not come from a broken home, nor did she experience trauma of any sort. As a matter of fact, she was surrounded by a loving family, enjoyed playing with her sister and friends, didn’t display any perfectionist tendencies and loved eating. And she was nine years old.

When anorexia enters your home, it does not ring the bell, rather it slips through the rips of the fly screen unnoticed. Her sister was the first to suggest Amy had an eating disorder, since “What child stops eating ice cream?” Chocolate, muesli bars and other treats quickly fell into the ‘unhealthy’-to-eat category. Who could argue with a child who didn’t want to eat churros, milkshakes or chips? Anorexia was very glad about this and started to make itself at home, unpacking its suitcase full of lies and deceits. By the time I started to become worried, Amy had already lost a couple of kilograms and her lunchbox came home half eaten. She had developed stomach trouble, was nauseous, constipated and hardly smiled any more.

We don’t know how starvation looks anymore. One of the most important starvation studies was done during the Second World War to find the best way to re-feed the starving population in Europe. Called the Minnesota Semi Starvation Study, healthy volunteers were recruited to lose 25 per cent of their body weight and then would be re-fed with food commonly found in wartime Europe. To the researchers’ surprise, not only did the men’s physical health deteriorated, but mentally the men’s health suffered as well. They became depressed and obsessed with anything food related, they collected recipes, mixed their meagre servings into strange, new meals and took hours to complete them. They isolated themselves socially, became more irritable and their fellow companions started to annoy them. They constantly felt cold.

Anne Tonner talks to Mia Freedman about watching her daughter struggle from anorexia. Post continues after audio…

Amy was also cold the whole time. It was the height of summer, but she wore sweaters and long pants. She started to eat more slowly, cutting up her food and chasing it around her plate. She cut out recipes and pasted it into a scrapbook and she became interested in baking. We took her to the doctor who ordered some blood tests to rule out anything else and referred her to a local therapist. Neither the doctor not the therapist knew how to get Amy to eat. There was a lot of talking, which resulted in her eating less and less. Anorexia liked all the talking, after all she didn’t have to eat while everyone was listening to her and anorexia pulled up a chair and made itself very comfortable in our home. After a couple of weeks of continued weight loss, Amy was referred to Princess Margaret Hospital for children (now Perth Children’s Hospital).

Anorexia is not a new, modern illness. In Queen Victoria’s time, her physician Sir William Gull (who coined the term Anorexia Nervosa) treated the illness by sending one of his trained nurses to his patient’s home to supervise all the meals. The patient had no say what to eat and had to eat often. Today, a very similar method is followed and is called the Maudsley approach, named after the London hospital which formalised this treatment. Also known as Family-Based Treatment, since the family (with the support of the hospital) are used to help the child to return to a normal weight by requiring the child to eat five to six meals a day. Medication rarely works, but there is hope on the horizon. In 2017, genetic studies showed links between anorexia and schizophrenia and other metabolic markers (such as type 1 diabetes).

Amy’s recovery was kickstarted with a two week stay at the hospital where she was fed by nasogastric intubation. Upon discharge to the outpatient eating disorder program she was given a meal plan, consisting of three meals and three snacks a day and nutritional supplements in case she wouldn’t couldn’t eat. Anorexia got the chair pulled from underneath it and didn’t like it one bit. She was not onboard with the treatment at all and hated us along with the hospital staff. She cried, screamed, threw food everywhere and was very depressed. It helped knowing that the volunteers at the Minnesota Study also struggled during re-feeding. They became even more irritable during rehabilitation than during starvation.

Gradually though, Amy started to gain weight and six months after her stay at the hospital she was growing again. Her anxiety and depression levels were sadly still sky high. She was back at her historical weight curve after another six months and she was now able to eat a more varied diet, even having some ice cream, something she didn’t have for years.

Kasey Chambers on suffering from anorexia at 30. Post continues after video…

Anorexia was being evicted from our home, bit by bit, like grabbing a bull by its horns and pushing it out of the door. Even though Amy looked fine physically, she still struggled with anxious thoughts. Typically, brain healing takes between 6-12 months after the correct weight is achieved and luckily, after six months the real Amy was back again, emerging from the anorexia fog with very little memory of the whole ordeal.

Anorexia stole two years of Amy’s life. She is now 12 years old, has normal teenager interests and most importantly, is eating without restriction. She is still young and relapse is always a possibility, so I’m keeping an eagle eye lookout for our uninvited guest, with a cricket bat standing close by.

If you or a loved one is experiencing an eating disorder, Mamamia urges you to contact The Butterfly Foundation on 1800 33 4673. You can also call Lifeline on 13 11 14, or the Kids Helpline on 1800 55 1800. If you or a loved one is in immediate danger, call 000.