Last year my 13-year-old sister was diagnosed with anorexia athletica. She was admitted to hospital for 3 weeks with a low heart rate. Obsessive exercise and limited eating left her with an unhealthy BMI. When she was released from hospital we went to family based therapy (FBT) for four months.
It’s one week since Lou was released from hospital and my mum, dad, brother and I are in our first family therapy session. Nobody is talking. I know what we are all thinking: Why do we have to do this, it’s not our illness.
Why did she do this to herself and why can’t she just snap out of it? The hospital told us it is the illness talking when she acts like this, but how can it not be her when the screaming and swearing comes from her mouth? Where did she go, I want her back.
Mum and dad take leave from work and become full time careers of Lou. At school they sit in the car and watch her eat recess and lunch to ensure it is not thrown in the bin. Each morning is a struggle to get her off to school.
She has a habit of throwing heavy objects at us. We have removed the door, curtains and any glass from her bedroom. She threatened to jump out of a broken window yesterday. Mum and Dad have warned the neighbours not to call the police when they hear screaming. When she ran away last time the police accused Mum of child abuse. Mum can’t deal with that again.
Each day we challenge Lou with food from her ‘bad list’. This could be something from a taste of ice cream, a couple of hot chips to a juice with lunch. It must be something extra, outside of routine, which is usually pre-warned in the morning. Sometimes the challenge comes with little resistance, but many times we have to fight to get her to eat it. Negotiations are a big NO NO and giving in means anorexia has won the fight. Instead we have to sit it out, regardless of how exhaustive, embarrassing or threatening the situation becomes.
We are trying to have a ‘normal’ family outing. Dad holds Lou firmly against the table in the embrace the therapist taught. Anorexia makes Lou unnaturally strong. I watch in confusion as her small legs kick Dad hard in the face. Chewed up food is spat all over the table.
We want her to eat one chip. As a sibling it is my job to distract Lou from anorexia. Throwing out words of encouragement I say pointlessly, “just eat one chip and then it will be over and we can go home and watch Big Brother!” Onlookers consider whether or not to intervene.
The hardest part to predict is when she goes quiet. Sitting there completely still in a trance, she will either lose all control or snap out of it. Thank god it’s the latter. She grabs a chip, eats it and we go back to ‘normality’. Challenge accomplished. This is progress, she is doing well.