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"We want her to eat one chip. Just one chip."

Lou and I on a camping trip last year

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.

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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.

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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.

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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.

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It is now one year on since she was diagnosed and things are much better. The doctors at the hospital say she has made a full recovery.

The tantrums have become less and less, we still have the occasional outbursts, but she is now healthy and happy. Lou has learnt how to love and accept herself and those around her. She is positive and kind, with a beauty that shines from the inside out.

This experience has made me an expert in the field of mental illness. I can tell if something is up and am quick to offer my support – I’m not scared of confronting conversations and asking if someone is okay.

But I do have to be careful not to obsess over how much my friends eat or exercise – I never want to see anyone go through what my sister went through.

It has also affected me. I have always struggled with anxiety and the stress of this experience triggered my anxiety to the point that I was not eating or sleeping properly. I went through a period of time this year where I felt compelled to micro-manage my life. I wanted to be in control of everything, how much study I was doing at University, how much time I got to spend with friends, what I was eating and how much exercise I could do. I felt like my head was buzzing with thoughts and began to recognise how parallel these feelings were to what Lou experienced last year.

A note Loud left on my phone before I left for Paris.

When family therapy finished, I took the opportunity to travel around Europe for 2 months with my best friend. I decided this would be a good time to heal, a chance to break away from everything I had experienced and start anew.

But I did not heal, and only now as the year ends and I have settled into University do I feel more and more at peace with myself. I have had to learn how to love and accept all of myself, just as Lou did.

Lou will never be ‘better’ to the point that anorexia disappears. Anorexia will always be there, in fragmentation, but it is controlled and managed. Lou still feels compelled to exercise daily and walks for 30mins each day.

She is banned from running and must take the dog to slow her down. At night Lou eats ice cream and a piece of fruit for dessert. This is usually her only treat of the day. On special occasions she will eat other sweets, but only when required and this means no ice cream at night. Everyday for Lou is a struggle. But everyday is also a blessing.

Nothing can ever be normal again.

I love my sister unconditionally. I am her big sister and best friend and will never let anything ever take her away again.

If this post brings up any issues for you, please contact The Butterfly Foundation on 1800 ED HOPE (1800 33 4673).

 The author of this post is known to Mamamia but has chosen to remain anonymous.