Opinion: Listened to at last

Helen Falconer now feels supported rather than instructed in her battle with anorexia – and the experts

Anorexia is a difficult illness to treat because those it affects are often unable to see the medical danger they are in and, even if they do, may not want to get better. This puts the professionals trying to treat them in a tricky position – especially if the medical risks become acute.

The traditional treatment approach focused on attaining a healthy weight through bed rest and a high-calorie diet. This method has the benefit of limiting health risks in the short-term but does not necessarily lead to long-term success. Now, some treatment centres are adopting a more collaborative way of working. Although full recovery, including reaching a normal weight, is encouraged, patients can also work at maintaining a lower weight if they do not feel ready to let go of their illness completely.

I have found this approach more helpful. When I was treated in an in-patient unit by child and adolescent mental health services, I was made to reach a target weight set by my consultant. It felt like I was in a constant battle with the staff team there and, as soon as I was discharged after reaching this weight, I immediately set about trying to lose it.

The adult unit to which I later transferred operated differently. I found it difficult to adapt at first but now think it can be much more beneficial. I have had various ups and downs but now feel I am being supported instead of instructed and have a much better relationship with my therapist.

Problems do arise when I am able only to maintain a weight well below that considered medically safe. As I have felt fine at this weight and not had any physical difficulties, I find it difficult to acknowledge the need to eat more.

However, it is a fact that, below a threshold body mass index, the risk of a heart attack is 10 times higher. If a patient were to die, the medical professionals in charge of the case would have difficulty defending their lack of action.

There is also an argument that some people who have attained a healthy weight and then fully recovered would never have been able to achieve that weight if they had felt there was an option not to. This can be valid for young children and those who have not had treatment before.

My psychologist allowed me to stay at home for quite a long period when many would not have and for this I am grateful as I was far happier there than I would have been in a hospital. I was eventually admitted to hospital despite my protests but I can see the dilemma facing those treating me and cannot blame them.

It must be particularly difficult for “normal” people to understand because the desire to stay ill seems so perverse. I cannot explain it, despite having experienced it for years. All I can say is the past few years of my life would have been close to unbearable if I had not been fortunate enough to have a therapist who believed in working with me rather than trying to force me to do something I wasn’t comfortable with.

Helen Falconer uses mental health services

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