Thirty years ago, anorexia nervosa (AN) was a condition that few people even knew existed. In the 1970s it was called the ‘Slimmer’s Disease’ and was often mistakenly dismissed as an over-zealous bid to lose weight in order to be attractive. Since then, awareness has greatly increased, and more and more people are aware that this is a very real, and very distressing condition, and one that should be treated, not dismissed.
This book is intended as a self-help guide for those who suffer from AN, or who fear that they may be developing a disturbing obsession with body weight and food. Part One sets out what is currently known about the disorder. In particular, it details the physical and psychological effects of the illness in the long term, from the effects of starvation on your well-being and future health, to the emotional factors that come into play when the disease takes a grip. This is not intended to alarm or distress, but simply to make you aware of the seriousness of the condition, to persuade you of the benefits of healing yourself and to offer some reassurance that you are not alone in your fears about weight gain and food intake. Part Two sets out a sequence of steps through which you can begin to tackle the problem. This is above all a practical plan, and is offered as a flexible framework, not a rigid set of rules. No two people with AN are entirely alike, so you may well find that some of the psychological techniques do not suit you, and you may wish to adapt some elements of the treatment plan. The important point to remember is that the approach described here has proved a useful one for many.
In many cases of AN – particularly those where the illness is quite advanced – professional help may be necessary. How to go about finding the help you need, and what kind of treatments are available, are questions dealt with in Chapter 6 of Part One. However, self-help techniques can be useful even to those simultaneously undergoing professional treatment, and in such circumstances this book may serve as a back-up.
The book may also serve as a useful tool when trying to explain to those around you just what is happening to you, and what you are trying to achieve. AN is a complex disorder. It is both very public and very private. Much of the behavior is secret, and causes the person with AN a great deal of guilt and distress. It is also a very public statement of distress: the starvation state is obvious to all those around, even if apparently denied by the sufferer. AN has been described as an addictive disorder – the addiction being not to food but to food deprivation, to starvation. In many ways it is similar to addiction to drugs or alcohol in terms of the cravings, the preoccupation with the addictive substance and the withdrawal symptoms when it is removed. However, there is one major difference: the alcoholic or drug addict can conquer the problem by avoiding drink or drugs completely; the person with AN cannot avoid food, but has to learn to live with it and develop a healthy, relaxed relationship with it. This is not easy: very few drug addicts or alcoholics can reach such a state of controlled, relaxed use after a prolonged period of addiction.
This, then, is the task that faces you, your friends and your family. I hope that this book will help you through that journey. As you read on, please bear in mind the following points: