Cathie Kelly has lovely clear skin, good teeth and beautiful hazel eyes. But the scourge of anorexia nervosa has given the 28-year-old from Newtownards a drawn, sharply chiselled face and a skeletal frame which she clothes in children’s clothes, or size-four tops.
A former health and fitness instructor and beauty therapist, Cathie is on leave from her call centre job as she battles this devastating mental illness.
Emotionally scarred from some of her experiences while hospitalised, she refuses to take the antidepressants which she has been prescribed to help her cope with the irrational fears her condition raises, but does attend weekly counselling at the Woodstock Lodge centre in Belfast and consults a dietician.
Although she’s at pains to describe her hearty breakfast of a duck’s egg and wheaten bread — and her healthy (sugar and fat free) lunches and dinners — her tiny body, swamped by a well-padded armchair, is testament to the miniscule portions she allows herself. Tellingly, she doesn't touch any of the fancies she serves up with tea in the bright comfortable living-room of her family home in the country, on a hill above Newtownards.
Single, perfectionist and highly articulate, Cathie lives with her brother Ryan (30), a nurse, and her supportive parents Walter and Marilyn, both lecturers at Bangor Technical College.
Cathie and Marilyn spoke candidly to us, ahead of launching her blog www.cathiekelly|online.com which her dad Walter is helping her set-up.
'I don't like looking skeletal and bring ridiculed'
Never in a million years did I think I'd have succumbed to this debilitating mental illness. As a child, and teenager, I was happy, vivacious and so high-on-life that I chose to ignore any feelings of discontent towards my body.
Yes, I was a 'bigger' girl. At 5ft 2in, I weighed around 11 stone at my heaviest. I wore a size 14 trouser and size 10 top. But I was pretty – I'd nice hair, wore trendy outfits and was never short of male attention. Yes, I wanted to be slimmer, but there were so many other pleasant distractions that my body hang-ups paled into insignificance.
Any slimming regime I embarked upon would fizzle out after a matter of weeks.
I was heavily involved in equestrianism and often away at weekends competing with Oscar, my horse. I'd a busy social life and was studying hard too.
Things began to change, however, when in June 2007 I met my now former partner and moved out of home to live with him. He introduced me to the joy of running.
Weight loss was almost instant, and I began maximising results by restricting my dietary intake to ensure that the fat would continue to melt away, exposing that taut, athletic body I'd always desired.
Over the next couple of years I qualified as a physical training instructor with the TA and successfully pounded my way to marathon victory in 2009.
After this I continued to compete (albeit at a very amateur level) in various other trail running competitions and charity events. By 2010, I was demanding more from my body, training almost daily – a five, six-mile run around the hilly terrain of north Belfast where I lived at the time, followed by conditioning work at my local gym.
I'd then go to work, expecting my tired body to function and recover on a meagre 500 calories a day. If I was feeling lenient, I'd extend my rations to 800 calories. My diet was extremely calorie deficient, but everything I ate was abundant in vitamins, minerals, protein and other vital nutrients. I didn't foresee the repercussions of being so restrictive, as I'd deluded myself into thinking that the 'superfoods' would give me enough resilience to keep training, in spite of the insufficient calories.
But it was too late – the early stages of muscular atrophy had already beset me, meaning there was no fat whatsoever for my body to tap into as sustainable fuel.
My body was now devouring muscle tissue to survive. But like smokers who puff away oblivious to the risks I, too, continued to live this precarious lifestyle, rigidly governed by food.
Admittedly, my regime didn't fall under immediate scrutiny from my parents or brother, and I concealed a lot of the goings-on from my partner too.
I knew their intervention would quell this lifestyle to which I was now heavily enslaved.
When I'd allow myself to eat, it had to be 'earned'. If, for example, I hadn't run as well as the day before, I would punish myself by denying a single morsel past my lips until my evening meal, scant as it was. Consequently, recovery periods post-training became longer and soon I started picking up injuries.
During the summer of 2010, I awoke one morning to the most nauseating pain in my left knee. For months I was crutch-bound. My day began by strapping my leg up as tight as I could withstand and going to work. Then the hours that elapsed between getting home and going to bed were spent confined to the settee with an ice-compress wrapped around my injured leg. My despair worsened when even an MRI scan at Musgrave Sports Clinic returned inconclusive results.
The consultant's prognosis was a stress fracture, common amongst female athletes who drop weight so acutely and stop menstruating, causing thinning of the bones and early onset osteoporosis. So no training, no running, no gym ... I became depressed and resigned myself to a now sedentary lifestyle, with no hope of ever fixing the injury. I felt so contemptuous and angry towards myself, like I'd failed. I needed someone to blame and I was culpable.
Retrospectively this was when 'the demon' got a foot-hold – when I was vulnerable. My active life now over, all I could control now was what I put in and out of my mouth. Intermittent hospital admissions followed and I defied death on a few occasions. My potassium levels had become so depleted at one point that my heart could have stopped at any second. My weight had plummeted to an all-time critical low.
I can't count the amount of times family and friends had asked if it was all worth it. But this is not some ridiculous slimming crusade. This is a mental illness. It cannot be seen, like a broken arm. It lurks in the murky depths of my troubled mind.
And yet outwardly I present an articulate and confident veneer that belies any trace of mental disturbance, which I mask with smiles and small talk ...
Suffice to say, I've been on an extraordinary and turbulent journey. I have learned a lot about myself at the 'school of life', and continue to want to acquire knowledge about mental illnesses. Both my family and I strive very hard to banish the stigma surrounding anorexia nervosa. I'm one of the lucky few, who have an amazing support network at home, bolstering my confidence to overcome anorexia.
At the minute I'm a long way off, and learning to manage the disorder by challenging my anxieties and phobias and trying to mend the fractured relationship between my mind and body.
I'm so thankful to everyone who's backed me, including my employer and colleagues, for their continued empathy and support.
It's not just a case of 'eat a fry-up and get over it'. I don't actually like the way I look, an emaciated and skeletal figure, subjected to ridicule anywhere I go.
The appearance is merely an ugly manifestation of all the abnormal behaviours and abusive relationships I have cultivated with myself.
In time, when I have been able to reconcile my differences and conflicting thoughts, my body will reap the reward of having re-established a much healthier attitude towards food, using it as a means of nourishment to live a happy and fulfilling life.
I hope I can learn to love myself again; the day I lose hope is the day the fight is over."
In her own words...the search for help
Cathie was eventually diagnosed with anorexia after her weight plummeted to 5st 10lb in November 2011. She hasn’t menstruated since 2008 and is at high risk of early-onset osteoporosis. At the time of her hospitalisation in 2011, her daily intake was an apple, a yogurt, a meat-free salad, another apple, a small chicken salad and lots of water. Anything she felt she had over-consumed, she purged with laxatives.
As she recalls: “I collapsed at work at the call centre one morning and spent a couple of days as an in-patient on the medical ward at the Ulster Hospital, before an untimely transfer to the Mental Health Unit on that site. Life on that ward was so traumatic.
“There was a catalogue of mental illnesses to contend with. Between patients shouting, fitting, screaming threats and with alarms going off, my anxiety was through the roof. I never slept and received no encouragement to eat; I was just expected to get on with it and kept under close observation.
“I had to shower, dress and undress and even toilet within view of a nursing assistant. It was a harrowing ordeal and I’m still mentally scarred.
“During my stay there, my mum appealed with me to leave and come home. But the medical team and resident social worker said I would be sectioned under the Mental Health Act if I did not agree to stay on. So I literally ‘ate’ my way out of that prison. I found this six-week ordeal devastating.
“Over the course of a year since my discharge, I resumed all my old habits. As a result of laxative misuse and not eating, and regimental scrutiny of my daily calorie intake, my weight nose-dived again to an all-time low of 4st 9lb by August 2012 and I had to be admitted into hospital again, as my heart could have stopped at any second.
“But even when I got home, the old habits returned. Having relapsed again, I had reached a point where I wanted to embrace change, and co-operate with specialists who could help.
“But we don’t have any in-patient facility in Northern Ireland specifically equipped to tackle anorexia.
“The only clinic to avail of is Woodstock Lodge in Belfast. One of my bugbears is the fact that anorexia has the highest death rates out of all mental illnesses yet where’s the help?”
See Cathie’s blog on www.cathiekellyonline.com
What her mother feels...
Cathie’s mum Marilyn says:
Of course, I’d suspected things were not going well with Cathie before she was diagnosed but I had no proof, and she was living with her partner at the time. But in November 2011, there it was certified in black and white — she was anorexic.
Cathie moved home shortly afterwards, her relationship having broken down. In and out of A&E with Cathie, I became desensitised to doctors who told me that she could die.
She lived life on the edge. Apart from the worry, the other awful things included people staring at this ‘walking skeleton’.
To this day, Cathie has to suffer people looking, pointing, whispering. Others look at me, even judge me as if this is my fault.
Cathie and I work closely with the dietician to make sure that she takes her calories daily, but it’s hard. When your weight gets so low, everything is difficult. Struggling to cope with ‘fat’ and the prospect of being bigger is another issue.
All the behaviours that Cathie clings on to have to be dropped slowly, so that she stops body-checking, stops measuring herself and stops looking in the mirror.
What mother wants to see her child suffer? You may think that she has a choice in all of this, or it’s just a silly thing to do but it’s not that simple.
So instead of gawping, please think how you’d feel if that person were you or your child.”