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Anorexia: why would a clever, beautiful teen try to starve herself to death?

Harriet Davis, from Co Antrim, tells Una Brankin how she wants to help others battling eating disorders

Harriet Davis (21) is a quietly-spoken medical student from Ravarnet, outside Lisburn, where she had a happy, secure childhood with her brother Johnny (24), a postgraduate student, and her parents Elaine (56), a librarian, and John (61), a professor of agriculture and food economics.

Tall and pretty, she resembles a more feminine version of the actress Hilary Swank. Harriet has lived with anorexia for several years and has now recovered, although she is very aware of what she eats daily and has to be careful to stick to a routine with her meals.

"It's on my mind every day and I have to make a concentrated effort to have regular meals," says Harriet, who attends Lancaster University.

"If I miss a meal it's a real trigger – I'll think I'll have to miss it the next day too. It's definitely a control issue. I'm a perfectionist and I have to have things in order and precise. If my routine is changed, and where or how I have my meals is changed, I feel anxious and out of control."

Ahead of the 'Sock It To' Eating Disorders awareness week, which runs from February 24 to March 2, Harriet is raising funds for Beat, the leading eating disorders charity.

Her life has been deeply affected by her illness. In and out of treatment for years, she was once hospitalised in London for seven months and her family were left distraught as she slowly drifted closer to death.

"My brother also felt the consequences, so now he wants to offer hope to families too. He's running the London Marathon to raise funds and I'm going to do a skydive, in silly socks, to keep with the sock theme. I have set up a just giving page for anyone wishing to sponsor us –"

Anorexia has the highest mortality rate of any psychiatric disorder, from medical complications associated with the illness as well as suicide.

Research has found that 20% of anorexia sufferers will die prematurely from their illness. Bulimia is also associated with severe medical complications, and binge-eating disorder sufferers often experience the medical complications associated with obesity.

In every case, eating disorders severely affect the quality of life of the sufferer and those that care for them.

Harriet first felt uncomfortable with her weight at the tender age of six.

"We had a school nurse come in to assess our health and I remember feeling anxious about being weighed," she recalls, down the line from her student digs in Lancaster.

"There were a few more moments like this during my childhood but I wasn't obsessed with weight. I wasn't a really slim child but I wasn't really overweight either. I always felt big, though, and would often have to buy clothes older than my age, but that was probably because I was tall. I grew more conscious of my figure as the end of primary school approached, and it took me a while to settle into high school."

A growth spurt at 13, when Harriet was attending Victoria College in Belfast, led to Lenten promises to go off crisps and some moderate weight loss.

"I became much more confident after this but a year later I felt like I had put on weight and became very unhappy with my body, even though my BMI was healthy, at about 22-23.

"Around this time, some family members passed away, and with all this stress in the family I put my weight concern to the back of my mind. After a few months had passed, I decided to lose weight again. This was the beginning of my real struggle."

Harriet admits she always felt like "the fat one in the family." I know two women with eating disorders who say they were afraid they'd end up overweight like their mothers. Harriet's experience doesn't tally.

"My mum had always been slim and was naturally so," she says. "She had a healthy relationship with food and frequently ate buns, cakes or whatever. I thought my mum looked lovely.

"I was jealous of how she could eat and still be slim."

As her teens progressed Harriet started eating healthier food and going cycling.

She would feel unhappy if she ate more than the day before or couldn't exercise. Her best friend noticed very early on that her behaviour was changing.

She says: "I remember going on a beach holiday – I had wanted to look good, which also motivated me to lose weight.

"By the time we went on holiday I was really struggling to eat enough for my body and my thoughts had become more obsessive.

"As I didn't have my bike, I would get up and go for early morning runs so my mum didn't know. I avoided food like cake and crisps and would pick at meals.

"I later went to Romania that summer, away from family, and in a strange place this gave me an excuse to avoid eating. By the time I came home I think I had lost a huge amount of weight. My parents had hoped it was just a phase but now realised how serious it was. I would no longer eat family meals and wouldn't even sit at the dinner table.

"I would throw out packed lunches, do sit-ups, keep moving, lie about eating, point- blank refuse to eat, only eat at 8am and then again at 8pm, chew food but not swallow it, hide food and throw it out later."

As with most eating disorders, body dysmorphia played its part in Harriet's struggle.

"To be honest, when I looked in the mirror I couldn't see just how thin I was. I simply avoided looking at myself. I knew I had lost weight and I wasn't as big as I had been, but didn't see just how ill I was.

"Everyone is different, but in my case I feel like I never really felt like I had a child's body. I always felt big and so when I got so thin that I had no curves, maybe this was a way of letting me feel like a child."

As the illness worsened, Harriet was taken to see her GP, who initially dismissed it, saying that he had seen a lot worse cases. When she eventually got specialist help from the Child and Adolescent Mental Health Services (CAMHS), she was physically unwell to the point she had to be taken out of school, in September 2007.

She was subsequently admitted to hospital for six weeks and was fed through a tube. Her 16th birthday was spent thus, in hospital. On her release, she remained stable for a few months but then slipped back into her old habits, and had to be re-admitted for six more weeks in September 2008.

"I really resisted treatment and gained hardly any weight, so I was referred to a hospital in London were I spent seven months in a specialist unit. It no doubt saved my life but I hated it so much I made a pact never to go back in. I did lose weight when I came home but managed to stop before I was hospitalised again.

"I went on a girls' holiday that summer and when I saw the pictures, I could really see how I looked compared to my friends – like a stick, with no personality behind my eyes, as I was so engulfed in a world full of food and calories.

"I can't remember my lowest weight as this was kept from me in hospital, but it was maybe less than 43kg.

"I was constantly cold, couldn't sit on hard chairs, got heart palpitations, couldn't walk around very long and had to stop on hills. I was quite low in mood, my skin was dry and I had downy hair over my body. My periods stopped for five years. I was constipated. Now, I have osteoporosis in my hip which could affect me in later years as I have not built up my bones. I don't yet know if my fertility is affected."

After she was accepted on to a pre-med course, Harriet knew she had to get well again to study medicine.

"This was what really kick-started me into gaining weight and helped me get were I am today. While studying I lived in student halls and this gave me a fresh start away from home with new people who didn't know about my anorexia.

"I wanted to fit in, so I pushed myself out of my comfort zone and started eating takeaways and such again. I was doing well for a period of time but I am still struggling with my body image and food."

Elaine Davis took approximately four years out of her career and her social activities to care for Harriet, who often shouted and raged at her parents when they tried to persuade her to eat. They visited her every two weeks during her seven-month hospitalisation in London.

"My mum and dad felt at a loss. Mum focused her entire life on making me well. She would give up many social engagements in order to stay with me to eat, so I had a routine of meals. I pushed my dad further away as I didn't like him trying to help me recover.

"My mum has come out the other side, though, saying that good things have come from it. She is more close to several friends and is more involved in the local community by volunteering.

"I think it made my dad realise how strong our family was. My brother was away at uni for a lot of my illness and he would often come home to see me more unwell. He felt isolated, I guess, when there was so much going on at home."

Specialist services for eating disorders have greatly improved in recent years, offering a range of therapies and physical monitoring along with dietary help. According to Harriet, the problem is assessing these services.

"GPs need to take parents concerns' seriously – they need to pick up on the warning signs, denial of a problem, rapid weight loss, reflux in bulimics, rotting teeth. People with eating disorders can remain stable for a long time but it is so important to give them help earlier.

"The longer it goes on the more resistant people can become to treatment, causing longer term problems for the patient and the health service as they have to provide more intense treatment.

"An added problem is the lack of funding for specialist services. They need to be able to offer help to more people. With funding cuts you may save money in the short term but those that go untreated will cost the NHS more in the long term as the illness becomes more severe and more treatment is required.

"Everyone develops eating disorders for different reasons so treatment should be tailored for the individual. I think everyone can recover with the right help.

"There are some people who suffer for decades but usually they have not received help early enough."

Harriet adds: "It is not a way of life. I believe everyone should have access to treatment so they don't suffer for many years. With support everyone can recover. However, motivation much come from within oneself – no one can be forced to recover."

... that Kate Moss quote

Harriet on Kate Moss's assertion that "nothing tastes as good as skinny feels":

"This is ridiculous. If no food tastes better than the feeling of almost fainting when you stand up and feeling like your head is full of fluff and black fog, then the food industry need to do a better job of manufacturing!"

On pro-anorexia websites:

"They are so harmful. For people at the beginning of an illness they encourage starvation and feed the competitive nature of eating disorders. For those in recovery, they offer a temptation to slip back into old habits. They offer no benefit to anyone."

On her dreams for the future:

"I am fascinated by the brain. I don't think I could work in psychiatry as it is too close to past memories. I would love to work in neurology or neurosurgery. I hope to spend a couple of years working in London when I graduate and eventually move back to Northern Ireland to have a family life. I want my children to be close to their grandparents as these are some of the best memories I have."

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