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236: Recovery From Anorexia - Seven Health: Eating Disorder Recovery and Anti Diet Nutritionist

Episode 236: This week I'm speaking with Jo, a client I've recently finished working with. We cover her recovery journey from the depths of anorexia and now back to health.


Sep 3.2021


Sep 3.2021

Jo was diagnosed with anorexia a number of years ago. As part of this conversation, she explains how her eating disorder developed, the point at which she finally recognised she had anorexia, the recovering she’d done before we started together and then the work we did and how different things are now.

Here’s what we talk about in this podcast episode:


00:00:00

Intro

Chris Sandel: Welcome to Episode 236 of Real Health Radio. You can find the show notes and the links talked about as part of this episode at www.seven-health.com/236.

Hey, everyone. Welcome back to another episode of Real Health Radio. I’m your host, Chris Sandel. I’m a nutritionist that specialises in recovery from disordered eating and eating disorders or really just helping anyone who has a messy relationship with food and body and exercise.

Today on the show, I’m chatting with Jo. Jo is a client I’ve recently finished working with. For the last handful of episodes, I’ve been starting the show mentioning that I’m taking on clients, and conversations like this can be a great way for you to hear the stories of other people who have struggled with an eating disorder and what their road back from this place has looked like.

I started working with Jo in March of this year, and as you’ll hear her describe, she’d been diagnosed with anorexia a number of years ago. She explains about how her eating disorder developed, the point at which she recognised she actually had anorexia before she started working with me and the work she did as part of that, and then the work that we did together and how different things are now.

As a trigger warning, Jo does talk about a time when she contemplated and came close to suicide, so if you are sensitive to mentions of this, this is your advance warning. But it is a fantastic conversation, and it’s great to hear Jo be able to talk about how much she’s been able to achieve this year with her recovery.

I had asked Jo to put aside an hour to chat, and the time just flew by. There were some aspects of her eating disorder that we didn’t get a chance to cover, like many of the physical symptoms that she was dealing with, but she does such a great job talking about the psychological side of things and how this has shifted for her.

I’m currently taking on new clients, and at the time of recording this intro, I have just one spot left. If you hear yourself in Jo’s words and her experiences, then I’d love to have a chat and see if I could help. You can head over to www.seven-health.com/help, and there you can read about how I work with clients and apply for a free initial chat. The address, again, is www.seven-health.com/help, and I’ll put that in the show notes.

So with the intro out of the way, let’s get on with today’s show. Here is my conversation with Jo.

Hey, Jo. Welcome to Real Health Radio. Thanks for doing this with me today.

Jo: You’re more than welcome. Lovely to speak to you again.

00:02:37

What Jo was experiencing before getting in touch with me

Chris Sandel: Do you want to give listeners a bit of backstory on you and what had been going on with you before you got in touch with me?

Jo: Yeah, no worries. I started my slide into an eating disorder a few years ago. I’m not sure if everyone is aware, but you don’t just get big flags saying, “Hey! You’ve got an eating disorder.” It just kind of creeps up on you, and you find yourself in quite a sticky situation. And even when I was at my illest, worst, I was still convinced I was being very healthy. I was buying sizes smaller and it was great and that was an achievement, but looking in the mirror I still saw a big person, and that was not the reality at all.

I was really fortunate to be diagnosed with anaemia versus anorexia, so I set about fixing the anaemia, and that obviously put on weight. So I became weight restored in the traditional sense of no longer being underweight, but I definitely still wasn’t well, and I was referred to a charity that looked after eating disorder people. At the time I wasn’t convinced I needed them because I wasn’t ill; I was weight restored, I no longer had anaemia, and I went along and discovered on the third or fourth session with a counsellor that actually, I did have anorexia, and I was anorexic at the time, very much so underweight, but I was actually still suffering with anorexia.

After a few sessions, I got my head round it, felt comfortable enough that that was what had been wrong with me, and I wasn’t going to go back down that road. So, whoop-de-doo, off I go into the world.

That was a few years ago. I thought I was doing alright. I thought I was doing okay. Everything seemed to be ticking along. I was still weight restored. I was starting to exercise for joy rather than exercise for weight loss. And then Covid happened, and I was at home. Being a fairly anxious person, that rocked my world. I didn’t have to go in to the office, I didn’t have to see anyone. I could wear leggings all the time. [laughs] I could wear nice comfy clothing.

It got to the beginning of the year and everyone was starting to open up and talking about needing to lose the Covid weight. There was a lot of conversation around needing to be on diets, needing to change the way you were, had you been a healthy Covid-19 person or had you been an unhealthy Covid-19 person? It just started to play on my mind.

I’ve listened to your podcast forever, pretty much since I realised that I had an eating disorder, I stumbled across you. One day I was listening and it was like, “Hey, I’ve opened up my books” and I was like, “I think I need someone to steady the ship.” I wasn’t acting on it, but I was starting to think that things weren’t as normal as they should be, whatever normal looks like. So I reached out and started our conversation.

Chris Sandel: Nice. I want to go back to something you said about you were diagnosed with anaemia, not anorexia. If you had been diagnosed with anorexia at that time, what do you think your response would’ve been?

Jo: You know, because I’ve told you. [laughs] It would’ve been to laugh at them and tell them not to be so stupid. I was being perfectly healthy. I was eating healthily. I was eating, did you not know, and I was following the 5:2 diet and therefore everything was normal because that was on TV. So yes, I would’ve completely ignored it and probably ended up in a much worse situation.

Chris Sandel: So it’s nice in a way you got anaemia. And you were not the first client where something like that has happened, where some other illness has been diagnosed and that’s got under the radar and has led to changes starting to occur. I think that was very lucky.

And just so listeners know, how old are you?

Jo: I’m 49 now.

Chris Sandel: You’re 49, okay.

00:06:55

How Jo’s eating disorder developed

And in terms of the eating disorder, you said this is the last handful of years. What was your eating like in your earlier years?

Jo: My mum has always been on a diet. We had a clean plate club, so you had to clean your main course before you could have pudding. Pudding was considered a treat. Certain foods were considered a treat. Mum wasn’t eating certain foods, so she’d feed us but then there’d be a lot of chat around “I’m not eating that because
” or “I’ve had that, therefore I can’t have dinner.” So I think myself and eating wasn’t necessarily an issue, but I think the surrounding language was definitely there. And it’s still there, interestingly enough.

So yeah, I’ve had bits and starts of being ‘healthier’, and hat is very much in inverted commas, versus not paying attention. I remember when my husband and I were in our flat and we were settled and married and everything was hunky-dory, and we’d nip over to the newsagents’ and buy lots of ‘junk’ food, in inverted commas again. We would not actually care. We were living above takeaway, so we had a lot of takeaways. Obviously, your life changes. But then I never really paid a huge amount of attention.

Then I went on a bit of a health kick with regard to getting exercise in, because I didn’t really exercise since being in school, and that was the beginning of that fun path that I ended up on. [laughs]

Chris Sandel: So it was really your first main go at being ‘healthy’ and getting into exercise in a serious way, and then as part of that, having dietary recommendations made off the back of it, and it being a diet. Really, your first go at the merry-go-round was what slid you into that place.

Jo: Yeah, and it took a good few years of the exercising, but I’d been the person that would go to exercise class and do three or four in a row. I’d go on a Saturday morning and I wouldn’t leave until lunchtime, or I’d go to the gym and be in there for hours because that’s what I thought you did. No-one was pulling me up and saying, “Do you know you only need to do one class? It’s okay to just do one class.”

And yeah, then it spiralled. The numbers became a huge thing. I had to do a number of steps before breakfast. I had to do a number of exercise classes. There were so many ‘shoulds’ and rules that I had to abide by that, looking back, it was just like, based on what? Who wrote this down? Who told me that that was what was needed, that that’s exactly what I should be doing? I was just one of the unfortunate ones who got the anorexia stick.

Chris Sandel: At what point were people pulling you aside or your husband mentioning, “I think this is an issue”?

Jo: Oddly, it was my mum who actually started the whole thing by saying I looked pregnant when I wasn’t. She was like, “I think you’re too skinny now.” But of course I’m not going to listen to you, because you said the other side of the coin. [laughs] I don’t think my husband noticed particularly. We were dieting together, so therefore we were both achieving. But he didn’t slide down; he was just losing weight in a ‘healthy’ way. Again, lots of healthy references with inverted commas.

But no-one really started to comment. Everyone held me up as this really committed, determined, healthy person. It was only after that people said, “Your smile didn’t reach your eyes and we were worried about you.” It really came to a head on a holiday with the girls, if you want me to explain that fun time.

Chris Sandel: Yeah.

Jo: Just to let you know, this isn’t easy listening, for anyone out there. But when you are in control of your life to such an extent that everything has to be done in a certain order, has to be done in a certain place, has to be done to rules, these rules that were in my head – unknown to me why I agreed to this, I went on holiday with some friends to Las Vegas. Very different place, very different culture. I’d only been to America with work before.

I was up at 5 o’clock in the morning going to the gym, making sure I got my gym sessions in, and then I would walk up and down the strip before my friends would wake up. My eating was as crazy as it always had been. Going to restaurants, taking everything I could off the plate and modifying it so it was the bare minimum, and then stealing the leftover food from anyone else’s who hadn’t eaten it, which was just bizarre. It spiralled more and more and more.

I suppose my eating disorder voice was just shouting louder and louder and louder as the control wasn’t possible to maintain because I wasn’t in my normal place, and I found myself sat on a five-story balcony, thinking about jumping off. That terrified me so much. I had no idea where that voice had come from. I didn’t understand what the hell was going on. It pulled me round.

Now, I was being treated for anaemia at the time, so I think I wasn’t as bad as I had been from a health perspective, and something in my mind said, “No. No, no, no, stop. Just stop.” Pulled myself back and sat and cried for hours.

The holiday was a complete disaster, as you can very well imagine. [laughs] I was having a full-on mental breakdown. I couldn’t communicate. I was still trying to keep up with all the rules and the walking and the eating. When I came back, I was a shell. Fortunately, my husband was able to chat to me on Facetime. As soon as the UK woke up, he was on the phone just to reassure me that everything was okay. I just didn’t understand what the hell was going on.

So yeah, looking back, again, it’s one of those turning points. The anaemia was one; this bizarre voice in my head telling me that I wasn’t worth it, just end it, was another. I’m very, very lucky to be here.

Chris Sandel: Yeah. How shortly after that episode was the anorexia diagnosis?

Jo: About three months. I came back – I still held on to it for a while. I still carried on my normal behaviours. ‘Normal’. [laughs]

Chris Sandel: [laughs] Normal at the time.

Jo: Normal at the time behaviours. It takes some doing. I’m really lucky that I went to the doctor, who just said “You need to talk to someone. Here’s someone to talk to.” He actually referred me to a dietitian at the hospital as well as the charity, which was an interesting combination because I was trying to talk to the dietitian for ‘healthy’ ideas and talk to the counsellor – we hadn’t come to the conclusion that I was anorexic at the time, and it was quite a conflict.

And in the end I said to the dietitian, “I’m just so scared of going back”, when I’d figured out where I was and what it was. I said, “I’m just so scared of going back.” I think that’s the conversation we had at the beginning as well: “I’m eating okay; I’m just really scared of going back.” You might want to pick up the story and the fact I wasn’t eating okay at the time. [laughs]

Chris Sandel: Yeah. I can pick that up, but I guess the thing I would ask before that, before I chime in, is:

00:15:13

What prompted her to reach out to me

You’d mentioned about Covid and all the chat about Covid gain weight and “Have you been a healthy person during Covid or an unhealthy person?” and that that started to turn the gears in your mind around different thoughts starting to come up. So when you reached out to have the initial chat and think about working together, at that stage from your perspective, what was it that you were wanting to get out of it? What were you thinking “Hey, this aspect isn’t right or these aspects aren’t where I would like them to be”? What was your hope?

Jo: I think as I pictured it, I’d done a lot of the work, and it felt like there were just bits left over. I described it to you and people were like, “That’s horrible, thinking of your brain like this!”, but it was like my brain was a bottle that had been washed out but hadn’t been cleaned thoroughly with a bottle brush into all the nooks and crannies.

So it felt like there were still bits that needed addressing. And I didn’t know what they were; I just didn’t feel – it’s got to be the word ‘recovered’. I didn’t feel recovered. I felt like there was still this doubt in my mind that I was ‘normal’. [laughs] I keep using the word ‘normal’ and I laugh every time because there is no such thing as normal, but it just felt like actually, with all this chatter, there was a worry that one of these little bits that hadn’t been cleaned up could hook onto it and I could somehow find myself in a situation on the spectrum of eating disorder. I didn’t think I’d end up being anorexic again, but I’m obviously susceptible to having an eating disorder, and therefore I was like, “I could just do something a bit more or I could try and do something a bit different”, and it was like, no, I need to really stop. Stop and assess what is right and what’s wrong for me.

So when we had the chat, I think I described it as that. It was like “I just need my brain cleaned out a bit more. I feel like there’s bits that are still a bit mucky in there.” And whilst the voice is definitely not there, there was a fear that it could come back. It was just such an alien concept that this voice controls you. It was like, “Hang on a minute.” And I’d avoided a lot of the news. I’d avoided a lot of the conversation. But it was just so prevalent at that point. I was like, “I don’t like this. How can I protect myself against it?”

Chris Sandel: The thing that I remember most about that initial chat was just the point of confusion, where you were like, “I just don’t know what I need to do next. I don’t know what I don’t know. I’m just unsure as to where I really am as part of this recovery. Is this it, and this is what it’s going to be like forever? Or is there a better place from where I’m currently at?”

When we started working together, at least from my perspective, it became quite clear that yes, there wasn’t enough food coming in to actually support you. There was a lot going on that would indicate you were still not completely healed from a physical perspective, and that was also having an impact on your mental and emotional perspective. So yeah, I would think about you in terms of you were in a place of quasi-recovery. You’d done a lot of good work by the time we started working together, but there was still more to be done.

Jo: For sure. That’s such a weird thing, because I think I’d never heard of this quasi-recovery before. I think it was on your podcast you were talking about it, and I was like, “Yeah, that makes perfect sense.” [laughs] It’s really weird listening back to some of the other podcasts that you’ve shared after. I’d listened to them before meeting you, and then listening to them after our conversations, it really had a different angle as well. I could understand it a bit more in the context of myself versus just this generic conversation that you had.

00:19:29

What our work together looked like

Chris Sandel: Do you want to describe from your own perspective what the work we did together looked like? What stood out for you? How was it? Just for listeners, so they can get a bit of a sense of what it is.

Jo: It was a rollercoaster, I can say that. [laughs] I didn’t cry throughout it all, which I was very impressed with. I think I was quite proud after each session when I was like “Yes! Didn’t cry.”

It’s like taking a can opener and opening up your brain, I think is the easiest way of describing it. You’d ask questions that I would never have thought about in the context of my eating disorder or my future eating. It was a real holistic view of me, which you’ve obviously built over many years of working with clients and understanding. That first session, you sent me the introduction paper – to say that takes a long time and takes a lot of probing – yeah, that’s the can-opening session. It’s like, “Oh my gosh, I don’t know. What do I think about that? How am I about that?”

So I finished that and sent it back to you to say, “Hey, this is my” – I don’t know how many pages it is, but it’s multiple pages of information, and I sent it over to you. It’s like, wow, this is going to be all-encompassing. This isn’t just going to look at my food and my sleep and my mental state. This is everything all together.

I did tell you off for calling it ‘food logs’. You said, “How do you feel about doing food logs?” and I absolutely freaked, because I was an expert at food logs, I’ll have you know. So we rephrased it to awareness logs, which is just keeping an eye on what I’m eating, when I’m eating it, how I’m feeling, how hungry I was, how satisfied I was, how much sleep I was having, and general like “Am I exercising every day, and how often, and what does that look like?”

I think people should be aware that this is not a ‘Chris fixes everything’ and you just sit there nicely absorbing. This is very much an ‘in it together’ team effort, and there’s homework. [laughs] A number of times you sent me a link saying, “This is your homework between now and the next session” and I’d be like, “Why is he sending me this? This is the weirdest writing effort I have to do. I have no idea what this is relating to.” Then the next session you’d say, “Right, let’s go through it” and I’d say, “Oh yes, that’s what he’s getting at!” So yeah, it was a rollercoaster, but it didn’t tear me apart.

I think I was really lucky because I was already weight restored. I was eating, but I wasn’t eating enough. I’d got into a ‘press repeat’ stage, which was basically having the same thing every day, for breakfast, for lunch. Occasionally dinners were different, but over a period of two or three weeks, they were exactly the same. Had I checked out? I’d kind of checked out from the emotional side of things and fixing that.

So yeah, a lot of self-compassion, “How do I feel about myself? How do I feel about other things?” It makes you think. It makes you think and it makes you take a deep breath and accept that you weren’t 100% there. I was pretty sure there was going to be this tiny little thing you needed to fix, and that was me, good to go, off I went. And it wasn’t that easy. [laughs]

Chris Sandel: [laughs] Yeah. I would say the way I think about recovery is there’s two parts to it. There is the physical part of recovery and the nutritional rehabilitation and the neural rewiring and all the components that are directly connected to food and how food has an impact on the body, and exercise and those kind of things.

But it’s then the second part, which is largely where we were focusing because so much of the first part had been done, which is really the nuts and bolts of how you cement recovery so it doesn’t come back – by learning various coping skills, by learning about mindfulness and all of these different things that have a real impact on you being a human in this world and being able to cope with that.

And I actually think a lot of what I focus on would be relevant for any human being. They don’t actually have to be going through recovery; it’s just I’m looking at it through that lens with the people that I’m working with because that’s why they’re coming. But I mean, I’ve never had an eating disorder and never had issues around food, but so many of the books I read and recommend and focus on with clients are stuff that is really helpful for me. For me, it’s often using it in terms of my relationship with my wife or my relationship with my son or whatever it is. But I do think of this as more life skills, but life skills that then mean that when you can really do this and understand this, it means the need for an eating disorder disappears because you’re able to do this in other ways.

Jo: That’s a much better explanation than mine. [laughs]

Chris Sandel: [laughs] Definitely not, no.

00:25:10

What her relationship with food is like now + other improvements

So tell the listeners where you are in terms of your relationship with food now. How would you describe your relationship with food? How do you think about it now?

Jo: That’s such a weird question because I just don’t think about it. Which may sound really bizarre, but actually it’s a real positive. I’m mindful of it, so I know when I haven’t eaten enough during the day. I am wary of long gaps, and I’m also wary of my hunger – what I feel about feeling hunger. Obviously, when you have an eating disorder, being hungry is amazing. It’s the best feeling in the world. You’ve achieved blah, blah, blah. And it’s not. [laughs] It’s not the best feeling in the world. It’s actually horrible.

So when I’ve gone too long between food – I work at a desk all day, every day; I work with a global team, so my hours are extended between European time and US time. So I can literally be sat on the phone all day, trying to grab lunch. Obviously breakfast and dinner is easy, but grabbing lunch on the go. So I have a drawer of snack bars, which I know you’re going to smile at because you told me that you’d like me to put snack bars in a drawer near me and I freaked out and said, “No, I’m going to eat them all! They won’t be there! They’ll be too much temptation.” They’re there, and I grab them if I need them.

I have a huge variety of food now. There were certain things I was still avoiding without realising, and I don’t anymore. I was overeating certain things because I didn’t have pasta before. I had so much pasta because I was proving that I could eat pasta. I was eating cheese every day because I couldn’t have cheese before, and then I was eating cheese every day. Now I eat whatever’s around. It’s not a biggie, it’s nothing to worry about. There’s just no – this sounds so stupid – there is no thinking about food.

I’m organised with food, I make sure I have food around, I make sure I’m eating, but that’s kind of it. I don’t stress about it. I go out for a meal and instead of looking down the menu and finding the lowest calorie thing and then modifying it even further so it can go even lower calorie, I just pick what I want. Which is really difficult. It’s really difficult to go into a restaurant and actually be able to eat anything off the menu because that’s challenging. That’s what you think when you’ve gone in and picked the one thing that you know you can have – for me it was steak and salad with no dressing. Thinking about it now, it’s dull as dishwater. But yeah, it’s weird. Now I can go and have anything, and that’s fine.

Sleep-wise, I’m aware of my sleep. I wear a Fitbit, and it’s purely more for my sleep than anything. If it’s dipping between low quality, then I just need to check and see what I had the day before and the last couple of days and how much exercise I’ve done and whether I’m properly at an energy deficit and I need to up my food. And it’s not about calories. There isn’t a single brain cell that is used for calculating calories. I used to be a mathematician; everything and anything I did was adding, taking away, calculating. That brain capacity is freed up. Which is worrying, because then you have to actually use it for something else.

But yeah, I just feel okay. And my body size is just my body size. I think when we met, I was having a bit of an issue with it – not looking at it, not dressing it to my size, which is really uncomfortable. And now it’s like, it’ll be what it’ll be. It’s like, whatever. At 49, I’m menopausal, perimenopausal, whatever I am. So my body’s going to be doing all sorts of stuff over the next few years, and so be it. You can see me struggling a lot. [laughs] It’s like, whatever. It’s not an issue. It’s not a concern. I don’t care. I do care, but I don’t care. I don’t care like I used to.

Chris Sandel: The thing is, with the “I don’t think about food”, that’s a symptom of lots of other things that have allowed you to get to a place where you don’t think about food. It hasn’t been forced into the corner where you can’t think about food. That’s typically what people try and do and it just doesn’t work.

Jo: Oh no, God no. Your brain would explode if you were trying not to think about it. It’s just the same as breathing. I get up and breathe; I don’t think about breathing. I get up and eat; I don’t think about eating. It just happens. It’s natural. If I feel like eating half a tub of ice cream, I eat half a tub of ice cream. There’s obviously a reason somewhere that’s making me want to do that, so I do it. It’s not that “I shouldn’t have” and “I couldn’t”. I just eat. I exercise. I exercise for joy and the fact I want to get up in the morning – though sometimes after sessions I don’t feel like I want to get up in the morning. And I avoid classes I used to do. I don’t do the same classes I used to do because I don’t want to do them, because I don’t enjoy them. [laughs]

It’s actually giving myself permission to just be and be okay. Stop being horrible to myself, stop trying to dictate things that I shouldn’t be dictating. Just live a life. We’re not on this planet for that long. I wasted a few years in my forties. “The forties are going to be the best years of your life” – I was trying to shrink away and not be present. I’m hopefully going into my fifties in a much better position.

And I know I’m still at risk. I know that I have the propensity to be a person with an eating disorder. It’s almost like those checks and balances, but not obsessively, just to make sure that everything’s ticking along. It’s like a car. Keep your car serviced and topped up and keep an eye on all the levels, but you don’t panic every time you get into the car that it’s going to break down.

Chris Sandel: Yeah. But again, it’s because you’re doing all of these things that it becomes so normalised that you don’t even think of them that means things can run smoothly. When you say you don’t think about food, someone could hear that and easily think, “Oh, she barely ever eats.” It’s like, no, you don’t think about food because you’re eating at very regular intervals, you have food in the house, when you go shopping, there’s planning. You told me just before we started this call that you started doing HelloFresh.

You don’t think about it because you’ve done all the things that mean that structurally, that is taken care of.

Jo: It’s just normal. It’s just part of my everyday life. I eat. I eat a lot. I am very aware if I don’t. I’m much more in tune with actually what hunger should feel like versus the forced hunger of not eating. I don’t think I realised that there was a difference. It was like, surely hunger is hunger. No. Hunger when you’re eating is very different to hunger when you’re not.

So yeah, I’m aware. I think there was a couple of times when I came back and was like, “I got really hungry.” You were like, “How did you eat?” “I ate a lot.” “Fine. Okay, great.” [laughs] Again, no judgment. I think that was one of the things that I really enjoyed working with you. I could say anything, absolutely anything. We laughed about some of the stupid things and the situations just because they are so ridiculous when you actually voice them. When you have them in your head, it’s like, “Oh my God, that’s completely normal.” When you voice, people are like, “No, that’s so not normal. That’s so not the way to think about things.”

There was just no judgment. In my awareness logs I would send to you, there’d be days when the old me would look at them and go, “You can’t share that! That’s awful.” And you’d go, “Okay, so that was a day. Oh, look at the next day. You were completely different.” You didn’t carry on in that vein. You just readjusted. You changed your levels. You recognised, actually that was just a day. It’s just a day, and we’re on this planet for a lot of days. If you eat a day where you were just eating what would be classed as junk food, then the next day you’re probably not. And if you don’t eat a vegetable for a day, the next day you’re probably going to want a salad or want something that has vegetables in it because that’s what your body does naturally on its own. Who knew? [laughs]

Chris Sandel: And for you, that happened a lot quicker in terms of “I didn’t have some vegetables yesterday, and now the next day there’s more of a craving”, whereas for someone else, if they’d been in restriction for a really long time and all they’d been eating, or largely all they’d been eating, is vegetables, you’re then going to have a much longer stretch where “I don’t have any craving for that.” But with time, it does come back.

Jo: It does.

Chris Sandel: The body has that intelligence and intuition to point you towards what it really needs.

Jo: We chatted about what we thought my sessions would’ve looked like pre – well, I wouldn’t have seen you because I didn’t have an eating disorder, obviously. But if I’d come at the early stage, how different it would be. And I think that’s okay, too. I think the challenge is – the biggest step is to actually say, “Do you know what? I think I need someone to just be my guardrail, no matter what stage.” I had the charity when I first started, and they were my guardrail. I had the dietitian, and she was kind of my guardrail as well.

Then I was on my own, and then I didn’t have a guardrail, and I don’t think I was ready to completely let go of everything. But I did okay for a couple of years. It was like “Yeah, I’m good.” But then it’s like, actually, no, I just need that support again, just to say “It’s alright. Don’t worry. No judgment. No guilt, no judgment. It’s okay. Whatever you’re doing, it’s okay. Get up each day and keep putting one foot in front of the other, and that’s all you can ask for.”

Chris Sandel: Definitely. I remember there was a point – it was early on or even around the midpoint – where your work got busy again. You were going for a promotion, and things started to regress. You weren’t eating as much as you were before, and this felt a lot more unintentional as opposed to anything intentional there. Your sleep started to really regress. It was actually a really helpful thing to see, where you were able to have this experience where for a couple of months, things had been feeling better, you were getting better quality sleep, you were feeling more at ease, etc., and then there was this change.

And then off the back of that, there was another time where it was really busy, but this time things did not regress, and you were like, “Cool, I now know how to handle this. I know how important it is to make sure the snacks happen or to make sure I’m doing X, Y and Z.” It was a really good difference that could be seen between when that happened earlier on and when that happened later on.

Jo: Completely. Like I said, I work with a global team, so there’s periods of time when it’s flat-out all day. I do try and get out the house at least once. [laughs] I go for the dog walk first thing in the morning. But sometimes that’s just not possible. It’s literally run downstairs, grab, come back. So I make sure I have stuff that I can grab, even if it’s not actually what I want. And that’s the difference as well – the fact that sometimes it’s just about getting fuel in, and don’t stress about it. [laughs] Just get food in. When it’s calmer, when it’s quieter, in the evening, you can then think what you actually want. But yeah, I’ve got the snack bars still in the drawer.

And that’s okay. It’s giving yourself complete permission that that’s okay and that’s what your body needs, and you’re just honouring keeping those levels balanced. You’re topping up the oil, you’re making sure the water’s level, you’re checking the tyres. That’s all you’re doing, just making sure that everything’s okay.

Yeah, sleep is definitely my indicator, and at the moment it’s not fun. [laughs] But that’s because of menopause. I’m awaking up in the middle of the night, reading the book that we’ve chatted before. But actually, when I am asleep, it’s good quality of sleep. It’s just the nighttime, wake up in the middle of the night – but not to urinate, which is an interesting conversation that we had. A lot of wee talk as well. [laughs] But yeah, it just feels much more structured without being controlled, which is a weird sentence.

Chris Sandel: No, but I also think in a way, people are typically searching for control, and you get control of these one or two things and if you narrow your focus, you feel like you’ve got control while all of these other aspects of your life are crumbling and are clearly not within your control. And actually, what happens by relinquishing control of these handful of things, your life genuinely comes back into control and it’s this weird counterintuitive thing.

00:39:08

How hoarding was a part of Jo’s eating disorder

Jo: Should we talk about the hoarding?

Chris Sandel: Yeah, sure.

Jo: [laughs] The one aspect that became clear that I did as part of my eating disorder is hoard. I would buy seven shampoos because they were on offer, and then I wouldn’t use them, and they would just sit in the cupboard and not be used, because why would you use something that you’ve bought for yourself? I would buy t-shirts by the bucketload, or dresses, or shoes, or – gosh, the list is endless. Sheets for the bed. All sorts of weird and wonderful things, I would just collect and not use. Makeup. Just this weekend I opened up a drawer and it’s like, how many eyeliners does one person need? Apparently, twelve. And I don’t wear much makeup. [laughs]

Just these rules, like “I should have that, I need to have that.” I’ve got unopened makeup, unopened toiletries all over the place. You sent me a couple of podcasts to listen to that were around hoarding. It was still associated with that needing to be in control and not feeling worthwhile to use it or not feeling special enough. A weird and wonderful thing. So yeah, that’s something that I’m addressing and trying to get rid of some of the stuff.

I’ve got rid of some wool. I went through a phase of crocheting, and of course, you can’t just buy the bit of crocheting that you’re doing; you end up buying 20 balls of wool just in case you run out, for some reason. And I hadn’t used them. So I’ve given them to a school to use for their activities, and that’s okay. Nothing happened. My world didn’t collapse. I didn’t feel out of control. I didn’t miss it. It’s fine. So now the challenge is to try and apply that throughout my life.

I had 12 pairs of jeans, all the same. They were a smaller size, which I’m never going to wear again because that’s not my natural size. My mum’s given them to charity. But she kept going, “I found another pair!” I’m like, “Yeah, that’s fine.” She just couldn’t understand why I would have 12 identical pairs of jeans. But yeah, when you start to explore and peel back the layers of what this eating disorder life looked like, there’s all sorts of weird and wonderful things. Yeah, it’s interesting. [laughs]

Chris Sandel: Basically every session, one of the goals would always be “I’m going to clear out this thing” or “I’m going to focus on this other thing”, and it was typically stuff around the house, stuff in the closet, all of these things that then, over the course of the time we worked together – I’ve never been to your house, but I imagine it’s looking a lot cleaner now.

Jo: It’s clearer. Let’s go ‘clearer’. [laughs]

Chris Sandel: Yeah, clearer.

Jo: Yeah, some of the different aspects we touched on as we worked together – including cleanliness. I’d forgotten about the cleanliness. I wasn’t showering. I just got out of the routine of showering. It wasn’t because I didn’t want to look at myself. Just it wasn’t important. I didn’t feel it was important to look after myself – which, looking back now as a person that has a shower pretty much every day, is just really weird.

We started with I think one a week. Literally one a week. Well, one between sessions, which was two weeks, but I think I managed one a week. And then we went to “Maybe you can do double that?” It was like, “Oh God, I’m not sure about that.” I gradually did, and yeah, it became okay. It’s a weird thing, the psychological effect it has on every aspect of your life. It’s not just the food. It’s everything. Slight diversion, sorry.

Chris Sandel: No, that’s fine.

00:42:59

How she handles triggering comments from others

What about comments by other people and being triggered? I think that’s a really big one for a lot of people. Where are you at with that now?

Jo: Very recently, I was at a class and someone said, “I hear this is great for fat burning.” I said, “That’s really interesting. I’m a recovered anorexic. I really don’t want to be discussing weight loss with exercise.” She was like, “Oh my gosh, so sorry. Didn’t realise” and we got on with the class. We didn’t address it again. I’m very upfront. I will walk away if people are being particularly calorie-focused and a bit intense, and that’s their conversation, it’s not mine. I think that’s my biggest thing: it’s their conversation, it’s not mine.

My mum is still on a diet. Would always be on a diet. She has a cream tea and then sends a message, “I’m not having anything for tea because I’ve had a cream tea.” All right, you do whatever. You just do you. If you’re still thinking that way at your age, I just – yeah. And I tried to be the non-smoker. “You’ve got to change”, blah, blah, blah. Actually, it’s up to them to find their own space, because I know damn well that if it’d be me and someone had said it to me, I would be like, “Oh, that was so silly. That’s not me. I’ve not got a problem.”

So I think it’s stepping away, takin ga deep breath. It’s remembering everything that you have worked on and your self-compassion and your new structure and recognising you don’t need to go back.

One of the girls that I knew when she was very poorly reached out and we were having a chat, and I was telling her that I’d also ended up in an eating disorder. She was like, “Are you allowed to go to the gym?” I was like, “Yeah, I can go to the gym.” She was like, “I’m not allowed to go to the gym.” I’m like, okay, so she’s obviously not recovered. People are really worried about her and the way that she behaves when she goes to the gym. I just changed the subject. I was like, “I’m not going down that rabbit hole with you. I’m not getting involved in your way of thinking and your obvious desire to still be where you are.”

It was fine. I didn’t come out going, “Oh my gosh, I should do this. I’m in the wrong because I don’t think that way anymore.” It was like, that’s their conversation. And I’m a female, and I have female friends, and therefore the diet talk is always, always going to be there to some extent. You just pick it. I’m very open, and I’m like, “I’ve had an eating disorder. I would really rather not talk about that.” People will carry on talking about it, but I’ve told them, and that’s all I can do.

It’s a challenge, but it’s the society we live in. It’s not going away, and I’ve just had to learn to put my muffs over my ears when I don’t want to hear it, or walk away, or change the voice when it lands in my brain. It’s hard. It’s really hard. I would love to turn that volume down on a regular basis, but I can’t.

Chris Sandel: I think a lot of the work we did, especially early on, was looking at your values. I think sometimes that can be useful as well. You’re like, “Okay, these are meant to be my values. If they’re my values, this is the choice I’m going to make in this situation.”

Jo: Exactly. But it is really challenging, because you’re going against the normal. You’re going against what everyone else is supposedly – it’s like I’m picking a different path, and it’s really hard. None of this is easy. [laughs]

00:46:48

Recovery is challenging

Chris Sandel: No, no. And that’s something – I can’t remember if I was very explicit about that with you at the start, but I am with really everyone, like, “This is really challenging, what you’re doing. For the vast majority of people who are in the depths of it, this will be the most difficult thing that you ever do.”

I say that because I think expectation matters. If your expectation is that this is going to be easy, it’s not. Or if the expectation that it’s going to be easy when it’s not, there’s a thought of “I must be doing something wrong. I still need to find some other alternative way to do this, because if I’m doing it right, if I’ve embraced recovery, if I said I’m going to recover, then everything just gets better from here.” And that’s just not the case. It is really a real challenge.

And as you say, those thoughts still come up. I would imagine that with time, they will come up less and less, but the more important thing, and the skill that you’ve learnt, is actually not about “How do I stop the thoughts?” We don’t think our own thoughts; the thoughts think themselves. They appear in our consciousness. What’s more important is “How do I not get attached to those thoughts? How do I not take the action that those thoughts are suggesting?” Because if you can do that, that takes the power away from the thoughts and makes them just a thought.

Jo: Yeah, and I think the work – you’ve done a recent podcast on the polyvagal as well, and accepting that actually, you transition between states of mind, you transition between thoughts, you transition all the time, and not getting hooked at certain points of that transition. So if I was thinking of eating something and it became – it’s not at all, but if it became a bit obsessive in my mind, it would be okay. That’s absolutely okay. Doesn’t mean it’s always going to be there. Doesn’t mean I’m failing. It doesn’t mean I’m going back to being anorexic. It’s just a thought, and that’s okay.

And to just breathe and accept that you’ve got the guardrails, you’ve got the structure, you’ve got the information, you’ve got the strategies, and you’ve got the desire to get better and to stay better. I think reaching out to you, that was definitely like “I need to do this. I want to do this. This isn’t something that’s being done unto me.” It’s not like you’ve been sectioned and put into a room and you had to do this work. “This is something that I’ve signed up for, and therefore I’m going to do it to the best of my abilities.”

Sometimes the homework was coming in last minute because it was so challenging and I really couldn’t do it. [laughs] But I’d made that commitment to you. But I know that if I hadn’t managed to do it, that would’ve been okay, and we would’ve explored why, and actually that in itself would’ve been more information.

You asked me for feedback and I said you’re just such an easy person to work with because the judgment – I don’t feel judged. I don’t feel like I should be doing something different. It’s just fact. “What are you at the moment and how do we move you to being in a different state if you need to be, or appreciate that this particular moment in time is great? How do we embrace that and use that?” So yeah, it was definitely not easy, and it’s very messy, and you go backwards and forwards. Like you said, halfway through I suddenly found that I was really busy and I didn’t have that structure that I could hold on to. But we got over it. It didn’t become permanent. It was fine, because we could see it.

So yeah, this journey is not straight lined at all. [laughs] You don’t start and say, “Right, I’m anorexic, I’m going to get better” and then you carry on in a nice straight line and suddenly you’re into the sunlight. It’s really hard.

00:50:43

Jo’s advice for someone struggling with food or body

Chris Sandel: The final thing I want to ask is, what advice would you have for someone who is struggling with food or body or who’s listening to this and hearing themselves in the kinds of things that you’ve been talking about? And this doesn’t have to be like “You need to work with Chris.” That’s not what I’m asking for; it’s not meant to be gushing praise. It’s like, what would you like to have heard back then yourself, or what advice do you think would be pertinent to someone in your situation back then?

Jo: That you’re not alone. That actually, it’s much more common than any of us know. Everyone keeps it as a secret, and it shouldn’t be a secret. If you broke your leg, you couldn’t hide it. You’d be very much on show. This is simply something that’s a bit broken, that can easily be fixed with the right help.

It’s the desire. You need to want to change. You need to accept that you’ve got an issue. Like I said, if someone had said to me before I got anaemia that I was anorexic, I know damn well that the stubborn me would be like, “No, don’t be stupid. This is ridiculous. There’s nothing wrong with me.” My favourite line would be” You’re jealous that I can do this and you can’t.” I mean, how ridiculous is that now, to be jealous of someone with an eating disorder?

And talk to someone you trust. Talk to someone you trust and see if you can just voice it, because actually, half the problem is getting it out of your head. I did a lot of unconscious writing as part of my therapy because I found it worked to get stuff out. And then you read it back and realise how ridiculous some of it seems, like that conversation we were having, which is like “What is this going on? What is it?”

I think it’s just that you can be okay. It’s not going to be easy, but this doesn’t have to define you for the rest of your life. It’s not uncommon. It’s so common, and the more I know about it and the more I hear other people’s conversations, the more I know that they have an eating disorder or they’re on their way to an eating disorder or they’ve had an eating disorder and are struggling.

But yeah, just be kind to yourself. That I think is the biggest thing. Just be kind to yourself. Don’t beat yourself up. But remember if you carry on down this, your life is just going to be so hard. So hard. I look back now and what I thought was a ‘cooking on gas’ life was so not. There was no joy. There was just constant noise and constant voices that weren’t mine, and they weren’t genuine.

And work with Chris, because he’s alright.

Chris Sandel: [laughs] Awesome. Jo, I’m so glad that we got to work together, and I’m so glad that you’ve agreed to do this today and share your story, because I think there’s a lot of people who will benefit from it and undoubtedly will have a lot of similarities that you have. I 100% agree that this is way more common than most people make out, and the weird and wonderful or crazy things that you think you’re doing that no-one else is doing, actually most people are doing because there’s a lot of commonalities in terms of the kinds of behaviours that start to crop up with someone with an eating disorder.

I know it feels incredibly isolating, and that’s often the real big trap with an eating disorder – it then pushes so much of the things that used to bring you joy and used to be part of your life to the side, and they start to fall away, whether that be hobbies or friendships, etc. It becomes isolating in a true sense of the word, and it becomes isolating in a sense of “I feel like I’m the only person that has this as an issue.” But it is something that is common, and it is something that is very treatable.

Jo: It is indeed.

Chris Sandel: Yeah. Thank you so much for your time and for doing this with me today. I really appreciate it.

Jo: You’re more than welcome, Chris. I shall speak to you soon.

Chris Sandel: Yes, definitely.

So that was my conversation with Jo. She did such a fantastic job talking about her experience with anorexia, and I’m so pleased that she’s now in the place that she’s in.

As I mentioned at the top, I have just one client spot left. If you heard yourself in Jo’s story, then please get in contact. You can head over to www.seven-health.com/help, and there you can find more information.

That is it for today’s show. I will be back next week with another episode. Stay safe, and I’ll catch you then.

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