I'm a doctor, so why can't I help my anorexic daughter?

London GP Jane* speaks frankly about her child’s illness, which took her to such a dark place that she found herself wishing it was cancer rather than an eating disorder.

When my daughter plummeted into the grip of anorexia aged 15, four years ago, no one was more surprised than me. You might think a doctor would be able to spot it in her child or even prevent it. You might think I’d be able to get her help quickly because I knew the system.

You’d be wrong.

In fact, almost everything most people think they know about eating disorders is wrong, despite the figures climbing at alarming rates. In 2015-16, 13,200 people were admitted to hospital in England as a result of the illness; five years on, that figure was 24,300. Of that later total, almost half were under the age of 25.

Mothers like me, meanwhile, are still fighting to be heard – not just by the professionals but by our peers, our fellow mums, our friends. Here’s what we’d like you to know.

Anorexia has nothing to do with wanting to look good. My child did not care about her hair, her make-up, her clothes, her skin. People with anorexia have a morbid obsession with fat and that is it. Nothing else. They don’t put on nice clothes or wash. They don’t shower because they can’t bear to see their bodies. They cut themselves and scar themselves for life so their skin could never look good.

Nor has anorexia got anything to do with wanting to be a supermodel. Anorexics are not aspiring to look like Kate Moss. They live in a world of hospital admissions and suicidal ideation. They body-check to make sure they are thin enough. And even when they are skin and bones they feel fat.

Anorexia is best understood when viewed like schizophrenia as opposed to any kind of weight issue, and indeed the medication recommended to treat it is the same medicine doctors use for schizophrenia. The people who suffer from it have disordered thoughts and delusions. Their brains are so broken by the starvation that therapy cannot even start until they gain weight. My child marries successes and failures with her body size. She has an overarching obsession with the importance of body image and fat in herself and in others. Fat becomes a metaphor for bad, for ugly, for unwanted.

One of the worst things about being the mother of an anorexic has always been having to justify to people how ill my daughter really was. I found myself wishing she had cancer so people understood that her condition was life-threatening; I relished telling them she was hospitalised and not allowed to go to school so they could maybe grasp how serious it was. A local mum once said to me: ‘Oh yes, they all have a bit of anorexia at this age.’

‘Oh really?’ I replied. ‘Has your daughter tried to kill herself because you wouldn’t let her exercise too?’

We didn’t speak again.

When people finally do realise how serious the situation is, then it’s always we mothers who are to blame. We created girls who couldn’t cope, who couldn’t be soothed, who were high achievers. I sent her to an all-girls school. I dieted and talked about my big tummy in front of her. I commented on how pretty she is – so was it my fault?

We are forced to do family therapy and ordered to keep calm while we watch our daughters clamp their mouths shut rather than eat a piece of lettuce. I put on two stone trying to encourage her to recover. Every time she was meant to eat, I did, too, to comfort her. I stopped moving so she would not exercise.

I gave up work. I took antidepressants just to be able to get through the day myself. At one point I took three types of medication to cope. Yet despite all this, and even in the depths of my daughter’s illness, adult friends continued to regale me with their own weight ‘issues’. At one lunch, we had to stop a male friend from showing us his latest weight-loss app – the very one our daughter had used to fuel her illness. People insensitively told me ‘I feel so fat’ while I was desperate for my child to eat more than one meal a day. Fasting diets, calories on menus and exercise-mad colleagues make me feel sick to my stomach. Thank god for high-calorie food and normal milk and sugar-filled cereals. I have such disdain for all these fads and strange milks and clean eating. All trying to lure her back in. It was the Coca-Cola and the ice cream and the processed tasty food that gave her back her life, the fuel she needed for her brain to start functioning. Calories on menus put her life at risk again: they stop her from being able to make the choices she needs to make. We ask for calorie-free menus in restaurants and if they don’t have them, we leave.

Anorexia changes families for ever. We concealed as much as we could from her younger siblings, but they lived through the screaming and the thousands of ruined family meals. I used to beg them to come to the kitchen to eat so I wasn’t left with her, and so she could watch them shove toast and KitKats in their mouths like normal kids.

Six times a day I had to sit my daughter down, to eat three meals and three snacks. I never knew if she would, but had to sit for 30 minutes attempting it, all the same. If she did eat, no one was allowed to comment on it. The tension was palpable, even on a good day. Immediately after eating, she would feel ill, bloated and guilty, so even a good meal ended badly.

If she didn’t want to eat, then it was horrific. Screaming. Anger. Throwing food. Destroying food with her fingers. She would almost be in some sort of psychotic trance. Arguing over the lettuce leaves and drinking vast quantities of water to fill herself up.

Even now, in recovery, I hate family mealtimes and celebrations involving food. Everything became tainted and, at absolute best, joyless. My other kids won’t discuss food. Ever. They don’t feel they can.

At the nadir of my daughter’s illness, it was kinder to me to imagine a world where her life was actually over: after all, that was what she wanted. I would sometimes visualise what it would be like if she died. How it might be easier: for her, for us, for her siblings. One day I remember her waking up surprisingly early on a Sunday, looking at the clock, seeing it was 9am and asking myself how I was going to manage an entire day with her. But we did. Somehow.

Those years were dark, hellish and dirty.

Even though my daughter is now, officially, moving out of the grip of her illness, I will never tell you that she has recovered. Because I am so scared that she hasn’t.

*name has been changed.