Anorexia: A Patient's Story

Hadley Freeman discusses the reality of being an anorexic patient and how she finally managed to recover

The latest episode of the What Your GP Doesn’t Tell You Podcast - Anorexia: A Patient’s Story is now available on Apple , Spotify and other podcast platforms. And you can sign up to the podcast mailing list at What Your GP Doesn't Tell You, where you can also find out more about the pod. The next podcast episode will be available on Tuesday 22nd August.

This week, I am talking to journalist Hadley Freeman, who spent more than two and half years in hospital as an anorexic teenager and has just written a brutally honest account of her experience in her new book: Good Girls: A Story and Study of Anorexia.

Anorexia is one of the most puzzling of all psychiatric conditions, it tends to begin in adolescence when a child will either gradually or suddenly stop eating. The majority of cases occur in girls or women, who according to the UK’s National Institute for Clinical Excellence (NICE),¹ have a lifetime risk of around 2-4% of developing the condition. Estimates of how common the disease is vary, partly because some cases are never diagnosed.

Anorexia remains an incredibly hard disease to treat with the highest mortality rate of any psychiatric illness, which is sometimes due to medical complications from the illness and deaths from suicide.

Talking to Hadley, in this podcast clip, I began to get an insight into the thought processes that an anorexic patient can go through, which for friends and family can seem so incomprehensible.

I asked Hadley what she felt would happen when she stopped eating, which at one point led to her becoming so ill, that her GP told her mother to prepare for her death.

In total, Hadley stayed in four different hospitals and had nine admissions in total. While hospital admissions are essential to keep an anorexic patient alive, as Hadley reveals in this extract, there is also a downside, because it gives patients the opportunity to teach each other strategies to try and outwit the system.

In one hospital Hadley was in, I was really taken aback to hear, as she explains in this clip, that all the patients in the anorexic ward were given electro-convulsive therapy (ECT). She wasn’t as her parents didn’t give permission for the treatment.

NICE in its ECT guidelines does not recommend use of the therapy for anorexia² . And a recent research paper by Gallop et al³ pointed out that there had never been a randomised control trial to test electro-convulsive therapy in eating disorders saying: “the evidence in favour of ECT is anecdotal and its safety and tolerability have been questioned, particularly due to the associated memory impairments, we would not presently recommend its use in EDs (Eating Disorders)”.

However, controversially, as the medical literature reveals, ECT does remain a treatment used in at least a few anorexia patients, and a number of papers⁴ ⁵⁶ continue to suggest it may have benefits.

For Hadley, what was key to her gradual recovery, she believes, was continuing with her schoolwork. It helped give her a connection with the outside world and doing her GCSEs and A-levels gave her something to aim for. Whereas all the other anorexic patients she met had stopped school, so when they left hospital had little to focus on. And this along with supportive medical professionals, in particular, she credits her eating disorders therapist “JF”, enabled Hadley to start rebuilding her life, although it would be a long, slow process.

And she told me what advice she would give a parent today who suspects their child is anorexic:

NHS CAMHS (Children and Mental Health Services) that Hadley mentions in the clip can be contacted in each local NHS region. You can hear Hadley’s full story on the podcast.

Good Girls: A Story and Study of Anorexia by Hadley Freeman is published by 4th Estate

You can find out more about the podcast at What Your GP Doesn't Tell You and follow me on Twitter @lizctucker.

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1. https://cks.nice.org.uk/topics/eating-disorders/background-information/prevalence

2. https://www.nice.org.uk/guidance/ta59

3. https://link.springer.com/article/10.1007/s11920-022-01321-8

4. https://journals.lww.com/ectjournal/Abstract/2019/12000/The_Use_of_Electroconvulsive_Therapy_in_Eating.11.aspx

5. https://www.mdpi.com/2077-0383/9/8/2358

6. https://www.lidsen.com/journals/neurobiology/neurobiology-04-03-069