Brittany Farrant-Smith’s new book on overcoming anorexia: ‘I became fixated’

NZ Herald

3 Jun, 2023 05:00 PM12 mins to read

Brittany Farrant-Smith has written a book about anorexia, Living Full: A Guide to Overcoming Your Eating Disorder.

Brittany Farrant-Smith was diagnosed with an eating disorder at age 19 during her second year at Victoria University, where she was studying psychology.

The mental health advocate and life coach believes it “started brewing” before that when she went to live with her dad in Qatar and played competitive football.

But her anorexia revved up a gear when she moved into the halls of residence, as she shares in this abridged extract from her new book.

Suddenly, I was living with 400-odd other students. For me, this meant an abundance of people to compare myself to and feel intimidated by. For me, the most sensitive part of living there was the fact that the hall was catered. In my already vulnerable state, I became fixated on what others were eating, how much they were eating and how frequently they were eating, and then tailored my own eating patterns to what the group norm was.

The bad thing about this was that most of the people around me had relatively shambolic, disordered eating patterns themselves: eating snacks for main meals, skipping breakfast, eating the same lunch; day in, day out. These are habits that I now understand to be a silly thing to judge my own diet off, as we’d all left home for the first time and were navigating having the freedom to eat what we wanted, when we wanted.

My hall of residence also had a gym (with a set of scales), and this quickly became a place I visited as part of my daily regime. This was in part due to the routine and familiarity of working out, in part due to my desire to stay on my A game physically, and in part because I felt insecure in myself and thought moulding my body to a point where I was happy with it might bring me the fulfillment I was currently lacking.

What I didn’t know then was that changing my external reality without changing my internal reality wouldn’t get me anywhere. I started weighing myself before every gym session, and soon I saw the number on the scales dropping. I felt a sense of achievement and a rush of joy when I saw the declining number on the scales — it finally felt like I had a purpose, like I was winning at something.

Unfortunately, over time, as the number decreased and the rush intensified, the desire to lose weight became more and more prominent — until there was nothing much left to lose.

Brittany Farrant-Smith says her diseased revved up a gear at university.

After my first year at university, I moved into a flat with my friends and, for the first time, I had complete control over everything I did with my time and the food that went into my body. This was when s*** got real. This was when anorexia took hold of me and became the dictator of my life. She was the voice that isolated me from myself and everyone around me. She was the voice that pushed me to work out four-plus hours a day, the voice that told me I had to earn my food, that I was ugly and fat and that I would never amount to anything if I didn’t work my ass off in the classroom and the gym.

At the time, she gave me comfort. She gave me a purpose. She made my life small and, in doing that, she made it easy. You can’t get hurt when you get so disconnected from everything happening around you, right? Wrong.

Before I knew it, my mind was consumed with the constant chatter of my eating disorder’s voice. The negative record of insults played on repeat day after day, the exercise compulsions loomed over me every time I felt the negative effect, my emotions remained numbed and life became reduced to a series of numbers — calories, weight, circumference. I had stopped living and started engaging in destructive behaviours that would only make me feel worse in the long run. One of the things that many people do not understand about an eating disorder is that it is controlling and takes on a life of its own. People seem to think that you can snap out of it and if you have enough willpower, you can recover overnight. Unfortunately, this is not the case!

This is an illness, not a phase. It’s a disease — an addiction — and, as such, it is not simply something that can be cured by eating or exercising some willpower. An eating disorder is deeply ingrained, and this is why it’s so hard to break the associated habits.

The intervention

The eating disorder voice started to become a real intruder in my head, and soon the destructive behaviours followed. I began exercising in secret, totalling more than four or five hours a day. At the same time, I was eating less than half the amount of calories I was burning, while also slowly reducing the number and variety of foods I could eat, to the point that I reached a BMI (body mass index) far below what was healthy for my height. BMI is a measure used to determine the “health” of an individual. It does this by dividing a person’s weight in kilograms by the square of height in metres.

In my opinion, the BMI is a problematic health measure as it fails to take into account muscle mass, age, race and bone structure. In fact, I believe BMI fosters weight-based discrimination and stigma and exacerbates mental health concerns and body dissatisfaction.

At this point, people started catching on that something was wrong, and this is when my flatmates called me in for an intervention. They told me they thought something was wrong and that I needed to see a doctor. I was in complete disbelief, but also very defensive — how dare they challenge behaviours that I believed were keeping me safe!?

Brittany Farrant-Smith, pictured front row centre, says her anorexia ramped up when she played football in Qatar.

In my stubbornness, I told them I would see the doctor and I would prove to them that I was absolutely fine because, in my mind, I was. When I went to the doctor (the first time), he told me that I had nothing to worry about. He said that I could do with putting on a bit of weight, and that I should simply eat a chocolate bar every day, because “I could afford to”.

He also told me that I was lucky to be as slim as I was, and that I was lucky to be able to eat all that chocolate because lots of other people would put on weight just thinking about it. Safe to say, it was a completely unhelpful session that just perpetuated my worries about eating foods like chocolate.

At the same time, it supported my story and gave me what I needed to push back against those who cared for me: “I’m fine, the doctor said so.” Thankfully, despite my denial, my friends (God bless them) persisted and insisted I seek a second opinion. Two weeks later, at the same clinic, a different doctor gave me a very different diagnosis.

“I think you may have an eating disorder,” the doctor said, before giving me a referral for a local eating disorder service: Central Region Eating Disorder Service (CREDS). In a way, I was relieved to hear there was a reason to explain my current state of mind, but I was also very taken aback by this information. Things were so much easier to manage when I was in denial of the facts at hand.

Suddenly I was accountable, which meant I couldn’t hide behind my unhealthy coping mechanisms anymore. To me, that was terrifying.

After submitting my referral to CREDS and nervously waiting for a couple of months to find out whether I was eligible for their services, I finally got a call informing me that I would be added to a 12-month waiting list for therapy.

In the meantime, I would be able to see a dietician monthly. While I was thankful for the acceptance and a spot on CREDS’ list, having to wait so long for treatment had a very negative impact on my mental health. I started to have conflicting and recurring thoughts. Was I really sick enough to warrant help? Was I taking a space from someone who was sicker than me and who actually deserved it?

Ultimately, this caused me to engage more religiously in my disordered behaviours as a form of validation, to the point that I was exercising to my maximum capacity and losing weight drastically from week to week. My weight dropped so quickly that at one of my dietitian appointments I was suddenly bumped up the list and told I needed to receive more intensive treatment immediately.

The dietitian told me that I could not be treated in an outpatient setting as it was not working. She also said she was concerned because I had lost a significant amount of weight while putting a few millimetres of muscle mass on my arms. Suddenly, I was being told that I would have access to a therapist as soon as possible, but that I should also move into residential treatment within the next month. I was in a state of shock at this news as I realised what dire straits I must have been in to warrant this kind of treatment.

This is where it is such a shame that patients are prioritised using their weight as a measure of the severity of their illness, particularly when eating disorders manifest in so many ways outside of anorexia nervosa, and the fact that this is a mental illness, not a physical illness.

I know this is due to underfunding and a lack of resources, but this approach means that treatment is reactive, meaning people have to get into a crisis state before receiving help. It also means that people suffering from anorexia in a larger body or suffering from binge eating or another form of eating disorder can be overlooked, perpetuating, and fuelling this idea of not being “sick enough”.

Consequently, I want to make a few things clear.

• You do not have to look a particular way to have an eating disorder.

• Eating disorders are not one-size-fits-all.

• You can have an eating disorder even if: you are considered to be a “normal” weight or “overweight” (according to your BMI), you think you are “too large” to have an eating disorder, you have never had to have a feeding tube, you have never been hospitalised, you eat regular meals, your laboratory test results appear “normal”, you think some people have it “worse” than you, your family or friends don’t understand.

If you are struggling with a preoccupation with food and/or weight and this is impacting your ability to function in your day-to-day life, you are sick enough and absolutely deserve to seek help and treatment.

Eating disorders are mental illnesses and, even though society perpetuates a limited image of what it means to have an eating disorder, I am here to tell you that we cannot tell how much someone is suffering based on their physical appearance. The exclusive representation of eating disorders in popular culture is narrowly focused, and this creates barriers to care for people who need it, including misdiagnosis or failure to diagnose by medical professionals, lack of access to treatment and lack of education and awareness in underrepresented populations.

Healing

I started seeing a therapist weekly and engaged in cognitive behavioural therapy (CBT) and schema therapy. The majority of this work involved learning about the way I was speaking to myself and identifying the beliefs that were underpinning this. It was about understanding why certain destructive behaviours had developed in me, and learning activities and tools I could apply to change them.

There are two standout moments that come to mind from these sessions. In one, I was made aware of the fact that I am severely self-critical and most of my internal chatter is me calling myself an idiot, dumb, weak or things along those lines.

The other was when I learnt about my emotional range (or lack of), and how I tended to resort to anger or frustration rather than sadness. My therapist talked about the “anger iceberg” and the fact that when we take on anger as an emotion, it is usually underpinned by a range of other emotions — especially pain, which sometimes feels too unbearable to handle — hidden beneath the surface.

Living Full – A Guide to Overcoming Your Eating Disorder by Brittany Farrant-Smith.

While I found these lessons to be extremely confronting, the resulting self-awareness was life-changing. I think everyone can benefit from therapy. I believe it should be less stigmatised because it ultimately allows you to understand yourself and take control of your thoughts — knowledge is power, my friends.

As part of my treatment, I would do an hour-long session of therapy every week. In these sessions, I was given various activities, which encouraged introspection. I also had to keep track of my diet and exercise regimes, and was given a sample diet plan to follow. This gave me an idea of what a “healthy” diet should consist of.

Edited extract from Living Full – A Guide to Overcoming Your Eating Disorder by Brittany Farrant-Smith, out June 5, RRP $34 .99, published by Bateman Books.